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AF - 46070� 6� ,, i � :'1 %� �✓1 , _. / City of Fridley, Minn. � 1 � ' , � f �, f 1 � • : _ .� .,t� � � , 1 � 'i . , ,�- .��.� .. � / ��v:z��l.� � ...�_...,.�,��.�1 .:�' � ,�:. � �� , CATI OF BUILDING No.�� Street a�e�� a�� _�� P oP Lot Lot –��_ Block � Addition or Sub-Division �� Corner Lot ` Inside Lot � Setback _ �� _ Sideyard �� Sewer Elevatton — Foundat3on IIeval3on � DESCRIPTION OF BUILDING T Used Front _,/ � Depth ..�I� Height �� Sq. F't. E�� C�. P't��G�`� Front � Depth fTeight ��. Scl. F't. e��! _ G�1. F� �.�� Type of ction F.st. _ To be Compieted In constderation oP the �tssuance to me of a permft to co the uilding described% e, I a do the proposed work 9n accor�dance with the description above for�ij , in co p all ona of oidinancea of the dty of FrYdley. � � ,,� - � %° � � � �`/ � �� i'i'/' In conafderation of the payment of a fee oP $��, permft is hereby granted to to canatruct the buflding or addition as described above. This rmit ia granted upon the exPress conditfon that the person to whom ft is graated and hia agents, employees an�worl�nen, 3n all work done in, around and upon said building, or anypart thereo� shall conform in all respecta to the ordinancea of Fridley, 112innesota regarciinng location, conatruction, alteration, maintenance, repair and mov3ng of buildiugs wio�� dty ]iaoits and this permit may be nevoked at aay ��upon viola�ion of an�► of the Provisions of said � 1 Bt�iiding Inspect�r aoric� ild� p�rmN deas eot eer� t6s eeadwdioe, inshllalloe �e� vr1Ae9. P��+�9. 6n 6uNng, ssw�r er wmr. e� wn to as Na BniWiue I�r tor pparrM p�rmiu /or Was ttsms. .-°"�`.,/--�✓1 ;.✓ -----_ ,.'•�LGc%i i r° fi)C�(� - ' > :." �s f �� Gr S/ °�' APPLIC�►TION �'0�.3 BUILDTNG PERMIT C3TY 0�` FRIDLEX. MTI�NES�A • _ � - l �` / i ! � � ' �- � � � . . - - -� % % ' �" i. i • . . /f/ _ ,,r,�- i , � LOGATION OF BUIT,DING No e � Stseet_ ,,�is�.l �`,�� - Part oi Lot i�1��,1�� Lot ��/ �Block � _,,.Rdditi.on or Subdiviaion`� .� Corner Lot � �Znside Loic _�Setback,�,3"�Side-Yard .�'� g' SEV1E�t EI�EVATION - FOUNDAT�ON ELEVATTON � Applicant �.a��ach to tTzis :�orm Certiiicate o� Survey of T,ot and proposea build3.ng location. DE�CRIPTION OF BUTLDING �� i o �oe used as a � �.,�/�'.�� .:.�-��s� � �ront �,�� epth �� Heigh�t �' �. Sq s Ft . �'G� �',� Cu . Ft . .__.� �� ,�''�' ,� Front�Dep�h �.� � i3eight � � . Sq . Ft . dS �D Cu e�'t . . . v� lype of Construction ��,�,� Es�ixnated Cos�,�� io be Completed � ��-,�'�� , The urideraigned� 'herel�y ma]cea application for a permit �or the wogk herein specified, agree�.ng.to do all work-in strict accordance with �he City of �r�dley Ord�.narices and ruling o� the Deparf.�nent of IIuilcl-� ings, and heremy declares that all the facts and �epresen�ta�ions s�ated in. this apg�l�.cation are true and co�cr D,�TE � /� / � � SIGNA3' (Schedule of Fee Cos�s car� be found an thas Reverse Side) . *s. � . r �. • .