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AF - 45939sue�ecr • PERMIT NO. City of Fridley . 1281 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r i � CEIPT NO. � `y _ COMMUNITY DEVELOPMENT DIV. � r � � PROTECTIVE INSPEQTION SEC. � �Q�g 1 i � / ! ( /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV �"'•� � ,'� 612-580-3450 910-F15 11 18 74 � � lOB ADDRESS 6530 Hickory Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ll��],�j 6 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS � Z�P PHONE Leif Henriksen 6434 R:i.verview Terrace N.E., Fridley 3 CONTRACTOR MAIL ADDRESS Z�P 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 Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK , Construct a 36` x 32'4" Dwellin nd a 23F8° x%�t 24' Gara e 8 CHANGEOFUSEFROM TO STIPULATIONS Provide a hard surface drivewa.y. Provide a verifying survey before capping. SEWER LOCATION: 3' South of Manhole (S. Inv. 828.03) Wye Elev: (W/3' Ri.ser) 831.68 Top of Footing: 835.00 Mi.nimum , WAir�R LOCATION: 10' North of sewer service SEPER�T� PERf�iTS ��4JIPED F�� {�i�•�r . �p.. rt -i- � w �(+ q"< 1 i` D t: a-°, �� r"'� fi '"� �' '(, 1�, i� � TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO, VENTILATING OR AIR CONDITIONING. WOOCI FY'aIIl@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�. �.�.BF) 30, 270 Tota ANY TIME AFTER WORK IS COMMENC�D. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $29�739 �'4.87 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERF RMANCE OF CONSTRUCTION. � y�S%.00 �`300.00 � a PLAN CHECKFEE TOTALFEE � �� - 371.87 . SIGNAT EOFCONTRACTOHORAUTHOR12EDAGENT IDATEI HE PROPERIY VALIDAT THIS IS YOUR PEFiAAIT � F � SIGNATURE OP OWNER UF OWNER BUILDERI IDATEI BLDG �NSP DATE ""^' �_. r-' c „ AP.PLICATION FOR RESIDENTIAL, ALTERATIO�`; OR AllDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNLSOTA ow�x� s x� : � r; � ��, r; �s � �, BUILDER: ��,`-rr� �1' e h r � �'s� �-, AnnxESS :� y3y s�'ile r v,°� �`7�� r y-„ annx�ss : ��3z/ )'�; ve v �,�� Lv NO : . � l -��(� STREET : �� i c ,�� I Sf � � I,OT : %� �BLOCK: �� ADDITION :� CORNER LOT: INSIDE LOT: !� SETBACK.: SIDEYARD: Applicant attach to this form 7tao Certificates o£ Survey of Lot and proposed building location drawn on these Certificates. HESCRIPTION OF BUILDIIVG To Be Used As: �--°__ �� s� Front : ,�� Depth : ,�07 — � Height : Square Feet; � Cubic Feet: �} � � � � r � � Front: � �- � Depth: ��_Height; � � J �� Square Feet; � Cubic Feet: �e � � Type of Construction: Lv �ar�1l Estimated Cost: To Be Completed; _� !.� y► P / 9' 7`� The undersigned hereby makes applicativn for a permit for the work herein specif ied, agreeing to do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. � �„ !�� c O% DATE : _ �� /S — �% � SIGNATURE : (See Reverse Side For Additional Informatio� � � , d--� � j ,�- �- �� f-�f>�� ..-��,�7s�-�� p � �°j I y � :.+ .� _ <� , ` O � � � � � � � �� r��rG�.�� l/ S � � �' � �-.� .