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City of Fridley, Minn.
BUILDING PERMIT
Date: __ 0 c t. 1� 19 �9
�;_ Ralph L. Wirtz B„�� �ama
Adaress 7343 Hayes St . N. E. Ad� Same
���� 7
N° 10436
LOCATION OF BUILDING
No. ���t�et -1�� S S t N E. ._._. part of Lot
J /�' O 1V J U 1, G
Lot _ Block Addii3on or Sub-Division Aud . Suh _#�9
Coraer Lot _ Inside Lot — Setback — Sideyard
Sewer Elevation �— Foundatlon IIevation
DESCRIPTION OF BUILDING
To t� vs�a es:
G a r a�e Front ____2A=! ne�tn �' xe�nt ._.__1.D.' sq. Ft. � c;u. Ft � 0
� Front Depth I�eight Sq. F't. Cu. Ft
Type of Construction F a am e F�� Cost �.�..r�.Q..Q.. __ To be Completed
Drainage o.k. ifdriveway cut down to slope to street.
In conaiderai3on of the issuaace to me of a permit to construct the building described abave I agree to do
the proposed work in aceordance with the deacription above orth aad 9n compliance with afl provisiona of
ordinances oP the dty oP FrfrIIey. � � �' ,•
��
In consideral3on of the payment of a fee of $-9....Q1L_, permit 3s hereby g1'anted to R S.� n� �?'t z
to construct the buflding or addition as de.acrYbed above. This perazit is granted upon
the expresa condition that the person to whom it ia granted and hia agents, employees and worl�en, 9n all work
done in, around and upon said building, or any �art thereof, shall cbnform fn all reapecta to the ordinaace� oE
Fridley� Minnesota regardiag location, construchon, alteration, maintenance, repair snd moving of bufldinga
within the dty ]imits and this permit may be revoked at any time upon violation of any of the provisiona of said
ordinances. �
('.1 a r r� n C.� � 6== '
NoncE:
'll�b psneH d�s aof eevsr �hs soe�cHoe, 6nlaQaMee ier �rWeg, plumbteg, ga h��ttnA, ssw�� or wahr. Bs wea to a�
1he Buildin8 laspseto� for mpararo permha for fhess Itfms.
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APPLICATION FOR BUILDIATG PERMIT
CITY OF FRIDLEY, MINNESOTA
e
ot� �s rr� �f'�/�/� �-� Gr/i�7�Z s�zi.nn� S� /��/-°
AnD�ss �3l�3 t��9-y�� s s1% /�. �' �nDx�s
,
LOCATION OF BIIILDING
No .9�l� 3 s� f�„� ,1�/-�'S s/'�' _�/, ,`�
so��� �' O� �/�
LOT/V, /y� 'Lti7`�J BLOCK ADDITION OR SIIBDIVISIONf%� S� r—/�/� °� ��
CORNER LOT INSIDE LOT ,%C SETBACK SIDEYARD
SEWER ELEVATION TOP OF FOOTING
lpplicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on theee Certificatea.
DESCRIPTIOPT OF BIIILDING
To Be IIsed Ae:
���� � �' Front � � Depth �� Height � �
Square feet G� '�% �, Cubic Feet �j ?�S �
Front Depth Hei�ht _ _...�'
Squa,xe feet - Cubic Feet � • �P �
Type of Conatruction �'%' � I✓/ /� Eatima,ted Cost
To Be Completed <���7-�=�� �f �- e,i� °� ci�
The undereigned hereby makes application for a permit for the work
herein apecified, agreein� to do all work in etrict accordance with the
City of Fridley Ordinances and rulinge of the Department of Buildings,
and hereby declaxes that all the facts and repreaentatione atated in
thie application are true and correcto
DATE � 3�- � � SiGN�TIIRE �
(Schedule of Fee Coata can be fouxa.d on the Reverse Side.)
