AF - 46383�
City of Fridley, Minn.
BUILDING PERMIT
Date: _..��:.._..�. `_`.""__�...��_._..._.._.._....___._.__.
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Owner: .:6..�:5.:�:`.�-���---• ��="�'� ,�...�;��':4�:-:�:
Address � � '�� °'`✓ ,� ,�" ,;,� ��
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N° � 5'78
Builder ������:�� �•s.L...'��..�.:iC�".�� �.._.��-
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Address .�� .�
.� LOC�4TIaN Of BUILDING
No. _� �:. ��._�Street _..���".�--..�°_ �r _ �e"' .„�! ���. .---��I''�#�.. Part oP Lot -----------�---._..._..-----_.._-----_..._..____.�.
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Lot ...._.... ... �.. ........ Block .------ - ----....__._ ................. Addition or Sub-Div3sion �-?��'1..� . _ . :t�r.�: . �:��� �.-. �f ... .
. � �( _ �`� �. ��..�.�, � r�
Corner Lot ........... �--...---...--•--.... Inside Lot ... �--� ....--�--. Setback ---��--�-�----�--•--....---•-•--�------ Sideyard .--�--•�-----t?_.�..-------._.....---- _.
Sewer IIevation
Foundation IIevat3on
DESCRIPTION OF BUILDING
To be Used as.
�r���,�' ��� !�"� y�; w� � n
� ���.�.t.._ Front .�..,r-••- DePth --��..�.��.-.. Height ,�"��;r�--- Sq. Ft. ��.,G�'. Cu. Ft. �t���:���
_..........._.__......_-.._.......----.......... Front ...-----.._ _...--- Depth ....._......_�:H� ghtr...__......�..�..`« 5q. F� -----...---_..__.. Cu. Ft. ...--.........- �--
Type of Construction .........7'.'°„�� .1.L�-a�,��..... Est. Cost..---... .._:�.... �
,� ,�.. ........_........ To be Completed ....._ ............._............_......._........
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�E�N C�F �',�''�' ;� ��� _.-=-�
�;i_{j��j1� - I _��'„, i i_ � f��'I�) `�l.��iG_�� ,�1;'i � ;� ,'��'a�
:V�._; i'i~.: 1 E�'i;'�..� 1 fE. ���'i_^�.
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
ordivances oP the dty of Fridley.
.�....._...._._..._.._..._....�...._.___._. . _...�.__._._.�
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In considera�ion of the payment of a fee of $-- -.------------------•., Permit is herebY granted to...._.._.----•-.-..-.------..--
�-------------•-----
...____.____.._...___.._._.......�.._.... to construct the building or 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 worlrnien, 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, repa.ir and moving of buildings
within the dty limits and this permit may be revol�ed at any time upon violation-qf any of the provisions of said
ordinances. �'"- „ �► )
�'Building Inspector
NOTICE:
This permif does not cover the eonatrue�ion, inatallation for wiring, plumbing, gas heafiing, sewer or wa�er. Be sure to see
the Building Inspeefor for separate permFfa for fheae ifems.
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BPPLICATION FOR BUILDIIdG PERMIT
CTTY OF FRIDLEY, �VN�Ofi�
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LOCATION OF BUILDING
No. '� Q °� � 3tre'�,,, ���y=� C�-�_ � -G .Part of Lot .
E�ot � Block Addition or Sub.Div. ,(„�� ,����. �o ��i.t�s
Corner Lot�Inside Lot_� 9et Back Side-Yard ��"��"�
SEW�R ELEVATION FUURIDATION ELEVATION
Applicant �.ttach to this form Certificate of Survey of Lot and proposed building
loca.tion. ` '
DESGRIPTION OF BUILDIIdG
To be used as:
F�o�t . / � Depth �I� Height � � _
Sq. Ft. au. Ft.
, k'ront Depth Height
Sq. Ft. Cu. Ft.
_,,�1 � ao
T;qpe of Construction `/f-'��,. Tstimated Cast /� Sr�
To be completed
The undersigned hereby.makes applica.tion for a permit for the work herein specif3ed,
agreeing to do a11 work 3.n strict accordance with the City Ordinaaces and rul3rig of
the Depertinent of Buildin�s, and hereby declaxes that all the facts and representa-
tion� stated in t�i.s applicat3on are true and correct. �
DATE � �STGNAT�E G�
(� Schedule of Fee costs cari be found on the R8VeP9e Side.)
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$IIILDING PERMIT FEE SCI�DULE
Sect3on 2. The Inspector of �ildings sh�].1, before issuing any permit
for the erection of arty bui.lding or structure, or for any addit3on to
ang existin� building or atructure,, or for ar�,y alterations or repeira
to any existing building or structure, upon �,pplication therefor, require
the pa3►ment by the applica.nt for such permit of fees to the amount herein
below set forth and in the manner herein proeided to-wit:
2.1. For any such permit for the erection of any fire-proof bu3lding� other
tY�an a�arage, warehouse, factory or grain elevator, or for the erection oP
any i'3reproof addition, for similax occupancy, to any exiat3ng �.ii].d3.ng
sha11 be at the rate of �1.40 for each one thousattd cub3c feet� or fraction
thereof, in such cubical contenta.
2.2. For an�r such permit for the erection of ar�r fireproof garage� ware-
house, fsctory or grain elevator, or for the erection of ar�q fireproof
addition for similar occupency, to ang existin� build3ng she.l.l be at the
rate of �1.25 for each one thousand cubic feet, classified as "firepraof"
by Section 502 of the Mir�neapolis Building Code.
OH IISES
2.3. For any such permit for the erection of any non-fireproof bu3lding
other than a garage, warehouse, factor�r or gra3n elevator, or e.ny r�on-
fireproof addition, for sira3lar occuparacy, to s.ny e�cist3ng building.
Permit $1.00 for each oae thoueand cu.bic feet.
GARAGES
2.�.. For an� such permi.t for the erection of any norr-fireproof gara�e,
warehouse, factory or grain eleeator, or for the erection of ax�y non-
Pireproof addition, for similar occupanc�� to a� existin� buildin� �r
for each such building or addition. Ninetg Cents for each one thousand
cubic feet or fract3on theraof, in the c;ubical contents thereof with a
m3nimum of $�.00. �
For the purpose of computing fees for building pex•mits the cubical c:on't�nts
of any 'build3ng or eddition to a Zuiiform he3ght throughout by mil.tiply3.a�
the ground area covered from a point six (6) 3.nches below the floor line of
the basement or cellar to the average height of the upper aurface or to the
average height of the roo£ surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an ex3s'�ing structure� the fee shall be
at the rate of �3.00 for each Five Hundred Dollars ($500.00), or �action
thereof in the cost of all proposed work.
