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AF - 45158City of Fridley, Minn. n BUILDING PERMIT N° , 6920 na�: � °—% �__� _�_ � �� owaer: swuaer Adaress Address LQCATION F B ILDING s� � No. .�� street �.._„ �`3 ��. �,__�� Part of Lot — � 7 -� Lot _ Block Addition or Sub-Divfai �.� �� 6 Corner Lot _ de Lot —�_ Setback _.�,;�� Sideyard �� Sewer IIevatian � / �� ._ Fotmda.tion IIevation �s� �� ° DESCRIPTION OF BUILDING T v�a 8 ' F'ront _,��. Depth � Height � Sq. F't. �_.�� Cu. Ft o�•�! i? � . Front ��Depth �� FTei�►t ____��_ Scl. Ft _'�� Ctt. FL _�/ � 7� Type of ction Fast Co's f� � '��o be Completed ^ � ��l� ��l�l � ! ,,�� In consideration oP the fssuance to me of a permit to conat th� proposed work ffi accordance with the d�scrlpl3on above aet ordinances of the dty oP Fridley. In consfderat[on of the payment of a fee of descrlbed in peranit is hereby granted to to do �na of to construct the building or addition as d�cribed above. This rmit is granted upon the eupress condition that theperson to whom ft fs granted and hia agents, employees an�workmen, 3n all work. done in, around and upon said building, or anypar� thereo� shall conform fn all reapects to the ordinance� of Fridley� Minnesota g location, conatruct�on� alteration, maintenance, repa3r and moving of bufldiuga within the dty ]3rnits�s d�tbis permit may be revoked at anY/ l��%�of any of the provl�lons of eaid ordinancee. Buildiug Insp¢ctor �"'\ NOTICEa i6b p�rmit doa eot ee�nr Hts coettrueHoe, lestalldioe h� �rU1e6� P�+�B. 6a huNeg, aw�r er waf�r. B� sur� �s ses tM Bnilding I�sr tor ppartla p�rmhs fo� 1ka� hurn. � ,, . .. � , . APPLYCATION FOR BDILDING PET,�ffT CITY OF FRTDLEY, P�INNESOTA 04d1�R' S NAME 1� a ��. � � �_�%�;��1�BUILDER �/9- �°! � ADDRESS � � � �� g �� e� /1�� ADDRESS �" �� LOCA7"tQN OF BTJILDING � �� f/� / ��,� � / � No. -� �f$/�,I��6'�- Street Part .of L�ot �� Lot Block � Addition pr Subdivision��.�e�e��r_�'��.�w_e��,� °� �Z Corner Lot`Ias3,s1� Lot�_Setback .,3� � Side Yard �� H Rr+4 �. sr�L SEWER ELEVATION ��/ ��'o`� ELEVATTON e/ S°o < b� aZ �—�� o� r��+T�� Applicant attach to thia forn� T�io Certi�icates of Survey of Lot aad proposed build- ing ].ocati.oa drawn on these Certificatea. � DESCRIi�IOAi OF BII�DING To be used as: e / S v n�� L� A-i�i ��„_ Front��_, ��i.i:h �� Height . Sq. FC. // � Cu. Ft.. 7 � � � ¢¢��t- � ,_ Front �� 'i � � Dzpth � / � :Z �� Aeight . �— . Sq. Ft. Cu. Ft. Type of Constructian /��1 r° Estimated Cost ,' / d° �- � To ba Completed � �C� �� ,�,� ' 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 Ordinancea and rulings of the Department of Bu�.ldinga, and hereby d�clares that all the facts and represent�t3ons stated in Chis application ere erue and correct. DATE � �° S"� � � SIGNATURE � _ �(Schedule of Fee Casts caa be found on Che Reveree Side). � � � .� � , � . � .� , ` 8 BUILDING PERI�;T FEE SCHEDULE Sectioa 2. The Inspector of Bu3ldings sh�ll, before issui�g at►q pea�.t for the erection of any building or structure, or for any addition to any €�ist- ia� buildin� or strucCure, or for any alterations or repair� Co a�ay esie��.a�g building or seructure, upoa application therefor, require the pa�ment bq Che applicaat for such permit of feea to the amount lierein below set fort� ar_d ia the manner herein provided to-wit: 2.1. For any such permit for Clie erectioa o.f any fire-proof buiZding, other than a garage� warehouse, fectory or grain elevator, or for the erectioa of aaq fire-proof addieion, far sim�.lar occupancq, to any egiatin� building shall be ae the rate of $1.40 for each ane thousand cubic feet, or fractioa thereof, in such cub3cal content�. 