AF - 45566City of Fridley, Minn..
BUII.DING PERMIT
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N° 5196 �
Date: __� �` """ � / .
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Owner: � .:.�.��.�-'"'#'.� Builder :� --
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Address Address — __ _.�
,l,,, LOCATI O� UI DIRIG
No. ��� Sfreet �-��`-��r��..�:._.. Part of Lot ___._._._._�.��
Lot ..._,..��� Block �r Sub-D3vision .�� �
.r. � /
Corner Lot - Inside Lot ....�� Setback _�,�� �� Sideya.rd _...�-.-�il�"'� �
Sewer IIevation � _ Foundation IIevation
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DESCRIPTION OF BUILDING
T U : �
� �� Front �" � Depth _� f� Height -� Sq. Ft.�.11
+� � Front � Depth _� Height L� Sq. Ft. •-.�.,�-
J �', r' �r�
7.j�pe f Construcl3on �° � Est Cas �.�� •`•.�� To be Completed _
Cu. Ft�p����
Cu. Ft. -;F-�- L�X
In considerai3on of the issuance to me of a perinit to construct the bwtlding described above, I agree to do
the proposed work in accorflance with the description above set forth and in compliance with all provisions oP
ordfnances oE the dty of Fridley.
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In consideration of the payment of a fee of $..:��- y , Permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person_ to whom it is granted and his agents, employees and worl�en, in all wo�rk
done in, around and upon said builduig, or any part tlzereof, shall conform ui all respects to the ordinence$ of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving oE buildinga
withfn the city limits and thia permit may be revoked at any time upan viola�on of any of the provfisions of said
QT(;lIIAI1C@8. e+'"""w, w i�% '�
$1131diIIg IIIBpCCLOT
NOTICE:
This permN does na1 aovee 1he construeNon, tnatallsdon for wirine, plumbing, eas heafing, sewee or water. Be wre to me
ths Bulidieg laspeetor for separate permib fo� the� hema.
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�iPPLIC�ITION F� BQILDIAIG PERMIT
CITY OF 1�'RIDLEY, MIINNESaTg
Obmer' a Name /�� Bu3Zder �,G(%� �
�d.dresa �� ��� �' � Address, � i e / /� �,��,,; ;�
._.. . ���_
LOCATION OF HIIILDING
y /
No. / J�^� 3fi.reet �•�-G° . Part of Lot
Lot �`� Block Addit3on or 3u�l�.vision ��• � s� 9'
Corner Lot ___,_„___Inaide Lot '� Se
a . _ s�► - —
S�1'ER ELEV,
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�pplicant attach to this �foY`m Certificate of Surve�r of Lot and proposed bu�.lc'l�uag
location.
To be used as:
4
DESCRIPTION OF BUTLDIPTG
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Sq. Ft. Cu. Ft.
. �' Sq. Ft. Cu. Ft.
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Type of Construction Estimated Coat /� �
To be Completed � � o ��
The tandersigned hereby makes applicat3on for a perm3.t for the work herein specified,
agree3.ng to do a7.1 work in sfi.rict accordance with ttde City ardinances and ruling of
the Department of Buildin�a, and hereby declarea tha.t al]. the facts and representationa
stated in th�.a applicat3on are true and correct. A� � .
Ne ��
DATE �� � � �,� SIGNgTURE � Gi%C�'t� %� �,
(A Schedule of Fee Costs can be found on the Reverse Side.)
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BUILDING PERMTT FEE SCHEDUIE
Section 2. The insgector of Build3ngs ahall, before issu3ng ar�y parmit for the
erection of any building or structure, or for anx addition to ang exiating build-
ing or structure, or for any alterations or repairs to an�r existing building or
structure, upon application therefor, require the pe.yment by the applicant for
such permit of fees to the amount here3n below set forth and in the m8nner herein
provided to-wit:
a.l. For any such pex�mi.t for the erect3on of a.ny fire.-proof building, other than
a garage, warehouae, factory or grain elevatar, or for the erect3on of any fire-
proof addition, for similar occupancy, to any exist3ng building ahall be at the
rate of �1.L,A for each one thousand cubic f eet, or fractioa thereof, in such
cubicel contenta.
