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AF - 46693City of Fridley, Mirm. �UILDING PERMIT _��` � Date: _.. ° .r....�,�..._____.. _.__._� Owaer: Address N° � 4 4 60 x� c.- '^'"� �; . Builder _ .'�-�?'��y�_ e ,r�,.�� Address ......__.r.__._..._-----_.� �/ LOCATION OF BUILDING No. _.�_:�.._�_�_.�.__ Street �.� . �. '� �` t� �.....___..w...---_._.__ Part oP Lot .��i.�..__._._.. ___...._. � Lot .•--.....---�--��-•--�----...--- Block _--- ...............�-•-�----�--...._............. Addition or Sub-Divis�ton _..:�......---...._...... Coraer Lot ....--.--_----........._---••--- Inside Lot Sewer IIevation To be Used as: �� nt__..._...._.___:'.!�...._�..'�._.__....._ ._ ..--- .............._......----...-�---..._.............. Front Type of Construction Setback ...----•----...._....__...._........ Sideyard .._.._.. Foundation IIeva.tion .................. DESCRIPTION OF BUILDING Depth... -=---.......----. Height ....:_-------------_.. Sq. Ft ..._.___.----•- Depth.--�------......._.. Height ....................... Sq. F'� ---.._......------- .._.... Est Co�� .�..�.°�,��.....�.."""`.... ..°....... To be Completed C,`u. Fk Cu. F� In conaideration of the issuance to me of a permit to cons ct the building described above, I agree do the proposed work � accordan� wlth the description above s��th and �in �m�ce�� provisio of ordinances of the ci of Fridle . � In consideration oP the payment of a fee of $._-�_"°"'_`_:"".--, Permit is hereby ted to....--•--..._.._......---..._......._-----......._.. _._ to conatruct the building or addition as descrihed above. This permft is granted upon the express conaition that the person to whom it is granted and hfs agents, employees and worl�nen, in ali work done in, around and upon said building, or any part thereof, shall conform in all respects to tt►e ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and movittg of bufldings wlthin the city limits and this peimit may be revoked at any time upon violation of any of the provisions of said ordinances. � Building Inspector NOTICE: Thta permit does no1 eove� the eonsiruelion, tnslallation fe� wirine, plumbing, gas healieg, :sewer or waten Be aure to see the Buildin8 Inspeefor fo� aeparafe permita fo� fheae ifema. ` "',� � �.� ° " .+'�. � 1�. �,: � - �--� _:��"1.;:� . _ ,�� a �C�.t'8S8 � � ' .?: �� No. /�� Str� a APPLICATION FOR BZTILDIldG , PE�T CITY OF F13IDLEY', MIN11jESOT�i . .. -. _ .__.. . i� ' ' � .. , � . � �'(-/�" � � � BL1�.C1@1' ��1'�?�Z�Z" ♦��'" • " E� �" ``° / ", �'`'` �C�'888 i� �1 ? f� �`r, � �� 2�� n—� , )AT� UF BUILDIlJG �� of Lot Lot Block dd.dit3on or Sub.Div. Corner Lot '�iside Lot •,.,Set Back Side-Yard - SEWER ELEVATION... FDUNDATION ELEVA�TOId � Appli�nt attach to thia form Certificate of Survey of Lot a,nd propos� building loca.tion. DESCR PTI . ' . UILU ]NG . � � • , �;��:-� � � .� . , � � � . _.,:... . . . To be t�sed a : � . , � ., �� . ��/�'�'�` l � � Front ' Depth Height Sq. Ft. Cu. Ft. Sq. Ft. �_:'.�Cu. Ft. Type of Constructio �� '�� To be . .�� .. .. . Depth : • .He�.ght ,, r � /y^-,'///(`//ll//''�� ,� � �- �� '� ��, �. . ' .�` "�i`� V � V P � �.,.! ,� ��'�� 4� , ei�� E,stimated Cost � � �� e — �a %'7 � � � The undersignecl ��by makes' applica.tion for a.permit for � the, work herein speci�'iert, agreeing to�do a1Y wi�rk in strict accordance with the Cit� Ordinances and ruling�of the Department of Bi:i3ldings, and hereby declares tha.t all the,facts and �epr•esenta- tions s d in this ap lication are true ' d cor �. �� ' °`iO �-'�!(s � ". 'I�ATF'. �� (a(� a �� e'' � GTRAT�T e � � ,%� , ! � ;� of Fee costs can be found � �. � ' � i� e R� s- • BIIILDING PERMIT EEE SCHIDULE Section 2. The Inspector of Buildings'.