AF - 42800�
Date:
O�er:
Addres�
n
�
City of Fridley, 1Vlinn.
BUILDING PERMIT
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N°
a���
'710�.
Address�.._....._._.__.._........___._.. .__...._._._.__..._._�_____._
L TIO P BUILDING
Na ..�.l��.l� Street � �..,�.�._ P Lot
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Lot .�.�. � __ Block _.�.. �_�....______.._.__._. Addition or Sub-Divisia� � � _ _......_._....
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Ca�ner Iat _. 7nsid�e Lot � Setba�k ��_._._ Sideyard _� �`% �
Sewer Ele�vatlaai �..�..L�T ._.._._...._...._._._____....�•Elevatian ...._._._.... _..._._....,.._._._..._.._._
DESCRIPTION OF BUILDING
v
Front %�-L�— �P� ,� � Height � S9. F'L ��� ld C�u. P'�����
_.._ _�___ rp� t Depth _._._ Height _.__� Scl. Fk __. Cu. F`k
7.�►pe of Caa�stntetion t�z-=!��... F�t. C'dst �� �_.p�''to be Completed
Ea ca�sid�eration of the issuanoe to me of a permit to caa�struct the building described abave, I agree to do
t6e propo�ed v�ork in ac.cordance with the d�scriptioa above set forth and in c:ompliance with all pravisions oi
ardinances o! the dty of FYidley. �
..��
In coos[deratioa o! the payment of a fee o! i� •, Permit is herebY Sranted to
to c:onstruct the buildin.g or addition as described above. Thisperm� t is granted upon
the express c�►dition that thepe rson to whom it is granted and his agents, employees and workmen, fn sll work
do�ee in, around and upoa� said building, or any thereof, shall oonfarm fn all respects to the ordinanoea o�
Fridley, Minaesota locativa4 co�struct� alterati�, maiat�ance, , repsir and movin8 of buildings
co tru
wio '�� dty limits and permit may be revoked at aqy tuue ugan v�0l�tion o! any o! the pmovLdona o� said
/1 / 1
Buildfn8 InsPectar
NOTIC�
1Ys p�ewk do�s �ot eewr fh� �. vM�pMiee �er wIrIM. P��Y. N� �N. Nw�e er wN�r. M am fe aN
fM �viYip I��e1x tor s�p�ra� P�i1s fe� t`w 11w.
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LocnTSOH,,o�' Fap�,iic . , . _ �w. r.. A.� :t .3� .
�-�Q ���,,,:�.;�,_'�:,.�i.,..r�;� � ��,�s���.�� �� �� _�,� 4•�����g.sar�_
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-.LV� � ��F.�,��rBi.00k.. .f�. .. .,.i�T?�'���'� -�4V�i'�'[�iiT`�ai'.�� �� :i/? �'i'�NiF�
. . � . . . . . : . . � � •. � ,.. � i ' { , � �' i . - � ' . � : Tf - 7�
Corner Lot�_Inside bot � � Setback � 3 � r. � �apl�,c� ���,:�� '
. . . �ss�� � >4, �~�$��.
sg�a �vn�oN Fov�s�toc� �svnriaa� •� �:�., �,-� �� i
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�ili�cant� ��t�,b�;. �o .��}i.,s ..,�onl4�T� ����JlF� �.��D►� Q�,;Ls�t �and ��� buiZd-
inS �,�4�?��?� .dr�?� �s► •�tha� ��?��A+��se ., �: . . . :: t: .. , �. :� , �• ; � ., .
S . .. .,- ..... . ; . - . �-. ........«.._. , .j_ . .. • ._ - , '.. :-.�.. .'..y-., "'��=1,� ri 1�� .i. _ .. .
� .. � ........ r.. . . .±7C)i,�. �.rS,'.i ;�i"'. .
DB8CRIPTION OF BUII.DING
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To be used as: _.� .__ _ ...
