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City of Fridley, Minn.
BUILDING PERMIT
��; Seutember 15� 1965
N° �454
p�; Aarland E. Berr.,�r g�� Harlan.d E. Ber�y,
pd�,� 6963 icko y•ircle ?�?.R. Addre� 6963 H�Lckogy Cir�l e iQ F
�091 �OC�►TION OF BUILDING
No. � Street '�i _ orv (!i� N.F:. Psrt of Lot
I,� .?---- _ glock 1 Addition or Sub-Divisian Ostman's Third Addi ti oz�.
Coraer Lot — Inside Lot 8 Setback 3.'�� Sideyard
Sewer IIe�atqan ___,_ 85 2_ 9 8 Fotmdatlon IIevation ��.'3.9 g
DESCRIPTION OF BUILDING
To � v�a as:
n u�c , b_ Run��alow Front ��pth �1. � I%ight �2� 5q• Ft 1r612— Cu. Ft �_2.,.2�D
�arag,�_, FSront �.�_ Depth .�� � Height �� Sq. Ft _��. Cu. F't �.4.0
Tj,� op ��{��q� Wood �, � 519,.,500.0�_ To be Completed
In conaideration of the i�uance to me o4 a�rmft to conatru�t the bwtlding desQlbed above I a.gree to do
the P�P�� work ffi acr.�rdance with the d�scrlption above �t o�, ���n��� �fu ��o� �
ordinancea of the dty of r'rY�ley. -� �� �, 1,,��
Ia conafderation oP the Aa3►ment of a P� of $-3Z�04 , P�t fs her�aby granted
to conatcuct the bufldir;g or addition as d�cribed above. This �ermit fs gra�►ted upaa
the express condition that the person to whom ft 9s grauted and hia agenl�. emPloyees aad workmen, 9n all work
dome fn, aro�md end upon said building', or anYpart thereo� shall conPorm in all respects to the ordinaac� of
Frldley� Minnesota regarding location, conatrvcttTTon, alteration, maintenance� repeir and moviag of bufldings
witbin the dLy limita and tbis permit may be revoked at any tinne upoa violation oP an,y of the provia�tons of eafd
o�dinaaces.
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NOTICEs
7Ys p�rm� dea eof eevu fhs esmtructl�, tnsta0dtoe h� �te6. P��+�6. Ya 6uNng, sara er rrme. B� sms to as
dn Boqdiae ��� tee aparat� pum6s tor tha� hwn.
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APPLICATION FQR B'- ZNG PERMIT
, CITY OF FRIDL�iiy �NN�SOTA ,
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OWNTR`� NAME BUILUER
AUDRESS �5 � .4 AbDI�SS
�OC�TiON OF _ ���A1G
No. � �� �l9 � S
Lot � B1ock Ad�
Cornc.r Lot Inside iot_ �( ._.<.-�e�ls�k �°� � Side Yard �
SEWER E�EET�ATiQN � � � � � � _ FOUNDATION EL$V'V�l'i'ION � � �5 , 9 � -
Appli�ant ate��h to thi3 form,Two Certificatee of, Survey of�Lot•and proposed build-
ing location d��wn o�1 these ��f'ti£icates . -
DESCRIPTION OF B�DIPTG
To b� used �s: ,
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����.� � 1 ronC�^�_„DepCh � / Seight . �.�' . �. C.'
� 9q. FC . 1 � / _ Cu . Ft . ° y r.•, n_ �' �� � e/(�
s_
`_ Ftont a a Depth �,� Height � %C�
S�. Ft. 7� � y Eu. Ft., ��ei�
y. �.
� Type of Construction _ . � ' Estimated Coat �/��i ��`' �
_..To--be Co�mpl�et�ed - --
The undersigned hereby makes applicatioa for a pexmit for the w�sk herein apecif3ed,
agreeirrg �c� �o a11 work ii� strict accordance with the City of Fridley Ordinances and
rulings �� tlae Department" of Buildiags,`and hereby declares that aIl the_f�.cts and
representations stated in this application are true and correcC: -
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�Sc�edule of Fee Coate can be found on �he Reverse Side).
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BTTILDIATG PERMI� FEE S��
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Seetion 2. The Inapector bi'�H�iil`d�.ngs �s�ali, �be�or4 ise.u,i� eay per�ait for
, th� erection of any buildiag or stru�t�ure, ;cr • for aay adcl�.t3�, ts anq euist-
,�ng building or structure, qr �or, an�j a�,Cerat#�r'qr�� repatr� t� anq euisCing .
. buiidi.pg or etructure, upon applicat�;or� �er��or, �eq�aire� the pay�apettt by �h�
appllcant gor such permit of fees �b �iie amount •her�ip��below set �forth...a�d
: �in the manneY herein provided to-w�G: ^�
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_ __ . . .: _. . ._ _ _ _.. ... . . : . : . ._ , t,
.-.T --.�.1. F�r any� guch permit �or the er,e�.tiori�o.�.e� augr fire+ip��� bu�i,d�.p�, cther :..
