AF - 45552i
` �- � � Village of Fridiey, Minn.
�..
� BUILDING` PERMIT
Date: .... ....... f...f.�'�:..:5�.('.......
Owner � . . . � �l-�:-!�.�,�'Lr.
Address . . . . <, .���. . . �.G-�L�.�.at�s�. . .
�
N° 1857
Builder.... .........................
Address ....�-��Cy� ............................
OCATION OF BUILDWG '
No . ............. Street ...�.�*•'��.i�:.............. Part of Lot . . .. .........
Lot . . . . .� �. . . Block . . . . . . . .. . . . . . . . . . Addition or Sub-Division ��s���:?�t.�: �`. :"�. . ...
� •
Corner Lot . . . . . . . . . . . Inside Lot . . . � Setback . . . �� . . Sideyard . � � .� � � y. . °. .�7• . • •
i
�s" �'I, ��,—�, �i .,< <.�,-_
DESCRIPTION OF BUILDING
To be tised
/4/• . . ......
Type of Construction
Front . .� ."!. . Depth . .�-. �. Height �� .'-!. . Sq. Ft. . . . . . . . . Cu. F't. . . . . . . . .
Front .��. . . Depth ..!� � Height� ��. • Sq. Ft. . .. .. . . . Cu. F� . . . . .
d' P — � ��'
. ��?.^�`: . . . . . . Est. Cost . �'l . . . . . . . . . . . . . . . To be Completeci�%.�.�. . "' % . . . .
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the viliage of Fridley. _
�� �� �
v� "
-
Tn consideration of the payment of a fee of $�........., permit is hereby granted to
.y�. • (/�G�•�i,�,�.�.s�f�
......................... to construct the building or addit' as described above. This permit is granted upon
the expre�ss condition that the person to whom it is gran and his agents, employees and workmen, in all work
done in, around and upon said building, or any part reof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construc ', alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may b voked at any time upon violation of any of the provisions of said
ordinances.
( ,,,, � ,,,,., ............... Building Inspector
NOTICE:
This permit does not cover the constructio�, installa,tion or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Buitding lnspector for separate permits for these items.
p��
y 7 �
�P
��
Jut��► 9, 196K�
Mr, Dar�iel C. �rritigtaa
162t� Ge�rdenia Av�rnun N. �.
i�linxaeapoiis 2.�.� I�ir.�sso�s
�ear Mr. SI�..rriri�n s
i�i +�swr�r tc� �rour l�tter of' ,�'u�e 6� 19�Q� regarding t,hs first p�tragre.ph
c�f your �.�rtt�r�, �r� �ai� �a adv3se ;Tou that any addi'�ion c�r a�.�E�t�.cua
�►� �r,y e�.et3n� �tr�.ictv�e �rlhere ths coet wi21 eocceec� �7�.pi�, a pex�.i.�
is req�ir� an�l 3n$}a�e�ica�� aa �pec3�i�d by the �ld�ri� �nsp�ctar.
If �.rs,y �.terat,idr� is beia�g done thst wc�u1� alter the '�a�ic ��tssu�ur�
mf an ex3.��ing buiZding� �egarfl2��� of ca�'� of �a� altars�L3onf a
�ermi� 3.s r��zire�. �1� �s� �u.r� i�u:i.�.ding ccxies arad reqx�iremen�� in
coz����aae��.s��a� a� t�:� t�s +�� ca���.���,�.�n �o� p�yni.t� t'�� �ii�lir?�
���;���-�c�r =, :1? :�:i-�3.�c� ,:�.�w w,3 ��� G..,�a�� `� � �������� �� ��u..� �r�i�.�:
���:��.
>b9�� x,,,ry �M ,y � �� �t _L „n'��.yAn °{ �a ;.: � � � n r,• y .�...� ,.�,y-. a"�"�,y-.,o n �t'*1 �.��...,,,.�w.
.t... _ '� ».�a w:�. � ... �L . .. �. ..,,.,�. ::�a. '� ' .. 1 ,? a.,;> _. '�:. .. � �"'`�*T.:.:,� +s � r :'3 ;�."�. i"3 y '["_� �. <1 .., �
���^`�l?:i� �.+°"?�.w.�.:.:.t"Jd3.;+ �:.;:� �'+� `a`.�.��� ;?a3t� ,L•'.��� v'�'d�.�'?2 �.i °".��.."�:'��3°'..'a;��.;J'o ��^1;�.�3 �.�'i�'.'S��'"��`•3�,.
"��.�Y1 'C,r.3�" 33 �°.�'.�� t^3'.��,c°��.3.2i�.t� :+i.".i °�'i,.'{3!.�. .k771�.� i�:�.x'1"��.' «���°"�&3a�'i�'i�.�i3% �a'.'�`+�7'.,�' .:.�"�x.�E33A`�'iar
We hape �ha� w+� ha►ve ar��ror� all �af your que��ic�tsa anci if there are
�zay tlart,k�er �,ue�t�,ona! p1�se r�o n4t hs�ita'�e �a ca�at�act �ur o�'�'ia�.
