AF - 46151. sue�ec* � � MIT .
City of Fridley o t97Y5
ATTHETOPOF7HETWINS BUILDING PERMIT��
r ' ECEIPT NO.
� �
• COMMUNITY DEVELOCMENT DIV.
� j V ������'
r � PROTECTIVE INSPECTION �SE0. � � O
I
`-_Mj �'°�'� �GTYHALL FRIDLE� 5$�32 NU4BER REV. O�TE PAGE OF qPPROVEOBY
ti 1� 612-571-3450 9io-Fi5
10/24/88 � �
J08 AODRESS g30 Hacl�ann Avenue N.E.
t LEGAL �OTtiO. BIOCK �RACTOAADD1T40N SEEATTACNED
OESCR. PdTt Of t. I- AUCIltOZ�S Sllkl. �IZS SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PMONE
Robert Gilstad 930 Hacl�nann Avenue N.E. 571-6875
3 CONTHACTOR MAILADDRESS ZIP GHONE UCENSENO.
Same
d ARCNITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIIADDRESS 21G PHONE LICENSENO.
6 USEOfBU1LDING � ' �
Residential �
7 CLASSOFWORK
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
e DESCRIBEW�RK
Construct a 26' x 22' Detached Garage
9 CHANGEOFUSEFqOM TO
STIPULATIONS �
provide a hard surface dxiveway,
SEPARATE PENMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TVPE Of CONST. OCCUPANCV GROUP OCCUPANCY LOAD
YENTILATING OR AIR CONDITIONING... � � �
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SO.FT. CU.FT.
AUTNORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSiRUCT10N
OR WORK IS SUSPEN�ED OR ABANDONED FOR A PERIOD OF 120 DAYS AT -
� ANY TIME AFTER WORK IS COMMENCED. � NO. DWLG. UNITS OFFSTREET PARKING
I HEREeV CERTIFV THAT I HAVE READ AND E%qMINED THIS APPLICATION S7ALLS GARAGES
ANDKNOWTHESAMETOBETRUEANOCORRECi.ALLPROVISIONSOFLAWS yp�UATION SURTAX
ANO,OR�INANCES CaOVERNING THIS TYPE OF WORK WILL BE G�MPLIED �`$�213
WITH WHETHER SPECIFIED MEREIN Ofl NOT. THE GRANTING OF A PERMIT $4. il
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1TFEE SACCHAqGE
PROVIS+ONS OP ANV OiMER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION. ].OH.00
PLAN CHECKFEE iOTqLFEE
$112�1�.
$IGNnTUREOFCONTRALTOPORAUTNOA4EDSGENT �DCTEf' . EN PRO R 1 ED THIS IS YOUR PENMIT
S��GNGTpREOFOWNERpLOWNER8U�L0ERi iDATEi �� a�-�Y
OG ��+SO ��rE
I�W [ 7
A11YV [ I
�� � �
City of Fri�ey
R-1 ADID R-2
�,;�dinq Pe�it Appl.icatian
EEfective 5/
i �
���%
Cbnstruction Address: i�� f�s'GK� w-, t}-V'2. /V �. ?�'sl//� y—
Legal Descriptim:. �'slrT aF� LaT / Audi'�� r.5vb �'o"'zS°'
Owrer Nane & Addr�s: /P/ fter�` Cv' iGST./,� �,, %30 .�!�rcr�i� ►� �U i- Te1. i� `��°'.J�
Oo�ractoz: �L5�9U � L�i�-�'er+a Te1. # /I l/
Address: S�9-r,a�
u,. ::•.
r ::H' ..`:
� �.«;
�1y:i�•
Attach to this applic�tion, a Certificate oi Sl�cvey of the
lat, with the ptoposoed aonstruction dras�m on it to scale.
LESQtIPP7AN oF Il�RONF?ffia
Length wiath aeic�t &j. Pt.
L�tgth .�6 , Width �eZ � Heic,�t /a FT. 93. it. �%Z �� �1—'
I.�gth Wi�h Hgt/Grotnd _ 93. Pt.
Q�rner Iat [] Inside Lot [] Ft. Yd Set�ck
Zjrpe o� Wnstrud.ian• G�000�
Approx. Compietion Date:
_ Side Yard Setbacks
Fstimated Cost: S ..'�-/� a �'
Alt. A Al� B
Proposed Driveway Width If New Opening Is Desired: $ &
Width + 6' See Back Page
.
�g. /O a APPLICANP: Tp1. # .57� �c ��,�`
CiTY II5� CtI.Y
P2si.t PIeE
StBte Surd�arge
S1�C (t�arge
D�fvevray Bsccw
Park F�e
Sewer lsain Q�arge
TO'�S.
•� r � � � :
/ I�
„
S
S
$ /-2,
Ppe Sd�edule on Reverse Side
5.50/51,000 Valuation
$550 per SAC Unit
Al� �' or Ai� 'B' Above
F�e Determined by Fhgineering
Acgeenent Neoessary [] Ncit Neaessary [ 7
� ,. ��,,C�'��
o�-
� • �;�� Y :l�+ ^.«:i��. � �
., before issuing permits for the erection of any
����� a.0 ►ciiiti� to any existing building or structure, or for
existing building or structure, upon application
/� he applicant for such permit of fees to the amount
� „�. G�a- �anner herein prwided to-wit:
� (/�/�dt.... G�-,c� FEF.S
�.u,�-� �s�....�1.
� =/�-r /- '�n��
� ��� �R,2A6�
$?5,001 to 550,000
550,001 to $100,000
$100,001 to $500,000
m rMx is sls pius surcl,arye)
et 5500 glus S2 for mch additional. 5100 or fraction
and inc].uding S2, 000
rat 52,000 plus S9 for each additional 51,000 or
areaf, to and inclading 525,000
8252 for fiz� i25,000 plus 56.50 for each additiana7. 51,000 or
fractioa� thereof, to and including 850,000
5414.50 for first &50,000 plus 54.50 for each additional 51,000
or fraction thereof, to and including 5100,000
Sp9.50 for first 5100,000 plus 53.50 for �ch additional 51,000
or fraction thereof, to and including 5500,000
5500,001 to 51,000,000 52039.50 for the first 5500,000 plus S3 for each additional
51,000 or fracti� theteof, to and including 51,000,000
51,000,001 and up 53539.50 for the first &1,000,000 plus S2 for each additional
51,000 or fraction thereof
� : ia„4 � �• : . • � `,r•.�.,
• - - . -- •
Alternate "A":� R�nwal and replaoement a� wrb and gutter only - Driveway width plus 6
feet times S]3.50.