� � ,� .. � ;�� , BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: > UNIFORM BUILDING CODE: Zjipe 1, 2& 4-$2.15 for ea.ch one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of camputing fees for building pernits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average � •height of the roof surface of the ma,in gable of a pitched roof. For repairs or alterations to an e�cisting structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. Ia no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper reviera of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the founda.tian, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be ma.de ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. � 1 , , �. ; , . . . ; � x�„ '_. �: � 4.. � < <� � � � 5_ �_- � i OY �A U'£74 '� � � • � ° � " �d � � � � � �0..7 � �/ � � � � � q-�tm9 4�04 P{.�. �STFi §TREET 788�-� COLU➢WHIA Hi21GHT5 55424 1 p.�ig�qg�Y GERTIf9'Y THY RiG68 �t7EDE1.AkD tJRV'�YORPUND R Ti-(� tAW4 OF THE TA7E OF M NNESOTA�CT SUP1E�VtS10N A N O T S 1 R Y 1 A i M A D U L. ,' 1 _, � DATE �--- D / 7 ,` _ . a � � ,�—�—� . SCALE t"= 30� �. ;: � -.�,..�c-a , Pvil�fN�SOrTA REGISTRp►TION P�10. 5332 ` O=iRO� ia�o�v�n�Er��' NOT E�� L1NES SET FR�M . PREV1011S SURV�YS °� L1NES OF \ � OCCUPAT�O�V � PLAT �F EDGE. - � 1nip�TER GARDENS. o �� . ' O � , \�- � /� �� ` ` �i�— Lots 14 and I5, Block fi, Fridley Park, Anoka County, ilinnesota �� ` � ' e ' . � � � °P �' �� G�' i � �.� % � �o � �°�-� � � � �-� �� , �-J r� � / � �� o� �� °- C�� ` �.�� ..�/,� � �' ��- a � _� � �� ,�� s�- _ � � �� /�� C��1�i /�� /� �'� � � . , 0 � :� (�l 7 � � � � �r '��/�l/P!� �i� � � 5�=��-� �� . 1 CERTIF'ICATE OF' SURVEY .JAMES L. KURiM , LAND SURVE.YOR �$01 t�l.�. STN STREET 9?Co�i COLUM�IA'MBIGMk�B SE421 . yBe_�� i MR116�Y CliRT1/Y TMAT, TNIe �7RpEY. li.AN. OR R6PORT WA9 pRQPA1QED BY MB OR UN�ER MY OIREGT BtaPERVI810N ANO TMAT I AM A DIiLY IItGiST�RtO (.MI� ANR1[BYOR YNOER TNE LAWS �F TN6 STATB OP MINNESOTA. � � DATE � T�� -14 �� SCALE 1"— 3C,�_ ,M�NES A R�G�STR'ATION _NO. 5332 � a=1 RON MONUMENT .�I�TE � LSNES �ET Ff�OM `�` Hs�• �ot• e-16-�5 � _ PREVIOUS SURVEYS °� LIN�S OF ` y " aCGUP A`TiOIY a P� AT Q� E D�� ,. � - _ - _WAT�R_ Ca��RQ��S. 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N �� ''o�. ct y a 7 � � � ~ 61 � 7 ' '�'< Q 7w� N ti N '1 � '� °' 'C�' x � � � V � m d C' °' � 'o � m].i°� C � �' n .� N . 'Jp�tf. � a0 � ` � �, O .� \ y��t O tGD�p� a �e n aO.� �� PDM � �� o � �' r p � 1� �a � i � � P�'°' � � tn �'9 � e� � IP° F�7 i ,� i � E� � � � �W � � � � � � P � �� r � � � �� ,c � ''� e v`� �� coa �� v� � �.� o° � � � � c G>1 � � °!� �� r � �� y �9 � � �� Ps0 �� _�;� _-" - - � ��'"�' � .d �'�_� �s._ ! �� ' ` , HEJ1T �LOSS �ALCUUTIONS � p�/�'�'�IT OF' BUILDINC.g 'r We�ihet�Inpr . . CeBwretan No. Imd�tiM G�ide � A Iv�i"�.�— Wmdaw ( Doon Re(erence Out. W�II lal. W�II Ceilip� iioof Floer Kind 1�e�► Pp ._�,.., Y��— e e�— 19_ � FI. �� Roo� Len��h W�h Hei�At Fl.� �. Roe� V�nb W�ti H��h� !� �_ Windo.w end Doore—Cruko �nd Area W�ndow� and Deon--Cncka�s aed An� �rw�n N•�Rno •. •t n�e� t. wer� w�n�� .�ra� N•. •t •o� 1�. wrN �i N�. of ose• �f o��s Ii�Ab �f e►�tY N. Ne nf o��• ef M�► Ilfh�� f �ruY N. 11 2 � �', '�'... �� I � � �� :�`a �":� .�: � C«f. Btr c'n.f. W� In6lt�ation � �`� � � InFltntion �± � � � Gla�e '�„ ' o � Glue � o � fsp. wall �� Esp. wal) r� Net esp. well � p � �, �. � Nat e:p. �►all /" � � Int. wal! � f� Int. aall Ceihng Ce�bnt � .. Floor � ',�.� ��' Fleor ; v � � � Total B�u. - Total Btu � � Required sq. ft. ED.R. or �q. im. W.A, Laader an� Reqn;red .v, ft. E.D R, or eo. in�. WA. Le�der �re� ..:. - _ Fl.