AF - 42791n
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City of Fridley, Minn..
BUILDING PERMIT �vA '710 3
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Address
�L TIO P BUILDING
No. Street .���L�— ��.� Part Lot
Lo��%�_ gloc;k Additlon or Sub-Division
� B
Coraer Lot _ Inside Lot � Setback _�--- Sideyard � �
Sewer IIevatfon � �dP � 5� _ Foundation IIevation .��.3 � 'J�
DESCRIPTION OF BUILDING
T Vsed �
Front l�� DePth Height ��-��-- 5�1. F� Cu. FL�
Fro t Depth fTeight ._._�� Sq. Ft Cu. Ft
7.j�pe of Conatntcl3on �Es� �� �__�To be Completed
In canstderation of the issuaace to me of a permit to construct the building descrlbed above I agree to do
the proposed work in accordance with the description above aet forth and in compliance with al'1 Provla�tona of
ctt�inancea oE the dty oE FricIIeq. �
In co�asideration of the payment of a fee of ��� P�t ��b3' S�� t°'
. � _ to vonstruct the building or addition as described above. Thiape rmit ia granted nPon
dthe expresa condition that thepe�o n to whom it is graated and his agen'ts, emPloyees and worl�nen, in all work
ane fn, around and upon said building, or anyp�t thereof, ahall �nform fn all respects to the orrii�►ances of
Fridley, Minnesota reg�l�otn, �na��4uctC��alat anY t�ae u�n��� ���3' °f the p�roviaiona oP�saia
within the dty limfts and
or3inanc�. � o� il
Buildin8 I�apector
NOTICE:
n '1hb psemh deai no! eerar �ta eomtwcNoe, 6utaWfim fer wMng, pbmbte6. 6as 6ullee, awu m water. B� suro to �
tks &rfldie� leqneto� for saparN� psrmhs Mr �na N�os.
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OWNER�S
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API'�ICATION FOR� $UILDING �'ERMIT . _±��: . ; . .; ; � �,,-
CITY;,.OF. FRIDLEY, MINI�E�Q�A-� . ., ,; .r , �� . . . , ..
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ADDBESS � aa S�l � �� �-?a� ,� -- ADDRESS � . �
: . . . , . .� -
� � LOCATIOId OF BUILDIN� ; � ' ..
No� . �� r� � ��,, - S�zeet ��..� ; ��: . P,art� �of .Lot�_
,l p�
�. .
Lot 0�� ��y." , B].pck �, .. Addit�.on., or Subdivision �J���� . 0
Corner Lot Ins ide Lot t� ^�
I a
Setback `3'� � � Sida-Yard �.E� � : 4�► . �
__
SEWER ELEVATION FOUNDATION ELE9ATION �,"4
Applieant ,attach to ,thie:,form T�q Certificates of Survey of I.ot aad proposec� build-
ing locatiion drawe;on.the�e Certifiaate�. , . . �.� _ _.
. , _ _ _ ,
. . , . .. .�. ..: � .
DESCRIPTION OF BUILDING
To be used as:
��►s�.��%w► ' , . FroIIC� . �� " . ]�ptb ,�1=�" , � ��$hC �,, �; c.
. � � . sq;� �t.�.� ���� - � cu►� Ft�� .Iq�.�:l�.o�
Front _ _ _ Dmpth Aeigh�.
. � , Sq;. .F:t ,� .. _ Cu .� Ft . .
. �; : �. �
Type of Construction �n�-�e� ' .� Eatimated .Cost • _ � � b�� • � �
�,.
To be Completed . . ._ _
The undersigned hereby makes�applicat�on 'f�r.,a germit fa;.th8 �rk herein.epecified,
agreeiag to do all work in strict accoida.nce�wi:th the City of Fridley Ordinances and
rulings of the Department;,.o£:,Buildings, and hereby declar�s thaC a1�l,the fac�e and
representatioas stated in this applicatian are t�e and�correcC. �
DATE l � � �
�Schedule of P'ee Cost� caa be found on Che Reverae Side).