2.2. For any such perm�t For the erection of any fireproof garage, warehouse,
factory or grain elevato'r,�or-for the erection of arry fireproof addition, for
aimilar occupencg, to a,ny exi,sting building sha11 be at the rate of �1.25 for
each one thousar�d cubic feet, claes3fied as °fireproof" by Seation 502 of the
Mi.nneapolis Building Code.
HOIISFS
2•3. For an�r such permit for the
than a garage, warehouse, factory
addit3on, for simi].ar occupaney,
each one thousand cub3c feet.
GARAGES
erection of any non-fireproof build3ng other
or grain elevator, or aay not�-ffreproof
to any exiating buildin�. Permit $]..00 for
2.L�. For an� such permit for the erection of any nor�fireproof garage, warehouse,
factory or grain elevator, or for the erection of ari� nori fireproof add3iion, for
similar occupanc�, to an� exist3ng building or for each auch building or addition.
Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical
conF.ents thereof with a minimum o£ �4.00.
For the purpo�e of computing fees for building permits the cubical contents of a.ny
building or addition to a uniform he�.ght throughout by multiply3ng t,he ground ares
covered from a poi.nt six (6) inches below the floor line of the ba.aement or cellar
to the average height of the upper surface or to the aeerage height of the roof
surface of the main gable of �, pitched roof. .
2.5. For repairs or alterations to a.n existing structure, the fee shal]. be at the
rate of �3.00 for each Five Hundred Dollars ($500.00), or fraction thereof in the
cost of all propoaed work.
2.6. In no ca.se sha11 the fee charged for any permit as set forth in Sect3on 2 t�e
less than $4.00.
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Wea�herstraps �, . 3 Conatruetion No . 4*�'- �__ ti.: F m Insulat�on �':`
Ctnide
Windows Doors R�ference Out. Wall Inf. Wall Ceilin g Roo f F l o o r Ki n d - How A p plied ..
Yes—No I, Yes—Na 19_ I ., �'� _E � F .
Fl.� � '"' Room � Leagth � Width ��' �Height ' F7.� . Room Leagth ��° Width � �'�Height �
Windows and Doors—Crackage and Area Windows and Doora--Crackage and Area �
�Vidth Helght No. ot L1nea1 f. Area Width HelBht No. oL Llneal it Area
No. ot Dane ol pane Ilghte, oCcrack eq. [t. No. ot pane ot pane lfghts of crack eq. ft =
r�. - �`�� , ��� , /�f �1' "� ,�',,� - .�`� - .� �• `
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Coef. Btu Coef. Btu
Tnhltration �� ' 1� In6ltration � �ii+�:
Glass j� "�"+� Glss, a - - �;� �j
. _ P•: , ° � . Eap. wall ` " " ` � '"
' �:a" wall _ "� . ., . �
Net exp. wall .:'-� :>` � .. �.� _ ° : ,;r? - : .� .�,.
Net eap. wall � +I�� � ° '� i
Int: wall , - __ _ _ , " ` " _ Int..w�. -_ ;;:, , . . .
Ceiling _ . ',� �� r''� T +�r�ai"` ' Ceiling ' —
Floo� , ' Floor ` �.
'�'otal Btu; : . ._ ,
Tocal Btu. �'
Required aq. ft. E.D.R. or aq. ins. W.A. I.eader area ' Required. sq. fG E.D.R'. or aq. ins. W:A. L:e�det area '�
;' �. - �� ( [�o� -� ��' " w�a��°p :- . He��t �- �:I �m l ���' " w;ac� /�'.. HG�ghc : � �
Windowa abd Dobts--Crackage and Atea ' VNindav►� and Doors�rackage and Area ; _
WIdLh Helght No. ot L1aea! iL Area • WHIth �8�1ght No. of Lineaf tt. Area Lw[�.,+��+��
No.. . ot DQne ot pene `:Li hte �ot craok °�. tt• ' = No. Of yane _of �a.ne ]lghts , of crack - ep. [t �''� � 6/' � -.
