AF - 46429BUILI)Il\TG PERMIT
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V�.l.la�e of Fridley, Minn. �� 2 2� 4
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Date . . ...:.� . .; � -:{z:�.. .. .. .. .. .
Owner �'', ��. . .�-''��. . .'. *�. � �.'�-'��. ". .'�•°� � .
Address �.�'�". : �. .�. �� � ; ����. ���� .�.� . . . .
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Builder �; � �, �t�-��.. . . . . . . . . . . . . .
Address . :��,...?'t'°`� °p �� �� �. . � . . . .
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LOC�4TION OF �UILDING
No.���'R �..�
:�°: . `�., �. . . . . . . Stree� . v �': . .��f. .�. . . . . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . .
. ...... ...........
Lot................ Block ................ Addition or Sub-Division .......................................
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Corner Lot ........ . Inside Lot ............ Setback .. "
.......... Sideyard ..........................
. DES�CR[P'1'IOiV OF BUILD9NG
To be Used as:
d, � .� � ��'`' ���
. . . . . . . . . . . . . . . . . . . . Front . ". �. . �.�. Depth . . . �. . Height . : . . . . . . . Sq. F't. . . . . . . . . Cu. Ft. . . . . . . . .
.................. �F'ront ........ Depth ........ Height�.,,�......
S � f
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Type of Constructia : :`":�'' Est Cost .':�. . . .�.� . . . . . . . . . . . . . .
Sq. Ft. ........ Cu. Ft. ........
To be Completed ...................
In consideration of the f�ssuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
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•.���consideration of the payment of a fee of $. :`. . . .. . , permit is hereby granted to �` "�"��``���'t �"""�`: ; , ,
........'........... to construct the building or addition as described above. This pernut is granted upon
the express condition that the person to whom it is granted and his agents, employees and worlmien, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesot�. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village 13miis and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. �,� �" �
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NOTICE;
This permit does noY cover the construction, installation or alteration for wiring, plumbing, gas heattng,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
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City af Fridley, Minn.
BUILDING PERMIT
nat�: � 25 � 1965
p��: P�erle B. P38rce ��r Sus881 Co.
Aaaress ��n� A4e• N. E. aa�ess 1850 Como �venne
Na 7526
LOCATION OP BUILDING
No. 5�7b st�et Hn�h�s A�e. �T. �. Part of Lot
Lot _ Block Addil3on or Sub-Divisfan �
Corner Lot _ Inaide Lot Setback Sideyard
Sewer IIevatiam
Foundation IIevation
To be v�a as:
Garag,e Front
Frant
Type oP Conatruction
DESCRIPTION OF BUILDING
Depth Height Sq. Ft Cu. Ft
Depth �Teight Sq. Ft Cu. Ft
�. F�t. Cost �QQ�._ To be Completed
8ebuild Garage �torm Dama�e Repair
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In canaideratlon of the issuance to me oP a permYt to construct the buildiug described above I agree to do
the proposed work in accordance with the d�scription above aet forth and in cbmpliance with a'11 provlsfons of
ordinanoes oP the dty of FrirIIey.
In camsfderation oP the paqment of a fee of �-�-•� = , Permft is herebY granted to u�9sel COmpBt�*'
to construct the building or addition as described above. Thispermi t is granted upon
the expresa condition that the person to whom it 4a granted and his agents, employ�s an� worlunea, in aII work
doae fn, around end upon eaid buflding, or anypar� thereof, shall conform fn all reapecta to the ordinanc� of
Fr1d1eY, Minnesota lacation, conatructt�on, alteration, maintenance, �epair and moving of bufl�inge
wi�th�e dty limiffi� an�� permit may be revoked at an,y tiime up� violation of any of the provisions of ssfd
Buildia8 Ins��ctor
NOTiC�
ihb permtt dea ao� eo�e t6s eeustroeri�, tnshilatioe M� �rirtng, plumbtng, ea hadng, aw�r e� wafsr. B� an to a�
tla Batldiu8 lasputor for ap�rab p�rmN� for 1ha� h�ms.
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APPLICATION FOR 8 ZI�TG PERM[T , ,. .d
� � C�Tii OF FAIDLEYy !�IN1�30'�A `
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LOG�TTON OF ��iidG
No.— �� � �C� ` St���t , �� , �,E �� %''� ��� �" �'art of :Lot .
Lot Block Addit.io�! or Subd��ision
Corncr Lot Inside 3,ot_ __z,.�et�s�k Side-Yard
SEGJER, E�EVATIVN FOUNDA�.'ION EL�VVA°r'iON .
Apgli�ant attach to thi3 form,T`ao Certificatee o£ 3urvey of Lo� and praposed bulld�
ing location di��wn o�i these t;eY'tificatea .
DESCRII�ION OF BUII.DING
T�o be used �.s:
!� '� He,ig2it f c�' E
.... ....•
9q. Ft. Cu. Ft. �
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FronC Depth Aeight
St�. Ft. Cu. Ft.�
Tyge of Construction ��';��,,c Estimated Cost ��� ��
. . ,�„
The undersigned hereby makes application for a permit for the work herein specified,
agreei� �o c�o a1,1 work ii� atr�.c� accorda.nce with the City of Fridley Ordiaan�es and
rulings o� tl�e Department' of Buildin�s, aad hereby decLares that all the fsacts and
represeatatiaas stated in this applicaticn are true and correct.
