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AF - 45791� City of Fridley, Minn. BUII,DING PERMIT � �� .�.� .�� .�. Date: .. ..... ......... ....... Owner....................................... Addre�s ...................................... � N° 3718 �._�`�s s p Builder �!��'G1�. .. .....�a�'� .1... . Address ............................................. LCaC�ITIQN OF BU[LDING Q� ��,� e No. :�.�... �... Street ..��.'�::� ... ..................... Part o ................ ... .... ..... G� /�. ��' Lot . � . !. . . . . . . Biock . . . . . . . �. . . . . . . . . Addition or Sub-Division .4�� . . . .Y. �- . . . . . •. . . Corner Lot ...�....... Inside I.at ............ Setb�.�� .... Sideyard %Q.�.�.� ................ DESCRIPTION OF' BU(LDING To be Us : ,,i� �, Front ?'.� � y Depth �� Height f. .��. �.� Sq. F't. � G4�.� � G`u. Ft.�F ��/ �� °�''�� . ... . . . . . .... p � y p � �f � .. .... . . .. . . . Front ./�.�� .� Depth .��. �. :�� Height �.�: .��. . Sq. F�. �v�.�/a . G�. F`t. �.��'..� � y '�' /� � Z'ype of Constructton . . . . . . . . . . . . . . . . . . . �t. CcBt. �1��. �� .":� : . . To be Completed . . . . . . . . . . . . . . . . In consideration of 1�e issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance witli the description above set forth and in complfance wi�h all provisio of ordinances of the dty of Fridiey. 6 . � . .O�e�, J. '. .a. . . . . . . . . . . . �..,�1. . , . . G . . . . . . . . . %�j� CJ'� In consideration of the payment of a fee oP $. �?'� .!. .. .. ., permit is hereby gran4ed to . .. .. .. .. . . .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . to conatruct the building or addition a� described above. This permit is granted upon the express condition that the person to whom it is granterl and his agents, employees and woil�en� in all work done in, around and upoa said bu3lding, or any part t3iereof, shall conform in all respects to the ordinanoes of Fridley, Minnesota regarding location, construction, alteral3on, maintenance, repair and moving of bu�lldings with- in the dty limits and this germit may l� revoked at ax►y time upon violation of any of the provisions of said ordinances. , — : !.!.�j�. . .�,, . . Build3ng InspeCtor NOTICE: This parmit does not covar fhe construction, Installatlon or alteratlon fo� wl�ing, plumbing, eas heating, sewe� or water. Be su�e to sea the Building InepecRo� fo� sapa�ata permits fo� these Itema � § j 1� ��u�� , � ffiUBINIESB carr wrs _ TC700RAPNIC b1APPW0 q � I. l��oe�' l, asr�.�N `s %�� 9'�,�e �r�� -�. : C. E,.COULTER � P`"''""° ' LAND SURVEYOR FARbt BURV6Y8 � LAK68MOAE REGISTERED UNOER LAW9 OF S7'ATE OF Mtt1NE80TA ruo�cta�. ; LIC6NBED BY 0[iO1NANC20R CITY OR AlIIVNEAPOLIS � 3300 LYNOA4E AYE. 80. MINNEAPOLlS 8. MtNAi. ', TAYLOR 4A370 " SU�PVEY FD�i !�I/?. �v'IC,�° � �mnegar'a tfIrrffititatp ,. � Sc�►c E �` / =4C! � •/ y � c� �� I D .n , ��f � ��"� �'� . �.�. o�> -� - �� . _ ��' � �� . ,. , ,� r �� ,� � , ; .. _ � � - . , ; . I la�a�esby c�e�c�i�y tbat �he. etsov� i� � tru� aad �or�eat, p�.at o� 8�rvey of : � Ioct� 3e'veYtte�n ( 37� • Block tiae � 1; •�`�lAN�3 THIAD ADI)ITION � Au�e E��y'� , �Tl�ti1�$O'i&'s. 1� �x'veyed by me �his 2�8 d�,y of Jun� 1958, A.D. . - Si gned � � I�inmesote Reg�.etrat3,9n No, 25�L� f • � �' -' � � � r - - $,� � ` a -` �'� �.�— � �"1��"'�.;.3'�,/��l�.� . . ��. . . �x �� , --,-._�; ---�� 7� e�% (�: � ��I � y �n DQ �' �� o L� 9�-. H .�i. O M �] � y �' M h�p 7. `� 7�, O '�d �: " yxj Ro � � � � � t*1 � � � o � � � ,ry � � 9 � m � O y • y : : q : : �� . � H � Hy t' � � � �� r r+ 0 � � N � � � � y � �• �. y � p � � � � m � � � � � V� e � � � � o �, r bo m � � � C � � y O � � o � w � �?, 04 O '�7 � o � �O '^,.t � J�^ � . m : . � . � c� : : � : : �: � � : i i i � . k � � � : N � � 9 P 9 � O r�! in �n � fn H � � i oy r 00 � � � � 0 0 � � n � � h �,�� C� ► � w � � � � tD � � � 0 � � � t� � � � � � x � � � S C�'' �,.' �� b b h7 � r� ags� �� y R. O+ <D f�D ~ � � � � � � vi• �p � ,e R. !�. � � o �° R° � � � � R° R° � � '� w��' �' y p� Cs' p{Y � oo�G �a� ��G �� °�� "'ar�a� � � b�� .��* �� O O � F O O G G l7 � w � � � o * � � � `'��' '� � b� � � w � � o � � b � � � � .� � � a • '� � m o : v��' ��o 0o m�: o a r�, ; : :° ,� ?' e�i, : . " � o : � � � o . m o . . : � : � � o . : o a' o : : 0 ' : � � °o g : : � $ : : : : : �``' : : : : � : : : : ..0� ..... .... ..� ..... .... ::�� ::::: :::: : : � : : : : : : : : : : � � � � � O O O o O <n �ra v> tn � � °x M O � O � l z � � � � � � � � � � O 0 � 0 � � g � � � � � � N � � � � 0 0 0$ o 0 0 0 o r� �» sn vs rn �n O `� � y � � � � W � oa IJ � � �� . �� , �� o °�� d �. �� l`'D�OE� Q' F3 � � �� I � ��'�'� m � � ��b w�� p�'`+w� w �aQp p' �., o . �� a �b u am�� O ~� e4 � �� .