� � � � ��-�. :, � BUILD�?G PERI�IT FEE SCHEDULE Sect3oa 2. The Inspector of Suildings shall, before iseuing any pa�rmi� �or the erection o� any building or structure, or for any addition to any exiQt�.n� building or atscucture, or for any alteratione or repairs to any oxistinr� building o�c �tructcure, upon appl�.cat�.on icherefor, requ3se the payment by tYie applicant for suct� permit of fees to �he amount herei.n be].ow �set �ortls and in the maru��r herein provided to-wito 2.1. �'or any such perm3t for the �r�etion of any £ire-p�oo� build9.ng� ather than a garage, waacehouse, factory or grain elevator, or fcr the erec�ion of aay fire-p�oo� acldition, for similar occupancy, to any existing building shall be at the rate of $1.40 fer each one thousand cu�ic feet, or frac�ion thereo£, i� �uch cubical contents. 2,,.2. For any euch permi� �or fii�e �rection o�E any fire-proof garage, wa�cehouse, facto�cy or grain elevator, or �or the erection or ar,y �ire- proog adc�ition, �or e�.milar occupaancy, to any existing build3.ng shail be at the ra�t� oi $1.25 for each one thousand cubic feet, clasei�ied as "fireproof" by Sec�ion 502 oiE �he M9.nneapolis Building Code. HOUSES 2! For any such pesmit for the e�ection of any non-gireproof build- ing other than a garage, warehouse, �'ac�ory or grain el�vator, or any non-rireproc�E addit�.on, ior similar occupancy, to any exieiting build3rig. Permit $1:00 �or each oae thousand cubic feet. GA'�P,t3ES ..�_..� 2.4. For any such �ermit for the erection o�c any non-fireproo� garage; warehouse, factory or grain elevator, or for the ereetion of any non-fireproof addition, �or aimilar occ;upancy, to any existing, building or �or each such building or adclitioa. Nin�ty C�n�s �or each one thousand cubic �:eet or fractior� thereo�, 3n th� cub�,eal contente thereof w�.th a minitmum or $4.00. For tihg purpoae of co�aputing fees for bui�.ding permite the cubical con- tents of any buii�ding or addition �o a uriiform height throughout by multiplying the ground area cove,red �rom a point e�i..x (6) inc�h�e belaw the floor 1.ine o� the basement or cellar to the average height of the uppe�c �urface or �o 'cha average heiqh� of the rooP eurface of th� main gable ofc s pitched �coo�. � 2.5. For repairs or al.terat3one to ar► �xisting etsucture, th� fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500�00) or �raction thereos in tiae cost o� all gropoaecl work. 2� ia no cas� shall the �ee charged fior any permit as s�t forth in sectio�n � �� as #�''uz $4.00. ,� � , � �° �' - • . � Lond P/onnin9 La�d Sw�veyin9 .SoilsTestin9 Civil b Municipol fn�ineerin9 6B7'S-Hi9Mvoy =GS NE. Min�a�av/is31. � ENGINEERING� iNC. M�nnesvfa SUntet4-6066 — En9i .neers � Su� vecJors — cesrts : icate o� su,sve �A: �° �N� � � � . .��.� _: .� &�� .