1:���. `�
.���ule n�£ Fee Costs can be fouad on the Reverse Side).
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Seetioa 2. The �nspector o� Buildin�s •sl��.11 f b��o'rp :is�.uiug any permit for
, th� srection of any buildi� or stru�t,�l�re� ar tQr ar�y add�.ti� t� any exiat-
. i�ng bu9.ldin� cir aCructure, or fcr �lay g�teta��4�s�¢�r�:repair� ta an�► exiating
buildi..�g or sCructure, upon applicat�:oc� �}�refor, ��q�ire the payme�tt by tbe
applicant for �uch permit of feea •kp� �the amoun� •�i�reia• below set �forth a�ad
�in Che manaes here3n provided to-w�.t:� .
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2 �1. �'�tr �ny �uch permit �or the ea.e&,tion �ofi�' anq �_1aG�ja��f build�p�, o�her
• ' , tban a �,ar�ge, . r�ar•eiaoua�, factory ot� &��..a' °�'�e�ra�.r.�, � �ar. the e��stion of . ,
.' �y fire-p�of addi�i.on, faz sin��,lar":oic�;iip8ncy� -�b: at��+ c��:is�t.i�ig bu�1d�.�g . ...
�hall �e at tha rate gf $1.4Q for aa�l��ott� thausE��nd �t�bic feet, or�i°r�rf�a
�r ., thereof, i.n such cubical aont�n�a.� . �. . . . � . ' ' � � . • �
n �
2,_2,�, For any such� permit fo�•...��e exectioa o$ any firerpraof g�rese. ����^�•-^,, :
f�ctory sr grain elevator, or fp�� the �c�c.tion e�E aa� �;ir•�pr�oo� .•.�
f�r similar .occu�paa�y, to any exieting jt��ldi�ng sha],.1� •be �t tbe ��
.�.•�for eaeh oue .Chc�usend cl�bic .feets'..�lasai�ied �asi"f3reptovf" by S�
the �.iinn�,.���a sutidins co�e..:;,s.::,: � . '
�� aovs s
� 2.�:. Fcir aa�q such permi� for athe er.�ction of any non-firepa,�v�f buiid3ng ottt�r
'the,n a�axt�8e, warehouae, factory or. grain elevator, 0r auy �oa-f3repr�►f �'°,
edditivn, gor s3msd,�� ocCup�hcq, to an��► eakisttiri� "�iuild3n,g - pesm3� $�.�QO fos
each �one thou�ati2i c�biiC, fe��.. .
GA�A�ES . , .
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�` For any euch per�it f�r the erection of any non-fire�soof gaaa�e, ..
warehou�e, factory or �rain �levator, or for ehe erectio� ;,E 4r.y non•firepraof -
additioa, €or similar occupancq, to aay exist3ng building br for eec� such �' �
i�ui].diag or addition - niaety e�ats ($0.90� for each oae thousand cubfe feet
` or fraetion thereof, in the cubic�l�conteats thereo£ wfth a minimum of $4.00.- �
For the purpose of camputing fees for building permits, th�.cubic�l cvr�tesCs-�
of aay buflding, or additfon to a uniform.height throug°hoi�r:'by muleiplying �1i� �
gro�tnd are� aovered .fsom a poi�t eix (6) imch�� b�lo-�r� �he �loor 19aa�a ttf the
baeement or cellar to the average heigh�.of the upper su�fece or to the
average height of the rpof suzface of the maim g;able of a,�93tched roo:€. �� �
2.5. •. For repairs or aiter�tions to an exiatirt� sGsuct�r�.y �g �ee s�al�l be ��'r .
: at the rate of $3.Op per egch Fiv� F�undred. Dollar,,a .($S0�':#��}) qr �raction
..� therebf it► L�he coe-t ��t .�11 propoaed work. , . ' , � � a� ' , , � � � . .
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2_.6 _ Ia ao. car= :-�.�a`�.� �3i� fee,. charged-�fcx r�i�y ��,::.�t� .�,, set gdi�'tH itt �
� Sectioa 2 be lesss e:�an $4,00: . . • , . � �; '
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BLOCK
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NAME
ADDRESS
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AREA
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SIZE :
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City of Fridley, Minn.
BUILDING PERMIT
nate: dune 1, 1965
No '7626
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ovvner: �r�rl�Pier�s swufler S�asel Co.
�are� _Sl?���es N. E. A� 18_ 50 C�c�o St. P�ul, I�3nn.
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LOCATION OF BUILDING '
No � Street H�B� �• �'• Part oP Lot
Lot _ Bl�k Addition or Sub-Division �
Coraer Lot
Sewer IIevation
Inside Lot Setback Sideyard
Foundation IIevation
To be Used as:
Front
Front
Tj�pe of Construct[on
DESCRIPTION Of BUILDING
Depth Height Sq. F'k
Depth FTeight Sq. Ft
-- Fs� Cost �-a z�* � To be Completed _
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4 :
Cu. FL a —
GtiL Ft
Dett. Gar. Storm dam,�ge repair
Ia considerat[on of the 9�uanc� to me of a germit to construct the 1
the proposed work 9n accrordance with the d�scrlption above set fo� an
ordinances oP the dty oP Fridley. (/ / r
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ng described ai�ve I agree to do
comPliance with a'li provisfona oP
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In consideratlon of tl�e paymeat of a Pee of $ 10• (� � permit 9a herebY granted to StlBSel Cfl •
to construct the buflding or additfon as de�cribed above. This �ermit is granted upon
the expres� cronclition that the person to whom it is graated and his agents, employees and worl�nen, in all work
done fq around and upon seid building, or anypa� thereof, shall conPorm fn all reapects to the or8inance� oP
Frldley, Minnesota regarding location, construct�Ton, alteral3on, maintenance, repair and moving of buildinga
within the dty ]imfts and this permit may be revoked at any 1�iaae upon violai�lon oY any of the P�vls�ttona of said
ordlnance.s.