� Room ( l.en�tb Wid►h Hei�ht � Fl.l � A Room I Le�qth W�th l�ht I Windo«n and Dr.or�-Cracka�e �ad Area qlindoMn and Doore—Craeka�e and Are� � wiai� •�i�� Ne. oi LIa��1 !t. A�q wia�e H•�rne t+e. et un..i n. •.e• Ne. ef p�w� ef pnn� Ilf�tr of er�alt w. N. No. of o�a� sf pan� II�AN �f er�tY p ft. 6 �c►� � 'L�, l �. � � � � 1C_4�� _.� � a'8+ I '�% � �� I Coef. Btu f• In6ltratiee � � In6ltr�tion `�- , � Glau ` o n c� Glau ��. �'� Esp. wall ,d Esp. w�l) � �' {�� Net csp. wall � �. � � �p Net e�. wall � `'� � �E� � �? ; +� Int. wall Int. wall � 2� .,a �� Ceiling Ceilin� �► � ` s� �loor C� Floor Total Btu. � Tntal Btu. `� �� Required iq. (t. E.G.R. or sq. in�. W.A. L.eader area Raquired �q. h. ED.R. ot �q. ie�. W.A. Leader a�e� Fl• ��, /' oom � L.en�th Widtli Heil�t Fl.� �:Rl � Reee� I Lee�th Width HeiRht Windows and Doon—Cnek�p �nd Ana Wiedew� aad Doon—Cneks�e and Are� N w�� NN��t No. at e��l ft. Ar�� IdtA tl�ht a�t leul !t. An� Ne. ef o�w� of p�� 11�11t• sf tnelt N. ft• Ne. �f /as� �f p�� Ilt�l� �! enek N. n• 'L.o � � `� .�� . I % �0 _ Ceef. ' � �� Coef. B►r InMtntian �' �,� ° � fip lnfeltratioe �� .,1 �. � � Gl.0 � �i � �r;� Gla.• �`"�,� � e?� `�L�- l� � EsV. wall f j? �' Esp. wall �, ,; ,: <, N�t esp. wall 7', _, ;� �a �A a— Net e:p. arall �� , � Int. w�ll Int. wall ' . Ceil�n� Ceiling � �-i �l �? � d fleer ��;;n,� � � , floer . Teal9tu. � ,� Tot�I 8m. , � „� R ite� .�t. E.D.R. er p.. ie�. wl.A. L�a�n a� ReM�d � h. f.D.R. a iu. wl.�. Lta�dw tw� ��` ` t � ' f . �'t ~,� �: � � I ��^ {�. �:.'�� '/ HEAT 'LOS�, CALCUUTI(NVS ^`� . p�p/�'�T OF �11LDlNGS �� s�" ,' I We�lher��np� . . Ge�roetan No. Inwl�tiM '� Wmdo�w Doon R terence 0��. Wall 1�1. W�q CeJi�` Reef Fleor Kind l�e�r Applv�!"�� Ye�— e I e�— 19_ ----� I F�• Room Lee�th Wid�l� Heqht Fl.� Rosm Len�b Widtl� Heqh+� � Windo.w �nd Doon--Cruka and Ana W�ndow� an� Door�ntkM asd Are� I avai� Mr��na �. •t n�u �. •er� �a�e .�re� N•- •t w�� . wrN Nn. •f Oae• �i a�� 1��111• �f !r�lY fl. Ne n( o�e• ef M�• IIfh1• nf �rteY M. fl ��. � � � �� (� �� 20 � ��+ i . � �.;; � C.�f. Ba �n.f. � �� o IniiU�ation °� t� infsltntion �� o � � � Cl��e ,3 O D o a Gl�u f� �� E.tp. wall Esp. wall �' Net exp. wall � �o � Nat e�. wall d u. Int. wal! Int. wall � Ceihn� ,'Z,O v 0 O a� Ce�hn� '� o/ b �"L o�. Floor Floor Total B�u. �a � • TotalBtu. �` D S O Required.sq. ft. E.D.R. or �q. im. W.A, Leader �re� Required w• ft. E.D R. or io. in�. W.A. Leader �re� Fl.� o Room � Len�th Width Hei�i�t �7.1 Roem I L.ee�th Wid�h Hei�he Windown and D►.or�-�Cracka� �ad Area Windo�n and Doorr-Crulu�e and Atea N�ath HH��t o. ot L�snl ft. •n� Wlatn H��rn� Ne. et L►n�d it. ♦n� Ne. ef o�w� et pen� Il��t� st er�eY �. N. �le. ot wa� ef p�n� II�At� �t et�eY �o f�. 3 Ceef. &u f. � In6ltntioe In6ltration Glaa Gl�u fsp. wall a� �1 Esp. w�ll Net esp. wall Net esp. �rall Int. wall 1n Ceiling � B � � � Ceilins �loor Floor To�d Btu. o�� Tetal Btu. Required iq. (t. E.D.R. or sq. in�. W.A. L�tader �rea R�qu'ued �q. f� ED.R. or sq. iu�. W.A. lsader are� Fl• - ZRoom � L.enph Width He+l�� Fl.� ii�em I Lee�th alidth HeiRht Windows and Doen—Crack�p �nd Area Mlindew� aed DeerF-��aekap �ed Aro� 'W�� MN�NI we. oe e..i n. wn. �e�n •ir � ..t in..� «. �.+. Ne. �f o�w� ot oaw� II�AI• �l eratY N. t!• N�. �f M�� K N�� IIfAt� af eHeY . ft. 2a ��.. �� Gef. Btn Ceef. Bh � Inl�lu�tim % [� � Infiltratioe Gl�u � Q �. o Gla�� F.so, wall isp. wdl IWt eap. �11 Net e:p. Mrall Int. w�l) lnt. wall Csihn� �� p Ceilin� fl�o� Floor � ,I TNaI Btu. � p TotalBw. i R irti . it. E.D.R. or p.. in�. wl.A. Lt�ie� a� Re�ind �o. h. E.DR et ia. �1�. L�t�dw s�r� �I� I r � I a sbo.3aso C��O �'��[�' � �. . ANOKA COUNTY . 