.,�.:;.-� a�ar�ge�., war•ehouse, --factary -Qr•� g���t` �'ev��;,- .�_..fa�r. the� ex�e�tipa of `"•
.' aay fire-�r,�xot eddi�ion. fa�. eim$�;ar°�o�p�aay# �o: �,y �xxiat�i�►g bu�id� ' �•::� -�:�• .,�
shall be at the ra�e �# $f,.4a for �astt,;pta,q th��ad .g�,tbi.e feet, ar�fra�t;ion
. sr- .. :thereof, in such cubical c��oat�a�s.� : ��: �'�:��'" �� � '
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��� 2__2. ,For. an s�ch � �.
Y permit.. faK_„�e--erectio� -a# anq fire-Prooi g�raee..-*�•��--.-�; �
�astory sr grain eievator, or ��:the �cection � a�y, �.��,�� r•�
. fer sfmilar occupaacq, ._ to any . exist�ng ��l�tiapg• ��s'bel.�,• �be-. �t .t'�e . . . �'..
. .:��fo=�'�aeh oae .thouseaci cubic _feet;�..�lassi�ieet .�ss,�fizeproo��" 'by� .5�.
the :Minn�np�;ie...�,s��ding; �Cot1,�..':.ds:�,��. �� - . � _
. '4 �0+�� ' .' � _". .. �. . . . . . ' '�. . � � . � • • ' � �
.- . 2r�;: Fcir �any �surh germi�'fot the er�eatioYa of au�► non-iirep��f b`uild3ag � .
ti . 6..:'���f�
f� t�a g 8ar�ge, warehonsa, factory or, rain elev�rtar� ' br aa noa-firr�
additivn, for s3mfd,�tr ocCu � ' y P�'l�f�°:
P�y, to an�� eici�ttir�g �1i�ildia�g - p6�mi.t $�.�QO for -..
eech �oae thou�ain� �c�bi.�, fe�a6.. . •
. �� � .� � .
GARAGES •• . . .
. . . • • ati+
�. For anq such permit f�r the erection of any aon-fireproof garagQ, .
w8rehou�e� faatory or'grain elevaror, o� for the erection of anq non-fire�raqf'"
�j''O°� -�-�-�mila�' occupancq, to ari� existiag building br £or eec� such
-_�,� �..:_.�1.ding or addition - nine�ty � cents ($O�g�} for 88c� one thaue�cl tatbic f�et
or f��;� �ereof, io tbe cubical� contenta thereo�_ wf th a minim�ma of $y.,pQ,,, ��
For the purpoae of camput ' � � '
� af any buildi � feea for bu3lding parmits, th�.cub3cal ccsi�teat� ��
ag ar addiEion to-.a.. uni�orm he�ght �througisol� �'by multip�yi�g t1�._� .
8reund are� covered .fiom a point siu (6) inch�� bei�cr the �loor liae c►f.,.the-:,��,.
. basement or cellas to the awerage height oi tha�upper su�f8ce or Co the �
a�erage height of the rpof surface of the �af� gable o£ a,p$tche3 roo€.
Z 5_•. For repaira or alteratione to an exist �•, ���, � , :.. -�' •': .
. at the rate of $3.0� per each Five �uadred � ra�t�e.. �te tee ah�11.b��.-�''"r' �:
,�there6f i� �he co�-t 'of•�11.prop�sed. work. . . �i�g�Q�'a�)• os iractia� . .
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2.,s� In no aase sh�li-�'�he ' � ' . . •• , , _ . : 'e . .
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� � Sectian �.2 be les ����d..for.-anp-P�rmi�.-ia►� .set fe�Yth .it� . " ,
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MEMO TO: Mark Burch, Assistant Public Works Director
MEMO FROM: Darrel C1ark, Chief Building Official
MEMO.DATE: January 29, 198Q
REGARDING: 7093 Hickory Drive N.E.
The following are items of correction necessary to bring the structure
at 7093 Hickory Drive into compliance with the Housing Maintenance Code.
l. Install AC powered smoke detectror in lower unit.
2. Provide grounded appliance outlets at counter next to kitchen sink.
3. The door from the low er unit to the staixway going upstairs must be
20 minute rated and be selt-closing.
4. Provide a one hour fire separation between the furnace/laundry area
and the lower living unit; this includes the ceiling. (5/8 inch Fire
Code gypsum and one hour rated doozs with closers.)
CC: Steven J. Olson
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SuBJECT
City of Fridley
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I
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COMMUNITY DEVELOPMENT DIV.
L' PROTECTIVE INSPECTION SEC.
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`.-_.� �"' �•� CITY HALL FRIDLE� 55432 NUMBER AEv
i 612-571-3460 et0-F15
JOB ADDRESS
7091 Hickor Dr NE
t LEGAL LOT NO. BLOCK TRACT OFi AODITION
DESCR. 2 1 Ostman's Third
2 PROPERTY OWNER MAIL ADDRES$
Mike Beck 2649 171 Ln NE Ham Lake 55304
3 CONTRACTOR MAILAODRESS
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER ' MAIL ADDRESS
8 USE OF BUILDING
Residential
OATE
8/14/98
21P
PA6E OF
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27189
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APPROVED BY
SEE ATTACNED
SHEET
PMONE
434-1845
PHONE LICENSE NO.
