AF - 43564City of Fridley, Min.n.
BUILDING PER,l�IIT N� 6 6 8�i
Date: •�`�''"�' �� � �
Owner: �.�� Build..
Adclress Address
LOC,�TIOfV �F B DlNG
�z. �
No. � Street �� '`s � �'' Part of Lot �
Lot �_ Block � Addition or Sub-Division .�.,�� �'
-�'`�' �
�, � �� �
Coraer Lot ,_ _ Inside Lot —�— Setback ��� Sideyard
Sewer IIevation __._ �. Foundat[on IIevation
DESCRIPTION OF BUILDING
To Used a • +�' �
y�� �"✓ Frant "�_.�! _ Depth ��-�t � Sq. F't. �:!! �'�+ C�. �.����l��
• ' Fro Depth Height Sq. F� Cu. Ft
Type of Cflnstructfon � F�t.–C'os� �.�� o be Completed —
�
In consideration oP the issuance to me of a permit to construct the building described abave, I a�ee to do
the proposed work in accordance with the descript3on above set forth and ia compliance with all provisions of
ox�rlinancea of the dty of Fridley.
�
In cona�tderaiion of the payment of a Pee oP $ , permit is hereby granted to
to construct the building or addition as descrlbed above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�en, in all work
done in, around and upon said building, or any �art thereof, shall coffiorm in all rea�ci� to th� ordivanc�a of
Piidley, Minnesota regarding location, construchon, alteration, maintenance, repa4r aad moving of buildings
within the city liaait� and thia pernait may � revoked at any time u�n violation of any of the Provisions of safd
ordinanc�es. .�" � �� .,� ,�! . ,'`�
Building Inspector
NOTICE:
T6b permi! does eot eoree tfie eoeatroeHon, fastaQaMoe for wletng, plombteg, eas heaHap, sewee o� weter. Be sure to sae
f6e Butldiae lespeela� Poe esperate permils for theae items,
i�'
- �j-.! �y�....� __
4 �
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1PPLIGATION F'OR BIIILDING PERMTT
CITY OF FRIDLEY, MIIdNESOTA
�J
O�v°ner's Name Bui].der
�ddress
/ � %` / LOCATION OF BUILDING
� �/
No. 3treei ���� /I� �- Part of Lot
�' . . �� ��-� � r�S
Lot Dlock /��_Addition or Subdiv�sio�n ,_� �� �
Corner Lot _inside Lot � Setback ���� Side-Yard ��''
SE�rJER ELEVgTION�� � � FOUNDATION ELEVATION _____���
lpplicant attach to this form Certif3cate of Surveg oP Lot and proposed building
loca.tion.
DESCRIPTIQN OF BIITLDING
To be used aa: a
��if f f�
�� � Front '�`T (� De�th �� � _ _Heieht �
�. Ft. Cu. Ft.
F'ront.______ Depth Height
Sq. Ft. Cu. Ft.
Type of Conatruction ��� � Estime,ted Coat
To be Completed ���.r— / � a / � � �/
The undersigned hereby makes applicat3on for a permit for the work herein apecified,
agreeing to do all work in str3ct accord�nce with the City ardinances and ruling of
the Department of Buildings, and hereby decZares that all the facts and representations
statad in this application are true and correct.
. � f� � �
'�l/r(c 1
(A Schedule of Fee Coata can tae found on the Reverse Side.)
� � ��
:�� � -
BIIILDIlVG PERMIT FEE SCi�DUUIE
Section 2. The Inapector of Buildings sha11, bafore isawtag any permit for the
erectioa of exiy 'building or structure, or for any addit3on to en�r ex�.at3ng build-
ing ar structure, or ior any alterations or repairs to any exiating building or
s'tructure, upon application therefor, requise the payment by the gpplicant for
such permit of fees to the amount here3.n below aet forth and in the menner herein
provided tc-wit:
2.1. �'or any such pex�mi.t for the erection of ang fire-proof bu3lding� other than
a garage, warehouse, factor� or �a3n eleeator, or for the erectioa of any fire-
proof addition, for aimi7.ar occupanc�r, to any existing building sha].l be at the
rate of $1.40 for each one thousand cubie f�et, or fraction thereof� in such
cubic,a7. contents.