6431 UNIV�RSITY AVENUE' NE FRIDLEY, MINNESOTA 55421 . , August 6, 1975 P�� %�`,�°�'-' -� G�� . _ ° � 3 S� ��' �` �?,� ,�u � � �� .s.�y� � � � � Re: Verifying Survey for � ' Gentlemen: Please be advised that of this date, we have not received a verifying survey for the above captioned house. We would appreciate it very much if you would get this survey into our office no later than September 1,.1975. � Thank you for your cooperation iri this matter. � Yours very truly, � �� . • DARREL CLARK ` • • Community Development Administrator � DC/cs e "� _ � � IJ I � , � r 0 � � O°<, �� 1,6' '�' Q •� �� m ., � � � a �. o�� Wn �� o �� R � � �ti '•,Q ��o � ✓ .� $ � � � . �_ � �� : � �� . . � c�� _ � � : : � � . �° N � ! � : � � � : � � M � o � �8�8� 8 M M � � y � � � � e f> , �,, �1 ',. � a M . '} ')' �i `a � � � � � , J' � i ` s � a � � O r � °e � ;� ws w � � � �� g �. �� 8 a � � � � �° 8 � � � � � �°a 0 �i � � �a �� x� �� . � �� $ � o A y �� R� � � � �� . �:�oo 8 � 8 8 � � � � il � � � � z � � 8 a� � � � �� . � � ��: �s � : � � � : � 8 : ; : � 8 8 8 8 8 �� ° �, �� g� c �� G i iC I � 0 V _ • V �\ / � � � �, . � � � � � �� a � � � �� a��C �� o � .. � � a,�a�� : ��. � � . . 8 : : a g 8 8 8 � � � � f , ar r• ; � �.�.� � �� . ��.�. .. � �s� ,m. m o. o' ��m� �� .. �y ��"M� j� 'o �� 'O : �1 p� �� " a 01 �� a� �� a � � � � n T C �i+ � �. � ,� � � � � � � � �.:� :� 4� . � � v � � � � fi � ' . . .� � � • 1 �.. v � ;+ ;- I tD 1 � �o . . lf r• � x �='r !ci i: •1 � �storie� � � � ' � rwt�w � � � N 8 �� t1lYd / f M 1 n •J. ° � (A n � w � M A v u n � � n � n u��W�t i: q� � :�. ; J � � � n � c � i _ � �, • � � M n � � '� p M n � � � �' nros • t� r � O K M'G O � �'„ �: � ►� - O� L'. .� r� � -� tf '- c .. c x � G .. . w�..s �, � �y if "" ,r-r M �: � "" � w '� K .J . Q V iD fA • Q � • A ^ .. C • 'i► O � w '� • O ry ^ � C? Q� •` s��1►3 � • � � .+ � . 'Y' C r • r. '� � 1T �— - : u � � . L a v � � �' ? " � 3� "p � M�.. � r� �.` � M i � O O • Q '.�a7 • ["'�.1 jQ . ,�s � t wAK Iq � c - . • r • • ' ' 4 �s � � 7 . � � � il . . peu... 'C .� • �Q i� � � � • . • 0: �D • 7� � � � �OU►R. fy '.b.� ; e � : : � r,a� 2S ; .0 ; ; r • r�n s►�r.�s. P .b.s "'� • • • •. . � P � � � �. � � � • � � KOOw . O w � � ! � � � � � � • • • �' ' I-� P4A�MS � ^ 1 . �] • ' • ' ; � . ., . . O .. g - - • - -- rn �,.«� .. � . . . • • • • • • • alwMs 'y ''� • 0 . � � �� • • � • • • (i . 7 � • .� �• • • • • • V1 �� • A:llo p �. � � J � � • • • • • • • � '1 MALCn O O I T � f� � � , � • ..L �► Gu M iY ' rn �;, ,� • � . �z �� 1 � 0 � � N U'� V��l • . ~ . .< . L C7 � a^s . - � � � . .��.cc e "fs : x o � � " ' ..... �� ,• p c�s • " K x x x K x �'�' orun.r: (� I } . . « x x . •� N �ti a' �� t/� �9 � � W �j ' fJ � • ✓ � r IJ �7 � O J � II �� • NA � A �. A 1J � N O � V �i • � . � i O.. � C� � G V► M s l`1. • � � � � — • ..i/� . M � N N N N N � \� � E � p N /� I1 L1 M y . � � , O � � .0..� v�► � I � �i . U1' • �i y. �..°a I � i � �,`: • � y, �.. r +1 , o o r ❑. �. . ia*' � N � • . • ::�T -��► ��` * � • � .� •� ' � � • �� `° • � . � ' � • � � �; �? : 'T,, � �, 0 r� -f C 7C � � y � n . � �7 ��•j c� �: � H O a r � n 5 � iL i1 w . �C , ,� '� " � � , ..� St, .�. . 