Alternate "B": Ranwal and replaoement c� cvrb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width glus 6 feet times 515.75.
��; : v •;, •,- S•:1��: Y .;�
Permits for construction will be issued a minim�un of 24 hours from the time of
applicaticn to allow for proper review of the progosed structure and of the oonstruction
site.
A Certificate of Sluvey of the lot, showing the location of the famdation once it has
been wnstructed will be required before proceeding with tl�e franing.
5u9�EQ
City of Fridley
ATTHETOPOfTHETWINS gUILDiNG PERMIT
;,
� �• COMMUNITY DEVELOPMENT DIV.
� � """'.
r � �' � PROTECTIVE INSPECTION SEC.
� � �
� � i-"1 � CITV HALL FRIOLE� 55132 MuuBEn REv
�'""� � ,�� 612-571-3450 910-F15
JOB P.D�RESS 930 Hackmann Avenue NE
1 LEGAL ��TN�� Pdrt BIOCK TRACTONIIDDITION
DESCR. �� 1 All(1. Sll7J i�2S
2 PROPERTYOWNER MAILADDRESS
Robert Gilstad 930 Hackmann Avenue NE
3 CONTRACTOR MAILADDRESS
Same
d APCHITECTORDESIGNER MAILADDFE55
8 USE OF BUIL�ING
Residential
7 CLASSOFWORK
❑ NEW �l ADDITION
8 DESCRIBEWORK
Construct a 22� x 16' Addition
9 CNANGE OF USE FROM
STIPUTATIONS
See notations on plan.
10/24/91
ZIP
ZIP
n�GE Ov
� �
2.�
ICEIPT NO.
er
SEEATTACHEO
SHEET
PHONE
571-6875
PHONE LICENSE NO.
PMONE LICENSE NO.
LICENSE NO.
❑ ALTERATION ❑ REPA�fi ❑ MOVE ❑ REMOVE
TO
SEPARATE PERMITS REQUIFt�D FOR'
WfR(�lG. H�,ATii�JG. PL�!"�F31NG AND SIGNS.
SEVARATE PERMITS pRE NEOUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING. '
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITMIN 60 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR A6ANOONED FOR A PERI00 OF 120 DAYS AT
ANV TIME AFTEfi WORK IS COMMENCED. -
I HEREBY CERTIFY TMAT 1 HAVE REAO AND E%AMINEO THIS APPLICA�ION
aNDKNOWTHESAMETOBETRUEANDCORHECT.ALLPROVISIONSOFLAWS
AND ORDINANCES GOVEfiNING THIS TYPE OF WORK WILL BE COMPLIED
WITM WHETHER SPECIPIED HEREIN OFl NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTNOfiITY TO VIOLATE OR CANCEL THE
PROVISIONS OF qNV OTHER STFTE OR LOCAL LAW REGULATING CON-
ST(7UCLION OR iHE PERFORMANCE OF CONSTRUCTION.
a
WARNi��
Before digging call for
ali utility locafions
454•0002
REQUIRED BY LAW
ZONING SO.FT.
NO. DWLG. UNITS
1 STALlS
VAIUATION
$24�45�
PERMIT FEE
$252,00
PIAN CNECK FEE
SC $24.
PPOPE L
\
aiDC ��+Sv
✓
$12.23
CCMARGE
$N/A
�TAL FEE
$288. 68
LOAD
a
��w [ 1
ADDN I i
AL'd'ER I l
CiTY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXBS R-1 AND R-2
Building Petmit Application
Effective 1/1/91
Conmucdon Address: 93 0 �la ck M� n n � �er..��' �NC.
L,egal Description:
Owner Name & Address: %�o�r-j- (�' i(S-�c.� Tel. p S�!-(�� 7�
Contractor: Dc� r� e 2 Tel. A�
Address:
Attach to Uris appficatioa, a CertificaOe of S�mey of the
lot, with the proposed consftuction diawn on it to scale.
DESCRIPTION OF D►�IPROVEMENT
LIVING AREA: I.ength �� VYidth �_ Heig6t �
GARAGE AREA: Leagth Width Height
DECK AREA: Length Width HgUGround _
°v
��. �9 S
���jSq. Ft. 3 5 2-� �,'S �'y
Sq. Ft,
Sq. Ft.
OTHER:
asZ �c 6�.')'3 ,. Z, Z, �1 .
2��.�
Corner Lot [] Inside Lot [�(j Ft. Yd Setback �_ Side Yard Setbacks
Type of Conshvction: _�lts��.-,-� Estimated Cost: S Z'f� �c'�
Approx. Completion Date: 1 a 1 S q 1
�jor(� �.a..�i
Driveway G1�rb Gtit Width Naeded: _Ft. + 6 Ft =_Ft x S = S
DATE
APPLICANT:
�►Y11 � .
Permit Fee S ZSZ. � Fee Schedule on Revease Side
---y
Fire Surchazge S e�i�%.y� .001 of Permit Va(uation (i/lOfh%)
State Surcharge s l'L.Z 1 s.sasi,000 v��auon
5AC Charge S 5650 per SAC Unit
Driveway Escrow $ Alt. "A' or Alt. "B" Above
Tel. �
Park Fee S Fee Determined by F�gi�aering
3ewer Main Charge $ Agrcement Necessazy [] Not Necessu�y []
TOTAL
STIPULATIONS:
a �8�.6g
- :
Z.Y, �lo °
m
P
� ��� _ . _
�.,
EXTERIOR ENVEIAPE AV�RAGE "U""COMPUTATION
; ` r
is
'....
�,;
� ril"
. -.<�v�a.�k..
r
SITE ADDRESSt • 930 '��+T � ��"�� ; .�
CONTRACTOR lri��%h-�+'�`�+! D.4TE : � PHONE ��'l �o8�'f . , �
/� �r ��. ��-e„ ;;;
Determine working square Yootage oi_each.
1. Total exposed wall area...... /.J.a• sq. �`t, x,�,li a./�53�"%
r.tr��.
2. Total rooi/ceiling area..`.... '-3y�'�,sq. it. x��e'�3�a '�� �y" ";''
' Total exposed wall area above floor .
��.