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BUILDING pERMtT FEE SCHEDULE
Sect3on 2. The Inspector of Buildings shall, be£ore isauing any permi.t for
the erection of any building o� structure, or for any addition to any c�acfet-
ing building or structure, or for any alterations or repaixs to any existing
building or etructure, upoa application therefor, require the payment by Cbe
applicant for such permit of fees to the amount hereitt below set forth and
in the mannes herein provided to-wit:
2.1. For aay such permit for the•erection o.f any fire-proof building, other
than a garage� werehouse, factory or grain elevator, or fox the esectioa of
any fire-praof addition, for s3milar occupancy, to anq existing buildiag
shall be at the raee of $1.40 for each one thousand cubic feet, or fractioa
thereof, in such cubical contents. �
2.2. For any such permit for th� erection�of any fire-proof garage, warehouse,_.
factory or grain elevator, or for the erectioa of aay fire-prooi edditioa,
for similar accupancy, to any ex3eting buildi�g shall be at the rate of $1.25
for each oae thousand cubic feet, classified as "fireproof" bq Section 502 of
t&e Minneapolis Building Code.
HQUSES ,_
2.3. For �q such perm3t for the erection bf aay non-i3reproof buildiug ot�et
than a garage, warehouse, factorq or grain elevator, or anq noa-fireprc�f
�dditian, for aimilar occupancq, Lo aay existing building - germit $1.00 for
each one thousand cubic feet..
GARAGES
?.4_ For aay such permit for the er�ctian of any non-fireproof garage, _
warehouae', factory or grain �levator, or f_or the erection of any non-firegraof"
addition, �or-�similar occupancy, to anq existing buildiug or for each such
_�_-. �buildimg ar addi�tion - niaetq cents ($0.90) for each one thousand cubic £eet
or fra�tion thereof, in the cubical contents thereof w3th a minimum of $4.0��-
For the purpose of camputiag fees for building permita, the cubical coutents
of any building or addition eo a uniform�height throughaut by multiplying the
grouad area covered from a poiat si� (6) iaches below the floor line of the
bas�ment or cellar to the average height of the upper surface �r to the �
avera�e height of the r�of surface of the maim gable of a pitched roof.
2.5. For repaira or alteratioas to aa eacistiag structu�ce, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fractioa
thereof �.n the cost of all progoaed work.
2.6 . In ne case shall the fec4 .charged .for -ariY -Fermi� -a�s set forth -ia
Sectioa 2 be lese.fhan-$4.DD.
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SUBJECT PE .
City of Fridley . 14032
AT THE TOP OF THE TWINS g U I L D I N G P E R M I�
� � EIPT NO.
� `� _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �/ ���J
1 i , fC"
i___-� �����,`, CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVEO BY
L 612-560-3450
910-F15 4/26/77 � �
JOB ADDRESS 66I.6 Fridley Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ].2 �].3 2 Od�C C,rOVE Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Harold �hil 6616 Fridley Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Re sidential
7 CLASSOFWORK
[� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
S DESCRIBE WORK
Construct a 26' x 24' Gara e
9 CHANGE QF USE FROM TO •
STIPULATIONS provide a hard surface drineway. Provide roof design at time of
footing inspection.
SEPERAT� PERMITS f�EQUIRED FQ�i Wf�tIN�, W���
�'lEATIIVG, PLUIUlBING Ald� SIGN�r. 8��e ��g �� �Q�� �ii' es
T�I.EPHONE - ELECiRiC - �AS tc.
REQUORED BY l,A�
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOt3 EYaI[l2
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R—�. GZ� 6240
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4�6�-7 +�`2.30
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- .
_ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $24.96
PLAN CHECK FEE TOTAL FEE
$27.26
SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT f�ATEI a WHEN PF PERLY VALID TED THIS IS YOUR PERMIT
A� %�..,�.�i� �' Z 6 7 ��. ` � ( � �� v �
SIGNATUREOF OWNERIIF OWNER BUILDERI IDATEI a. BLDG INSP DATE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PER��ITS
iNEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWLJER: �� /�8G /> {� G �/ /� BUILDER: �/iq /� GG /� /3 /i /-f /L
ST /y, /_'
Addres s : � � � � /= �i' //,� /' �/ Addres s : G � / C �'� �/�� /` � S 7 . /i! C" /f�(?� 5.
�� /�L S, /l��it//+/ Tel. No.: S7 / -�GSS
No. : � � / � Street : /_ /2 //� L /- y S' T � i=..