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�( �`��� �� � l ���
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Froat Drpth Height
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TYPe cf G� ��tian,.:..,.,:� . ! . . :.� �, ,R! W�at�d �#�. � �� �+b� t� a ✓
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To be Com�leted� '
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The undereigne�dJ�heie�y meikes'applicat�#�};.for �-,�1q�� f�c t�lt�.��k hlr�s►.�etfecified,
agreeing to do all work in atrict accordsnce `rith the G"ity of Fridley Ordinances and
ruling�: ef�����P��ot; ���;.:�?���B,�:a�1�i�e��b_Y;�d���� tha� �ll�;:�hhe f�cCs spd
represen[ati�a etat4d in thfa aPpllcation sre t�t�a �1d:,ac�ur�aC: �� �:�.t �- ,
�Scl�dula of Fee Costa caa be found oa �ha Bev�erss Side).
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BUILDIN� P'ERI�lIT F8B SCi�BDULE
Section 2. T4e �diipe�tt�r of Bui�dings shali,+$efore iasulag any permit for
, tbe erectioa of aay�building os atruature� or for any additfa�a to aay exiat-
ing building or sts�nt�8r+�, or for'euy aitei�a�ions or repairs to any exiating
building or structure, upoa application therefor, require tbe psyment by the
applicant for such peroit of fees to the amaint herein below aet forth and
in the manaer herein pravided Co-wit:
.. _.. _. . _ _ _. _... _ __�_,... ... _ . _.. _. . . . _ . � . . _._.
2.1. For any such germit for the erection o,f aqy fire-proof buildiug,�,other
��t1. � _.8�r.�._ �sh�ta.��,%c�bry `�or ..graia_�,, .or .. for t.hs. e.�eat�oa '��
anq fire•proof additiaaa, for similar occupaacq, to any exieting building
ehall be at the rate of $1.40 for eaah one thousend cubic feet, or fractioa
tbereof, iD such cubical���s.
_.
._ ... .�,� :?�. � Fci� �y s.��..�,�i.t ,#�_ t�.._art�ct�ion cf any_. fire-proot.�g�a�„� �rahouse,_
factory or grain elevator, or for the erection of aiy� fire-ps�oof eddition,
�:� .�.�+�x....:��.y�;�d-agr`�aci�Eifig=betf`l�iag sba31 b8 at the rate af $1.25
for e�c� one thousaad cubic feet, cl�ssified as "fireproof" by 3ection 502 of
�.�e..1_'��E�� �'�i,�g.�.C�. � ,;
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. ' � ;� "�t a�cy �vietr Fe��� #dr t� ��re�ct�`at of �Vaay no�-ft�ireproof bui2diag other
than a garage, warehouse, factory or 4g�raia e�eva`to�, ar anp aan-firagroof
addit��a, fo� s:t�ilar oc�pa�cY, to aay e.�cist#� buiidi� -�wrm#t $k.fl0 far
each one thcusaad cubic feet.
,.
� . . ._ .
2.4. For any such permit for the erectian of anq non-fireproof gstage,
. _w� �. _ ��i:� �tp�pT__�� .S��Q' �lexat.ar,,_cut_ foY�`�htiia.- erectiot► of _.�y a�-#� . -
additio�, €or--similar occupancy, te eaq existiag building or €or each such
� �.-_-_�ila� or ec�dt�'�iaa(-'-=.. Ri�ety cen��_ .�$Q..9t�' for each oae thousatid cubic feet
or f�aetioa tbersof, in the cubical aanteats thereof with a minimum of $4.00.-
_.. _.. .._�_ . . �
. _ ___ _
For the purpose of caavputing fees for building permit8, the cubical cc�teats
_ °--f ���1.��`� �`�,��.t�a�t. to a unt8orm �eigiit throughout by multip�ying the
gro�md area covQred fran a poiat ei: (6) iaches below the floor liae of the
bs�a�eaC or cei��at ��f tl�- everaga _E�3,ght ..of ..d�e..uppeta aurface ' or to the .
everage height of the r�of surface of the main gable of a pitched roof.
