AF - 45966�• _ ,�••.
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v�ua�e of Fr�aley, Minn.
BUILDING PEB,�'IIT
N° __ 9 9 i O�ce of IN3PEGTOR OF BUILDING'rS
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Architect Fridley, Minn..�, _ � �: ,� -•; ��» , 18�,_='°�
Builder `� �
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LOCATION OF BUILD G
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No. ,F Street � ' ' �.�P �- ° Part of Lot
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Lot Block Additi�n or 8ub-Divieion
{Y,, ��g �' r.`' �' � DESCR.IPTION OF BUII,DING
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"� Fxont� ,� -. . ,: � Depth � � �-+� Height Storiea Ma,nner of Construction
�o be uaed as �� - -',� �-«�<, To be completed Eetimated Cost
Yr ' � �..4' ���"'�d`.-.°'j�£�"=�sF •
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Permit ie hereby granted to� �� � , ,i' � � �� � � °��K
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the building �s'�� �= described ia the above statement. Thie permit is granted
upon the egpresa conditton that the person to whom it is granted, and hie agents, employees and workmen, in all
the work done in, around and npon said buildfng, or any part thereof, ehall conform in all respecta to the ordi-
nancea of Fridley, Minn., regarding the conetruction, alteration, me,intenance, repair and moving of buildings
wlthia the city limits, and tbie .permit 'may be revoked at any time upon violatioa oP any of the provieione of ae3d
ordinaaces,
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t ;v _ `- - i���tnr oP Buildings.
AGFtEEM�N'�' AND SOVOAN STATEMIIVT
In consideration of the issue and delivery to me by the Inspector of Building$ of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinaaces of Fridley, and, being firat duly
sworn, I hereby state and say that the" fact� atated by me and coatained in the above permit are
true as therein stated.
Subscri}xd a�,d sworn to before me at Fridley, Minnesota, this— �- �-'�-�
yc" A !` {_q..
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day of �.. ",� D. 19 '.�:°� �, � ,L.__� �-_;_ -,�:•� _
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SUBJECT PERMIT N
City of Fridley 1311'7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT NO.
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COMMUNITY DEVELOPMENT DIV. ���
r � � PROTECTIVE INSPECTION SEC.
1 ` �
'4 /"�1 � CITY HALL FRIDLE� 55432 NUMBER flEV. DATE PAGE OF APPROVED BY
"�"� � ,'� 612'560-3450
910-F15 7/30/75 � �
JOB ADDRESS 6801 Hickory Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. L,� OSTMAN � S 2ND ADDITION SHEET
2 PROPERTYOWNEFi MAILADDRESS ZIP PHONE
James Antell 6801 Hickory Street N.E. X�$iE��
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton Johnson 2513 Central v 781- 48
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO.
6 USE OF BUILDING
7 GLASS OF WORK
❑ NEW ,� ADDITION � ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
re-roof
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LaAD
VENTILATING OR AIR CONDITIONING. Y'e-raof
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO 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 READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAL,SJ�TION SUR7AX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ✓�
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �� i�D
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR HE PERFORMANCE OF CONSTRUCTION. � �n , G' �%
� PLAN CHECK FEE TOTAL FE ��
��. �- �� � � -�s,,ee-
SIGNATU E FCONTRACTORORAUTHORIZEDAGENT IDATEI N PROPERLY VALIDATED THIS IS YOUR PEiiMIT
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SIGNATUREOF.OWNERIIFOWNERBUILDERI IDATEI BLDG INSP qq
w..�.- _ ,� - - �
:
. . .
•APPLICATION rOR RL•SI'DL'NTIAL., ALTL'RATION,
OR AllllITION. BUILDING I'�RI�1IT
CITY OF FRIDLEY, 1�tINNESOTA •
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OWNER' S NL11�1� : �/� �n �' ' %y � d �-s t e' BUILD�K : � � 1 % �� J � - �io �e J �� � �, - � ��s . . '
ADDRESS • % ��.� �: � (< Q !� S �. /� � ADDRESS : -� s � 3 �c�.,+ r �_9� �v �,. v;I-i� ,
N0: . �� �� ' STREET :,,J � , C � o /(s� S i , N C �
yQ� ; BLOCI:: � ADDTTION : �C/��'�%
� CO1tNER LOT: INSIDE I.OT: SETBACK: ___ SIDLYARD:
Applicant attacr. to this for:r. �.tao Certificates. .�f Survey .of L�ot and .pxoposed
buildino location dr:�an on these Certificates. .