�r. D�ff� G � �R��r Z�°" f � ��I�,o'� � ",' 1 �1 � �� !t' 13 � '°� d Dn �v� l 4 �n� `' --� a�� g� P�U �\, I � � � w �. 0 �� a .. ,' � ' �. ,�}. ��, :� �+ �e�°- � � �� +� R � � \ � � � v i� � '7 i� �D �'. /�: � �� ;��'� O � -!_ Y�'� � �� .� ea• .� i8.q � � .g i33 L ,� 6 . s �_�1'`�`� > � �� _N �� i Y 2 `a �� \ � �'PI �"�0 !'! a�' ��_ �'/'i< Nii 7 _ _ T rv r� �' ' � a//O P�u f �- //v, c 6 Nl �� , � ` � �' �� .�'•°uc-e /%%0 U Yf� L C1 /� F' .�e i'f.�: . 4° A_h °�` r' t�_;� ''1�s�h ,) / h�r+�fiy cerfi�y m� �;s � o��d �� ePresenFofian o�'o surret, �'llit b�n,dor�es �'fbr oba�r a�esur6rd lm�,d, cnd n�'/fa► larofion o�'o// builGin9s , f/rreon , ond ol/ ris'�6/e �arnv�imenfs ,��'�. �rn a,r an soid /ond. As su�veyed by me lfus 9—_ dby _ o�—T'" — A.�� SUBURBAN ENG/NEERING, INC. - - _ _ _ 6n9inerrs ff Surrufors �_ y �,' �� r �''" 3 � , -- ey � � . ��,-�_-��-�-�� ------ -- , .,,�' --� ,, -- � « �-,�:�.,.,�,,.� _ �� 6�' ---4� __ .�_: �:. d M 0 p o� � � � • tp t3! � � N � °� a � � �+ !'� � a � � � � � � � �'. o � w� � N � . o • o • °o � : o . . Gad : : �r . . 0 k �C 9! � � � °o q c � -08 {fl &! � O �� z � � � � � � � � z x 8 � n � � i� � � � � � � � w� � � � � � 5' � �' � y � � � � � . p, � y� � � � a° ° � � � � �,, : fD �' ; W _°o : �' � : � 0 ' �4 � OG � . . . . : � : : : : ; � . . . . 0 5C i4 k k k k W N W ►+ r+ ~ � w °p c�» °o 0 0 � ii! <fi {'i� {A {'� �fl � "e7 y O � � � 0 � x � N � � i i D � 1" � m � � 2 m C r m ° � o � � a o _ � � � '� a g � � �� 11 .K. • �P w p w� �j � � � � � � � � WATER �S � � �� URINALS � ,, e�rt+ O � p p sws�nS �d h�f I SINILS � � W� rt�tts DRINK. '�' FWNT. sHw�. FLOOR � DRAINS UTCFI �� uro WASHEtI GAS MPL �� RANGE GAS OPENINGS a • Z i �y � N � A m n p �� 8 8 M � � � �n � � ��-4 y � � .. � aa.� �� a � �- � o°q�'� a �� p• � ��o� � ��.o � � �' � � � � 8 ��Y�O m � � b �� r� � n �� w p � m o �a o p a' o y � M �� ¢�� o�y��p�'� e �Y fA f�C ►O! �� A � o-~+QO � a va' � m�� 3 � w � ro � � � m M � x� � � aM Rx &� p � M � M � � � � � �i � � � � � � � �� 7 � r v 0. �- � ro � � � » � �°.. oe � � . "+,y o b Q ° � a �A � iP � O 1� � � � � � 0 c[i x � N � �� N w � p �o � M � x z � � r � � � x x z � �n��o � � � z ��n � � ��. �n � � � � � m � tn �n � -�i �+ � � n _ !7 A � O < I�1 � � � C�1 � � � � Z^ YJ ❑ M. � � � M w a + y y a '" � W f� �'� �� t� o `�1,, � VJ N � � 0 o � o � : O • � . � : : � � � x k k k 0 N � °p o o � tfl tn +n `� C O \� � � ao � � '�d 0 � 0 0 0 0 O � .. � 0 0 s� \ � o w � � w � 0 � i. � H � � a � � z � � �, � � � � � � �O pd � � � � � � o � ro 0 r oa � pd � �° � o ta o� W � �, '� � � M O � � o �� c�D e� • �: �. � � � � � 0 0 � F'yl � � m � � � � � � � � �� o �y �- . 0 � � � � a a w N o °o � � �� x� � � � � � : .� �� O � '� G � c� y � � � � O �� i� ',� � F�o � N � w w en in o 0 0 0 0 0 t�s t�s tta M � � � �°�b �� .�.