2.6. In no case ahaa.7. the fee charged for any permit as aet forth in
Section 2 be less than �L,..t?0.
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City of Fridley, Minn.
BUILDING PERMIT
n�te: J�as 17, ].965
Owner: _�_ F�� B�ilder �obb Ina.
� 5'ss�
N° '7933
A�reas �_ $u¢hea lve. B.E. A�� P. �. Beac 2f�h7 1(s�t Brighto�
LOCATION OF BUiLDING
5dt9 xr�ghee
Na __..... Street ._.._�._ __.._._....._____ Psrt o! Lot
Iat 6-- Block � Additioa or Sub-Divls[an CarlsAms Sus�dt lYlancrr 3n.
Corner Lot — Instde Lot ____ Setback .�._ Sideyard
3ew�er Ete�vatim ______._...___._ �.�.._.� Foundation IIevatla� .._._
DESCRIPTION OP BUILDING
To be v.ed as:
F�ont — Depth ._.._ Height Sq. F'k Cu. Ft
F�+ont Depth I�eight Sq. Fk Cu. Fk
Zj►pe of Co�structton ___._._.._ F�� Coat �__..�__....__ To be Completed _..�..
'`�00. !l`-�
�ePB�T $t,0271 ��g6
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I31 COOddeT8tio11 Of the i88118AO2 t0 II!e Of 8 peTmit to C
� P�"oP�d work in accor8anoe with the d�scriptian abo�ve
a�+dinanoes a! the dty o! F�id1ey.
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In ceooddeTat[an ot the p�yment o! a!ee o�;��� Dennit 1s hereby granted to CObb ISe�
to coostruet the bui1ding or� dchtion as deecribed above. Thispermi t is gi�anted upan
the �a oo�tttai that theper� to wha�, ft ia grantea sa�a his agents, employeea an8 .wc�, in an worlc
done i4 � aad upon said buildin�, or aqypart thex�eo� shall oomtoam in all reapects to the ordinances o�
Fridley►� Minn�oRa locat[ao. cadst�ctfaq alteratiaq maintenanc�e, repair ead mo�vin8 c[ bu�
wiw1� dt,y limfts� per�ntt maY be revaked at aqy time upan violat[on o! a�► a! the D�� o[
11.�.11l dQA86II
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. APPLICATI�N FOR < G_PERMIT
;�. CI7,`Y OF FRIDLF'�� �N1�30'�A � . .
OWN�R' S NAl� ����� ` �
.___ �' BUILDER GR � /� L �-! �'
_._.__. �.�
,�nDx�.ss__ �� � �� .��* �;�,�� : �a ;,�-��= .tC[-a �unR��s :., J� - � . , � �� �_ f... f� -��.� �� � c�'� � �� �/
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- LOCEkTTON OF B�ING , . � .' �
N°• St���.� Part" o£ Lot .
Lot ' Slock�` . Additia�r or Subd�.wigionl.-n � �, �i� �
Cornes Lot�Inside i�ot � . _� ��e��k • Side-Yard . � � • :
SEWER E�ATIQAi FOUND�4TION EL�V'A'1TON . .
Appl3eant attia�h,to thi� form,Two Certificates o�.Survey of Lot and pra�sed b�i�d�°-
ing lacation� �l��wa o� these'.CBl�tificates . . . . . ���f���
, . ���� ��--��; .
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DESCRIi�1.ZON OF BtJILDING � `�
1`v be used �s:
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�� °nC DePth ' I�eight._._._, �,�....�`
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9q. Ft. Cu, gt.
„���"c'ont Depth Aeight
:, ��q. Ft. Cu. Ft: � � - �
r . . ' .,
Type of Construction � � � Estimated Cost�
-..,�.-be,�ompl,eted ' ' .
The underaigne� hereby makea appli�atiott for a permit.�or the work herein spe�ifi��,
agreei� �d `c�o abl taork ii� atrict accardance with the City of Fridley Ordinances aud
ruliags i� the Departmeat'pf,Buildiags, and hereby declares t6,at ail�the�f�cte aad
representations stated in this application are true aad co�re�t. °=
�/�`�
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_ ��� , �/if��-
;��.of Fee Costs caa be faund on the Reverse Side).
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BIJILDING PERMIT FEE 9��
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Se�tion 2. 'Fhe Inspector of Builditags •s�ali, be�Qre� issu�g �y pes�tait fcr
, th,� erection of any building or stru��,nra, s�r • for a�,q ad��.t3� ts any �i,sC-
_ iag building or structure, or for, any a�,terat��ii,s�bs'' iepaitb t� aaq emistin�g
.i�uildi�g or s�ructure, upon applicet�'o�.�er:e�or, ��re the p$��t by �e
ap�l3cant for such permit of fee� �1� �h°"� amouat �her�ia•��below acaC 'forth._a�d
�ia the manae= herein provided to-w�.Cs •`
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�•-�---- �2.1. F�a any �uch permit �or the .�s��,t�.an-c��.e a�y fire�g�# bu�Ld�pg, ather �.
� �;�-t�n ,a �ar�ge* w��ehouse, factory os, g�iat� �w�� .� ��r. tbe e�rr�ti�a ef :"'
. � $ny �fi�e-��of addi�ion. fQZ. ain,�]�a���'o,i�Ft�tayr �o: s�► �xis�t�i� b�i� � ?•:: � . - a
�hall d�e at t.he ra�e �f $�,.4Q f�or e�sb. p� th�sand �wbi� fee�, or� fr�
- ,�i- .. :thereof, in such cubical coat�n�s.. . .. �"� � ... . � . �� ' . . .
- ..
�'� 2�a. For anq auch permit f�or:.��e erectiaa of anq iirerproDi g�rs¢e--• ��
�ory �r graia elevator, or fq� •the e,�ce�tion o� at��� �: � °�a
0
. €��' gimilar occupaacy, td an�r eicist��ng ��1,ldia�,g si��.l� •be �t `e : -
. ....�-��c`-�a�h vae .th�usaaci cubic .fee�t;'. r��a.ssi�ied �, nftrep.rqaf" b�� .3�. �
the--�ia.ieaj�i,d,s._$u;E�j�g.. (,`ai4�i.�'°S6wn�, ' .
