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AF - 45799Date: :�JUi -i .,, . l". City of Fridley, �i.nn. BUII�DING PERMIT � N� 3795 . . . ��. � � : . . �: � . . . . . . . . . . . . . . . . . l��r�. �� a'..,Zs�� Builder .�.dY. . �'+a��,... .. .. . . . . �.s� �y� . ... .+wr� : o A. . �.�u . .� � �� . . t�t��l/. Address . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , LC3C�4TIO�V OF BUILDING No. ��. Street /�� ... ..��........ Part o t ................... Lot . �j� ��• �� f .. ..ef. .. .. . B�ack � .. .. .. . . . . Addition or Sub-DYvision . . "; ; •',�,r•C�� ^`� ... F � Coraer Lot . .. .. .. . . .. . Ins4de Lot . . .. .. ..... Setback �'�� SfdeYaz'd �� : ��.. .. .. .. .. To� Used as: �' .rl / . �1J�.... DESCRIPTION O� BUILDING � � �J �� /� Front c�� ;,Q Deptg <,�, ,�.� He3P�t�/. .°:� Sq. Ft. 75�1.�. Cu. F�i�� 7:�� om �� : � nern� ��'.� x�gnt /.� ` �^ s �. S�'Y¢ l�' .�y .�° q. . . . . . �. �. �� 1j►pe of Construction . .. .. . . . . . . .. . . . . . . Est. Coet. . . � . . To be Completed . . . .. .. . .. . . . .: .. . . In consideration of Yhe iss�uance to me of a permit to congtruct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in c:om lfance with all provisions of ordinances of the dty of Fridley. � .... � . �:,.-� _� In consideration oE the payment of a Pee of �� . �', P�t is hereby granied to . . . . . . . . . . . . . . . . . ... .... .......... ..... ... to construct the bwllding or addition as descrlbed above. Ttuis permit fa gra,nted upon the express condition that the person to whom it is �anted and 3r9s agente, employees and worlmnen, in all work done in, around and upon said building, or any part f]ie�op, shall conporm in all respects to the ordinances og FridleY, Minnesota regarding l+ocation, consLtuction, alteral3on, maintenance, repair and mov3ng of buildiugs with- in the eity lirnits and this pernnit may be revoked at aay time upon violation oP any oP the provisions of said ordinances. : . �. . e. . . . Building 7nspector NOTICE: Thts permit does not covar the construation, Inatallatlon o� alteratlon fo� w1Mng, plumbing, gas heating, sewe� o� water. Ba su�e io sea tha Bullding Inspeato� fo� separate pe�mlts fo� thase Iteme. ;: � �, ,.., APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, OTH � �9 �" �� ;y .�. Owners Name ° ` �. ��,�_, der�%'` � Adc'tress ��•�,� ��'�-�� Addrese �.' � ��,��"�� -,-�� .. � � � . � %OCATION OF Bt�-IF,DING . No..� Street _ �� Part of Let � _ y.._ ' � ,.. .. , � � Lot �. B�.00k .� �aa�.tion or 3ub. Din. �° � � � � �� Corner Lot ' � ihs�ide � Lot � Set Ba.ck � � Applicant attach to this form Certificate of Survey of�Let and proposed .. building location. , . " � � . 'DESCRIPTION OF BUILDING . To b� uaed . as � . . ,- � � � � � �ont Dep�h�Height Sq. Ft. , Cu. F°t. . . • F'ront �. ,- Depth � NAight Sq. Ft. Cu. Ft. _.�.......�. � ' � . �pe of Construct3on Estimated Cost _�_. Te be complete�l � ' � The undersigned hereby a�kea app�icaticn for�a permit for�the�work • herei.n specified� agreeing to do all work 3n str3ct accordance'with�the Cit1r Ordi.nances and ruling of the Department eg Buildings, and hereby ' decl.ares that all '�he facts'and representations stated in this applieation are fxue and correct. � � . . .� � a ��e�-�� Aate �,,��,�F-� `,� Signature '� E�^'�� h . -��. . � (� �ched.u�.e of Fee Cos�g �an-be foutad ori the Reverae Side.) . � _,Y.. �. � � �� BUILDING PERMI� F`EE SCHEDULE � Section 2s The Inapector of Buildings ahall, before issuing an� permit for the erection of any building or structure, or for any addition to any existing bu3lding or structnre, or for any alterations or repairs to any existing building or structure� upon applica.tion therefor, PEC]t1�.Y'8 the payment by the applicari� for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: _. 2,1 For any such pernit for the erection of any fireproof building� other than a garage, warehouse, faetory or grain elevator, or for the erection of any fireproof addition, for simi.lax occupanc�� to any �� . existing building shall be a� �%e rate of•�1.40 for era.ch one thousand cubic feet, or fra ctiori there�f., in sueh cubical contents.' � • , 2.2 For any suc�. pErnit for the erection of any fireproof g�„ra�e, ware-. .. . house� factory or grain elevator, or for the erection of ar� fireproof �.ddition for similar occupancy, to anq existing building sha7.1 be at t$e . . rate of �e25 for each one thousand cubic feet, classified. as nfirepr.00f" :. :;;. . by Section 502 of the Minneapolis Building Code. HOIISES 2�3 For an� such pexmit for .the erection of any non-fireproof building � . other than a garage, warehouse9 factbrg�•or grairi elevator, or any non-fix°eproof addition, for similar occupancy, to any existing building. Permit �1a00 for each one thousand cubic feet. GARAGES ° . _ .. _ 2q4 For any such permit for the erection of ang non-fireproof g�rage.