AF - 45698��
BUILI)ING PERMIT
Village oi �ridley, 1VIIi.nn. N� 2 5 31
Date •,/;;�,f . .�w �.,� . .� � . . . . . . . . . . . . . . . . . . . . . .
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Owner �_ . � � ...... Builder . ...............
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Address .. .�,r.��,, ,r,� .. s , , Address . . . . .. .. .. . . . . . . .. .
� �����k� i'�.,.�a�--��a�-9'� _
T[ON OF BUILDINC;
No. . ��.,,,� . �. . . . . Street ' �;i�`�� j,�'.'. . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . , . . . . . . . .
IP� '� %��`°'� ',�,'� ���'",.�.
Lot . . . . . . . . Block . . . . . . . . . . ddition or Sub-Division �, ,
. ��. . . �. . . �' �'�� ��_��. . .��. . �"�.��`'
Corner Lot . . . .. . . . . . . . Inside Lot . .�. . . . Setback ��.����, Sideyard g: . .., . . , , , , , , , , , ,
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DES�R[PTION OF BUILDING
To be Used as:
�`���� ,�,�!: : . Front a". . Depth r'�,`�.t . . . . Height . , . . . . Sq. Ft. , ,� . , Cu. Ft,
''�,�:��r��. •�� �� �q,�, $ ��.�+� . .. .. . . .
.................... Front ........ Depth ........ Height .... ... Sq. Ft. ........ Cu. F't. ........
Type of Construction �•``� . Est Co� �.���, .+�� . . . . . . . . To be Completed
���.� �. ...................
In consideratian of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
"�—� �",� $ — � ..�..,:�,��.
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In consideratibn tl�`t the g ent o� a fee of �� ;.•
1� Ym $. . , pe�mi�"is here y te� �0 . . $.�'" y,� .
..�., ��' to construct the building�+� additi�in as described a ove. This �!l�r���"'�n��"upon
.......... ��
.��e�p�e��'�condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done in, around and upon sa.id building, or any part thereof, shall conform ia all respects to the ordinances of
F'ridley, Minnesot,�, regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limi4s and this pernut may be revoked at any time upon violation of any of the provisions of said
ordin�ncee.
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�uilding Inspector
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NOTICE: ' �
y_ This permii does not cover the construcfion, installation o� alteration for wtring, plumbing, gas heatPng,
sewer or water, Be sure to see the Buiiding Inspector for separate pe�mits for these items.
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Caty of Fridley, inn
BUILDING PERMIT
Da�: August 25, 1970
p�r; Robert A. Schmidt g�� Same
Ad�re� 6925 Hickory Drive N.E. Ad� Same
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LOCATION OP BUILDING
No. 6925 S�t _ Hickorv Drive N.E. Part of Lot
Lot ...��__.__ Block 1 Addition or Sub-Division . Ostm2n's 3rd Addition
Coraer Lot — Inside Lot Setback _ Sideyard
Sewer IIevation _ Foundatlon IIevaf3on
DESCRIPTION OF BUILDING
To be Used as:
Addition to Garage �t 11' Depth 25 � Height 10' �. � 275' �� 2750'
Addit3on to No�t�ae �nt 12, �p� ls, g�p,ht 10' gq, r-t, 216' �, �, 21b0'
Type of Conatruction �� & Stucco �, �_ 4 000.00 To be Completed - l�ear
Provide Hardsurfaced Driveway
In cansideration of the fssuance to me of a percnft to construct the building
the proposed work in accordauce with the description abov�seL�ox�t� and jn�
ordinances of the dty oP FridleY. � /� % �
In consfderation oP the payment oP a fee of $ 14 . 00 , p�t
! agr2e to do
provisions of
granted to Robert A. Sc'hmidt
to canstruct the building or addition a� described above. This�� t is granted upon
the enpress candition that the person to whom ft ia granted and his agents, employees and worl�nen, ffi all work
F'ridley Minaesota drega�rding d�� g, or any �art thereof, shall �nform in all respects to the ordinaace� of
wlthin the dty ]imfts and this permi�t' y be rev ked at any time uPon ovi lalai n o�f and moving of buildfngs
o��� aay of the provis�tons oF safd
�
Inspector
CLARENCE BELISLE
A
NOTICB:
i6b psm� does eot eovsr t6s eoe�rocHoe, Insfalladon /or �rMag, plumbtng, ea 6etlies, sswu er watsr. B� �un to ss�
f6s Buildtoe lespeeto� fer apaeata pormW foe t6eas Bs�.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : �� ��'�/`��'•��l�// �� BUILDER :���i /i�T'` VGG��// ',f
ADDRE�aS : .��� fL �'/ d'P ADDRESS :����
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NO •. �� STREET : G � � P 1/ t° �f Q/� �
LOT : � BLOCK • � ADDITION • ( _�� 0'� �vlQ� S' � ��
CORNER LOT: INSIDE LOT:� � SETBACK: SIDEYARD:
Applicaat attach to this form 1�,io Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As: � r
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! f6G� � Front: �� Depth: �� � Height: �
�� f
� Square Feet: .� � Cubic Feet: � %� �
� ��A1 f���ont: Depth: � Height• � �
o �e�° � � `�� �
Square Feet; Cubic Feet:_
�/� �e
, �ipe of Construction���it�9� ���� � Estimated Cost:_ $ `� � °�
To Be Coatpleted: _� � ���
The uaderaigned hereby
specified, agreeiag to
Fridley Ordinances and
declares that all the
are true $ad correct.