LOT: /Z �Na / 3 BLOCK: 'L ADDITION: Q,� /f G�� O fi/'
CORNER LOT: INSIDE IAT: � S:TBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
6'/.�/�� G E Front: 2� /�T Depth: 2 Y'�T Height: /� f T
Square Feet: �'� Cubic Feet: 1����
Fron t :
Depth:
Square Feet:
Type of Construction : I�o o/� �R ��^ �
Gtiibic Feet:
Height:
Estimated Cost: $�L G/�, G G
7.b Be Completed: ���'P�" y� 7% Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired � $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: f� Z� 7� SIGNATURE: �✓G���� ����z�,��
Stipulations:
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BUILDIf�G PERt�7IT FEt SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or for any addition to any er.isting building or structure,
or for any alteration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: Removal and replacement of concrete curb and
gutter and i.nstall a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.40
ADDITIONAL INFOR��IATION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case sha11 the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
�(ERIFICATIO� OF FOUNDATION
NOTE: Permits for construction will be issued a minimiun of 24 hours from the time
of application to allow for proper review oi the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required k�efore proceeding with the framing.
C'tRTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building �rmit has been issued; and
sa3.d structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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CHIMNSY AND STACK VSRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (� No ()
2�. Is free from rust or deter3.�oration . Yes � No ()
3. Has no foreign objects lodged within Yes () No �
4. Is securely supported Yes (j� No ( j
5. Meets all current Code requirements for
size and total BTU's connected
6.__ Has total heating BTU's of ��`��� � J�
. All other BTII's �� �� '�l�o �� �
TOTAL BTU's � o�C�, �Q� ,.���
Remarks
Yes (� No ( )
0
List Alterations Beinc� Done:
f.
� C /� llc. � � '�U � v�. �-C.�_ �� "� t�� S � � � ( •-► t �. �tC�tc
�.�a( h,v � (1� �� �— � � d � � �.�-�.( � � �- �-�
HEATING COMPANY
Signed By
Date
���
S �/ - � �
�. .� < ���� e a
SuB�ECi
City of Fridley
AT THE TOP OP TME TWINS g � I L D I N G P E R M I T
r
� i
� i y����� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 . i
� � �"'1 � CITY HAIL FRIOIE� �13Z NUMBEF pEV
�"""� � ��� 763-571-3450 s�aF�s
J08 ADDRESS 6616 Fridley Street NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
oesca. 12,13 2 Oak Grove Addition
2 PROPERTY OWNER MAIL ADDRESS
.�erry Linder 6616 Fridley Street NE
3 CONTRACTOR MAIL ADDRESS
Sa.me
4 ARCMITECT OR DESIGNER MAIL ADORESS
5 ENGINEER MAIL ADORESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK ❑- NEW ❑ ADDITION ❑ ALTERATION
X
8 DESCRIBE WORK
Construct a 24° Round, Above Ground Swiu�ine Pool
9 CHAN(3E OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, NEATING, �
VENTILATING OR AIF CONDITIONING
THIS PERMIT BECOMES NUIL ANO VOIO IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANV TIME AfTEF WORK IS COMMENCED. NO DWLG.
I HEREBY CERTIfV TNAT I HAVE REAO AND EXAMINED THIS APPLICATION 1
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION
ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WILI BE COMPLIEO
WITM WHETMEF SPECIFIEO MEREIN OFi NOT. THE GRANTING Of A PERMIT ��F�OOO
DOES N07 PRESUME TO GIVE AUTMOiiITV TO VIOLATE OFi CANCEL TME pEqMIT FEE
PROVISIONS OF ANV OTMER STATE OR IOCAL LAW REGUTATING CON-
STRUCTION Ofi THE PEFFORMANCE OF CONSTRUCTION �97 . ZS
S�GNIR�W£0� CON'9ACJI��6n suTNOai2EAsGENr
�
_33796
RECEIPT NO.
DATE PAGE Oi APPROVED BY
8/12/03 / /
SEE ATTACHED
SNEET
ZIP
763-572
PMONE
PMONE
PMONE
LICENSE NO
LICENSE NO.
LICENSE NO
O REPAIR O MOVE O REMOVE
SQ.
STAL�S
GROUP OCCUPANCVLOAD
CU fT.
OfFSTREET PARKING
GARAGES
SURTAX
�2.��
SAC CMARGE
Fire SC $4.00
TOTALFEE
$103. 5
'ED THIS IS UR P RM
►� t"�'�
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effedive 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
�
Legal Description: `
Owner Name & Address: SE1zTr� L�.u�iZ Tel. # 7� 3- 57a -0�9�
Contractor.