�.._, ,.. , warehouse, factorg or grain elevator, or for the erection of any non- f3reproof addit�an•,...for, ai,�a►ilr3x ° occupancy� to any existii�g bliilding or .. . , for each such 'building or addition. N3ne�� Cents for each one thousand cubic fee� or fraction thereof, in the cubical contents thereof • with a minir,n.zm of �4a00A . For the purpose of computing fees for building'pe•rmits.the cubical � contents of an�r' buil•ding or. ad�lition to a uniform hei ht throughout by •� �-� • n�u].tiplying the ground t�.retj.. covered fro�i� a point aix �6) inE'hes below the floor line ��o�•'�the basenent or. cellar to the average height �of the '� • - upper surface or to the average height of tlie roof surface of the �in gable of a �pit��ied roof, . � 2�5 For repairs or alterations to an existing structure, the fee shall be �.t the rate of �3°00 ior each Five Hundred Dollars (�500.00), or fraction thereof in the cost of a11 proposed work. ' � 2.6 In no case shall � the fee chr3rged for any permit as se't for�h i:� .._ Section 2 be less than $4�00� �• e ti .� v � � � � BLO�CK .3, OSTMANS .3RD ADp/TION INDUBTRIAL C• �• C O lJ L T E F. ausuvess cerr�oTS �AND SURVEYOR , TOPOOiUP111C M1IPPINO REGISTERED UNDER LAWS OF STATE OF MINNESOTA LIC6NSHD BY ORDINANO� OF CITV 06 MINNEAPOLIB 3300 LYNDALE A4+E. SO. MINNEAPOLIS 8. MINN. TAYLOR 4-0370 I I I � � I � � � y�Ur�L /T r EAS � ' fr ( ( EM�-NT �1 f--- i� �tru�e�ur'e �llrrtifu�2r � � , � �O I � � N89°28's2'"W ( � /�2, 02 �o�'�. IRON e �Y I GARa�aE �� t�°�� R� °''�' I . ` . � � � � �� 4��, _ �e-i'`� � I Q � � ��z. � � � / I ,_ ► �� I I I I I � I� I � I �I 1 �� T 4 �9{� /RON / 7g. S�,' N� S2 58 "pN � / V SCAL E 1 ""�30' I � /�i ON--�' I �, _ _ __! —,.�. � � � � ' � � — � � - �� ,, / RON a 0 � o� a �°I PLATTINO FARM BURVEYB LAKESMORE JUOICIAL .� � � ��\ V � � � � � .\ I I / � � � L� . / I hereby certify that the above is a true and correct plat of a survey of: Lot Four (4), Block Three (3), O�TMAY3'S THIRD ADDITION, Anoka County, l�tinne sota . As surveyed by me this 30th. day of March 1959 A. D. Signed _ � _ �'� . �" ��'`- � � � Minnesota Registration No. 2584 1 1 556 2 - 53/.�8 . ^ r �+ �� kjR • t�/ Y � �• .. � m � � � � � � � � � � � � � � � � � � �� p � `�� H � � m � � � � � I � � � 'O � � � � � � w � �: � � � � � � � ,z � � � � � p, � r N' �� C�'�'.y °� b � o � � � � °° � � � �� .+ � � � � N � � � � � � a a � � � � � � � � � � a !'' �'' �n m p R° R° co $ m� R° R° �� w� oo�� '�� ° g � �� °�°� �� , �� ° g� � � �� o � � 0 � g� �� . °� m,� � 8 a � �� o ��o� �'�.: ��' �p : � : B : �9�c�g �o: : � a°� : �, � � �o. � ry . . . � O O . . � p Q � . . � . . � o • . . � p • . . � �` . : � � � o : . . � : . . : � : : : � � � : : : : : : : : : � : : � : : : : : : � : : � �� 00 � � � � :� :� � � � G b � � CV � � �N�� o �040 � � M 0 � � � � � �� O � "" � � � � � O ��O�� O O O P O ?=�'S l� ��y�� z � � � � � � � � bj�a � � � � � � a � � g �� ° � �' � � � �V �' v �G�. � n � \ �� a, � `�, � Nw�,�� F7� O C O O O O O �s i!i O t'' �a� � � �� s�� °��.�. ��o� ��° `° � � �� y � � � ��'� �� ye�� "1 � O N � � �� .�°a �� '� � ry �p �. A7 �� a� �� g ��. o � �y s� � � � G o .-t �. r+ ►+ i+ � ' to t0 m p� �' tf� I � �� '= Y D � � � � m � 2 m C m d � �. bd � � � a � � O � eg"'�� '�� . � � 4 � a� �' � a. '� �o � �_ �� yN� � � = � =° �� e� eii — � � � � 3 � � � , . - �.� Form$DS. ' ��/.�`'° �9i��`t�l�b"Bf�"� q�n•�5�� (G'€�� n%` � .• �fA'FC't'1SS CALCULATIONS BUILDING DEPAR'PMENT � 60LDEN VALLEY, MINN. Weatherstrips A.S.H.V.E Construciion No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19 . Room � Length �� Width f� Height � and Doors—Crackage and Area � 3" � Coef.l Btu Infiltration I � �` Glass , � � Exp. wall Net exp. wall B// Int. wall � �p Floor �r Ceil. ,� ,�� Total Btu. Required sq. ft. E.D.R. or sq, ins. W.A. Leader area � F� Room � Length /',� Width ,/ � Windows and Doors—Crackage and Area I Width Height No. of Lineal ft. Area No. of pana of pana lights of crack sq, ft. � °1,si �P,d �i �,%% i� L� ��e� � y� ar s� �� , ,�, � acl'° � �� Height � � Coef. Btu Infilfration � �J` } � GPass ry , � Exp. wall � � ° y� 't�� ,c� y' Net exp. wall •�,, yf p Int wall , �t �/ x �t Floor � � � Ceil. �� , �. � Total Btu. ° � � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � FL ��°1 ��, Room � Length /� � � Width /�j�.__Fleight �� Windows and Doors—Cracka�e and Area I :�'�l� , �� i /�'-T� , ,j �� R� . b .