2.2. For any such perm3t for the erection of any firepraof garage, warehouse,
factory or grain elevatpr, or for the erection of ar� f ireproof addition, for
s3�m37.ar occupancy, to an�r existing building shall be at the rate of �1.25 for
each one thousand cubic feet, classified as ��fireprocf�� by Sect3on 502 of the
Minneapolis Build3ng Code.
HOUSFS
2.3. For eny such perm9.t for the erection of a�r not�fireprooF building other
than a garage, warehouse, factory or grain elevator, or any not�-fireproof
addition, for similar occupancy, to any exiati.ng bu31d3.ng. Permit �7..� fos
each one thousand cub3c feet.
G�RAGE3
�
2.4. For any such permit for the erection of e.r�r nor�-fireproof garage, warehouse,
factory or grain elevator_, or for the erection of any non-fireproof �,ddition, for
similar occuparicy, to any existing bu3ldin� or for each such build3ng or addition.
Niaety Cents for. ea.ch one thousand cubic feet or fraction thereof, in the cubica7.
con�ents thereof with a minimum of �4.00.
For the pvrpose of computing fees £or building permits tbe cubical contents of any
building or addition to a uriiform he3ght throughout by multiply3ng the ground area
covered f°rom a point six (6} inches below the floor line o£ the basement or cellar
to the average height of the upper surface or to the average height of the roof
sUrface of the main gable of � pitched roof.
2.5. Far repaiss or alt,erations to an existing structure, the fee shall be at the
rate of �3.00 for each Five Hundred Dollars (�500.00), or fraction thereof 3n the
cost of all propoaed work.
2.6. In no case shall the fee charged for any permit aa set forth in Sect3on 2 be
leas tha.n �4.00.
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HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN�
Weatherstrips A.S.H.V.E, Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall C.eiling Roof F1oor Kind How Applied
No I —No 19� /'o � y _ 3 ,
Fl.� ° Room � Length �� Width /�,3, Heigh�' � Fl.� Room Length �� Width � Heigh��
Windows a d Doors—Crackage and Area Windows and Doors—Crackage and Area
�Yldth Helght Na. o[ Ltneal f. Area Wldth Helg6t No. ot Llneal tL Aiea
No. ot Dane o( Dane Ifghte ot crack eq. ft. No. o[ pane ot Dane llghte ot crack eQ. [t.
�i , � � �' � �6,d' <
, 1��� • � �
, ,
Coef. Btu Coef. Btu
Inhltration p� � ��
In6ltration �
Glass i ��
fap. wall
Net exp. wall � /� Y
lnt. wall
Ceiling � J� y7� �
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ina. W.A. Leader area 3`?/
F7• Room � Length f Width/ � Height o
Windows and Doors—Crackage and Area
Wtd'th He1ghE No. o[ Lineal ft. Area
No. of Dane ot pane Ilgbte ot cracB aq. it.
� � � �
�' iy ,� �
, ��,� � ,� �'',� 7 , �
Coef. Bcu
In6ltration � �
Glasa 'y. �- ,
Exp. wall �
Net eap. wal] � .
Int. wall
Ceiling � �
Floor
Tota) Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI• Room � Length �3 � Width � Hei
Windows and Doors—Crackage and Area
� Wldth Helght No. ot L1nea1 [t. Area
No. ot pane ot yane Ilghts of crack ep, tt.
,( 3 Y / l�� � ff��
Inhltration �, y
Glasa
Exp. wall �r
Net esp. wall � �'-"
Int. wall
Ceiling �
Floor
Tbtal Btu.