A• TOf3$7. WAII WiIICLOW AI`8$����}�����.�r�������• '!S
b. Total door 8T@$�"��i�����r�����������������• ,c.t
c. Total sliding'glass door area ............."'� ;
d: Total fireplace wall area....:.:.:'.:...... a ,
e. Total wall iramiag area (average 1096)..... - L
f. Total net wall area above Yloor..:........ '�,;.�
g. Total 'rim joist area...................... ,c 'sk[
s � f
Total exposed iouadation area � ��a o �;;;�
h. Ta�*a� �?�,:ndation window area.?ncluded.in.a ��
i. TotaZ net foundation area above grade.....%30 - ';,
Determine "U" value ot each wall segment,
8. � X �Uf� �s a ��� m
b. ert / x��U" +3Y . a `• S'
C. ?�_ X nUn ....5� s sJ(� ' �-
d. ,.�,Q_ � °U° �-;��� - ,5^, �
e• 7y , X MV� �'Y/1i i! �.�
f. �/`` �
p T x "i3^ �o, a .�S'•,�r.;
�•T
e. -� ° X^U^ ,a r a a.•r
h. !�,' X ntJ° -�^^ ffi .r .
i. -'--=r-- X n�M �� �.� r v�_
3 .......................Total = �: `"
--���."_
a
_� it� #3 is the same as, or less than item �1, you have met
the intent of SBC..6006(c}�.
';I
.�.
Y.�
i:
:,., i
�;
.:R i I
• �:
i
. ;
.. � T . . .. . . . . . . . . . . r. t.
PAge 2 �:. �
r�
_ . .�
_ i
.. �•>..
Total exposed roof/ceiJ.ing are3 = ' '3'� � : " i,�� �I
�j. Total skylight_area ............. :�... :.�.`.... D , z �:
k. Total roof%ceiling framing area Caverage 109b) �y ,
1. Total net insulated roof/,ceiling area......:. a�_ �'`,�
Aetermir.e '!U" value �or each root/ceiling aegment.
�, Q . X ��n ,r. s p
k, 3/ g njjtt ,C1� � e 0 -' r.
1. i�%8 x ^U" • � vR = ,5';.3$3 ..
.Total ��� `
4 ....................... a
� . ��.
It' total of #4 is the same as, or less than �2, you have met < ��
the intent oP SBC 6006(c)1. ' :`
�, �'�
� _ - ALTERNATE BUILDING ENVEIAPE DESIGN ,',{
.To utilize the total envelo e system method, the values establfshed
by the sum oP items #3 and �4 shall aot be greater thatt the sum of
items #1 and #2. .
�• ' 3'7 + 2._ /1-'•3L = /�S ,ol�;.
�_
, 3. !�_+4.='F�_�+/f�.�_� . E
,i
��
' �i
�t
;�
,
�I
� �;
�.
. �
�i
i.
,.
• �. �
�i
;�
. �� .. �
Page 3
'�R"' and "U" Va1ue A+ialvs{ s of the WaZl Sect�.ons
N
:: �: �
:..�,,,
,:�'
,
- . • � .:z,
:-+<
F. Insulated a�ea between studs - ".
E.
R-Va7:ue
� � ---� 6 � �-� f-�'
1 ._...__ , y�s � ��.•�;.�' . , ,
I •oo �i'r ,6�1-P-'r'S
a'�G �'�s ��� -
�T�
�L � � ' " '
--^- ��
� � / � � �h ��� .
� `�.� Total "f� " Value
�
TJ = 1 /F�, a �I I ' ' a , � O '}�' �
�''1 1
Studs/F�am±ng Area� .
R-Value
- ' ti�i Q►w+�i�1 f""k"°E
- ,, �,,� _� ��
!r �_sa . � � X G - 5�-�/
� '� ��� �/y� / -
� � "`+„"'"""�j
��j--- ' � t•r+.,�a.�.�i /�..1L-:+-
I /o � 53 Total "i� n Value 4
2
U,�,2 � 1 /�2 . 1 / � �t0
.:y
a
�
�..�
+z..
j...
: '�.
t� y
.�-
page 4 : �:';
;s
"?t�` and "'J" Va�ue An�lysis of the Roo�/Ceilin,g Sectiona. ,-��
, . ' . . . ' . .. .. . . . •�<Y•! �i
� . . . ' - � . .... '+L '.JI°f�
�. Insulated Area between the Joists
R-Value
w �
�__f� r ��-�
-�-, -_.- _
� !` ' �=�3y %x�i �' .rJ,; : ,,,,.� r
i � .
: Rb7t �'��.�+Ca.�F-`.*S
_ �� ' '�=�-'
v � 7G '�
�_. , Total. ^F�,1 n Yalue .
U = 1/�, s �� . -,. � � �Q�
w� � _�,_
K. Joist/Framing Area '
R-Value
- � 4 � t �� :
--ti'��"` '�"'�-i7.�-r����.
_-�3-�, �x y. 7�y+.�.
_ u u 5J _ ' �. ,y�: �y =►�*�•�
- , .-._____
� G r �� ��»„ �
, � Tota]. . ni� n value
2
u fi 2' � 1�R v2 a 1����� ° '/ aIZ
f
,., =::�`.
. ._.iy z..? �::..
T� �. r�;
� .,Z - Y: .
r .�
�. �
�.
e
6Rp�J�,
R�m Joist Area
. - , t _ . � , . ,i.
'� �
Page 5 ��
�
Izi.
:a 1N�
R-Value
�� ��,,�. - °
---��.�. ��;�► r�.:
- ,:
� � � -�-�' � � �'������- � � . �
�:.
�
`..�� �:�;� ��,::
.�,;�,.:� .
�'! Y
�y �r
' . � G 7 . � �pyw�R�..'" � L
��� T
. � .� . .. �.� T,yi��,. � � r..
�1��� h
. ' � . � . �! `- �Of'.A�. �M�� � V�.LlB. „ r�
. '�`;l r � r :�X ..�
U�, _'I s 1 � i ,..4 � a
3 /� / ,.� .
3 = � ,
3 -
,.:��,
I. Foundation Wall Area (above grade) #'�-
, .. - �
, - R-= =u= .� ti..
� . �. � �1_ , t�
y�--�
� �.`; � •f . �� '— -
� .�, �
�� Total "F� „ Value � �' �
_ 4 �; : ,
T`Jw a � �R _ a � � ' � � a �/ .. .':^
4 w4
B. Door Area
The Door units have been tested and Yound to have
and R-Value o� ,� 3.ncludiag',air films.