2.2. For eny such permie fos ehe erection of any ffre-pYoof garage, warehause� factory or grain elevator, or fbr the erection of aay f�.re-proof addition, for simila� occupancq, to any e.�cisting buildiag shall be at tbe rate of $1.25 for each one thousand cub3c feet, classified a� "fireprac�f" bq Section SG2 of the M3.nneapolie Building Codel HOUSES - 2.3. For any such permiC for the erection of any non-fireproaf buildin; oh�es Chan a garege, warehouse, factorq or grain elevator, or any ac�n-rf�epy�c�:� addition, for s�tmilar occupancy, to any eaisting build3a� - per�3t $�.�Ot� £oS each one thoueaad cubic feet. GARAGES " 2,_.4. For anq such permit for the erect3�» cr �;::P r�s�a�;;.a�yr�•,� �a��e, warehouse, factory or grain elevator, n:: '':�y: k.,3,-, r�=.•F:;��:.��r ��' �:r6;� noa�-�s-��,.;�roof add3tioa, -for--s;tm�tlar occupancy, to �.-:,, _��:•� �::v 4?��.,,.�,��: '.�, wo o�- �or eacn su�ch _. ��buildiag or addittion - ainety ce36^ �.a�:i,':��1 ;�^.:� �.;;::;i Q�e thoc��and c��c fee� or fractioa thereof, in the cu��.�.1 �-�-=�s.c��;�d: �;1,2'�,n,�]'� with a minimum of $4.0�-.- For Che purpose of campuC�ing fees i�-r �vT�`�.r�.in;; pprr,,d�s, the cubical contents of any building or additioa to a ua:ifc..� 'r..�e��;��:t tt�s=��:.�;haut by multiplyi.u� the ground area covered from a point sig (6) i:az,: �a be�, s�a �?�e floor liae of rbe basemeat or cellar to the average height of i:�•� �,�:,a>er su:iace or to the - average height of the roof surface of �he maiu �dule of a pftched roaf. 2.5. For repaira or alterationa to an exiating structure, the fee ahall be at the rate of $3.00 per each Five fluadred Dollars ($500.00) or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fe�_char�eed..for..,a,ny permi.t .a,� Bet forth in Section 2 be lesa. thaa $4.00. 's+w a. -� . � _ . _ � _ :. _r � %�� ^ y r - `'J .� [ond Planniny Loird Sur^ver�rn� Sous rst�y Ci'vi� b Muii�ci/�ol En9ineerinq . 68Y5-f/�Mray {6S A/.E. � Mini�eoPv/s32,. EN G I NEE R I N G� I P� C. Minnesota SUnse�4��66 — En�►ineers E Sur vecJo�s — ce�ts�sca�e o� su�ve �o: R��rd J, S�b�and a _ T � � o� C ARp��I� ��I�u � _ .�._ 8�� . ... . . . ��--. ,_ �' , �- - - -- �� -� --_- - - _ - �i � ,��` �I.� - i,�o 4 �. � � � � � 4-- `r � ! � �n °` � r � � � ''°�, :r 1 sy ,� = � � �" -� M f �` tr M � t , Q ,� � _ '�!5. ; � 1s-� ' � _o \ e� = � I ti� ��• / � , 1 � . �0� _r�_ - Sl.�i �� . � The Ea�t 1/2 af North 1/2 of Lot 35 Auditor's Subdivision #92 Moka County, Minnesata subject to an easement for road purposes over the North 30 feet thereof. Also known as the East 1/2 of the Atorth 1/2 of the East 1!2 of the Northwest 1/4 of the Northeast 1/4 of the Southeast 1/4 of tt�e North- east 1/4 of Section 24 Township 90 Range 24. � / beriebtf �r;r�y !h� iiris is o fiuE � corr�cf �epresentotion o�'a sr�►ey qi'1/a d�,.,edories �'�e a�on desray6�rd I, on�d �us o�('� /�n o�all truildin9s ,�� . ond d/ nsib/e p�rrnathmarft , r�'mry. �rn or arisaid /ar�d As s�rrret,ed � mP fhis sf- dotf °� J��y A'�'�� SUBURBAN ENG/NEE2ING , INC. � : __ - - - - rn � -- — � eers - fr S_�ur�reyo�rs --- � �� _� � _� ,,�.�;�5 a --_ — _ � �� .� _ _�__ . ____ - - � ,r-.u.