makes applicativn for a permit for the work hereia
do all work in sttict accordance with the City of
ruliags of the Department of Buildiags, and hereby
facts and representAt�ers RtAtP_[� i., rt,t� A�nit..nrt�.,
DATE : � �`al ' �' S IGNATIJRE :
(See Reverse ide For Additional Infoswa
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Iaspector of Buildings shall, before issuing pes�►its for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any exiating
building or structure, upon application therefore, require the payment by the
applicant for auch permit of feea to the amount herein below set forth and in
the manner herein provided to-wit:
UIVIFORM BUILDING CODE: Tj�pe 1, 2� 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. 1�pe 3� 5-$1.85 for
each oae thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is deteranined 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 heights of the upper surface or to the average.{
height of the roof surface of the ma,in gable of a pitched roof.
For repairs or alterations to a,n existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case ahall the fee charged for any permit as �et forth in Section 2 be
less than $5.00.
V�RIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours fram the
time of application, to allow for proper review of the proposed structure and
of the construction aite.
A Certified Survey of the lot, ehowing the location of the foundation, once it
hae been constructed, will be required before proceedin� with the framing.
CERTIFICATE. OF OCCUPANCY
Applicatioa for a Certificate of Occupaacy shall be ma,de ten (10) days prior
to the use or occupaucy of any atructure for which a building peYmit has been
issued; and said structure shall not be used or occup�ed until a Certificate
of Occup�cy has been issued. •
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- '� � ^ � 645-3601
TWIN CITY TESTING �o ENGINEERING L�►BORATORY. INC.
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REPORTED TO:
EN�INEERS AND CHEMISTS yaecT�
662 Cromwell Avenue - St. Paul, Minn. 55114 i� Z
REPORT oF: INSPECTION OF SOIL CONDITIONS
''e .�y
RESIDENCE ADDITION DATE: Septemb�r 29, 1970
FRIDLEY, MINNESOTA
Robert Schmidt FURNISHED eY:
6925 Hickoxy Drive coPtES To: Frid�.�y Bu3.lding Inspec. Dept.
Fridley, Minnesota 55421 Attn; Mr. Claxence Belisle
LABORATORY No. 9-2936
INTRODUCTION
7.'his report covers the recent inspection we performed of the soil ��t�ditions at the above
referenced project at the request of Mr. Ernie Schmic�t.
No deep soil penetration borings had been made for thia aita. Howaver, according to our
aveilable geologic data, the first bedrock at this site should b� the Pr�irie du Chien for-
mation at a depth of about 150 feet. The surficial materials are valleq txai.n outwash
deposits aesociated with the Des Moines lobe of the Wiscor�ain stage of gla�iaCion.
We understaud that the building addition will be a one-story, wood fr�ane garage axid storage
area. The total stress on the soil should be relatively light. W� ut�dexstand tk�at the
foundation plan ia to excavate down for the footings and place th�an on ad�quate bearing soil.
INVESTIGATION METHODS AND RECO�NDATZONS
On Septembar 24, 1970, we made a visual iaspection of the excava�Cion. The axposed soils
were visually classified in accordance with the Unified S�il Clasa3ficat3on Syatem. Also,
several shallow hand auger borings were put down.
The footings had been trenched prior to our inapection. The aoil exposed at the bottobn of
the footing trenches was mostly old fill, conaisting of a mixt�are of silty ssnd' lean clay
and black organic soil. Some disturbed soil had been washed into the footing trench in the
southeast corner of the proposed addition. The underlying natural sand was exposed in
several areas. The approximate depth to the sand from the bottom of the footing trench at
the time of our inspection is indicated on the attached sketch. It is our recommendation
that the fo�otings be carried dow� to the undexlying natural sand soil.
c�u,'`J
Because no deep penetration borings were put down, we caunot warrant the �onditions below
our ahallow hand-auger borings, or that the soils encountexed itt our boringe a�e truly
representative of the entire site.
TWIN CITY TESTING AND
ENGINEERIAIG LABORATORY, ZNC.