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BIIILDING PF�ftMIT�FEE SCHEDULE
SECTION 2. The Inapector of Buildi.:n�e shall, before isauing germits
for the erection of any buildin� or structure, or for any addition to any
�xiatin� structure or building,.or for �.ny alteration or repaire to any
exieti_ng building or structure, upon application therefore, require the
payment by the applicant for such permit of fees to the amount herein
below aet forth and in the ma.nner herein provided to-wit:
IIniform Building Code: Type 1y 2, & 4-�1075 for each one thoueand
cubic feet, or fraction thereof, in auch cubical c.on.tents. Type 3& 5- _ �"��
$1e50 for each one thousand cubic feete ��-' "
For the purpose of computixt� fees for buildin� permite, the cubical
c�ntenta of any �building�ag�addition to a uniform heig�irt'thraughout 'by '�
multiplying the ground area covered from a point six (6) inches below �
the floor line of the basement or the cellar to the average height.of
the upper surface or to the avera.ge height of the roof eurface of the
main g�.ble of a pitched roof.
For repairs or alteratione to an exiatin$ atructure� the fee shall be
at the rate of $3.00 per each five hundred dollaxs (=500.00) or
fraction thereof i.n the coat of all proposed work.
In no case ahall the fee char�ed for any permit as set forth in Section
2 be lese than $5.00. -..
NSSSD Coxinection Chax�es based on location - Area 1 or 2.
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c�ty of Fridley 29861
AT TME TOP OF TME TWINS g � I L D I N G P E R M I T
r
� � RECEI T NQ.
� ; v _ COMMUNITY OEVELOPMENT DIV. �
r � �' � PROTECTIVE INSPECTION SEC. � �
i .' ,
i--_- :;����,•� CI?Y HALL FRIDLEv jj1�i NUAIBE. pEV DATE PAGE OF ACVNOVEO Y
L J\ 6�2-5��-3aso s�aF�s 7/13/99 / /
lOB ADORESS �343 Ha es Street NE
1 LEGAL LOT NO. BLOCK THACT OR ADDITION SEE ATTACHEO
oescR. pt. of 21 Parcel 1520 Auditor's Subdivision #129 SHEET
2 PFOPERTY OWNEFi MAIL AODR�S$ ZIP PMONE
M ron Beachum
3 CONTiiACTOR MAII ADORESS ZIP PHONE LICENSE NO
Nea� Haven Const. 4208 83rd B -
4 ARCHITECT OR OESIGNEii MAIL ADORESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADDqE$S ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADOITION O ALTERATION �X REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOfiK
Reroof house and garage (25 Sq) Tear-off
9 CHANdE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
SEPARA7E PERMITS ARE REQUIRED fOR EIECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NUIL ANO VOIO IF WOFiK OR CONSTRUCTION 20NING SQ. FT CU FT.
AUTHOR12ED IS NOT COMMENCED V�(ITHIN 80 DAY9, Op IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERIOO OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY TNAT I NAVE READ AND E%AMIN�D THIS APP�ICATION STALLS GARAGES
AND KNOW TNE SAME TO 8E TRUE AND CORREC7. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND OROINANCES GOVERNING TMIS TVPE OF WORK WILI BE COMPLIED
WITM WMETHER SPECIFIEO MEREIN Ofi NOT. TME RANTING OF A PERMIT $2185 $1.09
DOES N T PRESUME TO GIVE AUTMOR Y TO IOLATE OR CANCEL TNE pEqMtT fEE SAC CMARGE
PqOVIS10 OF ANY OTMER S E LOCA LAW REGULA7ING CON-
STRUC N R TME PERFOR AN E CON RUCTION �83.25 Fi re SCi �2. 19
�/j � e� � P�AN CNECK f EE TOTAL FEE
�a � � Li C $5 1.53
S�GN uaE CON'A4CTOa Op 4UTti0A�2 D AGENr �OaiE� ME P VALIO TMIS I$�,OUR PERMIT
- �t� �
S�GNa�uaE O� OwNEQ��� OwwEp BU4DEp� �b�rE� � e G�roSP ' � nart
Jul 13 99 09:30a Kerri 566-7183
� •� APR-14-1999 11�34 FRDt�1 t1TY OF FRIDLEY TD
N� ( 1
ADDN [ j C.CTY OF FRYDLEY
ALTER [ J SINGLE FAM�I.Y AND DUPLEX�S R-� AND R-Z
Bt31LDING PE�RMIT APPLICATION �
ConstructionAat�tess: � �
Lc�at Aescriptioa:
Owner Name 8t Addcess:
Conttactor• i�'t1
Address: �C ii :