At3J a c�Ic�a
Youra very �u3.y,
ALL�T �. dEA�RN
Build�g Irispector
C 0 P Y
� + �.r
�ti'• Z�aaai.�l1. Crs �3$3'Y'3�'3�#�c?i�
�� �s�� ��� ���a��
��►���5 �1� �3a�nes�a
�ar �r. �3���ts
�QU� �t�r c��' J�z� �,� 39�3s r'�,',z��:i� i���.s� �c�+ro�:� '�i�
r�d e��i� +�' �,�ac� ���s�, ���th Q#' �►�n�.� �v�t�y �zaa�
be+��n i"��d �o t.his o��'�.� ��r rer�3�r, s� �c� ycrur �eccrnd �ra��s�h.
�' ����d �xL��i��a of �nj� ������ 1a3� �a� u� �n c��"f«»��
cr ,��� �.� ��^�e ���e� W wa�°� �#` ���; �.�3.� �5�r���, �. ���t 3.i'�sly r��a� ��
L:�°'�''�� �:T? ."�"i�Cf::" C:�'��lt�,€3�':'1*<,� � ��.� :a��:�':3.�":�. s�.�1�3 :�r�`i��� ��� `,;�,�,.�:�.���.'� ��T:'r»
:�'�.�i.�::3�w'..�"; ,,:'�+� �'�'.�'+;?;: y�''�i.":,,j �?, :3 s ";�:�`� :`.. . ,.3 �`;s,±'.�'..�'�" ;:3s��"`�r"�.�a.-`3 =_j.y �'°,�:•� a,v", '��+n".�
.:.za'.,��s•�„,.,��.°,'"w ��" ;" "!'. .°.�r...sy � � '.;",' '�--'�.., :' •n g�+ ��'�r* hro*c�:�-� �� a 'Rd;°y4.^�-.,i�srs�+
, � .z. � »� , 3 �:J.: �.. . _ .:.a a:'E? :c�6"'� �_3". w:..,�` �.a.. .+ �,�'+•�;... �e ,. ,c w
�"a Y � x.�,*^a `.. ";y e `"',� .. . _' 1. . _ k r 'y � ,Y��oVtMV.,:.�._x .3.` �b •,� ",:i°';J d� '4.. .,0.2„ ��. .
,4, ,+,�. . .s„ -.�} .�'+� �.__ :S,e ....M;� i 3 ..t...,." ..t ��'-u i. a ar;..n,. }"Ma -`w+..,,i�ai
s^tµ"1 . &' r .�fL+� 7 °.+� 1 `± "'1 � a ' ' � 3_.� 'ryv� ` �+al ✓�r.i�a��.v� «.�3.�i�ii ��.�an
iJ .s»+ a:' �.I..� ✓ +i�,J aF�'�- ..- .R.o y • �.i .i .. ,J r ....- ..'i�.. '.� N'�hJY] J...u. M .RS -i'.+.. '�,
.?,,5 .L . i ..�i t e �n..` "" '7 -�t�s ay , a � 7 � _ i `. ry.v'+ . y i'j � ^t t i 'u°� !"t �: ��' h � f ra "n
�';r� fh�t � ,��,�) .. . v:.�:�::�_..a �. ,. .> i �.u�� ..+ , .. �✓ w .» ! . . . ...:..`r....«..w �.��x� �. ..� ".� ��.tC �`,C�'
°�� � ��.�� ;����� �� � �z� _�:� ;'�+��, �� � �, � �y:� �4��s��:�. r����.��� t��.� �����°��. �
��e �rario� %e �r� iz� ��a�.� i��eci�.a� area.
Tt h�er �1 t��xir,�ur�i2.y ���a�d# ��r, t�t �e�� ���t
wb?�zl� �.�n�3 ez�uthW�3 ar� the +q�te� aecz�ie� l�e►' %n ��rdenia �v+e�•
�, 'Kh�.c� �m►�er 2iar� i� s3.�tu�t.ec3 bets�t� I,vt.� �3 and 3l�; ar�ci X�3.e� ia
ur��rat�,vd ��t ,�ou,� �� �r ��' Lot 3I�, �ld x�ot be � a pcasit�.sm ta
� t2�e ���s��y �,�� ���� �vc�� de+d�.catio�, t3u� to �he c%�rs�
�r+a��.�y sa� ;�r i�c�z.�� t� t� ����er �.#�me. �ra. ��ar�an� ca�zaer c��
%�►� 33 tc� t1h� �st �` �,� �Ec�� h�eve �uah a�e���r �a�d Sor �Lre� de�r�i�-
�c�tict� �a ��� tl��*e2'�ara� �e� 3�► ;�rs�Ir���y fair ta �32 co�cer�d ar�d
b�a�r �z� a�at �aa�t� �u�3� ��ic��it�►, �,�t li��l� t� �trr�ae'E��► a�!