_ _ _
2.5. For regairs or aiteratiocts tp an exiatiag struciuxe, the fee shall be
at the rate of $3.00 per each Five Hundred Dollare ($500.00� or fraction
� ' � '��ereo�' �ti �E1t�`1�Ct�C 8�= al#,'��. .... � _
$�'bFi�sed � �k. � :: - ,
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LA�ND SURVEYQRS
• Anoka� Minnesota
CERTIFICATE Of SUR1t�Y:
JOSEPH MAG i ASZEK I�AGANT
12�.0 PLAT
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LOTS 8 ANO q, BLOCK 2, OAK GROVE ADOITION, AN4KA COUNTY�
MINNE�OTA. ,
I ilRdY G�tU�Y TNAT TMS IS A' f�E AhW CORRKT �SBtfATK)N O! A SURY�Y Or .T� �A�6 O/ t!R A�pVE
D�CRNED LAND. AND THE tOCAT10!! O� ALl W�DNtGS� 7l�EOK MID ALt VIS�tE ENCR'�ACtYiA�S. I!' AN'r', ROM OR GN 3AID
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�3 3u�rED sY ME t1MS .......�........ w►1r or .......... �.. ciUNE....._ ............................. .�D. 19 6�... . '`
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N. G HOIUM AMD II�C, SURYEYORS
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City of Fridley, Minn.
BUILDING PERMIT
��; � une 1fL, 1970
pR,�.; _Vernon Strehlow � g�� Same ._
� 6646. Fridley St . N.E. ��,� Same
s" z
1070
tOCAT10N OF BUILDING
No. ._ 6646.�... Street ._Fridie�_____ _._.._..__....._......._--•-.--.._-.--- Part oi Lot .._...._._.....__._.___
Lot _. 8 8c 9..._ Blc�ck _�_2 _.....__.__._.____. Additioa or Sub-Div�isio�► ._.Q�.k.Sx�R.x�.._....__._.._. __ __._
Corner Lot ___..._._.._..__ Inside Lot .._._.._.._..._..___......_.. Setba.ck .._....._._.._.._____..... Sideyard
Sewer Elevation _._____.._....__.._._.._____._._.._._._.._.._..._.._._ Founda.tio� IIevatian _.._._.+.
DESCRIPTION OF BUILDING
To be veed as:
C:�]"a�� e F�ont _._2.$ �._ Depth _.2/�'...—. Height .._LII �— &1. F't. b? 2 Cu. Ft —6�Z2.0--
_...._ Fro�t ..._. Depth Height _.._ Sq. Ft Gti. P't.
Type og CO�st�lCtipn _.._ WOOd �t, Cpgt _�`.1,_,,_5 00 ___.—.___ To be Completed �1�.� Q s 197 0
In cos�sideration o! the issuance to me of a permit to co�sstruct the building described abowe, I agree to do
the propored vvork in acxordance with the d�scription abave set ! and in c:oma wI al pro!viesons of
ua�nances o! the dty oP �Idley.
In condderatton of the payment o! a fee of;1�..�_ ., permit is hereby grsnted to VPrn� Gtrehl nw
to construct We building or addition as described above. Thispe t is gi�eated upon
the exPr�s oouditioa that thepers� to whom it is granted and his agenta, employees and �w�rlu� in sll wark.
