AF - 46439SUBJECT PERMIT. - -.�.�- -- -
City of Fridley 12815
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
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� ; y _.._ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �� S
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�� �'�i � CITY HALL FRIDLEV � 55432 NUMBER REV. DATE PAGE OF APPROVED BV
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910-F15 11 22 74 � �
JOB ADDRESS 295 Iiugo Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 45, 46, 4 A Riverview Heights Addition SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Tri-Co Builders 7555 Van Buren Stxeet NE ���3 -�
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
X
8 OESCRIBE WORK
Construct a 40' x 24' IIwellin and a 2Q' x 24' Gaxa e
9 CHANGE OF USE FROM T�
STIPULATIONS Provide a ha.rd surface drivewayo Provide a verifying survey before
capping. Permit issued subject ta deed recording of Lot 45 before
verifying survey made or occupancy perm:i.tted.
Walkout on lot okayed.
SEWER LOGATION: 212° East of Manhole (Inv. 840.62)
Wye Elevation: 841e34
Top of Footing: 844.34 Minimum
WATER LOCATION: 10.9' East of sewer service
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HEA�TIIV�P PL�D�1�16�� l��f� ���i�R�.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCI Fr3IDE,'
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 R�. 9CO 24,000 Tota
ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $22/824 �'�'.4�'
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
ST C ION OR THE�R ANCE OF CONSTRUCTION. � $4SoOO �`300.00
�� PLAN CHECK FEE TOTAL FEE
�, $356.41
{�GNATUR'OPCO TRACTORORAUTHORIZEDAGENT (DATEI WHEN PRO E• V LI TED THIS IS YOUR PERMIT
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?GN"ATUREOFOWNERIIFOWNERBUILDERI IDATEI �-._81rDG INSP DATE�
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APPLICATION FOR RESIDENTIAL, ALTERATION;
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
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NO:��j STREET :
LOT : �b=1��a "Y �BLOCK: � � ADDITION : /Lv,i/-�y 2� ���,.7�
CORNER LOT: INSIDE LOT:�_SETBACK:�°3 S SIDEYARD: �O ��
Applicaat attach to this form 1�ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
0
To Be Used As ; --� �-�'�
/� i p ;�_-_
`C� Front : � Depth : o� Y Height : � /� - - _ .
Square Feet: �' Cubic Feet: ,� `�.�' �r� ��� ��
Front : „70� Depth : � � ��� Height : �--- : ,� '`,�
�`� '';� � ,
Square Feet; �' € Cubic Feet: � � �° � �-
Type of Construction; �I�p�-GPj�,� Estima.ted Cost:' $ oi ���` � p'
—} - � � ..� ,r �'i i
To Be Completed: ( - /��?S �-t ���'' � '� �
The undersigned hereby makes applicativn for a permit for the work hereia
specified, agreeing to do all work in stiict accorda.nce with the City of
Fridley Ordina.nces and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
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DATE: /�/O'!� f�d '- %� SIGNATITRE:
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(See lteverse Side For Additional Info ion. °� �-�, �
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing pernnits for the
erection of any building or structure, or for any addition to any existing
building or structuxe, or for any alteration or repairs to any existing
building or structure, upon application therefore, requixe 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:
iTrTIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, i.n such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, 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 of the basement
or the 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 uo case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
tiane of application, to allow for proper review of the proposed structure and
of the construction site. .
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupaucy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
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PHONE:
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� �ll'° ' DONALD a-f. DEUTSC{-0
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LAND SURVEYOR ��55 � 2��� '4'��'��� SOtYiGYd
MINNEAPOUB LICENBEO
MINNEAPOLI6, MINNE60TA 554�6
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I hereby aer�i�£y tha� �ha p1��; ���p�os� is a ta�ue ��d cso�r, ac�C ropx���on�a�;ion
o� a sur�veq of 'che i�ound��i�s o� Zo�s �.6 a�d �.7, B�.oc� A, RIVER �IE'�V �IGF�i'iS,
Anoks� Co�tyr, M�n�so�s, �s survey�d byr m� i;�a �;�'�,?:: ��ay o� Ma�ch, 1969.
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Telephone 784-6066
Engineers & Surveyora Area Code 613
Loan Survey for ��� ' � i�� ������
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ANvK� CDU{a�—
This is a true ond correcf representation of a survey oi fhe boundaries of the land obove described and of the
locotion oi oll. buildi�gs� if anr� thereon� nnd al� visible eneroachmenfs� if any� from or on said land. This surver is
mode only in connection wifh o mortgage loan now being ploced on rhe property and no liability is assumed
except to the holder of such mor4gage or any other inferesf acq�ired br the reoson ot sueh morfgage. If is
undarsfood and ogreed no �nioeuments have bean laced for fhe p�rpose of establishing Ipf Iines or boundory
cornen. Dated th1s�,�N�dor of� �'� "+ - q. D. 19�,d
5UBURBAN ENGINEERING, INC.