1 � C 4 P. ' � � � M � p ir '' � � �i . � ° •. . x `� ^ �� ~ •~ tin°'�, ~M ^ �r; ; L' � ► M � � o � : N � w � J � � +� � . M� a � o � a e= a �-� Q� . � =7 . o n �. �, . � .. � -ns � 9 � : • _\ � ' � �•�• A 7 `"� L' 7 �. « • � w�.� • t o, a � �' o Q� �4 ;„; � • -� � . 5 ~ M F-' a �S � � O � . • • . . • • • , . � 1 , � � � . • r � � . • • � . � i . . . � P1 � C � � G � � . v� x �� a � � � � a O , � � � � � _ � • . , u. ' :1. -a . ; : . Q�. � > l ti ��tt%a p, 7 o n � � '� .1 O M � .. � �.�„Q n 3 4, i ° ii '.ns � `� �' " w�. � :� ''' � � � � M �T � o �, �, ~ -� z x � � px� �. _ V p n [1L a� � � � e, � �. t�.-'. . . ro. = � _ . 1� w u p' . p L�L o � . � � n �^ � � . N � A p' ` . I-' A � A � • . `\ �^�� . •. aM�� M r ~ • T O A '� ��n1 ..q� . r a ' • . f' [L K • • �. o �� 7 � �u � �� n sue�ecr P . City of Fridley � �� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� y� f � � � �• COMMUNITY DEVELOPMENT DIV. r � ~ � PROTECTIVE INSPECTION SEC. �� 1 . � � � /"'1 � CITV HALL FRIDLE� 55432 NUMBER REV OA�E PAGE OF AVPROVEO BV �-""�' �'� 612-571-3450 9t0-F15 7/10/97 � � JOB ADDRESS 6530 Hickory Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 14,15 6 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mirth Langer 6530 Hickory Street NE 574-7365 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Same a ARCHI7ECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIIADDRESS Z�P PHONE IICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR 0 MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (Partial) 17 Sq (Tear-off) 9 CHANGE OP USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, 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 Oii ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILL BE COMPLIED WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �1�4'17 �•71 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- �/,�,H. SO Fire SC � 1.�!L STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CNECK FEE TOTAL FEE $50.63 SIGNATUAEOFCON'R Ctoao TNORIZEDAGENT �DATE� WHEN PAOPERLY LIDATED THIS IS YOUR PERMIT / / (.�=�L� �/ , Gt-2� 1✓ 7 � / O - � '% �/e Gr� — � SiGNATUAE OF OWNEA UF OWNER BU DER� iDATEi AI,AG �NSP qaTE NEW ADDN ALTER t �l [l [) ConstructionAddress: _ Legal Description: � Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: C�TY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� CT� � � �� Effective 1/1/97 �� S�4 -�ci�o�, �7. Yl -�O Tel. # s' 7y 7 3 L S' MN LICENSE # � Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed consiruction drawn on it to scale. DESCRI�"TION OF IlVIPROVEMENT Leng�th ,_ Width Height �ng� Width Height Length _ Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. c�0 Construction Type: �d- �� - Estimated Cost; $ �� j� � (F'ee Schedule on Back) Driveway Gbrb Cut Width Needed: Ft. + 6 Ft = Ft�-x $ _$ DATE: �- !m � 9 % APPLICANT: �� J. � Tel. # � � y - %� � �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULn'I'IONS: CITY USE ONLY $ �- � d Fee Schedule on Reverse Side $ . �% .001 of Permit Valuation (1110th%) $_ � �] / $.50/$1,000 Valuation $ $950 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ � $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary ( ) $ �� . � [3UILDING I'ERMIT EEE SCHEDUi,I� "I'hc Chief Bui(ding Of�cial shall, before issuing perniits for the erection of any building or structure, or tior any