����.��� ��Cs�r3oz� �1� +��a��.c�ar t,�tt�l�� �� �a�i�. �t;�y ��t� trma fi�
��tt ��d�r af' �te+r�s� �+�r��t ���t 3�� � In t,�is �t�, ��. c�u�.id las
ca11+�d u�aon �c� ���.��z� t� C�.i��r o� �r�. �#��s+�a,, 3,�a ����, �'or t�'�
�o��.� af � �'s�oL �3.dt� �.e�a �€�� ca��L ded�.���e. T�i�.� �� ,a c����
�ac��c��.+�� t3�r�i��►ut a3.�. c� �.�iea�.
;t, a
C Q P Y
:�l3"r ��:LB�. ty. z�x'��
;t�apc��.�.� 2I
i'�nr�s�t�a
�d t.ir�►r� '��en ��er ��ure pla�.n� �� . yea�r �rnav�c�u��,y� �
bu'i3dits� p�3�it �u3.d �rst 4�c�e �e�n gra�rtt�d �'t�r ym� #.t� b�.tl �c� +�1�
�o �Za3.� ���ic�n I3�, �e��� t�� �uC�a �o��:bl+� �i�ur� �t���� �3a��.rap�►
�rs� «
'�"3� t�►i� .proposa]. �`a�r t� ��uth�as�L ���sr p�r��l c��' �e '�mr#►�
�-� ca� ����.�n 2� �,� �.ven ��siderafi.��, qc>u t�.11 '� cY�.� aaa'�i.�-
�'i+��. �'�►� a�r �est g�*+��ea� y+r»r c� jectit�t.
�t i� t�'��ta�a�e, �'t� �sa�h ;��,� as�d �r�. :�eter�on� �'�� t1��.� g�ro�•
pr�e�d �st.re��, ����h r� �x�d;�.� .�,ven�te, t� �tt�� �i'�� ts���i+de�a�i� ��►
t� t� t3�at �Irs. ��s�+� �.� ��t,�od t�o ��e a�ared b��"+�r� '�
��t�i�. t� t��ec� � y�ur �+���aru� ���� ��.�� ao c�o�al� ���xt� �
�3��.� ��r'��° I�. ��,�.��-,+�_��� �,� ' � ��� � �sa� Z��.i e>��h ���y�;��i ��a��
,,,,x ,} , a,,, ,� +�
a`925.���`as is.Fs�',A:;�^0�"i5� ;J���.�A�' ���.�b i'e:�a��fi'4��» .. '{' i '� �.�,,.C�'�'�'"'���'w�3.-L,s'i'w`b�iu� -
.,.,. ,».r .....ca �.'�a'•.� v��.�.��'.�... .a.�.i' li���LJ.�� b..��{i � s'�
.
�r��'� �'! Rw q�e�� ��r .f� .
�w bi'-,.'�.w .7'�.ov.i �.:v�<�"� .�,�,n,�sa7 .'� �•s�ir✓�:.�.�.,1 ... .Sti.�g ,y' r.w,�q }4,�i1 +n—�f �'t' ?v .P+
„ .Jri a. 3.: t,�w:.�-r�E. .JCaiIVT3� ...�... �� .�,� M1' �'^,<."�i E�,�
��+ � o iT '! �y "r "1 .'1 y 9
� : ''� �} ,��t��..'3:,+ .,.. .2 ,iYw 'v�.G. .+...� .....M.a. » ,.:z�'=�� ., a,..�.. ,.ubr�"•,A,'?.�i 2 � «i. ��"J� i-.�.� .� v,j: �..."i.a�
'^�'.:�.'Y�'*iy ; ��y �...�. 6«�i �.. .,':s i 1_ ,4 �q^�5 ,-y.-�.r
:..! �:i � �"' .��... .� .,�.�. � . , .. . iy , . ., I
_ �' ,u;j�
..,, ,.+� t .n..h. a -� :-� -r '� "�
a t � -
. �' � .a r .,,.,+ ...,�... �> ..... . . . .._... ..,�'-,^+w.::�'��.�� M>. ar �. r��.�.:n .�''�w
f!'� �': �i 9ro� ,�'!, .*�
iy 4 yj
���=iD�
�{%%�" t+�`k�)%' �9Z3i'!!!
:��.��' �. K�?CF��iAH
��3rec�r af P�ablic '�sar�
,
.
�-
��
,�
r � �'
Fridley� 1►�inn.
June 6, 1960
Citg uf Fridley
6431 LTniv. Ave. N.E.
Mpl�. 21, li�3nn.
Dear Sirs:
I am coniil iering makar�g some improvements to the
�roperty at 162(? Gardena AQe. and �vu1d a�preca.ate
information art building permit requirerments. �hat if any
is the maaimu� size �ddition before a pe�mit is required
and is a permit required for paTing s dri4ewa�r ?
In view of rumors current�y eircu].ating in the
neighborhood I woi}�.d like some assuranee that this- property
i� not $cheduled for condem,nstion for extension of Benjamin
�street r�auth of Gardena before making an�y improvetnent�.