� � �o8 n�'J• y i � c � {J i-� F+ y+ (� p. A �, ��, 1`� � � � � s r � � T � _ m C 1"' m d � M ►� O� I a \ '�' , , ` V a o a w a f � � � � �� $ � � +r' 0„ � _. _ ��O � Ny� � o � o. =� v ` A• �Q . � "�'. � �• ', 0. P �.."£ �� d%,�,�� Q1��G� — 6 ��a�—�✓�o�� - .',=� �/�. — � � .r °'-'6" z`.� 6 ��''--� � � � % �� /S!�"O� �,.�� e �`. HEAT LOSS Ci1LCULAT10N5 DEPART-INENT OF BUILDINGS s� FRIDLEY, MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation + Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 19— F1•� �i i� � Room � Length /,� Width Height 8 / FI.� ��j�/ Room � Leagth / 3 Width Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area �Vidth Helght No. ot Lineal f. Area Wldth Hatght No. ot Llneal LL Ares No. ot pane oP Dane Ilghte ot crack eq. Lt. No. ot pane ot pane IlgLte ot crack aq. ft. �.r� � _. Js, � �o.a a T�� s� �� Coef. Btu In6ltration � � e� � / / �� Glass �' , � � � Eap. wall / 2 � X Net exp. wall /� � // �'� Int. wall �¢ � � Y Ceiling s° �2 �,�� Floor .� � 'j� x � Total Btu. Required sq. k. E.D.R. or aq. ina. W.A. l.eader ana �' F7.� v��' Room � Length /r� Width 3 Windows and Doora—Crackage and Area Width Helght No. ot Llneal f4 Ares No. ot pane o[ pane l/�hts ot craok rq. [L � �-� �i a 2/� 91s Coef. Btu Infiltratioa � �,� Claaa � % Eup. wall .� 'X X X Net eap. wall �� p Int. wall y Y �t Ceiling �� Floor "!( �l X X al _ Total Btu. ? ;t� � Required sq. ft. E.D.R. or aq. ins. W.A. l.eader area / FI. /.2��eG� Room (Leng� i 3 Width ' Height ,� Windows and Dooro—Craekage and Area Wldth Helght No. ot Llneal tt. Area No. o[ yane ot paae Ughts ot cracB sq. iL � � '/'�- _� s Coei. Btu Infiltradon }I y S! •[-� Glaaa x � Y x� Eap. wall �°� 1� 1! �l �c Net eap. wall p y p � p Int. wall � �! '1! �( �! Ceiling �' j �� Floor °k u l/ V '+� Tbtal Btu. � � � Required aq. ft. E.D.R or aq. ina. W.A. Leader area � � . Btu Infiltration j f �' D Glaea �,�/ Fap. wall � �l Y �/ Net eap. wall ,�'� /'/' '(�/� Int. wall ,( 1/ � � y Ceiling 1 � / %z f �� Floor �C �t � Z� Total Btu. p � Required sq. ft. E.D.R. or aq. ins. W.A. L.eader area O FI.I �-, /,��rTli Room ( Len$th �3 WidthG /�- Height 8' Windows and Doors—Crackage and Area Wldth Helght No. oL Llneal It. Area No. ot pane ot pane 1lghts oL crack eQ. tt �� i � �P �� Infiltra6on Glaas Esp. wall Net esp. wall Int. wall Ceiling Floor Total Btu. o� �� . �.u.�. oT sq. �S. W.A. l.eader / F1•� � i� �s � Room I Length Windowa and Doora—Crackage and Atea Wfdth HelBht No. ot Ltaeal LG Area No. of Dsne of.pane llghts of crack sp. ft J � � �� /✓. iG, i r�� ! r� '�! �f �f � i� �� k kX � �'�— � � � � �� r s ��+ Width � � � In6ltratioa Glaas �.,�u Net eap. wall In� waU Ceiliag Floor Coef. Btu $' � C� d �/ �' � � x �v�r s a't� x YX� � �. O � x �r Tocal Bcu. � _ Required aq. k. E.D.R. or aq. ins. WA. Leader area � �' ° �� - �-�� - _ . / � � � r �'�- Z�u6 . �° %�� 1.� r7 d NEAT LOSS CALCULATIONS DEPART-NIENT OF BUILDIMGS �� G� FRIDLEY, MlNlel. Weatherstrips A.S.H.V.E, Construction No. Insulation • Guide Windowa Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No ( Yes—No 19_ p Fl.� � f�r � Room � Length �.y� Width J� Height �' FI.� Room Length � Width �� Height Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area �Vidth Helght No. o[ L1nea1 t. Area Wldth Halght Na o[ Lfneal Lt Ares No. o[ pane ot Dane Ifghte of crack eq. ft. No. ot pane ot pane Ilghte ot crack sV. tL � �d �� o //'i� � �-�' `� Q. �':� L � r3 a� 2 e ° � � � � /�� %D.%a °,� °r� � °�L'% i� /�� :a— %D� i. B�ll Infiltration � , � � Glass ,�%" �/! i � Eap. wall �f� � � x X Net exp. wall ,��'' O/ �. D�� Iat. wall �! � � � Ceiling � y Floor �y � X Total Btu. � Required sq. ft. E.D.R. or aq. ins. WA. Leader area Fl.��ry�j9a Room� LenSth � Width �� Height �'. Windows Doors—Crackage and Area Width Helgbt No. ot Llneal tt Area No. of yane ot pane Ilghte o[ craok sp. ft ,$� �� d � � � 2.3� 2� dG �Y �� d � � .,� / I G bf% � � Coef. Btu In6ltration =��' Glase `0 „Z. y/ � Eup. wall Net eap. wall , � j � � Int. wall � y� � Ceiling �� . �, �s Floor �/� � � Total Btu. ,� Required sy. k. E.D.R. or aq. ins. W.A. Leatkr area >�. �6�`� R�m ��4gc� r W;ac� i� H��hc � Windows a Doora—Crackage and Area Wldth Aelght No. of Llneal [t. Ares No. ot Dsne of pane Ilghts ot crack sQ. f4 � s� � �� s,�0 %� �� ' e��e i� / �60� � � �� Coe£ Btu Glaaa Fap. wall Net esp. wall Inc. wall Ceiling 1� loor Tbtal Btu. �s o �( X �t � �� y� ft. E.D.R. or aq. ina. W.A. L.eader ana ( Infiltration Glaes Eap. wall Net eap. wall �. wall ra� Ceiling Floor Total Btu. fG E.D.R. or aq. ins. W.A. Leader area Fl.l Room ( Length Width Windows and Doora—Crackage and Area Wldth Helght No. ot Lfaeal [t. Ares of oane o[ oana Ilahb ot crack ea. tG Infiltratioa Glaaa Eap. wall Net eap. wall Int. wall Ceiling F7oor Total Btu. Req�»red sq. it E.D.R. or sq. ins. WA. L.eader area F1.