�hai.1, before issa�ing an�* permit for the erection of any building or structure, or i'or any addition to a.n� existing_ buildi.ng_ or struc�ure,. or _ for ang alterations . or rega�s�, .. to.any existing building or structure, upon application therefor� requ�re the_pagment.. by the .applicant for such per.�iit of fees to the., amoun� .herein, below set forth and in the manner herein provided �o-witr � 2.1. For�an��such permit for the erection of any fire-proof building, other tha.n. a,.gara�e, _ warehouse,� .. faato�y � or gra3:n eleva.tor, or for the_ erection' ��e�f any fireproof addition, for similar occupancy, to any existing building shall be- a.t the r�te•-.a� �1:i�,0� for ea.�h one thousand cub�.c feet, or fra�tion thereof, in such cubical contents. c;... .�..: :... ...__ '�. 2.2. For any such permit for '�lie" "erection of any fireproof gexage, ware- house� facto�y or grain elevator, or for�the erection of ang £ireproof addition, for similax occugancy, to any existing building sha11 be at the � rate of �1�25-for each one tHousand cubic feet, classified as "fireproof" by Seetiun • 502- o£ they Minnea�ol-is- Br%ildir�g Code: . ..°. . . . - _. .. _ .. ... . .. _... HOUSES . .. ...._ : . . � . . .. . . .. . . ,..:. .. . . 2.3�. --�a�--�rty- such permit for -the� erect�or� of- any non-fireprooi building �---- -�•• other than a gaxage, warehouse, factory or grain elevator, or any non- fireproof addition, for similar occupaney, to an�r-exist�.ng building. •• Permit $1.00 for each one thousand cubic feet. GARAGES 2.L�. �o� any such �ermit for the erection of an�r non-fireproof gar�ge, warehliuse;�, factor�`or_ gr�in.elevato�; or for:�the erection of'any,non- ' fireprpof��e.ddition; � for� sim3.lar° occ�.paric�, , to a.ny �xistYng buflding or `� for e�ch'�ucl��building or additiori:`� iVinety Cents for each one,'thousand cubic feet or fraction �her.eo£, ifi the cubical contents �thereof with a minimum of �L�.00. For the purpose of computing:£ees:for build3ng permits the cubical contents of any building or additzon td a uniform height throughout by multiplying the ground area covered from a point six (6.) inches belor� the floor 1i�e of the_basement or cellar to the average height of the upper surface or to the. average height of the roof surf�ce of the ma.in gable of a pitched roof. 2.5. For regairs or alterations to an existing structure, the fee ahall be at the rate of �3.00 for each Five Hundred Dollaxs (�500.00), or fraction thereof in the cost of all proposed. work. 2.6. In no case sha.11 the fee charged for any permit as set forth in Section 2 be less 'than �4.00. � � .r.'� �:a� �, �.' � a :�,:; SUBJECT P City of Fridley . 12594 AT THE TOP OF THE NJINS g U I L D I N G P E R M I T r � � C . � ; L ____ COMMUNITY DEVELOPMENT DIV. r � �, PROTECTIVE INSPECTION SEC. 1 = � �� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY •""�'♦ ,`� 612-5803450 910-F15 6/17/74 � � JOB ADDRESS 1365 Hil 1 LEGAL LOT NO. BLOGK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET dd'tion 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gerald Herlofsky 1365 Hillwind Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SaIIt@ 4 ARCHITECT OR DESIGNER MAIL ADOHESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a deck 9 CHANGE OF USE FROM TO STIPULATIONS Submi.t plan if rooi added later. SEPE RATE PERMITS RE��EaE� FOR �lf�iNG, HEATtNG, PLIJMBING At�D SIGtdS. � SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCI THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R 1. ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CEFiTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $I.