MN LICENSE #
Address: � Tel. #
LN1NG AREA:
GARAGE AREA:
DECK ARFA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, �ith the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length �dth
Length Width
�n�� t �_� �.�.
Height Sq. Ft.
HgbGround Sq. Ft.
Construction Type: Estimated Cost: $ ���OO
/
Driveway Curb ut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICAN • Tel. #��' S� D��/-..
_I
Call (763) 57 -3604 for Permit Fees if "' g in application. Fax to 763-571-128T if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
$ "'I
$ ���
$ �. ��
$
$
$
CiTY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not (Vecessary []
TOTAL $ I O�� cx� STIPULATIONS�
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $S00
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,Q00
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for ,the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construcdon site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
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Doughboy Recrea6onal • 11�i'I Jerse� Blvd. • Rancho Cucamonga, CA • 917� •(9091987-0741
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SuB�Etr
c�ty of Fr�a�ey
AT THE TOP OF TME TWINS g � I L D i N G P E R M I T
r
� �
� ; v �__�_ � COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� ; �
� �"'1 � CITY HALL FRIOLE� SS132 NUTABER i1Ev
�"""� � ��' 763-571-3450 s� aF� s
JOB AODFiESS 6616 Fridley Street NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
oesca. 12,13 2 Oak Grove Addition
2 PROPERTY OWNEq MAIL AODRESS
Jerry Linder 6616 Fridley Street NE
3 CONTRACTOR MAIL ADDRESS
Same
4 ARCHITECT OR OESIGNEfi MAIL ADDRESS
5 ENGINEER MAIL ADDRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION
8 DESCRIBE WORK
Construct a 23' x 22' Deck
9 CHANOE OF USE FROM
STIPULATIONS
See notations on plan.
TO
SEPARATE PERMITS ARE FEOUIqEO FOR ELECTRICAL, PLUMBING, MEATING.
VENTILATING OR AIH CONOITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 OAVS. OR IF CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG
I HEAEBY CEfiTIFV THAT I MAVE READ AND EXAMINEO THIS APPLICATION 1
AND KNOW TME SAME TO BE TRUE ANO COiiiiECT. A�L PROVISIONS OF LAWS yALUATl01'
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED
WITM WME7MER SPECIFIED MEREIN OR NOT. TME GqANTING OF A PERMIT �3�527
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL TME pEqMIT FE
PiiOVIS10NS OF ANY OTHEFi STATE OR LOCAL LAW REGUTATING CON• $92 � 7S
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
S�GN4
•GENT IDAi
� � '
iDATE�
h
DATE
10/7/03
ZIP
ZIP
PAGE OF
/ /
�33953
�
RECEIPT NO.
���9
AP7ROVED BY
SEE ATTACMED
SNEET
PMONE
763-533-1595
PHONE LICENSE NO
PNONE LICENSE NO.
PNONE LICENSE NO
❑ REPAIR O MOVE O REMOVE
OCCUPANCY GROUP OCCUPANCV
S�.FT CU FT.
S7All5
pF
GARAGES
$1.76
AC CMARGE
ire SC $3.52
OTAL E
$ .03
� /V��
NEW
ADDN
ALTER
I�
Il
I�
Construction Address:
Legai Description: �b� L ���- ��
Owner Name & Address: 6 Tel. #?(�v 5��� ��l 5__
w o�
Contractor. f� W��`z° � MN UCENSE #
. Tel. # _
Address:
z„ , ✓ . .,, . �
Attach to this application� a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
CITY OF FRIDLEY Eifedive 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 �ax
BUILDING PERMIT APPLICATION ��° -�
. ,,�,��; � ��°,� �� �
r ,
�A� � ��. ,
,
�� �-��.�y �7 ' ' R �
�
DESCRIPTION OF IMPROVEMENT
. Len th Width Height Sq. Ft.
LNING AREA: 9 �
GARAGE AREA: Length Width Height __ Sq. Ft.
D
ECK AREA: Length Width Hgt/Ground �. Sq. Ft. �`�
OTHER: �' .