Allen Jensen B„��s �
n NOflCEs
1W � dea erot wrer f6s eoeshueHoe, tes�aQ�on fer rrlrte5. P�m6. Y� 6�9, �w�r er wafsr. 8� aes to sw
ffis Baitdio8 I�ta� tor aparati p�rm6s h� f6a� N�ms.
A
OWI�R' S NAME
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APPLICATIAN FOR iNG PERMIT
CI7.`ii OF F'RIDL�Y� ; SOTA . ,
�f�G �� BUII,DEIt �,PS� �'�G �''�.
,ADDRESS ���� �ii���� .�a ��� �bDRESS • ��.� ���%i�l: °��-,��,�
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LOC�TiON OF E�ING
No. Stt��� . Part of Lot.
Lot B1ock Additio� or Subd�vigian
Corn�r Lot Inside �ot __:,:�et�k Side Yard � - �
S�WER E�E�VATIQN FOUNDATION EL�V�TON
Applieant atCach to th�i4 form,Two Certiffcates ot,Survey of Lot-aud prapased build--
ing location d��wn ort these Gei�tificates. -
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DESGRII�T'tON OF BVII.DING �_
��7"�/ .��'�'� - � ����-�e'�- G�°���6� ��'���a�G�%
T�v be used �,s : � �P �
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�rv�sC ��� Depth �� i�e3;ght f � 4 `
9q. Ft. _ � Cu. Ft. .
Type of Construct
-�-•��--�
Frant Depth Height,
T
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�/���� Estimated Cost ���
The undersigned hereby m�kes application for a permit for. the work herein apecified,
agreeing �c� �o a�l work ii� atr�ct accordance �riih the City of Fridley Ordinances and
rulin�s �� tt�e Department� of Buildiags, and hereby decLares thaC ail the_f�cta and
representations stated in this applicaticn are true and correct. �
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�Schedule,af Fee Coats caa be fouad on the Reverse Side).
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B�TLDING PERF9I� FLE S�UL�
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� Seetiaa 2. The Iri�pector o�f Build$ngs•si��13., b��o�� isauiag any permit for
, Ehe Brection �f eny building or aCZ�upfipur�, �tu for at�y add�.ti� t� any exiet-
iag buildiag or atrucCl�Ye, or for: an�► a�te�a�tfi��'��'� repai�b to an�► esisting .
buildi�g or etructu�re, u�ioa a�plieatio�ii �1}e�:efor, �eq�ire the pgymec�t by the
applicaut fos such permit of feee •�tb �lie amount •�ier�ia��below aet forth a�d
• �in the maanez here3n pravided to-w�C: „
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�.1. I�a�r aay �uch permit for the t�it��,Cion �o:�' anq :ire���qa€ but�d�.pg, other
� ��, �b u a g,ar�ge�_wa�eho�ise, .fac�ory ot'���$�iRn' ��ev�f�;, .�. :for. :the es�s.�ion of . .
,' aay fire-pz,,�of addi��.on, f4z sig���;ar"oic�iip�eq' -�o: e�,y ,�xis�ti�tg bu�1•d-�:�g �. . r.
shalY be et the ratr� �tf $1.4a �or aa�eb� �ot►ei t�ious�nd �tt�bi� fee�i or� fsa��tf�on
�r� .. . thereof, i.a such cubical coat�n�s .�' . � ' . . ; . � � ' • . �
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��$. g.or any_aucC �pezm9.e_fa�r•..,.�e. esectidn o� anq f3re-�ir,oaf gprage. �+��o��•.°_�,
g ry�r greia eievator, or �� the eRrection �,i atiy� �'r•�p�f .•.c
f�r s3milaa occ�p��cY.-.Co any _eicist�ug ��ldi�,g �sh�ll �be at .t�ie £ .
...�. for eaeh vne .th�uaend cttbic .£eety�..�ls�si�ied �ls:,'firepxoof" by S+
the t+�tn��apoiia avi�.atng codg.:;,�'s.:.:.• . .
� . �� �oUS�S � . .
� 2,� �'t�r aay such perwi.t for ��e er.�ation of �ny aon-firep�oirf i�uildii�g oth�r
�than a garsge, warehouse, factor or. ���''
y grain elevatos', dr aey �on-firepr�if
8ddit�LOa' �or 9fmfd,�t' oCCtlp�Cy3 to e�y e�i�tin�'buiidin� - per�l..t SI�,�00 gda' •
each bne thou�ain�1 c��i�. fe��.. . � '
GARAGES
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?,4._ For any euch pern�i.t f�r the erest3on of any non-fireproof ga�a�e, ..
warehouse, factory or grair� elevator, `bt for Che erectioa �,f acy aon-firepraof
addition, £or similar occupan,cq, to aaX exiatiag building dr for e�ckr such �'
bui.].diag or addition - niaety ceate ($0.90) for each oae thousaad cubic �eet
' or frattion thereof, in the cubic�l�coatents thereof wfth a minimum of $4.00.-
For the purpose of compueing fees for building permiCs, th� cubical cvCite�ts�� �
of any buflding or addltioa ro a uniform height throuffi'ha#t •�by multip�j*ing �ti.2 .'