� Room I L,ength Wiach Windowa and Doora—Crackage and Area Infiltration Glaaa �p. wall N�t �ap. Wau In� waU Ceiling F7oor Total Btu. Requued aq. k. E.D.R or aq. ias. WA. L.eader area DEf. Bhl � � !/ " �� o� � �� 0 Btu � e ,, — - T � , . � . � : _ « ,_,�, _ � ; , ,. . l , �� .� � . ,. �, . � , `�� , � . �d * � ¢.� � s„+;��''�'"��,� �:�' ��" . �, � � .. ,�.k - � _ �,� �. 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A..... . < ,. a ._ ..... . . .. . � � �bA"'_L_ . I� � City of Fridley, Mi.nn. BUII.DING PERNIIT N° 3 817 nat�: . . . .l�.�. . . .� . �:-: .5�� . . . . . . . . . . . . Owner ....................................... Builder .i!%!��i�.... . ... . . .. � � � Address ...................................... Address ..�.......................................... LOC�►TIOlV OF BUILDING / � No. . 4�! � �/ Street . . . . . . . . . . �. . . . . . . . ;��ld.��. . . Part oP t .................... .. ..... Lot . . . .� � . . . Block . . . . . . �. . . . . . . on or Sub-Dfvision . . . � ��`� .. .. � ............ . .. .. Corner Lot ............ Inside I.ot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILD[NG To be Used as: i . . . . . . � .�-.� yDepti, �� . : � Height ./. o . `� � Sq. Ft. ./.�� Cu. F't. ./. �!�!. Q .................... Froat ..........Depth ........ Height�..... Sq. Ft. ........ G�. Ft. ........ Z�►pe of Construction . . . . . . . . . . . . . . . . Est C�t. . . � .%/. � . . . . . . . . . To be Completed . . . . . . . . . . . . . . : . . . . In consideration of tihe iasuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in c�mpliance with all provisfons of ordinancea oP the dty of Fridley. ./�:��.. . ..��4�• •�� V . • � ..��.��. ,�/ � �In consideration of the payment of a fee oP $.../........., permit is hereby granted to ................... • • • • • • • • • • • • • • • • • • • • . • . . . to construct the bwtld3ng or addition as described above. This permit is granted upon the express condition that the person to whom it ia granted and hfs agents, employees and worlmden, fn ali work done in, around and upon said building, or any part thereof, shall conform in all resgects to the ordina.nc�ss of F�idley, M3nnesoffi regarding location, construction, alteration, maintenance, repair and movmg of buildings with- in the city limits and this permit may be revoked at a�y time upon violation of any of the provisians of said ordinancea. s . . . �. . . . Building 7nspector NOTICE: Thla pe�mlt does not cove� tha construotlon, installatlon o� alieratlon for wiring, plumbing, gas heating, sewer or water. Be su�e to see the Buliding Insper.to� fo� separate permlt� fo� these Itema .-:_ ..: � _„f •_ . 'I �' APPLICATION FOR BIJILDING, PERMIT CITY OF FRI�LEY, MINNESOTA ;� . • . � � `' Builder � s' � . Owners : Nam.q .. ---�-._ Addresa Q � � � -� � 1: ��ddresa _ a ' �� LOCATION � OF BIIILDING � , , , .. . No. 'StrQet,. ___.�___.._ �'t of..Lot . -: � .. . ' - . �� Lot .�__; Blci:k.... �� . &ddition or Sub. Div. Corner Lot side Lot Set �Ba.ck � � � � gpplicarit}�atta:�h to this form Certif3cate of Survey ef Let and propesed buildirtg .location. � . • , � ' DESCRIPTION OF BUILDING �. � ' To be used as ��/�e�. � � .� Front � �#�th �-� . Height � � . . . Sq. �°i. ... . �. �. : �: . . Front ...._.�._..Depth .._�...--Height Sq� �p�t, : . - � � G�.i. Ft. ..�_..�— . ' Type oF Cori�t'ruction . ,� - � �° Estimated Cost ..� � � � , � ��'�----�_� To be 'c�mpTeted .. -- The undersigned.hereby ma.kes application for a permit for the work herein spec�f3�d,.agreeing.to dp a1l�work in strict aecordanee w3th the City Ord3.i�ances :arid ruling of the D�partment`.ef Buildings, and hereby declares that a].1 the facts and representa.tions stated in this application are true �d correct: �` _ . . .. .. � Q � _ w.. Date ..�.� Signature �" �,=-,`; =--- (��Sc�ibdule of Fee Gosts can be fouricl on the Reverse Side) , �� / 7 / , � ° `'� � � .,_, �r �"� ,., s, w �x _ BIITLDING PERMIT FEE SCHEDULE � � Section 2� The Inspector of Buildings sha].1, before iss�iirig any permit for the erection of any building or atructure, or for any addition to any exis�ing building or structure, or for any alterations or regairs to any existing building or stxuc�ure� upon �zppl3cation therefor, require the p�.yment by the applica.nt for such permit of fees to the amount herein below.set forth and �n:th� manrser herein provided to-w3t:. 