AF - 46377BUILDING PERMIT
Village of Fridley, Min.n. �0 2 4 2 3
Date � � � .,T.".`: .'�! . � . . . . . . . . . . . . . . . . . . . . . .
Owner �� :�':�..�r. ...�:"���!* �"`.►�� Builder .��°'`.`�.�' ... ...... .. . .... .... .. ...
Address ��:''G�'f�.. �%��a�� �.es �. . Address .. .. .... ...... ..... . .. .. .. .... ........ ...
,S4y� LOCAT[ON OF BUILDING
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No. .�..... Street ...���'���... .......... Part of Lot .......................
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Lot . . . .. . �.. . . . . . Block . . . �/i0�. . . . . . . . . . . Addition or Sub-Division :���"`�� ;+?�`�!�;���; , , . . . , .
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Corner Lot . . . . . . . . . . . . Inside Lot . . �. . . . . . Setback . �.1�.'�. . . . . . . Sideyard � y". . .�_':' . . . . . . . . . . . . . .
To be Used as:
�`/.'�.',��C:���. . .
DES�CRIPTION OF BUILDING
Front . ��. . Depth . �. . i3eight �. �l? !. . . Sq. Ft. .�.�� Cu. F't, . . . . . . . . �
. .. . . . . . . . . .. . . . . . . . Front . . . . . . . . Depth . . . . . . . . Height . . . . . . . . . Sq. F't. . . . . . . . . Cu. F't. . . . . . . . .
� ���Type of Construction�:'��.�":�. . . Es� Cos .��,��'�� . . . . . . . . . . . . . To be Completed . � . :�!�" .
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 villa�e of Fridley.
...................................................
co ideration of the payment of a fee of $, .+!� ..., permit is hereby granted to .!�: �:���. .. .�: :�. ..
-�� ..�.'�.��"f�:�:'....... to constxuct the building or addition as described above. This permit fs granted upon
Y1ie express condition that the person to whom it is granted and his agents, employees and workmea, in all work
done iri, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding locai3on, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinanCes. "
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.. Building Inspector
NOTICE:
This permtt does not cover fhe construction, installation or alteration for wiring, piumbing, gas heating,
sewer or water. Be sure to see the Building Inspec4or for separate permits for these items.
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City of Fridley, Mi.nn.
BUII�DING PERMIT N� '7330
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Owner Builder ._. ���
Addresa.___.r.__._...— ��.._...___ Address _____..—_.._..__..__.__�_.__.._._...
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Na _� Street _W.. _ � . .:a►P Lot
Iat .._._.. �__ Block _.�.� ._. Additi� or Sub-Di on ��
Coraer Lot ____�____ Ineide Lot .__._��.__._. Setback .�l�O��"�- - Sideyard
Sewer IIevat3asi �— ...____._ F datia� Elevati�
DESCRIPTION Of BUILDING
. F�ont -ck'� Depth �� Height .�� Sq. F'L .��L��7`� Cu. FL �'."`�'_
Zj�pe of Ca�stivctian P'ib +...___.._.__ DepEst C6�t �L H' ' t�.� ���� �Cu. P't. _.._.
���
In consideration of the issuance to me of a permit to construct the building described abave, I agz+ee to do
th� propo�e8 work in acoordance with the d�scriptioa above set ��� �nd in c�om •! wlth all proviaions of
am8inancea oi the dty of F�idley. � � �
In caosideration o! the payment of a fee of �..r._._....._.., perinit is hereby graated to._._. ___..�
to oonstruct the building or addition as descrlbed above. Thispe rmit is granted upan
the express oonditiaai that thepe�on to whom it is granted and his agents, employees aad worlmzen, in all work
done in, around and upon said buildiu8, �' �►Y Part thereof, shall contorm in all respecffi to the ordinanaes o�
Fr1d1eY� Minnesota regardin� lacatia�, conatructio�, alterati�, maintenanoe, repair and maviu8 of buil�g�
wi� dty ]ia�its aad th�s permit may be revo�ed a t aqy t�n� i�p/ l aay � the P�'o�ot�s of sa�d
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1M lYiWip ��tlee far �paah Pwwhs /er fl� ih�w
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APPT.ICATIQp . FOS ��TII.DING FEPA'IIT . .
CITY bF�FRXDQ.EY, MINNBSQTA.
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.d �i � �;snvvxsss �� � r� 71�'.' .
: .s�aice,�to� oF st�r.i� .
DTo. �P.� .� � � . Str�eC . �,�t� o� Lot
i...�.�n � i i. . : ■..r• .. +ir+--�e�+►-- . .
Lot Block Ac'tdiE�oaa P� Subdivi,aicm �� �.� .�����
:, , . � _ � .
Caraer Lot`_Inside Lot � Setback � 3,fde�Y,a�d � ,
SBWBB ELBVATIOp FWND�iTI� ffi.BVATIO�
Applicant attacb to this fo�4m 1�io.�er�i�ic+�tes of.Survny of Lct,aad pr.ogosed build-
ing locatian dra'wn a►n �'Ctiese Ce;ti£icat�$.. .. > , .
DB3C�tIPT10N OF BUILDING � .
To be used aa:
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r�ront o� � ����..�h � �- �,ei,g�t
Sq. Ft. 7A ! ..� Cu. Ft. U
Front Dapth �Height
,,
Sq. Ft. Cu. Ft..
Typn of �Constriictian �/l�ra� -°—� "
, 8atimated Cost � � 7�
To be Com�iiated " . .
The undersignad hereby�makes applicatioa for a pesmit for,the �urk her�ia specified,
agreeing to db all work in strict sccordsace �rttii�the CiCy of Pridley Ordinaaces and
rulinga :of the Departmeat of Bufldiags, �tnd herebq ;declares .tiut _qll the faats snd
representatidas`'stated in tbia applicatiat sre true.iu� corr�at,,
.