�,. $...- OU3ES ' , , � ,
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�� � 2��:. FcSr aay such permi� fo= the er.�etion o# aay noo-Hrep�f b�ildi.c� �
'`,�- .than a gargge, �warehouse, factory or, graia eievator, dr ssty �son-fft�p�
�dditivn, for simi�,�� ocCup�y� to 8�y e�isti.t� �tiu.il�d3q� - pe�Lt $I.�JD f�r _=-.
each �one thou�a�n2� .c�bi�. fee6.. . .
GARAGES , ,. ' � �„
�_ �� 4_ For any such per�i,t for the erectiea of aay non-¢�,reproof gasa�e�,
warehousa, factory or grain elQVator, o� for th�i erec�ion of any aon-f
g`�`�� ri"" `' -�.ila�� occugaacy, eo ar►X esistin$ buildfng t�r for eac�c such .
�i��;ag or addition - nine cente
- �► ($�.90) for each one thous�d �sbi,c feet
or fr'a�tion thereof, in the cubical� cante�ta thereof with a mf� of �'y4.QQ�✓�-
' �
Fo'r the purpo�e of cazn ng gormits, kh� cubicgl c�tttest.�e�` �
� of an bu�.ldi �g fees for buildi .�
Y ng or ad+dition to a uai�orm height throug'hc� '�q �i,LYFlying t�,,��'
ground �aea covered .f�om a point si� (6) inch�� beldt� the �],00r lins e�f,,,l•he��„�„�..
basement or cellar to the average height of the upper su:`fnce or to the
average height of the r�of stirface of the maia gable of a.�itched reof. , ��
�_ 5. �. For repairs or a�.terations to an eaciaLid� ��ruc :'�� g�e at�]►1 �'��"�° �.
. rat the rate of $3.00 pe; egch Five iiundred DoLl,er.,a •i$�O��F..'�?e �r�lon . -,.
,, therebf in ehe cost 'of •�il_ proposed work. � . . . .
2,6 �` . In no case � '. . .. . . . , , . ��' . _ , � ''` �,,.
,_,�„ ahall the se� i��'th 3�. , �'•� •
� ,Sectio�_2 �be ..xeab�,�6an...$�i,�.pd; . . , . , �;.
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SUBJECT PER 13399
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T '
� � RE T
� `L __�_ COMMUNITY DEVELOPMENT DIV. �/� ,� ��
r � � PROTECTIVE INSPECTION SEC. �'�
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1 i �
i-_N A ��'�';,, CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L J \ 612-580-3450
910-F15 3/3/76 � /
JOB ADDRESS 5049 Iiughes Street N.E.
1 L�GAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 6 Carlson's SL1I�l3''� i�3IlOr $011�l �CIl.'t].OIlSHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ron Hewitt 5049 Iiughes Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sussel Company, Inc. 1850 Como Avenue, St. Paul
4 ARCHITECT OR DESIGNER MAIL ADDRESS . ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
RL'S].C�eIl't].SZ
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Cflnstruct a 12' x 16' addition to dwelling
9 CHANOEOFUSEFROM TO
STIPULATIONS
SEPERATE �'ER����T� �����R�� ���. �dR1N.G�
�iEATIfV�, PLt1��6i�t� a��� S1G��
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. �DDd �'7=d�te
THIS PERMIT BECOMES IVULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4�200 yfi2.�.O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE ° SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ' S�-C.00
PLAN CHECK FEE TOTAL FEE
� yS` �.8 . �. �
SIGNAwTUREOFCONTRACTOR ��AUTHORIZED � ENT (D EI WHEN PROPF�FiLY VALIDATED THIS IS YOUfi PERMIT
��., ,
— - ��' !L � �� � ' �� � °�� ✓'
, �, y � � �. �"�'� �� � — ��_
-�SIGNATI7REOF OWNERIIF OWNER BUILDERI (DATEI BLDG iNSP pA7E ,°
• � . - • ' . .. .
� � ' •, . .APFLICATION rOR RESI�DL'NTIAL., ALTLRATION,
. OR AllllITION. BUILDING PER�I�iIT
' CITY OF FRIDLEY, 1�iINNESOTA
�
�
r.
ota��t's ru�r�: /�r���? �l L.��1'T l BvzLV�x: ���?,S 5� L CC�°, J�� �r_, .
, �wn�ss : ���' � NJ L)t� 5 ADDRESS : � /f� � ���2� �4 � � �
. • . �ST T��4 � ► �... � . .
N0: ..`�C� q° �J STREET • �I �� �2��5 � .
I.OT: � IiLOCl:: (� ADDIT�O1�:Ci-�RLS�e�-�S �Sc.'�ih�� �i�4��CL 5�� ,q_��
. • CORNER LOT: INSIDE LOT:�SETBACK: � SIDL'Y�.D:
Applicant attacr. �o this for.r Tclo Certificates. �f Surve .of L�ot and.proposed .
buildino location drawn.on these Cextificates. . '
�� �HESCRIPTION OF BUILDING
. . - . .
� . Ta Be Used As : f �, �l �,�/ ��� �(� K-6� • �
�� �`( I t. Y Q�'�C'� i`-� Front : ` �. Depth : � � � Height : � �
� > .
� . • . Square Feet : ��-�:Cubic . Feet : �,.�� �
� � Front:� Depth: Height:
.. , . Square Feet; Cubic Feet: � � �
� 7.jrpe of �Construction: %��.C�C/�� � �",P��- Estimated Cost: $ � �.��%
, .
To� Be Completed: _ . �� D�`��� � � . • .. ' , .
The undersigned hereby makes applicativn for,a permit for the work herein
specified, agreeinfi to do all work in stsict accordance caith the City* of _
� Fridley Ordinances and rulings oi the DepartmenC of Buildings, and her�by
declares that all the facts and representations stated in this application
8re 'true and correct. � �
• s
• •
• D�ATE : . � % SIGNATUItE : � �_' `` �`�:�
. �
(See I�everse Side For Additional Information.)' �
0
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BU1Lll1N� L'.L'IU�lll rLL �w�iuua.c
� S�CTION 2. The InsPector oi Buildings sl�all, before issuing pexmits for Che
exection oi any building or structure, or ior any addition to any existing
buildin� or st'ructure, or for any altcr�tion or rcpairs to any existing
bui.lding or structure, upon application therciore, requirc the paymenC by Che
applicant to'r such perrnit of fees to fhe a�rount hexein below set torth and i�t
the manner licrein provided to-wit: . . • �
a • .