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Exp. wall j�' ,,,,, ,..� F.zp. waU . ` �� ' ; , :_ .
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F:.�otal Btu.,_-- == - - . : � � " _ . , . BEu,= --. �� - — — -
:,Reguired sq. ft: E:D.R: or�q. ina: W.A. Leader,ana �° Raquired dq. ft. E.D.R or aq: ins.�W.A. L.eader area �_ _
' FI: Room � Lengt6 ��- ' Width ��` Height , �'], �' Room I Length Width Height :;-
Windowa and Doora—Crackage. and Area W'indowa and Doora-�C'rackagc an Area '' -
Wldth Hefght No. ot �neel it. Area Wldth He16ht .- No. oL Llneal tt- Ares
No, o,i Dane ' o['Dane Ilghts '' ot crack` pQ.. tL:- ' , 4,e
- No. , ot ysne .,, �9f.psen 1i61rts � o! cnck• sQ. t!, -�.-,
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':In6ltratioa ° �i ' 'lF=#) In6ltration �i(,� ` ' ,�;i�
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Glass �'� �� . '� ' � � ` : `�}'
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-:Int. wall � _ � , . In� wall >.�
_Ceiling ` -°: _ Ceiling
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.: �loor •< ,,� _-,; , ' � r� . Floor _. . :,_ ,ti ..' _ ,
=:�Tbtal $tu. 1'atal Btu.
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SUBJECT _ER�T�AI�. � c
City of Fridley - ° '
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � ECEI NO.
� • COMMUNITY DEVELOPMENT DIV. �
� �ti: --_.__,
r i � PROTECTIVE INSPECTION SEC.
� .1 �
( 1 /'�'1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BV
�""'� � �'� 612-571-3450 910-F15 4/10/81 � /
JOB ADDRESS �355 Hayes 5treet N.�.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 34 A't1C1].'tOi � a''� Sl1I�. #129 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
J3m Hinricks 7355 Sayes- Street N.E. 784=3077
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Abbott Construction 945 1Kississippi Street N.E. 571-7188
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
R2S1C1P�iI.'t111
7 CLASS OF WORK
❑ NEW � ADDITION C] ALTERATtON 0 REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Finish.Basement - Complete rec. room and bathroom - Install fire esca window
9 CHANGE pF USE FROM TO
STIPULATIONS �q�de com'�ustion air to furnaee. Insta.11 fire alarm in hallway
leading to bedrooms if bedrooms are to be installed.
�EPERATE PERNl1TS RE��R�� �� ��R�� �
HEATINC. PLi�N�l11� �i� S�G�
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS APE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �j`].� rjOO �`. %S
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9�00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/ nC�� /���/' _ , �'�� � �� PLAN CHECK FEE TOy�,��F��
r �a
,�'J !z�L
SIGNATUREOFCONTRACTORORAUTNORI2EDAGENT (DATEI WHEN PROPERLY V/�ALIDAT O THIS IS YOUR PERMIT
C �+ .s� �/da��t�"�-�" / �1..! �5 `
SIGNATUREOFOWNER�IFOWNERBUILDERI IDATEI BLDG INSP f1ATE
. cxrv or �ItIDLCY •
, � APPLIC�TIQ'� FOf� (tESI[IEi�ITI/li_ DUILbIftG PEf��fITS
(tJc►�r, Ali:er��tians, /1ddiLians, or Repairs)
� Otl��ER: V,,M �°% i� ►^� C f�S
IIDDRESS: 7� 5,5� �e.,s' �
r
TCL �IO: %d'�% �j7%
�
�UILQER: �� bGf �'� St .