� � � � � � � � � � � � `"' � � � °s � R° � o � F � � Q � � � � o � P'' . � t�'i a � ' � o, ��s„ : G .. o . `�`' � $ : : � 0 o : : : m . : : : � � ca vi n� go o °o °c °o °o � � � � p � o N O a � � � � � fD `� O � ~' ~ a � � � C] � � � � �' � � � m � � o g b � � � � � �J � � � �� 1 � : � � � I 1` � m � �CP� i� �' 'd �' S � m '� � � �'�'� � m � R° R° � � � � a � � � � o � y �'R°y � � � ao � I � � b � ° � - i%�i m • �� : : � . . � ,°o : : o a . . o . . $ : : : n� en ca m � ea c o 0 0 0 o p �n O � t" � �� n ro��H � �� ° (�A � � Cp W ppM�a+ a � � � ot�op�°. eC y d�� , �� ° � s� �� i pp�~.•� er � "F*yOOr� 9 y r'�' Ff W. � � DG ��'w0 n -�j �Ry p�4�� m �p'op ��,o '! �� , � �. � a�� N ��A� �� G�o �.r. �. v � � �' m ro� �� 5' , D � r � m y _ m C m G b :• M � � p�' � a A V A V O � 'O � � � . O � �� O � D 0 0. �. d O = �� . � �� a � 0.� v< S� �i � � � � � � _��-e � -_� ---- 0 �' --. D 4 � � , �f 1� _ � 1 � �i � � �'�s `° � , r �" � �+ � i� I Cc�mplimen�ts� orth nt�ra Pub c Service Co., �.,, �,,� �� HEAT L099s„C.a1,LCULATION9 � / �I`�'� ✓ TowN � �, � tr DEPARTMENT OF BUII.DINGS VILLAGE Weatherstrlps A.S.H.V.E. Construction No. Insulation Guide Windows I Doors RePerence Ou� Wall IInt. Wall Ceiling I RooY ( Floor Kind I How Applied No No 19.. °�'` ,� � �'/ `" s � ;� � Fl, I Room � Length ,, Width ,� ight � 1. I�: # Room I�Length �"� � Width �!�'Height �g' � Windvws and Doors�rackage and Area Windows and Doors—Crackage and Are Wldth Height No. o! Llneal ft. Area � Width ileight No. of Lineal ft. Area No. , oP pane oE pane lights oE crack eq. ft. No. of pane oE pane lighta of crack sq. ft. �- � c � � �,� � -��; . � ` . I Infil'tration � �a � Glass sa '`!3 / Exp. wall � a�;,i � Net exp. wall � ff �� "- wal In� wall , Ceiling � . ., y� '�' Floor ,.- � Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I �� Room I Length �' � idth -� Height Windows and Doors—Cra.cka.ge and Area Width Height I No. of Ltneal it. Area No. oE pane oE pane lights of crack sq. Yt. , �. � y �+ e .,, .� I I � CceP. Btu InSl'Iratlon " � ° Glass '�i � Exp. wall `° ,�i +�-� Net exp. wall r " ��a Int wall Ceiliug �' � �+' � � `"i fi '� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. I.eader area � Fi, ��1� �,t �Room I Length �� Widt�h �" ��'i Height� '� f Windows and �boors�Crackage and Area Width Height No. of Lineal ft. Area No. 01 pane oE pane lighta o! crack sq. ft. : O / i, �• � � � l: ,Y b InSltration � ° - Glass Exp. wall Net exp. wall �° �. • In�. wall Ceiling �``' Floor ,/-'� Total Btu. ftequired sq. ft. E.D.R. or sq: ina. W.A. Lea.der area Btu In8ltration Glass �•� � �� Net exp. wall In�. wall Ceiling Floor Total Btu. Btu � Fl. I%i ri � Room I LengtYi��j � Width/ �� Height �� I Windo answ ti` Doors—Cracka.ge and Area, � � InSl'tration Gla� Exp. wall , � �, ,b.� �r Net exp. wall ___ Int. wall ICeiling � Floor i vceL a1.4 �� Required aq. ft. E.D.R. or sq. ins. W.A. Leader area �' ��'1, I�.�.