addition to any eaisting building or structure, or for any alteration or repair to any existing buildina or stiucture, upon application ttierefore, require the payment by the applicant fnr such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: . TOTAL VALUE $1 to $SQO $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,0p1 to $1,OOa,000 $1,OOO,Q01 and up FEES �21 FMinimum Fee is $21 plus surcharge) � $21 for first $Sp0 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,OOa or fra.ction thereof, to and including $25,Q00 $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 fust $50,000 plus $G 25 for each additional $1,000 or fraction thereaf, to and including $140,0� � - �- $887.25 for first $ipp,pQp plus $S,pp for each additional $1,(�O�or fraction thereo��y,ta and including $500,000 $2887.25 for the first $5�,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,�,000 $5012.25 for the first $1,000,000 pius $2.'75 for. each additional $1,OOU or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus b feet times $13.�0. 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 Pern�its for construction will be issued� a minimum of 24 hours from the ti.me of appiication to allow for pro��r review of the proposed structure and of the construction site. �> C:ei�tificate of,Survey o}� tlie lot, showin� the location of the foundation ��r�ce it has it i�as becn ce�nstruc�� ? 1�'i'? R,� reuiiircd h�fc�rc ��r��ccdin� «�ith ti�c framin<_�. v 'p 0 rn Q � � O C O�,U � v � m T � N � .�-► rn -w O r w � c `o' i � s � < ou � o � � i m �' � � N � �t �� o � v� � i O^ ' l/ ( �S < �7 m z � -o m � O z -n m m � cn 0 O \ _ 0 c � O � � D m r � � m � m �. v m � F' j N � � � c ° � o -n � � c � � � o O D o� o ni � � � � O � o �• � m \ r 0. rt N � � W 1 v � � v � � � � 0 � � � � � � 1� o �� 1 tn = � � m -i z � � m � � � � a �'�e � � � � � � . Q m m n c ii � 3 a a m N d N Oa O � � . � • a . � 7 Wo� � �' a o � � °n �' � .vf� � <. o N ` N, � I � _ '�O_ � i � � ci ' a � °; : � � � � � i Q o 0 a i � � � r � � � � °i � � i N � r' -,, i � � ° j r�+ (D � � � n � _ � + � � � � m m N N � � � 3 o D \ — �c<� ! � °-' �` ' � m rn � m o � � �� cn� o r -� ! � a1 D � o m � , � � � �C O i N G N � o; o � � � � ;^ � � °—' o ' O � 1'^ � V1 � -° � � p �. � � �� o r i � � o ,. -ti D N � N o ° � � a � 0 ? � ou D � N fD N � N � � � � m � N � . �o v oa Z m � � c � o� m ?1 lD v_ � m y . . �� "i � „ � O j U�1 � � rn m 01 ? rt � � � � � — � � a 'n p � c 3 � � � O � m c 3 m k� . � � �, � �, .cN» o 0 o c�''�i� °o °o °o °o °o � � � � � � � m 0 W � � N � v a N Z � � _ -o v� m � o ��-�� Q o N = Z� d rt m oa C � N n n O tD w = O o �° �D � � N � � � �a � 0 v = a o m � " � � � Z � O � d � D � � � W � a D � oa v N O a -Ni � � � � 1.� -o m � � -a z O D -� m � C7 2 m v c r �m � ` 0 W D v v z � p rn �' � n ((J �- W � � � n,�i � � p w�z � 'T1 ot in, �i � A � � w < � � N�� z m � � W W C � � r �' v N N Z o,�o � V' "0 m � 0 Z � D m � -n -o � r �a m � �-�i °z °z o n � z -o vo a � � m n .o Z � v � =1 � 0 D Z Z �v _rn � '� '� Z m � � � ZO O v � vz �� m z i� ...