ADDRCSS: �y',5" �j(�.�5 . Sf
TEL Id.O: ,5`7/— �
Consi:ruc�ion Location '
STRI��' NO: _l�_1�� STREET: ��Gy�,S' ST ,
. —�
�.,.. � � .
Lo�.�: ,� � � �LOac : ADDITION : / :
'� � �
Corner Lot: Inside Lot: `� SetbacY.: sa� Sideyards: s°`� ��
Ap�l.icant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale. .
DESCRIPTIOiJ pF COidST�UCTIOP� -
F. N� S �, ��.,5 � Front- �
��.L�t°oo r-m Square. r'eet_ .
4�c�i�M1.�o v}. ' .
F"re e S��'e �u ; r+da,., Frant:
� Square• Feet: �
Depth :
Aeight: �
C�.bic Feet:
DePth: � Height:
Cubic I'eet: �
Type of Construction : '� �� Esi:imated Cost: $��DD
Zb $e Oor,�pleted: Y � .��' �l . .
� . _ � Alt. A Alt. B
Proposed Drive��ay 69idth If New Openinq Is Desired: $' $
, ., S�E REVERSE SIDE OF SHEET .
�.Rie undersigned hereby makes application for a permit fcr the t�ark� herein specified,
agreeinq to do ,all work in strict accordance �•�ith the City of Fridley Ordiilances a�zd
ruling� of i:lie Depazfimei�t of J3uildings, and her.eby declares thzt all tlie iacts and
re�resentations stated in fi.his appl.icatian are true and co�rect,
D.'iT�: 1� �d _ � � SIGNATUF.E : �� �i�Q.�,
StipulaL•ions:
� y���s_
� �_.�
��._. �-
� �-��
�i 2 !� i
� •
;�
� �e. ' . , � �
_ .. 4
� . t�u��nii�lG f�r�r,��T�r r�:�� sc:��r_nu�c� � . .
;;1,C't'x01•� 2. • 7.'1�� 7n�:��ccLar. of l3uS.ldii��a:: ::hril.�, bcfor.c i;.ui.��q �,�cnnit:; Tor lhc crecL•�.on
of• ���iy l�u�.l.cl:in�� or :�i:��uct:urc, �r. �ax ��ii�► adQi.t:.i.��n L•o a�iy er,i�L•�.»c� l�tiildi.nc� or :.trucL•uxc,
. cir l:�r. al,y .i1.t�crzL•.i.c,n �r. r.cl,��ir.�; Lo �any c::S. .t:inc� 1�ui.l.di,�u; or sL�.ucturc, n��wz ar���la_cat�.on
..L•ticr.�ior.c:, r.c:qui�:c Ui� paymc��t: }�y t]�e �-�r�p].i.cant: �or. such per.r�S.L ot: fec; to tl�c �nvunt
hcz�in bcJ.o�•r set• for.th �ulc1 �.�i tlie manne�: hcrcin ��rov�ciccl L•a-a:a.L•: .
l�JE1�� COIJS'!'I;UC'�CIOt�:� Sing7.e i'��mi1.�► 1locres and Gar.aqes: ;:4.00/�,0�0 cub�.e tec:t:. .
PLTsF�t Clil:Cl:: 25 i�er_cer�t: of buz.lai�icJ J�e�-mii: fc:e.
UK1:��1:�:111' llL•'L�PI:SSZOt•; :(Cpncrctq GUrb �Lrects Only) ' �'
' Al.tcn�at:e n; Itc:moval and re��].acen�ent of concre�e curb and
qutL•er only; 17rivea�ay �•ric�th plus 6 i'eei: x$13. �0
ltl�ernate I3: Removal and rep�acement of concrete curb and
•� gutter and inst�ll a 3 foot r�ide approach �aiL-h ='
.• 6 inch depth; Driveway ��ic:th �plus G feet x.$15� 7�
• . �nDI3'IO��/�L I(�lf=0R��1/1TI0N �
Ibr the purZ�se of computin� fees for_ building permits,. t-iie cubicaZ cor.tents' of any
buil.d�.ng or. addition, is dci:cr.tnitied by mulLiplyirig i;.he ground arez covered trorn a
p�xnt six (G) inches belo�� ihe iloor 7_ine oi tlie basement or th� cellar to 'rhe .
average heights ai thc -upper surface or i.o i:he average height o£ the roof. surf:ace
o� t:�ie raain c�abl.e of a p�.tched roof. • '
Fox repai.rs or al.terations to an existing strti�cture, the fee shall� be �t the ra.ie
of $3.00 pex cacli five hundred do�lars -($500.00) er fracL-ion tihereaf in tiie cost
oi all proposed wor.k. .
In •no c.ase sha�.l the fee cliargeci fdr any penni.t as set forth i.n Sectian 2 be less •
than $7.50 plus $.50 �tai:e surcharge. � . •
v�rtrFrc�-rzo� oF rour�n�rtors
� NOTE: Permits �or construction ��ill be issued a minim� c,f 24 hours fram U�e time
ai apPlication to al.low for proper ret�iew of ihe proposed structure and oi �he
constxuction site. �
; �
A Certificate � of Suxvey of the lot, sho�,�ing the location of the foundation once �,t
has been coizs�nictcd �.��11 1�e required bef.ore proceeding with the �raminq.
.�FRTIFIGATE OF c�CGUPAt��CY ` '
� nFP�icatic�n for a Certiticate oi Occupancy shal]. be mad;� ten (10) days prior to the
use ox accupancy o� any stz-ucture for !JZ11C�1 a builcling permit l:as been issued; and
sria,d st�:uct:urc : ha1). iiot be used or. occupied witi.l a Ccri.i_fic�te oi' Occurancy h�s
bcen x�sued. .
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C�11VIlV�Y AND► S�"AC� VERI�'ICATION
The wtdersigned hereby verifes tbat thee exisbuo►� cb�imuaey or stack:
1. Has been carefully examin+�d Yes �) No ()
2. Is free firom n�st or deterioration
3. Has no foi+eign objects lodged within
4. Is securely supported
_ 5. - 1Pieeis alI cuircnt Co�e ��+r�_,M?E for siz�
aud total BTU's co�ted
Ci
7
8.
Has total heating BTU's of �5 ,� �'t7
All other BTU's 3 �� �
TOT.AL B'�TJ's 0 � �' �
Has a liner been provided for water heater
Has combuscion air been provided for water heater
Remarks:
Ya (� No ( )
Yes (�e) No ( )
Yes (�) No ( )
Yes (� No ( )
Yes ( ) No �
Yes� No ( )
�.ist ALTERATIONS Being�Done:
, N�sr�re..c-,,�1 � X ���� .��r � ��. �—
HEATINC CO:
$1gIICd Bj►:
Date:
.�'
�► zi�
�
SuB�ECT
City of Fridley
AT THE TOP OF TFIE TWINS g � i L D I N G P E R M I T
i `
� ; V �_��� COMMUNITY DEVEIOPMENT OIV.
f � � Pi10TECTIVE INSPECTION SEC.
i � .
i-__-� ��"'�'� CITY HALL fFIOLEV SS��2 NUMBEp pEV O�TE
� 612-57�-3450 s�aF�s 2/25/99
lOB ADORESS 7355 Hayes Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION
�ESCR. 3�F Auditor' s Sub .�� 129
2 PROPERTY OWNER MAIL ADORES$
Jim Hinricks 7355 Hayes Street NE
3 CONTqACTOH MAIL ADDRESS
Milton Johnson Co. 525 Lowry Ave NE, Mpls., MN 55418
d ARCHITECT OR OESIGNER MAIL ADDRESS
5 ENGINEER MAII AODRESS
8 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW
8 DESCRIBE WORK
Reroof House & Gar�
9 CHAN(3E OF USE FFiOM
P�GE Oi
/ /
784-3077
21P PMONE
781-9548
ZIP PNONE
ZIP PHONE
�IIT NCf`
8947
EIP
gv
SEE ATTACHED
SFIEET
LICENSE NO
2083
LICENSE NO.