� ��.,�, Room I Length� �Width �`-' Height��. Windows and Doors—Cracka.ge d Area J Width Height No. oY Llneal t. Area No. oi psne o1 pane lights of crack sq. ft. -' � � � ._ � � i- � � Coef. � Btu S � � � Glass ExA• wall �r ` �� r�, �,' Net exp. w In� wall f.� �i'1 Ce�1ng / � .� �l �. Floor �, �'F �,�' Total Btu. � � �.�,. � — II Required sq. ft. E.D.R. or sq. ins. W.A. Leader ar�. �� a �. r� s � � �� ,�.� R,00m I Length idt•h �' �Height �`_ Windows and Doors--Cx a,ckage and Area Widtil Height No. oY Lineal ft, Area �. of Pe.ne oP pane. llghta oP crack sq. Pt. � �7 �6 «'A � � ,: In8ltration GlaSs Exp, wa]i � Net exp, vvall Inf, wall Ceiling � � Floor Total Btu, C�P. Btu - �- � � � r�► � �� '? �'v 4� � % ,�' T '�' � � �' �!' / c_,� � � Required sq. ft. E.D.R, or sq, ins, W.A. Leader area, � �ai�� Room I Length�/'� �' Widt� Windows and Doors--Cracka,ge �d A�.ea No. Width Height No. oY Lineal ft. Area 01 pane o�f pane lights o4 crack sq. ft. '� % � a ir'� '� s � �. . � Infl1'Iration Glass Exp. wa11 ��t ei� Net exp, wa11 ; Int wall �''ira� '�,1'��s �o � �, �, '' Ce'uing 4��. /! �'' �,d ��1c�, ,�° j Floor %i��,� �, ,� ! Tota1 Btu, �� f. BL7,� f��',(, �' .�. S "l.+ � Required sq. ft. E.D.R. or sq. ins. W.A. Leader atea - ; �,�� :i��,�-,�.° Room I Length �% idth �' ^ ..��Ieight .–� � Wuidows and Doors—Cra,� � !�-- kage and .�,rea �� In8ltratiott ea ft. � _ :x _ I C'Oei. B'L1� G� � �'��'�. �3 �"�: �,-� : �p.= weu .� �.+r° . � Net exp. wa,ll �, � �� Int. wall +�f' � �+��, „� ,� � �� - . %,� G� . . � �� f � �� Floor � �= � .� � ��° Total Btu. �,�r '� Required sq. ft. E.D.R. or "�' 6r sq. ins. W.A. Le�ader a� t �, , � Tai c�TV oF FRI L Y DIRECTORATE O i PUBLIC WORKS ,�, .. �1 � ; • • � ��►, � . • / � • � • • - , �,,�,� OATE Apri 1 3, 1984 MEMO NO � 84--52 FROM D.P.W. John Flora, Public Works Director TO ACTION INFO• SUBJECT Ralph. Public Works Dir. S.I. X 0 1330 Hillcrest Driveway Councilman Schneider received a call from Miss Connie Modig, 1330 Hillcrest Drive. The driveway is settling in the boulevard area and her concern is that the City water line is broken and causing the problem. Please check this out and provide me a response. JGF/kh John: At this time, there is no physical evidence of a water break at this address. On November 24, 1979, we had a water break at 1328 Hillcrest Drive. We re- paired the person's driveway, but this would have no bearing on the broken concrete at the address in question. RV:lp � y « .. � � � � � � O ►�- � z a b �n � M M o � N sJ W M� '�y U O 11 O G y o � � N O w � b � N �O y n a M W a �n �n �o y � n Z v 7 m r r N � � P1 p n N N N ` o � Q � ro� C L N � B7 � � N !�7 � m O 'r1 � � Hz MK C t' :� C Z � � H n c`i M � r � � t7 � H N N r N 0 0 • a � o i d d ��° ��C m ° s y� w o�� o�C D cRi [ M� E ��'E O �p M N rt \fp ? � �q 7�C S H s m Oo ►Da � K O fC �O 1D O �t f1 er 0� M • � r* E M m Oi Or m ID fp O 1+� F '17 IC fC R i M 7 Oi �� M � h�t rp• w r a oo . � i < 1 1 �O �G � 7 M 2 � o. � n a ��o a ti M � n r 7r r a� ►'�+ a x � n � .. M G � m M �. � I I�I I I I I I I I I t/1 'r ti/ h N N fA N N N N N N N Z ►+ ►+ N r 1!