�OOO .SO 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � yS`C.00 PLAN CHECK FEE TOTAL FEE $6.50 �V,.:GNATUREO C N RAC70 RnU O IZEDAGENT l/+T EN OPERLY VALIDAT TH I YOUR P€RMIT f P � F' � SIGNATUREOFOWNERUFOWNERBUILDERI IDATE) BLDG.INSP pATE � r�i APpLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA , OWNER' S NAME :, ��.lc✓� ,�P-.�a� a��', �- BUILDER: ��_ �,,,� ADDRESS : /.�(a.� , , � <'°`:��,.� _, �/,?.',�!` ADDRESS : NO•. STREET• ; LOT : ,� BZOCK: O ADDITION : Q�ff f� , , ,,d� ,�`: r . ;-�`,�r CORNER.LOT: INSIDE LOT: � SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. r DESCRIPTION OF BUILDING To Be Used As: �� Front: Depth: Height: Square Feet; Cubic Feet: Front• Depth: Height• Square Feet; Cubic Feet: Type of Construction: �'�/oL/� Estima.ted Cost: $/_D o0 To Be Cornpleted: The undersigned hereby makes applicatinn for a permit for �he work herein specified, agreeing to do all work in stxict accordance with the City of Fxidley Ordinances and rulings of the Department of Buildings, and hexeby declares that all the facts and representations stated in this application are true and correct. DATE: ��,� SIGNAT[7RE: � _ � � "� ,`�� , �. �._' �` T , � �' �� (See Reverse Side For Additional Information. ) � , �!, ,', ; �---� �` ,' , � � ; , � � .3 .�' � := . O V: 5 `1 �_ � � e p i r �� , �, , � D i G � t �BUILDING PERMIT FEE SCHEDULE SECTION 2. The Tnspectar of Buildings shall, before issuing permits for the erection of any building or structure, or fox any addi�ion 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 ma.nner herein provided to-wit: UIVIFORM BUILDING CODE: Type 1, 2& 4-$2.15 fox each 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 computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches Ue1ow the floor line of the basement ox the ce11a� to the average heights of the uppex 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 existing stxucture, 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. In no case sha11 the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Pexmits for construction will be issued a minimum of 24 hours from the time of application, to a11ow for �roper review of the proposed structure and of the construction site. A Ce�tified Suxvey of the lot, showing the location of the foundation, once it has been constructed,�will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Cextificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure fox which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. � � � SUBJECT PERMI City of Fridley � 12686 AT THE TOP OF THE TVlIINS g U I L D I N G P E R M I T r � ` RE . � ; L ____�_' COMMUNITY DEVELOPMENT DIV. � �� r � � PROTECTIVE INSPECTION SEC. ' i ' � /�'�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �..---� • •,' s�2-sso-saso 910-F15 8�1��7� � / JOB ADDRESS 13 65 Hillwind Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DE3CR. S 1 Lakeland Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald Herlofsky 1365 Hillwind Road N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. ►S�'' 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO: 8 USE OF BUILDING residential 7 CLASSOFWORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK porch addition 9 CHANGEQFUSEFROM TO STIPULATIONS SEPERATE PERMITS REQ�tRED FQR WIRIIVG, HEATING, P�.UMBtNG AND StGNS, TYPE OF CON51. ucaura SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, W�Od VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS AND KNOW THE SAME TO BE TRUE AND CORREGZ. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 1� OOO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 5. OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE SIGNATURE OF CONTRACTOR�R AUTHORIZED AGENT� (DATEI EN �OPERLY VA � - v �l GROUP OCCUPANCYLOAD CU.FT. OFFSTREET PARKING GARAGES SURTAX .50 SAC CHARGE TOTALFEE 5.50 TED IS IS OUR PEHMIT �PLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �� S NLY'La i�� k�- r" � i! �,+ ' �� l$�JIZ�� i '� �, EiDDRE$S • ��j' : J. �F-- �� t � i ' ��' ADDRESS • , NO•. STREET: � � �'° ' � � ��_ - LOT : � BLOCR: ADDITION : % �,+ ` ' � � � ; , CORNER ZOT: INSIDE LOT:_�_SETBACR: SIDEYARD: Applica.nt attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. HESCRIPTION OF BUIL�•ING ` To Be Used As: '� ;:�, � i� � %�;� ��:N �� ;iFront: Depth: Height: Square Feet: Cubic Eeet• Froat; Depth: Height: Square Feet; Cubic Feet: �ype of Construction: �� ;; , Estimated Cost: $ ;�, ., );� ,�� ,,�� • To Be C+omplated: The uadersigned hereby makes applicativn for a pexmit for the work hereia specified, agreeing to do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Departxnent of Buildings,�and hereby declares that all the facts and representations stated in this application are true and correct. � ' � � � , K, � � DATE : ""�. -/ �'" `� "'" S IGNAT[T1tE : -�= ° ` '� ` A ��` �� ;�� (See Reverse Side For Additiona.l Information. ) �..��' � � _�, _-� _ x, , � - _ _,F , _{� � � l- _ . ��_: ��.` �a�r__ — �� ' '�� ,: ��„� � . : �_�.�.4��,�-y . r � 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 existiug 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: Type 1, 2 S� 4-$2.15 for each 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 computing fees for building permits, the cubical conten�Cs of any building or addition, is determined by multiplying the ground area covered from a point si.x (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 main gable of a pitched roof. For repairs or alterations to an existing 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. .� In no ca.se shall the fee charged for any permit as set forth in Section 2 be ].ess than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for c�nstruction will be issued a minimum of 24 hou�s from the ti.me of application, to allow for proper review of the psoposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certi£icate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for wtiich a building permit has been issued; and said structure shall not be used or occup�ed�until a Certificate of Occupancy has been issued. , � � � � , \ \ � SUBJECT P ,' ° City of Fridley � 19 3 S 5 BU ILDING PERMIT - AT TH E T OP OF TH E TWIN S ' r � � RECEIPT NO. COMMUNITY DEVEIOPMENT DIV. r �~ � PROTECTIVE INSPECTION SEC. � l L� � � j � `..__� �'��,`, CITY HALL FRIDLE� 55432 NUMBER fiEV. OATE PAGE OF APPROVEO 8Y j� 612-571-3450 910-F15 4111�88 � � JOB ADDRESS 1365 Hi.11wind R�ad N.E. t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Lakeland Eiei,ghts SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP' PHONE Gerald Herlofsky 1365 fiillwind Road N.E. 571-5902 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Builders & Remodelers Tnc. 3517 Hennepin Avenue, Mpls. 55408 827-5481 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential � 7 CLASS OF WORK ❑ NEW C� ADDITION ❑ ALTERATION ,❑ REPAIR • O MOVE ❑ REMOVE 8 DESCRIBE WOHK Construct an 18' x 10' Addition to D�elling 9 CHANOEOFUSEFROM TO STIPULATIONS Add three more 12" fxast footings v�ith 6" x 6" Posts, � �'�R�rE �� RNI�� RiI�G� H�� IT$ R� pU11�'E� BetorHO� �OEL�C�'�ICakGAS,Etc , P��MB�NG AN� � iELEP a, S( �� Ca � � �dy •a � � � N iJ� 9.