2.1 For any such perr,�.t for the erection.of any fireproof building' . other than a garage, warehouse, factory or grain eleva,tor, or for the erection�bf �ny fireproof additionp for similar� occupane�, to an� . exiating building aha11 be at the rate of �1,40 for each one thousand cubic feet, or fra ction thereof, in such cubical contents. ' 2�2 For an9 such permit £or the erection of any fireproof garage� ware- houae, factory or grain elevator, or for the erection of any fireprooF addition for simi.lar oc��a�ancy, to any oxisting building sh�.].l be at the rate of �1,.25_for each one.thousFZnd cubic feet, classified as "fireproof" by Section 502 of the Minnea�oli.s Building Codee � � HOIISES � � �� ' 2�3 For any such perinit for. tne. erec�Gion of any non-fireproof buildin� other than a garage, wasehouse, factory or grain eleva.tor; or any� � non-fireprooi �,ddition9 for si-,ni]_ar occupancy, to any existing building.. Perm:i.t �1,00 for each o�e thous�.nd cubic feet. " GARAGE,S � ' . 2-1* For any such permit for the erection of any non-fireproof gara.�e.�. warehouse, g�.ctory o� grain elevator, or for the erectiori��of"any non- fire�roof ac�d�.��on, for si�ilar occupasncy,�to any existing buildi�g or.,.. for eaeh �uch building or addition� Ninety Cents for each one thousanci'cubic f2et or•fract�.on�tM.�reof, in the cubical contents thereof . with a mininnzn of �1�,00� For the pur�ose of comnutin; fees for building permits the cubical con�Eeii�s'-6f�:any bu3.ldin� or add�tion to a uniform hei ht throughout by _ multiplying -�'ze gro�and area covered irom a point six �6) in�'hes below tho floor line of the b�.se�aen� or cellar to the average height.of the . upper surfac��or �o 'r,he a�Teraoe height of the roof surface oi the main gable of ��a pitc„hed roci F __ 205 For renairs or•��.ltar^tior�s to an existing structure, the.fee shall be at the rate of �3�00 for each Fiv� Hundred Dollars (�5�400), or fract3.on ther. eof in tre cost o� a].l prono�ed work,, 2 a 6 In no case shall the � ee cr��.rged for an.y perrait as set i'orth in Section 2 be less ihan �p/�00� � a � r i � • � �_�� ' �. �" ,� � s i v � _, i � J 1 � � , _ r � ' . � I E � 3 � � � . �� --I I �� I � G � �. � o � p � . M : °x : � . m . m . y : o � a . � 0 ' � : � • l� � N � .�'a � � � � � � `� cxi � p � �� o � �n � N • o • o � o � : o . . � : : � . . !� O � � � N N � O q G � t!i fiA H � � t" i � tro" R� z� � z� z z 8 � � � � y� .� � � � � � � � �� a " � � � � 1d � . C � �a a' p � � a° � � � � e,��n .. � . . � � ' � � : 00 � . . . . O : CD : : : : . � . . . . I I I I I I � �a x k �e � �e W lV W f+ �+ � � C�i� O � O O O � ii! {fl Efl {fl fA fA H H � 0 � x a � � � r � m N n � C r m � • � �, p ~ � ¢+ `�' v. x ^� � 8 � wnr�re � @ c�osers �p URINALS � enrH m �� ,� � � I SINILS Wl�i � � reavs DRtNK. FOUNT. sHwRS. FL�R o�� T� BASINS au�ro v/nsri� �GAS APPL GAS RANGE GAS OPENINGS � • 2 ! � D � m � � � �� m om. ►�+ M I � � p�� fD �p f� Yn � h'J � a °� bd � o � �' � � �' � rn Q ,� g � � � � �. � � . � z 0 �Fa-� Ny e ' �� y � � � °+; m ; �.°�� o � �. �, .. � �o � � ��oy � � � ��$� � ��°�. m� b��. �� p �' o � �o p . -o a ° M ��w � � � �� o��" � � � K �� m ��o h! � � � ~ � r� I w�fD �� ` _ � c� � d �A � � a0 �rx & �°n p � M � � � m � � � �• � �� __ -_� u'�y .. � - • �r d 0. �- w �� M � � � � �. ro � o � • � A �� 0 6 � � i � ' V h � �� sue�ecT PERM c�ty of Fridley 1810 3 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � REC . � `y _____ COMMUNITY DEVELOPMENT DIV. � �� r � � PROTECTIVE INSPECTION SEC. / �% � � i / l---. A ��",•� CITY HALL FRIDLE� 55432 NUMBER HEV. OATE PAGE OF APPROVEO BY L J� 612-571-3450 910-F15 ��9�85 / / JOB ADDRESS 6971 Hickory Circle N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],% ], OS'l�td,I1�S Third Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Joseph B. Gallus sr. 6971 Hickory C;ircle N.E. 574-0517 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residenti.al 7 CLASS OF WORK ❑ NEW ❑ ADDITION �7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 1�E�00� DW@�.