° I
� � UNIFOItM RUTLDII�G COD�: Type 1, 2& 4-$2.15 fox each one thousand cubic
feet, or fxaction thereof, in such cubical contents. �pe 3& 5-$1.85 for. f
' eacli one thousand cubic teet. • - '' .
ADDITIONAL I�IFORI�ZATION
Fox the purpose of computing fees fox buildin� �ermits, the cubical contents
of any building or.addition, is determined by multiplying�the ground area
. covered from a point six (6) inches below the floor line oi the basement •
ox the cellar ta 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 huridxed�dollars ($500.00) or fraction thereof in
the cost of all �roposed work. . ' . .
� ?aa no case shall the fee charged for any permit as set forth i.n Section 2 be
. � less .than $5.00. •. � � ,. � �
.4
� VERIFICATION OF FOUNDATION
� . �
I�pTE; pexmits for construction will be issued.a minimum of 24 hours from the
ti.,sne of application, to alloca for proper re�riew of the proposed structuxe and,
o� the construction site. , . • �.e �
A Certified Survcy of the lot, showing the location of the foundation, once it
has,been constructed, will be required before proceeding with the framing. -
CERTIrICATE OF�OCCUPANCY ' .
Application for a Certiiicate of Occupancy shall be made ten (10) days prior
to the use ox occupancy.of any sCructure for �iich a� b ildin�; pernait has beea
issued; �nd said sCructure shall not �.e�s�dCor ��'��'G7 1 d until a Certificate
of Occupancy lias been issued. . . ���� .�'�,� . ,
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"' ��- , , EXTERIOR ENVELOPE AVE�AGL "U" COMPUTATION
• {
OWNER (�d�.� }�1 �l.J l �
SITE ADDRESS � � 4� /J (�G � �' 211� 'F'
,
CONTRAC70R S U���- �'� 1/uCpATE 2? PHONE Ca ¢—O� /
Determine working square footage of each.
;
1. Total exposed wal l area o..., o �.3 � �sq. ft. x .17 = 1, �3
2. Total roof/ceiling area ...... �°� 2 sq. ft. x .05 = ,
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Total exposed�wall area above floor = 3°���
a. 7ota1 wall•window area ..........................0 2,4,,�.
b. Total door area .... .....................<..... —�
c. Total sliding glass door area ................... ���y�
d. Total fireplace wall area....... ..:...o....
..,...
e. Total wall framing a�rea'(average 10l�...'.v......< 3 z,�
f. Total net wall area above floor ..............o.. �, ��/
g. Tota] rim joist area .......................o.... 3C�,7�
7ota1 exposed foundation area = IIO,�
h. Total foundation window area....... .... ,....... ��,7�
. .e
i. Toal net foundati on area above grade 97�,.�0
. ............
0
Determine "U" value of each wall segment.
a. 2 4�54� X ����� , 5q-- _ /,�.5
bo X "U" _
c.� 3�,� x ����� ��¢ _ �d � ��
d, r— X ����� �_ `
8. �� e� X i���� � 1 4� = p�v'J`�'
f. � %bel� X ��Un � �l� � _ / S , 9�4
9• ��� �7� X ����, � 6 =�, 4 2_�
n. �2, �5 X �,U„ ��� _�A ���
;. 971.5� X o,�„ m 1�5'� _ ��,7zZ
3 .....................................Tota1 = � C��
.
If item #3 is the same as, or less than item #l,�you have met the intent
Y �f� �BC b006 (c ) 2. �,
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Total exposed roof/ceiling area = /% Z�p
j. Total skylight area............ ........ ...
k. Total roof/ceiling framing area�(average 10%)... /9, Z
1. Total net insulated roof/ceiling area........... 17 a,�_
Determine "U" value for each roof/ceiling segment.
� �. X ����� _
k. >9,z x���„ ��17 = z�,�z. .
1. I 7 z �8 x����� � a42 = 7, 25
4 ..................................Tota1 � . = q-�
� .
If total of #4 is the same as, or less than #2, you have met the ihtent 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 items #1 and #2.
1. + 2, ^
3, + q., _
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SUBJECT
City of Fridley
AT THE TOP OF THE TNlINS g U I L D I N G P E R M I�
;,
,�
� `L ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
i �
i' i '
--_•� ��"' �'� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF
� 612-560-3450 910-F15 7/28/77 � �
JOB ADDRESS 5049 Hughes Street N.E:
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. ( 6 Carlson's S�it Manor South Addn.
2 PROPERTY OWNER MAIL ADDRESS 21P
Rflnald W. Hewitt 5049 Hughes Street N.E.
3 CONTRACTOR MAILADDRESS ZIP
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
5 ENGINEER MAILkDDRESS ZIP
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION
8 OESCRIBE WORK
Construct a deck 14'�' x 14'
9 CHANGEOFUSEFROM
° 1425I
� / IJ D /
APPROVED BV
SEE ATTACHED
SHEET
PHONE
561-8337
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
❑ ALTERATION O REPAIR O MOVE ❑ REMOVE
TO
STIPULATIONS provide 42" mi.nimtun frost footings for all deck support posts.
Provide 36" minim� guard rail (if dec.lc is over 30" �above gradel with 9"
min�um spacings. Provide sketch with di.mensions of lumber used and spans
for City � approval.
SEPERAlt PERMITS REQG?�D FA�i WIRtNG.
WEATIt��, PLlJI�1NG AND Si�NS.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING. [q��d
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING
AUTHORI2ED 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. UfVITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ],
AND KNOW THE SAME TO BE TRUE AND CORRECT. AtL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �`GOO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE P�RFORMANCE OF CONSTRUCTION. � yS`%.5O
PLAN CHECK FEE
SIGNAT�F CONTF� � R OR AS/T-H'ORI� NT A�G E') ��
� �
r �'�.� �: � � .�
OCCUPANCY GROUP OCCUPANCY LOAD
S�. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$.50
SAC CHARGE
TOTALFEE
$ 8. 0�
RLY VALIDATED THIS IS YOUR PERMIT
l.l ! Y UI- I It t lli��Y
AP�'LZCJ'1TIOid f�OR RESIllCPlTIA� BUILDING PERI�IITS
;��'„/ ,;,� �,�"�� �f'��EW, �LTLR/iTIOfdS, �iDUITI'::(J�, OR REP/�IRS)
°, ;; ',� ;
o ,/ �—
wca�r�: �ei►OGd /� r.,s- /T'��i/T/ aulLVLiz: �t�-i hc` _
k
Address : ���e� , �,� � ' , 1lddress : ��
�
�
�`
�o. �`��`�'
LOT:
Tel. No. : ��p� " �� %
Street: ���=.�' Lld-� .�l_�� ��� �
�
v �
Br�ocx: � ADDITI�PI : f� � � � �'.�� '` � � � � � � y � �1 G"i�
o�.CSL��'L�l.✓ <_�C�1. 1 .