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BH:NEH:jd
COPIES T0: Bruce Haeainger, Geolo t-Inapector
(1) Fridley Bldg. I�aspec. Dept. �� q �
Attn: Mr. Clarence Be�isle
Laboratory Numbex 9-2936 Norman E. flenning, P.E
Vi�e-Presiden�, Eugineer t�g
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AB A NUTYAI. PROTEGTION TO CLIENT9. TFi6 PUHUC AND OUR9ELYEH. ALL REPORTB AItE BYBMITTED AB TXE CONFlDBNTIAL PROPERTY OP CLIENT9, AND AUTMOR-
IZATION FOR PUBLICATION OP BTATE!!L°NT9. CONCLUBIONB OH EXTRACTB FROY OR REGiARDIN6 OUR REPORTS 19 REBER�VED PENDIN6 OYR WRITTEN APPROVAL.
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' DRAIQfl1b BYa=E
'PROPOSEI7 �b171'�'IOI1I SCALE: ���=
Tr•a e tv, ��n IC
CNew►ove�
BY �l �
No. 9 - a 93 (o
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co��aoa �aa��:
Lega1 Description:
�ffective 3/1/92
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
° OTHER:
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MN LICENSE � ,�. �, Z �
` Tel. # ���-g(�l/
Attach to this appli�fation, a Certificate �'of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length �_ Width � Height /' (� Sq. Ft. o? �"�
Length Width Height Sq. Ft.
Leng�th Width Hgt/Ground Sq. Ft.
��� x �3• �'� - f/, 98i. ��
' Corner Lot [] Inside Lot �}Cj Ft. Yd S�back Side Yard Setbacks // 9�` ��
T3rpe . of Construction: i,�l c� a�,� �r�� Estimat� Cost: $ 3� _-
Approx. completion nate: 1- /- 9� .
(Cost on Back)
Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ = S
DATE: � � '� � � � APPLICANT:
Permit Fe� $ / .�S`. 00
Fire Surcharge $ //, g�
State Surcharge � �� �%9
SAC Charge $
License Surcharge $ �- � U
Driveway Escrow $ �
Park Fee $
Sewer Main Chatge $ —
TOTAL $ � ��' � 7
STIPULATIONS:
Tel. # ��3 -,��, / j
Fe� Schedule on Reverse Side
.�l of Permit Valuation (1/lOth%)
$.SO/$1,0� Valuation
$700 per SAC Unit
$5.00 (State Licens� Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary ( ] Not Necessary [ ]
BUII.DING PERMiT; FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erectioa of any building or structure,
ar for azry addition to any existing bailding or structUre, or for azry alteration or repair to any existing
building or struucture, upon application therefore, require ffie payment by the applicant for such permit
of fees to the amount herein below set forth and in the manner herein provid� to-wit:
TOTAI. VALUE
$1 to $500
$501 to $2,0�
$2,001 to $25,000
$25,001 to $50,000
$S0,(rol to $100,�
$lIX?,001 to $5(�,(f00
$5�,001 to $1,�0,�
$1,�,001 and up
FEE5
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $SOQ plus $2 for each additional $1� or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,�0
or fra.ction thereof, to and including $25,�
$252 for first $25,0� plus $5.50 for each additiona.i $1,�
or fraction thereof, to and including $50,�
$414.50 for first $50,� plus $4.50 for each additional
$1,� or fraction thereof, to and including $100,(}QO
$639.50 for first $100,(�0 plus $3.50 for �ch additional
$1,OQ0 or fraction thereof, to and including $SOO,WO
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,�0,000
$3539.50 for the first $1,�,000 plus $2 for �ch additional
$1,000 or fr�tGtion thereof �
DRIVEWAY DEPRESSION ESCROW
(Concrete Ctirb Streets Only)
Altemate "A" : Removal and repla.cement of curb and gutter only - Driveway width plus 6 f�t times
$13.50.
Alternate "B" : Removal and replacement of curb and gutxer and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issu� a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has been
constructed will be required before proceeding with the framing.
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sue�ecr P
c�ty of Fridley �-
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T `��`� ��
r
; � RECEIPT NO.
� � COMMUIVITY DEVELOPMENT OIV.
� �a: ----- �
r � � PROTECTIVE INSPECTION SEC. ��
� �
'` A� ����1 � CITY HALL FRIDIE� 55432 NUMBER pEV DATE 1/�f0/[] PAGE OF APPROVEO B�
L.���J�i/ \.I 1 GO �
612-571-3450 9t0-F15 �I / /
JOB ADDRESS 6925 Hickory Drive NE
1 LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 2$ 1 Ostman's Third Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Schmidt 6925 Hickory Drive NE 571-7559
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO
Tectone Construction 2422 Como Ave, St Paul MN 55108 645-5429 2245
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WOHK
O NEW O ADDITION � ALTERATION O REPAIH ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Bathroom Remodel (No structural work
8 CHANGE OF USE FROM TO
STIPULATIONS
Smoke detectors to be installed to meet State Building Code.