ground area� �overed � fsom a point eix (6) 3mmch�,g b�l�a� �he �1oor line c►f the
baeement or cellar to the average heigh� of tha�ug.per su�face or to the �
nverage height of the rpof surface of the main gable of a.�9itched roo€. •� �
2��. For repaiss or alCerat3ona to an exiati�l� s�zuct�r�y �a �ee a�al�l be ...r
: at the rate of $3.Op per each Fi�re iiundretl. Dollar..s .($5Qb';��) or �raction
. therebf �it� t�he co$� �� ..�ll. progosed �ork. . . � . � ; .;. � , ., �
� � . . :r��. .
2.6: In ao c��:- �.:.sa:,:i , 3�e fee, chsrged'fci c�n� •�;:?:::.,_iw �; 'seE f�ii`Ch in �,,'"' .' :":' �
� Sectiou 2 he 1es� �:�an .$t+..00,: . � , . . � � ��; .
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City of Fridley, Minn.
BUILDING PERMIT
.:- �r�. •�
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N° 8745
�r: M. B. Pierce guqlder �.�.i-4±a�e A�eri ean C�,grrete, I�c.
Addn� 5176 Hu�hes S�reet N.E. Ad� 26 9]]�apont Ave. So.
LOCATION OF BUILDING
No. � Stceet Augl'�es Street ItT. E. Part of Lot
Lot _.._ __ 81ock Addition or Sub-Divlsion ...�
Corner Lot Inside Lot Setback Sideyard
3ewer IIevatfon ` Foundatfoa IIevation
DESCRIP�TION OF BUILDING
To be vsed as:
Step 811d W8.7.1� F'ront DeP� Height Sq. Ft Ci1. F't
Gutters and �pnt Depth I�eight Sc1. Ft. Cu. F`t.
7�pe of Construct[gon Con.C�'efi,e �, �_�� _ To be Completed ��1966
In consideratton of the isauance to me oP a permit to conata
the proposed work ffi accrordance with the d�scription abop� set
or8inaaces oP the dty oE Frlaley. C-�,A�
t at�ve I ag�ee to
with afl pfov�ons
In coa�deratlon oP the Pa3►ment oP a fee of ��2�.QQ , Permit fa herel�Y granted to �Zl-S'tate .Am�TiCai1
��crete„� Inc. to conatruct the builaing or addition ae described abave. This t is granted u�n
the exp�ess condition that thepe�on to whom it ie granted and hfs a�ents, empl�oyees an workmen, fn all work.
done in� around end upon eaid buildiag, or any�art thereoP, ahall canform 9n all reapecta to the ordinsnce� of
Fridley� Mionesota regerdiag lacatlon, conatruct4on, alteratlon, maintenance, repafr end movia� oP buildinge
�� dLy ]fmits and this permit may be revoked at a�► time upoa vlolation oP a�y oP the Provlsions of said
, ALLEN G., JIItT�11T g�iiding Inspector
NOTIC@a
ihb p�nah doa �rot cora th� eon�t►narl�, ImtaWtioe hr wirtno, plambWO, oa ht�H�, awa or wat�r. e� �un to a�
tM Bvlidtua I�aeta� [or apu�ls pWmNi Por Haa H�.
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OWNER' S NAM13
AP`PLICATIOR-FOR BUI�DING PERMIT
- CITY OF k`RIDI,EY, MtNNESOTA
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ADDRESS ��� i'� ,�� L ��'�.a' /V,, - AUDRESS �� C��' �, s� �'�.� -��; -�i>
f
. �LOCATION OF BIIILDIDIG �
N0. S�� ��Q . . STREL�__ �. �:•� /?, =a PART OF LOT '
. ' �T e� - . . ,
LOT BLOCR � ADDITION OR SDBDIVI5ION
CORNER LOT_ INSIDE LOT SETBACR SIDE-YAR.D
SEWER ELEVATION FODNDATION ELEVATIQa
Applicant attach to this form Two CertiH�ates of Survey. of Lot and propo�ed
buflding location drawn on these Certificates.
DESCRIPTIOft.OF BUILDIPG
To be used as; - �
� ' � � �-� !��/ �� Front ,Depth Height
.
�.= . �'i.� ��=� ..��L-����
, - Sq. Ft. Cu. Ft.
��i ��� ���� � ��� ,
Front � Depth • Height�
. . Sq:.: Ft. � Cu. Ft.
. ��° �-�"%
Type of Construction ��r,�j�, �,���� _ Estimated Coat_�-��TT ,�i'�� "'�
�� . i � �
To be � completed_� , f��° �� � :��= � �
The undersigned hereby makes appiication for a-permit for the work herei�
apecified, agreeing to do all work in strict accordance with the City of
Fridley Ordin�#nces and ruZings of the Department of.Buildings, and hereby
declares that all the facts and..representationa stated ia this application -
are true and correct. . . �y
/�. , ,/ � �
` ` r� ���n ��� � 4� ��� �...N �-
/ l�l� `� �,�`'�
DATE ,� f�i B e � ` ;;�' i � SIGNATURE ' �� - � � --3-, - (�/ _ -� ' � ,��
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(Schedule of Fee Costs can be fouad on the Reverae Side).
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BUILDIlVG PEItMIT FEE S�iEDtILE
SECTTON 2. The Inspector of Buildings shall, before isauing any permit for
the erection of any building or structure, or for any addition ta any existing
building or str•ucture, or for any alterations or repairs to sny exiseiag
building or structure, upon applicatioa therefore, require the payment by the
apPlicant for such pei'mf,t of feeaAto the amount herein below set fdrth and in
the manner �ereia provided to-wit;
2.1. For any such permit for the erection of any fire-proof building,
othei than a garage, warehouae, factory or grain elevator, or for the erection
of any fire-proof addition, for similar occupancy, to any esisting building,
sha11 be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2 Eor any such permit for the erection of any fire-proof garage,
warehouse, factory or grain elevator, or for the erection of any fire-proof
addition, for similar occupancy, to aay existing building shall be at the
rate of $1.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneapolis Building Code.
SOIISES
2.3. For any such permit for ehe erection of any non-fireproof
building, other than a garage, warehouse, factorq or grain elevator, or
any non-fireproof addition, for similar occupancy, to any existing building -
permit $1.00 for each one thousand cubic feet.,
GARAGES �
2.4. For any auch permit fnr the erection of aay non-fireproof garage,
warehouae, factory or grain elevator, or for the erection of any non-fire-proof
addition, for similar occupancy, to any egisting buildiag or for each such
building or addition - ninetq cents ($0.90� for. each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of computix�g fee� for buildiag permits, the eub3.ca1 contenta
of any buildiag or addition to a uniform &eight throughout by multiplying the
ground area covered fr� a goint six (6) inchea below the floor line of the
basement or cellar to the average h��ght of the upper surface or to the average
height of the roof surface of the main gable of a pitched root.
2.5. For repairs or a�terations to an existing structure, the fee s?�PI1
be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fractitin
thereof in the cost of all proposed work.
2.6. . In no case ehall the fee ch�,rged for any permi� as set forth in
Section 2 be less than $4.00.
STORM REPAIR DAMAGE FEES: .
Residential: Estimated Cost of work up to $500,!?� - z�a!!�
Estimated Coat of work over fi4:;,:..�:-'! .< ;:;,�,��;p
Cou�ercial; Estimate�"'�ost of work u� �. _� �� ��;;; ;;�) -� :;?.��
Estimatec. y�8t �� `t7��i:. �J'.':��..'I:l:..�� " 4Llt�.%� � r
�s W
F�.' .
City of Fridley
r aT TN¢ TOP 0� TME Twu+Y
,
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.
r rL-----�-� COMMtiNITY pEVELO�IAENT Q1Y,
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( �
i �' ' i CITY MM.L FAIOLSY �H:
�.._�J`.� �.� er�-s�o-s.w
Job Address
ner
Contractor
Kind of Buildin
Coma etion Date
53-8li-s-915.5i
i��[CT
5176 N. E. Hughes Street
Del F. Price
;��i�
Frame
11-2-73
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PLUMBI�r, PERf1IT APPLICATI���d
se
���r�
s Phone
33b-1�l�53
s P one
Res.
os t
. 10.00
Plumbing Fixture Rates; N0. RATE TOTAL
Number Fix tures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg. x$3.25
Elec. Water Heater
x $2.00
Gas Fitting Fees:
lst 3 Fixtures x $2.00
Additional Fixtures x $ .75
Gas Range-199,000 BTU 1 x$5.00 5.00
Regeirs & Alterationa
See
Description: Code
S tate Surchart�e f�fass �'L��T ���charge .5a t , 50
TOTAL FEE $ 5.5�
The u�dersigned hereby makes application £or a permit
for the work herein apecified� agreeing to do all work
in atrict accordance with the City Ordinancea and rulin,
vf the Department of �3uildings, and hereby declare that
a11�th� tacts and represeatations atated in this
app� �����.�R` �d��ct.
, :�„
r
��'Sionat�irp ,����- nate
t I�
sua�ecr PER
City of Fridley 2 0$� 7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� ` RECEIPT NO
� ' COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC. � �
i ___'-
r ; ;
� . ,
� � �'��1 � CITY HALL FRIOLE� 55432 NUMBER REV. DATE PAGE Of APPROVED BV
�"""� � �'� 612-571-3450 910-F15 6/18/91 / /
JOB ADDRESS 5176 Hughes Avenue NE
t LEGAL �OT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ]. 8 Ca.rlson�s SUfiIRl't Njda,l'lOK' SO11�1 AC�(3L1. SHEET
2 PHOPERTY OWNER MAIL ADDRESS 21P PHONE
Arlene Pettis 5176 Hughes Avenue NE 571-1940
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Resident%al
7 CLASS OF WORK
❑ NEW ❑ ADDITION [� ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFK
Frame in Bathroom in Ba,sement
9 CHANGEOPUSEFROM TO
S7IPULATIONS See notati,ons on plan, Use treated bottom plates. Tnstall power vent
in bathroom. Provide a smoke detector in I�asemente �rovide combustion air for
furnace and water heater if gas.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REQUIRED FOFi ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION ZpNING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
O/i WORK IS SUSPENDED OFi ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3sOQQ $�-.5Q
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFiMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $�J4.�Q Fire SC $3.00
PLAN CHECK FEE TOTAL FEE
�'rJ8 �50
S� TUREOPCONTRACTORORAU7HOR12EDAGENT IOATEi WHEN ROPERIY VA HIS I YOUR PERMIT
�
SiGNATUREOFOWNE �il WNERBUILDERI IDATE� LDG �NSP TE
1�I [ ] Effective 1,/1/91
ADLN [] I�1 At�ID R-2 `/ i,� `_
AL'i�t [ ] Buildirg Permit Applicatiori ��'� ,1� ��
V `l �
�tiac� A�aaress: � / 7� � a �1 � � ,�Z l� /V . � /
i�gal Descr�tp�tian:
ow,�er rlame & Ad�aress: � v /t'h � Ve ffii s Tel. � .�'/ ' / �! �C�
.�
Do�ttactor: � Gv h� 1� Z+e1. �
14iu.�: '
Attach to this applicatian, a Oertificate of S'�uvey of tiye
lot, urith the p�roQoEed ca�vc.ticai drawn cci it to scale.
