AF - 46416�
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City of Fridley, Minn..
BUILDING PERMIT
Da�, L& 17 October 1966
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N� 9U58
Slab - Superior Concrete
p�r; L1oyd W. Fitzer g�� Se1f N �
Ad�esa 5108 Hughes Ave . NE Address �
LOCATION OF BUILDIIVG
No. .�5108 g�t _ Hu�hes �ve . NE _ �_ p� of Lot
Lot 10 __ Block � Addition or Sub-Divis�tan �arlson's S'u�it Manor South
22 E. of Mai� St.
Coraer Lot — Inside Lot _.._. x Setback � deyard ._
Sewer IIevation
Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Garage �t 24 �p�, 22 xeight 13 �. � 528 �� 6864
Front Depth Height — Sq. Ft Gt�. F't.
�pe of Constructfon ���e Es� Cost �1,100.00 __ To be Completed 1 J�uary 1967
In cansideration of the issuance to me of a permft to construct the building described above I agree to do
the proposed work in accordance with the description above set forth and compliance wlth a'11 provisions of
ordinancea of the dtq of Fridley.
� ��
In conafderal3on of the payment of a fee of $ 5.00 ��t � hereby granted to Lloyd W.
litzer to construct the buflding or addition as descxibed above. Tl�ia �raiit ia granted upon
the express condition that the person to whom it fs granted aad his agents, employees and worl�aen, in all work
done in, around and upon said huilding, or anypart thereof, shall conform in all respecta tfl the or8inanc� of
Fridley, Aiinnesota regardin� location, conatruction, alteration, anaintenance, repair and moving of bufldiugs
within the dty limits and th�s permit may be revoked at a�y time upon violation of aay of the provisions oF ssid
ordinances.
CLARENCE BELIS"LE B��S �
NOTICE:
Thb psemtt doa not ievar ths eons�rocHoe, InataUaHoe �er wtring. plmebine, ea he�ting, iewe� or waMr. B� wro to a�
1hs Bnildlep lesp�etoe foe �para» parmtfs Ior �6as tt�nn.
�-
APPLICATION FOR BVV�DIlVG PERI��,T
CITY OF FRTD'�,EY, MII�TESOTA
owNER's NAME �, /� �_, c� /� t-i>"�. �.
ADDRESS `f �`i C� ��.-, ���; �c/c �C/, �- ADDRESS
� �
LOCATION OF BUILDING
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�m � � /���e `� �� � ��'
NO„ �/ C� � STREET f� c.r �'��. s,�v�.= dtt///� PART OF LOT - ,.
. -� � dt,+�.06e�4-� "�_. ��',�,�-�
LOT BLOCR DI7.`ION Ol� SIIBDIV�Si�ON ��°��.-,� ��,�. �'�%.�
�����.��r-�- �. �. /�
GORNER LOT INSIDE LOT � SETBACR � ;�- � -� � ���F`� � ��DE-YARD � � � � �
,, ��- �
SEWER ELEVATION %'ODI6DATION ELEVATIQN
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on theae Certificates.
DESCRIPTION OF BUILDING
To be used as:
, ���� , .
r Front_���Depth�Seight /,�
� � Cu. Ft . �'� �� ��
� Sq. Ft._ �� �? 6
1�ront Dept ��_Aeight
Sq. Ft. Cu. Ft.
Tqpe of Construction Eatimated Coat_ f`� �y� "``
To be completed _
The undereigaed herebq makes.application for a permit for the work herein
apecified, agreeing to do all wo�k �n strict accordan¢e w�th the C�ty of
Fridley Ordinances and ruliags of the Department of 8uildinga, and hereby
declares tha,t a11 the facts and representatione etated in this application
are true snd correct.
DATE � F� ' �' � - � � S�GNATURE %%I/. �
' � �
(Schedule of Fee Costs can be found on the Reverse Side)�.
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BUILDING PERMIT FEE SCHEDOLE
SECT_, ION 2. The Inapector of Buildings shall, before iseuing any permit for
the erect3on o£ any building Qr atructure�'�or for any addition to any exiating
building or �tructure, or for any alterations or repaira to aay existing
building or structure, upon a�splication therefore, require the payment by the,
applicant for .auch periai:t of .�ees to the .amouat hereia be].ow set forth and in
the manner herein provided to-wit;
2.7.. �For any euch permit for the erection of any fire-proof building,
other tha a garage, warehouae, �actory�or grain elevator, or for the erection
of any fire-proof addition, for similar occupancy, to any egistiag building,
sha11 be at-:the rate oi $1.4�-for each.aa� thousand cuhic feet, or fraction.
thereof, in such cubical contents. .