If the pZan is to offset B�njamin through the vacant 1ot
to the west I avou2d �.ike ta earpress s�reliminary obj�etion
si�ice this e�oses � siar childre� to the dangers of traFfi�
and makes the pro�erty �ansuitable tor �rty uee.
Sinc ere�.y, -
� ' ' �
� � ���
.
�
��
i M
.s. �
€ � �
d. o �
Cr a
•+ �
S �
GfJ
0
�
� m �
d .� A a
� �{.L.
�
O .�
'` E
V �
�
C
•�
�.��i.
� a
� �
�w
00
30
� �
xa
H�a
�1 �
Q
�
x
�
,,�j:
�
��ro ��
��� °�
N � �
O Q �
� � �
� � �
�U�+�
w�'�-+ �i �"+
f+ O
r � � C)
�3.�� �
a a, a, �,
s� � �Y
�p�� b
s3 � � �
y � m A
u � �+
�y��
����� a
�x�N �
��
�a��
�
���� �
���� �
0
� '� `�° °
oa�
.�' � �
�o�vo
� v y y
� � �
b � � � �
� �
� �
� v � a
o ��� d
N
� v�b
U vai �N �
C j I I
�
_
�
3 < I
�
. z
• �
S9NIN3d0
sv� i
39NVtl
��
'�ddY
SV9
aa►+svnn
Ol(tY
SNISYB
M1�1V7
SNiV110
aooi3
•saews
'1N(lOj
'71NIT10 .� .�
SAVM1
HSYM I
� ��S�lN�S
��� a b
seru � �
H1W �
rnwan � � �
s�so�n o w
aatvM i� �
y w z
� b b
pq � c� a� � . �ft
��
.l I �
� � a
� � �
� � �
� y +�
`� ^� � W
•� a U
� .� �
s. O td U �6
� � � � � I
O � 5 H° W O
a�
:g
'� o
V
W
J
W
2
U
�
W
E--
Q
�
J
�
�
a
t
(
�
x �
�
� z
°a u.
'
a �
N �
F �
� � � � � �
4 � N O N O N
(Z .r .-i �-+ M N M
V�
iC iC �S iS k iC
0
z
: : : �
: Pa
: ' � o tw
: ���++ o �
. pq .� . � ii
V� p d N �
F : � � ° o
CA
°� � � o : � �
�k `� a, � v b
�� � k � � d �
� � � H
� � c�. w � x C7
� 'N � ." � �
x z w z � g z
00
aa
W
�
H
� � �
4 �°n, +° o
�y � N
k x k
°z ( � 1
, �
O
� o
� F' o
. +�-+ N
� v � �
w k c r�
z M � a
EN., � d Lh
�
�
Y
1
�
d
eFS w
W
. �
H
b •
U ;
w :
M •
w
irIa
Z
0
�i •
W a
�
�
� a
•U
� a
� A
a
�a
,;;
f. ..'....'.
M
�
rn
�
t0
�
C
�
, �
C
�
m
>
�
N
w
�
0
Z
O
F=
W
� � .
Z Z
�j Q rNi
v
� N �
�
� � � O
u. �c �p
O � � ch
� M � N
V �O LL 1~
� �
1
�
�
W
�
. a
0
Q
m
O
�
�
1--
O
E-
W
Q
Q
0
Z
iii
W
Q
�
W
�
t�-
x
LL
�
Z
m
�
�
J
a
_a .: "t ,�,��. � a`"
� ��
�
T � W _
+ tA 1 V
� ,�. � � ,p ^� o
. o '� 1 " i � o
m �
U '�, �,-
>. � � U �\` �
V
� V � � Q �/i
: L � O' '�
j � � � O C �"
� 3 � C� . Z tL �
: m � m
� U U �
L C G1 ...
s � � m
i o � °d
U � O
� � L �
{ �j 'Q U
► .. c a
i �'+► `° a
L C C �
s Y O N
f � y�
1 p � .�..
i 3 p �
: � m m
, p 5 +.
i �° = i�i,
1 � m M
C
� � m o
! :m � 'r
n m "" c
f G{ y N
' m � a
s = � m
► m a v
= ani m �
�
Z
h-
�
�
11.�
a
4� �Z �
Q
a
� �
� o U� �
y U � �
� � Z
a�
a� � `� m W
� v E � (�
� �
O m' w a m
0 0 0 0 0 0 0 0 0 0 0 0 0
o'o 0 0 0 0 0 0 0 0 0 0 0
�.: ����: ^ ti o ti o 0 0 �
vi�vi�rsv��s�i��v�v3 » �
IIIi(li1IIIIzI
N
N
}
v
a�
�
� N Q'
' C U �
X Y �
as '
c — �
3 ` � Q � � �
u� fl- � c
Z� � �� rn�j � a>i
� � C � C ` � -tG—, N�, m �
N
� a � � � ° � I� S = � �' � � y
LL
ti 0 � �� 3 Q... ��� p n.