I�'s_��+; �:1y �'� •i� �,,�{;.�1��'lY�J�1�7
L1VII� A�A: Lengtii Width Heic�t Sq. Ft.
t�,RAGE ARE�I: I,engt'rl Width iieic�t Sq. F't.
D�lCR AtiEA: L�x�th Width Hgt/Gro�nxi Sq. F't.
0►II�3t: I—/2f4 i� � /'l�1 ��?- d'D O �v�--� 11'7 �ri' S f�rc �-e �c �
Cbrner Lot [] Inside Iat [ J Ft. Yd Setback Side Yatti Setb�acks
Zjrpe of Do�str�tioal: Fstimated Ocst: $�, po �
--�
Approx. �letion Date: ��?��� S�
e
Pra�osed Driveway Width If New Openir�g Is Desired: Ft. S $
Width + 6' See BacJc ,Page
DAZ�: ,r� - �� — cl � APPLSCANr: �� /I� ,a Te,1• # J'�7l — l � �� I/�'
,�'%/— � �7D �
GITX T1HE Q�Y
Pexmit Fee $ �
Fire Surd�rge $ � �
state S�arge $ 4 �
SAC Ct�an�e $
Driveway Escrow $
Park Fee $
sewoer Main �arge $
� s �� �
Fee Sci�cfiule an Reverse Side
.001 x Pezmit Valuat3an (1/lOth $)
$.5o/Sl,aoo valuatian
$650 per SAC Unit
Alt. °A" C�' Alt. "B" Above
F�9e L)et�2�i fled bj� �; r�r; �
�eeo�t NeoessaYY L] x�t Neo�salY I]
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F`._i1���i����t=';���4�a="= =�:i:���i :
�e Chief Buildirg Official st�all, before issuir�q permits for the erection of ariy
�,; i ding or �une, a� fo� any additian to any e�dsting buildir�g or stn�cture, or
for any alteratian or repait to any existirg buildit�g ar�. u� a�ii�tio�
therefore, requ,ire the payment by the applicant far � petimit of fee� to the a�no�mt
i�erein belcw set forth ar�d in the mar�er herein p�vvided tro-�rit:
'IVI�iL VAIL]E
$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
��a.
$15 (Minim�mn Fee is $15 plus a�arge)
$15 for fixst $500 plus $2 for each additianal $100 or
fracticci thereof, to aT�d includirx3 $2, Oa0
$45 for fitst $2,000 plus $9 for each additional $1,000
o�' frdctiari thel�eof, to ai�d i�cludil�g $25, 000
$252 for first $25,000 plus $6.50 for eac31 a3ditic�al $1,000
ar frdCtiCCI tl]ereDf, to BT�d ir�Cluding $50, 000
$414.50 for fixst $50,000 plus $4.50 for each additional
$l, �0 or fractiac� th�ereof, to and includir�g $100, 000
$639.50 for first $100,000 plus $3.50 for each �Ciitional
$1, 000 or fractiart thereof, to at�d itiCludiTlg $500, 000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1, 000 or frdctiaa'1 thereof, to az�d ]ncludirig $l, 000, 000
$1,000,001 ard up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 ar fractian thereof
�tIVEi�1Y D�Pl�BBI�T F.�C3�JW
(Oo��crete Q�rb Streets arilY)
Alte.rnate °p,�� : ROaova,l arid r�lao�oent of a�rb ani gutter aa�ly - DriveWay width plus
6 feet times $13.50.
Alternate "B" : Re�oval ar�d r�lao�ent of curb arxi gutter and install a 3 foat wide
approac3i with 6 irrh de�th - ID'iv�ray width plus 6 feet tiioes S15.75.
1'/�; �:� �'c M � , •i� :�� �i,n ; � � �
Permits foY' Coa�stnyCtiarl will be is.�l�ed a�ini,�.nn of 24 hai1Y5 fYn� t�1e time of
applicatiaai to allcw for proper review of the pr+oposecl st�v+c4ire and of the
coa�stnyctiari site. '
A Dertificate of S�rvey of tibe lot, showin3 the lxatiaai of t��e faa�datic� aa�oe it has
it has be 11 ooavtnx.�ted will be required before pznoeedirx� with tl�e fr�nin�.
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Ar-Del Enterprise
4803 University Avenue N.E.
Columbia Heights, MN 55421
(612) 571-Q870
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SUBJECT MIT N'� ' -.
City of Fridley 2 � 58 8'
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �'�.,,
f
i � '"R€P.ffiPT"NO.