�• . .
2.2 For, any such permit for the erection of any £ire-proof .garage,
warehous:�, factary or graia eleva�o"r, or for the erection of any fire»proof
addition, for similar occup�ncq, to any existing building sha11 be at the .
rate af $1.25 Eor each one thous�and cubic-feet, classifiAd as "fireproof"
by Section 502.of the Minneapolis 8uilding Code.
HOIISES
2.3. For any such permit for..the eraction of any non-fireproof
building other than a garage, warehouso, factory or grain elevator, or
anq non•fireproof addition, £or s3milar occupancy, to any existing bufldiag -
perm�.,t $1.00 for each one thousand cubic feet.
GARAGES � -- , - . � ..
�_
2•4. For any such p�rmit for the erection of any non-fireproof garage,
warehouse,.fac�orq or ffiraia elevator, or for the erectian of any non-fire-proof
addition, for similar�occupancy, to any �$fseing buildi�g or for each such �- -
building or addition - ninety ceats _($0..9,.0) for each one thous.and cubic feet
or fraction thereof,- in the cubical contents thereof with the minimum of $4.00.
For the-purposa -of computing fees for build�ing permits, the cubical contents
ot any building or addition to a uniform height throughout by muitiplying th�.
ground area covered frrsm a po�nt six (6) 3nches below the ftoor line of the
basement or cellar to the average he�ght of the upper aurface or to the average
height of the roof surfa�e of the main gabls of a pitched roof..
2.5. For repairs or alteratioas.to an exiating eCructure, the �ee ehall
be at the rate of $3.00 per egch Five:$uridred Dollare ($500,00� or �racti�n
thereof in the cost of a1Z proposed work.
2.6. Ia no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00. ;,. -
STORM REpAIR DAMAGE FEES;
Residential;
Cor�nercial;
` ' -� .
Estimated Cost of v�ork up t� �5�0��0 -$S.qp
Estimated Cost of w�rk over }_z "�:,�� �;J -$� G, a0
Esti�r.�e�ost a� �a��rlc up f:� ;;�� h:i�q:� $1�0
Est�i�,.te� _;ost of wuik over $5G"�1.U0 -$�. 10
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6��,�� ~��NG HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND ELECTRIC. INC.
ADDRESS � APT. FLOOR CITY F�B��'�� SUBURB
OCCUPANT �� Z� OWNER
HEAT LOSS DATE HT(3. INST.
SOLD BY INSTALLED BY Bt.A►YN� HT�, AdG ,;=�.� d�'. �R.�;;�
Electrieat Wprk By Gas Llne By y�- %'i `` °� +•�
TYPE OF MfAT OA FA HW 3TEAM_ SPACE HTR._ UNR HTR. OTHER . d `d
OAS DESIGN CONVERSION
l�IAKE MAKE OF BURNER
Model Model
��a� r 'Z Max. BTU Reting
-IMPilT - — - — -- -- -- _ - '"KEIIFF'l1RNACE- ---
CONTROLS
THERMOSTAT Hea4 Plug
Valve
Umft
, 'Ltmit Sefling
Fan Setting
Pilot Type
Pilot Make
Model
e�
ve� s� � .
KIND OF UNER PQS� _ SIZE NONE
DraR Hood R�ulator
Fllters Size Number
Chimney Localion Instde Outside
Chimney Construction
Pilot Model Smoke Bomb WIHng
Pliot Timing Draft Test Tag
L W. Cut Oft Door Pressure UghUng Inst.
Pressure Percent CO, e Date Tested � r�
Input CFH Pereent O, Company Testing �
Stack Temp. Pereent CO e�' NBme of Tester
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
f
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COMMUNITY OEVELOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC.
� '_ �"'1 � CITY HALL FflIDLEv 55432 NuMBER
�""� � �'� 612-571-3450 910-Ft 5
JOB ADDRESS 5108 Hugh'�s .Avenue NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 10 7 Ca.rlsonts �
2 PROPERTY OWNER MAIL ADDRESS
Fitzer, Lloyd 5108 Hughes Avenue NE
3 CONTRACTOR MAIL ADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL
6 USE OF BUILDING
Residential
7 CLASS OF WORK � NEW ❑ ADDITION
8 DESCRBE WORK
Interior alterations. to kitchen/
9 CHANGE Of USE FROM
STIPULATIONS �ee n9tations on plan,
REV DATE PAGE OF
4/6/93 / /
t Manor 5outh Addn.