� or sq. ins. W.A. Leader area Coef. Btu �a � , � �' � � �� ' �� "� �' ,,� '�e �r '�e �c � ,B� �✓.5'� _ FI. �� ., Room � Length �,� % Width ,� �— Height Windows and Doors—Crackage and Area I Width Height No. of Lineal ft. Area No. of pane of pane liahts of crack sa. ft. 0 � � Coef. Btu Infiltration ��: � �/ � v Glass `� Exp. wall � � �,� Net exp. wall ,�� Int. wall � � � Floor .� � � � Ceil. �� '��p, Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � FI. �,�j, ��r'j� Room � Length f� Width �' Height �! Windows and Doors—Crackage and Area No. lWidth Height No, of Lineal H. Area of pane of pane lights of crack sq. $. � Coef. Btu Infiltration � , � � � Glass y � � Exp. wall � � • � Net exp. wall � �� p: Int. wall y� �.� Floor � � ry� s� ,.r�' CeiL ��- �� ,��. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FL ��,.� , Room � Length y�� Width �..� Height �� G�Q� �� B �9. ft. �g� Glass � Exp. wall B�°.�. �. � ,,,Q_.,r� Net exp. wall �.� � �-- �� A � � wall o. � Floor f,s}�' Ceil. Total Btu. Required.sq. ft. E.D.R. or sq. ins. W.A. Leader area �, Coef. Btu �+ ��• t� � � �� ,� Forr�r��D5 :-�'F-C�'.+S CALCULATIONS BUILDING 0 Weatherstrips A.S.H.V.E. Construction N Windows Doors Guide Reference Out. Wall Int. Wall Ceiling Yes—No Yes—No 19 � FI.� �� r� .%j _ Room � Lengthi �`�� Width �� 9 Height �; Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pana of pane lights of crack sq. ft. / � � � ,� �l`,� I.��. �� ` � �.y ��' a ' , � d � .� � �' �: `� �. � � � �� . '2.�'� �/, �. Coef. Btu Infiltration � � �/ � Glass �% 4 � ,g � 6 Exp. wall % y �r' s,+ yc Net exp. wall e r°L �,� Int. wall � y�• • ,� Floor 9c � �r � Ceil. '�r � Y' Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � FI. � �,�. � : Room � Length % �i'�INidth ,� ��--- Height ;� � � Windows and Doors—Crackage and Area Width Height No, of Lineal fF. Area No. of pane of pane lights of crack sq. ft. / � O'6 %�.�'f/_ ��. � �� $� Infiltration � d�� , �/ ,�,� Glass �, % �� Exp. wall f � '� '�' � sd Net exp. wall , � f�' � Int. wall � �r �e •� � �,e Floor �� v � � � Ceil. � �� t � � Total Btu. � � . Required sq. ft. E.D.R. or sq. ins. W.A. Leader area o%'o % ,� FI. ��,� Room � Length �� Width /�� ei ht �; l Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3 � � � �.� ,s �' - n . o � �. Coef. Btu Infiltration Za� ° � �� Glass �,.�� -. � Exp. wall � Fs ,� x Net exp. wall � ' ��- Int. wall X � � �e �' Floor �t -� + � k� Ceil. � Total Btu. Required sq. ft. ED.R. ar sq. ins. W.A. Leader area - /� x= �.� _ �"-� � EPARTMENT MINN. �. Insulation Roof Floor Kind How Applied �j FI. ��, �, Room � Length �gs/��JfVidth ��'' Height 6 Windows and Doors—Crackage and Area Width Heighfi No. of Lineal ff. Area No, of pane of pane lights of creck sq. ff. _ �?- �� i�1G� � iD � Coef. Btu Infiltration � e�/ �p Glass B�� 3 �. Exp. wall -a p� � � Net exp. wall -'��' ed 2,` � Int. wall y �,• a Floor � � �. CeiL , Total Btu. Required sq. ft. E:D.R. or sq. ins. W.A. Leader area � FI. ��,�f,�'� �,er Room � Length ,�� Width � Height � Windows and Doors—Crackage and Area No, lWidth Haight No. of Lineal ft. Area of pane I of pane I lighh I af creck I sq. ft. B �% � � �6 i�` Infiltration ?�? �/j 2p Glass �� C� Exp. wall �� Net exp. wall �/ � � Int. wall � n � Floor �� CeiL �� ;,j � Total Btu. �, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �fl. �;�� Room � Length �� Width �� Height � � Coef. Btu Infiltratian /�.� �/ �--� � Glass '�',�/ !f3' �p, Exp, wall � � � � �! Net exp. wall �,,/ r'/ �/� Int. wall � % �� y' � Floor ,� �y� �k � Ceil. '' ,� 2, "� �� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area °f'/O �or �� ym ❑ � M y � �. � o r p � . M . 7i . � . � ; N : o . � �3 : � . � • ts� � � � � 0 -� N � � i`i '�-'��k+' � �,; � � r+ !'�i � .•� � w � � �' � � � s� � � � L�7 • O • O � : O . . Gd : : � . . 0 i4 �a �e N ►��+ � O O O � si tr� �] 0 � r � � � e � � � z x e � � � � � � � � � � � � �' � � y CL y : tp � � ��d . O � � �1 P b � Y � �j � � �� °°��: N . . Gl _°o : u5 : •• � � . � . . O : W : : : : : � : : : : 0 �7 p9 �d p4 k >4 G� t�7 CO r+ r+ r � w o e�» °o 0 0 � � tsa t� fn H 0 � � � � C r � w � cfl � � .. � � I"' � ""� � � � m v i m � • � O, p ~ M � � � m �8 � .� �� p �� 8 ►+ N � � o m � � �,�� z � ; � � � 8 � °� b� b� n � �; \ � s`� a o�a � � � g � I � z WATER � �� en�t 7vB5 �� SiNKS WASH TIi/�vs DRINK. FOUNT. s►+w�. FLOOR DRAIN$ CATChI BASINS auro WASHER GAS APPL cns RANGE GAS OPEIdWGS +� • a • � � A m � A w a a. �- � � o � `° � � � o� �m¢ � o � 6' 0'�" ;e � � R � w,�o� � ��.�� °��.� � b � �b � � � � a �� p � �' o p � � o p � 1 `r� y ¢�7 p�J Q �, � � rP,� N A+ � �� p ¢,�cD �� p��p f� e3� � y � �� Q O � ��'. �-i .