�.lri� 9 CHANGEQFUSEFROM TO STIPULATIONS Us.e. tvao layers of 15 lb felt, a�opped up to 2 feet inside outside wall or 3&' inches of 50 or 90 lb staxter roll. � SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATINp, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES C30VERNING THIS TYPE OF WORK WILL BE COMPLIED $$ .rJO �`. rjO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $]_Fje OO ST UCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECK FEE TOTAL FEE $16.50 IGNATUREOFCONT�ORO urH E GENr iDnTE� WHEN PROPERLY LIDATED THIS IS YOU^R P RMIT ``� �° �' � / y SiG AT REOFOWNERIIFOWNERBUiLDERI IDATEI -- v BLDG INSP pA E � [ ] City of Fridley Effective �/1/8� ADDN. [ ] R-1 AND R-2 AI,TER. [ ] Building Permit Application Construction Address ��1Cko� .v�� Legal Description• L-°-F �% 1�1 ° � � C�is't� „`°`�.,,`�s ��,`'° `� ��`"t� � °-� � ��s�� e �� 1�s J s . Tel . � �7 _ p S' J � Owner Name & Address: - Contractor: �rm � � Tel. � Address• Attaeh to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROYEMENT width Height Sq. Ft. I3ARAGE AREA: Length Width Height Sq. Ft. DECB AREA: Length Width Hgt/Ground Sq. Ft. ��RI Karo� '� ��w.o�� p\c� 5��...c1\�� Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setback Type of Construetion: � s�'`0. � ��`�� -^ e Approx. Completion Date: g � �� Estimated Cost: $ �s �- �" Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE• � APPLICANT: ��'`�. �°-Ii"5 `��' Tel. �-��`t-ds 17 Permit Fee Plan Check State Sureharge SAC Charge Park Fee Sewer Main Charge r� ��, r�i:�� STIPULATIONS• CITY IISE ONLY $ /Co. UU $ � �� $ � � g ��o. S� Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Yaluation $�F25 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] _ � � . BIIII.DING PERMIT FEE SCHEDIILE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existiag building or structure� or for a��y alteration or repair to any existing building or structure, upon applicatio n 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 Valuation �1.00 to �500.00 Fees $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for eaeh additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 �32•50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1�000 or fraction thereof, to and ineluding $50,000. �50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for eaeh additional $1,000 or fraetion thereof, to and ineluding $100,000. $100,001.00 and up $u33.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROiiT (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approaeh with 6 ineh depth - Driveway Width plus 6 feet times $15.75 VERIFICATION OF FOIINDATION Permits for eonstruction will be issued a minimum of 2u 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 location of the foundation onee it has been eonstructed Will be required before proceeding with the framing. _d ,. .. ;.. t i r� r ► 1 n � n � a �r A �� 7 a � O � � np � H O n a� 0 . � : n~i 'a a � � a . � a � 0 c n � O c Q d n � r. �°o � 0 , N d � � � � n d e+ O � 0 7 � A � d � � � � c � 6 n A N A ►• � � b3 M cz N r� y3 O � N t*1 HO d7 � CZ A� �_ n� �� o !�l � H N M �n 0 0 �p w O o °� � < ~ � m O �p �O ►t � �0 �y m f w d N�1a� � A \ � �, 1 � � 1 G C � �Gp � [=7 W �l a 0� O. y � " " :. 1° i �c �i O �t � C1 K IG ~ � � � � z °' pj � � � � � a � p�� n ^ � _� _�_ P7 9 ►p'� A R '= Z � n �7 � _ '7 0� C V1 M � .- m N 7 � O m � � � m � � $ � ' � � �' � " � � � � � � � G 0 70 � w 7 m 'O � r 5 � � N � � 0 0 � y K �m K � � y G M n ? � � � N N N \QG o \ O i Z m c M � c� �o � H � 0 � 0 � O r �• M °� n a t�" r 1° v M � ►3 � H � b W r � � M O M 7� N � � N ►a+ � O � � � O � � � Y � � I� � O � ■ C M c� N W F+ M •O A K O M m LL O<i \ ►�'� r� O � Oi 7 �M � i� � O .�►- �a `. � � �, mM m M R O 7 �� fA r 0 0 0 � c� ci rii oe �n v� m Of�pm MM G�p ►�t � r" � h � F77. m � '0 r � i M 1P $� y S r m f0 � O r hr . � � � � �g » ,.� n rr a `� � ti ` m •C � N N N N p O o o � 0 0 0 o cn 0 0 0 0 N N N N N tA y �� O � � E W 7 �No IaE r 15 O O,tD rn � m C � � s o � P� r - G Y+ 'w J � a� oa w �� O fC 1 ►1 R 7 � ►'CI .�a � �O O m T � � m S 7 p, K G o �o �c � a �' 9 ° � °o �j o a a o- y, � ��o.� � � � m o R � � 7P W �-' '9 d n IC "' 3 A � ►°•' °' .� �, b < � 7 C �-• r � r� 7 w � T S G� f0 O �" 7 m� ti W K o � m � � < � .• d o 0 .-a � n z n � � � � Ul �Ag" � � d°�� - � — � „ .- � e °' M. ry, .°•' � d S~ =c ° m z�'i � � ■ A O 67r�-� tNi� 0 8RK7�C W . ti N r K � � �� ~ �C o o m s 0 0' w O. 'f � m N b �° � � m D n � C Z rC O �'1 � O - S m .�O a � a a z c-� � O N 2 o a � C ? D � � 2 N � < � N �1 n �n O y O 2 � v • m m � � i'i — m � N ... O z a m T � � m .� D � O 2 D z v l"f �--1 � O T T 7C O r m � t�1 Fh M fD n rt c m � � F� 'r '� � 0 CHIMt�EY AN� STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,) 2. Is free from rust or deterioration . Yes () 3. Has no foreign objects lodged within Yes () 4. Is securely supported Yes () 5. Wleets a�ll- curreRt Code r�quir�nents for size and total BTU connected . Yes ( ) 6. Has To tal hea ting BTU�s of All other BTU's TOTAL Rema rk s No ( ) No ( ) No ( ) No ( ) No ( ) � Cam pa ny _ Sig�e� �y Da te / i i rh K O D � � �.. g r F� � � m � 0 0 Mp � 6 „ �. g � wa �� w � � q r• M � �� C w � c n � Q Oi � � .