� . .
To Be Used As :
�
BESCRIPTION�OF BUILDING
0
0
� • Front: Depth:� ' Height:
.- . . Square Feet: � Cubic.Feet:
� Front:� Deptli: �� Height:
.. . � Square Feet; Cubi,c Feet: �
. ljrpe of �Construction: . '�'�/�-�� Estimated Cost: $ o'A � ('�'�. �-zd
To�Be Completed: • � . • • .
. .
�� The undersigned hexeby makes applicativp�for a permit for the work herein
specified, agreeing to do all worlc in stiict accordance �aith the Cit}• of
' �'ridley Ordinances and rulings oi the Department of Buildings, and her�by
declares �that all the facts and representations stated in this application
are true and correct. ' � � �
.
� • ]�ATE : - � °-� _ � w� SIGNATt1RE : �/ ' � �' �.� �� •
• �(See l�everse Side For Additional Informztion.)� '
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� �� BU1Lll1N� L�.1:1tr�11 rLL �w�LUU,.�
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� S�CTION 2. Tlie Xnspector oi Buildings shall, beiore issuing permits for the
cxecCion ot any buildin� or structurc, or for any addition to any existing
buildin� or structuxe, ox ior any alterntion or repairs to any cxisting
building or structurc, upon app�.ication therefore, requixc the payment by the
applicant tox such pennit of fces to thc an:ounC hexein below set forth and in
th� mannen c�rein provided Co-wit: � . . •
° i
UPiIFOr�i BUILDING COD�: Zj�pe 1, 2& 4-$2.15 for each one thousand cubic ;
feet, or ixaction thexeof, in such cubical contents. �pe 3& 5-$1.85 for �� ' i
each�one thousand cubic feet. • �' �
ADDITIONAL INFORAIATION
.For the purpose �f .:omputing fees for building permits, the cubical contents
of any building or addition, is detexmined by multiplying•the ground area
. covexed from a point six (6) inches below the floor line of the basement •
or the cellar ta the average heights of the upper surface ox to the average�
height of the•roof surface of the main gable of a pitched roof.
. .
• Fox xepairs•or aleerations to+an existing structure, the fee shall be at the
° xate of $3.00 per each five hundred�dollars ($500.00) or fractian thereof in
. tl�e cost of all groposed work. ' .
�� � Ir� no case shall the fee charged for any permit as set forth in Section 2 be
� less rhan $5.00. �. � , '
� � VERIFICATION OF�FOUNDATION �
. . • � ►.
NOTEt Permits for construction will be issued.a minimum of 24 hours from the
ti.me of application, to allo�a for pxoper review. of the proposed structuxe and,
oi �he construction siCe. . • ., •
A Certified Survey of the lot, sho�aing the location of the foundation, once it
has been constructed, will be required before proceeding with the framirig.
CERTIrICATE OF�OCCUPANCY
Application for a Certiticate of Occupancy shall be made ten (10) days prior
to tlie 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.. . e .
. ` °" ' '
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_ . I:CCGZPT I�OR CIiRTTC•ICATG 4C TI'PLE • ''•
� �� la-aq � ���� �
� Recezved of 1'he City of Pxidley of Anoka County, �•tinncsota, Q�oner's,Duplicate
� -
Cer�.ificate of Titic No. '�7���8� � ; � •
�V�tnesses
S'['A7"r.' Oi���t���,��c ;Cl���/�'SOTi� � ) ss a .