CORIQER LOT: INSIDP, LOT: S;:TBACK: SIDE ARD�:
Applicant attach to this fozm �ao Certi�icates of Survey of Lot and proposed
building location drawn on these Certificatcs.
DESCRIPTION OF BUILDING "
To Be Used As: '
/ � � � /
Front: �� Depth: 0� Height: �
Square Feet: Cubic Feet:
Fron t: Depth : He igh't :
Square Feet: Cubic Feet:
Type o£ Construction: ���G1/�%�� Estimated Cost: $���� P�
To Be Completed: /��/�� Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
P'ridley Ordinances aiid rulings of the Depar:ment of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for addiiional ' formation.
DATE: _ % ��'��_ SIGNATURE: C -� � � s �
,
Stipulations:
/
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J `, , � � j " ��` ,i. y _
� �_ I i
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r x
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�� �...� �....
•� ✓
: 3.
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�i .. . � ti.: � � t:,/'. -'. / / �
r aC -. ,�c_� _,, �. �. � � �' � ' ' !% '
, .. .... > � . :.
j � P'" �� . , ! � . ��
. , . x,_ , ..� , .- .
,. ... : . . ., .. '� _ ..
... , . ,� � ` ._ L. $ .
.. . � y '_'. , ,..
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L ' ; �iF . .. �' • . -: , ' ....' : f . ' .
�:-
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L�L/11.1.�a�a � � i_� �:t � � ��. v�.���, uv� �.
SE(:TIQi•d ?.. The Ins��ector of- i;uil�3iiu��� ::}►�ill, before i��suiiic� ��ermits ior thc c:r.cctic�n
of_ .�iiy 1�u.i.]cliii�J c�r .tLruct_ur.c•, c,l: for. ,:;:•; c�l�lit.i��i� L�� r�r,•< <•ri::ti�i�{ l,uil•lir<<� c�r. :,t.r_ii�..tur�•,
or iuz .���y .i1.Lc�rr�i-i.c��� ol r�.F,�iir:, Lr� u:,� c.r.� ;�in{� b�» l.clin�� ��r :tructur_c:, u��:,r�i �3j>j�l]c'��!.���:1
thnrLLUtc:, rc:<�uiL�� t}�c: �a�y�nc�rit Ly U�c �ai���lica��L f:ur� :�uc}i }.,�ri;�it of. Lc:c� Lo tlie antoui�t
hc:rc�in }�clow sc:L iurtli anci il� th� m�n�,cr. 1�cicin �>rc,vicic:ci �v-wit:
?IE�•� C01J�'i'RUCTIUP�: 5inyle P'ami.l7 Homes ancl Gar.ac�es: $�1.GU/1,UOU cubic fcei�.
PLAtJ Ci1I.CY.: 25 I�crcent of. buildiny pciznit tee.
DRIVLt�7AY llEPI2IiSS2Gi1: (Concrete Curb Strects Only)
Altcri�ziLF. A: N�rMaval �ind reE�lacemc;nt of concrete cur_b and
gutter only; Driveway width j.�lus 6 feet r. ;11.7�
AIt:G1"I1c1tC Ts: RemovaJ. and reF�laccmei;t of cor�crete curb and
guttcr and install a 3 foot wide a�proach with
6 inch cieptti; vrivew�y widtl� plus 6 feeL- r. $15.����
ADDI T I OPdAL I NFOR��IAT I ON
For the purpose oi computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying thc ground area covered from a
point six (6) inches below thc floor line of the basement or tn� 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 case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATIO� OF FOUNDATIQf�
NOTE: Permits foz construction will be issued a minimiun of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction si�te. �
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedir,g with the framing.
CtRTIF1CATE OF �CCUPANCY
Application for a Certificate of Occupancy shall be made ten (1G) days prior to the
use or occupancy of any stivcture for �ahich a builcling permit has been issued; and
s:�id s�uctur� shall not be used or occupied until a Certificate of Occupanc}� has
been issued.
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SuBJECT
City of Fridley ,
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
� `L __�___ COMMUNI7Y DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
� � �
� ����1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF
�"""'� � ��� 612-571-3450 910-Ft5 10/9/80 / /
JOB ADDRESS 5049 Fiughes A�enue N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 6 6 Carlson's $1II01Il1't M3Y101" $011'�.
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ronald Hewitt 5049 Iiughes 561-833'7
3 CONTRACTOR MAILADDRESS ZIP PHONE
Exterior Finishers 2835 Rice Street 482-8966
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE
5 ENGINEER MAILADDRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
❑ ADDITION C� ALTERATION
8 DESCRIBE WORK
Alteration to Deck (Add benches and railing)
8 CHANC3E OF USE FROM
STI PU LATION S
TO
'� 1596
.RECEIPT NO.
APPROVED BY
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
PHONE LICENSE NO.
O REPAIR ❑ MOVE ❑ REMOVE
SEPARATE PERMITS ARE FIEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
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 PEAD AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT $�-��-�0
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pERMfT FEE
PROVISIONS OF ANY OTHEii STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 1S`9s OO
PLAN CHECK FEE
�/ l � �' , '� ��
SIGNATURE OF CO ACTOR OR AUTHOfiIZED AGENT IDATEI u�uv.� nor
IDATEI �
OCCUPANCY GROUP OCCUPANCY LOAD
SQ. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$. 55
SAC CHARGE
TOTALFEE
$9.55
�RL VALIDATED THIS IS YOUR PERMIT
�'c.��' l C���i��"G,
CiTY OF �itIDLGY • � °
APPLICIITIO;d FO(Z (tESIUf:PI � IPt�_ QlIILDIi�G PERt�ITTS
(tde►•r, Aller�tions, Itddii;ions, or Repairs)
Ot�JIdER: � dP � � .
ADDRCSS : .��°J �i'�f �b�r�G�
�
TCl �i0: �f l � �33 �
0
�
�UI LDER : . - '
nndncss: 5 �
7c� r�da: y��-- g9��
Construction Location � '
• STItL�T NO: SJQ � STREF.T: �
. `
L07.': G/ BLOCK : �
� � :� ',+. /;_ja. _��_.,�a.�...�.. J ��.�.1..
Coxner Lot: Insicle Lot: SetbacY.:, Sideyards:
Ap�lican� attach to tliis form two Certificates of Survey o�' lot and
� proposed building location drawn on certificates to scale. �
� QESCRIPTIO�d OF COt•aSTRUCTIOfd •
� G�� Front: � Depth: Height:
( �-o�,�� .�� Squa�e. k'eet_ (xibic �'cet:
%t�e.,e_Q�.%rt ) •
. Front s Depth : Height:
Square� Feet: Cubic I'eet:
Type of Construction:
2b Be Cbr,�pleted:
� •
�
Estimated Cost: $ ����
. . Alt. A Alt. B
Proposed Dzive�•�ay W'idth If New Opening Is Desired: $' $
. ., SEE R�VERSE SIDE OF SHF�T
�iie undersigned hereb�� ma}:e� ap�lica�a.on for a permit i'ar the t:�orJ:� herein specified,
agreeing to da ,all work ir� stra.ct accordance �•�ith tlze City of Pridley Ordinances 2I1C1
rulings of i�lte DeparLment of Bui].dings, and hereby declares that all the iacts and
rcpresen tations stated :si this �.pplication are true and co�rect.
D�'�Tr: %O " f"�C.� SIGNIITUF�::
SL•i��ulations :
� C� C �;i
� Sf
______—�
� % s � � �_
��,�.,� �
�� -�--��' L`
�� �
� _ _� .�
;
' ' ' y�
• IIU1L1)ll�rc ��cr;�lr�r�' r-c�: sc:�irr�u�_�� �
_ .�..�,.. ..
�S1.:C'rx01�� ?.. • 7.'l�Z 7n�.:��ccL•c�r of 13u�.1c'.in�j :::lu�).7., bcfc,r.r. i.; .ui.���J J�cnnzL•s for t:he crr.cL•i.on
vf .�ny l�u�.].il.in!� ar :�t::.•uct:tirc, or. To�: any aQcli.Li.��n +�r� e�ny cr.i;;Li.��c� l�tiilclz�lg or :;L•zucL•ur.�.,
ci�' f:��- �,�iy .�J.t.c�:ltian or. r.clriir.:; L� •any c;:a. :�.s_„�� y�U�.�.a�.;��� or = L�:ucturc, uJ�wi ar���li_cat.i.on
thcr..:f.or.c, r.cqui.rc 1J�c ra}►mc�►t l�y Uic �-�Y�p].i.c:ant: �or. ��ucli per.mi.L• of fees to tl�c �n�unt
hcr�i�i bcl.cx•� scL• for.th �uid a.�i tlic tnannc�: hcici.n provid!scl t�-�•:it: •
l3El�l COIdS`I7:UC'LIOId: Sing].e 1'�zmil:y tlotr�es and G�r.ac�es: ;:4.00/7.,000 cul».c £ec�. .
]?LTs:� C1I1:C1;: 25 l�czce��t: oL• buj.lcli.ncJ ��er.mit ice. .
URI��I:I•:AY llL•'1'RI:55I01•:: (Concretr., CLl'f.}� �L-rcet� Only) '
' A�.L'Cl'll.lt:e A: Ite�noval and rej�lacctrient of concrete cuxb and
yui:t•er only; llriveway �•I1fItI1 plus 6 feet x�:],5.75
1�].L•crnatc I3: ]:emoval and rap�.acemcnt of concrete curb �nd
.� guttcr and iiist�ll a 3 foot r�ic3e aPProac:h �aith �'
' .. 6 inch depth; DrivcY�ay a�ic:th �plus 6 feet x$17.85 �
. . �pJ�I i' I O�/lL_ I f`FOR►t1AT I OP
Por the purl�se of compui;ing iees for building permits,. L-he cubica3. contents of any
build�.ng or. addition, is detcr.mi_ned by rnultiplying ihe gr�und area coverecl froni a
p�a.nt six (G) inches below thc floor J.S.ne of the basement or th� cellar to thc
average heights of i:he •unper surface or to ihe average heicPub of the roof surf:ace
oi �tie nain gable of a pitched rooi. �
Fox re�a�.rs or a].terations to an existang stn�cture, the fee shall ba at the xate
of $3 . i?0 rier each five hundred dollars `($500.00) or fract�ion ther�of in fihe cost
of all proposed wor.k. . . �
in •n� case sha�.l thc: ��e cliarqed ior any pennit as set iorth i.n 5ectian 2 be -iess -
tha:i $7.50 plus $.50 state surcharge. � '
- � � v�RrFic�Tro� oF rour�tnnr�or�
NOTE: Pennits �or consti�etion FT11� }JC'. issued a minimtuzi c,i 24 hours £rom Uie time
of appI.ication to d].low for proper reviec� of ihe pro�osed sLucture and oi ihe .
construction si.�e. �
� �
1� Ceri�ificate � of Suxvey of the lot, shoc.=ing the location of the foundation once it
has been cons�nictcd �.*ill be required before pr.oceeding ��ith the iraminq.
.�.�LF� ClIT� �F 0�..t'��PAt�CI'
npplS.ca�ic�n ior a Certif�cate oi Occu��ancy shall be mad� ten (10) days prior to the
use or accurancy ot an�► sti-ucture for �ahich a buil��i_ng perr,►it 2�as been issued; and
saicl stiuct.ure shal]. uot be used ar. occupied t•sitil a Ccrti.L•icate or Occui�ancy has
bceti i.ssucd.
n
0
f �
F°.-� .. ,� �� .
( �
�
� SUBJECT pE
City of Fridley 16 0 6 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � RECEIPT NO.
� i 4______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� i �
' /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF qPPROVED BV
4'""-�� � ,�� 612-571-3450 910-F15
3/16/81 � /
JOB ADDRESS 504� Hughes Avenue N.�'..