3-o a`' o°� E a��a � c��a `� �' �'~
z O m m U a� n 3 3 3 c7 c7 m
+�-� Z
Q m
c �
� _=.t
L a
�
¢ Z
Q
�
O
LL
W
W
a LL
m °' �
N �
o �
a Z
¢ �
� �
a
� �
�.
Z
O
F-
Q
� W
W W
J u-
Q � •._J
�
Z U t �
Q C � F-
� � �
c� a �
a Q �
W � �
O � N
�
co O X
�9 �
� Q o
LL �
� >
U W �
2
~ `o
c � 3°
a°'G Q �
Building
Inspections
763-572-3604
DATE Z'� '�
SiTE ADDRESS �
THIS APPUCANT IS:
�
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E•MAiL ADDRESS
�
O OWNER �ICONTRACTOR
PROPERTY OWNER/ Nq�; �� ( prc-S �G'��°�
TENANT nDDltESS: E �D Z.'J ��'�c" ��
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPWCATION
PROPERTY TYPE
.�'
Permit No.:,
Received By:_
Date Rec'd:
CITY ir'v�[�I�y STATE�''�ZIP S
PHONE:
NAME l�Ir�iS �'' CDns? -� f. _
�S
STATE LICENSE # �� �3 � �� EXP DATE �� �� � �� 2�
ADDRESS: � O�°'t I�PG �''�- /V F� CITY e� S� 1��'` STATE M ZIP ���
PHONE 76�-�'l/�`�3 �l FAX �63 'W� �'�11.�
SINGLE FAMII.Y/NEW CONSTRUCTION SIZE �G
❑ TWO FAMILYMEW CONS'TRUCTION STORIES _
PERMIT TYPE � �D�oN u v�+�
D BASEMENT FINISH .�ROOF
0 DECK O SIDING
O SWiMM
TYPE OF WORK:
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT 22-
RooFmc �.�
NUMBER OF SQUARES
�ARAG�S
PROPOSED SIZE:
PROPOSED HEIGHT:
�
O Vinyl
❑ Aluminum
❑ OII1W
AiR O
O DRAM TILE
❑ OTHER
(3 POOL
, t �-po � ��r
�ING
�f�0
TH G 2 WIDTH 3 2 HEIGHT
❑ HOU3E & GARAGE
❑ ATI'ACHED GARAGE
O DETACHED GARAGE
Ft.
BASSh"ENT RFw►ODE1_-_�?� SUB{vllT:
1. Existing Floor Pian
2. Proposod floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
�o�-�� A.1�DI7'IONS. & PORCHES SUBMIT:
�Trim 1. Siu Plan/Survey showing the existing structures
Fascia and proposed projec�
2. Two sets of construction plans
R�INDOWS 3. Epergy Calculations
[N EXISTiNG OPENMGS ❑Ycs �No iACAT10N OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WMDOW TO BE MSTALLED NUNBER OF WINDOWS '
ALL FEES ARE BASED O1V VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Surchazge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
�?,��, �.�
$
$ -���
$ �,oc?
$
$
$
$
S ,
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Ivlinimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for detennination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks �avable to: Citv of Fridley Attach
THIS 1S 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 wi11 be in
conformance with the ordinances and codes of the Ciry 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; that the work will be in accordance with the approved
plan in the case of atl work wnhich requires review and approval of plans. �
SIGNA7URE OF APPLICANT 1�/ '"' PR1NT NAME �`�r'� ��` �� DATE � Z^ I��
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
stxucture, or for any addition to any existing building or structure, or for any atteration 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
S1 to SS00 $23.50 (Minimum Fee is $23.50 plus surcharge)
$SO1 to 52,000 $23,50 for 1" $500 plus $3.05 for each additional $100 or fraction, to and .
includin $2,000
$2,001 to 525,000 $69.25 for 1' 52,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,OO1 to 550,000 $391.25 for 1" 525,000 plus $10. t0 for each additional 51,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for lp 550,000 plus $7 for each additional $1,000 or fraction to and
includin $ ] 00,000
$100,001 to �500,000 $993.75 for 1� 5100,000 plus $5.60 for each additionat SI,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the I n$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" $I,000,000 pins $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 strvcture 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
�uilding
Inspections
763-572-3604
DA
BtTILDIi�tG
RESIDENTIAL APPLICATION
CITY OF FRII�LEY
YOUR E-MAIL ADDRFSS
Permit No.:
Received By:�
Date Rec'd: �
��
SITE ADDRESS t�Z� Ga20� r� A,�SV�
THIS APPLICANT IS: ❑ OWNER f�50NTRACTOR
PRO-t ERTY OWNER/ u.yr,�:_ D�c LO(U S 1�AQLt1 r(G TaN •
TENANT ADDRESS: I E�ZV G/�LhL�I /� A�i�c CITY �C1.1 � llc� STATEM�I�P�
PxorrE:_ 16� . 57 I. O 21 Z
CONTRA.CTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PRO�ERTY TYPE
TYPE
N��— The Home Depot A.H.S. Inc.