dane in, sround and upon said buildia8. �' �Y P� thereof, shall oonf�m ia all respecta to the ordinanaes o�
Fridley� Minnesota regardin� locatio�, constructia�, alteration, maintenanoe, repair and mwinB o! buildin�
within the dty ]i�nits and ttus pesmft may be revoked at auY � uPon violation o! aay o[ the P���+ o� said
� �
CLARENCE BBLISLB
NOTICE
1Ws p�n�M dwr aot �evK Nw �dte�. M�t�B� hr vrYiW Pbwri�W N� Iw�Ny. Mw�e er wM�r. M aun te �
fl» Wild� Yapbor fer s�p�rNr P� Ior fl� NMa.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : r��� ��(,�-��� BUILDER 2 G i.�.�'�.h�-- ����d�
ADDRESS• ADDKESS: C� r �
NO • . S TREET : :/� ,Ql�
-� d —
LOT: BLOCK: e� ADDITION: _ ���,� �k�.�,
CORNER LOT: INSIDE LOT:� SETBACK: SIDEYARD:
Applicant attach to this form ZYao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
�ESCRIPTION OF BUILDING
Front : �1 r Depth : �`( r Height :+ �r� /
Square Feet: Cubic Feet: � %��
Front: Depth: Height•
Square Feet; Cubic Feet:
Z�pe of Construction: Cr>� Estimated Cost: $ T„��Q�'�
To Be Completed: C) p '
�
The underaigned hereby makes applicativn for a permit for the work herein
specified, agxeeing to do all woxk in sttict accordance with the City of
Fridley Ordinances and xulings of the Department of Buildings, and hereby
declares that all the facts and representations stated ia this application
are true and correct.
L1ATE : �_ �O S IGNATIIRE : 7�1.t„��.`. �
�
(See Reverse Side For Additioaal Infonaation.)
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BUILDING PERMI'�' FEE SCHEDULE
SECTION 2. The Tnspector of Buildings ghall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alter�tion or repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for,such penait of fees to the amdtint herein below set forth and in
the manner.herein pravided to-wit: � ,
UDTIFORM BUILDING CODE: �pe 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubi�al contents. �pe 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is dete�tnined 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 a#- $�, OD per- ear,h _ five h�a�e� c3aL " __ _ ..., _ , _ -
_ __ �s-��-3A�.-80) ar:���`�t�ereo� iii
the cost �f all proposed work. , �
In no case shall the fee chaxged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION 0� FOUNDATION
NOTE: Permits for construction will be issued a mini�um of 24 hours fram the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey af the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedin¢ with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate o£ Occupancy shall be made ten (10) days prior
to the use or occupancy qf"any structure for which a building pexmit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued. •
�
/1
e
.
dERALO T. COMNR
30O BRUNSWICK AVE S
GOIDEN VAIIEY, MINN
+NDUSTRiAL - JUCKIII:
`C:MMFRCIAL TODOGRAPHIUL
CITY LOTS - PLATTING
l+�iT St�R�YS CE��AlM� ' �t'''�°►��"o`�"�'�'
� BkOOKLYN PARK, MINN.
LAND SURVEYOttS
� i11�1t� LA'fIS O! t?�TS OP l[IxI11a0=� .
IdC'lf11Bn sY OEDiX�11C= OF CSt1f Ol 7tI1f�Af�0Ii8
6917 idalw Ave. N. �*`�•�
liinneapolis, Ltinnew�ta ��328
�urbcporg �cr�`�S�K�� �� �MBtNif�l� MQRE TNAN �i rEAR$ OF
�. AND a�1RVEV�NG EXPERIfNCf IN THf
MFTRQPOLITAN AREA
�
Lots 8 and 9� Block 2 a¢�d the
�ASt 1/2 of the vaeated alley
��Y�6 ad j�cent �i�ereto, Oak
�ve Addition to Frii,ciil.ey Park
Wd hs►al�r c+�tify Mwt tkis is � tru� sw� co�a1 t�}s�s�at�.
tion of e sr�wy of �6� bo+�irduits of tl» aY�v� �udii�I
� fend and fh� Iek�Noa of •k! SuilJi�t aii vit� enero�tci,
� n►�nf►. iF any, froa� or on said I�ni. �-p���^�
Yurveyd bp us iLifl �.L��' ��y sf "�.—! �--. 1�.-Y.
f '� .