SEPARAT� P��2MITS REd�UIRED F6R
VdIRING, HEATIN�, PLUMBING AiVR S�G(VS.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTfiICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Oii ABANDONED FOR A PEfiIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED � NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CEFTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAL�S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOYERNING THIS TVPE OF WORK WILL BE COMPLIED $1Z�OOO �C).00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• 187.25 Fire SC �LZ.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $210.25
SiGNATUREO%CONTRACTORORAUTNOR�ZEDAGENT �DATE� WHEN PfiOPEfiLY LIDATED THIS IS YOUR PERM�IT,��/j
K1¢ l^� ' /
S�GNATUAE OF OWNEA UF OWNEA BU4DERI iDATEI BLO �NSP paTE
NEW
ADDN
AL'I'ER
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ConstructionAddress :
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R 1 AND R 2
BUILDING PIItMIT APPLICATION
�
Effective 1 / 1 /97
Owner Name & Address: (�� ��^�l ��-" � °� Z � � � C �Ue•/ [ �v. Tel. # ` 5 ��-- %c,��
Contractor: ��C.T,o� C p�n15y-Q.c�'.7-td � MN LICENSE #�,�.�1 �
Address: �� Z Z� ��� �"I�.- �- � p�LI�- �( (�g Tel. # 6�i 5 ` 'rJ`'LZ.�
�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DEC� AREA:
OTHER:
Length
Length
DESCRIPTION OF IIVIPROVENIIIVT
Width Height Sq. Ft.
�Vidth Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
� �
Construction Type: Estimated Cost: $ , (�
f (Fee Schedule on Back)
Driveway Curb Cut Width N�ded: Ft.. + 6 Ft = - �t x � $ � _ $ . -
DATE:. l 7 Q} APPLiCANT: � ��1,N� �e �t . : � �.�? [C �Tel. # 6`l'� ` �l Z�
CITY USE ONLY
Permit Fee $ � 7� ZS Fee Schedule on Reverse Side
Fire Surcharge $ �", Do. .QOl of Permit Valuation (1/10th%)
State Surcharge $ ` .dv• U $.50/$1,� Valuation .
SAC Charge $ $954 per SAC Unit
�� �
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Y
�
License Surcharge $ 5.C1�t) $5.� (State Licensed Residential Contractors) �+
Driveway Escrow $ � Alt. "A" or Alt. "B" Above �
Erosion Control $ $450.i� Conservation Plan Review �
{ ��
Park Fee $ Fee Deternuned by Engineermg � �
Sewer Main Charge $ Agreement Necessary j] Not Necessary [] (�
�
TOTAL
STIPULATIONS:
$ � °�
�lb• 1"s� ���7,�'f
�.���' _ �
CJ " c �
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l�"'
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/ ��
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BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure,� or for any alteration or repair to any e�cisting building or
structure, upon applica.tion 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:
; TOTAL. VALUE ; � FEES ,, _ � ;� ; �
$1 - to $500
$501 to $2,0(30
$2,001 to $25,000
$25,001 to $50,0{}0
. ' $21 (Minimum Fee is $21 plus surcharge) -
$21 for first $S�.p1us $2.75 for each additional $100 or
fraction thereof, to and including $2,U00
$62.25 for first $2,000 pius $12.50 for each additional $1,000
or fraction ther�f, to and including $25,000
$349.75 for first $25,� plus $9.pp for e�ach additional$1,�
or fiaction thereof, to and including $50,0�
$50,001 to $100,000
$574.75 for first $SO,IX}D plus $5.25 for each additional
$1,� or fraction thereof, to and including $1QO;t100
$100,001 to $SUO,OQO
$500,001 to $1,000,000
$1,000,001 and up
_. .
$887.25,for*;first $1�,OQ0 plus $5.(� fo%each additional - ;
$1,1�0 or frachon thereof, to and mclud.ing;$500,000
� � ,: _ - 4 - : '
$2887 25 for the �firsf $500,0(� 1ns $4 25 ,for each additioml
P F'
� . _ � $1;000.or fraction thereof; to �and includtng'$1,O�;OQO d` °�``- _.
, . . - 2 �. - ,
. . ,,
, . .
. . , ,
,
.. . _. _ .. _.�:._�,._.. _ _ _. _ _ ,. �,
._,_. _ ..._
$5012.25 for the fust $1,0�,0� plus $2:75 for each_ additional
$1,0� or fraction thereof _
_ r�,.. :
��:- , . ,
DRIVEWAY. DEPRESSION _ESCROW ' ° _
_ (Concrete C�irb,3treets;On1Y) - � .