LICENSE NO
❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE
25 Sq) Tear-off
ro
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIqED FOR ELECTFICAL. PLUMBING. NEATING.
VENTI�ATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING
AUTHOR12ED IS NOT COMMENCED WITNIN 80 DAYS. OR IF CONSTpUCT10N
OR WORK IS SUSPENOED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED NO DWLG. I
I MEREBY CERTIfY THAT I MAVE READ ANO EXAMINED TMIS APPLICA710N ].
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VA�UATION
AND ORDINANCES GOVEHNING TMIS TVPE OF WORK WILL BE COMPLIED
WITH WHETMEfi SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT �2a 142
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pEqMIT FEE
PROVISIONS OF ANY OTNEFi STATE OR LOCAI LAW REGULATING CON- �74. �S
STRUCTION OR THE PERFONMA CE OF CONSTRUCTION
" PLAN CNECK
� �' � � �-' I ° Licen
�. S�GNATUAE O� CON'aACTOp Op AUTMOA�ZED eGENT IDATE� E
�
S�GNATURE Oi OWNEAi6 OWNEABUIIDEpi iDAfE� , �- B OG
S�.
S7ALLS
C �5.
GROUP OCCUPANCVLOAD
CU FT.
OfFSTREET PARK�NG
GARAGES
SURTAX
�1.�%
SAC CMARGE
Fir SC $2.14
TO l FEE
82.96
D TMIS IS VOUR PEpMIT
.� �'� �-
OttE
N 1:\V
ADDN
ALTGR
(XI
[I
l. 1
' C[TY OF FRIDLEI'
SINGLL' FAMI(,y pND DUPLEXES R-1 AND R-2
BUILDING PERM[T APPLICATION
Cffective 1/1/97
ConstructionAddress: 7355 Hayes Street N.E. � .
Legal Description:
Owner Name & Address: Jim Hinricks (same) Tel. /� �84-3077
Contcactoc: _Milton Johnson Companv MN LICENSE# 2083
Address; 525 Lowry Ave. NE, Mpls. 55418 Tel.li 781-9548
Attach to this application, a Certificate of Survey of the
lot, with the proposed constiuction drawn on it to scale.
DESCRIPTION OF IMPROVEDZEl�'T
LIVING AREA: � Length � Width Height �
GARAGE AREA: Length Width Hei�ht
DECK AREA: Length Width Hgt/Ground
OTHER: . .
Sq. Ft.
Sq. Ft.
Sq. Ft.
Tear off and re-roof
Construction Type: 25 sq. • � ,�� �G.a� Fstimated Cost: � � �.� � ��'� � . .
� �Fee Schedule on Back)
Driveway Gtiub C�t .Width Needed: Ft. + 6 Ft = Ft x $ � -� _ $ � � �
DATE: ��� y s A►PPLICANT: . - - Tel. # � s.1-954 8
'ermit Fee
�ire Surcharge
�tate surcharge
�AC Charge
.icense Surcharge
)riveway Escrow
:rosion Control
arh Fee
ewer Main Chargc
TOTAL
C[I'Uf.A'('[nNS:
$ `7/ �
$ a,iy
$ /,o�
$
$ �' � o 0
$
$
�
$
� 8� �
CITY USE ONLY
Fee Schedule� on Reverse Side �
.001 of Permit Valuation (1/lOth%) �
$.SO/$1,000 Valuation �
$950 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 [ )
m
. ;.