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ( 6 Carlson's �ulTIIQlI].'t Mc7S10Z' S011'�1 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
� i�nald S�ri.tt 504� Hughes Avenue N. E. 561-8337
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Av�ard Roofing 7801 Regent Avenue North 560-8849
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
R051CIPI1.'tl..d�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
.RerOOf DieiC�.�.].Il
9 CHANGE QF USE FROM TO
S1IPULATIONS
Roof can be. second but not third roof. Install ridged galvani.zed valleys.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP 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. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,375 �`.69
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
P OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S CTION OR THE PERFO CE OF CONSTRUCTION. S�. OO
PLAN CHECK FEE TOTAL FEE
$9 . 69
r1.� �. ��
SIGNATUR CONTRACTORORAUTMORIZED GENT �DnTE� - WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�;���� � cc� �
SIGNATURE OF OWNER�IF OWNER BUILDERi IDATEI BLDG iNSP �AT
0
0
CITY OF' FitIDLCY
Af'PLIG/1TIO�a r-orz �:ESIUI"i�ITIAf. E3UILf)IiJG PERt�7ITS
(We��r, All;er.ai:ions, !',ddiLions, or Rcpairs)
��
� dtdldER: �-�;_,�,r'�'F.� � a�.� �UI LDER : � -
ADDRESS: �Q�� � ��.� 1`� _ AUDRCSS: 7�� ` R�,,,,� � (�.
TEL �0: _ ��s � � 'b �3� �, 7EL t�d0: �J �o� � ����
--- _____
• STRI�T NO : � O � q
STREF.T:
Consi:ruction Location � '
o -
L07.': �j BLO�.^TC: �p A17DITION: �a`� ���� ��- „
Corner Lot: :Cnsicle Lot: Setback: Sideyards:
Ap�licant attzch to L-his form tcao Certificates of S�zruey czf lot and
� proposed builcling location drawn on certiiicates to scale.
DESCRIPTIOiZ OF COf�lSTF:UCTIOPd -
l�ro;it: Depth : Height:
S�uare. �'eet_ CuL�ic �Feet:
, Front: DeP� = Height:
Square• FePt: � Cubic I'eet:
�
Type of Construction: �?',f��,�'�� Estimai:ed Cost: $�°�7 �j �
7.b $e Cb��pleted: �� 1C � • .
.�..._� �
t •
• . - Alt. A Alt. B
Proposed Drive��ay tividth Tf New Opening Is Desired: $' $
. - �• SEE Rc.VERSE SIDE OF SHEET
�iie undexsigned liereby make� applic�-�tion for a permit fcr the �•vrk� hexein specified,
agreeing to �o ,a].1 work in str�.ct accordance c•rith the City of I'ridley Ordinances and
xulings of tlte Departr,ient of Buildings, and hezeby declares that all tlie facis and
iePres�n tati,ons stated :n this applicatian are true and correct.
D.'�T�: � SIGNRTLIF�E: ���'H (�C3.
Stipulations:
��b .� �. � 4,
?-•..� "
� �,.^ C�e��� °___.=-
�, � �j
! i ` .� �
? � A ���
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� � y'J�w
' • � e
4. _ . , . . . . • �
. �uli_n�r�c f'f:ft1�1•r r-�:�, :>c:�ir:r.�u�_�� ` .
;1.C:'.Cx01�� 2. '1.'1tL� 7n�.:��cctc�r. of' l�ui.lc?in�i %::liril.)., bcfc�r.c: �.:: ,�aa�►g ��w�niL•� tor t:lie crc:cL•i.on
uL• ��iiy )�u:i.l.rl.ir��� az :�t�-uct:tiLC, o�' fc»: .�ny .xdcli.l:i�m !:o any cr.i:;l:incl l�ttilcli�lc1 or :;tzuc�ur.c,
. ciY. l:c�r. a�iy t�].t:�•rr.�Lion or. r.clr�ir.:. lo �any c.:i.�:t:i»�� ht�i.l.di.�r.J or :;L•�.ucturc, U�)G11 a����la.r.ata.vn
'thcl:�ior.c, r.cc;ui.�-c tJi� P��ymr_��L• }�y U�e �zpp].i.cant: �c�r. sucl� per.i�i.L• OL' fCC.^, to tli'c �no�nt
hexciri bcJ.c�a� sc:L• tar.l•h �incl 5.» tiI1C ���annc�: hcrcin provicic:cl L•o-wit: •
. IJLI�� CO2J��!'I;UCTIOI�: �ingJ.c Famil.y ilotaes and Gar.acics: ,.4.00/).�0�0 cuLic �ect:.
)?7,F:.� CII3:C7:: 2.5 r�r.cc�►L- �f bui.lcli_ng j�e�-�nii: iee. .
URI:VI:tJ11�' UL•'YP.i:5Si01•; :(Concrefi.c, G1irU �trcets Only) '
• Aa.L'crn.Zt.e A: Itc:�noval and rej�lacement oi concxete curU and
yutter . only; I�riveway ��idth plus 6 iee� x�:�,5.75
A].t�ernate I3: }2emoval and repyacem!•nt of concrete curb and .
. guL-tex' and install a 3 ioot wide ap�roach �.►it}� '
' . 6 inch depth; Drivc��ay �•�ic:th �plus G teet x$17.85 �
. ' . Anni� �onn� IN�or�c��nLiori
I'or the purl?ose oi comput-i.n� tees for building pezmits,. tize cubica]. contents of any
buildi.r�g or. addition, is detexini.ned by rnuli:iptyir�g L-iie ground area covered f-rom a
p�a.nt six (G) inches below thc floor ].ine oi the basemenL- or th� cellar to the
averuge hcights of thc •upper sur_face or to ihe averaye heicPub af the roof. surf:ace
oi ilie raain gable of a pitched roof . �.
Fox ze�ai.rs or alterations to an existang st�-�icture, the fee shall� be at �the rate
of $3.00 xicx each five l�undred dollars °($500.00) or fracL-ion tliereaf in fihe cost .
oi all proposed wor.k. - -
Ir •n� case sha3.l th� �ne charged fc�r any pp-nnit as set. iorth i.n 5ectian 2�: �css �
tl�i $7.50 plus $.50 state suxcharge. � '
-� �� v�R r F r c� o_,� �F Four�nnr i or�
' NOTE: Permits �or construction tai7.]. be issued a minimtun ai 29 hours i'rom Uie tilne
�i application to a].lo�r £or proper review of the pro�osed si:ructnre and oi ihe
construction site.
A Ceri:3ficate of Survey of the lot, sho�aing the location oi the foundation once 3.t
has Ueen �constntcted �.*ill be required before �r.oceediaig ��ith the iraming.
�FRT I F� Gl�TE �,F �C�'�llPl�t�'CL • .
' i►pplication i'or a Certificate oi Occu}�ancy sha1.L bp madz� ten (10) days prior to the
L1�:C or OCCLll?3IlCj7 of an�► stz-ucture £or �aiiich a buildi.�tg perr,iit l.as heen i.ssued; and
s�aa.d structure shall iiot be used ox occupied t:iitil a Cextiiicate of Occurznc}► h�s
bcen xssu4d.