+ O O O O�I O �I J�I �I Y� ► d O O O O O O O O O O O O O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 B tl tl 6 0 ql p/ 0/ � � N N N N N t/1 N N N N N N H a 9 x s Y r 0 � v �,Q M vV� � � � y A � '� 1 ' V � � N v x � � �o � W � � � \,^ V \ p � g r .G �p f� m o °' � • KI �o r � 2 C� � =`i C �D m y r.. � a �1 m N �S+�1 C7 O r 1�1 'p � M �1 0 � y r ° W N r Stories � .� re rs a a n � � � � Cloae[s ,o � Orinals g� S s.cn �es i �5 � Basins 0 a y Sinks � '� Yash Trays � � Drinking ,o Fountains Showers � Floos Drai � C�tch � Hasins � Autamatic E ila8her � Gas Appl. Misc. Fixt ` � Ges Aenqe• � � � Other mm m� r „ n O � o ��'1 ' N � � o � � m � ►Ci tn r y M � � O M � � H O � � � 'pV � \ � 'if ` , � N H 1 O � 7c � z � p b � S 7 � H tD oa�� a n rr O C � � ~ (1 ►. r. G p' i�n� O,� O� �� °' ;, A � .�'i o N q � N N '�C S 7 O� W 1p � m '0 S O� f� O ft � `^r�o C � a O d ►ai o � � O ... m � v n ~ A C N N 0 0 ,+ .� ., c� 0� 7� 9 h7 � n ry� C r• r � W a • � �� . «• n � w n R fp C M• 19 � h'• � � ►i• S N A � G �� i'M 3 r, G 7 n ti Z tl! �yv� �, ,.. 7�1� N � A a o '< � K Q Q B ~ < �~ ,C � r' Q O � � at ti r 7 M � \° .mi �+r•' � � e o n ¢ 1► 7 H O �+ Oi m rt M �p � e7 �C 7� a�� tl� t. 0 Q O� ti � m \ \ � \ � � � n D 1 O Z � 0 70 'C E r' s = � � � O T a z O T 7D G� �--� a e� rn r m T � � � 2 G� � m � � n M fJ r. R < n G R n C. u G Oi ►S � r r � �o Y� sue�etr p City of Fridley AT THE TOP OF TME TWINS g � I L D 1 N� P E R M I T 2 8 3 51 ;, ,� . � • COMMUNITY DEVEIOPMENT DIV. /� / r � v � PROTECTIVE INSPECTION SEC �� . � ( � /"'1 � C1TY HALL Faio�E� SS13i NUMBEP pEV OATE PAGE OF APPROVED BY �'""� � �'' 612-571-3450 910-F18 10/21/98 � � JOB ADORESS 1330 Hillcrest Drive NE 1 LEGAL LOT N0. BIOCK TfiACT OR AODITION SEE ATTACMED DESCR. 2(F 3 Nioore Lake Hills SMEET 2 PFOPEiiTY OWNEp MAIL ADpR�S$ ZIP PMONE Richard Modi 571-0550 3 CONTRACTOR MAIL ADDRESS 21P PNONE UCENSE NO Custom Remodelers Inc. 474 A ollo Dr. Lino Lakes 55014 784-2646 1748 d ARCMITECT OR DESIGNER MAIL AODRESS ZIP PFIONE LICENSE NO 5 ENGINEER MAII ADDRESS 21P PHONE UCENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK ❑ NEW O ADOITION � ALTERATION � REPAIR D MOVE O REMOVE 8 DESCRIBE WORK Reroof house and ara e 24 S) Tear-off• Reside, soffit and fascia 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. Install soffit ventillation to meet the State Building Code. TYPE OF CON T. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS AFiE REdU1RE0 FOR ELECTRICAL. PIUMBING. MEATING. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CQNSTRUCTION ZONING SC. FT CU FT. AUTHOR12ED IS NOT COMMENCEO V�IITHIN 80 DAYS. OR IF CONSTqUCTION OR WORK IS SUSPENDED Oq ABANOONED FOR A PERIQD OF 120 pAYS A7 ANY TIME AfTER WORK IS COMMENCED. NO OWLG. UNITS OFFSTREET PARKING I MEREBY CERTIFY TMAT I MAVE iiEAD AND EXAMINEO THIS APPLICA710N STA��S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VA�UATION SURTAX ANO ORDINANCES GOVERNING TMIS TVPE OF WpRK WILL BE COMPLIED WITH WHE7HER SPECIFIED HEREIN Ofi NOT. TNE GRANIING OF A PERMIT 13 056 �G.S3 DOES NO� PqESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CMARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON- - STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 19 .]S Fire SC 13. OG PLAN CNECK FEE TOTAI, f EE se SC 5. U 224.34 S�GNATUAEO CON'NACTOpOAAUTMOp�ZEDeGENT �O�rEi WMEN PROPERLV IDATED TMIS IS VOUR PERMIT �'Q°� / —�� IJ��/e c — �i —� S�G 4T OWNEp��OWNENBU�lOEp� �OAIEi � BLD �hSP � q6ft a NEW ADDN ALTER [] [l �l CITY OF FRIDLEY SINGLE FA11�III.Y AND DUPLEXES Rrl AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: � � � � J�; Legal Description: Owner r Contract� Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/1/98 � � g 3�' � a ? � Tel. �# �%/�`��'C7 MN LICENSE # Tel. # _�� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Ixngth Length DESCRIPTION OF IlVIPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. � � /1✓cR'�j Jrj �� Ca�'-�� Gd � �� Construction Type:�� ,� � ��-�' t,uvs��ated Cost: $ �� o� , �U (Fee Schedule on Back) � �� ^ti Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � J DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Tel. # $ / ,�� $ , � 1 � $ $ j , u� $ $ $ $ $ � � �� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuati0n ' $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 [ ] . - •s BUII.DING PERMIT FEE SCHEDULE The Chief Building O�cial 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,QQ0 $2,001 to $25,000 $25,001 to $50,000 $50, QO 1 to $100, 000 $100,001 to $500,000 $500,001 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,OQ0 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 $100,0{l0 plus $5.00 for each additional $1,0(}0 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,OOO,Q00 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. 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. Bu11Cl]Ilg ��Nj��.�, Permit No . Inspections �SI�EN'�L �PLICA'�IIOl�TT Received By: � 763-572-3604 C� �� E� � D�'�UN �.6 2QQ DATE �` � d m �� YOUR E-MAIL ADDRESS sTCE ADDRESS �� Q•l a l 1 Cr � E � j° THIS APPLICANT IS: ❑ OWNER �CON1'RAC7'OR • PROPERTY N,�tv�: l.�l C, � f'( �s �( �� - OWNER/ ADDRESS: ��.� O� e I I C Y'��5� � d� C(Ty +'� B a�I �- STATEI1it� ZIP ,r�L TENANT �or�• '��?� � � '� r • c� � � �� CONTRACTOR co�,� r�.�: ' � � � s �` �° ��'-� � ��- `�s SUBMIT A COPY OF ��'�� P�ON: �`'�`=� �' e� a� YOUR STATE ST'A7'E LICENSE � E7�' DATE LICENSE WITTi ADDRESS: ��-W � %'��..( �e �' . � � CT1'Y �i� i a� � STATE P'I�ZIP � � ��— APPLICATION PHONE �6`�' �� d f�S � F,qX , PERNIIT TYPE ��GLE FAMILY ❑ TWO FAMILY O TO�irNHOUSE TYrE oF woRx: °1�'' ��c�m�r ❑ ,�.