.
Ud,� = 1fR�1 . 'k./ � ; _� .a +x; �- .
.�.�. .
;: �
"xi a
. . �p.: � _ . _
;`
� f 3 y- �
, . ,.M � 1 � .. �
r
y:
< rj�G
� �
`'��f
, '��
.;�I
_ �_.
,;; �
�:�
�x '
yti
��'
.p
1
,{
�_I
- • �
m
�
�
�
C
m
m Z
W O
S
� W
W
� ;
io
S�
a
U y
� W
z
F`
S �
f9
aZ
0
��
5�
2
a 0
U
3¢
a
��
Z
�a
n �
tl 0
Oa
F= ¢
� W
U �
d LL
0 Q R
z
0
U
W
aW
y Z
Z
} � �
� � �
Q y
LL j Z d
LL c � o
0���
F m ? N
U��iuhi
�' \
�i
�
,
�
�
�
��
�
m
O
�
W
_
�
Q
om
� a m
3 � m �
t ; � � 0
«
�i v �
� � a
€ a '� Q�J
L 'a
�mo�\
�� � C
% c
� % O �
G C pq �.
�
U � � �
c p
� ; c o
w ,`Q6D�m
Y `� � C
E O m m
Q C �' �
m � `o
d a� v
t � � � �
m a 2 m �
c m v ii m
�'� � ` �
O� � .L..
� c o R �
m m � � m
r m. �
F-c � �b
�
�
a
�
�
`�
0�
�
��
W
y
�
�
z
O
J
�
m
�
r
_
d
z
H
�
¢
W
a
\�
a �'
0
_0
�
y
0
U
O
W
a
f
N
w
J I I
H I
0
a �► w v�
m O O O O
� c o 0
¢ � o d o
� � �
r► vi �s w
I
C
�
m
Y
3 $
O �
� �
�
m 8 :.
��
� S �
C ¢
c
� ii 6
(�7
m
�
�
C
V
3
a
Z
�
3
'a
m
�
�
m
¢
�
�
�
O
�
(9
I
N
O
O
�
N
$
N
Q
I
�
C
O
�
O
U
Q
<
a
W "m'
z 3
¢ „
m =, ¢
¢ Z W aD6
J
O
< � N m
tN �j
2 0 �
Q m U
LL � �
� � a�
1 �
Q
a
¢ ='•
� `
�
0 �
c m
2 �
Z
O m
d � f �
zrm'a
(
I
H f9
Y
U
m ,
O �
N �
v
Y
� 3 �° O
a� 3
�
m $y o
��� a
< =° 3 g`�
a�n� �`
a �� � O
¢ 7 m
��e�m
m � .. >
L�`��`o
O
— � �
a U �
�
W
Ul
a
_
E
m
z
v
�
F
`m
m m
�
�' I
�
H
�
L W
� W
� LL
N J
� H
�
N O
�
4�
�
Z
<
w
x
�
�
�
z
�
�
w
�
�
1
\
i
N
m
�
0
�
�
m
�
�
�
I
t
7
O
Q
�
m
�
0
G
a
0
w
W
W
LL
�
�
U
W
a
y
Z
W
¢
7
O
L
3
� •
m
T ;
� O
N �
� �
C 0
m $
��
� C
� °m
c
c `
U
C
� O
O �
��C
o �
U
� �
Q 3
W
�
2
¢
�
�
f-
z
W
�
W
g
a
w
¢
SuBJECT
c�ty of Fridley
ATTHETOPOFTNETWINS gUILDING PERMIT
;,
�
� � ��_ COMMIINITY DEVELOPMENT �IV.
� � L PROTECTIVE INSPEGT�ON SEG.
�
i
� � �"'1 � CITY HALL FRIDLE� 55�32 NUMBEN
�""'� � �'� 612-571-3450 970-F15
JOB ADORESS g30 Hackmann Auenue NE
1 LEGAL �OTNO. BLOCK TRACiOR�DOITION
DESCR. Pt. I, AU(i� Silli. i�ZS
2 PROPEFTVOWNER � MAILADORES$
Robert Gilstad 930 Hacl�ann Av�ue NE
3 CONTRACTOR MAILADDRESS
Same
< ARCHITECTORDESIGNER MAILADOflESS
6 USEOFBUILDING
Residential
7 CLASSOFWORK
�] NEW
8 DESCHIBE WORK
Construct a 12�' x 16�
9 CNANC�EOFUSEFROM
MAIL
16
•TE I P�GF OF I�VVROVEO 9•
lOn4i4� / /
SEEAT7AGMED
SHEET
ZIV PHONE
571-6875
ZIP PHONE LICENSE NO.
ZIP PMONE LICENSE NO.
ZIP PHONE UCENSENO.
❑ ADDITfON ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Shed
ro
STIPl1LATiONS Shed to be at least 3 feet off any property line and of£ from any
easement. Shed can be no higher than 14 feet. Shed must be securely anchored to
the ground by either a£oundation or tie-downs,
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, MEATING,
YENTILATING OR AIF G�NOITIONING.
THIS PERMIT BECOMES NU�� AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WOfiK IS SUSPENDED OR ABANDONED FOF A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCE�. �
I HEREBY CEFTIFY THAT I MAVE READ AND EXAMINED THIS APPIICATION
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OP LAWS
nND ORDINANCES C�OVERN4NG �NVS iYPE OF WORK WILI BE COMPLIED
WITN WHETHER SPECIFIED HEREIN OF NOi. THE GFANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TME
PROVISIONS Of ANV OTN STATE OR LOCAL LAW AEGULATING CON-
STRUCT,l� OR THE PERF�MANC�fJ OF �ONSTRUCTION.
� � n i nY // -r1� /7
'i a/F
1 ISTALLS
_UATION
$1�0��
iM1T FEE
$25.00
GROU7 OCCUPANGVLOAD
CU. FT.
$.�J�
iACCHARGE
Fire SC $1.00
OTALFEE
$26.50
) THIS IS �OUR PEFM
! d- iq -a
NEW ( ]
ADDN ( j
ALTER[j
� � ��� � �� �
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Percnit AppliCation
�l;' e- /�' C� � -
Legal Descrippon: ' �� ' 1. o-`� 1 � -� S � � �
Effective 3/1/92
Owner Name & Address: �6{,^� �c1L5%/9,/ Tel. 11 S?� �c � 7�
Contractor: �'e��- MN LICENSE #
Address:
Tel. 1f
Attach to tbis application, a Certificate of Survey of the
lot, with the proposed construction drawa on it to scale.