'�_.Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
r�l
� `� %
Glaas � 6
Fap. wall Z
Net eap. wall , y lp �y
Int. wall
Ceiling � � /p ����
Floor
7'otal Btu. L
Required sq. ft. E.D.R. or aq. ins. W.A. I.eader area
FI.I Room ( l.en8th �3' Width o' Height�`�
Windows and D�ra—Crackage and Area
Wldth Helght No. of Llneal It. Area
NO. o[ nane of oane llvher nf �.00tr ... r�
�I�
In6ltration
Calaas
< <S /�3! �
�p. Weu ��
Net eap, wall ,3 � � � y
Int. wall
Ceiling � � � /3� �
Floor - .
Total Btu. ,,r,�gg y
ed aq. fG E.D.R. or aq. ins. W.A. I.eader area
t�� I �agc��i ( w;ac� ,�� H��h �
dowa and Doors—Crackage and Area
Wtdth Helght No. o! Llneal It. Ares
o! pane ot Dane Ilghts ot crack sp. iL.
Btu
� Inhltratioa
a�J Glass
E:p. wali
�_ N�t ��. W8u
Int. wall
�II
� Btu
�
�
�
Ceiling � ���
Floor
?otal Btu. . 7�2
ired u�. k. E.D.R or sq. ias. WA. Leader area
,�
�-
SUBJECT .
City of Fridley 19557
' ' AT THE TOP OF THE TWINS g U I L D I N G P E R M I T RE�E�P .
r
� � COMMUNITY DEVELOPMENT DIV. 9
~ PROTECTIVE INSPECTION SEC. �9 D � /
� i _'_�-�
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� � /�"1 � CITY HALL FRIDLEV 55432 NUMBER REV bATE PAGE OF APPROVED BY
�----� � �'� 612-571-3450 910-F15 6/23/88 / /
J08 ADDRESS 1227 Gardena Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 1 Moore Lake Hills 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Jean M. Quenomoen 1227 Ga.rdena Avenue N.E. 571-5756
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Viking Home Impronement Co. 4832 -� 2�.Street N,E., Mpls. 55421 572-1820
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
6 USE OF BUILDIN(3
Residential
7 CLASS OF WORK � NEW �] ADOITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroo� �elling and construct a 3� x 24' Deck
9 CHANOEOFUSEFROM TO
STIPULATIONS See notations on plan. Th�ee foot cant. joist must be treated and be
12 feet lonc�. Use all treated wood.
WARH���
Before digging call I�ca! utiliti�s
���.����� pE�[V�P°�"S REQU'IRE� FO(� TELEPF�ONE - E1E�7►�!C - G.t�S Et�.
1�r"1ii6��G, ���'i��y �'�.l:PNIBCE�� ��L� �IC�IVS. �E���R�� �'� L.�cb;^�,J
TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY �CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND ,ORDINANCES GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OH NOT. THE GRANTING OF A PERMIT $g�2�� $2.�'O
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-
TRUCTI N OR THE PERP RMANC NSTRUC ION. S%Z .00
LAN CHECK FEE TOTAL FEE
� �� $74.10
rURE FCONiRnCTOao AUTHORIZEDAGEN iD 7Ei WHEN PROPERLY VA TED THIS IS YOU PERMIT
� � 3 �
SIGNATURE OF OWNER�IF OWNER BUILDER� IDATEi BIDG �NSP f1ATE
I�1 [ ]
AIDN 1�
U
AL�R [ �
mnstructian Adaress
City of FYidley
R-1 AI�ID R-2
Bui].ding Petmit l�lication
C-? �-�(�i P.v �" �4 v
EEfective 5/L88
�u L
i�l Descriptfm: `°�` � ��rc i Med� ��-KP �; ��s, �,A-� ��1��-� �o��
Owner i�lmae & Address: �� r-�-l� M L�u �,v D,� �.� �l C�� �+ 2 y i� Te�.. ���i-�"�J'�
d
�ntr actor : _ \ � ( �� i i+s �i _�-v �/I e fii►� � d! � v�,� � �Y �' � Te�.. �% Z _l � �a
Aa�ress. Z � �� S 7� l �1.�5�-/ 2 l a,
Attad� to this appl ication, a Certif i�cate oi Suvey of the
lat, with the proposoed oonstructiasi drawn on it to scale.