�
0
� .,�-.. _ __ .
. '
�
0
�
sue�ecr p
City of Fridley 271 16
AT THE TOP 9F THE TWINS g U I L D I N G P E R M I T
�
� � T NO.
� • COMMUNITY DEVELOPMENT DIV.
� LL ������, �'
f � � PROTECTIVE INSPECTION SEC. �s� �%�
i • � Cl [
( � �'��1 � CITY HALL FRIDLE� SS03P NUbIBER REV DATE PAGE OF APPROVEO BY
�----� • •`' 612-571-3450 910-Ft 5 8/ 11 / 98 / /
JOB ADDRESS
5049 Hu hes Ave NE
t LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACNEO
DESCR. ( 6 Carlson's Summit Ma.nor South Addn. SHEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
Ronald Hewitt 5 2-8337
3 CONTRACTOR MAIL ADDRESS ZIP PNONE UCENSE NO.
Suburban Exteriors 97 1 Pe n A X%X 42
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION 0 ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Reroof house and ara e 2 S Te r-o f
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZpNING SO. 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
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVf READ ANO EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHEF SPECIFIED HEREIN OR NOT. THE Gi;ANTING OF A PERMIT 2O8S 1.O(�,
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
TRUCTION OR 7HE PERFORMANCE OF CONSTRUCTION ]I{, ],rj Z.OS Fire SC
�PLIlN CHECK FEE TO FEE
ce>�:�%� �— I ( "�� .
SIGNATURE OF CON7RACTOR OR AUTMOR12ED AGENT IDATEI EN Fl VALI T THIS 1S R P MIT
� �J a
S�GNATURE OF pyyNEA UF OWNER BU�LDERI IDATE� BL �NSP qpTE
� �
NEw
ADDN
ALTER
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ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
C�
/U�
Effective 1/1/98
��1�' ���
� �b
Owner Name & Address: �� V���. � �� � '�� 9' ��eS /� �Tel. # �� � � 37
Contractor: ��/�t�F'�dA v1 �.�"� jn5' MN LICENSE #�-Z�j�
Address: �Ul Q�V��- �p. S, e��N„e �v�. S��f�/ Tel. �t �� � � �Z3Z
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:
�
DESCRIPTION OF IlVIPROVEMENT
Length
Length
Length
��Si
Width Height
Width Height
Width Hgt/Ground
- � ��O �- � �
�
Sq. Ft.
Sq. Ft.
Sq. Ft.
� �
Construction Type: Estimated Cost: $�� p�L:��� �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �� 1� ^� APPLICANT: � r,re �� i�v �a9�'Sc� Tel. �#
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ ��� . � .��Fee Schedule on Reverse Side
$ �� - C� c�_'_ .001 of Permit Valuation (1/lOth%).
$ /, � � $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ .S � � ` C� $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 O�cial shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$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
$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 $1,000,000
$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 times $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 minunum 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.
D . ,
3uilding
Tnspections
763-572-3604
�ITE ADDRESS
i HIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRII�LEY
��
����
❑ OWNER
�RO-I'ERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
I YOUR STATE LICENSE
WITH APPLICATION
PROFERTY TYP�
PERMIT TYPE
�E oF woiuc:
�
�ESCRIBE WORK BE]NG
>IZE OF Il��PROVEMENT
200FING
dUMBER OF SQUARES
=A.RAGES
'ROPOSED SIZE:
'ROPOSID HEIGHT:
n
�
ADDRESS
S � �'G �Y� crrY
N��— The Home Depot A.H.S. Inc.
sTA� Lic 3200 Cobb Galleria Pkwy.
anDx�ss: Atlanta, GA 30339
PH� 763-542-8826
❑ �rwo FA License #20268257
0 BASEMENT FINISH 0 ROOF
O DECK ❑ SIDING
❑ SWIl1�IIvIIIVG POOL
LENGTH
❑ HOUSE ONLY
❑ HOUSE 8c GARAGE
0 ATTACI�D GAR.AGE
� DEfACHED GARAGE
Pernut No.:
Received
Date Rec'd: �%� �7��
'��!
r .� o s� S
: �i��� 3��s-���7
LTTI' STATE ZII'
❑ DRAIN TILE
❑ OTf�R
ZtS!
HEIGHT
BASEI��NT REMODELING SUBNIIT•
1. Existing Floor Plan
2. Proposed flaor plan
3. List of structural members to be osed
Ft
;IDING FOR NEW CONSTRUCTION INCLUDING DECKS,
� v�Y� OSoffit ADDI'TIONS. & PORCHES SUBNIIT•
�`���� � TT� 1. Site Plan/Survey showing the eacisting strucwres
J Ofher ❑ Fascia and proposed project
5'INDOWS 2. Two sets of c�nslructio� plans
I� EXIST'IIQG OPENINGS C�ie QNo LQCATION OF WINDOWS D� lll ilL� rb o�') 3. Energy Calculations
)R FOR NEW OPENINGS-DESCRIBE SIZE OF
>PENING CHANGES &
'YPfi OF WIISDOW TO BE INSTALLED NUMBER OF WIl�IDOWS �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA,TERIALS;
(LTSING �E 19 7 U.B.0 FEE SCHEDITLE)
TOTAL JOB VALUATION $ I/ ��� OCCUPANCY TVPF
'ermit Fee
'lan Review
�urcharge
'ire Surcharge
,icense Surcharge
AC Charge
:urb G�zt Escrow
;rosion Control
ark Fee
ewer Main Charge
`otal Due
$ ��, ��_ � C�
$
$ .9
$ I.�iC9
$ S� OO
_$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (Sta.te Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks pa_yable to: Citv of Fridlev Attaeh
THIS IS AN APPLICAT70N FOR A PERMIT-NOT VALID UNTII. PROCESSED
olatinne
hereby appIy for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in
onformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a
emut 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
lan in the case of all work which requ' e review andapproval o€plans.
[GN�URE OF APPLICANT � I % � PRINT NAME �! �- � �G� �l'�� DATE � ( � � � � O �
Page 2- Builda.ng Residential Application
BUII�DING PERNIIT FEE SCHEDULE
The Chief Bui.l.din.g Official shall, before issuing permits for the erection of any bu.ilding or
structure, or for any addition to a.ny e,�isting building or structure, or for �xy alt�ration or repair
to any e�sting building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth an.d in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Permits for constructi4n will be issued a minimum of 24 hours from the tim.e 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 wi.l.l 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