� � Estimated Cost: $ ��°� � �
Constru�tion Type:'��- A-"� � �-�^'`�g-
Driveway Curb Cut Width Needed: _Ft• + 6 Ft = Ft x$ -$ �eM�
DATE: /� - 3' d� APPLICAN ' Tel. # 7( �' � 7� - 04 i q
Call (763) 572-3604 for Permit Fees if mail g in application. Fax to 763-571-1287 if using credit card and we will
call you for card number. ��N USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
• SAC Charge
License Surcharge
Cur� Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ .. 7.S
$ �. ��
$_ �. 7 �
$ �
� _
$
$
$
� .� �
�
Fee Schedule on Reverse Side
.001 of PermitValuation (1/10th%) '
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. A or Alt. B Above
$450.00 Conservation Plan Review
Fee Determined by Engineering • ,
Agreement Necessary [] Not Necessary [ J
.►
.; �
BUILDING PERNIIT FEE SCHEDULE
The Cluef Building O�cial shall, before issuing pernuts for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or
sttvcttue, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
�23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.Q0 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,0�
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
. CURB CUT ESCROW ,
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. .,
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
.�
�he Home Oepot # 2802
�650 �MAIN ST, NE, FRIDLEY, MN 55432
�63)571-9600
"hu Sep 18 17:01:14 2003
�he matenais for this project will cost $1615.90
ERRY LINDER
'OOL DECK 9/18
30888
±eck Layout
�
�r /���l�
���
i�/
'he Home Depot # 2802
;650�/IAIN ST, NE, FRIDLEY, MN 55432
763)571-9600
�hu Sep 18 17:01:14 2003
"he materials for this project will cost $1615.90
ERRY LINDER
'OOL DECK 9/18
30888
'ost Layout for Deck 2
� � 9 ��
4'
3 ��'�
-- --- �
----------�BasePoint
�
�
�
�
l0 N 01
tfl O N
�-1 N N
� ■-21' 9"
� �
� I
i I
�--j18 � r 5 ��
! i
;
6' 4"
t
4� 8��15� Z,.
1�11�.4,�
' 11"
� 8n
,
T�e Home Depot # 2802
5650 MAIN ST, NE, FRIDLEY, MN 55432
(763) 571-9600
Thu Sep 18 17:01:32 2003
JERRY LINDER
POOL DECK 9/18
130888
Construction Specifications
deck 2:
Construction Method = Beam Flush With Joist
Footing Type = Pier In-Ground
Live Load = &0
Dead Load = 10
Decking Spacing = 0 1/8"
Joist Spacing = 16"
Beam Spacing = 138"
Post Spacing = 64 5/8"
Decking = 5/4X6 Thompsonized Prem. Southem Pine Standard
Beams = 2X8 .40 prime Southem Pine No. 2
Joists = 2X8 .40 prime Southem Pine No. 2
Posts = 4X4 .40 Treated Southem Pine No. 2
Deck Height = 48"
Diagonal Bracing = No
Deck Skirt = No
Joist Overhang = 0"
Beam Overhang = 0"
Decking Deflection Factor = 360
Joist Deflection Factor = 360
Beam Deflection Factor = 360
Pref Decking Size =
Pref Joist Size = NONE
Pref Beam Size = NONE �L������i/�.�. �`�
Pref Post Size = NONE ��,f'r
VE/� ��.4/L
Stair 1:
Step Width = 48" ��
Step Height = 48" /�%�r'CiC . �` � � �
Step Rise = 6 21 /32"
Step Run = 11" �//
Stringers = 2X10 .40 Treated Southem Pine No. 2/���i✓� /�GIn� .
Risers = 5/4X6 Treated Southem Pine Standard
Treads = 5/4X6 Treated Southem Pine Standard
Railing 8:
Railing Height = 36"
Baluster Spacing = 3 3/4"
Railing 9:
Railing Height = 36"
Baluster Spacing = 3 3/4"
Railing 1:
Railing Height = 36"
Baluster Spacing = 3 3/4"
Railing 2:
Railing Height = 36"
Baluster Spacing = 3 3/4"
Railing 4:
..�'T � +,
• �/4i
s��+C� L� ��
Railing Height = 36"
Baluster Spacing = 3 3/4"
Railing 6:
Railing Height = 36"
Baluster Spacing = 3 3/4"
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r' - 5 F'�' M 330�I I - - i -- -. ... j_.I , I• I ` I i � I �.I. I I I �
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I , A; 1� , � , � f � � � .. ; ; , . I f ! �--�____�...�1.._:
The Home'Depot # 2802
5650 MAIN ST, NE, FRIDLEY, MN 55432
(763j 571-9600
Thu Sep 18 17:01:14 2003
The materials for this project wiil cost $1615.90
JERRY LINDER
?OOL DECK 9/18
130888
Deck Dimensions for Deck 2
___ _
12' 5"—
RfVIEWED
,�� � .