�' �t. .�,� ���
� —
T BLTRVLY�$. CO`I�PANY
''�wr" y
� s�
.
�
�:� •. ,xs"�a,s,::;.;::'�i^--�-�- , �
SUBJECT
City of Fridley 1894�3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
' ' R
� �
� `y __._�_ COMMUiJITY DEVEIOPMEN7 DIV. ��
r i � PROTECTIVE INSPECTION SEC. �
� � �
, � �'��1 � CITY HALL FRIOLEY 55432 NUMBER REV. DATE PAGE Of APPROVED 8V
!"'"'� � ,�' 612-571-3450 910-Ft5 5/11/87 / /
10B ADDRESS 6646 Faridley Stxeet N.E.
t LEGAL �OT NO. BLOCK TRACT OFi ADDITION SEE ATTACHED
DESCR. S�� 2 Oa,k Grove Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Vernon StrehloHr 6646 Fxidley.Street N,E. 571-6342
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
same
4 AHCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUILDING
Residenti.al
7 CLASS OF WORK
O NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOHK
Rexoof & Reside Dwelling/Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOFi A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFF$TREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �. STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS OF I.AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .�`2 Q�SO Sl e�
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �Q
LAN CHECKFEE TOTALFEE
$39.53
NATUREOFCONiRACTOR A M0�7�E GENT �DATE� WHEN PROPERL LIDATED THIS IS YOUR PERMIT
� � O
SiGNnTU E OWNER�IF EHBUI�DER� iDATEi a y -�' BLDG WSP �pTE
NEw [ I
City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AKD It-2
pLTER. [ l Building Permit Application
�
Construetion Addresa:
Legal Description:�
Owner Name & Address:
Contractor
Addreas• v
Attach to this application, a CertiPicate of Survey of the
lot, With the proposed construction draWn on it to scale.
LIVII�IG ARSA:
GARAGE AREA:
DECR ARBA:
OTHER:
DESCRZPTI011 OF IMPROYBNIEI�N'P.
Length Width __ Height _
Length _ Width Height _
Len�'�n l�dth _�s_______ Hft/Grou�d
,
� Sf ��
Corner Lot [ ]
.
Type af Construction:
Approx. Completion Date:��
. Yd.
,
Tel. # � �
. # -
Sq. Ft.
Sq. Ft.
Sq. Ft.
� ��J
Side Yard Setback I��
�.�4�Estimated Cost: $ g� �
�O� 7a�,� �
Ali. A Alt B
proposed DriveWay Width If New Opening Is Desired: See Back Page for Explanation
DATE: � � ArtLICANT:
Tel. �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sexer I�Isin Charge
TOT11L
STIPULATIONS:
CITY IISE OI�I.Y
$ ,� Fee Sehedule on Reverse Side
$ _ 25� of Building Permit Fee
� /'. , $.50/�1,000 Valuation
� �525 per SAC Unit
a _ Fee Determined by Engineering
� Agreement Neeessary ( ] Not Necessary [ ]
�
�y'..53
n
. -s
d
BOII.DIAQ PB�IT FSB 3CHBDIILS
The Chief Building Official shall� before issuing permits Por the erection of any
building or structure, or Por any addition to aay existing building or strueture, or
for any alteration or repair to any existing building or structur.e, upon applicatio n
therefore, require the payment by the applicant for sueh permit ot fees to the amount
herein belo�► set forth and in the manner herein provi�ed to-wit:
Total Valuation
=1.00 to =500.00
�501.00 to �2,000.00
Feea
�10.00 (Minimum Fee is �15.00)
�10.00 for the first �500 plus �1.50 for eseh
additional �100 or fraction thereof, to and ineluding
�2,000.
�2,001.00 to a25,000.00 �32.50 for the first �2,000 plus $6.00 for each
'additional a1,000 or fraction thereof, to and
, — _�_-_,�_ _,___., �._- -.J- _ - _ __. -- -�-r;e�#-r�- � � �3d:
�25,001.00 to �50,000.00 �170.50 for the first �25,000 plus �4.50 for each
additional �1,000 or fraction thereof� to and
� ineluding �50,000.