LIVING AREA: Length
GAILAGE AREA: Length
DBCK AREA: Length
OTHER: S
DESCRIPTION OF IMPROVEMENT
Width
Width
Height _
Height _
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Comer Lot [ j Iaside Lot [] Ft. Yd Setback Side Yard Setbecks �-�-� ,_
Type of Construction: �;; o c� �� o-; t, � F.stimated Cost: S /,_( CG -
n�oR. co���oa nac�: � s� P- f,�U d�.-H,� .
(Cost on Back)
Driveway Curb Cut Width Nceded: _Ft. + 6 Ft = Ft x S =$
DATE: C � q�� APPLICANT: Tel. �i S i{-(�� /�
Per►nit Fee $ =:1S .- C'�
Fire Surcharge $ /. o 0
State Surchazge $ : SC�
SAC Charge $
License Surcharge S
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ �1�,. S2?
C��f.YZ1I�(�4`1
Fee Schedule on Reverse Side
.001 of Permit Valuation (UlOth�)
$.50/51,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Conhac[ors)
Alt. "A" or Att. 'B" Above
Fee Detemuned by Engineering
Agreement Necessary [] Not Necessary ( j
M
W
�
�
7
c
�
C
O
m
>
tS
�
w
�
O
O
LL
2
�
Z
0
0
W
J
J
r
�
z
W
m
O
�
W
Q
�
F
X
LL
LL
�
Y
¢
¢
�
>
0
Z
O
F
w
a W
� Z
z
LLj ¢' cNi
v
� w �
¢ `m 2
u. c � °ip
O} � � w
F '
M :O N
U t�0 li N
y
�
�
V
�
`J
M
m
O
�
�
w
a
¢
i
..
�
w
¢
2
w
¢
F�-
X
LL
(7
z
m
�
�
J
a
a
m �
O
U m
�, ._.
u �
m �
� L
L �
m3 �
m
c m
m v
v �,
O �
U m
O � .
� L
� a .
� C '
�
C C
Y �
`o f°
3 '-
0
� �
o �
� a
O �
Ol m
c m
m �
� � �
W y
� c
w `
m a
a c
N /6
�
�
W
�
�
�
�
�
�
�� i b_
��
�
�
1 `
� �' O
n) �
'J '
m
� � y
o c !-
. .. Z �:.. LL � .
� w I W
�_ � a
O �Z
F-
� �
� a ��
�
� � �
� vl
.�n I
\ ¢
.6 N
0
m U
7 a
rn m
� c To
c � £
� m W
s
Y
Z
Q
a
�
�
U
�
2
m
�
J
a
I 1 I ( � ( � I � � I I
O O O O O O O O O O O O �
O O O O O.O O Q O � � 0 p
�: 'v ui n n n n o r� o 0 0 ,�
� � � � � � � � � � � � . �
I I I ( ( I I I I Z I
�
m
i
v
m
� '�
a� v
� c o m
rt Y �y • ¢
u. � — � m Y
� a m m
3 v F-- a � c
Z � c '� � rn W � �i
m
m � C � G J.•� � m N d
� .m u�i � �ap m ¢ m m °ro' � °' p .
3�t=xx LL
n � p m Z' d
LL � p �"� GI N N N� Y ].
'O 3 C �'
zommci¢�'n333c�c�m
m
0
w
Z
�
�
m
a
a
C
�
L
w
7
O
Q
�
�
m
a
>
0
a
a
Q
\I �
�
2
O
F
Q
w
J
a "
0
�
� �
Z U L
Q Cro U
� = �
o� a m
Q a �
a ¢ m.
o ¢ `o cn
o m
Q
m O X
� o LL,
� Z
LLQ`o �
m
�
O W W '1� i
$_t=- o ���
C O �. i �.
¢ a 5 F
Y�
�
N} I
N
�
�
w
w
LL
�
�
�
r
City of Fridley
AT THE TOP OF TNE TWINS
;,
� �; L COMMUNITY DEVELOPMENT DIV.
r ,
� PPOTECTIVE INSPECTION SEC.
�
� � �"'1 � CITV MALL FRIDLE� 55432
�'°"� � �'� 612-571-3450
JOB nDDPESS 930 Hackmann Avenue NE
1 LEGAL �OTNO. BLOCK TRRCTI
DESCR. ],
2 PROPERTVON�NER MAILRDDRES$
Robert/Gloria Gilstad 930
3 CONTRACTOR MAILADDRESS
Same
< ARCMITECTOADESIGNER MAILADDHESS
S ENGINEER M�A��
8 USEOFBUILDING
Residential
7 CLASSOPWORK
❑ NEW X
S DESCFIBE WORK
Construct a 444 Square Fo<
SUBJECT
BUILDING PERMIT
910-F15
Auditor's
DATE P�GE or
6/10 94 � �
#25
� _ • �
9�
a�
SEEATTACNED
SHEET
�ICENSE NO.
LICENSE NO.
LICENSE NO.
ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan. Provide smoke detectors as per UBC 1210 adjacent
to all sleeping areas and in basement.
SEVARATE PERMITS ARE t±EOUIRE� FOR ELECTRICAL, PLUM9ING. HEATING, �-
VENTILATING OR AIR CONDITIONING.
THIS PENMIT BECOMES NULL RND VOID IF WORK OR CONSTFlUCTION Zpp
AU7HORIZED IS NOT COMMENCED WITMIN 60 DAVS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOfl A PERIOD OF typ OpYS AT
ANY TIME AiTER WORK IS COMMENCED. - py�.
1 HEREBV CEFlTIFV THAT I MAVE READ AND EXAMINED TNIS APPLICATION
ANDKNOWTNESAMETOBETRUEANDCORRECT.ALLPROViS10NSOFLAWS yp�
AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL 8E COMPLIED
WITN WMETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PEHMIT
�OES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEq
PROVISIONS OF ANV OTNER STATE OR LOCAI LAW REGl1LATING CON--
STRUCTION OR iHE PERFORMANCE OF CONSTRUCTION. •
�O�iEi
WARNaNG
Before digging cafl for
a!I utility locations
454•0002
REQUIRED BY LAW
GROUP OCCUPANGYLOA�
CU. FT.