s . S��r.�.c � � �
p.l
5667183 P.01i0?
W�
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����i'���� MN UCENSE # 2 �7 7 � � --v
i ���'� �%f/�f%i� �i/C�'� . i1 D, / � Tel. i� ��G !G � S � �'���
Attach W this ap�Iication, a Certi�icate of Su:vey of the `�`��Y�
lot, with the proposed conswction drawn vn it to scale.
DESCRIP'1'I4N OF IlV�'ROVEMENT
LIVING AREA: I�ength -- Widrh �Ieight Sq. Ft.
GARAGE AREA: Leqgth � Width Heighc Sq. Ft.
DECK AREA: Length _ Width Hgt/Gxound Sq. Ft.
OTI�ER:
Z..� 5 � -� , ,r —,
t� � P � � Estimatcd Cost: $ � r �-' �'
Cansttvction Type: �. � �
(Fee ScheduIe on 8ack)
Driveway Curb Cut Width Needed: Ft. + 6 t= Ft x S =$
• '' � % APFLICANT: � ,I �P S�t.. Tel. I� �� � –' I � �
)ATE.
Ptrmit Fee
Firc Surchazge
State Surcharge
SAC� Charge
License Sbrcharge
Driveway Fscrow
Fmsion Control
Park Fee
Sewer Main Charge
�'OTAL
S1'IPULATiONS;
$ � � , �-��
,
$� �.�`i
$ j e� �
$ _
$ ��' i�l �-)
$
$
$
$
$ � ..��
CITY USE QNLY
Fee Scheduk on Reverse Side
.001 of Pcrmit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 ger SAC Unit
$5.00 (State Licensed R�idential Contractors)
Alt. "A" or AIt. "B" Above
$450.00 Conservation P1an Review
Fce Decermined by Engineering
Agreement Necessary ( ] Noc Necessary [ ]
Building
Inspections
763-572-3604
DATE 6 ` � �"D �'
srrE Annt�ss '
THIS APPLICANT IS:
PROPERTY OWNER/ N,,�,
TENANT �I
PHC
CONTRACTOR Ne*
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
� � S ��`
❑ OWNER p1CONTRACTOR
� �/� L° /1%f1 �
:�5� 73 Y3 ����s
,�• cp ( 2 ��D - 72� t'
SUBMIT A COPY OF S?ATE LICENSE #�
YOUR STATE LICENSE ADDRESS: �
WITH APPLICATION pg� �
PROPERTY TYPE
PERNIIT TYPE 0�DTfI0A1 ❑ GARAGFJSI�D �T WS
❑ BASEMENT FINISH ❑ ROOF O DRAW T[LE
� DECK ❑ SIDING ❑ 077�R
❑ SWIIvIlvmVG PQOL
TYPE OF WORK: �
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
ZE
ROOFING
NUNIBER OF SQUARES
GARAGES
PROPOS£D SIZE:
PROP(?SED HEiGHT:
G�•s�.l.•r
Permit No.:
Received By:1
��I�41G
TH WIDTH HEIGHT
O HOUSE 8c GARAGE
❑ ATfACF�D GARAGE
❑ DETACHED GARAGE
���Z
STATE ZIP
�ASEIVIEM' REMODELING SUBMIT:
1. Existing Fl�r Plan
2. Proposed floor plan
3. List of strucwral members to be used
Ft.
SmIIVG FOR NEW CONSTRUC[70N MCLUDMG DE,,CKS,
0 Vinyl �Soffit ADDITIONS. & PORC}�S SUBNIIT:
❑ Alwninum ' O Trim 1. Site Plan/Survey showing the existing structures
❑ Other . ❑ Fascia arid proposed project.