�Rn�now�onn. - ETAII,ED DESCRIPTTON OF VJORK�2��'�I � I�.e�� -��'�` �� PER MS 16B.665 the permit fee is a minimum of �15.U0 or:5%;of the total cost up ta_$500.00, whiehever is greater, for the improvement, installation or replacement of a residential fixture, excluding ttie 5xtures. ('Phis shouid°ieffecC only the cost of labor ) Labor cost under $300 °$15.00. Labor cost between $300 to $5� = cost of labor x.OS = FOR PROJECCS Wi�RE U�►BOR EXCEEDS $SQO, FEES ARE BASID ON $10.00 PIIt FDCfURE, EXCEPT WHEREN�TED';: Fl?CTUl�ES: (INpIGATE TOTAL NUMBER OF EACH BIIII,�Vdj �r EquiPmentInstaUed . IvffG: W ��"� MODEL: ��°� �t`d� �S=,tJ' SSIZ�B� c��'i� MFG: MODEL: ' MFG: MODII.: SrLFJBTU i A/C $25.00 F[REPLACE (GAS) $15.� . GAS:R�iNGFJOYII�I $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (I�OOD)':$35:OU I3EW GAS' GRILL 310.00 BOILER $35.00 _FIJRNACE $35.00 _GAS �JNIT iTIR 510.� CHIIvWEY UNER $10.00 GAS DRYER 510.00 POOL iiFATER $35.00 DUGT WORK $10.00 GAS PIPING 510.00 VEIJT�.ATOR 515.00 —�!�'�y .. . •.. . ... ,� ��r�� . � �k119F�1 ��... _ �.. , , - 4 . . .. .. .. . __ ... ' .� ... ... . .•� ..� .. . � � , . . �� _....-cs-+ . �.... . ......� � .. .. � .. . . �. . - ' . . . � . , � ., . .., � •' • . Pertnit Fee $ Number of fixtures @$10.00 x$10 00 =$ Surcharge S .50 Number of fixtures Qa $15.00 x$15.00 =$,�,_ 1'OTAL DLJE $ Number of fixtures @$25.00 p x$25.00 =$� � Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $� � � � � THIS I5 AN APPLICATION FOR A PERMtT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I ackn�wledge that the information above is complete and accurate; that the work will be in confotmance 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. SIGNATURE OF APPLICAM � Gs. �c �i 0� �i� _PRINT NAME �� "- �J � � f0/� DATE �- l ( ° �� ...�� ."�,�.. ;f7t3�3�,.��'�?R��I��c,t�Y��Ck..��. ��'�_ .�:C:��'�� .'.: �m� a , �� -- (.,1L� OI r rlulCy �uilding �nspec�ions Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FA,Y: 763-502-4977 �� REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATIDN HVAC � ❑ NEW HOMESIADD(�IONS EXISTING HOME ❑ MAKE-UP AIR � REQUIRED FOR NEWlEXiST1NG HOMES 1. Combustion Air (See note below) . � Oil or solid fuel TMC Chapter 7 with MN Amendments b. Natvral Gas or Propane/�GC Chapter 3 with MN Amendmenis � 2, Make-up Air (See note below) a. JMC G'hagter 5 with MN Amendments . ,� 3. Venting � a, Gas appliances 1FGC Chapter S with MN Amendments � � b. Fuel other than gas IMC Chapter 8 with MI�T Amendments REQUIRED FOR NEW HOMES o� 4. Heat loss & rboli.ng load per room. a. Required-on new constrn.ction IMC 1346.03T2` 5. Ventilatian a per IVlN En,ergy Code 7670 or 7672 � 6. " Duct Desi.ga Per IMC 1346:0603.2 a. ACCA Manual. D NO'I']E: Centerpoint Energ� Mechanical Code Guidelines sofiware may be u�ed for comb.ustion and mnake up ai� calculat�ons