� �. �' c� �. co �o ro �u � I I � �� M V' p�±C �(� ^ ly a� � � � � p � °� D0 '�I � � � � � � � �i 7 � � � � � � � �7 r � � p'/��, :'�' 1 _ Y► °� � � � ro � O � � � �� V eV 0 ., � ��`�� d � � � � � o� p � � O : � ' M • M : O � a • m y : �h : � ' � � �I- N � � W hi �+ !'� � a � ;; � � � � m � o � w � N � o � o � o � . O . . � . . � O � � � N 1�-+ � O Q O � tta 4n � O d � � � �"� � z� � z� z x 8 � � � � � � �,� � � � � � H � �� d y : O � � � � � � o y � a o : � �- : � N . � � o : �� • � � . . . . O : � : : : : I I I I I I � �a � � � � �e � � W N lA t+ F+ ►+ C�tl p C�7� O O O � tt� tn tsi � rss H H � � c�i x D � r � m �^ `J 1�°I C r m � • .� G. p ~ � � a `�" � � � WATER � � CLOSETS �� ua�was � enn+ �m n� a � s�siNs � � I SINKS � � WASH TRAYS DRINK. FOUNT. SHINRS. FL�R ORAINS cnrcr+ BASINS nuro w�n w` GKS � APPL GAS RANGE � OPENINGS � • z e � � � �� p � � m o m ►�+ M �� ° � ° � � �° � � � � � � Fn � y � � � � � � � o � � � � R. o�a� � �' w � g � � � � � � �a� �� : (��. � . p o V` o � ry � m _a � . � � � � �� `�° �� o a � � �o�� 4 ��... ��o�� o� � � � � �� °°° � o� � ro ��b � �ro �� .� m � � p, o p �'�o N y ��w � a� �� . � m �? � �� m � � M ."r �i f'' fD 'J' 1�`�' � p � �'' � �� ' d � � �ro R. n'� rx � � p � .�,. � � � � � � �. � '1 � � � � � �7 � � d Q � b » � � M, 00 � �. ro � o � � A � �,. � 0 0 � ' � •�`�_- � —�f�,. � , _ � �, �,. SUBJECT PERMIT c�ty of Fridley � 13047 AT THE TOP OF THE TWINS g U i L D I N G P E R M I T r � � RECEIPT NO.� � �y_ - COMMUNITY DEVELOPMENT DIV. � �� f � � PROTECTIVE INSPECTION SEC. ' i ' 1l /��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L•"'� � •�� 612-580-3450 910-F15 � � JOB ADDRESS JOHN W. MISKOWIEC, 6988 HICKORY DIZCVE N.E. FRIDI,EY 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 OSTMAN � S TH1'RD Z'j'I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE JOHN W. MISKOWIEC 88 I 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. G 4 ARCHITECT OR DESIGNER MAIL ADDRESS IP HONE NSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING RESIDENCE 7 CLASS OF WORK ❑ NEW �l ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK 8 CHANOE OF USE FROM TO STIPULATIONS ��1�� pERAT� PE�i�t�S REt7U1RED FOR WrRi��, � 0 ��,3� H�TING, PL�i�t3i� A�1�i? S�NS: M`� ��bi�,3`�p a�o�aA •�'�'�� eaol �� a\ sa��c►1 �� 1�` � SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINCi, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 HEREBY CERTIFY THAT I HAVE FEAD 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 4 OOO Z.00 DOES NOT PRESUME TO GI E AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF OTH STATE OR LOCAL LAW REGULATING CON- STRUCTION OR PER RMANCE OF CONSTRUCTION. 24.00 PLAN CHECK FEE TOTA� FEE �'°�,��'� 2 . NATUREOFCONTRAC ORORAUTHORI2EDAGENT �DATEI WHEN PROPE�VALIDATED T IS IS YOUR PERMIT _ �-> SIGNATUREOFOWNERIIFOWNERBUILDERI (DATEI BLDG INSP �R��7 �q_ c.. _ i w a ..�-7'_IIy - �APPLICnTION FOR 1'.�SIDiiNTI/�L., ALTER�ITIO�, � OR Alllll�'�Otd. BUILDIti'G P�RAIIT CITY OF �F1:IDL�:Y, AIINNESO'I'�1 �WNER � S N!1�iE :.,�,.r/�� /�1 S l�f Ouil eG �iJILUEF :,�/ ✓ �5 E' � �•94►�j/ 1�DAItES S : 6 � � � !T �G� O r y �r ��D�T�ES S : � �" yd Gji /G o� a/U /7� 1�0:. STI'.EuT: ./!"�C�o�✓ ,�/✓� • . - — � ZOT e BLOCK • � At�DIZ'ION : GS �� q'/� S 3.�. COItNER LOT : INS IDE I,OT :��SETBAC�:: SID�YARD : sp�� icant a��acr "o this foY:r �.`c•lo Certificates of Sun=ev . o� �ot. .an3 :propose ' building location drawn on these Certiiicates. ~ DESCRIPTION OF BUILDING To �e Us d As : �4� � 5��. �� f/4i�S � Front ° Dep�h ° �Ieight ° • . Squaxe Fee�: Cubic.Fee�: • � Front; Depth• Heigh�• . .Square Feet; Cubic Feet: �ype af�Constructio�: Estima�ed Cost: $ '/�� . To Be Coinp ieted � �^ � � L 7S _ • � , � . T'he undersigned hereby makes applica�ioa fox a pexmit for the work herein specif�ed, lgreeinh to do all work in sttict accordance ��1i�h the Ci�y of �'ridlcy Ordinanccs and rulin�s of the Department of Buildir.;s, and hereby . declares that 411 th� facts and xepresentaL-ions sCatecl in Chis applicatior are true and corrcct. � ' DfATE : CO��Y� 7 S SIG�IATUI'� ° _ • (See �evexse Side For Additional Intorraation.)' . � � y, a � �� —�- � � ° m � �� . . o? � � a o �r��c�� , _ . . � � .._r • �BUIL,DII�;G PL'•P.lIIT FEE SCIIi:llULi: SECTIONd 2. Tne Insp�ctar of Eui.l�in;s shall, tiefore issuing pernits iox ih.` erection c� any buildit�g o� structure, or foz any addition to any e.;is�::ino bu;.ldin;; ox s �ructure, or fur ��y altcration oT� repairs i�o any existi�� }3t111C�.11tb or struc�uze, upon app.licatior_ thexeforA, r�c�t�ixe the paymer_�� hy t.h:� applicant =�.r such permi� o� f.