UAT8�0'%�� � 5���.�i 7 SIGiiNTtT�tB
7—
�Schedule of Pee Costa caa be found aa ths xeverae Side).
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BUII.DING PERtu,'T FEB S�DULE
Sectiaa 2. The Inspector of Buiidfngs'�sbail,`before igsuiag my permit for
the erection of eny building.or structure, or for any additioa to aay e.:iat-
ing building or structure,'or for anp alteratidna or repeira to any egieting
building or etructure, upoa application tberefor, require the p�ymeat bq the
applicant far such peFmit of feea te the amouat iLarein belaw set fortt� an�d
tq tha aaaae� .her�e3�t ��pvided to-wit:
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�2.!s, �or aay +ach ae}�i„t for the erectt� oi aa� f'#�re-�pof fil�tld,t�g, other
�t�► $ '�ar+�8$s .iaar�ad,-- �aatory or grai� e'1eve�ai, � � the �erection of _
!�y fire-proof addition, for similar occupancy, ta auy existing buildiag
shall be at the rate of $1,40 fpr e�ch oae thousaad cubic feet, or fractioa
thereof, in such cubical coate�ts.
_ 2,, 2_ Fbr any such .pQSmit io�c� � tha areotion of at�► -i�re-pr�p� gys�age, . aarehouse,_
faktary p�: gra#� eT+vator, os for the erectioa af a�� fire-proof add�ai.o�,
:f� id,mi�`�c occizpancTy,. to afny �xieting buildiag -sha be at the rate bf $1.25
for each oae thousaad cubic feet. clasai�ied as "fireproo�" by Section SG2 of
the Mianeapolis `Bui�dfizg Coda. , .
HOUSSS ; , :
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2.3. For any euch petmit for the erection of �aiq'.uo�i-ftrepropf bui�dir..� ol:�er
th8a a garage, warehouse, factorq or grain elevator,�or aay naa-fireprc���
addition, for aimilar occupancy, to aaq existiag building - pertcit $1.40 for
each oae thousand cubic fe�t,.
GAx�S
2.�_ For aay such �eYmit for the er��ri�� �r R<�; r.,�n-�:±a��rcN,f g�xa�a, .
��auae, f�tory a� g�aia elevator, �• ':�.. a.�z�> F�e:-?::�c+t� a:, �rc� non=�f�s, pr�oo#
addi.ticn, -�or�-e3milar occupaacy, to =}-;� ,�.���.s ::�,r.� i:�:.;.;.�;.;:o or for each s�.ch �
__... .. . buil�diag or eddition - t�ivaty r_a�. �!�c'. ':�.� t i�c �r���'. one thcc:sand culai� feet
or fractiai thereof, ia the cu�ic�l =-.��� �n;.:� c;.�r�ci with a minimum of $4.00.-
For the purpose of caaputiag feea £�,r 'v�. '�.=.izs�; p3xtai � s� the cubical coatents
af any building or additioa to-a uaficw-:� � e���:t tlir���;hout by multiplying the .
8re�acl 8see covered frem a poiat aix (6) in�ches �eizw the floor ,liue of ,�he
bas�t ot callar to the average l�eight of ��� �:•rr�er aux�ace or to the �
average height of the rooi surface of the maiu �aule of a pitched roo�E.
2.5. For repaire or alteratioas to an eacistiag structure, tbe fee shall be
at the rate of $3.00 per eaCh Five Ruadred Dollsrs ($540..00).;or ise�ctiqn -
thereo�` in rhe tcost of e�ll p�opooed � work. ,
2.5. ia no case shn11 �he fee,_charge$..for.aay pes�it a$ set forth iu
Section 2 be less_ thaa $4.D0. ,. _
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City of Fridley, Minn.
BUILDING PERMIT
��: � May 28, 1968
�a�
N� 9'768
p�r; ___„R�ald 2g� _,_` g��. Solmica Midwest Inc.�...__�� _
� _._.�...._.—
Adar�s __. 5 025 __. Hughe s Ave . 212 - 15 th Ave . S out h
_.._.._.._.._...._..._.......__ Address _..__ .____.__..._.._._.._._.__....___.._._.._..�...._.__._.
LOCATION OF BUILDING
No. .._._.S.Q?.� Street _._..__._..I3.l�f�-.g�_A.�.a.__..�.._.----_..._.__...--------.. Part of Lot ._.._..�....
Lot _. 4.......__.......__ Block ._.._._�_____....6.....__ Addition or Sub-Divisiaai -.----.._..��arlson's Summit Manor
Corner Lot ____.._._.__ Inside Lot
Sewer Elevati�
Setback ________.�_._.._ Sideyard __._._._.— �_._..
____ Foundation IIevation .._._.._._..._._........_.. � .
DESCRIPTION OF BUILDING
To be Uaed as:
,� Residin� �,� �t ___.. Depth ___.. Height _—..._..._._ Sq. Ft.
..�._..__..__...._.._..._.____._._ Front _.__.._...__ Depth __._......._..__ iieight ._._........_.__ Sq. Ft. _.._..........
Zj�pe of Construction � Aluminum �� ��$2500_00 _ To be Canpleted
C�1. F't.
G�1. Ft
In co�sideration of the issuance to me of a permit to construct the building described above, I agree to do
th� propo�ed work in accordance with the description above set forth and in compliance with all praviaiona o!
a�dinances oi the dty of FMdley.
