AF - 46064City of Fridley, Minn.
BUILDING PERMIT
Date: _ � "" —'��#! —._ .
� ./ '^ ' ^ 2
Owaer: ���y =: y° �
Address _.�..—
No. �'a'i
I.ot �
Corner Lot
Sewer IIevaUon
N° ��.
Builder — —
Address --_ /
LOCATIO F; �{�r ILDING
street � • �.:.r�' � -fl�,--- Fart . L°t�—�---- �� E--
. Block _—_ . �lAddition or Sub�� —_ �` t � �-��1.....—
-'--
� w
...__._ Inside Lot —ai.�_. Setback _. — Sideyard _��_.._._ ^ —��..—
Foundation IIevation
DESCRIPTION OF BUILDING
�*-y���_: �t � nenrh �� xe�gtic .� sv. �. ��'�cti. Fc �C�7
��onAc -.— ne�n _� �� s � sq. Fc. __._ ct�. Fc
Type oi ConstruCtio�G{'� f� " Est Cost� ��� -- To be ComPleted _..--.-----
� � � f ��/
� / t
} f
/
In c�sideration of the issuance to me of a.. permit to construet the building described above, I agree to do
the proposed work in accordance tvith ffie description above set forth and in compliaace with all provisiona of
ordinances oY the city of Fridley. �
� L,, ,
In considerat[on of the payment of a fee of �,��'��., permit is hereby �anted W.—_.
._._.._.---.._.�.__..... Yo construct the building or addition as described above. This permit is granted upon
khe expreas condition that the person to whom it is granted and his agenta, employees and worlanen, in all work
done in, around end upon said building, or any part themof, shall conform in all rnspecTs to the oidinaaces of
Fridley, Minnesota regarding location, construction, alteratioq maintenance, repair aad moving of bidldiags
svithin the city limits and this permit may be revaked at aay time upon nf� of aqv of the provirions of said
oTdiflADCEB. /�i ..I A/ 1
BUI1�8 TIL4PECtOR'
NOTICE:
This p�rmif doas net covsr fhe sonahueHoo, inalalleHon for wiring, pfumEu�g, 8q Fealing, uwar or wafer. Bs wn fo sN
�h� Buitd6p Inyector for apanro pa�mib,for thau Ifsms. .
C `�
O�mer' e
�ddress
6PPLICATI03�T !'Qi. BUADING P�Y
CITY �' FRIDIEY� MII�RI�SOTA
�
�' :i � � ���r
NO.�T_StS'69t � � _�LLi1i� �CJ/ PBTt OY LOt
Lot � 5— io —1 B1ock S dddition or Subdiviaion ���-�- ��
Corner Lot Iaside Lot � 3etback 3 S Side-Yard �-�� —� S�
38WER ELEVATIQd�I FO�ATION ELEIiAPI�I
8pplicant attaah to this Porm Certifi.cate of Surveq of Lot snd propoaed building
location.
To be ueed as:
r� � n . .
DFa^QiIPTI�i � BTJIIDING
sQ. Ft. 9 z S a�. �. l�, S o 0
l�ont Depth Height
Sq. Ft. Cu. Ft.
Type of Conatruot,ion �Y tie—�--` Eetimated Coat �l t a o 0 0. o a
To be Completed
The uadersigned herebq makea application for a permit for the xark herein epecified,
agxeeiag to do all vork in ata'ict accordance vith the City Ordirianoes snd rul3ng of
the Department of Huildings, end herebY dectarae that all the facts and representatione
stated in thia annli�tion are true and correct.
(9 ScheduZe oY Fee Costs can be fotimd on the Reverse 3i.de.)
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FIEAT LOSS CALCULATIONS DEPARTMENT OF BUIIDINCS ,33. J
A.S.H.V.E.
Weatherstrips Construction No.