R'IIVDOWS 2. Two sets of construction plans
IN EXISTD�iG OPENIlVGS � �IVo L 110 OF 3. Energy Calculations �
OR FOR NEW OPENWGS-DESCRiBE SIZE OF ^ �
OPENING CHANGES &
TYPE OF WIIQDOW TO BE WSTALLED NUIvBER OF�VVINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $�/�O �"� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Cherge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Dae
$ See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $1675 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ �, a..'� Make checks aavable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-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 ordinances and code of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application f e t and work is not to start without a permit; that the work will be in accordance with the approved
lan in the case of all work w' u s e and roval of lans.
SIGNATURE OF APPLICANT . G�� �P PRINT NAME vNV�'( �G��/d!y" D?�TE ��Z+ —� �
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
shucture, or for any addition to any existing building o� structure, or for any alteration or repair
to any existing building or structure, upon applica.tion therefore, Teqiiir� the pay�ent 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 conslruct�on will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the const�uction site.
A Certificaxe of Survey of the lot, showing the location of the existing founda.tion will be
required before proceed.ing with the framing. New Houses Onlv '
City of Fridley
Building Inspections Department
- — — - - b4�-1 �lniver�ity �4v��e NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
.
� � � (� �� From:
Building
Inspections
763-572-3604
763-502-4977 FAX
DA'It �Li � — �
S!T'�ADDRFSS v/�,
THIS APPLICANT 1S:
PROPF�RTY
OWNER/
TENANT
CONTRACTOR
SU BMIT A COPY OF
YOUR STATE
LICENSE W1TH
APPLICATION
PERMIT TYPE
of Fntltey I o: t�d�ti144�'I Nage:1►5 uate: �1a1'1taJy i:4l :1L rm
ME�H�IC�L Permit No.• � - �'
RESIDENTIAL APPLICATION Recei"ed sy:
CITY OF FRIDLEY D��= o r
n
PHONE: �/
COMPAIdY NAM���:y
CONTACT P��610, _
STAT� LIC�NS�.
PHON�
FAM1l.Y � TWO 1�'AMILY
TYPE OF WORK: I❑ N�W �RtiP1AC�M�NT
DETAILED DESCRIPT[ON OF WORK
DAT�
� TQWNHOUS�
❑ ALT�RATION/RN:IVIQD�L
STA7'� 'LIP,
��
Bquip�nt�lnstalled O� $30.Q0 PLR FlXMTNRL�, XC� L�PT WHLRL VOTLD. �'7 MOD L: �vD}�� `i I't�L'�°�L� SI'L�/H UH�l7-,�
�—
MNG: L��f�X MOD�L:��/�X [�� Sl'LEl13TU ���
MlrG: MQDtiL:
I A/C $25.00 r1R�PLAC� (dAS) $15.00
_AIR TO A1R �XCHANG�R $!5 MIREPLAC� (WOOD) $35.00
_BQ1Lh7t $35.00 �FURWACE 535.00
CHIMNBY LIN�R$)0.00 GAS DRYBR$10.Q0
DUGT WORK $10.00 QAS PIPING $10.00
31'LhJ13TU
_GAS ItANQ�lOV�N $10.00
NBlN CiAS GR1LL $l0.00
_CiAS UNIT HTR $]0.00
PQQL HBAT�R $35.00
VBN'I1LA'COR $ I 5.�
THIS IS AN APPLICATION 1+QRA PLRMIT-NQT VALID UNT1L PRt��S5BD
I hcrcby apply for a building pern�it and I acknowledgc that thc information abavc is completo and accurato; that thc work will bc in
canformancc with thc ordinanxs and codcs of thc City of Fridlcy end with thc Minna�ota Consh�uction Codas; that [ undcrstand this is
not a perrait but only an application for a pc�mit and work is nat to stiart without a permit; that thc work will bc in accordancc with thc
approved plan in thc cesc of work which rcquiros vicw and approval of pla g.
SIGNATUR� 01� APPLICAN 9����� PRINT NAM��Y If � �I`�� 1RDAT� � L� � – I�
City of Fridley
Building Iaspections Department
6431 University Avenue NE, Fridley, MN 55432
7b3-572-3604 FAX: 763-502-4R77