ZIP
ZIP
'M'ERMIT NO�
217�5
ECEIPT NO. �
Iazz
APPROVED BY
SEE ATTACHED
SHEET
PHONE
572-8248
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE IICENSE NO.
ALTE�iATION ❑ REPAIR ❑ MOVE ❑ REMOVE
livina room areas
TO
SEP
rVlRjN�'� TE pE�,�
, �� T'��� �s ������'
���e��� � F��
��� �,G�';
.
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PWMBING, HEATING,
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. UN
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �"
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`],O, � OOO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOfiITY TO VIOLATE OR CANCEL THE pEfiMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`1].7sOO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FI
N/A
OF CONTRACTOR OR AUTNORIZED AGENT IDATEI
d �� �.��„� � .��� ;��
.r n�nrn�rc �ic nwNFH R L ER�- IDATE�
�CCUPANCY GROUP OCCUPANCY LOA
SQ. FT. CU. FT
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$5. 00
SAC CHARGE
Fi:re SC $10 . 00
TOTALFEfE
.�13G e00
:RL LID TED THIS IS YOUR PERMIT
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h'= W 6'=0" ;-�<.�- K.x.r_ .kt,-. ti/,4�.,.c,s. -
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. This Plan Must
-:SCAL� ; " - ' �� �- � Be Maintained And
Y . . r - 8 _. _.. _ . _. . Accessible On The
� . Construction Site
� �.Q��-F1T..Z��R. -----�-- . .
5'�oe�j-u.C�t.►ES �Sv��+t.�+---- - .
. � .�92=e24B�.- ----=-- � - .���i�
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N� [ l
ADDN [ ]
ALTER [ ]
Construction Addr�s:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
�� ff��°�cs
0
Effective 1/1/93
��o2Z
j,egdl DPASCtIptIOD:
Owner Name & Address: � %a� �. �� E� Tel. �iTS �� - 8� Sl �
Contractor:
Address:
MN LICENSE �
Tel. !�
Atxach to this application, a C�rtificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
U�
p��.�� �,� � . � e
LIV NG AREA �I.ength �� � Width /%� � Height .�, _ Sq. Ft.
GARAGE AREA: Length � Width Height Sq_ Ft.
DECI� AREA: Length `Width Hgt/Ground Sq. Ft.
OTHER: ���s'n� / �' i�� j� `� .� � I
Corner Lot [ ] Inside Lot [✓�
Type af Construction: _
Approx. Completion Date:
Driveway Curb Cut 'Width Needed:
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $./ 0, � �� L�
(Cost on Back)
Ft. + b Ft = Ft x$ _$
�
DATE: `- � ` �� APPLICANT: � ��- ��' Tel. # S %� � �� y�
Permit Fee $ �i � � �
Fire Surc�arge $ 1 D • � �
State Surcharge $ �. C�O
SAC Charge $ p�'-'
License Surcharge $ ��
Driveway Escrow $ ��'
Park F� $ —�
Sewer Main Charge $ ---
TOTAL
STIPULATIONS:
$ l 3a. Do
CITY USE UNLY
Fee Schedule on Reverse Side
.001 of Permit Valua.tion �UlOth%)
$.50/S1,(}00 Valua.tion
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Ait. "B" Above .
Fee Determined by Engineering
Agreement Necessaiy [ ] Not Necessaiy [ ]
0
BUII.DIN(i PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or stiucture,
or for any addition to any existing bailding or structare, or for any alteration or repair to any existing
building or . shvcture, upon applir,�tion therefore, require the payiae� by the applicant for such permit
of fees to the amount he�ein below s� forth and in the manner herein provided to-wit
TOTAL VALUE
$1 to $500
$SOl to �$2,000
FEFS
$15 (Nlinimum Fee is $15 plus sarcharge)
$15 for fust $500 plus $2 for each additional $100 or
fraction thereaf, �to and including $2,000 �
$2,001 to $25,000 .$45 for fust $2,000 plus $9 for each additional $1;000
. or fraction thereof, to and including $25,000
$25;001 to $50,000
$50,001 to $100,000
' . $252 for. � first � $25,000 ples $6.50 for each additional $1;000
� rn' fraction t�tereof, to. and including $SO,U00
$414.50 for first $50,0(� plus $4..50 for each additional
$1,000 or fraction thereof, to -and inclading $100,OQ0
$100,001 to $500,000 $639.50 for first $1�,000 plus $3.50 for each additional �
$1,000 or fcaction th�eof, to and including -$500,(m0
$S�,OOi to $1,000,000 � $2039.50 for the first $500,0� plus $3 for each addit[onal
$1,Q00 or fi�ction thereof, to and iacluding $1,000,0�
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for �ch additional
$1,OU0 or firdction �thereof -
DRIVEWAY DEPRESSION ESCROW
(Concrete Ct�rb Streexs On1Y)
Alternate "A" : Removal and repla.cement of curb aad gut� only - Driveway width plus 6 feet time.s
$13.50. -
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide.
approach with 6 iach depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for coastructioa will be issued a minimum of 24 hours from the time of application to allow
for pro�r review of the proposed structure and of the cons�ruction site.