� ._ �.. _ .. ; - ------ ,,_�--��¢ i M= �''� �''� . � _ ��. t =„� �_ NEW [] CITY OF FRIDLEY Effective 1/1/2002 ADDN [] 6431 Universiiy Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Ins ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ,^� ��l L�i1 D BUILDING PERMITAPPLICATION '°��L> � �J � Construction Address: � �D � � C`�� Legal Description: Owner Name 8� Address: ��1 i� �- �- d �f � � -- Tel. # %�� 7 � m �� 7 Contractor. �C-� �� e .�� i`> �> ad�,/ MN LICENSE # Address: �� 3 2 � � �r t�4 .S , Tel. # C�l Z->2 �- �- - �s"d'� �- LMNG AREA: GARAGE AREA: DECK AREA: OTHER: 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 ' Length Width Height Sq. Ft Length Width HgUGround Sq. Ft �` d r a��'i.�.,�Yi? s,�+o�1 �a� Construction Type: �� y t��'',�,-� Estimated Cost: $ �-.�� ' — � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ DATE: �' l '� �� APPLICANT: � �i �'�''�'2 Tel. # G`'/Z � 7 L �- - �� Z Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ �� f�0 $ �°7� $ $ $ �� $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ $ � • � STIPULATIONS:� � �. � BUII.DING PERNIIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any addidon to any existing building or structure, or for any alteration or repair to any existing building or structure, upon applicaxion 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 tawit: TOTAL VALUE $1 to $500 $501 to $2,OW $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.� for each additional $1,000 or fractio� thereof, to and including $25,004 $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.(� for each additional $1,000 or fracrion thereof, to and including $100,000 $993.75 for first $1(�,000 plus $5.60 for each additional $1,IX10 or fraction thereof, to and including $St10,000 $3,233.75 for the first $500,(300 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,0� $5,608.75 for the first $1,000,(�0 plus $3.15 fur each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Ciirb Streets Only) � Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 fe�t 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 Building Inspections 763-572-3604 SITE ADDRESS _ THIS APPLICAId1' IS: PROPERTY OWNERI TENANT CONTRACTOR BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAII� ADDRESS ❑ OWNER �ONTRACTOR Permit No.: Received By: Date Rec'd: ADDRESS: ��.r��t� � CITY� � O STATE ZIP, PHONE:21ir �,_=�17 ../�f O � SUBMIT A COPY OF STATE LICENSE #%D j��d� fo // EXP DATE �Si/� � YOUR STATE LICENSE �D�S: ��5 -l'�R �� L� _� � l>' � STATE ZIP��f WITHAPPLICATION pHONE /Z� —1 Z F� PROPERTY TYPE INGLE FAMII.Y/NF ❑ TWO FAMII.Y/NEW PERNIIT TYPE ❑ ADDTI'ION u c�axa� ❑ gASEMENT FINISH .�200F ❑ DECK ❑'SIDING TYPE OF WORK: I � ❑ � DESCRIBE BJORK BEING DONE: T�� //1� � SIZE OF IMPROVEMENT NUMBER OF SQUARES � GARAGES PROPOSED SIZE: PROPOSED HEtGHT: ❑ DRAIN T1LE ❑ OTf�R LENGTH WIDTH HEIGHT O HOUSE ONLY ❑ HOUSE 8c GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GAR.AGE Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of shvctural members to be used SIDING FOR NEW CONSTRUCTTON INCLUDING DECKS, � V�Y� psog� ,F� DTfIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing stroctures � pr}i� O Fascia and proposed project 2. Two sets of construction plans VVINDOR'S 3. Energy Calculations IN EXISTIl�TG OPENINGS OYes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & • TYPE OF WII�TDOW TO BE INSTALLED NUMBER OF WWDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (iTSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S ,,, OCCUPANCY TYPE Pertnit Fee Plan Review Surcharge Fire Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ 1�� , $ �, ��,� $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) tunes