� � Z 'V � �� \ W � � N � < fD \ N O O �P FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMM�N VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When realacina an existinct furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbovus and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assist� and �tat�FaE dra� appliances. The existinq combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installinA a new ventina svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specfications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes( ) No( ) Appliance Tvpe and Size/Common V/ent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tdal Btu Input Cvmmon�fern�-�ype - __— �ter►t-FfeTght --- -E3ian�ee� — --i�re�re�--- Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describel " ' • � _ _� % i , '� �,�, �i �� ' �.l • - � : , I ��!/ /�' , ' . � ._. �_. Building Inspections 763-572-3604 763-502-4977 FA�. BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: g �1�NER ❑CONTRACTOR Permit No.: ,� - -, : � � , � ..y : �i'\• '�� , ;'. _ 1 I �' i � '' _. PROPERTY OWATER/ I N,v�: "�\��T1�I TENANT qpDRESS: C��L� �� 5 i CITY i�i��,� ST'7�TE�j_Z1P J S�I�� PHONE: CONTRACTOR �wDRESS:1�-loCa`� u�J..�� CI'rY��i�C�'`� STA'1'Elv Zrn°�`�`(�Z SUBMIT A COPY OF pHONE !l�� °��?O�`1"�S`�I F� YOUR STATE LICENSE STATE LICENSE #� �� `'(� 3ZS� EXP DATE ___ PROPERTY TYPE PERMIT TYPE �,SINGLE FAMILYMEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ ADDITION ❑ GARAG ❑ BASEMENT FINISH ❑ ROOF ❑ DECK 0 SIDING TYPE OF WORK: I❑ NEW HOME CONSTRUCTION ❑ MAINTENANCFJREPAIR DESCRIBE WORK BEMG SIZE OF ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WIlVDOWS �" IN EXISTING OPENINGS �vices ONo OR FOR NEW OPENIl�TGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WIN�W TO BE INSTALLED�/� S1ZE ING POOL ❑ ADDITION �REMODELING ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE � DETACHED GARAGE ❑ DRAIN 1'ILE ❑ OTHER BASEMENT REMODELING SUBMIT: I . Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Trim 1. Site Plan/Survey showing the exisdng structures O Fascia and proposed project. 2. Two sets of conswdion plans 3. Energy Calculations LOCATION OF WMDOWS % OF ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING TAE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $`7 r;vi� �-`�� _ OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ $ " (�.� $ $ $ � $ $ $ . 1 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) $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 ( Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED Attach I hereby apply for a building permit and I acknowledge that the inforn►adon 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 pertnit and work is not to start without a permit on site; that the work will be in accordance w'th� oved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT - PRINT NAIVIE � i'IOF�MA� DATE �all b�� APPROVED BY DATE Page 2- Building Residential 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-e�.isting h�ilding—or. �iructu�e, u�on 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 provi.ded 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 $39125 for ]�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for IS` $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 including $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�` $1,000,000 plus $3. ] 5 for each additional $1,000 or fraction VERTFICATION OF FOUNDATION Pemuts for conshuction will be issued a minimum of 24 hours from the time of application to a11ow 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 Faz: 763-502-4977