COMMUNITY DEVEIOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC. -� j � 9
� �
1 �1 � i/
� 1 /"'1 � CITY FIALL FRIDLE� 98432 NUMBER REV DATE PAGE OF APPROVED BY
�""� � �'' 612-571-3450 910-F15 9/4/98 / /
10B ADDRESS 5176 Hughes Ave
t LEGAL LOT NO. BLOCK TFiACT OR ADDITION SEE ATTACNED
� DESCR. 1 8 Carlson's $il'IDIIlit Ma.nor $011til SHEET
2 PROPEFTYOWNER MAILADDRES$ ZIP PHONE
Arlene Pettis 571-1940
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Nutzmann Bros Const. 736 lst Ave N6J New Bri h on
4 ARCNITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WOiiK �
� NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and ara e(22 S Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL, PLUMBING, HEATINO, �PE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTIiUCT10N 20NING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR If CONSTRUCTION
OR WOfiK IS SUSPENDED OR ABANDONEO FOH A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINEO 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 �LSBS .94.
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEAMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OF THE PERFOFMANCE OF CONSTRUCTION. �59.5� Fire .S�'i 1.88
PLAN CHECKFEE T07ALFEE
License SC 5.0 67.32
� SiGNAT REOFC�� iRACTORORAUTMORI2EDAGENT IDpTEI WFIEN PROPEfiL ALIDATED THIS IS VOUR PERM17
�
�
SiGNATUqEOFOWNER�iFOWNER8UIL0ERi IOATEI . BL �NSP � DATE
er,a
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY �
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 1 ���
� �
ConstructionAddress: � `� -�/ vS �� �-
`� % �l �
L,egal Description:
Owner Name & Address:
Contractor:
� a ��..J / .��r� �
��
Tel. # .S7/ /�'�/a
MN LICENSE # �a�� �y��
Address: %`�� l S� �'Yu� iU� — �'t/ew %��.G�s--�r✓ Tel. # �a �--a� ��f
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Widths Hgt/Ground Sq. Ft.
� i �-.
OTHER: ,-,� � � ��-, .
�
�_ �, , � �'
Construction Type: �,� � a Estimated Cost: $ /���
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � i'� APPLICANT�- Tel. #��� �%�
CITY USE ONLY
Permit Fee � ��'. ��'` Fee Schedule on Reverse Side
Fire Surcharge $ ��>� .�1 of Permit Valuation (1/lOth%)
State Surcharge $ � � �� $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � - ���='
$
$
$
$
$ �`��� �
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary. [ ]
� �
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-vt�it:
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)
Altemate "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 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.
�y o �
SuBJECT ,
City of Fridley 277 64
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
S � RE .
� `y � ___ COMMUNITY DEVELOPMENT DIV. ���
r � � PROTECTIVE INSPECTION SEC.
� i �
� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED BY
�""� � �'� 612-571-3450 910-F15 9/14/98 / /
J08 ADDRESS 5025 Hughes Ave NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. /+ 6 Carlson's Summit Ma.nor South Addn. SHEET
2 PROPERTY OWNER MAII ADORESS ZIP PHONE
Ronald J Zemba Same 572-9268
3 CONTRACTOR MAI� AODRESS ZIP PFIONE LICENSE NO.
Owner Same
4 ARCHITECT OR DESIGNER MAIL ADDREBS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential �
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION �] REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Reroof garage (8S ) Tear-off• Reside ara e
9 CHAN(3E OF USE FROM TO
STIPULATIONS
Reroof - Underlayment must comply with the State Building Code.
Reside - Call for building wrap inspection before covering.
SEPARATE PEF;MITS ARE REQUIRED FOii ELECTHICAL, PLUMBING, NEATING, TYPE OF CONST. OCCUPANCV (3ROUP OCCUPANCV LOAD
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO S�. FT. CU. FT.
AUTHOFi1ZED 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. N0. DWLG.' UNITS pFFSTREET PARKING
I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS APPL�CATION SFALLS GAqAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALU14TION �y,� SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPUED �],�28S.lJO �.64
WITH WHETHER SPECIFIED HEREIN OR NOT. TFIE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TFIE pERMtTFEE SACCHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING con►- $43.00 Fire SC �I.ZH
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE $ TOTAL F
,% $44. 92
SIG �E OF CON7RACTOR QAUi. 4E0 nGEN� ����� p pER LID TED IS� IS � P��M ,T�
• /��r � .
S�GNATUWEOFOWNE:IUF ER u40 Ri �DATEi � BL N p ryarE
�
NEw
ADDN
ALTER
[]
��
�
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effecrive 1/1/98
� � ���
�, P �
ConstructionAddress: .� � �' /`�vq/1�S �U��, it/,�' �i2/!J� yr�/�i� S'55�2 /
LegalDescription: lCo�� �` �/D,�/NG O'.V G�4�.41 �
Owner Name & Address: �it.%I LD �,(� �@� ,�� Tel. # S%� —�'f'�c�°
Contractor: .���.�" �'` ���� � MNLICENSE#
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length
Length a �
Width
Width �- 5�
Width
�
Tel. #
Height Sq. Ft.
Height / ' Sq. Ft.