Cour.ty of---=���0l�/9 . ) � . �
(ln tl;is._._�� �� dai' of�,��C�z�l?8� 2, A. D. 2� %J'�, before me, a
�� I�'o�arti° _I�uUli.c ti.itt� in anci for said Cauiity, personally appclrcd
-_- . _.s_1..z��%��:E� L
to r�e ::u�tan to Ue th:: person � described in and �aho executed the furegoing inst-rument
and r�ck�io:vledged tliat he execut�d L;�e sam� as . �/ S free act a�ic! ilced. �
___ — • a��ZG�� /� �'��!i� ,
%_��C7' /7r �' � �. �, �S/
�'� � / /�/C_iCO�`t� �i �'c �%
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-' � 01/6' �lOTRRY PGBU� — MINivESOTA
�'��� : ANOKk CQG�NIY
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.�..' MyCommissian Exp�res Oec_ 23. 15?a '
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SUBJECT ,
City of Fridley 2 5 E 3 o V°
�
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T
� � RECEIPT NO.
� ; y �_�__ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �j / ��
� . � es ye
i..•- � �'�','� CITY HALL FRIDLEV $5432 NUMBER REV OATE PAGE OF APPROVED B�
L �� 612-571-3450 910-F15 10/24/97 / /
J08 ADDRESS 6801 Hickory Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �+ OStII18.11� S 2nd SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PNONE
Ninky Ferber 6801 Hickory Street NE 786-3886
3 CONTRACTOP MAIL ADDRESS 21P PHONE LICENSE NO.
David Ehne Bldg & Remodeling 12826 Crooked Lake Blvd NW, Coon Ra.pids, MN 55448
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
755-2265 2891
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential.
7 CLASS OF WORK
❑ NEW � ADDITION C� ALTERATION O FIEPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Interior Alterations
9 CHAN(iE OF USE FROM TO
STIPULATIONS See notations on plan.
$�PARqiE PER�ITS REQUIRED
wIR��G. HEATING, PLUMBlNG ,q F��
1�D S1G�.
�.. �
SEPARATE PERMITS ARE FEDUIRED FOFi ELECTRICAL, PLUMBINO, HEATINO, TYPE OF CONST. OCCUPANCV (3ROUP OCCUPANCV LOAD
VENTILATING OH AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AU7HORI2ED IS NOT COMMENCED WITHIN BO DAVS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO OF 12p DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIFV THAT I HAVE FEAO AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES
ANO KNOW THE SAME TO BE TFUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT $45, 000 �L2. SO
DOES NOT PRESUME TO GIVE AUTHOFITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR E ERFORMANCE Of CONSTRUCTION �529. 7.5 Fire SC ��F.S. ��
2��� � ,, lPLAN CFiECK FEE T TAl FEE
I � ����``' ����d�� (°��l �� Zicen e $5.0 $602.25
SIGNAT EOFCON7RACTORORAUTMORIZEDAGENT 1DATEI EN H P VAL A ED THIS IS VOUR PERMIT
- , �
i
S�GNATUREOFOWNEAi�FOWN.ERBUILDERI IDATEI BLD iNSP f�uTE
IVE�'V
ADDN
ALTER
(1
[1
[1
ConstructionAddress:
Legal Description
' CITY OF FRIDLEY
S[NGLE FAMiLY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�D� ici%
�- y . ,
��. . �hJ a�
�
Effecti��e 1/1/97
(� �� ��/ 20
y>c� �
� �D
i,S`��32
Owner Name & Address: /1(j y f VN��; j`�'��L Tel. # 7�� , 3�� �p
Contractor: f _ _ �Q 1J �,�; � ���,,� ��� � �CENSE # � �9
Address: / Gh 8 a� Tel. � `7�"� .- 22 �,�'
.