�50,001.00 to a100,000.00 $283.00 for the first $50,000 plus �3.00 for eaeh
additional �1,000 or fraction thereof, to and
� ' including �100,000.
�100,001.00 and up
��33•00 for the first $100,000 plus �2.50 for each
additional a1,000 or fraction thereoP.
DRIVEiiAY DEPRS�SIOii ESCROfi
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement oP curb and gutter only - Driveway xidth plus
6 feet times $13.50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approaeh �ith 6 inch depth - Driveway Width plus 6 feet times �15.75
- —T--- -- - - _ _ _ . ._ -_ �--- -
aSRIFICATION OF FOUNDATION �
Permits for construction will be issued a minimum of 24 hours from the time of
application to a11oH Por proper revie�r of the prdposed structure and of the
construetion site.
A CertiPicate of Surwey of the lot, showing the location of the foundation onee it
has been oonstructed xill be required before proceeding with the framing.
.�__ ,.,,.,
sus�[tT
c�ty of Fridley 3 i 645
AT TNE TOP OF THE TWINS B u' L D 1 N G P E R M I T
f
� � RECEIPT NO.
� `� __��� COMMUNITY OEVELOPMENT OIV.
f � � PROTEC7IVE INSPECTION SEC. � 33
� _ ,
� �"'1 � CITV NALL FRIDLE� SS1�2 NUMOEp REV O�TE ��GE Of AIvROVEO /r
�.---� • •', 612-571-3450 9t0-F15 2/12/O1 / /
JOB ADDRESS 6646 Fridley Street NE
t LEGAL L07 N0. BLOCK TqACT OR ADDITION SEE ATTACFIEO
oescR. g,9 2 Oak Grove Addition SHEET
2 PiiOPERTY OWNER MAIL AOORES$ 21P PMONE
Charlie & Jackie Newmann 6646 Fridley Street NE 763-574-9841
3 CONTRACTOR MAIL AOORQSS ZIP PNONE IICENSE NO
Lifetime Siding/ABC Seamless Newport 355 21 St, Newport MN 55055 651-458-0844
1 ARCHITECT OR DESIGNER MAI ApORESS ZIP PMONE LICENSE NO.
1780
5 ENGINEER MA11, ADDiiESS 21P PNONE LICENSE NO
8 USE Of 8UIl01NG
Residential
7 CLASS OF WORK
O NEW O AODITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHAN(3E OF USE FqOM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on aIl levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REOUIREO FOR EIECTRICAL, PLUMBING. HEATINa, TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
VENTI�ATING OR AIR CON�ITIONiNG
THIS PERMIT BECOMES NULI ANO VOIO IP WORK OR CONSTRUGTION 20NING SO. fT CU fT.