Gwde
Windowa Doon Rcferenee Out. Watl Int. Wall Ceiling Roof Floor Ku
Yes—No � Yes—No ( 19—
' Fl•� ') yi rj Room Lengt Wid � Height F7.� . Room
Windows an ��rs--Crackage and Aroa Windows and Doora—(
Wldt� Helght No. ot Llneal f0. Area wwcn HetgLt 1
No. of Dane of pane Ilg�b o[ ertck w. �. No. o[ pane e� C ne I
2 % vZ. / Z
2, z, � z�G Z 3 a >
Glass /
Eap. wall
N<< �P. Weu o
Int. wall
Ceiling
Floor Z(� 6
Totn] Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl.� Room Length (o Width
Windowa and Doors—Crackage and Area
wiatn xe1`nt No. o[ Llv.at [t. wre•
Ne. e[ eam n[ wne Ileht� o[ crack ea. ft.
GIHSE
Exp. wall <
Net eap. wall �
Int. wa11
Ceiling
Floor � �
Total Btu.
Required aq. ft. E.D.R. or aq. ina. W.A. Leadi
FI. Room �Length /Z W:
Windows and Doots---Ccackage and Area
:oef. 8tu
o jZoo
S� � .s�
/ o ZO a
/ o
i >oaa
BiI1
-io
r �--7
/( o
�-t'—
'z 7 n
C«f. Btu
�I1�tI8tiOp �?`L. U
Glaaa / � ,y �
Exp. wall �t
Net exp. wall p 0 0 9
Int. wall
Ceiling
Floor b � � 0
'fotal Btu. Z. �
Required nq. ft. E.D.R. or sq. ins. W.A. Leader area
�
InGltratioo
��
wall
Net ezp. wall
Int. wal!
Ceiling
`
i
MINNEAPOLiS. MINN.
Insulation
How
W�dch
Are�
oef. Btu
(,� /(so
� o0
7� /I Lo
Floor 113 � I �J �^ � o
Total Btu.
Required aq. ft. E.D.R. or aq. ina. W.A. L.eader area
�.I . �m I �o� q wca� �z
Wiudows and Doon—Crackage and Area
�
Infilaation
Glasa
Fap. wall
Net exp. wall
io�..,..0
Ceiling
Floor
Total Bcu.
Requ'ved aq
�.I
i Windowa
�c
IN��<<a�100
� Gla�a
Esp. wall
Net ezp. wall
Int. wall
Ceiling
Floor
Total Btu.
� L��� '
� t.31 .
�=f�. .
��
or aq. ins. W.A. Le er area
�m I Lengt�/ / Width '
—Crackaae and Area �
k. E.D.R or sq. ina. WA. Leader a�ea
� t. •
�
.
.
City of Fridley, Minn.
BUILDING PERMIT
�3T,��-
N° .6994
nate: _._�—'.�� -- -(4-�
Owner: ,�'i� �2_. Builder _. ._. .. .... ..- ---------
Addresa_.__..__.._...__.._ ._._.__.._.:_.. _..— Address ---...._.___..---._.....__....__._.
No. � d�.� 8treet _� ...— -- - ..__ �F.iPa�t.e{LotN.
Y � 7J . %�
Lot cS �1' �-.-- Block --..__�---- Addition or Sub-Divlsiai 11GlefL_
Corner Lot .._-.--...__ Inslde Lot __ �� ..__9etbacki����/�. .�Sideyard
Sewer Elevatlom -----------.----._._.._._.._..__.._.._ Foundation IIevation ._.._..---
DESCRIPTION OF BUILDING
To U �/� � �( /� ��j� �"[/
_ Front ,�E�.[_.. Depth iE� Height �IL_ Sq. Ft .,��F � Cu. FL/��
_____. .__._ _._ t �— Depth �_.. FIeiBht _�� �8Q. Ft. _._—_.._ C,1i. Fk —� _._
7y�pe of C�structton C��.._.. Est ��' �.� To be ComPleted _._..._.._...�.._._..--
/
Ia coasideration of the isauence W me of a permit to emstruct ihe building described above, I agree tA do
the P+'oP� work in accordance with the descriPtion above aet �� and in ooanpvance with all provisions oP
ardinancea of the dty oP EYidley.