, � : � .., , _
Alternate "A": Removal and replacement of curb and gutfer only - Driveway�:width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and_ gutter and::install �a 3 foot wide -
approach with 6 inch depth - Driveway,;widtli plus 6 feet times $15.75. ,
VERIFICATION OF FOUNDATION -
;- . � .,
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper -: .
review of the proposed structure and of the cons�uction' site. -"
A Certificate of Survey of the lot, showing the location of the foundation onc� it has it has been constructed
wiil be required before proceeding with the framing. .
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CITYOF
FRIDLEY
FRIDLEY MUr1ICIPAL CENTER • 6431 Ur1IVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 1, 2002
Mr. Richard Schmidt
6925 Hickory Dr NE
Fridley, MN 55432
Re: Final Inspection at 6925 Hickory Dr NE
Contractor: KCJ Enterprises - Mr Rooter
Dear Mr. Schmidt:
A plumbing permit was issued on February 16, 2001 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final
inspecrion shall be conducted on the work authorized by this permit. As of this da.te,
no final inspection has been called for.
The permit fee that was paid covers the inspecrion to make sure the work was
completed according to the Code. We will keep your pernait open for another 30
days and if we do not hear from you within this time to set up the inspection, we will
mark the permit "no inspection called for" and take no further action.
To set up the inspection or to have any questions answered, please contact the
Building Inspecrion Division at (763) 572-3604.
Sincerely,
� �� �
• ` ' sue�eti r IT N . `-- �
City of Fridley ' 3 i� 9 9
�
AT TME TOP OF TME TWINS g�J f L D I N� P E R M I T
r �' �__.; COMMUNITY DEVELOPNIENT OIV. �������� RE� NO.
� •
� �y PROTECTIVE INSPECTION SEC. v��
� . �
� � �"'1 � CIiY MALL FRIDLE� S��3P NUMBER � REV OAT@ PAGE Oi APPROVEO BY
�"'"� � �'' 612-571-3450 910-F15 6/13/O1 / /
JOB ADDRESS 6925 Hickory Drive NE �
1 LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACMED
DESCR. 2$ 1 Ostman's Third Addition SNEET
2 PROPERTY OWNEFi MAIL AQGR�S$ ZIP PHONE
Robert Schmidt 6925 Hickory Drive NE 763-571-7559
3 CONTiiACTOR MAIL ADORESS 21P PMONE LICENSE NO
Fridley Roofing & Remodelin Inc 830 Main St W, Anoka, MN 55303 763-780-6210
a AHCNITECT OR DESIGNER MAIL AODRESS ' 21P PMONE LICENSE NO.
20269030
5 ENGINEER MAII AODRESS 21P PHONE LICENSE NO
8 USE Of BUILDING '
Residential
7 CLASS OF WORK
❑ NEW O AODITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WOFK
Reroof House & Garage (32 Sq) Tear-off
9 CHAN(3E OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
��rmit lnspectio�
Will Be M ��r��
T� Homcow� eiled
r To Pos�
TYPB OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOFi ELECTfiICAL, PLUMBING, MEATINO,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO If WOFK OF CONSTRUCTION ZONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCEO WITHIN 80 �AYS. Oii IF CONSTRUCTION
OR WORK IS SUSPEN�ED OR ABANQONED FOF A PERI00 OF 12Q OAY$ A7
ANY TIME AFTER WORK IS COMMENCED. " � NO DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAYE READ ANp EXAMINED THIS APPLICA710N 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS Oi LAWS VAWATION SURTAX
AND OROINANCES GOVERNING TMIS TVPE OF WORK WILL Q� COMP4IED
WITM WHETMER SPECIFIEO HEREIN OR NOT. TNE GRANTING OF A PERMIT �3�Z72 �1.64'
DOES NOT PRESUME TO GIVE AUTNORITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CMARGE
PROVISIONS OF ANY OTMER S7ATE OR LOCAL LAW REGULATING CON- $97.25 Fire SC �3.2%
STRUC710N OR TNE PERfOfiMANCE OF CONSTRUCTION
PI,AN CMECK F E T� Al. FEE
�
Lice e SC $5 0 %�$107.16
S�GN4TUAEO�CON'pACTOpOAAUTMOp�ZEDAGENT iD�iEi yyM PR LV VALID ED TNIS IS VOUR PERMIT
S�GN4TUAE O� OWNEp��� OWNEA BU4DEA� iO�T�� ' 8 G� �h5 � - ' I�ai ���
� A �
�
N� Effective 1/1/2000
ADDN CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER ❑ SINGLE FAMILYAND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
ConstructionAddress: 6925 HICKORY DR NE FRIDLEY MN 55432
Legal Description:
Owner Name: Robert Schmidt
Tel. # 763-571-7559
Address: <Street>6925 HICKORY DR NE <City>FRIDLEY STM<Zip>55432
Contractor: FRIDLEY ROOFING AND REMODELING, INC MN LICENSE #20269030
Address: 830 WEST MAIN STREET SUITE ANOKA MN 55303 Tel. # 7637806210
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LMNG AREA:
GARAGE AREA:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Sq. Ft.