PNONE LICENSE NO.
PHONE LICENSE NO.
7 CLASSOFWORK � NEW ❑ ADDITION ❑ ALTERATION � REPAIR � MOVE � REMOVE
8 DESCRIBE WORK
9 CHANOE OF USE FROM
STIPULATIONS
TO
Underlaymust must comply with State Building Code.
TVPE OF
SEPARATE PERMITS ARE REOUIREO FOH ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
ON WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DW
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATI
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT OO�
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMiT
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGUTATIN(3 CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $]/{, ;
OR AUTHORIZED AGENT IOATEI
�ER BuILDER� IOATEI
ST. OCCUPANCY(3ROUP OCCUPANCYLOAD
SQ. FT. CU. FT.
UNITS OFFSTFEET PARKING
STAILS GARAGES
SURTAX
1.��
SAC CHARGE
Fire SC $2.00
,FEE TOTALFE
77 5
:N P P IDATE T S IS V PER IT
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ALTER [ ]
ConstructionAddress:
Legal Description: _
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�`�l �1G�i�rV � I�%L
Effective 1/1/98
Dwner Name & Address: /�`/j��� ��.�e('!� �e��%� /'%��/J �1� Tel. # �� %��`���-�
,.�' `!c%d� �'� �i. i��li''✓ � i� !
x Contractor: �c�.>�'✓� � MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OT�R: ��C�� - {���t� �� rJJ�/+/P/� dy� [ �Ja1CJ�lll� ��t�' �i�
Construction Type:
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ ���
�NI� `'
DATE: 1.�C'- � �'7 � APPLICANT: �' ';':�� /, �?'� Tel. # �%�-�'��i'`��%
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ '7�1. °7��
$ o?- c�o
$ /-DC�
$
$
$
$
$
$
$ `7'�- 7s�
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 [ ]
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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 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,OQ0
$25,001 to $SO,Q00
$50, 001 to $100, 000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $2 Y 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,U00
or fraction thereof, to and including $25,000
$349.75 for first $25,Q00 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,0�
$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
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.
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Building
Inspections
763-572-3604
763-502-4977 FAX
DATE—�
SITE ADDRESS lG
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-08
YOUR E-MAIL
� '7��� f��� /
❑ OWNER 4d�ONTRACTOR
CONTRACTOR ADDRESS: S J
SUBMIT A COPY OF pHONE C�S �
YOUR STATE LICENSE
STATE LICENSE
�
PROPERTY TYPE I❑ SINGLE FAMILY/NEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
PERMTT TYPE 0�DTI'ION u v,�xau
❑ BASEMENT FINISH ❑ ROOF
❑ DECK �SIDING
SWIMM
�iC/ CITY?`
_���—
P�+.�r .
: /f2
FAX
SIZE
STORIES
TYPE OF WORK: ❑ NEW HOME CONSTRWCTION ❑ ADDTfION
❑ MAINTENANCE/REPAII2 � REMODELING
DESCRIBE WORK BEING
SIZE
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDWG
'�i Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yes �No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
�� S'�{,�,-7`S'
❑ HOUSE ONLY
O HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
Permit No.: a�b� °v o� y'�
� - - . : m!
.
�.�� ... � � 11;
►�� , � -
A'
CITY ��'i�,2�/r�i� STATE�/� ZIP,
EXP DATE � �� v �!
❑ DRAIN TILE
❑ OTHER
HEIGHT
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT:
�HlSoffit 1. Site Plan/Survey showing the existing structures
❑ Trim and proposed projec�
f� Fascia 2. Two sets of construction plans
3. Energy Calculations
LOCATION OF WINDOWS
OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
��SING�TI� 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION S .�G�u _ 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
$ Q�,,� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ �'�� .001 times the total job valuation
$ /� . .0005 x Permit Valuation Minimum $.50
$ �,o� $5.00 (State Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ V Make checks payable to: City of Fridley Attach
' THIS 1S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the informatio 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 C des; that I nderstand this is not a permit but only an application for a perrnit and work is not to start without a
permit on site; thaz the work will be in accor ce wi e roved pl i the case of all work which requ e review and app;oval of plans.
SIGNATURE OF APPLICANT � PRINT NAME�f������'�` DATI�`����"
s� �__ ..P G� . � r� a� �� �
APPROVED BY
Page 2- Building I�esidential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official sha11, 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 S` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $391.25 for l�` $25,000 plus $]0.10 for each additional $1,000 or fra.ction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 151$50,000 plus $7 for each additional $1,000 or fraction to and
includin $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 includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
� fraction to and includin $1,000,000
$1,000,001 and up $5,608.75 for the ]�` $1,000,000 plus $3.15 for each additional $I,000 or
fraction
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