Ea cooaiderati� of tbe payment of a Pee oP a / permit is hereby granted W—
to construct the or addition sa detcribed above. 'Lhia permit is gracited upaa
the expresa c�ditiaa that the persoa to whom it is granted end his agents, employees and worlmien, in all work
done in,� aramd and up� eafd buildin6. or a�' Part t6ereof, shall wnPorm in all reepects to the ordinances of
Fridley, Minnesota regarding location, constructi�, alteratton, maiatenance, repair and movinS of buil�
within the dty ]imiffi and t6is permit may be revoked at any� upon vioJaxi'pn of any of t6e provi�oas a�f said
°ramence% / �. /1 / 1
Bulldin8 7nsPecta'
NOTICE:
iW PMwY dw� �e1 eswr IM maqeueNon, ImNAMkn fer Wrley. P����F Ya MN(ny, Nw�r x wabr. B� an b w
�M &iBdiB �� /er a�pr�N pMwha hr Ma� IN�c
> �
APPLICATION FOR BUILDI�:PERD�e ;.,.-. :�
i4 . . • . . . _ .. . . . .. . _ _ -
. i.. !r. . "l: . .. . . l. � . " . . _ 1 r...s - . . . J. .
r, +>', . : , , _ , CITY OF F�,IDLEY, . MINNES9�► � x ' rt �,,; _ c �
L . ,. . . ... . . . . .. . .. .... e�71 . i-. ....i7
owr� , .: ° J,(�c?/�.�m �',a�-�� .�:: .. .
x s xnrffi suII.nax , a�%��"`
•nnn4ee.�. . � ., �• �J -/�,. • .1f7//�-...ri
y
,.: ,
.. . �.' ' _.� . :. � " ; '�.: . - .. ,.. .. , ' .' � i ' ... . . . . . �.:.'...
LOCATION OF BIlII.D�E1G: _
�'
No, � � �. J,. _ SRreet ,�,�����P�yt,C:Ci ,:Pa;.t.;of Lot
Lot Block,. Addition,or Subdivieion.;
---^—�. -
Coraer Lot Inaide Lot�_5ethack � Side-Yard -,,
SEWER ELEVATION FOUNpATION ffi.&VATION
Applltant:attach.to.thxs..form liro ¢ert�ficatee of;Survay oE Lat-aad.proposed build-
ing_locat�on drawn on these,Certificatee.. _ , .
DSSCAIPTION OP BITILDING
To be uaed se:
_ Front � Q. . DE
,
'J . . � . . , .. , .
;' .. ,� , , . , .� Sq. Pt. _ CaS,. ;Ft+ , ;,
- , , r , , ..,_ , ., ,-
Froat pepth Aeight
. - r.;. . , .
S�..Ft. Cu. Ft.�•
Type of Constructioa C��.O�ryat.. $stimsted Coat '
To be Com�leted ± ��J �.l �> ) . , �
.
, • . i ; .� -.;; .. ; - ._.
The undereigned Nere'by makes�application-�foF.,a perndt for the york hereia apecified,
agreeing to do all work in strict accordance ai.th the City of Fridley Ordinances and
rulings ef,the Department of Buildiags, and;hereby decl�res tbet 411 the facte and
representations etated in this application are t;ue,and correct,
�(Schedule of Fee Coata can be found on the Heverse Side).
,� , •- � � .._�..
NEW
ADDN
ALTER
[ ] CITY OF FRIDLEY
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Addre�
Legal Description: �
Owner Name & Address:
. •
2��c�
Tel.
N
Contractor: �'o � e p!A e,C MN LICENSE #
P,ddress: �O�g o�1���a� ST N� Tel.#7�3-i8��-8�a5�7
LMNG AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Cert�cate of Survey of the
bt, with the proposed construction drevm on it to'scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
� .n
Width
Height Sq. Ft
Height Sq. Ft.
Width HgUGround Sq. Ft.
OTHER:
g �a� �
Construction Type: �°�/e Q Estimated Cost: $� / 59i�
Driveway Curb Cut Width Needed: _Ft + 6 Ft =_Ft x$ = S
DATE: Z� �iS a�� APPLICANT: /�` ��. Tel. #
Call (763) 5723604 for Pertnit Fees 'rf mailing in appiication. Fax to 763571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$ g 3•°ZS Fee Schedule on Reverse Side
$ 65% of Permit Fee
$�� � �� 001 of Permit Valuation (1/10th%)
$ ( � 1 .7 $.50/$1,000 Valuation
$ $1450 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Aft. "A" or Aft. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary ( ]
$ � v ' `�' J' STIPULATIONS: