AF - 46326a
BUILDING PERMIT
Village of Fridley, Minn. N� 2 3 8 7
�.
Date ��w�.:":':�..�`M.�%/ ............................
Owner �� � . . .�ir. �:�: :<�'Lg � . . . . . . . . . . . Builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.� +
Address � � ��. . . . � �"� r-�+�t . „�,r {. Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOCATION OF BUILDfNG
No. �.� .�s. �. .. . . . Street . ./.�'''^"'t:�"�:':i�"i:#,6 . .���"�?. . . . . . . . Part of Lot . . . .. . . . . . . . . . . . . . . . . . :'"�..
Loi ................ Block .. ........... Addition or Sub-Division .......................................
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ..........................
DESCRIPTION OF BUILDWG
To be Used as:
,,��...... . . ........ ........
� Front . f .�. . Depth . �: �4 Height ,%. .�:�l. ". Sq. Ft. Cu. Ft.
.................... Front ........ Depth ........ Height ......... Sq. F.t. ........ Cu. Ft. ........
r �` � L �
Type of Construction f�Z-D�"!� Est. Co�t".��.'�� ................ To be Completed �A�'.�.�..:.'�.tj.'. ...
� . �.� � �* �
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
���.:� ��1,�,, :i•�,,.k �: ; . f � � . . . . . . . . . . . . . .
�f
In consi ra�ion of the payment of a fee of $. �`��'� , permit is hereby granted to .... r
�'�H�.:�,;,�.... to construct the building ar.addition as described above. This permit •is granted upon
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit rnay be revoked at any time upon violation of any of the provisions of said
ordinances. � �/ ,�""'�� r
. Building Inspector
NOTICE:
This permit does not cover the construetion, installation or alteration for wiring, plumbing, gas heating,
sewer o� water. Be sure to see the Building Inspector for separate permits fo� these items.
,�
sue�ecT P IT N O.
City of Fridley 18200
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � REC .
� `L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � �a-Q�
iI = �
.-_-� � ���,.� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED 8V
i 612-571-3450 gi0-F15 9/10/85 � �
JOB ADDRESS 5236 Hori�on Drive N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. �.2 2 Cc'�r�.SOA. � 5 aummit Manor North SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Bona 5236 Horizon Drive N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Seviola Construction Co. 1Q550 Yres. Driye, B.laine, NIl�T 55434 757-5764
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ClX ADDITION ❑ ALTERATION O REPAIR ❑ MOVE � REMOVE
8 OESCRIBE WORK
��lf� Construct a 20' x 14' Living Area Additi.on and a 198 sq. ft. Deck
9 CHANOE OF USE FROM TO
STIPULATIONS .
Mini�aum rear yard setback is 40 feet.
�IAR����
Before digging call local �tilities
SEPAR,q3E �F��'�°� �� TELEPHONE - ELECTRIC • GAS E�tc,
WI��1��, HEA�� ���'ED ��� REC�UIRED BY LAI�V
� ������ �� �����.
SEPARATE PERMITS ARE HEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
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 OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APP�ICATION ]. 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 $6� SOO �3. ZS
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. SGZ,SO None
PLAN GHECKFEE TOTALFEE
,,Z s — O'� ! $15.63 $81.38
SIGNATUREOFCONiRAC70RORAUTHORl2 AGENT IDATE� WHEN PROPERLY VALIDATED THIS IS YOUR PERM�T�
/
SIGNATURE OF OWNEii1IP OWNER BUILDERI IDATEI � `
BLDG �NS� �aTE
NE� [ J City of Fridle�• Effective 4/1/84
- ------ -
A�Dt� . [� R-1 AFD R-2 j
pLTEA. [ ) Building Permit Application
Construction Address:
Legal Description:
Z► �to -
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�.s� � S�'.
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Ownez Name s Address : �-�A1 A� 5► Z-7i�i •�"10�i� L�r"' �TR �C� Tel . i
s �V �oGo �'Qa�r. �
Contractor: • Tel. f y
Address: i����' ��'S . �iZ. ��.A��3� .,,,�i�1.���3�
LIVING AAEA:
CARACE AREA:
DECR AAEA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, �ith the proposed construction dravn on it to scale.
DESCRIPTIOA 0� YalPROOENENT
Length � ilidth � Height �%. � Sq . Ft . Z� �
Length �`___�__ � liidth �� ' la� Height Sq. Ft.
Length �_ width C� �� Hgt/Ground Sq. Ft. l�_
����c I�.�`� - � 2�9, (� -�- t�B�C �.�7 � �°��� ��
Corner Lot [ j Inside Lot � Ft. Yd. Setback Side Yard Setback
Type of Construction: �� �:1A���`� ' Estimated Cost: S%A�O •��'
Approx. Completion Date: 10 �* � • � � ���
Alt. A Alt B
Proposed Drivexay �iidth If Ne� Opening Is Desired: � 3
See Back Page for Explanation
DATE: _��' `' �
Perait Fee
Plan Check
State Surcharge
_ SAC Charge
Park Fee-
SeWer Hain Charge
TOTAL
STIPULATIONS•
rn �;� �.��-�
APPLICANT: � Tel. � 7 ' ��
Y DSE ONLY
a ���� Fee Schedule on Reverse Side
� I��•�� 25i of Building Fermit Fee
� ��a� �.50/�1,000 Valuation
� �425 per SAC Unit
a Fee Determined by Engineering
�
Ig� � Agreement I�ecessary [] Not Necessary []
�
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s �
BOII,DING PERMIT FEE SCHEDDLE
The Chief Building Official ahall, before issuing permits for the erection of any
building or structure� or for any addition to any existing building or structure, or
for an�• 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 Delow set forth and in the manner herein provided to-xit: _
Total Yaluation
=1.00 to a500.00
�501.00 to �2�000.00
Fees
E10.OQ (Ninimum Fee is E15.00)
�
�10.00 f�� �i�e first �500 plus �1.50 for each
additional �100 or fraction thereof. to and including
�2,000.
�2�001.00 to a25�000.00 �32.50 for the first =2,000 plus �6.00 for each
additional �1,000 or fraction thereof� to and
including �25�000.
�25�001.00 to �50�000.00 �170.50 for the first �25�000 plus �4.50 for,each
additional �1,000 or fraction thereof� to and
including �50�000.
�50,001.00 to �100�000.00 �283.00 for the first �50,000 plus a3.00 for each
additional �1�000 or f raction Lhereof, to and
including �100,000.
�100�001.00 and up
�u33•00 for the first �100�000 plus �2.50 for each
additional �1,000 or fraction thereof.
DRIVEiiIAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Renoval and replacement of curb and gutter only - Driveway vidth plus
6 feet times �13.50
Alternate "B": Aeaoval and replacement of curb and gutter and install a 3 foot wide
approach With 6 inch depth - Driveuay xidth plus 6 feet times �15.75
VERIFICATION OF FOUNDATION
Peraits for construction Will be issued a minimum of 2�1 hours from the time of
applica�ion to a11oW for proper reviev of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, shouing the location of the foundation once it
has been oonstructed vill be required before proceeding �ith the framing.
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CHI1rII�TEY AND BTACR VSRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (�No ()
2. Is free from rust or deterioration Yes (,�No ()
3. Has no foreign objects lodged within
4. Is securely supported
5. Meets all current Code recluireanents for
size and total BTU's connected
6. Has total heating BTU's of '' ��
All other BTU's �/� L�
TOTAL BTU' s 1 I a ��
s�
Remarks � �e C'� � � �� ' � ���5 �i %" C_
Yes ( ) No (�
Yes (�No ( )
Yes (�No ( )
List Alterations Beinq Done:
HEATING COMPANY
� ��i3,d ����i�'I�J� �:y C;�uti��,lN9� �
Signed By •: �n o t����s�A �v��r;�ti;��:� ��.
�., y.;.:��;��d ;�s;�i�, ����� �:�<<���� �
Date ��'���-8���
�
,�C% ps ��°/
�--
HOUSE HEATING TEST RECORD
ADDi�SS�"'� � -� ' �'`' h �'� ' ;k � �-!' '� '� �� �� APT. FLOOR CITY ' ' `�SUBURB �` ���..,�.
OCQJPANT ° -� '� '�: `, '`- �A " �� � � - OMINER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrieol Work' Br �, � Gos Uns By
TYPE OF HEAT GA FA �"<__HW STEAM SPACE HTR. UNIT HTR. OTHER
--- uGAS,DESIGN CONVERSION
� �� � � :"'" �_��L �� �!'� . � l� �-.:d
MAKE �^ � �� MAKE OF BURNER
��
Modsl `� '�'�,��1��'�"k`'-°((_a �y?�"°'� Modsl
+-�<,
Ssrial � � b ���' �� �� � �� � Max. BTU Ratiny
� i y . �;.� .� .
INPUT � . � +� ��» MAKE OF FURNACE
c�� � __,
Model
-_,r �� CONTROLS � E�
ti - °' i- ° _ _, _
THERM ,STAT 6 � « u -� �— - — -;<� _ : _:.r- --- - _._ T,.
Q z Heat Plug � vsnt Size
Valvs � ���� �� KIND OF LINER �� SIZE � A NONE
Limit � �� � �� � �� Drah Hood .,Reyularor
Limit Sstfing "'�'� Filters Sizs � umbgr
Fan Setting , Chimnsy Loeation 4lnpide ��c' r� Outsids
Pilot Type I. `u'.`�' i � Chim�ey Construdion ��_� �p�l� ��:� !+_'`1
Pilot Make
Pilot Model Smoke Bomb Wiring
,.
Pilot Timing Draft �'`� � �'"°'� Tsst Top �� '
L.W. Cut Off Daor Prossure Lightin9 Insf. ��
� k, r_ f ,^ .,, ..
Proasure �_��. — � Percenf CO2 = -�' Date Testsd � ��� "°{� �`� , °
�
� Pareent 0 ?� " '.� ` � ��' � �' - f <�-°`-�
Input CFH '� V Z � � Company Testieg � � ,��� �" °� �� �! �:� ,-^
Staek Temp. ��� ���!� � PeFCent CO � � Name of Teater � � � �P�� `j.,�� "F} ti�
Form 235 �
SuBJECT
City of Fridley � � � � �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � COMMUNITY DEVELOPMENT DIV. RECEI T NO.
� �~ PROTECTIVE INSPECTION SEC. �� `� j - �
r ; �
,
� ,
;
`._-_ �;�'--,.� CITY NALL FRIDLEY 55432 NUMBER REV DATE PAGE OF pPPROVED Br
i �� 612-571-3450 910-Ft5 10/1/96 / /
JOB ADDRESS 5236 Horizon Drive NE
1 LEGAI LOT NO. BLOCK TRACT OH ADDITION SEE ATTACHED
DESCR. 12 1 Carlson's Summit Manor North Addn SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Bona 5236 Horizon Drive NE 572-1023
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO
Same
d ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDHESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Interior alterations to kitchen and bathroom
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEpARATE PERMITS REQUIRED FOR
VY'1RIIVG, HEATIIVG, PLUNi�ING AN� SlGNS,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV lOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR Alq CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHOHIZED IS NOT COMMENCED WITHIN 60 DAYS, Ofi IF CONSTRUCTION
OR WORK IS SUSPENOED OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO @ @
WITH WHETHER SPECIFIED HEREIN Ofi NOT. TFIE GRANTING Of A PERMIT W2S�OOO y�12.SO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE
P SIONS OF ANY OT TATE OR LOCAL LAW REGULATING CON-
TRU ION OF THE P FORMA CE OF NS UCTION. �3�F9. %.5 Fire .SL' �25.0�
PLAN CHECK FEE T L FEE
.�-� "� $387.25
SIGNATUAEOFCON'AACTOAOAA MOA�ZEDAGEN7 IDATEI N Pfi Y VA AT D HIS IS VOUR PERMIT
w ��., ` �
SiGNaTUAE O: OWNER ��c OWNER BUiLDERi �DATE� G�NS ���TE
NEW
ADDN
ALTER
[l
�]
[]
ConstructionAddress:
Legal Description:
Owner Name & Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
�����
C
�' oZe� � \`�.
- \� �al��
0
Tel. #
Effective 3/1/96
�S��,m6rt
��1.`
�� I ���
Contractor: � �� MN LICENSE #
Address: � �, ,�cs � Tel. # � a�n�-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
DESCRIPTIOli1 OF IlVIPROVEMENT
�n� Width - Height S�. Ft.
�n� Width Height Sq. Ft.
� Wid � Hgt/Ground(� _ Sq. F�
� - � � ��c-�� �.� � �e� �G�
Corner Lot j] Inside Lot J_ F. Yd ack Side Yard Setbacks
Type of Construction: �c7� ��rv�� F,��a� Cost: -
. . . s 5,��
Approx. Completion Date: � ' . . ..'
Driveway Curb Cut Width Needed:
DATF: I � °'� `-� APPLICA
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
(Cos t on � Back)
+ 6 Ft = -,�CJ ! � - $
� �� Tel. # � - (��
� - �� � �1��-���C
CITY USE ONLY
$ r`7 � Fee Schedule on Reverse Side
$ � , � .(�1 of Permit Valuation {1/lOth%)
$ /2, � $.50/$1,� Valuation
$ $900 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 ��
BUILDING PERMIT F�E SCHEDULE
The Chief Building Official shall, before issuing permits Por 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 $100,000
$100,(�1 to $SOO,OOQ
$SOO,OOY to $1,000,000
$1,OU0,001 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,Q00
or fraction thereof, to and including $25,000
$349.75 for first $25,(�0 plus $9.� 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 frac�on thereof, to and including $1 fl0,000
�887.25 for first $100,000 plus $5.00 for each additional
$1,�0 or fractionthereof,.to and inciuding $SOO,OOU �
$2887.25 for the first $SOO,OQO plus $4.25 for each additional
$1, � or fraction. thereof, to and including $1, 000, 000
$501�.25 for the first $1,0�,� pius $2.75 for each additional
$1,OQ0 or fra.ction thereof .
DRIVEWAY DEPRESSION ESCROW
(Concrete C�xrb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.�.
Alternate "B" : Removal and replacement of curb and gutter and insta.11 a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it� has it has been constructed
will be required before proceeding with the framing. .
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sue�ec, PERMIT NO.
c�ty of Fridley 2 710 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
� �y------ � �./�✓��
r � � PROTECTIVE INSPECTtON SEC.
�
i� _ ,
_---� �"','� CITY HALL FRIDLE� 55432 NUMBER REV OATE PAGE OF APPROVED BY
t 612-571-3450 9�aF�5 8/11/98 / /
JOB ADDRESS
5236 Horizon Dr
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 12 1 Carlson's SUmmit Manor North SHEET
2 PfiOPERTY OWNER MAIL ADDRESS ZIP PNONE
Ro er & Jane Bona 572-1023
3 CONTRACTOR MAIL ADDRESS ZIP PHONE �ICENSE NO.
New View Const Inc 2355 Ben'amin St NE M ls 782-8535 3894
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGtNEER MAIL ADDRES3 ZIP PMONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION $K REPAIR ❑ MOVE O REMOVE
6 DESCRIBE WORK
Reroof house and ara e 29 S Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTIIATING OFi AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WOHK IS SUSPENDED OR ABANDONED FOR A PERIOO OF 120 DAVS AT
ANY TIME AFTER WORK IS COMME ED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY TNAT I HAVE D AND EXAMINED THIS APPLICATION STA�LS GARAGES
AND KNOW THE SA TO BE TR D CORREC7. ALL PROVISIONS OF LAWS ypLUATION SURTAX
AND ORDINANC OVERNIN T IS TYPE OF WORK WILL BE COMPLIED
WITM WHETHER IFIED H REI OR NOT. THE GRANTING OF A pERMIT 2/�.1$ �1.21
DOES NOT PR TO GI E A THORITY TO VIOIATE OR CANCEL THE pERMiT FEE SAC CHARGE
P OVISIONS F N OTH S ATE OR LOCAL LAW REGULATING CON-
S RUCTION R PERF R NCE OF CONSTRUCTION 7(}.7,rj �Z.LFZ Fire SC
PLAN CHECK FEE Tp L FEE
5 0 c ns 83.38
ATURE OF CONTRACTOR OR AUTMORIZED AGENT ionrEi • NEN R A I T D THIS IS P IT
/
I /
SiGNATUAEOFOWNEPiiFOWNERBUILDERI IDATEi , _ .: ,� B �NS � ppTE
NEw
ADDN
ALTER
[]
[l
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
I�O
�^ ` A1 ��
ConstructionAddress: ✓ � �1� �I �21� � ((L
Legal Description:
Owner Name & Address: ��%� � �� � �� h� �r Tel. # ,�' � Z. � 1 � � .�
Contractor: '�1� I F1—Vt� ��(��a'., ��� MN LICENSE # t�� � 3� g�°
Address: �i�.�a'� ��7�P�Y1'►� ,� ��'� � � 1��.'a Tel. # � � � — � � '��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
�' C �c�-�o . � � ��-r' � l��C' -
- - � �� G��
���f.� ��%
Construction Type: _ � _ _ - " � — ^� • n fl�A �� �tnnated Cost: $ ' ° �C� �
(F e Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 — t x$ _$
DATE: � � l '� APPLICANT: Tel. # `� � � ° � � 3 �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ "J��S�
$ �• �
� /: � /
$
$ � • f��
$
$
$
$
$ � �°
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,0� 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 [ ]
� : -- -
BUII�DING 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 $100,000
$100,001 to $500,000
$5�,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, 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 $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,Q00,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof ,
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been copstructed
will be required before proceeding with the framing.
*
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C� l I OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 7, 2003
Mr. James Bona
5236 Horizon Drive NE
Fridley, NIN 55421
Re: Final Inspection at 5236 Horizon Drive NE
Contractor: River City Sheet Metal Inc
Dear Mr Bona:
A mechanical permit was issued on June 19, 2001 to install an air conditioner at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date the inspection has not
been requested.
The permit fee that was paid covers the inspection to make svre the work was completed
according to the Codes.
Please contact us within the next 30 days to schedule this inspection. To set up the
inspection or to have any questions answered, please contact the Building Inspection
Division at (763) 572-3604.
Sincerely,
DJ/mh
�
11l01;'��;E5 15:1? ���9°59
,
TIh�1B�P.!�°tiFT ''GE 02
��� -��-� �
RI�VJ � I J CIIY OF FRIDL�Y �flectiye 4/72009
--revura [� 6431 Univ�rslty Ave NE, Fridley. MRJ 55A32 (T63) 672-3604 @Idg Insp
F'+���� f�{ Slld��� �AMILY AND DUPL�XES R-9 AND R-2 (763) 371-1287 F8k
BUILD1tdG PERMIT APPLICATION
r�rlbtKa�ti�r� A,�dr��r: _._.. . 5236 tics��.��rb Dri�e 1�;
��., t,�r���al�G.+l�" ��;
�'" l c•�:ud�r rJ �-Subj ls� 5 tt Gi:ain.�c U il �e Al
L:.0 �:�i,:, vw��ui Vrl. Line-
`.:��.•i,_, ii..sii�� �=.t'.LIl11C��:�jz�tyur_�.l—lia�-I' ti i.l��°�t> Gcti han�kj I@�.� �g Y
�u� il� �ti:tu� : `1'ilt���f L- Eci ° � � ��:�q . 7r1�. NIN UCENSE #�62/#
��`���: ��� ������ ��-��,#� �� Tel. # 651-633-8611 ^
tJebj BrlytYtOii, IpIIJ 55112
Atiach to this �pplication, a Cert�cate of Survey of tlte
bt, with the propo�ed Construction dre�wn on it to scale.
�IVINu l�R�A'
t�/1FtAUt Altl=1�:
DESCRIPTION OF IMPROVEMENT
�enycn lydi�tr� � i-ie��nt sq. F�.
LuuyUi 1�'di�,ltti FIEi�I�I Sq. Fl.
t���1C J�RGA: Lenglh
OTt-IER:
V'Vic�tl'i 1-Ig1/GI'Ound �_ Sq. Ft,
Gonstn.�e;tiort Type: S�orm � n� _ t'�nai ra Estimated Cost: $ 20.000.00
Di ivew�y Curb �ul Width Need�d: ��ht, + 6 Ft =,,,�Ft x$ �$
c�. .�, _.!.��;�;�;1 i�!� �1►°F��t�'APJT: L�,��u, Lucl::�i� `i'o1./1 651-633-86� 1
�:��� (7'Q:j)1�7'�P3�u�t i�r F'UniUt Ft�s iF rn�llf�►� 1�� a�alictttlori. f�x to T63-�7 `1-1287 if usin� cred9t eard and we wlll catl
yu� ic,r G�r'�I nuuib�e.
�emiit Fee
Fl�n R�view
Fir� �w�cl-iar��
S�ate Sur�h�ar�e
��,C t: I��d�c��
Li�e:i i;.e �w ul idr��:
Lui'L- Cut ��i��uw
E�o�ion �;onirol
Park �ee
�dwei Main Ch�rge
1 �;�1'�"�,�
��. , � . �
CtT'Y IJgE 4NLY -
$ .o�J Fee Schedule on Reverse Side
� % �5% of I'errnit Fe�
$ �� � .GG`1 uf Rc►iilit ValuaGuti (`I/10th%)
� ��0� $.50/$1,000 Valuation
`� �13�� �a�r �,�,� 4�nit
� !� c �%� ��.u� ��tai� Li�r��s��l i�e�ider�ti�l �ontractr�r�l
:1 Alt. "A" ur /�Il. °B" Ai�ove
� $�150.00 Cur�seroation Plan RevieW
� Fe� �etermin�d by Engineering
� A�reerr�ent Mecessary [ j Not Necessary []
°� -�.es�-,�. STIPIJLATIQNS:
11/01/2905 15:26 6338859 TIhiBERCRAFT P�GE 01
T
TI��������
�a ���d���►�,a �a��h�� �w
Idew �Ir'i�1�i�n, IVIN �5`112
Phane: t�59d��-8611 Fex: 851-�3.�-�868
_�
�u: uuN�lii iy li �;��!�+Lli��il;: F�um: L��I�y �ona
(�un�Nt��►y�
pi hflClloy
����sa
(Including Cove�s��t)
�nx M 1 7�3•571-12�7
Phera �! : 783-572-36�9 Bete: � //-� ` p S�
Rwo Petmft Ap�6c�tk�ri �C:
(-] �r,����t ���r �ev��w L� pro,�.a �o��t �I ����e ab�h LI Plssas ttueyele
Pi3ase prucess tho attachoG porrni� appllcation. I►�ould like to pick up the peRnit on Monday. �t you
cai � iet n�e know il�e cc�st I�vill bi i� ig In a che�k when � is ready.
We are rspaUing the properry dus to storm damage. The repairs entall new rooiing, new slding and
u �ter�car p�t�n snd Ralni.
1/ t 4 �
W �� � �,J�
�� �.' I/.� _,}! i Le. "✓'!. � s..G G' f`1 ��� i G�� C`�' l,d��'a •��.
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11%�l%GbaS 15•26 6338859 T BERCRAFT
. � PAGE a3
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