Hgt/Ground Sq. Ft.
c
°��� D � ���-� � - v � (oQ�
Construction Type:_�e,�L,�c� 5,,�/r.cl6Les F�ioi�tlG Estimated Cost: $�° �^ ���e�
���—
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: %��-- �� APPLICANT: %�� P Tel. # 3'��� 9� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
`V s V t/
$ /- ��
$ l��
$
$
$
$
$
$
$ � -9
CITY USE ONLY
Fee Schedule on Reverse Side
. 001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� . +
BUII..DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$SO1 to $2,000
$2,001 to $25,000
$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
$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,(�0
$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)
Altemate "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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. �
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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CHIIyIIVEy AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefiilly examined Yes � No ()
2, Is free from rust or deterioration Yes � No ()
3, Has no foreign objects lodged within Yes (�l. No ()
►,�
5.
6
7.
�
Is securely supported
Meets all current Code req�irements for size
and total BTU's connected
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Has a liner been provided for water heater
Has combustion air been provided for water heater
Remarks:
List ALTERATIONS BeinQ Done:
Yes � No ( )
Yes� No ( )
yes ( ) No ( )
yes ( ) No ( )
�
HEATING CO:
Signed By:
Date:
Su6�ecr
�
City of Fridley 3 0 9
AT THE TOP OF TME TWINS g � I L D I N G P E R M i T
f
� � RE EIPT NO.
� `L _���� COMMUNITY DEVELOPMENT DIV. � ���
r � � PROTECTIVE INSPECTION SEC.
� ; i
1 � �"'1 � CITY HA�L FRIDLEv jj4$i NUMBER REV DATE PAGE OF APPNOVED 8Y
�'"'"� � �'' 612-57t-3a50 s�aF�S 5/30/00 / /
JOB ADDRESS 5176 Hughes � NE
t LEGAL L.OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
oesca. 1 8 Carlson's Summit Manor South SMEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE
Allen/Arlene Olson 5176 Hughes Ave NE 571-1940
3 CONTRACTOii MAII ADORESS IIP PHONE LICENSE NO
Window Lite Home Improvements 8400 89 Ave N, Brooklyn Park, MN 55445 425-2227
4 ApCHITECT Ofi DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
20039258
5 ENGINEEp MAIL ADDRESS ZIP PFIONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION fX] REPAIR O MOVE O REMOVE
8 DESCRIBE WOfiK
Replace 1 bow window and two doors
9 CHANOE OF USE FROM
tI•]
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
��'�'mlt ���pec�so� ��
�lill �� iM�i � ��p�s
�'� �0�� ��d
Q���� �'� �'����
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NUIL AND VOIO If WORK OR CONSTRUCTION 20NING
AUTMOR12E0 IS NOT COMMENCEO WITMIN 80 DAYS. Ofi IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOii A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO NO DWIG. UNITS
I HEREBY CERTIFV 7MAT I MAVE READ AND EXAMINED THIS APPLICA710N 1
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yp�UATION
AND ORDINANCES GOVEqNING THIS TYPE OF WORK WI�L BE COMPLIED @
WITM WMETHER SPECIFIED MEREIN Ofl NOT. TME GRANTING OF A PERMIT WS�3OO
DOES NOT pRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TM� pEqMIT FEE
PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION �LLS.LS
PLAN CHECK fEE
License
S�GNGTUpEOFCON'AACTOAOpAUTM0�7i2EDOGENT IDAfE� , sa�
� iOATE� ' � �
� , _
SO.
STALLS
11
OCCUPANCY
CU FT.
IFFSTREET PARNING
IGAqAGES
iUR7AX
$2.65
AC CHARGE
Fire SC $5.30
OTALf
�1 .2�
/= 1$��/�I�
NEw
. ADDN
ALTER
Il
Ll
[]
ConstructionAddress:
Legal Description:
CiTY, OF FRIDLEY
3INGLE FAMILY AND DUPLEXES R-1 AND R-2
BUII.DING PERMIT APPLICATION
�/'i �
Effective 1/1/99
�\ ��
D� ��
�
�� s"�''���
� ,9'//� d ,¢�/..er�c �/s�1
Owner Name & Address: �-/7� - ,/v�{�� .,g,�,� � �; �/,� �„/ �'�'.�,L�/ Tel. �# ��%'/ — /�
Contractor: J ; n �j� ,(_,,°� 5L/�j,��, ��n �/ �� MN LICENSE �t �oo3�as�
Address: g?vU - � �- �r1IL /f a , �� � . q, �S� Tel. # 7'0�,5- �a �.
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 .Il�ZPROVEMENT
Length
Length
I.ength
Width Height
Width Height
Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
/��cJ �i/��
Construction Type: a ���j�� timated Cost: $��Q �, � D
{Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE:� � APPLICASJ'��Q/yx,t° �,���� �'.�'./�. Tel. #� �yv? �
Permit Fee
Fire S�archazge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
$ J`
$ 5, 30
$ �
$
$ Jr. Oa
$
$
$
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,OU0 Valuation
$1050 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 [ ]
TOTAL $ ��0 � �� �
.
-��, � 6�r�s /'✓ �G�1L ���/�'���
STIP TIONS: d vl.�r �� _�����
/r�
�.�� � �� ,���� ar T�✓�-..���r�-�'�� �
��; z ��c. 3/0. � /, � ���� ���C..
BUII..DING PERMTf FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of aay building or structure, or for
any addition to any elcisting building or st�ucture, or for any alteration or repair to any existing building or
structure, upon appl'ication 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=wits �
TOTAL VALUE
$1 to $500
$SO1 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,(}00
$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
9r fr�ction ihereofT 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 �� Stree�s Only) -
Altemate "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 aad ir�stall a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
'°-._ _r