. . ' � ''
�cu��,n�,vc. ����.���trr rr:c sc�{�uc��.��.
'Cli� Chief I3uilding Ofticial shall. l�efore issuing J2emiits for the erection c�f any building or ctrucwre, ar 1i►r
any addition to any cxisting building or stntciure, or for any alteretion c�r repair to any existing buildin� or
stiucwre, upon application tlierefore, require the payment by the applicant for such permit of fees to the amount
lierein below set forth and in the, manner herein provided to-�vit: �
TOTAL VALUE
$1 to $S00
$501 to $Z,000
�2,OU1 [o $25,000
$25,001 to $50,000
$SO,OOI�to $100,000 .
$100,001 to $500,000
$SOO,OOl.to $1,000,000 .
$1,000,001 aad�up �
FEFS
$21 (Minimum Fee is $21 plus surcharge)
$21 for fust $S00 plus $2.75 for each additional $100 or
fcaction thereof, to and including $Z,000
562.25 for first 52,000 plus $12.50 for each addi[ional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.� for each additional �1,000
or fraction thereof, to and including $�0,000
$574.75 for �first $50,000 plus $6.25 for each additional
�1,000 or fraction thereof, to and including $100,OQ0
.$881:25 for fust $10�,000 plus $5.00. for each addidonal
$1,OOO�or fracfion thereof, .to a�d �including $500,000
$2887.25 for the firsf $500,000 pius $4:25 for eacli .additioffi1
$1,OD0 or fraction ther�f, to and including $�1,000,000 '�
$5012.25 for the fust $1,000,�0 plus $2.75 for each additional
$1,000 or fraction thereof
�
DRIVEWAY DEPRESSION ESCROW � . .
(Concrete Gtirb Streets Only)
�lternate "A"�: Removal and replacement flf curb and gutter only =�Dri.veway width plus 6�feet times $13:50.
I ternate "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 $15.75.
VERIF[CATION OF FOUNDATION
�
.:rniits for constcuction will be issued a minimum of 24 hours from the time of application to atlo�u for proper
:��ie�1� ol' the pr�iPosed structure and of the construction site.
.{.;crtitic:ate of Sun���� c�f thc lot, showin� the location of'the found.ttio�i �+nce it has it has he:�n c�nstrvctcc!
•'� :'*_ r���uir��l l��i�►r� ��r�r.:t:t'(�lTll, u�ith thc fr:unin�.
'- <_
,. ;
sue�etr PER
City of Fridley 0825
AT TME TOP OF TNE TWINS � � I L D I N G P E R M I T
r
; � RECEIPT NO.
� ; v _�_�_ COMMUNITY DEVELOPMENT OIV.
r � � PROTEC7IVE INSPECTION SEC. a% ���
1 . � i/\
i-_--�; �"' �•� CITY HALL FRIOLE� S51J2 NUMBEN pEV D�iE v�GE O: �6nnOVED Br
t 612-571-34b0 s�aF�s 4/13/00 / /
JOB ADDRESS 7355 Iiayes Street NE
1 LEGAL LOT NO. BLOCK TRACT OF ADDITION SEE ATTACHED
oescA. 34 Auditor's Sub. ��129 SNEET
2 PROPERTY OWNER MAIL AODRESS 21P PMONE
Jim Hinrichs 7355 Hayes Street NE 784-3077
3 CONTRACTOR MAIL ADDF;ESS ZIP PHONE LICENSE NO
Northern Crest Inc 7401 Central Ave NE, Fridley, MN 55432 (763) 792-9364
a ARCNITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
20098415
5 ENGINEER MAIL ADDFiESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW O ADDITION ❑ ALTERATION � REPAIR O MOVE 0 REMOVE
B DESCRIBE WORK
Replace windows in existing openings
9 CNANGE Of USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPARATE PERMITS ARE REOUIREO FOR EIECTNICAL, PLUMBING, HEATING,
VENTII,ATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITMIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED NO OWLG. UNITS OFFSTflEET PARKING