�.. fdD � 0 , n Oi n � < � � � d r+ O 7 0 7 � � � d � � w � c i � o� r+ A N �0 3 N3 N � o '9 N� HO �� N �' A� � c� � ta � b � � H H � � cr+ 0 0 ��C -.2 � � ° w � r � � Z O' � o m � � � iW �H \ �' "0 7pD � G C F' ? 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N N N N 0 0 0 0 �y° 0 0 0 0 � 0 0 0 0 V► {p N N � � n � � � W 7�O m K fD 2 On W fD H h+ rr '0 � m C M� s O M m rw � y�rn� a� o. a ��5 � k�N Oi M W W� ,,RR�� M ro o W O m M � m w � � G ��T m W � FWp+, Pi m y- � ��o� � m � m � r � � W � K � r � a a •°a � w � r x �o � � � � w 7 W K Q � �sam m « � 7 m 7 M W ''� V � � m Q � � n m r� m m o w. � a n h Z � µ�8� '� � 'i � a g `� � � Oµ. � �p �,� m � m m � � � � m • m �'n � r«•$ v� A 8 R 'RC �Mi' W r K r m �� 5. � m O O' � �o W � � � \ '� � � �, � � ^, - ` 4 p� A �b' � r m a � � =m�, °z C T � O � 0 � m � a� � � z c� --i o tn z t� a ••• Z --1 C O = Z D � � Z N G� -( � y -+ n �n o 0 H r C � m m ..�. � n m � N � O Z � m T � � m � D � O z � Z d .TK , , s � A. - M a� ep �t8 pau6�s �fuedwo� s �.� 2waa lt/101 S�f118 �a4�o llb �o s, N,8 6u �� eay � e� ol s eH • g i) oN i) saA pa��auuo� (119 le�� pue az�s .�o� s�uawaa�nbaa apo� �ua.�,�n� ��e s�aaW •5 ( ) oN ( ) oN ( ) oN ( ) oN ( ) saA pa�aoddns �f�a.�n�as sI 'b () saA u�43�M pa6po� s��aCqo u6�a.�o� ou seH '£ () saA uo��eao�aa�ap ao �sn.� wo.�� aa.�� sI •Z (') saA pau iwexa �t� � n�a.ae� uaaq seH • t !��e�s .�o Fauw�y� 6u��s�xa ay; �e41 sa��.�an �'qa.�ay pau6�saapun ayl NOIltI�I�Ia3A ��tl1S GNd Jl3NWIH� . °,' HOUSE �i ATING TEST RECORD �' ADDRESS �� APT. FLOOR _ OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY — Eleatrieal Work By Gas Line By �_ �r',i}.��'� CITY _ SUBURB TYPE OF HEAT GA FA�HW STEAM SPACE HTR. UNIT HTR. OTHER . GAS DESIGN CONVERSION MAKE ��'� � MAKE OF BURNER Model.�� Model Seriai � � � � � Max. BTU Rating INPUT �� MAKE OF FURNACE Modsl CONTROLS �� THERMOSTAT ��;��{ Heat Plug Vent Size Valve ��` KIND OF LINER �'� SIZE NONF Limit A �+ Draft Hood � Regulamr Limit s+►I�g Filters Size Number Fan Setfing C�imnsy Location Inside � Outside Pilot Type �� Chimney Construdion � �-T��"' Pllot Make �� Pilot Model Smoke Bomb Wlring Pilot Timing Draft Tsst Tag � L.W. Cut Off Door Prssaws Lightinp Inat. � � !' CProasure �� S Percent CO �� Date Tested �� 2 f�� Input CFH �� Percent OZ �� i Company Testing Staek Temp. � � � �' Percent CO . � " � Name of Teater '^—� Form 235 SUBJECT IT NO. City of Fridley 2 7 5 3 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ;, ,� . � i v�_�� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �/�� . � (8�..� � _ /"'1 � CITY HALL Fq10LE� 55432 NUMBER REV DATE PAGE OF pVP VED BY �"'"� � �'� 612-571-3450 9t0-F1S / / 9298 J08 ADDRESS 6971 Hickor Circle NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 1 Ostman's Third SHEET 2 PROPERTY OWNER MAIL ADORESS 21P PHONE Terr Wood 574-9976 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO U To Constr. 2737 lllth Ave C 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P ' PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDINt3 Residential 7 CIASS OF WOHK ❑ NEW ❑ ADDITION � ALTERATION �C} REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and ara e 32 S T ar-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY (iROUP OCCUPANCV LOAD SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CON3TRUCTION 20NING SO. FT. CU. FT. AUTHOHIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOHK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAqKING I NEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCE E G THIS TVPE OF WORK WILL BE COMPLIED WITH WHETH PEC D H REIN OR NOT. TNE GRANTING OF A PERMIT 27/{2 1.3] DOES NOT ESU T GIV ORITY TO VIOLATE OR CANCEL THE pEFMIT FEE SAC CHARGE PROVISIO OF V H ST AW REGULATING CON- STRUCTI N OR HE M UCTION ]/{. � rj Fire SC 2. %�F � PLAN CHECK FEE T07AL FEE � � '�� License SC 5.00 83.86 SIGNAT aEOFC �AACTO OAAUTMOAZEDAGENT IDATEI WHEN PROPERIY LIDAT D THIS IS VOUR PERMIT SiGNATUREOFOWNEF1�iFOWNERBUILDER� �DATEI ABLD NS�o � ^ ^��uT� NEW _ [ ] ADDN [ ] ALTER [ ] ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 �� Owner Name & Address: ��,� � l�m� � Tel. # J 7� - q� 7( Contractor: (/ e° a� MN LICENSE # 7 7/ �7 Address: � �. 3 7 /// �''� �� Tel. # �/07� °�7�5,5� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlIZPROVEMENT Length Width Height Length Width Height Le�r Width Hgt/Ground �.�,� ..; �" ��' �� , ; Driveway Curb Cut Width Needed: DATE: , , � , �� APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: $ '�� . f .� � �� /-�� $ $ .� . �-�'� �'� $ $ $ $ �� -� �� ` $ �''-� �-��-� Sq. Ft. Sq. Ft. Sq. Ft. e �"� Estimated Cost: $ �. ,��f��- (Fee Schedule on Back) Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) � Tel. � �� -�.