`:�(lc.L I! � " "I.�,l
In consideration of the payment of a fee of �.__�..z0._Q___.., pexznit is hereby gianted to.�.. Solmica Midwest, Inc
to construct the building or addition as described above. This permit is granted upos�
the expresa caridition that the pereon to whom it is graated and his agents, employeea and worlQnen, fn all work
done in, around snd upon said building, or a�yy part thereof, shall conform in all reapects to the ordinaucea o�
Fridley, Minnesota regarding locati� constructio�, alteratiaa, maintenance, repair and maving o! buildin8s
withiu the dty limits and this pernnit may be revoked at aTMy time upo� violation of pmovisians o� sa�d
ordiaaaoes.
arence Belisle
NOTICE:
i6k p�ndt doa aof eowr fl» w�roeNee, 6a�aq�Hoe hr vniriN. Pw��W Op �Y. �w�r x wN�r. M wn h aN
tM luiWiao Inip�e/o� hr apuah p�emifs fw fha� IMm�
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APPLICAT;�ON FOIt BtTILDiNG PERMIT
CY!t`Y � 0�' P'�f.E�F; I�Ir�$Q�l'A
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, . � , ;r•� , . ��rl i� Buxx.�±zrw' _ • . t ` �
�o. � � � �' ��� �. s��r . — .�L=
.�,��:;: j �4�i�:;;;sl�.� _., . E -�� . °► %�'� ..:�r..�'��..ADDITION �O�R SUBDI�S�01i �Y�y%.£g�► ✓�' S� n�n� %
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,.'i� ;`le, ,Ft . •.7. t �''' . F�7f3 �"iC��fC: ' ., •. , ,,.,, � ` •
� COItTiE$ �.OT 7NSIDE LOT _ . SETBAC�C�.tr : c; SIDI:iGA�`..._..: !�
SEiJ�R ET.EVATION TC3P OF FOOTiN6
;.. App�iC�a�, a�tact�. tq,�ia foo�o► TNo:;9e�tasz,'o,�; Sur�vey- atf-� Lot aad- pcoposed
' ' . ; �i���..1P��t�:o�. �ReWa at��, theq,,e• C�r,��tl�4 � t s; ... .
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'_, . .i�: '� �' - ��r �a�VN Q�' �f+4a�t�±V�v: :'{' � . :
To Be Used As s� � , • .. � , f a•� � r�a.i � �r; . . .
.r� � � U� ��
, x,�( � .. , •
. :i• � ' Square: feet ,� :.: Cubi� Feet . Y
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�: . : F�r�ARt;�� '.c' � �: �i►�� -� :`�i�t
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Square feet Cubic Feet
Tqpe of Conatruction R~ ^� � _____� NEstitaated. Cost t� ��
To Be Ccmpleted �
The undersigned hereby makes appiicatioa for a permiC for the work herein
specifted, agreeiag to do all work in strict accordance aith the Citq of
Fridley Ordinaaces a�d rukings of the Department of Buildings, and hereby
declares that alI the facts and representatioas stated in thie application
are true aad correct.
DATE _ _ ._ _ _._,_._ _ _SIGNATURE _______ _ _ �.._�
(Schedule of Fee Costs can be found on the Severse Side).
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._ .__ . SE�TIOH 2. The ..Inspectar of Btiilc#ings. sha1.1, .befo�e �slluing. pereaifc�� for
the erection of �tay building or atructure,_or �ox .any.8d$ftibn td sny.
-�. -. .: exiating--structure or �uildiag, or fsr any alteratiaa Q� - f�p�irs .�d atiy
�� existing building or: structure, upaa applica��ots. thereft�fes �r�Q�iire the
the payaient by the applirs�t` for such pertniti' of izes to the emot�nt hereisi
belc�w set forth aad tn th� manner herin pro"vfded to-wits
, ;.. . �
....
. -. :l�E�.Dtiildi�t Gode; `.'Tp�e 1, 2, 6� 4- $1.y5 for each .oee thou�r�rid� c�bic
feet, �r fractioa .t�e,�eof,•: ��.s��• suc� cubical cait�fi�b.. �Tqpe 3� b S- $1.50 for
esc�i oas_ t�+busai�d .cn6tc fee�. � _ .
, _. .. . _: ..
F�r the �tr�'e _'��..tbe�putit� fiies fo= t�f�d��ig �e�qtits, th� , tu'b%cai
� � �onteats �►f eny bt�ild,iqg.,i�- �I�t,�:�tti' C�1 a� 1�d�id�1 ���git�` t�rcwg�h�zt..b9
.., ,•��.multiplyi�ig Eha giFou� a�ea c.olier� ��c�in. ��o�En� a�x� (6) inchc�� beZow the floc
line •f t1�e b�ement or-���f��e�.l� �C/r the�av�rage 1�eight of the upper surface
br t� th� �►ergge height df �h� .�au�f� surface � oi tbe main gable of a
�it�h�� �bo�► : ..
.._ _.._��� r�is#tc�i1 pt ai2terati�i'`to. an esistiug._�rttuctare,. the fee slull be. at the
i�at� of $3.C18 per each five hundred doilare ($500.00) or-fractioa thereof
_.�l..tbe �:c��t a�: a�.-'�'.: Fs'+o�ct�+d avork. � � ,: .
._ ..Ia q4' �* ��� e11e £e� citieucgetl for .anq .p�itinit aa . set farth ia- Sectian 2 be
less �han $5 . 00. : .. . . . .
._ _ _ �.. � • _ � _ ._ . . - s
"�'�liS53D C�nneatien Charges based on locatisis• •Ar�a 1 or 2.
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SUBJECT �
City of Fridley _-16 0 8 2�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT .
' • COMMUNITY OEVELOPMENT DIV.
. �� ------. a � ��
r � � PROTECTIVE INSPECTION SEC.
� �
i
�, � ����1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
----� . ..�
612-571-3450 910-F15 .�f� � / /
JOB ADDRESS 5025 Hughes Street N.E. �
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 6 Carlson's Summit Manor South SHEET
2 PROPERTYOWNER " MAILADDRESS 21P PHONE
Ronald Zemba 5025 Hughes Street N.E.
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Economic Builders, Inc. P.O. Box 20-390 Mpls Mn 55420 432-6143
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER , MAILADDRESS ZIP PHONE IICENSENO.
6 USE OF BUILDING
residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construct 2nd story 40' x 24'
9 CHANGE Of USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAI., PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING Ofi AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ncO
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT �V
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THtS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 29 $QQ � 4..90
DOES NOT PR '7fUTFlaR VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS ANY H STATE OR LOCA W REGULATING CON- 1�, OO
STRUCTION O THE P FOR NCE OF CONSTRUC
PLAN CHECK FEE TOTA�F„�.,�• no
.S J �
� SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI WHEN PROP LY A D T S YOUR PERMIT
- � �r
SIGNATURE OF OWNEii11F OWNER BUILDERI IDATEI SP DAT�
� - _ `
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER �C O.�v u� �, b ��. Yr� �3 ig
SITE ADDRESS SO"L� Nu��ye s �T.
CONTRACTOR �GO p/0 t�r �L t3t...p2 S i itiC, DATE 1- I 5- c�'i PHONE
Determine working square footage of each.
1. Total exposed wall area...... �l¢�.¢¢ sq. ft. x .i85= �/,;z, 6�
2. Total roof/ceiling area... ... iG0 sq. ft. x .0 4= 3�, 9.
a.
b.
c.
d.
e.
f.
g•
Total exposed wall area above floor= %p �q-
Total wall window area ..................................... 6�.�g-,
Total door area ............................................ --__
Total siding glass door area ............................... �.__„
Total fireplace wall area ..................................
Total wall framing area (average 10%)....� 6. Z
Total net wall area above floor ............................ /
' _- �t+�..t . %�
Total rim �oist area .......................................
i ���44
Total exposed foundation area= � -
h. Total foundation door area .................
...............
i. Total foundation window area (includes sliding doors)...,� �
j. Total net foundation area above grade.....�����,����.����� __�
k. Total wall framing area ( average 10�) . . , . . � „ � � � � � � � � � � � � � __�
1. Total nei Wali�framing area.......�,��������..�.����.����.
Determine "U" value of each wall segment
a, e� �.� f° X�,U,� . 4 1 = az 9, l6
.�
b� "'_—� X��U�� �—._� _ •--,
�� �----, X��U�� «—� _ ---,
d. X��U�� _
�—
e � -�'jE , � X��U�� , f � _ �� . J l
f. s� 6�. 7-� X,�U„ ,�-� = 6 0. 6
.
�. /�S,q4 X��U�� ,Q -� = a? )8
h. �-- X�,U�� — _ -��
i. „_' X��U�� _ —1
j� •—, X.�U�� "� _
c------�
k. -----� X��U�� - — _ -�--�
1. X��U�, � ^��
3 ...........................................Tota1 = I�•D�'
If item ��3 is the same as, or less than item ��l,,you have met the intent of SBC 6006 (c)2.
�
� -
_ s
Total exposed roof/ceiling area = cj (��
m. Total skylight area ................................
n. Total roof/ceiling framing area (average 7%)...... � 7,, Z
o. Total net insulated roof/ceiling area .............. ��'ja_�
Determine "U" value for each roof/ceiling segment.
m� X��U�� _
n. � `�, Z g��U�� , t ! 7 = � � ��o
O. �!oZ .� X��U�� , O 3 Z„ - a2 � S '7
4 .................................Tota1 = 3 �• 4 3
If total of 4�4 is the same or, less than 4�2, you have met the intent of SBC 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum
of items ��3 and ��4 shall not be greater than the sum of item ��1 and ��2.
1. + 2. _
3. + 4. _
.
�
�
'�. � I ��3.1. Fraarie R
1 - Interior Ai.r Fi]m .61
2 - �" 5h�eetrocJc .45
. 3- 5�" Soft W�od 6.87
4 - btterior Air Film .61 '
Zbtal R 8.54
Zbtal U .117 �
5
4
3
_2
3
�
3
9" Insulation
1 - Interior l�ir Film
2 - �" Sheetrock
3 - 9" Insulation
4 - bcterior Air Film
Zbtal R
Zbtal U
3
3 -,1�
R
.61
.45
30• 00 , }
.61 a m
31.67 z z
.032 0 � Q .
FYaQne Wall R
1 - Interior Air Film ,6g
2 - �" Sheetrock .45
3- 3�" Soft W�ood 4.35
4- 1�" Fiberboard Sheathing 1.22
5- 7/16" Med. Dense Fidbd .67
6 - �cterior Air Film ,17
Zbtal R 7.54
Zbtal U .13
Insulated Wall R
1 - Interior Air Fi]m .68
2 - ��� Sheetrock .45
3 - 3�" Insulation 11,00
4 - �," Fib�xboard Sheating 1.22
5- 7/16" Med. Dense Hdbd .67
6 - �cteriar Air Film .17
Zbtal R �-
Zbtal U .07
Rim Joist R
Interiar Ais Film .68
2 - InsulatiQn 3�" 11.00
1- 1�" Soft Wood 1.88
3- 7/1G" Med. Dense i�d .67
Exteriar Air Film .17
Zbtal R 14.4 �
�btal U .07
1 A Conc. Blk. Uninsulated
Zbtal R 2.12
Zbtal U .47
1-B Conc. Blk Stripping & Styrofoam 3/4"
& � �� Sheetrock
Zbtal R 6.7 �
Zbtal U .15
.,
�� �.e- ,
LL
0
W
z v�
W W
O O
N �
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Q
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LL
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�- U 2
F� N N
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a
tit Unit
BdS[ri� t UriLt
G-336
G-436
�536
G-44
G-54
G-64
G-55
G-65
G-805
Patio Door
6068
WIN3
WG.LYJ
W3N3
W4N3
W5N3
W1N4
W2N4
W3N4
W4N4
W5N4
W1N5
W2N5
W3N5
W4N5
W5N5
WX2N3
WX2N4
* WX2N5
2832
3032
2846
3046
3446
18-4446-18
Pease 3� x 68
Pease 28 x 6$
Side Lite
*NOt $�C�d2�
AAIDIIZSON WII�DCJ�n1 UNITS
Sq. Ft. Sash
Opening
3.11
9.75
12..6
16.8
14 . 7
19.8
22.4
23.3
27.5
37.5
38.0
5.98-
12.42
18.86
25.30
31.74
7.87
16.35
24.84
33.32
41,80
9.79
20.33
30.88
41.42
51.97
13.75
17.93
22.51
8.4
9.5
12.0
13.5
15.0
34.5
20.
17.7
7.7
�
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
1.85
7.10
7.10
1.85
U
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
� . 54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.54
.14
.14
.54
❑
' }
o m
Lin. Ft. CYack z z
� Z a
a
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8'-0" � .
9'-4"
10'-4"
11'-4"
11'-4"
12'-4"
13'-4"
].4' -4"
15'-4"
26'-g"
18'-11"
10'-4-3/8"
20'-8-3/4"
31' -1-1/8 °'
41'-5�"
51'-9-7/8"
12'-4-3/4"
24'-9�,"
37'-2�"
49'-7"
61'-11-3/4"
14'-5-1/8"
28' -10 �"
43'-3-3/8"
57'-8�"
72'-1-5/8"
21'-6-3/4"
25'-7�"
29' -8 4"
13'-11"
14'-11" .
16'-7" '
17'-7"
18'-7" .
27'-2"
19'-4"
18'-8"
15'-8"
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� � CzTY �r �itla�.cY •
� . f�t'f'LIGf�TIO:`d FOft RESIULi�dTIR�_ 6U1LD1i�G t'GfL`�II'fS � •
� (Ide��r, �ll:er�ations, lldditioits„ or ficpairs)
_ ,�
; � � �
• p;�li�ER: i�
noo�;css : .�� �. �
�rc� n�o: ��l �,3 °��`7 -
. �;. d _ �. :: _�,�.
�UI LQ'�R : . •
ndnacss: �C�a- n :.� � za
TEL td4: �3a � 1 � 3
Consi:ruction Locaiion '
. sT���r rio : �Z� sa�r��:T: ��
. . e
L07.': � BLOC'iC: �r
_�._
�_'1 � �
�nzTZON : �.�u�►�+o. ���" � �r-�,, :
Corner Lot: Inside Lot: SetbacY.: Sideyards:
Ap�licant attach to L-his fbrm twa Certificates of �urvey, of lot and
proposed building location dra�an on certificates to scale.
� DESCRIPTIOit QF CO��jSTRU�Ci"IOPd
�- `�� � - . �c� �' �"-�
I'ront: � y(� Depth: 0� Height: c,r �+ �
Squa�ee. �'eet: ��d Clabic Fcet:
� k'r�ont: Depth: � Height:
Squar.e� Feet: �{o � Cubic I'eet: _
2,`� X `i� r - ���d
Type of Construction: 1��. \ Estimai:ed Cost: $
xb Be Cbr,�pleted: �
� � Alt. A Alt. B
Proposed Driveti•�ay 6r'sdth If New Opening Is Des:�red: $' $
� . ., S�� RF.VERSL SIDE OF SHEET .
7.Sie undersigned hereby n�ake: applicaticn for a permit £cr the �:�orJ:� herei.n specified,
agrec�inq to c.'o ,all work ir� strict accardance �•�ith - City of I'ridley Ordinances and
rulitlgs of L•11e Dep�rtment. of Buildi��gs, and h cby d . the iacts and
xepre�entations stated an this applicatian e true d c xrect.
D,7Tr : _____�.'�:�'� � , SIGNA'.�U F2�; :
5ti��ulations :
���
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_ _ 131I1 Li)I I�1G i'[�RMI'f FI:t: :�C11(:T)Ut_�� � ' . .
;):f"i'I01�� 2. � 7.'1�L 7n�.:��ccLc�r. of' l�ui.lc?i�uJ :::Iui7.]., bcfal:c; i.r,sui.��q ��ennzts for t:hc crr.c�i.ort
caL .i>>y )�u�.l.�l.i.n�{ c,z :�i:�-uct:urc, c»: fa�: �lny �xcicIi.L•i��n +.:o �111j� CY.1;3i:i.►u� l�uilclzng c��: :stnicGu%c�,
. ci�' l:a�� �u,y .iJ.t.r_rat.ic�n or., rcl,��ir.s l.o •��ny c�:S.��:t:iiicf )�ui.).di.ii�.l or. sL•�:ucttirc, u���» ar�J���.ca�zoi�
�L•licr�i.'or.c, r.cqui.rc t�l�^ }�aymcut: }�y tlic ar�Z�l.i.c:ar�!: S:ar. :.ucii per.mi.L• of: tees to tlic arn�unL•
j14)CL.1.11 )�Cl.p�•1 5CL fdY.�:�l FLIlCl ).11 � t.�1C �nannc�: hcrc�.n j�I:OVJ.c7CtC1 i:U—�:11:: '
• )�11:1•1 CON4`I7:UC'.CIOI1: Sing].c l:'ami.l.y 11oir,es and Ga�-�zcics: Y4.00/J.,000 ctxl�i.c fec:t:.
I.'J.,Ts':d C1ll:C1:: 25 l�er.cc�►t: oL Inii.lcli_ng }�e�-,nit f�e. .
U1ZI��I:k'11Y llEl'P.c:5S70t�:: (CUncretq C�irb �L-rcet� Only) �
�
• A].�ern��tt:e A: ltc:m�val and repl.accrr►en� of conczete cux2� and i�,s v
c�uLter. only; l�riveway caidth plus 6�eet• x -�
1#1t,rernaL•c II: ]temoval and xct�lacemcnt of cancrete curb and ..
, gutter and install a 3 fooL- wic3e aPproach taith
• . � 6 inch depth; Driveway a�ic:th �plus 6 feet x;�-S� '
• . . s �S'7S
. . �nnI i I Ot�/�L I nf= R'�i I0� -
�'or the purl�se of co:nputi_ng �'ees far. building permits,� L-he cu2�ica]_ coi;tents of any
bua.I.d�.rsg or adc�ition, is dctcr.mi.ned by rnul�iptyir�g ihe ground area covered fro:n a
paxnt sir. (G) inches below the floor ).3_ne of t-he basemen� or th� cellar to the
averac�e 2icights oi-ihe -upper sur_�ace or L-o ihe average height of the roof: s�rf_ace
of tlie naa.n gahZe of a pS.tched root. �.
Foz reFai.rs or a�terations to an existing structure, the fee shall: be at the xate
of .$3�.00 ��er eacli five hundrea doJ.lars -� {$500.00) er irac�ion t:her�af in the cost
oi all pro�osecl wor.Y,. . - .
xn •no case sha3.1 the fee charged for any pennit as set i'orth �n SeatS.an 2 be �ess �
than $7.50 plus $.50 stai:e surcharge. �
V�RT F I C�TI 0�! OF f=OU��[DI17I Ofd
' NOTE: Permits �or constxuction r�ill be isstted a minimum ai 24 hours from i1�e time
�i aYplication to a].l.o�a for pro}?er rcview of the proposed structurc and oi the
construction site.
l� Certificate � of Suivey of the lot, shocti=ing the locati.on of the foundation once it
has been cons�nictc� �.iill be required bef.are pr.oceediizq �•�ith the �raminc�.
,�$TIFIGQTE �F �C 1lPAf�Ci'
' Tspp7.S.cation i'or a Certifa.cate oi Occupancy shall be mac3;� ten (10) days prior to the
u�e or. occu�ncy ai any st-L-ucture for �ahich a�.�uilcii_nq perr,�it l.as been issued; and
sai.d stLUCt.urc : iial�. �iot be used or. occupied L:riti.l a Cezi��.iicate of Occul�ancy has
uecn �ssued. '
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sue�ecT p ,
City of Fridley 3 3 0 9 7
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
r
; � RECE�PT NO.
� ; y __��__ COMMUNITV OEVELOPMENT pIV.
r � � PROTECTIVE INSPECTION SEC. �j���
✓
� � �"'1 � CITY NALL FRIDIE� SS132 NUMBEii pEV O�TE v�GE OF •VCROVED Br
�""'�� ,�' 763-571-3450 9t0-Ft5 9/18/02 � /
JOB AODRESS 5025 Hughes Avenue NE
t LEGAL �OT NO. BLOCK TFACT OR ADOITION SEE ATTACMED
oescR. 4 6 Carlson's Summit Manor South Addn s►+EET
2 PROPERTY OWNER MAII ADORESS 21P PHONE
Ronald Zemba 5025 Hughes Avenue NE 763-572-9268
3 CONTRACTOR MAIL ADDRESS Z�P PMONE LICENSE NO
Same
4 ARCMITECT OR DESIGNEF MAIL ADORESS ZIP PHONE LICENSE NO.
S ENGINEER MAII ADORESS 21P PMONE IICENSE NO
6 USE OP BUIIDING
Residential
7 CLASS Of WOFK
O NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof House (12 Sq) 2nd Layer
9 CMANGE Of USE FROM TO
STIPUlAT10NS
Roofing can be the 2nd layer but not k�e 3rd.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAp
SEPARATE PERMITS ARE REOUIRED fOF ELECTRICAL, PLUMBING, MEATING,
VENTIIATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION 20NING SQ. fT CU fT
AUTMOR12ED IS NOT COMMENCED WITH�N 60 DAYS. OR If CONSTRUC710N
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT
ANV TIME AF7ER WOFiK IS COMMENCED. NO OWLG. UN175 OfiSTREET PARKING
I MEREBY CERTIfV TMAT I MAVE READ ANO EXAMINEO 7MIS APPLICATION 1 STA��S GARAGES
ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS yA�UATION SUR7A%
ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WI�L 8E COMPLIEO �966 �. SO
WITM WNETHER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEqM11 FEE SAC CMARGE
PiiOVISIONS OF ANY OTHER STATE OR IOCAI LAW REGULATING CON• $3H.7S Fire SC �.96
STRUCTION OA TNE PERfOFiMANCE OF CONSTNUCTION
PI.AN CHECK iEE TOTA� FEE
$40. 1
S�G AEO�CON'�7A(;i q�UTMOp�ZED�GENT �DATE� MEN OPE 'IOATED T IS VOUA PERM�T
, i . V�f/�� � � �
$�GNSTUqEO�O�NNEpi�i NEpB l Ai IDATE� � BL �N$� l�LiE
NEW
ADON
ALTER
( j CITY OF FRIOLEY Effective 1/1R002
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp
(] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Cohstruction Address: ,,5'D a S- f-�v 91t e g �� E /U ��•
Legal Description:
Owner Name 8 Address: oti�� � 2��� Te�. #%(�3 r�7a -�a6�'
Contractor. � �L-F MN UCENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
length Width Height Sq. Ft
Length VVidth Height Sq. Ft
Length Width HgVGround Sq. Ft
,QE /Qoo�' �oa9E ��►�',c� .�A�y�/� �� �'9i�,�RE3
/j �- —� � /
Construction Type: /`C E �B � /C Estimated Cost: $ `2 � �o
Driveway Curb Cut Width Needed: Fi + 6 Ft = Ft x$ _$
DATE: -/ -D 2 APPUCANT: �� ` �y✓�- Tel. # ���' g7� �92�'�
Call (763) 5T2�604 fo� PeRnit Fees if mailing i� application o� Fax to 763-571-1287 if using c�edit card and we will
call you for cani �umber.