I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED THIS APPLICA710N 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PfiOVISIONS Of LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMP�IED $9 � 786 , �4 . 89
WITH WHETHER SPECIFIED HEREIN Oii NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CNARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON• �181.25 Fire SC �9.%8
STRUC N OR THE PERFOF;MANCE OF CONSTRUCTION
� �'��� PLAN CMECK FEE TOTAL FEE
' � ense C $5.00 $200.92
S�GNATUAEO�CON'AACTOpOp4U1NOp�2E0AGENT IDATE� NE ROPEpLY VALIOATED TMIS IS VOUR ERMtT
i
S�GN4TU�7E Of OWNEA��� OWNEABU40EA� �DATEi ip5o � p E
N� [ ] Effective 1!1/2000
ADDN [] CITY OF FRIDLEY 612-572�604 Bldg Ins�p
ALTER ��j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `
BUILDING PERMITAPPLICATION Q,��\Vl
^ �u y�
ConstructionAddress: 7355 Hayes St. NE �'
Legal Description:
Owner Name & Address: Jim Hinrichs Tel. # 784-3077
Contractor: �orthern Crest, Inc. MN LICENSE# 20098415
Address: 7401 Central Ave. NE Fridley, MN 55432 Tel.# 763-792-9364
LIVING 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 iflNPROVEMEFIi
Length Width Height Sq. Ft.
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Construction Type: replace windows Estimated Cost: $ 9, 786 . 00
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 4-6-00 APPLICANT: Bill Olson Tel.# 792-9364
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in application
Permit Fee $ ��/�, �.�4 Fee Schedule on Reverse Side
Fire Surcharge $ �/• ��� .001 �f Permit Valuation (1/10th°./o)
State Surcharge $ � , �� � $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ $1100 per SAC Unit
$ � C� � $5.00 (State Licensed Residential Contractors)
$
$
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL $ ��`-� , ��
STIPULATIONS:
--�....__
Building
Inspections
763-572-3604
763-502-4977 F,
DATE `
SITE ADDRE S _
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICEIJSE, BOND AND
CERTIFICATE OF
INSURANCE
PERMIT TYPE
TYPE OF WORK:
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL
❑ OWNER a�ONTRACTOR
ADDRESS: <,�L CITY,
PHONE: ���- 7�S1" 3�7%
�.
Permit No.'. 'U
� ,;
Received By:.,��.��" '
�Q� R��d � � 10
NAME:�i iG/� �p �e"s ZCl.�jk/�
S'fATE LICENSE # �Q // � EXP DATE
Al'E Z1P,
r
STATE BOND # EX/P DATE
ADDRESS: v�S S CiTY IYI9'v�1.-° U^r'OUl STATF�ZIPSS36q
PHONE ��,� 3 _ yJ�'3 - ,�i(pb FAX
GLE FANIILY
■C7. a'1
DETAILED DESCRIPTION OF WORK
❑ TWO FAMILY O TOWNHOUSE
FEES ARE BASED ON $10.Q0 PER FIX'IURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELAW). MINIMUM FEE
$35.SQ.
BATH SWK/LAV _FLOOR DRAINS SHOWER WATER PIPING
BATH7UB GAS PIPING (NEED CITY L[C) SWIMMING POOL WATER SOFTNER ($35)
_ CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_ DISHWASHER _ LAUNDRY TRAY =WAT'ER HEATER ($35) F� IRRIGATION
WATER METER «THER
THIS IS AN APPLICATTON FOR A PERMIT-NOT VAL[D UMIL PROCESSED
I hereby apply for a plumbing 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 Constrvction 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 on site; that the work will be in accordance
with the approved plan in the case of � wo Ic hich re ' s review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME //� �G� n� I�1 Ze(,�'It%DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977