LESatIPrIOiQ �' I1�RWH�
LIViI� ARFA: L�ngth Width 8eic�t St�. Ft.
� . . Length Widtt: � 8ei�t �. Ft. '
� a,«; ;
��4:��;
� R�c� It�
mrner Lot [ ] Insic]e Lat
�pe c� Gbnstruction:
Approx. Cbmpletian Date:
���a co�:
Alt. A Alt. 8
Proposed Driveway Width If New Opening Is Desired: S S
Width + 6'� See Back Page
, �� Zv
n� . �- � � Te�. � �7 � -
• � � r�ic�:
DSE �Y
Pe=mit Flee
State Surc��arge
SAC �arge
Driveway Escrow
Park Fpe
S��r I�1afn marge
�
�u�.e�u.,�r,: icra:
S �A
S ��c�
�
8
S
$
S � A
P�ee Schedule on Reverse Side
5.50/51,000 Valuation
5550 per SAC Unit
Alt. •A' OL Alt. "B" Ab�VE
F@e Det�erm3r�ed by E�gir�eering
Agre� NeCessary I] Not Neaessary [ l
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Tt�e Qiief Building Official shall, before issuing permits for the erection of any
building or etrtacture, or for any ac7dition to any euisting t�uilc7ing or structure, or for
any alteration or repair to any existing building or structure, upon application
therefore, require �e payment by the appiic�nt for such germit of fees to the amount
herein belaw eet forth and in the maru�er herein prc�vic�ed to�it:
�TAL VALUE
S1 to �500
5501 to $2,000
S2, 001 to 525, 000
�25,001 to 550,000
S50,001 to 5100,000
5100,001 to 5500,000
_�, � `.
S1S � Qrlinimun �1ee is S15 plu� surcharge )
�15 for first 5500 pl� S2 for each additiona]. 5100 or f raction
thereof �*.�o arid including S2, 000
S45 for first 52,000 plus �9 for each additional 51,000 or
fraction thereof, to and including 525,000
5252 for first 525,000 plus �6.50 for each additianal 51,000 or
fraction thereaf, to anc7 inclt�in9 SSp,000
8414.50 for first 550,�00 plus 54.50 for each additional �1,000
or fractia� thereof, tm anc7 including 5100, 000
5639.50 for first 5100,000 plus 53.50 for each additianal 51,000
or fractian thereof, to and including 8500,000
�:�J,001 to $1,000,000 52039.50 for the first �500,000 plus S3 for each additional
�1,000 or fracti� thereof, to and including 51,000,000
51,000,001 anc3 up 53539.50 for the first 51,000,000 plus S2 for each additional
Sl, 000 or f raction thereof
DRIV�.�v D ��rnN �aRx�
(Concrete Curb Streets On],y)
A7.ternate 'A°: Renwal �d replaoement c� c�rb and gutter anly - Driveway width plus b
feet times $13.50.
A1.ternate '8": Renwal and replaoement c� curb and gutter and install a 3 foot wide
ag��aa�i: with 6 ir�h dcpth - Driv�aay width plus 6 feet times 515.75.
i�+: � r• M �.� �,` ��.�J� � • M �'
��
P�rmits for construction will be issued a minimum of 24 hours f rom the time of
applicatian to allcw for proper review a� the proposed structure and of the a�nstruction
site.
A Certif icate a� Slu'vey of the lat, stw�wing t,he location of the f�c]ation once it has
been wnstructed will be required before prooeec]ing with the framing
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CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MWNESOTA 55432 • PHONE (612) 571-3450
August 18, 1988
Viking Ha�e Improvement '
4832 - 2�i Street N.E.
Fridley, MN 55421
.
Re: 1227 Gardena Avenue N.E. - Correction
� 'i
Dear Mr. Merrell;
A f inal inspect3on was conducted on August 16, 1988 of the ahove adflress and
the f ollowing item was noted which must be completed before the construction
can be finaled:
The post whexe the stair meets the front deGk railing
must be made a�ure.