Permit Fee
Fire Sun:harge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
� ��_. _'�^S__�_
fy
$ �i
$ , S�
$
$
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1 �000 Valuation
$1200 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 [ j
TOTAL $ �Tl , o�� STIPULATIONS:
BUILDING PERMIT FEE SCHEDULC
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 tlie 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
$500,001 to $1,000,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fractio� 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 each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 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 $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
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.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of die existing
proceeding with the framing. New Houses Onlv
,
_�
foundation will be required before
SuB�ECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
�
� �
� �
� • COMMUNITY OEVELOPMENT DIV.
� j V �"�� ,
f � � PROTEC7IVE INSPECTION SEC.
� . �
� � i'�'1 � CITY HALL FRIOLEV SSIJ2 NUMBEt1 pEV O�TE ►AGE O:
�""� � ��� 763-571-3450 9/0-F15 11 / 15 /02 / /
JOB AODRESS 5025 Hughes Avenue NE
1 IEGAI LOT N0. BIOCK TiiACT Ofi AODITION
oescR. 4 6 Carlson's Summit Manor South Addition
2 PiiOPERTY OWNEfi MAIL AODRESS
Ronald Zemba 5025 Hughes Avenue NE
3 CON7RACTOp MAIL ADORESS
Sears Home Improvement 5512 Lakeland Ave h
� ARCMITECT OR DESIGNER MAI� AODRESS
S ENGINEER
8 USE OF BUILDING
Residential
7 CIASS OF WORK
MAII AODiiESS
O NEW O AODITION O ALTERATION
8 OESCRIBE WORK
Replace windows within exis
9 CHANGE OF USE FROM
TO
tal, l�i 552
ZIP
21P
� REPA�R
33256
•►vnOVEO !r
SEE ATTACNED
SNEET
763-572-9Z68
PHONE LICENSE NO
612-382-5491
PMONE LICENSE NO.
20090017
PHONE IICENSE NO
O MOVE � FiEMOVE
STIPULATIONS
Provide smoke detectors in a�i sieeping :aoms and ora aII �eve�s of the dwe���r.g
per Sect�or. 310.9.1.2 of the 1997 Uniform Build�ng Code. Cauik and �lash al?
e�:terior openirgs .
. .. - - -- --. .
A ATE PERMITS ARE fiEOUIREO FOF EIECTRICAL, P�UMBING. HEATING,
VENTI�ATING OR AIF CONOITIONING
THIS PERMIT BECOMES NUIL ANO VOIO If WORK Ofi CONSTRUCTION 20NING
AUTHORIZEO IS NOT COMMENCED WITMIN 80 DAYS. OR If CONSTRUCTtON
OR WORK IS SUSPENDED OR ABANOONEO FOR A PER100 OF 120 pAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO OWIG. UNI
I HEREBY CERTIFV THAT I HAVE REAO ANO EXAMINED TMIS APPLICATION 1
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VALUATION
AND OROINANCES GOVERNING TMIS TVPE Of WORK WILI BE COMP�IED
WIT►i WHETMEii SPECIFIED MEiiEIN Oii NOT. THE GRANTING OF A PERMIT �3,761
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT FEE
PAOVISIONS OF ANY OTHEfi STATE OR LOCAL LAW REGULATING CON- $97 . Z5
STRUCTiON OR TME PERfOFMANCE Of CONSTFUCTION
PLAN CHECK fE
� � �Q� I,�C�22
SiGN�TUAE OF �QN'aACTOp •UTHOA�ZEO �GENt ID�TE� ,ue. �
S�Ga��UQE O� OWtiEA��� OwHEp Bui�OEA� �O�fEi
6 •
SO.
S7A�LS
GROUP OCCUPANCVLOAO
CU FT
OffSTREET PARKING
1GARAGES
SURTAX
�1.$$
SAC CMARGE
Fire �C $3.76
$5 0 $ 7.89
LY VA�IOATE TMIS 15 �O R PERMiT
�' '�''.�—
f�i T E
,
�
NEV1l [ ] CITY OF FRIDLEY
ADDN [ J 6431 University Ave NE, Fridley, MN 55432
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
.
.
Constcuction Addcess: . ��� � _ ��� �C�-� � � / v� � , °
Leaal Description: -. .
Owner Name � Address: "'- i��1�} � Te1. #
Contractor. ��S lYQliiE. .�,/J'1 ��r`� (�. MN LICENSE �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Effective 1 /1 /2002 .
(763) 572-3604 Bldg �}sp
LNING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width HgUGround Sq. Ft.
OTHER:
�7 O
Construction Type: G�'�lU��f,�i ��iLAC��.TEstimated Cost: $ �/ ��'�
�
J
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: �� `�Gp�qPPUCANT: Tel. # �/�'' �o.� ���'/7/
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
�
Permit Fee $ 7 a� Fee Schedule on Reverse Side
Fire Surcharge $ .'7�e .001 of Permit Valuation (1/10th%)
State Surcharge $ l, 8� $.50/$1,000 Valuation
SAC Charge $ $1200 per SAC Unit
License Surcharge $ � �OU $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge .$ Agreement Necessary [] Not Necessary []
TOTAL $ �(, % S �
STIPULATIONS:
BLTILDING 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 l�rein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,040
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$SQ0,001 to $1,000,000
$1,000,001 and up
FEES
$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 each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 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 $500,000 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
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
�
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 fe�t times $15.50.
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 $23.25.