Sq. Ft.
DECKAREA: Width Hgt/Ground Sq. Ft.
OTHER: �-� QO � �� f � �� �� _--- /����
,� J� i/
CJ ����
Construction Type: Estimated Cost: .00
Driveway Curb Cut Width Needed Ft. + 6 Ft = Ft x$ _$
DATE: 06/05/2001 APPLICANT �` "`� Tel. # 8883301777
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailtng in appllcation
$ /, a� Fee Schedule on Reverse Side
$ - o�% .001 of Permit Valuation (1/10th %)
$ l- �� $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ � �� b $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary0 Not Necessary❑
$ 1��.1�
�,/y.61
�PR. 9. ,�J6�. 9 � 5E�M
i,v.wc ��,,
N��R� �a�- R���TRA�� A�oR�►�n��
1, �te urrdersian.d� I�w ii�e �1 a�+ati�►1� en�r r� ��•�d �� �
behaN or ��npmy rd ��+("� r�►"�. � 1�+ �u�+�e AM�I+�, �e�. eo�
• C0�1Y� th� �1' �1t�611: I�IQ+N U�► �IeOl�Ato'�p�l fYN 1l1� �ll �1'�► dt�l�� 61dllttllt�l
by N�l�ric at rnY �' � C�n�a1�►'� laj�if�
+�tp any oF tl►e d�n�l Npna� �iav ib� u�s an domtrn� a�mttied b�l N�r& aa+
nry +�� Com�my'� �eN�, In 114u ai� �4y Imp�r� �f�'�
t�l�n�by�t'�r� �n ot p*r�c�y'� ��p����+ Iara�� �h N���k,
'Ciu �olbwi� att�horl�d �pl+�lrta�Y+� ind'�ne��ntple�lea� N�Ya n�t Rlr�f►��� ta �y►1�'� �Idl� +�
t� r�ip� of eml ��um�n#s prA�i �hrwygh N�i�� In t� ���N �Y• Thar �a�
are da�lgnat�d '1�r ihe purpoua of p�ap�rir� �nd a�nA o� ���.
Tadi � ��._._�.. ,
C�t�ai�eNmae ('I'� - �1
Coudi� se�Vice Nra� (7�'ypo � P�t)
Soa� R�at�rbe�y
Nat�Ork�1s� a - t)
Ne�l�Nerne (Typ� - )
�� ��
Co�or's Na�e gi��
FI'�DLEY RaO�ING AN� RF�M�I76aING, INC ��7fl00��0 r____
.. � � �,
Cama�a�v Nagne Pbs�
Q
6 1, ., SHl�itlPlGN L, �AHERTY
6 � �,;�� Norarrv�c-�o�
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t t-
rCity Sprint - UltraEx (Minneapolis)
� 5555 West 78th Street
Edina
MN 55439 6129430300
I,
�
DELIVERY DAYS: Monday, Thursday, Friday
DATE PROCESSED: 06/05/2001
NetClerk
• Deliver to the city address on the cover sheet
• Pick up any outstanding permits
• Submit the envelope to the Clerk and have them process the appropriate paperwork
• Sign any applicable documents needed
• Fill in the checks and put the check amount on the stubs and retum to NetClerk
• Place approved permit and job card, if any, in envelope addressed to Contractor and mail
Job Deliver / Process at S ecial Handling Instructions
Fridley
STOP 1 Building Courier Instructions
6431 University Ave NE 1. Fill-out Agent Authorization beforehand
Fridley 2. Transfer info. onto original
MN 55432 7635713604 form at caunter of necessary
720 Dubuque Ave
STOP 2 South San Francisco —
CA 9408o COURIER INSTRUCTIONS (3}
<Street> CALL NETCLERK AT (650) 616-4518
STOP 3<�;ty> IF THERE ARE ANY PROBLEMS
ST <Zip>
>PER�lIT !t�' . C{�NTRACT{1� ' '_ CI'I'� j ' PER�i#T !�i[3DRESS = �I�ECK # ' .