�.�s to the amoun� h�reiu tielo�a set foren and ir. the manner h��ein provided to-=.•�it: . � UI�FIFOI:it �UT_LDIA:G CODE: Type 1, 2& 4- $2.15 fox eacli one thousand cubic fee�, ar fraction thereof, in suclz cubzcal conte:�.ts, iype 3 d. 5- �1.85 �ox each one thousand cubic fee�. ADllITIO:�AL TNFORbi�TTON I�'ox the purpose of compucino �eas for building pe-rm�t�s, the cubical con�en�5 o� ar.y buildixzs or addiiioi�9 is determined by mul�i.pl5r].nb the ground a�ea covered fram a point six (6) inclies below the floor li:-�e of the basemer_�C ox tl�e cellar to the average tieigilts of the upper surface or to the average.� height of the xoof surface of the ma.i�.i �able of a pitched roof. � For rep�ixs ox altexations to an exis�ing structure, the fee sha11 be at �he rate of $3.00 per each fi.ve hur�dred dollars ($5Q0.00} or fraction thereof in the cost oi all pxc�posed work. � In no case shall the fee charged for any permit as set forth in Section 2 be less than fi5.00. VERIFICATION OF FOUNDr1TI0N � 1VOTE: Percnits for construction will be issued a ncinimum of 24 hours �ro:n the time of application, to a.11o�a fox proper review o£ the pxogosed stxucture and of the construction site. A Certi�ied Survey of the lot, showing the location o� the foundation, once it lias been cons�txucted, will be required befoxe p-roceec�in�- t,rith the frami:�o. CEF.TII�ICr'�TE OF OCCUP�`,i�'C1' Appliration �ox a Cextificate o� Occupancy shall be made ten (10) days pri�r to the tis� ox occupancy of any structure for which a buiZding permit has been issued; and said sti-ucture sliall not be used or occup3.ed until a Certificate of Occupa�acy lias been issued. �"r : u „ . . . �. : � `. � ��3 ! SUBJECT / 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 � � � � COMMUNITY DEVEIOPMENT DIV. r � v � � PROTECTIVE INSPECTION SEC. � � i . � � _ �'�'1 � CITY HALL FRIDLEr 55432 NUMBER REV DATE PAGE Of �""� � �'� 612-571-3450 9t0-F15 10/16/92 / / J08 ADORESS 6988 Hickory Drive NE t LEGAL �OT NO. BLOCK TRACT OR ADDITION DESCR. 4 3 Ostmants Third Addition 2 PROPERTY OWNER MAIL ADDRESS John Miskowiec 6988 HickoYy Dxive NE 3 CONTRACTOR MAIL ADDRESS Automatic Garage Door 220 �- 77th Ave NE 4 ARCHITECT OFi DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS ZIP ZIP RMIT NO. 21616 � �eo er SEE ATTACHED SHEET PHONE PHONE LICENSE NO. 571-2525 1990 PHONE LICENSE NO. PHONE LICENSE NO. 8 USE OF BUILOING Residential 7 CLASS OF WORK � NEW ❑ ADDITION �] ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install ZeroRclearance Direct��vent Fireplace 9 CHANGEqFUSEFROM TO STIPULATIONS Fixeplace to he installed accoarding to the testing agency's specification�. TYPE OF C SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONIN(3 AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLI I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATIO OCCUPANCY(3ROUP IOCCUPANCYLOAD STALLS AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $21�Q� WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROV.ISION OF ANY OTHER STATE OR LOCAL LAW REGULATING cow- $54.00 STRUCTI R THE EFFORMANCE F CONSTFiUCTION. PLAN CHECK FEE � , f� Lic:ense SC $5, SIGNATURE OF CONTRACTOR OR AUTHOR�2ED AGENT jDATE HEN P510'PEii� iOATEi - CU. FT. �FFSTREET PARKING IGARAGES SUHTAX $1,45 SAC CHARGE Fire SC $2.90 TOTALFEE $63.35 D THIS IS YOUR PERMIT lr'�_ l9 -�'a' NEW [ j ADDN [ ] ALTER [ j CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Constiuction Address: �} f'l� I�' G ��O/� y r(�� ► Legal Description: Effective 3/ 1/92 Owner Name & Address: �]�'O �/� M l�%� f� W 1�� Tel. # Contractor: ¢�- (,t�'D M �7z c� �'s � +�� /�- MN LICENSE # b�3Q • � � � Address: �-'Z(3 � Z ?'� i� � d� � � . Tel. # .S'%l �- �S�S" Attach to tlnis application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IIVIPROVEMENT LIVING AREA: Le�ttgth Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Z�e4 CLE/�1�� D! fi�G7` UF..,tJT� ��G/iG�E. Corner Lot [] Inside Lot [] Ft. Yd Se,tback Side Yard Setbacks Ty� of Construction: Estimat� Cost: $ o� �DO. °7� Approx. Completion Date: Driveway Curb Cut Widt� "�°°�'°�' �+ �- � Ft = DATE: d (Cost on BackJ Ft x $ _ $ Permit F� � �`., � � Fire Surchazge $ � � �� State Surcharge $ � � �-�� SAC Charge $ License Surcharge $ � - (`"�' Driveway Escrow $ Park Fee � Sewer Main Charge $ TOTAL STIPULATIONS: � $ �=" � � � CiTY USE ONLY Fee Schedule on Reeerse Side .�i of Permit Valuadon (i/lOth%) Tel. # 5"'7� �. 51.� $.50/$1,000 daluatian $7� per SAC Unit $5.