A Certificate of Survey of the lot, showing the location of ttte foundation once it has it has been
constructed will be required before proceeding with the framing.
�-_,
�--,.. -
sue�eer P
City of Fridley .
�
AT THE TOP OF TME TW�NS g U I L D I N G P E R M I T �2 9 � s 2
,,
, �, �'9��
� `y � � _ COMMUNITY DEVELOPM�NT DIV.
r � • � � PROTECTIVE INSPECTION SEC.
1 .1 �
� 1 �'��1 � CITY MALL FRIOLE� SS�32 NUMBBR REV OATE pAGE O� AVPROVEO 8Y
��°��' �'� 612-571-3450 s�aF�s 4/12/99 / /
JOB AODRESS 5108 Hughes Avenue NE
t LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. ],O 7 Carlson's Summit Manor South Addn SHEET
2 PROPERTY OWNEFI MAIL AOOR�S$ 21P PMONE
Lloyd Fitzer 5108 Hughes Avenue NE 572-8248
J CONTRACTOR MAIL ADORESS 21P PHONE IICENSE NO
Viking Home Improvement Co 4832 2 1/2 St NE, M ls., MN 55421 572-1820 4772
4 ARCHITECT OR OESIGNER MAIL ADDRESS 21P PHONE IICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE IICENSE NO
8 USE OF BUILDINO
Residential
7 CLASS OF WORK
� NEW p ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear-off
9 CMANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
� TYPB OF CONST. OCCUPANCV GROUP OCCUPANCr LOAD
SEPARATE PERMITS ARE REOUIRED FOFi EIECTRICAL, PlUM81NG, HEATINfi,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZpNING S�. FT CU FT.
AUTHORIZED IS NOT COMMENCEO Y�IITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS A7 '
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIfV THAT I MAYE READ AND EXAMIN�O TNIS APP�,ICATION 1 STALlS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
ANO OROINANCES GOYERNING THIS TVPE Of WQfiK WILL QE COMPIIED �, 94
WITM WHETHER SPECIFIED MEREIN OF NOT. TME GRANTING OF A PERMIT �1 �SSS
DOES NOT PRESUME TO GIVE AUTHOqITY TO VIOLATE OR CAMCEL TNE pEqMIT fEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING coN• �59.SO Fi SC �L.BH
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
,Q��or� PLAN CMECK FEE TOTA F E
s/ 67 % Z`�� Licens $5 .0 7 .32
SIGNOTUAEO CON:AACTOpOpAUTMOp�2EDOGENT IOATE� EN O A AT IS �S VOU PERMIT
, � �
S�GNOTUAE O� OWNEp��i QWNEA BU0.DEA� �OAfE� � Bl0 �NS� ' fj°TE
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��.�y..
BUILDING PERMIT APPLICATION (,�� a.0
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ConstructionAddress: .� /0�' /� � G N-�-S /� ,� L- �/-� •
Legal Description:
Owner Name & Address: /�iTz�✓�
Tel. # � lz �.�7Z -�L r�
Contractor: tJ.�i� zi�- y �� �� .�.� P_ Cv • MN LICEN5E # y� � 2
Address: ���� �- �Z s �� �v . � , Tel. # % �Z -S � 2 -i�' z �
LIVING 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
Length Width Height
Leng� Width Hgt/Ground
-_� . �`.y6 ,-►,�� �I���E �' � -J �� �
Sq. Ft.
5q. Ft.
Sq. Ft.
� °
Construction Type: /�� ��� F Estimated Cost: $ 2 Z� ���`" �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: G y- i 2-� S APPLICANT: ����- Tel. #��2 �2- ��Z d
Permit Fee
Fire Surcharge
Sta.te Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ - c�L�
�_
$ l � �� ���
$ �'�
$
� �� �'��
$
$
$
$
$ � ��
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,OQ0 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contxactors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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BUII.DING PERMIT FEE SCHEDULE
The Cluef 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
$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 G�trb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
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 $23.25.
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 requireel before proceeding with the framing.
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