OFFSTREET PARKING
GARAGES
SUR7AX
SACGHANGE
Fire SC $3.62
NEW II
ADDN � � CITY OF FRIDLEY
ALTER � j S[NGLE FAMILY AND DUPLEXES R-1 AND R-2
Buiiding Permit Application
ConsKructionAddress: y3 0 ���'yic�ltiK U-2�__
L.egxl Description:
Owner Name 8c Address:
Contractor:
Adciress:
Ei'fecUve 1 / 1 /94
�a I��
TeL � S'�/��o � 7S
MN L[CENSE N
Attach to this applicabion, a Cenificate uf Survey of the
lot, with the proposed construction drnwn on it to scale.
DFSCRIPTION OF IMPROVEMENT
TeL X
:i i ,
LIVING ARSA_ Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length .(�F ao2f 1' Width Hgt/Ground Sq. Ft. ��Y
OTHER: ��(/� �v� �f !D � y ��
�
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Sexbacks
Type of Coactruction: 1�pc,�i Estimated Cost: $ 3�� g•� d
Approx. Completion Date: %'� � Y
(Cost on Back)
Driveway C�ufi Ctitt Width Needed: _Ft. + 6 Ft =_Ft x S =$
DATE: APPLICANT: �('abp/ir �', LG%,4D TeL # S�'t% �o S7 �
Permit Fee
Fire Surchxrge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 3,Oa
$ 3 -6�.
$ •${
$
$
$
$
$
$
$ ��, 3
CITY USE ONLY
Fee Schednie on Reverse Side
.001 of Permit valuation (i/tOth%>
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (Sfate Liceased Residential ContracWrs)
Ait. "A" or Alt� "B" Above
$450.00 Conservation Plan Review
Fee i)etermined by Eagineering
AgreemeM Necesvey ( ] Not Necessary [ ]
STIPULATIONS: �/,Gls--�r��'(� !� ��a��e�'(.�d0 �`7 ���z : ..,.y.�0
1
�
�...---- -- _ _ ___ �
/,T_ ` - - �—
,
/� I , _�__
� Q� - - : �+ = i: -
�.� �,
,.��� q 4 ,�; i
� � j . ��
�
� � �
' f ; i i
, , �
�1
n� , I . . I . I Q
V , � ,
+ � �
-_ _ .:._, l j � � � i �;
� +. I ; ' i �
�_ � � x
� � � , �,
- ------�I
,\
• �.: �
�
i ''- � �
�.s �
I ! i
�,� . � �
. _ ...__ ' �� 4 . . . �
.-1-�. � — , ; � j h { ; ` � 1 �
: ,o , a ,
� .f
�� _ �
- - -- k..
—� - --
�
. ----- _ - - ,-
� .
---- - ---_+ -, �
,.
,.
— �� ,
..a � --� —r � <_
'''�� " � - - : ' � L
� r �i � �
� � °` . -- ! --�
� � --- '
� � �- _ ' � -
�— { n_ _
0
� �_ _��,,� � ,
, ,°=T=--�-: a � . _ � �
W, ! �.
C l .
n�� _.._..._....._.'..._��._�... _ . ,� �
C� �
a�
:: ..' _'._.. __i�.. .. �. .
@ ..._._. _.._. . I
^ J
. � �; . ,'� �l L� � p
� a y� �, I / �-
.. -----�_4_.._�..---�---_}_..�. �
� �C � � .
�__. �._ __...._. _ . .. _..
\._ _
�.
--_. ----_ _- – _ __ _ _ -- - --.-__
J
�' i
�y �
:
i
- - �
I �
�
•� �
�
; ,a
i
� ��
� �r
. �
�,
R ►.
,
- __ �.
���,
�
_.. _ A
�.;
�
1-
- ,_ M
3� �
a � -. ;
� .i
, - _— ,; — ,
I�-- —. � ,
`-r� S �� _ i
� � .; �
,., ; � ; �
� ��
� `� , ; --- _ �
� � i : i ---�
ii --- ,
�.`. , � . j -�
; �� _.�
,� : � �j_=__ __ :�
,. _
oi � :� ---
–� � - --}
� -------
; t i _ __ _ :�
� �`_ ! –__ . _ _.,:.—�
I
i�
i
� `9j
� `''
�I
L `f
i.' ry
r;
ZI ci
Y� �"
t.� <l
� V7,:
� �
� ��
<
�� ��
! e
[( $'
�\
c' ,� �
� .
r �'
.,.� . ` ,
�� >
.� 1 � �
,� 3� � �
' k
� -�---� �i
_ ; _�.-__ r-
� �� _I
1
-}.
�'.
I.:
Vi
�g;
7.
�(.
;�...
�n
�ya
f7!
� � •�
'�' `: ���
�� i,
"� ;.
�. �
�
�
�
e
�
- i
� 'dl� CI
: �i �,I
:� � � : ��
, �.
� c��;
. ; i.
` , � �_
� F1�
u
�- b �
K
o R`
.:,; ,
,,
� �
,a �
�_ ' ` �-=`J �
�
3
G
, -. . _ _
- - -= -- � x
_ _ __- -
I — -- - -
� _ --- - a 1
�i . �
�-- - � I - - - --- -` I � -
-- � �-�_
�
.,
�
�
v�- � -�-_ ,
--�-=- �� � -- ..
�. — � -
-: _- - -- . ., _
�r�. . _ -3 _-.
;� -
; , _ _ ---
� ' - --
� -.-::__: _, _ : ; -
; i �; - _-
i �l � s- � _ --
� �,,,s , __ _" _
� -
' � f,� ._.____ r. � . _�
I �I q _L____ . ..
� ��� � � _ _ . .
� �l
.� -
; , � � _ __
, ;
; , �-- --..
� ---
,�.� — . . �
_ _ � ----_--
.�
�r
�
a
i
'3�
I� �tI O
' tG
i ��,
e___ �I
,— - =—�;
i'
;
i
�
�
1 �
��
t
,. Y� a
w�
3i
,�
:
��
�
�, �
h!n
0
(
,,i
� r
� i
� i
� �
i 3
�r
,
0
J
. .�-#" 1 � �
i_ --._ �;4 _- - - �
�� --__
� � �� �
� ��
s; �;
� � "
� ��
��
;;
;_ .
. � � � �,
. �� ?