� (State Licensed Residential Contractors� Alt. "A" or Alt. "B" Above Fee Deternuaed by Engineering Agreement Necessary [ l Not NecessarY [] 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 bailding or structure, or for auy alteration or repair to any existing building or s�ructure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the ananner herein provided to-wit: TO'�AL VALUE $1 to $S00 $501 to $2,000 $2,001 to $25,�0 $25,001 to $50,000 $50,U01 to $1(�,000 $100,�1 to $S�,OQO $500,�1 to $1,000,� FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fraction ther�f, to and including $2,0� $45 for first $2,�0 plus $9 for each additional $1,�0 or fra,ction thereof, to and including $25,(m0 $252 for first $25,000 p�us $6.50 for each additional $1,000 or fra.ction thereof, to and including $50,0� $414.50 for first $50,� plus $4.50 for each additional $1,000 or fraction there�f, to and including $100,� $639.50 for first $100,OD0 plus $3.50 for each additional $1,000 or fraction thereof, to and including $S�,U00 $2039.50 for the first $5�,� plus $3 for �ch additional $1,000 or fra.ction thereof, to and including $1,(�Q,ODO $1,OOQ,001 and up $3539.SQ for .the i5rst $1,(�0,� plus $2 for e,acli additional $1,�0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete G�rb Streets Only) Alternate "A": Removal and replacemem of curb auid gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter aad install a 3 faot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION UF FOUNDATION Permits for constructioa will be issued a minimum of 24 hours from the rime of application to a11ow for proper review of the proposed structure and of the conslruction site. A Certificate of Survey of the lot, showiag the location of the foundation once it bas it has been consbructed will be required before proceeding with the framing. a � � * = D W ^� � ` ' O � Q � o � m o � � � � n o � � 3 a� o � � -o � � -o a 0 � � � y i � � ; 1 Q � � 0 c ., � � � � �o n C --1 Z n -i T �� a�o ° z r" D � c� � m -N-I C� � < m � n � 0 z z � m z � '� m n � z � m m � w 0 0 0 D � '� 0 � a W � � 0 c co � 1 � v � � � � � v a: m � �7 N N cc � � �. � z 0 � vl UJ � � � 2 � Z � i�i � 'D a z .-< � � �' � � V � � !%. � o 0 1 D y G� � � o O � y � � O � � � O v A� n• C W fl. � �`' (b c� �\ = -, w � m � � � o � � °� �' cQ � � � D u, i � � � � f?o D D � m � � � O � y 0 0 o L N o .-. p� � "� ur—i � � m � � Z � m � n r� �, � 3 j j � � � °o °o � � � � 0 l� � � a� � � � � cQ � A� y � y � '� � � "� � � .�_.r, cQ � t/� m Z m m � � m � a o- -n v � � c 0 � � � � m O m � � � W c � � � � � i � � � � -► N � 0 � � iv °o °o o m � � � � � �� o (m!� C3 � CQ,' _I m — � o Z = D � fi � � m � m v Z � � N o � _ � � m � �� " � O = O � 2 '� � � C� '11 � � A � � � C C7 � � � n 1� ,�. m � w � a m °- � � v -v o Qoo � � � � v ao • o °° -_+ ,..,, C � � Z � Z � W � ... � � � � _ � D y � V:> v 00 C r v_ Z � c � m 0 'o .., � O D r r* �, c� � -� CN °�+`� � N3 � � � > > n � y � � O � 3 -'ti � co�ac�� ' � c � a a��o m m � Q -o .. � tic t�i� � p � � W o � .+; fl, p� f/1 � � � O � �v�� Q o y � � „ �, � � � o `��'�m � m o � 'a a, a � C� �G j �. � Q n O � � � � � � _+ m m N � � � � t0 � � m � n 2 m v C m � � �. � � � � rn n V �. ? iv n, w � � � A � ? O Z � � � �' v �'� r � N � � zZ mN .-o n -i O z ao a ° < � � �n m� —vi z � � ZO D � Z -fl vp a� �m c� �0 o� Z � v� -� � oa zZ zo � _ � -�-I Z � � zp � r m� n � mm � � � O � z �, � � O � w � c w � .i cc co j CHIMNEY AND STACR VERIFICATION - The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No () 2. Is free from rust or deterioration Yes ( j No () 3. Has no foreign objects lodged within Yes () No ( j 4. Is securely supported Yes () No () 5. Meets all current Code requirements for size and total BTU's connected 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks Yes ( ) No ( ) List Alterations Beinq Done: �`� �2 .'�� 4' . 4°� � �cJ � J ✓' i�e' � (� L yl� t'� . f +� � �� HEATING COMPANY � ej �` 1' '� � c�- _P� Signed By i Date �1 0 sue�ee� PERMIT NO. City of Fridley 2 8 4 5 3 AT THE TOP OF TME TWINS 6 U I L D I N� P E R M I T r � � RECEIPT NO. � `V __��_ COMMUNITV DEVELOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. �3� 9 � _ � l_---�,��,'� CITY MAI.L FRIDLE� SS:�i NUMBER REV OATE PAGE Oi APpqOVEO BY t 612-571-34b0 910-F15 10/28/98 � � J08 ADDRESS 69�8 Hickor Drive NE t LEGAL �07 NO. BLOCK TRACT OR ADDITION SEE ATTACFIEO DESCR. ,(� 3 Ostman°s Third Addition SHEET 2 PROPERTY OWNER MAII ADOFiES$ ZIP PMONE :Tohn Miskowiec 571-1587 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO All American Roofin & Rem. 4112 97th Ln NE Bla ne 501 86-6676 5160 0 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Reroof house and ara e 23 S Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYpE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMI7S