sTa,� r�c 3200 Cobb Galleria Pkwy.
aDDxESS: Atlanta, GA 30339
PHONE '763-542-8826
❑ s�rGr� License #20268257
❑ TWO FA
Q ADDTITON ❑ GARAGEJSHEI
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
TYPE OF WORK: � ��'�'
❑ MAIA
❑ SWIIviMING POOL
❑ ADDITION
❑ REMODELING
crrY
�
_.DRIES
-�WINDOWS
❑ DRAW TILE
❑ OTHER
DESCRIBE WORK BEING DONE:_�'�(!Lh� 2 Qt�O2.pOm 1r�( l�•�pp►.•/ Z'
SIZE OF IIvIPROVEMENT
�[IMBER OF SQUARES _
3ARAGES
?iZOPOSED SIZE:
?ROPOSED HEIGHT:
LENGTH _
❑ HOUSE ONLY
L7 HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
WIDTH HEIGHT
TE_ZIP,
BASEMENT REMODELING SUBMTT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
iIDING FOR NEW COI3STRt3CTION INCLUDING DECKS,
� Vinyl ❑Soffit ADDTTIONS. & PORCHES SUBMTT:
����n� ❑ Trim 1. Site Plan/Survey showing the existing structures
� ��' ❑ Fascia and proposed project
h'Il�TDOWS 2. Two sets of construction plans
N EXISTING OPENfNC,S�Yes ❑No LACATION OF WINDOWS 3. Energy Calculations
)R FOR NEW OP�NINGS-DESCRIBE SIZE OF Q�,�n(j+r1 S.
>PENING CHANGES & "
'YPE OF WIrIDOW TO BE INSTALLBD 1 r( NUIviBER OF WII�IDOWS Z
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 1 57 $,°p— OCCUPANCY TYPE
'ermit Fee '
'lan Review
;urcharge
'ire Surcharge
,icense Surcharge
AC Charge
:urb Gizt Escrow
;rosion Control
atk Fee
ewer Main Charge
'otal Due
$ - S'� . 0
$
$ .?
$ (
$ s�.oc�
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0045} times the total job valuation – Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State 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: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I aclaiowlectge that the information above is complete and accurate; that the work will be in
�nformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a
:rmit but only an application for a permit and work is not to start without a permit; that the work wiIl be in accordance with the approved
.an in the case of all work which requir�s ev' w and approval o�plans.
GNATURE OF APPLICANT �� pKINT NAME T I� S CI-�tTVk-- DATE � (Z- d6
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Buildi.ng O�cial sha11, before issuing permits for the erection of any building or
.structure, or for any addition to any exi.sting building or structure, ar for �rry al�eration or repair
to any existing building or structure, upon application therefore, require the pay�ent by the
applicant for such perm.it of fees to the amount herein below set forth an.d in the manner herein
provided to-wit:
TOTAL VALUE FEES
$1 to $500 $23.50 (Minimum Fee is $23.5-0 p��s surchazgej-
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each addirional $100 or fracti�n, to and
includin $2,OQ0
$2,001 to $25,000 $69.25 for l�` $2;000 plus $14 for each additional$1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for ls` $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 1S1$50,000 plus $� for each addit:ional $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 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 additionai $1,OOU or
fract�on to and includin $1,000,000
$1,000,001 and up $5,608.75 for the 15` $1,000,000 plus $3.15 for each additional $1,000 or
fi-action
VERIFICATION OF FOUNDATION
Pemv.ts for construction will be issued a mi�um of 24 hours from the time of application to
allow for praper review of proposed structvre and of the construction site.
A Certificate of Survey of the lot, showing the loca�ion of the existing foundation will be
required before proceeding wi�ii 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
3uilding
�nspections
763-572-3604
DATE 7 � /
SITE ADDRESS �
THIS APPLICANT IS:
I'R�t ERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENS:
WITH APPLICATION
PERMIT TYPE
TYPE OF WORK:
EUILDI3�TG
RESIDENTIAL APPLICATION
CIT� OF FRII�LEY
YOUR E-MAIL ADDRESS
� • .I�L :
ADDRESS:� �i ��— � `� CITY
PHONE: T(�2 — S7 /- DZl Z
N��— The Home Depot A.H.S. Inc.
sTA� Lic 3200 Cobb Galleria Pkwy.
a�Dx�ss: Atlanta, GA 30339
Pxor� _ '763-542-8826
�.SINGL� License #20268257
❑ TWO FA
QADDTI'ION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK 0 SIDING
❑ SWIIvA�TG POOL
❑ NEW O ADDTI'ION
_ ANC ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF
tJiJMBER OF
SIZE:
HEIGHT:
Aluminum
Other
;�nvnows
N EXLSTING OPET�TINGS �Yes ONo
�R FOR NEW OPENINGS-DESCRIBE SIZE OF
�PENING CHANGES & � �
O HOUST� GARAGE
Permit No.:
Received By: �
Date Rec'd: �'
�y3z
CITY STATE ZIP
�
_ .OKIES
❑ DRAIN TILE
❑ OTf�R
�s �i � �C��-r�- •
WIDTH HEIGHT Sq. Ft.