VERIFICATION OF FOUNDATION
Pemuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
� � . _ ,,
.� �.38• ;7
Building;
�i'1Sp�Ctl Q,riS
j 763-572-�36U4
BUILDING
RESID�NTIAL APPLI�ATION
�ITY OF �'RID�.EY
i7ATF'�,_�," ��' '_��.._ YUU/�R��E��MAIL�� �DRh`+5 _
3fIL AuUILESS :,. �O oZ 'Jr, .�-�.. n v'r ... . /V �- _' _... _ —
THIS APPLI(:ANT IS� ❑ OWNF.R `ONTRA(; I�()R
�'1tOPEN'!'Y� OWNER/ NAMB;_, I. °�' Q� e 1'n R ^
TENANT /.�DRFSfi�_ 5o a��F� �/�� �r�d ..
u� N ca�rv_.. �
- PHON�: �C�_3_5%� �,,,/g
� CONTRArCTURM '►r(AMFh• W i nda W C O h C e P'4'S ��
Sl1UMCT A C.OPY UF�'
YOUR STATL LICk:WSE
Wi7ii APPL,'iCAi7pN
PROPER'�Y TYPE
l�EliMIT TYPE
TrnE
SIA7'� LiCENSti !I_ ,'d o t ta,�
,auu�ss: `�90 L.oh e �
PIIONR � a 5 0
O SINCit,F fAMILY/N .W GUNS
fl 'I'WO FAMII.Y/NEW C:c)i�STR
d AL)1'1IT10F1 �
❑ k�ASP,lv�ENT FIN{SH
❑ UCCK
L�ESCR113� WQKK B�(NCi D(7N�!:�� n! Q.G
'f
S17E Ul'' iMPftt)VEMLNT
exr na���� _
oad�, S-Fe. ll
rnx C'o s/
❑ ROUt'
0 SIDINC�
o swuvtM
���� �
'� CITY_.. E
0� � ..� %�
NS �
� INDOWS
CI DRAfN T1LE
❑ U'I]�1�;R
NUMt%�it OF S(2UAR�5 __,,,.,_ 0 FIC1U5� d[ QARACi}i
�ARk�FFS iJ A'I'fACHEll GaRACi�
PRUPE)$ED SIZk's�,_ , L7 1A�TACHF:U GrtRA(:if�
YROPt)Si?I)iIGICiH'1': _. I dOU� �y��� s�a�rs
p�;,� C4Svmt � �QSG/n.81� ��roem �
❑ Al�sninum ❑ Tria� ( Cau��'- �droo�, a
a onpr _. , q r���� � cabe.�w�' — Iaeelre o�n 3
yVINGUWS � ( C ���Jy�
1N K7fISTINC* ()F"CNIN(iS�CS ❑Nu LUC:ATION UF WINi7()CL� '
Utt POR N4'iW 01'liNtNGS NSCRIBk: SIZ� QF .. --
or���� �►,�N�S & �...—. 5
zYPE o� Wn�ow To s� iKST,�t,�,ku run�cR ar wttvDOws
ALL!F'EES ARE BASEB ON YALl�AT1K1[�I, IIYCLUDIKG TH13 COST OF 1�A1
(II9[NG THE 1997 U.B,C �'EE SCI3EDULE}
TOTAL JU� VALUA'fION $_ 5G S I.: O � OCGUPANCY
Permit Pee
Plan itevie�v.
Fire Sur4harge
Surchar�e
License Surc�harg�
SAC Chargei
Curb Cut L'.acrow
Emsion Control _ _ _
PerE Fee
Sev�er Main;Charge
F�t ��� 3��
Kec�iv d By: � �
�
Date .�,
�^% S ATB ��P � �yal
�. " zT �^' ��P 55/al
l.
z.
3.
FUR NL•1�4
�
�.
2.
1 3.
0
IiEtGHT
.17
tistin¢ Fkto PIeA
�
PropnxCd flao plw�
l.ist c�f struc mcmt� tu;bG usul
(,'UNSTRU. P10I�' WGI.IJDIN(i I?ECK.S,
ITI()NS- K ' ' .�
Sitr Ploa/Su ysiwwing � existing s�n�aures
and prop�i projaal.
7rvo aet� of nstrucUon plm�s
h'.nargy Gr,ln� IMtons
i MATR AUS: T
g Z� ScR Back Page for Fee Schedule
$ 659�0 of Buitd'u�g Pennit Fee
$ � -� .U01 tim�s the tntal jub valuution
� � .0405 x Permit Vuluation Mininlum �.SU
�"� >(} $5_UO (St�te Licw'r►sed R�sid�ntial CanU•aators)
�' ' $PG75 par SAC [Jnit (Plans to MWCC for d�tenni tio»;
_'$ f't+bfl•= _ftxS2l=$_—
� $d50 Conservntion PlFUi Review
_ ---
� F'ee Aetermined by�nginenritig _ _ _ _ ___
� � A�reement necessary ( ) Nan Neceseary ( )
� ifS IS AN A+PP1.�L C)N PUK A P�RM1'f-NO'T VAL{l� UN'�'IL FIt�CCSSED
I hereby apply for a building periuit a�l oH'led};ts that tue lnfor�matiot� abovo is completa ruid accur
cus�formence with the ordinances and eodes of the City o1' C�ridley and ��ilh t3�e Minaesots C.on�truction Codes;
per.nit but only An npplic�tion for a permiti and �'ork is not tc� start with(wt a perntit; tbat th� wo� will be in �
p]a:► in the c�3e af all wark whi requires revie� -nd�ppravaL c�f�plans. A I^ M�. . .'.n
SICNA'I'[!itE OF APPLlCANI'
th�t the w�ork wri6 be in
1 understanci tlti3 �s not e
rdnnce witfi the a[ipraved
� / —` Q
Ld Wd90:b0 L00Z �Z '��0 : LS�LTLS�9L: 'ON Xti.� Fia ta '
[P � ,to fi�?�: WOti