AUTHORIZED IS NOT COMMENCEO V111TMIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO POii A PER100 OF 120 QAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DW�G. UNITS OffSTREET PARNING
I HEpEBV CERTIFY THAT 1 HAVE pEAO ANO EXAMINEO TMIS APPLICATION 1 S7A�L5 GAqAGES
AND KNOW TME SAME TO 8E TRUE ANO CORRECT. ALL PROVISIONS OF �AWS VALUATION SUR7AX
ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMP�IED
WITN WHE7MEfi SPECIFIED MEREIN OFi NOT. TME GRANTING Of A PERMIT �11�HO7 �S.9O
DOES N07 PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEpMIT f EE SAC CMARGE
PiiOVISIONS Of ANY OTMER S7ATE OR LOCAL LAW pEGULATING CON-
STRUCTION OR TNE PERfORMANCE Of CONSTRUC710N �.ZO9 . 25 Fire SC � L L. HO
P�AN GMECK fEE TOTA� FEE
License $5.0 $23 .95
S�GN�TUpEO�CON'A�CTOpOp�U1MOp�1E0�GEMT �O�rE� p p q IpATE T S IS YOUR AMIT
I �
S�GNATUNE O� OWNEp ��� OWNEA OU40Fp� �D�TE� � g0 � � i��
�� ` °
�r� t � E�e �nrzoa�
�wa� i� cir�r oF ��o�.�r �ss� a�z��oa s� i�
ALTER � StNf3LE FANNLY AND DUPLFJCES R•�t AND R 3
6UI�,DING PERMIT APPI�CATtpN
Constructiort Add�eess: �
legai Descrlption:
Own�r Plame � A�
cor,�aaor: __(,��e
LMNC� ARCA:
C�3AARAt3E AREA:
RA
DECK AREA:
-� Tel. #, j(D,'S ° J t`�- 7 xY /
�nN ��c�,s� # 1 � �D
Tc�� [�s/-��S��F�
Attad� to this application, a Ce�iflc�te of Survey af the
lat, wtth the propaaed cx�rrstrudion dra�nm on it to scale.
DESCRiP'f10N OF tMPROVEMENT
Len9th ____,_ 11Vidth N�ight � Sq. Ft
LengM �, Width H�ight Sq. Ft
l.Qn9th � Width � HgtJGround Sq. Ft
oTM�:
ConsVu�don Type: 1,��(� Estirnated Cost: �� ���d� �
��.������ _
D�iveway Curb Cut Width PJae�ded: ,.,�,_Ft. + s�t = Ft x� _$
DATE: — —C� I ,,,,,_, APPLIGANT• �l�l%� l�YT �l�� � Tei. #� - �'�
X1a3/
� �• - •., �
Perm�t Fee
Fire 5urcharge
State SurChstrge
SAC Char�e
License Surcheuge
L�riveway Esc�vw
Erosion Con#roI
Park Fee
Sewer Main Charge
ToT�
Ca11(763� 572�3804 for Permtt �ees if maUin� in applicatio�
$__� Fee Schedule on R�sverse Side
� Q .401 of Perrnit Valua#ian (1l10thiD�)
$ �� $.50J$1 �OUO Valu�ion
$ $1150 per S�AC Unit
$ 5. C�O $S.Ofl (State �iaensed Residential Cantractors)
� Alt. "A�� w. Aik "��� Ab4ve
$ $45Q.00 Cons�nration Pian Review
� Fse t�etermined by Engineering
$ Agreement Necessary j] Not lwfeoesaery []
���
�
s�QU�n-noNS_�� o,��.. ��-�'�Z`.�'.,�.
������ !�
��9 � � �. 3�' . 9 l y.,
� 8 .
ZO�Z@'d S9@I85btS9 Ol ��"i�ZT� �0 1,1I� 4Ja2i� SS:B� Z0@�-60-�.�
Building BUILDING Permit rlo.: �� U� ��'�
Inspections RESIDENTIAL APPLICATION R '� $ . - `
763-s�2-3604 CITY OF FRIDLEY n����'C���'
763-502-4977 FAX EFFECTTVE 1-1-2010
DATE " U YOUR E-MAIL ADDRESS
SITE ADDRESS ST . R � D /1�l l\I �S
THIS APPLICANT IS: O OWNER OCONTRACTOR
PROPERTY OWNER/ NAME:
TENANT ADDRESS:_�pG�l! �21bLt�► ST.. CITY ��lDI�S� STATE ZIP
PHONE:
CONTRACTOR NAME: �)CE r L� � S G��/tG ���
SUBMIT A COPY OF STATE LICENSE # C• O EXP DATE
YOUR STATE LICENSE
AND CERTIFICATE OF ADDRESS: "�� CITY�I,�STATE�ZIP_����
INSURANCE pH0 / — F O C
PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCT[ON STORIES
PERMIT TYPE ❑ ADDI770N O GARAGF/SHED ❑ WINDOWS
O BASEMENT FINISH �ROOF ❑ DRAIN 77LE
0 DECK O SIDING ❑ OTHER
O SWIMMING POOL
TYPE OF WORK: 0 NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCFJREPAIR ❑ REMODELING
DESCRIBEWORKBEINGDONE:_R�.���� OK�, �Ib Cy�t�A�
SIZE OF IMPROVEMENT S. LENGTH WIDTH HEIGHT S FT
ROOFING 2 p HOUSE ON[.Y BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES � J O HOUSE 8c GARAGE
I. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
O Vinyl OSoffit ADDITIONS_ & PORCHES SUBMIT:
❑ Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures
and proposed projcet.