the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residenrial Contra.ctors) $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 UNTIL PROCESSED I hereby apply for a building permit 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 applic 'on for a permit work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wo 'ch requir vi w and prov of plans. SIGNATURE OF APPLICANT , PRINT NAME �iG� � �� ✓I/ DATE � Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building O�cial sha11, before issuing permits for the erection of any building or structure, or for any addition to any existing building or stntcture, or for any altera.tion 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: 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 eonstluction site. A Certifica.te of Survey of the lot, showing the location of the existing founda.tion will be required before proceeding with the frazning. New Hou.ses Onlv City of Fridley Building Inspections Depariment 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fu�: 763-502-4977 3uilding nspections 163-572-3604 � ITE ADDRESS _1 'H1S APPLICANT IS: PROPERTY OR'NER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE BUILDING RESIDENTIAL APPLICATION CITY O� FRIDLEY YOUR E-MAIL ADDRESS —�rc�l�,� ��i'�e ��/� ❑ OWNER �03�ACTOR NAME: �.FJ/�l/� �//% �° .AnDxESS: /�v'..3�f Gs�i'�d-�iti� i PHONE: STATE LICENSE ❑ TBJO FANIII. �l Pernut No.: R��ea By: Date Rec'd: ` � � � DATE �� .. crrY�d�°n� s�ra�%z� �S3 � �eY �/%�%�!�'�01� PERNIIT TYPE O ADDTITON � GARAGE ❑ BASEIv1ENT FWISH O ROOF ❑ DECK � TYPE OF WORK: JESCRIBE �VORK BEING DONE: �%/I±1i 3IZE OF IlVlPROVEMENT �UMBER OF SQUARES _ JARAGES ?ROPOSED SIZE: ?ROPOSID HEIGH'f: "IDIN myl 7 Aluminum � Other R'INDOWS N EXISTII�iG OPENINGS OYes �No JR FOR NEW OPENINGS-DESCRIBE SIZE OF �PENWG CHANGES & TYPE OF WIIQDOW TO BE INSTALLED ADDITION f� ❑ HOUSE & GARAGE ❑ ATfACI�D GAR.AGE ❑ DETACHED GAR.AGE �nm ascia LOCATION OF WINDOWS NUMBER OF ❑ DRAIN TILE � OTHER HEIGHT FL �ASEMENT REMODELWG SUBMIT: 1. Existing Floor Plan 2. P�ogosed fl�r plan 3. List of structural members to he used FOR NE9J CONSTRUCTTON INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: I. Site Plan/Su�vey showing the existing strucwres and proposed project 2. Two sets of conswction plens 3. Energy Calculatio�s ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LTSING � 199 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ � 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 $ $ $ $ $ $ $ a _ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) 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 aavable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ardinances and codes of the City of Fridley and with the Minnesota Conslzuction Codes; thax 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 work whi r uires eview and approval of plans. SIGNATURE OF APPLICANT=,` K/l� ;L►ri!�� PRINT NAME �TL'�t"z�'!��^ DATE I� /O �c:S Page 2- Building Residential Applica.tion BUILDIIVG PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any add.ition to any existing building or s�truciure, or for any altera.tion or repair to any existing buildi.ng 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: VERIFICATION OF FOUNDATION Permits for construction will be issued a m;n;mum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certifica.te of Survey of the lot, showing the location of the exi.sting 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