AqE REGUIRED fOR ELECT/iICAL, PLUMBING, MEATING, VENTI�ATING OR AIR CONO�TIONING THIS PEFMIT BECOMES NULL ANO VOID IF WORK Ofi CONSTRUCTION 20NING SQ. FT CU FT AUTMORIZEO IS NOT COMMENCED WITNIN 60 OAYS, OR IF CONSTRUCTION OR WOiiK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOpK IS COMMENCED. NO. OWIG. UNITS OFFSTREET PARNING I NEREBY CEHTIFV TMAT I NAVE REAO ANO EXAMINEO THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS yALUATION SUFTAX AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILI BE COMPLIEO WITM WHETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT ];9%], .98 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TNE pEqMl7 fEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUlA71NG CON- STqUCTION OR TME PERf NCE OF CONSTRUCTION 62.2 Fire SC 1.97 • PLAN CNECK FEE 7 � FEE �C C � 70.2� NAT PEO�CON:�7ACTQROp4UTMOp�2E0AGENT �D�rE� pOP A VALI T THIS IS VOUR PEpM1T ' l0 � S�GNO7UREO�OWNEp��FQyyNEABU40EA� �D�rE� BL �NS� ��6Tf NEW [ � Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��('� � BUILDING PERMIT APPLICATION �� ConstructionAddress: (o � g � � «k u � y D R • N � ` � Legal Description: Owner Name & Address: , o�c+� Wi rs Kocas a� Tel. # S��- f S�� Contractor: P`-�- ��E �« �"� rroo f«q - r�e w�d e(� Kg MN LICENSE # �� v Address: � l � �- �q � t" L.N w �. Tel. # � �� —� �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground �2 aj �q � � e� �j a�7 � � 1 �( °71, o0 Construction Type: T"�a2-6� r-cro�fr Estimated Cost: $ �f v a o�°� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � , DATE: � �o °-a �, 9� APPLICANT: �� Tel. # � �� - � �? � Sq. Ft. Sq. Ft. Sq. Ft. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL S'TIPULATIONS: $ C�`�.�� $ I�,� `7 $ .9� $ �V � 9 �.J l� $ $ $ $ � �.i CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.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 [ ] . � 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 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $SOO,OU1 to $1,000,000 $1,000,001 and up FEES $21 (Minimum 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,Q00 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) Altemate "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 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 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. * � D r,: � � o $ � � � o N� � y. (D O N � A : �' o � � � 0 Q � O �• a � � OC n (D � . Q. O � � �' � � Q o �D � � c�n Q . � rt � 0 c � D v � 0 < m a � 0 C Q4 � � � d N � � � v � m t�� . � m z N � m n � 0 z 'T1 m m � � v O O � 2 � N = aa a � � � � �: �T � v � �- ,� � « .o �. �� ...s � � n 3� cQ ifl � � tJ'f �� n 0 3 � �� ' � � o �3 � �o � °, �. N \ fD p, C �� D � � � �' � f� c� 0 � � O � o � � D � r � '�1 C rn � m � d a� m {�1 4f1 �---� � `J O � � H � � � � 3 � � � � m � u � Q �on.� �� p1 �"r pl N � � � �. y � �, fD �,_,�a r,. av � � � o � o- � a a- � p o � �+ � � 3 �' N� p> � ?• � N '� � � ni �. Q N- � � �.� A• � � �' �' � � n � '+�o° c � � � m �' � -o � y (Ap � �3� � � o °+��, � �, o 1 � � 1 p..p S fD �' �D Ci �D d� o w pn �' � � N Q N N fl1 � � r D �a o s < � 1 p� N \ � � � O � D 1. N '�p_ Qo c�' D m `�° O � �o � O N � r � � 0 Z � D C� � ... 69 cW � m --I � a � z � m _ � N N� N z 0 m 0 � �� n c� 0 � 0 � � Oq D � N� cD N G� � N v f�D � G� G� D �e�D 01 N y C N � �^�c�i � � 'p. Cn fD �p rr � � � � � d � a- -� < � m '"� � ,��. � Cl 7 Q • � � o � T ,... a .� �._�7p _ _ � 3 � � �C rt � < � � � � O � g n x � ~` v v � W � C � � fnD � � � � � � ,cNr� o 0 0 0 � o° °o °o °o °o rt m 4A 69 f� r f>, � r�. �W-IZ m C � ° - °- o m �, � � Q� e� fD =� � � � N _ O � �? � n � CD a O > > � � N .n-r ^ CD N a N� r N ar"z� � �a� 2 °. � � �D v � � v � � � � � n �,,, r �� m � � D -� m � � � N � � \� � m � � z 0 � _� !_/ W c r � Z � c � m 0 .� � m N n x rn 0 C r � . LL � � � � �� cn 'n a� C� V �. .p — ivaw� r Cl � C � � Z m � A� v W < � N m Z Z N m� m _I � z � C � a � � z � r � -�i �O L� Z m� a� �� O� Z� Z � v� aD � Z ON vz �v o= �- Z m W Z� D � Z � � -� N n � rn0 �N Z a �� z� �m vZ < � � � � Ri ,� � y � ? � � � � � � � � � m � C m 0 � N � � 0 r � � � C�y�Ey AND STACB VE�CATION The undersigned hereby verifies that the existinS chimney or stack: 1, Has been carefully examined Yes ( ) No ( ) 2, Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) Yes ( ) No ( ) 4, Is securely supported 5, Meets all current Code requirements for size YeS �� No () and total BTU's connected ( Has total heating BTU's of � All other BTU's TOTAL B'TU's �. Has a liner been provided for water heater Yes ( ) No ( ) g. Ha s combustion air been provided for water heater Yes () No () Remarks: List AL'I'ERATIONS Being Done: gF,ATING CO: Sign.ed By: Date: Building � Inspections ! 