� v `�l� V SEPARATE PERMITS ARE REQUIRED FOH ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCV OROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTAUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED 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 �F LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED WITH WHETHEFi SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3 ,750 S�-. SS DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE P VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR CTION OR TH ERFORMANC OF CONSTRUCTION. $S4. SO lAN CHECK FEE TOTAL FEE a { i` � $13.63 $70.01 SiGrv URE Of C 7RACTOR OR AUTHORIZED AGENT � TEi � HEN PROPERLY VA�I E THIS IS YOUR PERMI SiGNATURE OF OWNERIIf OWNEA BUILDERI IOATEI BLDG INSP �a l �� N�� [ ] ADBN. [�Q pLTER. [ ] Construction Address . , t City of Fridley R-1 AND R-2 �. Building Permit Applieation ��C/� %�/�Gt� r � i� Le�al Deseription: r� =' � �- a � Effeetive 4/1/86 — ,L ; - � , � _ - `� Owner Naate & Address : �° �� ° �" s� Y Te� . � � -7i -' yo Z Contractor• '��F�S � �� -LNG� Tel. � ��"� `�� Address: 3�17 fFes��,�ih i4-I�G !'`It�s 7''�� SSy�� Attach to this application, a Certifieate of Survey of the lot, with the proposed construetion drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Len�th i�J � Width �� Height Sq. Ft• �O � GARAGE AREA: DECR AREA: �— OTHER: (�a Corner Lot [ ] Length Length Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. xaG.�3� -�- 3?�N Inside Lot [] Ft. Yd. Setbaek Side Yard Setback Type of Construetion: 3 -S��-s°�' (�°�`� Approx. Completion Date: Estimated Cost: $� • 3��v Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation $ 6�� ..�� - g y � � DATE: 3 -�6 � APPLICANT: Tel. � CITY IISE ONLY Permit Fee $ �� Fee SchedulE on Reverse Side Plan Check $ - .� 25°b of Building Permit Fee . State Surcharge $ �� 0/$1,000 Valuation SAC Charge $ $�5Q per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ � Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS• � 9 7C� • b � ,,�, 3�M�.fl�� Z��— � o o✓ �� ,= ti . 3a. s� bb . .,- a �J� �� BUILDING PERMIT FEE SCHEDULE Tr.c Ch�ef building Offici4l shall, before issuing permits for the erection of any ��Iilriing or structure� or for any addition to any existing building or strueture, or for any alteration or repair to any existing building or structure, upon applicatio n tY.erefore, require the payment by the applieant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: Tota�-Valuation .�t.00 to $500.00 Fees $10.00 (Mi.nimum Fee is $15.00) � W501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for eaeh additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.OQ for each additional �1,000 or fraction thereof, to and including $25,000. w25,001.00 to $50,000.00 w50,C01.00 to $100,000.00 �100,001.00 and up $170.50 for the first $25,000 plus $u.50 for each additional �1,000 or fraction thereof, to and ineludin� $50,000. $283.00 for the first $50,000 plus $3.00 for each additional $1�000 or fraction thereof, to and including $100,000. $433•00 for the first $100,000 plus �2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCRO�T (Concrete Curb Streets Only) klternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13•50 Alternate "B": Reaoval and replacement of curb and gutter and install a 3 foot wide approaeh 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 onee it has been constructed will be required before proceeding with the framing. s �, n ` �a, ,, .., �.. �. N� ; -- --- ---- - -- ____ - -, ` �.,CJ �..�� ` � ��`� T\ � � 1 �\ �. � . � t � � � ► i� o � � � � � t � x ; 1 W ? ' � '� r , e �` t ; G � « � v u : ` c � � ^� r � t = r ` � .s � � � � , '- ; � ` ? a d � S � o Q � 4 o � ` 3 v� N � b %� Y � ��p t a`` `' , � ' .'+ - e e � o • � e � ` i � � f , � . ' � �- , s s + � r — c � � � +r � �f �, ; � = e C t � ` 4 � � ` C � � O � ` q � �, , 3 6 q: d �► w b � t ! � � � �. p �• � � � +' � � • � t . �,a� � . .o M � p ` �O O � r' � � a � f • � ' � � � � $ c ? < <r * �+ ► � � i Q � � - t � e � � Q r C v C� �� 3 . : 2 � : t ,� � � ��t��°� � t � * ` Q��`" � 0 � � � � °' 3 �1 t < �� n � t� A 0 ? 0 � y c 1�� x � � � y F � s � • � .r �x ,r [ r t �. v � ' � � u � F � a .,� � _ �1! � �i� os L� ea �—_r _... s�. — � �' ��, ��` 3 h I � �-.w �..