�� $.50/$1,000 Valuation $1000 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 [ ] BTJII.DING 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 existing building or structure, upon application therefore, require the payment by the applicant for such pemut of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minirnum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and ,including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter 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 width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue�eei PERMIT NO. c�ty of F��a�� 320�3 � AT TME TOP OF TME TWINS g � I L D I N G P E R M I T � � RECEIPT NO. � ; L ��_ COMMUMITY DEVELORM�NT DIV. ��-�� / ' , ; PROTEC7IVE INSPECTION SEC. j � _ �� `.--. A; ��,'� CITY NALI FRIOLE� SS�32 NUMBEII NEV OATE CAGE Oi AVpqOVED BY L J\ 612-571-345Q 910-F15 7/26/O1 � � r JOB ADDRESS 6971 Hickory Circ].e t LEGAL �OT NO. 9LOCK TRACT OR ADDITION SEE ATTACHED DESCF. ].] 1 Ostman's Third SNEET 2 PROPERTY OWNER MAIL ADpRES$ 21P PMONE Terry Wood, 6971 Hickory Circle, Fridley, MDT 55432 763-574-9976 3 CONTRACTOR MAIL ADDRESS OX ZIP PFIONE UCENSE NO Minnesota Exteriors, Inc., 8600 Jeffersoa Hwy, Osseo, MN 55369 763-391-8814 2877 4 AqCMITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO. 5 ENGINEER IqAll AODRESS ZIP PhIONE IICENSE NO 8 USE OF BUIIDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION � AEPAIR p MOVE ; O REMOVE 8 DESCRIBE WORK Soffits &fascia 9 CHAN(3E OF USE FROM TO STIPULATIONS � Ventilation mus� meet State Building Code. SEPARA7E PERMITS ARE REOUIRED FOii ELECTNICAL, PLUMBING. HEATINa, TVP� OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED V�1ITHIN 80 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANQONEO fOR A PERIOD OF 120 DAY$ A7 ' ��' ANY TIME AF7ER WORK IS COMMENCED ` NO DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I MAVE REAO ANO EXAMINEO TNIS APPLICATION STALLS ' GARAGES AND KNOW TME SAME TO BE TF1UE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SUR7AX ANO OROINANCES GOVERNING TNIS TVPE Of WpRK WILI QE CAMPI,IED Fire SC WITM WMETHER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A PERMIT �Z,550.-0U �Z.SS DOES NOT PRESUME TO GIVE AUTHOpITV TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR I.00AL LAW REGULATING CON- STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION $8� . LS � SC � 1. L�I PLAN CMECK FEE TOTAL FEE icense $5.00 $92.07 S�GNGIUAEOFCON'FACiQAQpAUTNOp�2E0OGENT iO�iE� yyM PFOPERLV VALIDATED 7H15 IS YOUR P RMIT S�GNniuAE O� OwwEp��F OWNEpBWIDEAi IDAiE� ' � iN$p � � f� � ' I' �=r .�. NEW [ ] ADDN [] ALTER [ ] Construction Address: �� Legal Description: Owner Name & Address: 7��,�°�'� Contractor: ,��'�� Address: �a � ��,.��, � LNING AREA: GARAGE AREA: DECK AREA: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION � Effective 1/1/2001 (763) 572-3604 Bidg Insp �'c� 1 �S ��Tel. # %�.� � �/ �i��i�� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft Length Width HgUGround Sq. Ft OTHER: o � • � �� : � Construction Typ� ' ; �t. Estimated Cost: $ Driveway Cur Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � APPLICANT: _ /s` "�'� ��- r.��et- Tel. #_��.j �� " CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAr Char� License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ ,�� `�� Fee Schedule on Reverse Side $ ' • � .001 of Permit Valuation (1/10th%) $ �� - $.50/$1,000 Valuation $ ' $�'!50 �F �� llni# — -- -- $ .� � $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "6" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � —� � u � 1 ,2� I •�,� � Z :� � .�, BUII,DING 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 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,(300 $25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each addidonal $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $100,001 to $SOO,OQO $500,001 to $1,000,000 $1,000,001 and up $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for fi�st $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRE5SION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "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 $23.25. VERIFICATION OF FOUNDATION Pernuts for construction will be issved a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will he required before proceeding with the framing. New Houses Onlv �r - �CT-17-2005 13�04 CITY �F FRIDLEY 3�.ild�an.g nspections 'b3-572-3604 �3U�DING RES�DENTL�.L AP�'LY+CA�TIt�N �ITY I]F" FItID�� a� �l - z � -v � �o� E.�. �� rrE,an�ss f� �I i l l�'i�� i rl i��, H[5 APPLICANT TS: ❑ OWNEii �?