��
23'
12' 10" 7' 3' 2"-
7oist Spacing = 16 in. o.c.
3aluster Spacing = 3 3/4"
roe Spacing = 3 3/4"
�ailing Height = 36"
" 1 L ' 1 U " / ' ---+�-.5 ' L "-
23'
0
:�
:�
�
�. .
"f�e ho� ne Depot # 2802
5650 MAIN ST, NE, FRIDLEY, MN 55432
(763) 571-9600
9/18/2003 "
JERRY LINDER
POOL DECK 9/18
130888
Materials for Deck:
Qty UOM SKU
137
6
1
1
38
4
3
10
20
4
1
10
4
1
1
8
4
7
10
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
557285
374097
368011
326626
326627
831461
365287
392960
368011
368090
374474
374097
162841
162833
162825
162825
161451
392960
162612
48 EA 864870
17 EA 164365
17 EA 206379
2 EA 735002
34 EA
34 EA
34 EA
34 EA
3 EA
4 PK
.a.E,q
3 � ���;'�: _Eq
32 � ``" EA
32 EA
1 EA
544208
538892
538981
169765
735003
462810
454141
544208
538892
538981
735002
Use
Baluster
Beam
Beam
Decking
Decking
Decking
Decking
H Top Rail
Joist
Joist
Joist
Joist
Post
Post
Post
Railing Post
Stair Stringer
Tread
V Top Rail
2x8 Joist Hanger
4x4 Post Foot Brkt
AnchorBoltw/N�(
BalusterScrewGreen
Beam Bolt 4x4
Beam Nut
Beam Washer
ConcPierin-Ground
Deck Screws3inGreen
Hanger Nails 2x8
Joist Framing Nails
Rail Post-Bolt
Rail Post-Nut
Rail Post-Washer
Step Screw Green
Description
2X2-42" BEVELED BALUSTER CLEAR/.40
2X8-12FT. N0.2 PRIME PT SYP .40
2X8-8FT. N0.2 PRIME PT SYP .40
5/4X6X8 THOMPSONIZED PREMIUM
5/4X6X12 THOMPSONIZED PREMIUM
5/4X6X14 THOMPSONIZED PREMIUM
5/4X6X16 THOMPSONIZED PREMIUM
5/4X6X8 TREATED Y/P STD/BTR DECKING
2X8-8FT. N0.2 PRIME PT SYP .40
2X8-10FT. N0.2 PRIME PT SYP .40
2X8-16FT. N0.2 PRIME PT SYP .40
2X8-12FT. NO2 PRIME PT SYP .40
4X412'#2SYP.40
4X410'#2SYP.40
4X48'#2SYP.40
4X48'#2SYP.40
2X10-8FT. N0.2 PT SYP .40
5/4X6X8 TREATED Y/P STD/BTR DECKING
2X4X8 #2 PT.40
2X8-JOIST HANGER
4X4 ADJUSTABLE POST BASE
1/2X61N.ANCHOR BOLT
W/NUT-WASHER-EA
GREEN 5LB 2 1/21N DECKMATE DECK
SCRW
CARRIAGE BOLT-GALV. 1/2 X 8
HEX NUT GALV 1/2
FLAT CUT WASHER GALV 1/2
80LB. CONCRETE MIX
GREEN 5LB 31N DECKMATE DECK SCRW
10D JOIST HANGER NAILS-150PK
16D 3-1/2" HOT GALV BOX 5 LB
CARRIAGE BOLT-GALV. 1/2 X 8
HEX NUT GALV 1/2
FLAT CUT WASHER GALV 1/2
GREEN 5L6 2 1/21N DECKMATE DECK
SCRW
The tofal cost of in stock materials is $1615.90 plus tax.
This`estimate was-created on 9/18/2003 and is valid for 3 business days.