0 A7TACHED GARAGE
� ETACHED GARAGE
❑So
❑ m
Fascia
Z �" � �
NA,T�I'ON OF WINDOWS %yeOyQ'dri'1
,T
!'YPE OF WII�IDOW TO BE INSTALLED NUMBER OF WiNDOWS �
BASEMENT REMODELING SUBNIIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of shuctural members to be used
FOR NEW CONSTRUCT[OId INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMTT:
1. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of conshvction plans
3. Energy Calcnlations
ALL FEES ARE BASED ON VALUATION, INCLUDING TAE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCAEDULE)
TOTAL JOB VALUATION $_ /.�'7 j�`• OCCUPANCY � TYPE__
'emut Fee —
'lan Review
>urcharge
� ire Surcharge
,icense Surchazge
�AC Charge
;urb Gtixt Escrow
>rosion Control
'ark Fee
ewer Main Char
'otal Due , �
$
$
$ I . Sg
$ ,� (xj
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Mininnum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State 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 APPLICATION FOR A PERMIT NOT VALID L3NTIL PROCESSED
ulations
hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
�nformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
�rmit but onIy an application for a pemut and ork is not to start without a permit; that the work will be in accordance with the approved
lan in the case of all work whic q�s vie approvat of plans.
GNATURE OF APPLICAN]' l�� pRINT NAME=�� S�/�'C �i�iG DATE �
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building O�cia1 shall, before issuing permits for the erection of any building or
- strU.cture, or for any adrlition to any e�isting building or structure, or for -any- al#�ration or repair
to any existing building or structure, upon application therefore, require the payment by th�
applicant for such perm.it 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 $23.5-0 pitts surchargej-
$501 to $2,000 $23,50 for ls` $500 plus $3.05 for each additional $� 00 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2, 000 plus $14 for each additional $1,000 or fracrion, to and
incl'udin $$25,000
$25,OOI to $50,000 $391.25 for 15C $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 15` $50,000 plus $� for each additional $1,000 or fraction to and
� includin $100,000
$100,001 to $500,000 $993.75 for ls` $100,000 plus $5.60 for each additional $1,000 or fi-action to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each ad.ditional $1,OOU or
fraction to and includi.n $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
fra.ction
VERIFICATION OF FOUNDATION
Pernuts 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
�.
Building MECHANICAL
Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
DATE nV�- �� YOUR E-MAIL ADDRESS
Si'CE ADDRFSS � `
'THIS APPLICANT IS: � OWNER �C32'ONTRACTOR
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WTI'H
APPLiCATION
PEItN.IT TYPE
TYPE OF WORK:
PHONE:
COMPANY NAME:_
CONTACT PERSON:
Permit No.:
Received By: �c-
Date Rec'd: �J � �
_ t;
STATE ZIP,
STATE LICENSE � � EXP DATE ,y�, �
ADDRESS: /�L� ���i � � �G CITY STATS� ZIP�
PHONE �1i�°�S�1D��� FAX
O S�D1{'iLE FAMILY O TWO FAMILY D TOWNHOUSE
t�
O NEW ❑ REPLACEMENT �.TERATION/REMODEL
DETAILED DESCRIPTION OF
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtwes. (This should reflect only the cost of labor )
��5 • �
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WF�RE LABOR EXCEEDS S500, FEES ARE BASED ON S]0.00 PER F�XTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOV�
Equipment Installed . MFG: MODEL: SIZEBTU
�(',; MODEL: SIZEB"fU
MFG: MODEL: SIZE/BTU
A/C 525.00 FIREPLACE (GAS) SI5.00 GAS RANGE/OVEN $10.00
AIR TO A1R EXCHANGEER $15 FIREPLACE (WOOD) 535.00 NEW GAS GRILL $10.00
BOILER 535.00 FURNACE S35.00 _GAS UMT H'TR $10.00
CHIMNEY LtNER $10.00 GAS DRYER SI0.00 _POOL HEATER $35.00
DUCT WORK 51000 GAS PIPiNG S10 00 _VENTILATOR S15 00
, �� �OR �I�fiDE ,� SOU�' .. ,--�"����� � . -
., .. . . � �,
�?�viY���EE�i�,. .�� �. " ` : t� q ,�.��`�'��S�O'�R 50�;
Permit Fee $�_ Number of fixtures @$10.00 x$10.00 $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ l$ •�x� Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Tota1= $
TMS IS AN APPLICATION FOR A PERMtT-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; that the work will be in accordance with the
approved plan in the case of all w k which requires review and approval of plans.
SIGNA7URE OF APPLICANT PRINT NAM ��'� I C����� DATE �`I �`�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
�.