O Other � F��a 2. Two seu of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS DYes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MAN[1FACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
�u.i. rr.r,� axr, ist�r,u v1v vALUAi1Vrn,1PIl:LUUllvli lriE C:U�1 VN� LA13VK A1Vll MA'1'L:KlA1.5:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S_ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ '
$
$
$
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2100 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks aavable to: Citv of Fridlev Attac
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge 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
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case o 1 rk '-�s re ' w and approv���q#' plans. '��
SIGNATURE OF APPLI� � �,�„� PRINT ¢�,'�. c'lf��'t� ./d �%/ - 1 a
Page 2- Building Residential Application
BUILDING PERNIIT 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 applic�tion 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 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�$500 plus $3.05 for each additional $] 00 or fraction, to and
includin $2,000 '
�2,001 to 525,000 $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 each additional $1,000 or fraction to and
includin $100,000
$100,001 to 5500,000 $993.75 for 1" $100,000 plus $5.60 for each additional $I,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 53,233.75 for the 1" $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1 000 000
S1,000,001 and up $5,608.75 for the 1� 51,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of appiication 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 framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE '�
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BIING
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
❑ OWNER
Permit No.:
Received By:�
Date Rec'd�6
T�ZIP
STATE LICENSE #_ �T C '�(�;S! `(ZS �j� EXP DATE .3 � I — I �
ADDRESS: [' �d •- `o `Z �/4 V CITY�L_STATE%�ZIP.
PHONE P/ �� % S-^ ?U I� FAX
O SINGLE FA ILY/NEW CONSTRUC110N SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ NEW HOME CONSTRUCTION
❑ MAINTENANCE/REPAIR
❑ ADDITION
� REMODELING
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑ DRA[N TILE
❑ OTHER
lNDD�S
F'f
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl OSoffit ADDITIONS_ & PORCHES SUBMIT:
❑ Aluminum O Trim 1• Site Plan/Survey showing the existing structures
and proposed project.
❑ Other ❑ Fascia 2. Two sets of construction plans
WINDOWS 3. Energy Caiculations
IN EXISTING OPENINGS �1'es ONo LOCATION OF WINDOWS FOR WINDOWS – PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-bl�sCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES 8c �
TYPE OF WINDOW TO BE INSTALLED � ER OF WINDOWS
ALL FEES ARE BASED N VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
., .n_ �LJ�iG THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ ��� See Back Page for Fee Scfiedule
$ 65% of Building Permit Fee
$ .001 times the total job va(uation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ �• � Make checks payabte to: City of Fridlev Attach
'fHIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a bui(ding permit and I acknowledge 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
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the e a r whic r uires review and approval of plans. �
SIGNATURE OF � \ PRINT NAME��/(C� / L E! S�IfR-C� /� �� 3�� �
Page 2- Building Residential Application
BUILDING 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
app(icant 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 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1� $500 plus $3.05 for each additional $]00 or fraction, to and
includin $2,000
$2,001 to 525,000 $69.25 for 1� $2,000 plus $14 for each additional $I,000 or fraction, to and
includin $S25 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 each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1" $100,000 plus 55.60 for each additional $1,000 or fraction 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
fraction 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
Permits for construction will be issued a minimum 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 framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977