Parameters from UBC.cod parameter file.
Parameters`used for Deck 2: 60 psf live load, 48 inch footing depth.
_� _
WARNING:
THIS IS NOT A FINAL DESIGN PLAN. VARIATIONS IN BUILDING CODES, SPECIFIC ARCHITECTURAL
CONSIDERATIONS, OR SITE CONDITIONS MAY REQUIRE CHANGES TO THIS DESIGN. YOU ARE RESPONSIBLE
FOR THE FINAL STRUCTURE, CODE VERIFICATION, MATERIAL USAGE, AND STRUCTURAL SAFETY OF THIS
DESIGN. BE SURE TO CHECK AND VERIFY THE DESIGN WITH YOUR LOCAL ARCHITECT AND BUILDING
INSPECTOR.
�
The t�iom� Depot # 2802
565� L.9AI4`JmST, NE, FRIDLEY, MN 55432
(763) 571-9600
Thu Sep 18 17:01:14 2003
The materials for this project will cost $1615.90
JERRY LINDER
POOL DECK 9/18
130888
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR Afe1D COMBUSTION AIR VERIFICATION
When replacina an existina furnace, the unde�signed hereby verifies that the
venting has been examined and is free from rust, deterioration, obstnactions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
spec�cations including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacture�'s specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
Th� exi�tina comla�asti�n air is sized ans! installsd to me�t th�current�d�s_
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installina a new ventinu svstem, the undersigned hereby verifies that
it is a listed assembly and meets the cuRent codes and manufacturer's
spec�cations. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes ()
Is the common vent and vent connectors sized and installed coRectly after
an appliance has been removed from the common vent and vented
separately as per current codes.
No ( )
Yes( ) No( )
Apaliance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Tdal Btu Input
Common Vent Type Vent Height Diameter inches -
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describe)
HEATING CO:
Signed By: Date :
—�'� �.s� � _�'�� �Z�' � L,� �� � - ,l .s �� �y-
Building
Inspections
763-572-3604
DATE �� °� � ' D
SITE ADDRESS ��
THIS APPLICANT 1S:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE �
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
OCONTRACTOR
Pernut No.:
Received By:.
Date Rec'd:
aDnxFSS: (�[n /(.d �JLi��1 ST crrx ��� STATE� 5S �
PHONE:� -��- S 2'a • � ��
NAME:
STATE LICENSE # � DATE
ADDRESS: CITY STATE ZIP
PHONE FAX
❑ Two F.v�u.Yrn�w
❑ BASENNIENNT FINISH
❑ DECK
u
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES � �
GARAGES �� � °
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
0 Vinyl
❑ Aluminnm
❑ Odier
SIZE
❑ GARAGFJSHED ❑ WINDOWS
� ROOF ❑ DRATN TII.E
❑ SIDING ❑ OTf�R
❑ SWIl�M�ID�TG POOL
❑ HOUSE & GARAGE
❑ ATfACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
WINDOWS
IN EXLSTII�iG OPENINGS ❑Yes ONo LOCATTON OF R�iDOWS
OR FOR NEW OPENII�TGS-DESCRIBE SIZE OF
OPENING CHANGES &
NUMBER OF
WIDTH HEIGHT
Ft.
BASEMENT REMODELING SUBMTf:
1. Existing Fl�r Plan
2. Proposed floor plen
3. List of structival members to be used
FORNEW CONSTRUCTION WCLUDINGDECKS,
ADDITIONS. & PORCHES SUBMTT:
1. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of conshuction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING 1997 U.B.0 FEE SCHEDULE}
TOTAL JOB VALUATION $� lo Sr O� OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ � ��'. o�,�
$ -' p—
$ , y'3
$ ,� � �
$ �
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Pertnit Fee
(.0005) times the total job valuation - Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (Sta.te Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATTON FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building pernut and I aclrnowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
pemut but only an application for a pemut and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work wl '�yu �jr'n�es� r�w and�roval of plans. � , f
SIGNATURE OF
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official sha11, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Min�um Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional$1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional$1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1� $50,000 plus $7 for ea.ch additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1� $100,000 plus $5.60 for each additional $1,000 or fra.ction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fra.ction to and includin $1,000,000
$1,000,001 and up $5,608.75 for the 1$1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Pemuts for construction will be issued a min.imum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the fram.ing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977