� �� 1' � � I � I I R �'� I ...., .! � . J ..� c� � � � � � � " 2 �► �► i ; � � 2 %-- l� , . v � ° � � '�, � ` ` � 1 � I 7 � � � `r �- � �I � I 7 � �:, � � � r� � I ` � � N ,,ie 1 �``' `'• ow 1� i�O N 1 [r1 . "� � �a ._...� . . . .. ...� ... L —__1.°_____�� ,` . ��. � r�\, e � T ,i __.._.. N .� _.,,- . � ..__ � � :. � 1 C r y� �. `tZaa� ,�..�.. 1 ` O u � ` .. •-- '��., y � � 4 � . .. ._. .. � w ,:. __ ..:.._. ; or _..._ . � 11. _ _. ..._� �� a� Y. i� � e 0 O � r 0 0 � � � 1 i �� 11v �� r� � � � V � .� n � � � � � � � � � � - f � -* o ' ,. � � � c � Q � U w� d � _ � ;� � ._ .�, �, BUILDING PERMIT Village of Fridley, Minn. N� 2 2 01 �, :, /�;_;� Date'� . r .r ,� . . f'� . . . . . . . . . . . . . . . . . . . . . . . . . . Owner .. � � �.� �f ..�.�;��. ............ Builder ....��! ........................ � . Address �*.,��.�.�'i:f....�.�....1�� .................... Address ......................................... /�(�` LOCATION OF BUILDING No. . .,��.`...�. . . Street . � ;l��-�/.f:-d�L�'. . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . Loi ................ Block ................ Addition or Sub-Division ....................................... .. Corner Lot . . . . . . . . . . . . Inside Lot . . . . . . . . . . . . Setback . . . . . . . . . . . . Sideyard . . � .'•�?lr . . . . . . . . . . . . . . . . DES�CRIPT[ON OF BUILDWG To be Used as: �� 6a � � ��,� a • :�.-i:�.�.�w.r.r�: . Front . .� :�. . . Depth .t � . . . Height . . . . . . . . . Sq. Ft. . . . . . . . . Cu. Ft, . . . . . . . . �� .................... Front ........ Depth ........ Height ......... Sq. Ft. ........ Cu. Ft. ........ '�� }►L""E��"' `�" � �{ ��r. � Type of Construction ..:�`::�;�:•..�:.. Est Cost .+:�"' :... ................ To be Completed ................. f`�L^G.�'r!` ,l�,T�.Gar- +.-� .�c:.�.,.T .i��'��;�'' '`''(d"'.,'v,viss�+,�+ -�`W"'�'4'�t� «^r"�''�t, �'�G`dr �J'°�'f '7 �i� + ,f+�j'M`�fs�'�" ,�' �?�is.+��s`'� In consideration of the issuance to me of a permit to construct the building described above, I agree to do Y.he proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. � �� !l . , ��'',:� . . J►.p� � tJ� �; �'i � .�"'.,`W' ,�.r,�,tR4� . . . � J':y. � . . . . . . . . ...,- . „ ,�. �In con�deration of the payment of a fee of $. ..:..., permit is hereby granted to ` ' -'• •: � . °: .° �:! . . . . . . . . . to construct the building or ad dition as described above. This �p . • � 't .is. granted upon the�express condition that the person to whom it is granted and his agents, employees and worlmien, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of �'ridley, Minrtesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time u on violation of any of the provisians of said ordinances. , T��.� , „ a #,/ � ��y�� .;r .� - -- . ,s�.�': . . �': . . j�'.-� � �: .. . . �: : `p; . . . Building Inspector NOTICE: This p,ermit does not cover the construc�tion, installation or alteration for wiring, plumbing, gas heattng, sewer or Hiater. Be sure to see the Bullding Inspector for separate permits for these items. 3uilding nspections 763-572-3604 ir�aa: � �� fITE ADDi�F.SS � .�i /o i7-IIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATTON PROPERTY TYPE PERNIIT TYPE �E oF woRx: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY — � � YOU'R�, rE-/� L ADDRESS 5 /�i /�i�s � � � /'td � �� I�'SWNER OCONTRACTOR Permit No.: Received By: Date Rec' d: r ' � � �°' �° AnnxESS: � 3 � � l�, �/u , , � d i2 d crrr ��. , �/e � s�rn�� PHONE: � / � — .3 � /— % i 9 � . .