C'��' �'�p� 1��tta�ch��is pp1icafio , 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 IMPROVEME`'T
Length . � Width Height
�n� Width Hei�ht
��� Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type.: .�J�� jo�.. � S�,j�.n,'�ld�r, Estimated Cost: $ �', r�
(Fee Schedule on Back)
Driveway C�rb C�t.Width Needed: Ft + 6 Ft = Ft x$ - —$ � �
DATE: v / APPLICANT: � }��// c� �L! IV � Tel. . # ���= �� �o�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge�
�riveway Escrow
�rosion Control
�'ark Fee
Sewer Main Charge
TOTAL
'�"t'[PUL/1'l'IO�ti�S:
C1TY USE ONLY
(� �' (�i�/I1 i�.t� z'[�
$�� �� Fee Schedule on Reverse Side
� �`7�- ����
�_ �� � .001 of Permit Vaivation (1/lOth%)
$ �� $.50/$1,OQ0 Valuation
$ $950 per SAC Unit
�_ �� � $5.(?0 (State Licensed Residential Contractors)
� Alt. "A" or AIt. "B" Abflve �
$ -$450.(� Conservation Plan Review
� Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessan� [ ]
� (�
. [iVILUING 1'E[t�ICI' rFE�SCi-iEUC'[,!;
"Che Chief Building Officiai shall, belore is.suing perniits for the erection of any bui(ding or �tructure, or for
atiy addition to any existing buildi►�g or structure, or for any alteration or repair to any existin� buildin� or
stiucture, upon application therefore, �equire the �3ayment.by the applic�,nt f�r suctiepermit of fees to the amount
herein below se� foft�:and in�fh� �r�a�n�ei "herein' pfovide'd 'fo=�vit:• ' . � � " `
TOTAL VAI.,U,E � " ^ ,'4 dFEES � , '� ,
, . � � ' ,. � • . ' "•1. , •Y• • a , .
$1 to $500 ' � , ': . $21 (Minimum Fee �is •$2T p(us°s�ncharge) . '. ` , . . `
. . , .. . . , . , � � � ' , . . , . ,. � -•a' . o
$501 �to $2,�0 � $21 for first $SQO plus $2.75 for c+ach�addieional�$106 �� •`�a - :
fraction thereof, to and including $2,0(}0
�2,OU1 to $25,000 S62.25 for first S2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$'L5,001 to $50,000 $349.75 for first $25,OOq plus $9.00 for each additional �1,OQ0
or fraction thereof, to and including ��0,000
�50,001 to $i{?0,000
$574.75 for first $50,000 plus $6.25 Cor each additional
�1,000 or fraction thereof, to and including $100,000
$ lOf1,001 to $500,000 � �`".$887.25 for f�rst $100,(�0 plus �$5.00. for each additionai
$l,��or fraction tlieneof,.to and�in�luding $500,000
$500,00� to $1,000,000 �
$1,000,001 and -up
� > .
,�
$2887.25 for the first $SOO,OQO pius $4:25 for each .additional . :
$1,(�0 or fiactioa ther"eof, to and ineluding $�1,OOQ,000 �� �� �
$5012.25 for fhe fust $1,OQ0,0� plus $2.75 for each additional
$1,0� or fraction thereof
DRIVEWAY DEPRESSION �ESCROW
(Concrete (�rb Streets Only)
�Iternate "A": Removal and replacemet�t :of curb and �gutter only - Dri�e�vay width plus 6 f�et times $13:50.
�(ternate "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 $15.75.
VERIF[CATION OF FOUNDATION
'crmits for construction will be issued a minimum of 24 hours from the timc �f application to allow �or pro��r
evie��� of the proposecl stiucture aiid of the constn�ction site.
��:�ertiticate of Surve}J c�f the (ot, showinR the location of�the foundation <>nce it has it.has hc�:n constY�uctLv
�: '�. t-c:C�uii"Ct1 1��1_c�i'� P��t�:����iiin�� ���iii� thc I�r:ttnin�.
_ : .��
�
�
� � sue�eti � PE .
City of Fridley 2 8 295
AT TME TOP Of THE TW�NS g � I L D I N� P E R M I T
r �
; � • R O.