88713 FRIDLEY ROOFING AND R FRIDLEY 6925 HICKORY DR NE
� R��utrx �lan�l�ng ins#c'c�i�t�c�n� i
�.,
_ _ � _ _ ��_ � ___:__ �as_�. __.. _ _ ._ ._ __ __�
Mail to Customer
❑ Enter Permit Approval # into tracking system
❑ Other
�' PE1�IT RE.tE�'Y�t?N F��ASCiNS {�tleas�.ch,e�k r�so�n���. G ...� �` E � _._,___ __ �
�: _.� _ �: ���____ � � :� . � � ��, �. . ..�
� Workers Compensation � Authorization Form � Wrong Jurisdiction
� Business License ❑ State Contractor's License
� Wrong Fee Amount —Correct fee amount is $:
� Job Description
*►f other, p/ease call Customer Serv/ce @ 888-318-8444
_ - _ _ _ �__ ____� _ _ _ � _ ,
q__ __ ________ __ :
� ___ ._ _ � �� �. � ; i
�flN'�ACi' �N�tiRMATION '� _ ' �
If you have questions about the content of this package, If you have questions conceming city procedures or
please contact: customer information, please contact:
NetClerk Distribution CUSTOMER SERVICE
distributionCc�netclerk.com customerserviceCc�netclerk.com
877-846-5888 FAX 877-846-5888 FAX
650-616-4579 DIRECT 888-318-8444 TOLL FREE
� # r� � � .
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.-�) F .�C��� i� �,� � �i . �r
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In Person
720 Dubuque Ave., South San Francisco, Ca. 94080
Government Services: 888-330-1777
Fax: 877-846-5888
To: Fridley
Building
6431 Universitv Ave NE
Fridlev
MN 55432
Phone:7635713604
p�; 7635711287
Email:
Permit
Application
ID# 88713
Contractor Tnformation
Company: FRIDLEY ROOFING AND REMODEWorke�s Comp Carrier: exempt
Address:830 WEST MAIN STREET SUITE 10:yyorker's Comp No.: exempt Exp.01/01/2002
City: AN�� State Contractor's License: 20269030 EXp, 03/31/2002
State / ZIP: MN 55303 Llcense Class / Type: BUILDING Exp.
Phone:�637806210 Exp.
Fax: 7637805424 Business License #: Exp.
Email:
Credit Card Information
Credit Card Number: Visa: �
Expiration Date: Mastercard: �
Card Holder Name: Other: �✓ CheCk
Project Infarmation
Homeowner Name: Robert Schmidt Homeowner Phone Number: 763-571-7559
Project Address: 6925 HICKORY DR NE FRIDLEY MN 55432
Valuation:3600.00 Residential ❑ Commercial �
Job Description:
tear-off and re-roof
Notes
Payment�heck Attachments: WCO SCL OCBLO CCADAA SASE ❑
Permit Type: Paper Agent Authorization: ORG. ❑ NOT. ❑
AA Type:
�a_sns
Building MECHA.NICAL
Inspections RESIDENTIAL APPLICATICDl�T
763-572-3604 CITY OF FRIDLEY
DATE, J��� �� YOUR E-MAIL ADDRESS
srrE �wDxESS �9dS � � c ,t'� !L % '� �- N �
THIS APPLICANT IS: 0 OWNER
Pernut No..
Received By:
Date
PROPERTY Nq�: ��� B✓ � c�' �, M� 1 .
OWNER/ CI1'y STATE ZIP
ADDRESS: l�i o�7-�
TENANT PHOr�: � Co'3 �� 1'7 S5�
CONTItACTOR �o��N�: H�me Ener �
SUBMIT A COPY OF
YOUR STATE
LICENSE WI i H
APPLICATION
PERMIT TYPE
TYPE OF WORK:
CONTACT PERSON:
STATE LICENSE # EXP DATE
15200 25th Ave N#1 �8 ct� P�Ymouth STATE MN ZIP�
ADDRESS:
Pxor� �63-476-1990 F,4x 763-476-1143
— ,_
�Sl SINGLE FAMILY ❑ N✓0 FAMILY
O �W �`7 REPLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWN1�i0USE
❑ qL,TERATION/REMODEL
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the totat cost up to $500.00, whichever is greater, f�r the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost beiween $300 to $540 = cost of labor __
x.05=
FOR PROJEGTS WHERE 1-ABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE> EXCEPT WHERE NOTED. FZXTU1tES: (IIJDICATE TOTAL
TIIJMBER OF EACH BELOV� SIZEBTU ��' ��
MFG: . �� �a �1 MODEL: �a sC I 3 SIZF.lBTU ��C�
Equipment Installed . . MODEL: (�
MFG: � '� MODEL: SIZEIBTU �—
/ ��'� GAS RANGFJOYEN $10.00
✓ A/C $25.00 �i�"��CE (GAS) SI5.00 _J�W Gp� GRII,L $10.00
AIR TO AIR EXCHANGEER SIS _,FIREPI-ACE (WOOD) $35.00 , _Gp� �T HTR g10.00
URNACE $35.00
_BOILER $35.00 � � P40L HEATER $35.00
_GAS DRYER $10.00
�HIMIdEY LINER $10.00 VEIdTILATOR $15 00
DUCT WORK $10.00 GA�PIPTNG $]O.QO �, ,� g
�.�.-,f. �.� ����ti�.���'`+,ia'�''� +�, ���°�,.��� �'����.�`�`�
Permit Fee
Surcharge
'fOTAL DUE
.��� �...� _ ... . . _
Number of fixtures @ $10.00 x $10.00 = $
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @$25.00 1 x$25.00 =$�.