�
� m
i j J� �
� f � �
� � Z� w
�.:
�I
� U'. u,
; C�
' Q
---�- 1
� - -�� : _-� -�:- . t�-
�� � ,
� � ,.
�
-- _; o
. �-- __ _�� � �
I J
� J
t .:' � �
y, � I
�
, �.
�
sueiec* PER
City of Fridley �;
ATTMETOPOFTHETWINS gUILDiNG PERMIT ����'2
� � RECEIPT NO.
� •
` . COMMUNITY DEVELOPMENT DIV �j ^�
r ��' PROTECTIVE INSPECTION SEC. iSG�(
' ✓ CJ v�
� -
� i �
� /"'\ • CITV NALL FRIDIE� SSIJY NUMBEP eFV D�iE o�GF O� wcvROVEO Bv
i'-°� � ,'' 612-571-3450 9t0-Ft5 / /
9 13 94
JOB ADDRESS 930 Hacl�ann Avenue NE
1 LEGAL LOTNO. BLOCK TRACTORRDDITION SEEATTACMED
DESCR. Pt. 1 Auditor's $llb. �25 SNEET -
2 PROPERTVOWNER MAILA�ORES$ ZIF PMONE
Robert Gilstad 930 Hacl�ann Avenue NE 571-6875
3 CONTRACIOR MAILADORESS DP VNONE UCENSENO.
Same
a ARCHITECT OR DE5IGNEF MRIL ADORESS ZIP PMONE IICENSE NO.
5 EN6INEER MAILADDRESS ZIP PHONE LICENSENO
6 USE OF Bl11LDING
Residential
7 CIASSOFWORK '
❑ NEW ❑ AODITION ❑ ALTEHATION g REPAIR ❑ MOVE O AEMOVE
8 DESCRIBE WOf±K
REroof House (25 S uares) Tear-off
9 CHANGEOFUSEFROM T�
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCU�ANCYGROUP - OCCUPANCV�OAD
SEPARAiE PERMITS ARE REOUIRED FOR ELECTRICAL, 7LUMBING. HEATING,
VENTILATING OFl AIR GONDITIONING.
TNIS PERMIT BEGOMES NULL AND VOID If WORN OR CONSTNUCTION zONING SO. fT. CU. FT
AUTMORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ON WORK IS SUSPENDEO OR ABANDONED FOR A GERIOD OF 1M DAVS AT
ANY TIME AFTER WORN IS COMMENCED. NO. DWLG. UNITS OPFSTREET PARKING
I MEREBV CERTIFY TMAT 1 HAVE REA� AND E%AMINED THIS AiGUCATION $TALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL GROVISIONS OF �AWS yp�UpTION SURTA%
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED
WITH WMETHER SPECIFIE� HEREIN OP NOT. THE GRANTING OF A PERMIT I.00
DOES NOT PFESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pENMITFEE SACCNARGE
PFOVISIONS OF ANY OiHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR THE PERFORMANCE OF CONSTRVCTION. .p�{3.00 Fire SC I.HH
PLANCNECKFEE TOTALFEE
4 .88
SiGHn�unEOrCON'enc*OAOPnUT�oa¢EOaGEN* �OarEi WHEN PqOP Y VALIDATED THIS IS �OUR PERMIT
.__ _ i'L / / �
SiGNa�UFEO�OWNEA�i�pWN[RBUILDERi iDITEi B G �NS> �E
NEW
ADDN
ALTER
��
II
��
ConstructionAddress:
Legal Description:
Owner Name & Address:
ContracWr: �
Address:
CITY OF FRIDLEY
SiNGLE FAMILY APiD DUPLEXES R-2 AND R-2
Buitding Permit Application
O f%��'lasln f}-II� N�_ �=/t'CGI�
��; SZ
Effective 1/i/94
.�3�a
�
Tel. /� S?/— � � ) �
MN LICENSE #
Attach to this apptication, a Certificate of Suivey of the
lot, with the proposed conslruction diawn on it to sca(e.
DESCRIPTIOIV OF IMPROVEMENT
#
aS�� _
LLVING AREA: Length Width Heigttt Sq. Ft.
GARAGE AREA: Izngth Width Height Sq. Ft�
DECK AREA: Length Width Hgt/Ground _ Sq. Ft.
OTHER: %'ec� of� cc,.-,.�.� ,P.e� o�'
Co;net Lot (] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construcdon: 7A�c.eef�� �e�Qoe� Estimated Cost: $ j, .F7S `'"
Approx. Completion Date: O'c� /S'�
(Cost on Back)
Dtiveway Curb Cut Width Needed: _Ft. + 6 Ft =____Ft x S
DATE: APPLICAN'F:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Conuot
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
1! • ► -
_ $_
Tel. #
$ `�.3, � Fee Schedute on Reverse side
$�_ .001 of Permit Valuation (l/llkh%)
$ /. `� 5.50/S1,000 Valuation
$ $800 per SAC Unit
$ $5.00 (State Liceased Residential Contractors)
$ Alt. "A" or Alt_ °B" Above
$ $450.0� Conservation Plan Review
$ Fee Determined by Engineering
$ Agreemen[ Necessary ( ] Na Necessary [ ]
i
� __---<' _—
City oi Fridley
•T'�E'°°°f'�E �'NS BU ILDING PERMIT
; ,
.
� � � LOMMUN{TY DEVEIOVMENT DIY. �
� � PRpTEC11VE INSPECTIpN SEC.
r ,
�
� �
l-_--� �"'�,� CITV NALI FRIOLEY SS�Si xUMBEN M[v WrF
ti 614-571-3450 g�p.FtS 10/30/00
�oe r�ooRess 930 Hackmann Avenue NE
1 IEGAL �OTNO. BLOCK TRACTORADDITION
oesca. pt 1 Auditor's Subdivision #25
t PROPERTYOWNER MAILADDRES$ ZIG
Robert Gilstad 930 Hacl�ann Avenue I3E
J CONTqACTOR MAIL ADOFESS Z�P
Same
S
Residential
� /
3i538
SEEATTACNED
SNEET
PMONE
612-571�6875
NO-
PHONE LICENSENO
� �� ������ ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Install Bay Window in Existing Opening
9 CHANGE OF USE FROM
STIPULA71pNS
Install per manufactuxer's specifications.
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL. Pll1MBING, HEATING. ���� w� �
VENTILATING OR AIF CONDITIONING �
THIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSiPUCTION ZONING
AUTMORIpED IS NOT COMMENLED Y�1�TNIN 80 DAVS. OR IF CONSTXUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF /2p O�VS AT
ANY TIME AFiER WORN IS C�MMENCEO. NO. DWLG. UNITS
I MEREBV CERTIFV THAT I MAVE FEAO �NO EXAMINEO TMI$ APPLICATION I
ANDKNOWTNESRMETOBETRUEANDCORRECT.ALIPROV1510NSOF�AWS yALUATION
AND OAOINANCES GOVEHNING TNIS TYGE Of WONK WILL BE COMP�IEO
WITM WMETMER SPEC�FIEO MEREIN OR NOT. iME GPANTING OF A PENMIT �2 �OOO
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI TME pENMITFEE
PROVISIONS OF 4NY OTNER STATE OR LOCAI lAW REGUU7ING CON� �
STqUCTION OR T11E GERFORMRNCE OF LONSTFUCTION $69.25
I*O A�jr+OA�D�GENt �O�iE�
II �/
OiFSTREET PANKING
STA��S GARAGES
$URTA%
�1.��
$ACCHnRGE
, Fi sc �z.00
TO FEE
/ 2.25
Y V�LIDAT THIS IS YOUA pEAM
i �i _ I . /�
l
�,
_ _ �--_ T
_ �;
�
��
2 --�O
� r,
��
�
�Z�
' �� �
d d.- � =
'� \
� � �
� �
R -� -_
� � '�
0 �°
,
� ;
�
� :
�
�� �
��
�� �
;
--__� __ �
_ � ---_
_�
��
�� ���5
i � x�
� �� /
I, ..
�
LyT��
�,:-..
!��`'" .:� -- -'�t
' i
� �� .�.�.;- .�; � �� �� , .
f '..' '
� ry r 7 �� i C..�'`� °� i,�F
t c,� i� ..i, . ,
a
�
' !r.a F, fi k+. �u �.
f:. tr:', �� k� i. t�^
� �,a
:�� , �: � 1 � f
y1f_. {',
` � .Y � 0
� ��.�
=��-� �/�
��r� oh,o�l�
/�l/rt< <,6� "" x /O a
— �� �l �,���e i�
�����
.�;`
�e-
,�
l;,j
. �„/�i .'_.
/C ,�!" '. �" � . .
'."_�,._w._,,,�,�-r
, � �f^
J
� �� �� �
� ; . � ' ,�.,� sUBJECT TO FIELD
i ; ` � � �
' �
; s �,,�� '
�`�w Pi f ' } �
�.. � , �
1a � � . �`
�._ 4. " �
. ���, i3._.._��'�.
..... ....;�- e, :
f,� r}
���"
7 ,. _ . , .
NEW [j
ADDN []
ALTER [ ]
Construction Address: �3 0
Legal Description:
Owner Name & Address:
Contractor: 5e C /=
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-7 AND R-2
BUILDING PERMITAPPLICATION
�
Effective 1/1/2000
(763� 572-3604 Bidg Insp
r�'.����i�u,�4e�. # � /Z IS7J 6 �r$,
MN LICENSE
Address: S.¢irl� Tel.#
LIVING AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'f10N OF IMPROVEMENT
Length Width Height Sq. Ft.
GARAGE AREA: Lengfh
DECK AREA: Length
OTHER:
Width Height Sq. Ft.
Width HgUGrour}d Sq. Ft
°�'� � �� „DC.
Construction Type:_ �Rl� Gr/�ncrGuJ Estimated Cost: $ �� O B p
�i
�
Driveway Curb Cut Width Needed: _Ft. + s Ft =_Ft x$ _$
DATE: � 30 dd APPLICANT: ����_��i�_ Tel. # S'7 /' �'�7S—
CITY USE ONLY - Call (763) 572-3604 for Permk Fees if mailing in application
Permit Fee $ .�?,� Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ <00 $.50/$1,000 Valuation
SAC Charge $ �•00 $1100 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary ( ]
$ ?a���
- � . ' ,
Building
Inspections
763-572-3604
STfE ADDRESS �
THIS APPLICANT (S:
PROPERTY OWNEIL
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR StATE LICENSE
WITEI APPLICATIOt.'
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
ADDRESS
OCON7RACTOR
' � ����S��.T�
STATE
❑ BASEMENT FPIISH [9'ROOF
❑ DECK U SIDING
o swmu�
DESCRIBE WOItK BEING
�
SQU.� a �s
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Vinyl
O Aluminum
n om�
Gi
❑ HOUSE & GARAGE
❑ ATIACHED GARAGE
0 DETACHED GARAGE
OSoffit
❑ Trim
❑ Fascis
N'INDOWS
IN EXIS7TNG OPENINGS �Ya QNo LOCATION OF WINDOWS
OR FORNEW OPENMGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE PISTALLED NUMBER OF G
AJ.,L FEES ARE
Permit Fee
Plan Review
Surcharge
Fire Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$
$
$
$
$
$
$
DATE
❑ DRAIN TILE
❑ OTf�R
Pemut No.:
x����a By:
Date Rec'd:
WIDTH HEIGHT
(USING TIIE 1997 U.B.0 FEE SCHEDIJLE)
�3 �
BASEMENT REMODELING SUBMIT�
1. ExisOng£IoorPlao
2. Proposed floor plan
3. List of strucwral members to be uced
FOR NEW CONSTRUCTTON INCLilI7iNG DECKS,
ADDTT'IONS. & PORCHES SUBM17'
1. Site PladSurvry showing the ezisting svucmres
�d proposed projut
2. Twro sets of consW c[ion plans
3. EnergyCalculatio�
See Back Page for Fce Schedule
65% of Building Petmit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1l10°/a)
55.00 (State Licensed Residential Contracmrs)
$1450 per SAC Unit (Plaas to MWCC for determina6on)
ft+6R= Rx$20=$
5450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
checks oavable to:
THIS [S AN APPLICATION FOR A PERMIT-NOT VALIA UN'fII, PROCESSED
Attach
I hereby apply for a building permit and I aclaowledge 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
pernfit but only an application for a permit and work is not to start witUout a permit; that the work will be in accordance with the approved
plan in the case of aLl work w}�iqh �,equ'uss rev,�eA+ a/�1 a�prqGjal of plans. � _ „ , ,
OF APPLICAN7