We will expect this item to be completed by August 26, 1988 and a reinspection
called for. If you have any questions on this item, please contact me at
571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
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c�ty of Frid�ey 3 8 4 9
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AT THE TOP OF THE 'fWINS � � f L D i N G P E R M I T
; : No.
� ; y ��_�� COMMUNITY DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �o'{G,�o
1 . � `/ l
' � �"'1 � CITY FIALL fRIDLE� SS13$ NUMBEp REV DATE PAGE O� AOPROVED BY
�""�� �'' 612-571-3450 91Q-F15 4/24/00 / /
JOB ADORESS 1227 Gardena Avenue NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED
oesca. 6 ]. Moore Lake Hills 2nd Addition SMEET
2 PiiOPERTY OWNER MAIL AODRES$ IIP PHONE
Layne Johnson 1227 Gardena Avenue NE 586-9788
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Same
d ARCHITECT OR DESIGNER MAI AODRESS 21P PHONE LICENSE NO.
5 ENGINEER MAII ADORESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOiiK
�7 NEW O ADDITION O ALTERATION ❑ REPAIR D MOVE 0 REMOVE
8 DESCRIBE WORK
Construct a 12' x 20' Deck
9 CHANdE Of USE FROM TO
STIPULATIONS
See notations on plan. Call gopher state before digging.
�v��Nrw�
B�'f�w� di��ing c�ll for
ail utility locadons
4540002
ItEQUIRED BY LAVV' �
TYPE OF CONST. OCCUPANCV (3ROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING.
VENTILATING OR AIR CONOITIONiNG
TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED VjIITHIN 80 DAYS. Oii If CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONED FOF A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING
1 NEREBY CERTIFV TMAT I MAVE 1iEAD ANO EXAMINEO TMIS APPLICATION 1 STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPI,IED �
WITH WHETMER SPECIFIEO HEREIN OF NOT. TNE GRANTING OF A PERMIT �Z s 2�6 � 1. 13
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEpMIT FEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE OR IOCAI LAW iiEGULATING CON- @
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION �53. ZS F re SC y�2. 2G
PLAN CMIECK FEE T TAL F�E
$86.64
S�GNAT OFCON:FACTOpO UTMOp�ZEDAGENT i0�i8� ME P O V VALI AT D 7M15 IS VO RMIT
_ 2�i�e� � Da
S 4T Ep��� ON�NEp BWLOHp� DATE� BL +h50 -! �i E
N� � � . Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �
BUILDING PERMIT APPLICATION �� ��
Construction Address: � � � � ��.,��� /4� /f f � J ��
Legal Description:
Owner Name & Address: � vr�-� _ �o � h c� .-, Tel. # %�3"Sg� %7��
Contractor. /��i� MN LICENSE # � �
Address: a� � � GG'cr c�
I �n � �J� Tel. # 7� 3-s-8� - ��'g-
LMNG AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA:
OTHER:
Length � Width v?I> Hgt/Ground �� Sq. Ft ��.�'
Construction Type: ��G � Estimated Cost: $ ,�U��^' � �S ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: L DD APPLICANT:
_$
CITY USE ONLY - Call (763) 572-3604 for Permlt Fees if mailing in application
Permit Fee $ �.� ��� Fee Schedule on Reverse Side
Fire Surcharge $ �� �� .001 of Permit Valuation (1/10th%)
State Surcharge $ /', / � $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
Te�. # 7� 3 `S8"�— � 7S�
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$,
$
$ �,(o`
.Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BUII.DING PERNIIT FEE SCHEDULE
The Chief .�uilding Official shall, before issuing germits for the erection of any building or structure, or for any
additioII to� any elcisting building or structure, or for any alteration or repair to any existing building or structure,
upon applieation 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 .OS 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,Q00
$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 farst $500,000 plus $4.75 for each additional
$1,Q(� or fraction thereof, to and including $1,000,0{}0
$5,608.75 for the fnrst $1,000,000 plus $3.15 for each additional
$1,Q00 or fracdon thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
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 the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existlng furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plasticJPVC and meets ali cuRent codes and manufacturer
specifications 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 manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the cuRent codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installing a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
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. Yes () No ()
Appliance Tvpe 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 Total 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 :
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CIlYOF
FR(DLE,Y
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 16, 2001
Lane Johnson
1227 Gardena Ave NE
Fridley, MN 55432
Re: Final Inspection at 1227 Gardena Ave NE
Contractor: Mr Rooter of Anoka Co.
Dear Mr. Johnson: `
A plumbing permit was issued on March 8, 1999 to install a water heater at your address.
According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted
on the plumbing authorized by this permit. As of this date, no inspection has been called for.
The permit fee paid covers the inspector's time to make sure the appliance was installed
correctly. We also check to make sure combustion air has been installed and that the vent and
vent connectors have been sized properly.
If you would like the installation inspected, please contact us within 30 days to anange the
inspection. If we do not hear from you we will expire the pernut and note that no inspections
were called for.
Any questions can be addressed to me at (763) 572-3603.
�
3uildin.g
rnspections
763-572-3604
�ATE �� -'L —'�
;rrE fwn�ss ��.
i'HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
� PROPERTY TYPE
PERNIIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
C��lt��,. A�. ��
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NAIv�:
ADDRESS: � � °e� � CiTY
PHONE: � V � °' � � �o a 5
NAIv��S � � i
STATE LICENSE � E3Q' DATE �— ! ' � '�I
ADDRESS: % � CTfY�
PHONE ��� ' 'rj �� �U � � La FAX
SINGLE FANQL.Y/NERi CONSTRUCTION SIZE
O TVJO FAMILYMEW CONSTRUCTION STORIES
� BASEA�NT FINISH �$ROOF
O DECK O SIDING
DESCRIBE WORK BEING DONE: ��� ��
SIZE OF IlMPROVEMENT
OF SQUARES �
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
Sm�iG
❑ Vinyl
❑ Altmiinwn
❑ Other
R'INDOWS
IIJ E}QSTIIQG OPENIl�IGS OYes ONo
OR FOR NEW OPENWGS-DESCRIBE SIZE OF
OPENWG CHANGES 8c
TYPE OF WII�iDOW TO BE WSTALLED ___
0 REMODELING
LENGTH
�i HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACI�D GARAGE
❑ DETACi�D GARAGE
OSoffit
❑ Trim
❑ Fascia
IACATION OF WINDOWS
t►11u�: � •
O DRAIN TILE
❑ OTf�R
Permit No.:
Received By: �
Date Rec'd: ��' �
HEIGHT
'�
A'C�I�IP �J ���
Ft
BASEMENT REMODELING SUBNIIT:
I. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDII�IG DECKS,
ADDITIONS. Bc PQRCHFS SUBMIT:
I. Site PIarJSurvey showing the existing strucUues
and proposed project
2. Two sets of consWction pians
3. Energy Calcuiations
ALL FEES ARE BASED ON VALUATION, INCLUDING TI� COST OF LABOR AND MATERIALS:
(USING 1997 U.B.0 FEE SCI�DULE)
TOTAL JOB VALUATION $ �`�i'� o OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Dne
$ �`. a2`� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ ,� .001 times the total job valuation
$ � .Q� .0005 x Permit Valuation Minimum $.50
$ S ,(� $5.00 (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservarion Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ @ I_��' Make c6ecks payable to: City of Fridtey Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building perrait and I acl�owledge that the infortnation 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 '�i �id work is o start without a permit; that the work will be in accordance with the approved
plan in the case of all work whi e' es r va1 of plans.
SIGNATURE OF APPLIC ���='`P .�•! PRINT NAME ���� lo- y e� DATE �'� �S '`�'
Page 2- Building Residential Application
BUII..DING PERMIT FEE SCHEDULE
The Chief Buildi.ng Officia.l shall, before issuing pemuts for the erection of any building or
structtire, or for any addition to any existing building or structure, or for any alteration or repair
to any exis�ting 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-wi�
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 pro�sed structure and of the construction site.
A Certificate of Survey of the lot, showi.ng the loca.tion of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
$uilding Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977