�TRJ�G"TOR �RQ��RT'Y aw�ERl NaME: _%�'�°�1 �ic�v v�cC, TEN�Alv1' corrr�cc raz� P.02�04 Perrnit Nd. ` ; ��,�� ., e �� r��a �y: L7�.te Rec'd: � � l��° �� aw�x�ss:��% Z1 ��i <_ Ka� CA re le crr�r F�yr �d l ec�_ . srn�2�_ss�� an�:, `7� 3- S� �- �9 7� D� SUBMJT A COPY OF '�A� ��E � � . E� DATE - - �rovR s�ra� Lscnvs� �w��: �� o /U. L-�i V�ieu' cmr�o f-�vs /� sra�'?/t� Ss�i 3 tfiTTi'H AP�'iIGATION p�iONE fo S l-ln 9$` .3G� �'U Fa,3C __— � �'7'u� Ti�PE 0 ADDmON u cin.l�c'r O BASEh�TTf FAYISH O RdOF ❑ DECK � SIDWG O S�RvIM T'YPE OF � DRAW TII.6 O 07HER 7ESCRIBB WO�tTC �£ING AL7NE:�%t> (iiJ�f't Gt !� i-U — 3T�E OF �ER OF SQUAR�S ,,,a�►c� 'ROPOSED S1ZE: _ ''ROPOSID ii�iGHT: — StDYNG � v;my1 � Alutt►im�m Q otha � �E'�S�T�IG C�i'ENATCrS Y� N�Na OR FOR NEW OPENIl+IC�- E S�ZE OF OPENTNCr CHA1+iG$5 & a' l, HO'USE & GARACs� a arrac�n �attac�s ❑ UEI'AC� CrARACrE oso� 0 Teim G Fs,�ia �a�rtrna o� wnsnows — 'eV NCiMBIIt OP VVII�TT ALL FE�S ARE SAS�b ON vAY.UAT�UN, YNCLUD�N'G'1�iE COST OF (iJSJlTTG'I'g[E 1997 �1.B.0 FEE �CF��T]�,� V. T�IGHT �L BA�'!' REMODFL3NG_SiIBMiT: 1, �g F1oor Pl� � Z� Proposea fioor plan 3. L.esi of strncdual roanbers to he uscd FORNEW CONS1RUCflON ll�1CLLIDING DFClCS, �DiTIOT�S_ & PORCHF_S SUBMIT: l. Siee PIaNSurvry shovvfng the exssting sorucmres �d p�vpesed pro�ecc 2. ?VaD S�tS Of'C01Lad'uctiori plmts 3. Ettragy Calcula�ions MA' Permuit Fee $ ((�`�il� (l�� ;�(/ 5ee Back Page for Pee Sck►cdule(( -y ��-� �%�°� � Plan Review � 65°/a of Building Perrt►it Fee Swebarge � °� ,� {.0045} times the totat jo]� valuation � Minimum S.SO Fire 8urcbsrge $ R�,�' AO � x�ermit Valuatian (1l10%) Lieense S�charge $ �; '�' $�.00 (S1ate Licensed �tesidearial Co�°actors} SAC Cbarge $ $1450 �r SAC Unit (Plans to MWCC for determination) Curb Cut Escrow S £t + 6 ft = ft x$20 =$ Erosion Control $ $450 Conser'vgtiaa Plau �teview park Fe�c $ Fee Determnnoed by �ngineeriag Sewer M� Ch�rge $ � �' � � Agreement necessgry ( ) Nom Nec:essazy ( ) '�'vtal Dne � a- lVlake checks ble to: ' of F�idte A,ttac FOR A PERMff NpT VALID i}NTIL PROC$SSED I hereby apply for a building germrt and I ac�wle�ge that tbe information above is cemplete and accurate; that tbe work wi�l be in con.£armance vvi� the ord�anees and codes af th� City of �ridley and witb the Mm�esota Construction Codes; that I uaderstaQd this is not a pernut but om�y an applic�'�tion for a pecnni�t and work xs not so stact without a peno�it; tl�at the work wili be in accordance witb thc approved lan it� the case ef all work w'ch requires review d a�proval ofpians. � % �r � . . s � �� _".`. I �. , � , .`. _ � � �1►� :i, r / i �� Building Inspections 763-572-3604 763-502-4977 FAX DATE l�i ' �I' (.., SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMTI' A COPY OF YOUR STATE LICENSE AND CERTTFICATE OF _IN� JLRANCF. PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IMI'ROVEMENT �200FING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER �ONTRACTOR :: tYbr �Tex r V., � :sss: to �. �1 Z-�°71a -U^-A_ Permit N Received By:�' Date Re�� S E �� STATE LICENSE # a�T� EXP DATE 3�3I �O ADDRESS _p�� E�,�y� �V�iV. CITY._��Q� STATEYVIriZIP S�3b� — • — —�— -- ` �wSINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ BASEMENT FINISH ❑ DECK ❑ NEW HOME CONSTRUCTION ❑ MAINTENANCE/REPAIIt ❑ GARAGF/SHED ❑ ROOF ❑ SIDING � SWIMMING POl SIZE ❑ ADDTTION �REMODELING ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑ DRAIN TILE ❑ OTFiER F"I' �ASEMENT REMODELING SUBNIIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structutal members to be used IDING FOR NEW CONSTRUCTION INCLUDING DECKS, � V�y� ❑Sofftt ADDITIONS_ & PORCHES SUBMTf• ❑ Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. Z. Two sets of construction plans �'�'��H'S 3. Energy Calculations IN EXISTING OPENINGS IffiYes �No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) 'II'O'�'� .pd�B �'�d..iT Pernut Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due \ o tDC�ii�r�iCi' 'i'Y'PE - - $ 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) $ $2000 per SAC Unit (Plans to MWCC for determination) $ i}+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Deternuned by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ �/�, �,�' Make checks paysble to: City of Fridley Attach Stiaulations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge 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 applicarion 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT S�,lyV1M�, `�N pRINT NAME CY�.':� {�`�'1 Y� \Sh.7(� DATE �`�, `V 1 PLEASENnTF.' �RPARA'i'F.PF.RMTTCARF.RF(liiTRR71FC1RPT.iTAiiRTATf� �'TRr'rr�TreT n�.mt��nu�rnn�T .tirnnv