Number of fixtures @ $35.00 � x $35.00 = $ 3 �5�2 �
State Surcharge = $ 50
Tota1= $— D �
TH1S IS AN APPLICATIOAT FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the wark wi}1 be in
conformance with the ordinances and codes af the City of.Fridley and with the Minnesota �Construction Codes; that I understand this is
not a permit �ut only an applicationn �or a permit and work is not to start without a permit; that the work will be in accordance with the
approved planii rt e�case of all wq�¢ which requires reviev� and approval of plans.
// �\ . . i.-. i.. � r,e�f'F �r� ��'��
SIGNATURE
City of Fridley
uilding Inspections Department .
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FA�: 763-502-�977
,..
REQUIRED ItJFORMATION NEEDED TO PROCESS PERMIT
�� , RE SIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDt�IOi�lS ❑ EXISTING HOME ❑ MAKE-UP A(R
R.EQUIRED FOR NEW/EXlST1NG HOMES
1. Combustion Air (See note below) .
a. Oil or solid fuel II��iC Cha�ter 7 with MN Amendments
b. Natural Ga.s or PropanellFGC Chapter 3 with MN Amendments -
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
� Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas TMC Chapter 8 witl� MN Amendments
REQUIRED FOF2 NEW HOMES
4. Heat loss & cooling load per room
a. Required on new covstruction IMC 1346.0312
5. V en.tilation
a. Per R� E$ergy �c�de 76'�0 or 7fi'�2
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
.
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
comliustion and make up air.� calculations
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE � �� I l ''
SITE ADDRESS �G% �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BIING
SIZE OF IMPROVEMINT_
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
❑ OWNER
�j .: � 4j
Permit No.:
' _ : • : ��. �
�
- �: , � �
. i. �. � ,�,.
;ar�- ,� - �� ��, � f �;�
YOUR E-MAIL ADDRESS s��'� � w� �`� �`= N`lS �s - e 1' �'°�
. Nt _ tt�22 i J Li � . M � '�"3'`�/ ? �— --
�ONTRACTOR
y�i i
ADDRESS: �� /`�L S� N� t LJ� lt"'i � CITY,
PHONE: � % I �%��
Nan,�� �C.: i' �+ e 2r�'�T
STATE LICENSE
ADDRESS: �i�/ � `/r C is.� ; �+f
PHONE G l� Z 9�' — 7 7 C? iu
�INGLE FAMILY/NEW CONSTRUCTION
O TWO FANIILY/NEW CONSTRUCTION
� BASEMENT FITTISH
❑ DECK
❑ NEW HOME CONSTRUCTION
�1 MAINTENANCE/REPAIIt
. Kr'�u�� .�Sbrc��—.
❑ ROOF
❑ SIDING
O SWIMM
�.., ►r. +�
❑ ADDI1'[ON
0 REMODELING
_ EXP DATE _`i'�
CITY -f}� Ci"�
: �/� �'S S� 2 7i
�ss y
eWINDOWS
� DRAIN TILE
❑ OTHER
�?"i�:� %2l1 �k c:�: �
ATE �� ZIP � ,3 L
ATE��i�lLIP � .?L—
�1@ �.l
f�lY
xtOOFING p HOUSE ONLY gpSEMENT REMQDELING SUBMIT:
NUMBER OF SQUARES ❑ HOUSE & GARAGE 1, Existing Floor Plan
GARAGES O ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of suuctural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION IAICLUDING DECKS,
SIDING ,�nniTT�NS & PORCHES SUBMIT'
❑ Vinyl OSoffit 1, Site Plan/Survey showing the existing struchues
❑ Aluminum ❑ Trim and proposed project
❑ Other ❑ Fascia 2. Two set� of construction plans
WINDOWS 3. Energy Calculations
IN EX1STfNG OPININGS �Yes DIVo LOCATION OF WINDOWS �bl�(—N FOR WIN�WS — PROVIDE U-VALUE AND
OR FORNEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE S17CKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED .� f.� £ N� I•1[JMBER OF WINDOWS
ALL FEES ARE BAS�D ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
mTAr_, JOB VALUATION $��� ��f ���., OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Swcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Total Due
$ 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)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
Q Make checks payable to: C� of Fridley Attac
THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building 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 Construction 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 a11 wo � which requ' es review and approval of plans. , /�
SIGNATURE OF APPLIC �� -/ � ' , PRINT NAIVIE� f�2 (�— � ` � `� `S c�
�
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration 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 construction site.
A Certificate of Survey of the lot, showing the location of the existing founda.tion 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