� `v _ COMMUNITY QEVELOPMENT DIV. ���
r � � PROTECTIVE INSPECTION SEC.
l-_-• :;���',•� CITY NAIL fRIDLEV jS�3Z NUMBEp NEV DATE PAGE OF APPROVED BY
t �� 612-571-3450 910-F15 10/19/98 � �
JOB ADDRESS
6801 Hickor Street NE ``
t LEGAI LOT NO. BIOCK TRACT Ofi ADD1710N SEE ATTACMEO
OESCR. (�, OSt1Il2II � S ZACl SNEET
2 PROPERTV OWNER MAIL ADOR�S$ ZIP PMONE
Nink Ferber _
3 CONTRACTOR MAIL AODpESS 21P PMONE IICENSE NO
Hall Enter rises Inc. 56 6 -
a ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDliE$S , ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW O ADDITION � ALTERATION � R�PAIR O MOVE - O REMOVE
B DESCRIBE WOHK
Reroof house and ara e 30 S �Tear-off
9 CHAN(3E Of USE FROM TO
STiPULATIONS
Underlayment must comply with the State Building Code.
TYP� OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPARATE PEFMITS ARE REOUIREO FOR ELECTfiICAL, PLUMBING, HEATING.
VENTILA7ING OR AIR CONDITIONING
7HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU fT.
AUTHORIZEO IS NOT COMMENCED V�IITHIN 80 DAYS, Ofi IF CONSTRUCTtON
OF WOfiK IS SUSPENDED OR ABANQpNEO FOR A PERIOO OF 120 OAYS AT
ANY TIME AFTER WOHK IS COMMENCED. ' N0. DWLG. UNITS OFfSTREET PARKING
I HEREBY CERTIFV THAT I HAVE REAO ANQ EXAMINEO THIS APPLICA710N STA�LS GAqAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. AlL PROVISIQNS OF LAW$ yALUATION SUR7AX
AND ORDINANCES GOVERNING THIS TYFE OF WORK WILL d� COMPUEO
WITM WHE7MER SPECIFIED HEREIN Oii NOT. TNE GRANTING OF A PERMIT 2S]], 1.29
DOES NOT PRESUME TO GIVE AUTHOfiITY TO VIOlA7E OR CANCEL TME pEqM17 fEE SAC CHARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUlA71NG CON-
TRUCTION TME PERFORMANCE OF CON T C710N 7�}.75 Fire .5�,' Z..rJ7
Pt,AN CNECK FEE TOTAL FEE
� ' 78 61
S�GNATUAEO�CON'i7ACTOpOA OaiiEDaGENr �O�rE� WMEN PROPERLY �IpATED TMIS IS VOUR PERMIT
S�GNATUAEO%OWNEaii�OWNEiiBU�lDEpi ib��Ei � � B�D �ti5� � - q�1E
NEW
ADDN
ALTER
c.
� �
��
Il
ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERNIIT APPLICATION
� 1 �---1 � c_ � ��- - • � � _
��
Effective 1/1/98
�I3�
���
�� a ��
��
Legal Description:
Owner Name & Address: �� ►� jw K� �l���h � �$b[ �'i'I'c k�ry Tel. # ��l - ��7�
Contractor:
MN LICENSE #
Address: �� ° � f� �� oZ %f> J�1 �,,C, �"i�%e��y, ��'��✓�— Tel. # �`�� . 63�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width HgtlGround
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: � � � �- � �I �'�'�°"� Estimated Cost: $ ��� �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ c��
DATE: V"G� � [ � APPLICANT: �Oh iVtp hti N'/�LL. �� %��,�• �YI �� �NCTeI. f� ���%` %���
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ . S�
$ �-��
$ l�9
$
$
$
$
$
$
$ 7����
CITY USE ONLY
Fee Schedule on Reverse Side
. 001 of Permit Valuation (1 / l Oth %)
$.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 [ ]
A M
BIJILDING 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,(}00
$100,001 to $500,000
$SOO,QO1 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 $2,000 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 $SOO,OQO 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,OU0 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.
Altemate "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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. -
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
sue�ecT P IT N .