�.i STATE LICENSE � EXP DATE ADDRESS: CITY STATE ZIP C'+3'�INGLE FAMILY/NEW CONSTRUCI'ION � TVJO FAMILY/NEW CONSTRUCTION ❑ BASEMENT F[NISH GM�OOF O DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER O SWII�M�IIJG POOL DESCRIBE �VORK BEING DONE: � � � � SIZE OF IlvIPROVEMENT NUMBER OF SQUARES _ /� ° ��— GARAGES PROPOSED SIZE: PROPOSED HEIGH'f: SIDING D Vinyl 0 Almninum ❑ Other WIIVDOR'S IN EXISTING OPENWGS DYes �No OR FOR NEW OPENIIdGS-DESCRIDE S1ZE OF OPEND�TG CHANGES & TYPE OF WD�iDOW TO BE INSTALLED ❑ HOUSE & GARAGE O ATTACHED GARAGE ❑ DETACI�D GARAGE ❑Soffrt ❑ Trim ❑ Fascia LACATION OF WINDOWS NUMBER OF HEIGHT �ASEMENT REMODELING SUBMIT: 1. Existing Fioor Plen 2. Proposed floor plan 3. List of sfi»ctural members to be used Ft FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMTf: l. Site Plan/Survey showing the existing structures and proposed project 2. Two sets of construction plens 3. Energy CalcWations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LJSING 1997 U�.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �, OCCUPANCY TYPE Pemvt Fe.e Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Totat Due $ �.v9 $ 1 _ Ca �� $ $ $ $ $ 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) $1550 per SAC Unit (Plans to 1VI�CC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT /"�i n „ �� ✓! � �-%l0 PRINT NAME / �r,... �./ /1,�,�/.� � �/� _ DATE `1— �"L� — Page 2- Building Residential Applica.tion BUILDING PERMIT FEE SCHEDULE The Chief Buildi.ng 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 buildin.g 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 pmvided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the tixne of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building Inspections 763-572=3604 DATE ' •'� ` SITE ADDRESS _,� THIS APPLICANT IS: PROPERTY OWNER/ TENANT - �� BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY 0 CONTRACTOR I NqME: SUBMIT A COPY OF STATE LICENSE � YOUR STATE LICENSE ADDRESS: WITH APPLICATIOld pHONE PROPERTY TYPE E-MAIL ADDRESS ❑CONTRACTOR FAX i�►�� .: 4 PERNIIT TYPE O ADDITION ❑ GARAGE/SII�1D O WM�WS ❑ BASEMENT FW1SH O R�0F O DRAIN TILE O DECK I�IDING O OTHER � SWIMMMG POOL �rYrE oF woRx: DESCRIBE WORK BEING SIZE OF IMPROVEMENT 0 Permit Received By:�� Date Rec'd: 3� � WIDTH HEIGHT 'A�� STATE ZIP Ft NUNBER OF SQUARES ❑ HOUSE & GARAGE BASEN�NT REMODELING SUBNDT: GARAGFS ❑ ATTACI�D GARAGE �' E��IIg �O°r p�� PROPOSED S1ZE: O DEfACHED GARAGE 2' Pr°p°Sed fl°°r p�an PROPOSED I�IGHT: 3. List of strucwral members to be used g�g�G FOR NEW CONSTRUCTION INCLUDWG DECKS, my1 OSoffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ' ❑ Trim 1. Site Plan/Survey showing the existing swctures ❑ pther . O Fascia and proposed project. WD�iD�wS 2. Two sets of construction plans 1N F.XISTIIJG OPENII�IGS OYes �IVo LOCATION OF WIIVDOWS 3. Energy Calculations OR FOR NEW OPENWGS-DESCRIBE SIZE OF OPEAiDVG CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF�WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ /�Of� OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Sutcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ �'� OZ� $ $ /. J� $ , `�5 $ $ $ $ $ � $ 5L2,o?S 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) $1675 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��able to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT Page 2- Building Residential Application BUII..DING PERNIIT FEE SCFIEDULE The Chief Building Official shall, before issuing permits for the erection of any building or shucture, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for I$2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fra.ction 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 fracrion 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 $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for pmper review of proposed shucture and of the construction site. A Certificaxe 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 Fax: 763-502-4977