763-572-3604 DA'['E � . l I �. SITE ADDRESS ISt � THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER PROPERTY OWNER/ I NAME:= TENANT aDnxESS: PHONE:, CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ YOUR STATE LICENSE ADDRESS:� WITH APPLICATION pgp� �JL9 ° PROPERTY TYPE � SINGLE FAMILY/NE ❑ TWO FAMILY/NEW PERMIT TYPE ❑ ADDTl'ION ❑ BASEMENT FINLSH ❑ DECK TYPE OF WORK: � NEW ❑ MAIN7 DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: � Vinyl ❑ Aluminum ❑ Other YOUR E-MAIL ADDRESS � ONTRACTOR {�VI ( 5�(°�, W I P C r � �� - s 3 F.� CONSTRUCTION iNSTRUCTION ❑ GARAGE/SHED ❑ ROOF �'SIDING ❑ SWIMMING POt ❑ ADDTTION Qt � REMODELING `�� O U LENGTH ❑ HOUSE ONLY � HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE Pernut No.: Received Date Rec'd: � —/�� e�sh- STATE ZII', EXP DATE �� STA�� s�a ❑ DRAIN TILE ❑ OTHER WIDTH HEIGHT BASEMEN'I' REMODELING SUBMTT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. � FOR NEW CONSTRUCTION INCLUDING DECKS, �Soffit ADDITIONS. & PORCHES SUBMIT: �Trim 1. Site Plan/Survey showing the existing structures �Fascia and proposed project. 2 Two sets of construction lans WINDOWS ' p IN EXISTING OPENINGS DYes ❑No IACATION OF WINDOWS 3. Energy Calculations 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 SCHEDiJLE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ /// � z�' $ '— $ �, $ � $ �� 67i $ $ $ $ $ $ • 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 (Sta.te Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( Make checks payable to: City of Fridley TION FOR A PERMIT-NOT VALID UNTIL PROCESSED Attach I hereby apply for a building pemut and I aclmowledge tha.t 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATUREOFAPPLICANTJ�/°C• PRINTNAME /�lYIM �• �/�/��'� DATE I— II `011� � 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: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for ls` $25,000 plus $10.10 for each additiona,l $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for lB` $50,000 plus $7 for each additional $1,000 or fractionto and including $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the ls` $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the ti.me of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fa�c: 763-502-4977 Building pI,jJMgING Permit No. �- �� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE i� OV @ YY�472� �o. rd �O(�fo YOUR E-MAII. ADDRESS SITEADDRFSS ��g �'IC�GOYV �f �i'� TH1S APPLICANT 1S: O OWNER �CON1'RACfOR PROPERTY xnME: ��D�nn /Uii sk.t) v�1 l 2 C OWNER/ AnD�sS: �BY �-hCKt�t�V `�i- l�lE crr�t �ICII(� s1'A�fv�z��3� T'ENANT PHONE: �'I63 ) S� l' I S$°I co�c•roR NnME: T►vn �� Q v►a. � itv P t u.v,n1�� v,r, SUBMIT A COPY OF STATE LICENSE # r".l��tbp M EXP DATE YOUR STATE anDRESS: �J'�v 3�.vrtr0.l AV P crrY �S�,P O �A� M AI �p F,c�� LICENSE WITH PHONE l"�6� )�i l° G� G�-tl FAX APPLICATION PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW L�t��.ACE1�N'1' DETAILED DESCRIPTION OF WORK '�e�I G�.�2YV�.rt{' OF DIDe � V(�,�VQ e �-e� PER MS 16B.665 the permit fee is a minimam of $15.W or 5% of the total cost ap to $5011.00, wluchever is greater, for the improvement, installation or replacement of a residential fixtiue, excluding the �. (This should reflect only the cost of labar ) Labor cost under $300 =$15.00. Labor cost between $300 to $5� = cost of labor x.OS = FOR PROJECfS WHERE LABOR EXCEEDS $500, FEES ARE BASID ON $10.00 PER FIXT`URE, EXCEPT WHIIiE NOTED. FIX1'URES: (IIVDICATE TOTAL NUMBER OF EACH BII.OVI� BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING pvvsen crar rrc�✓se) SWIlVIIvIIATG POOL WATER SOFI'NER ($35) CLOTf�S WASHIIt KITCHEN SINK _ WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHIIZ _ LAUNDRY TRAY WATER HEATER ($3� FOR IltRIGATION _ WATER METER _ OTFIER PERNIIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECI'S OVER $500 Permit Fee $ e�. C.l Number of fixtiues @$I O.W x$10.00 =$ Surc e .50 Number of fixtur� @$15.00 x$15.00 =$ TOTAL DUE $ l5 .� 1�Tumber of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acl�owledge tbat 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 germit and work is not to start without a permit; that We work will be in accordance with the approved plan in the case of all work wluch requires ceview and approval of plans. SIGNATUREOFAPPLICAAITC�K.��C, �'y4� PRINTNAME ttC.st�l -�C/1SY�Y ��iC� DATE �II' �'OE3 PLEASE NOTE: SEPARATE PERMITS ARE REQUIItED FOR BUILDING, ELECTRICAL AND MECHA1�iICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977