City of Fridley 33622
AT TME TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
, ;�- .3
r � � PROTEC7IVE INSPECTION SEC. ���,j
� j �
� �"'1 � CITY NALL FRIDLE� 33�92 NuMBEa pEV D�TE PAGE OF �vvROvEO 8r
�'""' � � ��� 763-571-3450 910-F 15 6 / 17 / 03 / /
J08 ADDRESS 6801 Hickory Street NE
t IEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACMED
DESCR. LF Ostman's 2nd Addition SNEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE
Nicky Mullin 68�1 Hickory Street NE 571-4678
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Skyline Exteriors 6491 Arthur St NE, Fridle MN 55432 763-574-1531
4 ARCHITECT OR OESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
20215480
5 ENGINEER MAILADORESS ZIP PFIONE LICENSENO
8 USE Of BUILDING
Residential
7 CLASS OF WOFiK
❑ NEW O ADDITION ❑ ALTERATION _❑ REPAIR O MOVE ❑ REMOVE
I�
8 DESCRIBE WORK
Reside House
9 CHANOE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather resist�ve
barrier be placed over exterior sheathing to protect the interior wail covering.
Exceptions for this provision would be if sheathing is an approved weatherproof
panel or when the siding 3s an approved weather barrier. Vinyl siding is not
a weatherproof covering unless the manufacturer states this in their application
guidelines. Call for inspection of wrap before covering or take pictures. Cau1k
and flash all exterior openings.
TYPEOFCONST. OCCUPANCV GROUP OCCUPaNCrLOAD
SEPARATE PERMITS ARE REOUIRED FOp ELECTRICAL, PLUMBING, HEATIN(i,
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION 20NING SO. fT CU fT
AUTHORIZED IS NOT COMMENCED WITMIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONEO FOFi A PERIOO OF 120 DAYS AT
ANV TIME AfTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I HEREBV CERTIFY TNAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOYERNING THIS TVPE OF WOfiK WILL BE COMP�IED @
WITH WMETMER SPECIFIEO NEpEIN OR NOT. TME GRANTING OF A PERMIT `P3sHOO �1.90
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEpMl7 FEE SAC CMApGE
PROVISIONS OF ANV OTNER STATE OR LOCAL LAW REGULATING CON• $9,� � 25 Fire SC �3 .8O
TRU TION OR TNE PERFORM NCE Of CONSTRUCTION
PLAN CNECKFEE TOTALFEE
°�-� - Licen SC $5 .00 $107 . 95
S�GN4TUAE0%CON"AACTOpOAAUTMOAi2E0oGENT �O�iE� EN PqOPERLV VALIOATED THIS IS YOU�IT �
S�GNATUAEO�OWNEA��tOwNEpBWIDER� IOATE� (� �N50 O6tE�
NEW [ ]
ADDN [ ]
ALTER [ ]
Construction Address:
CITY OF FRIDLEY Effective 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
'01 t/,�l(��� �� �
Legal Description:
Owner Name & Address: G{�'r"c�� �►'1 vl��'i Tel. # �� �°� y�°�8
Contractor. /��-e � `7f`�%�✓i � MN LICENSE# ���l.sy��
Address: ��// �f � �� �� ��i0��� Tel. # %��-��` ��%
' .
LNING AREA.
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DE$CRIPTION OF IMPROVEMENT
Length �dth Height Sq. Ft.
�
Length Width Height Sq. Ft.
DECK AREA: Length
OTHER:
Width HgUGround Sq. Ft.
�
Construction Type: ���� ��— Estimated Cost: $ ��` �
Driveway Curb Cut �dth Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �` ��� � 3 APPLIC T: �� � Tel. #�` 3—�Y l S^�%
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
� �
� � r , ��
$ o�� c: Z�
$ / _ ��
$
$ S � C� �
$
$
$
$
$ �L�'�,���
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 PERNIIT FEE SCHEDULE
The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any e�sting 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 pernut of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5(?0
$501 to $2,000
$2,Q01 to $25,000
$25,001 to $50,000
$50,001 to $1�,000
$100,001 to $500,(�0
$500,001 to $1,000,000
$1,000,001 and up
FEE5
$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 $25,000
$391.25 for first $25,000 plus $10.10 for ea�h additional$1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,0� plus $7.00 for each additional
$1,�0 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $SOO,Q00 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
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
Permits for construction will be issued a minunum of 24 hours from the time of application to allow for proper
review of the.proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
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
- - � ,