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITiONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES �
1. Combustion Air (See note below) . �
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane!lFGC Chapter 3 with MN A:nendments •
2. Mak�up Air (See note below)
a. TMC Chapter 5 with MN Amendments .
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
� b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new conshuction IMC 1346.0312
5 . V entilation .
a, Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used �or
combustion and make up air calculations
., ,.
Inspections
763-572-3604
763-50�-4977 FAX
SiTE ADDRSSS I td �
THTS APPLICAt 1T I3:
PROPERTY OWNER/
TENANT
From: 612 788 0313 Page: 2/3 Date: 9/29/2008 3:03:03 PM
BUILDING
RESIDENTIAL APPLICATIUN
� OWNER
CITY OF FRIDLEY
YOUR 6-MhIL ADDRFSS
PHONE: _
C`QNTRACPOR an�RESS: .'7 I �} _
SUBMIT A C7C)PY OF pHONfi f�j � 2' i i
YOUR STA'iE UCENSE
sra� �.rcnvs� �_ r
TYPE
TYPE
Q S�TGLE FAMILY/NEW CO1�S7RL'CriON
❑ TVYO FAMTLYJN6V1%COTfSTItUCiTON
0 BASF.1r1ENT FINISH O ROOF
O DECK �.3IDa1G
Permit No.:
Receiwed By:
iTY �✓'� C� � P U STA'C6�IP �
'
�'i CTTY STATE !�i JI�IP
F� a v - i
sxr DA� 1 D�
SiZE
STORIES
WINDOWS
O DRAlN TI[.E
❑ 017iER
TYP� OF WORK: O NEW HOME CONSIRUCTION O ApD1T10N
�d PdA Tl3IVAi�ICFJREPAIR O Rfii�[ODEF.ING
DESCRIBE VI%ORK BEING DONE: 1 'e X 1 �
SIZE OF lbiPROVEMENT LIIVGTH WID7i1
ROOFING Q HOUSE ONLY
NL'MBER OF 3QUARES O HOUSE 8c GARAGfi
��GI�4
PROPOSED S12E:
PROPOSED HBIGR7':
❑ llluminum
� Other
WINDON'S i
IN BXIS'ffNG �PF�RNGS�IYes ONo
OR POR N�W OPGNIIVGS-DESCRIB� S[ZE OP
OPENIlYG CHe!ANGES & �j
TYPB OF WINDOW TO BE INSTALLED U", Yi
TOTAL JOB VALUATION
Permit Fee
Pian Reviev�
Fire Swaharge
Surchsrge
License 5urcharge
SAC Charge
Curb Cut Escrow
Erosion Coirtrol
Perk Fee :
Sewer Main Ctiar�e
0 ATTACFIED GARAGE
Q DETACHED GARAGS
OSoffrt
O Trim
Q Fascia
LOCAT[ONOF WINDUWS �.-t V �Y1� Y�t;M
TIOR, INGLL'DING TAE COST �F
3 THE 199? iiBC FEE SCREDU4L�
�/� � i uJ!/�Ll
�AC T R6MADEI ING StJBMff•
1. Existing Floot Plen
2. Proposad floor plan
3. List of struehual mambas to be usod
[•ORNBW CONSTR(JCI70N INCLUDMG DECK3,
ADDI7101YS_ & PORCH&3 SUBMIT:
1. Site P1arJSiavey showing t6e existing shuchaes
and Dr'�Posea Pm1xt.
2. Two sds of con.struction plms
3. Encrgy C�cuS�ons
A�TD
���� �� Z E'j See Back Page fa� Fee Schoduie
� b59�6 of BuiEdiug Petmit Fce
S jp �'j .001 tirnes the total job valuatia�
$ A005 x Permit Valuation Mmimam S.SO
$ <' 55.00 (State Liceosed Rasidential C•o�tractots)
$ a1825 per SAC Unit (Plans to MWCC for determinatian)
$ ft+6ft= Rx$2t=S
$ $450 Conservation Plan Review
$ Foe Determined by Engirreering
$ Agneeaneat necessary ( ) Non Necessary ( )
S � Make chedcs n�vable to: Citv of F�ridleY Attsc
THIS IS AN APPL1CA7i02�t FOFi A PL'KMiT-NOT VALID UNf7L PItOCBS3GD
1 hereby apply �Or a b�aldiag permi! aad 1 acknow3edge that the iaf'amation above is aompkte and aiecucete; that the wock vtill be in conforn+ance with the ardinanoes and cnd�s
of the City of �`ridiey and with the Mirme�ota Consmxtion Codes; that i undasoand this is not a pamit but anly an application for a permit and work is not uu start wiHw�t a
permii on site; tl�et the uvrk will be in exard�,yrithLGr��an id�f ap work which r� nview and spproval of plar►s.
//
SIGNATU[�E OF APPLICA�\�T' � dv PRINT NAME�"Si:��[;[��' � .1Y1'1 `i DATE � D
APPROVED BY DATE
SEPARATE PERMCTS ARE REQUIRED FOR PLUMB W(i, ELECTRICAL