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�.< 1�'f !.� 7I�S DEPAIiT 'd' OF i1V�PE�T10�1
C�estrnxti�n �Vo> �seilaeea�
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�Icatheratrips A.�' • Coaatructioa No. Ynsul�tion �
Guide F1ow A�plied
Windows � Daor � ( EZe�eeea�e Q►ut. Wall iut. �lall l",�il°eng �oof _F1�- - ��nd ___.._ -
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O1/indow� a»d Doors-Crack�ge a�d Arem O�` �inds�ws anc9 ��or�---�rackage and Area °' .
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� tV:d�A Height { nr,. o[ Pdneal ft Aroo (fj 1 ; ��� �VfdtA �He16dt ' No. ol Llneal tr� A�rea � �...
N�. ot ae^r ! u- ne t.��;�c.. otcrsck �Q,tt. �U�/ a`' t . lau, !��n_; �;ra� ilp�a.�n ; otc ��-,-� u. ft. ( �� �
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sua�ecT PERIyllI_N.Q�
City of Fridley - � � � � 4
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T �_
�
' � AECEI�T NO.
� i y_���� COMMUNITY DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � 3`7 a
i � �
i
� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV OATE PAGE OF APPROVED Bv
�""��� ��J 612-571-3450 910-F15
8/31/94 � /
JOB ADDRESS 295 Hugo Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 45-47 A Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDHESS ZIP PHONE
Michael Rennert 295 Hugo Street NE 780-0153
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO,
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION ❑_ REPAIR O MOVE ❑ REMOVE
R
8 DESCRIBE WORK
Reroof House (21 S uares) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Provide smoke
detectors adjacent to all bedrooms and in basement.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV 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 WOFK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WOfiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED THIS APPLICATION ], S7ALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS Of �AWS VALUATION SURTAX
AND ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1,575 �.%9
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PEFFORMANCE OF CONSTRUCTION. $3%.00 Fire SC �I.SB
PLAN CHECK FEE TOTAL FEE
39.37
SIGNATURE OF CON � RACTOR OR AUTHORIZED AGENT IDATE� WWEN PA VAL TED THIS IS YOUR PERMI
�� ��
S�GNnTURE OF OWNEA i�F OWNEA BUiIDEAi �DATE� �pg itigF� riaTE
l,j
NEW [ J
A�DDN [ J.
ALTER � [ ]
Construction Address:
Legal Description: _
� � � ,CITY OF FRIDI.EY �
SINGZE FAMILY �AND DUPLEXES R-1 AND R-2
Building Permit Application
�
Effective 1 / 3 /94
� ' � �. . � .
Owner Name & Address: � l Tel. #��O - 0/ S� �
Contractor: _� ��.�. � � . � � - M�1T LICENS� # � �.
Address:. � � � .. � � � Tel.. # � ��—�--
Attach to this application, a Certificate of Survey of the
1ot, with the proposed construction drawn an it to scale.
. . : 1?ESGRIP'1ION �O�F�.I14�1'RO�EMENT . : � � � � � � � �
LIVING AREA:
GARAGE AREA:
DECK AREA:
QTHER:
T.eng�th
Length . .
I.ength
Width � Heighx � �
' Width � ' Height
Width Hgt/Ground
. �.
Sq. Ft. �
Sq. Ft. �
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Ya�cd Setbacks
Type of Construction; ��� �� $
Apprax. Completion Date: �a� ��
(Cost on Back j ,�- ��g
Driveway C b ut Width Needed: Ft. + 6 Ft — Ft x =$ ����'
DATE: � 3 '�� APPLICANT: � � Tel. # �
�� USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway E.scrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� ���.
��_ � �
$ •� �
$
$
�
$
$
$
$� � �
F� Schedule on Reve2se Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,t�0 Valuation
$8Q0 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ l Not I�tecessary [)
STIPULATIONS: � � "
��� _ � �����.
�
� ��� � ����
�
F3UiLlliN� I'ERMIT; FEE� SCHED(ILE
"l�tic; (,i►ief 13uildir�g OCticial shatl, t�efore issuing permits For the erection of any building or structure,
c�r t��r <iny adcliti<m tc> any cxititing building or structurc, or for any altcration or rcpair to any cxistin�;
(�uildi«�; c��- struc�urc, u�wn aPplication thercfore, rcquire the payment by thc applicant foc such permit
<>1� fccs to tlie amc�unt ficrcin bclbw set f«rih aad i❑ t]�� c�tanncn c�reia Providcxi to-wit:
I'O"1'AL VALIIE
Ft;F:S
$i to $�00 : - .. $15 (lt�iirrimu�n Fce is. $15 plus surcharge)
$501
t° �,� . ��IS for fiist $SQp" pIus $'L for each�additional..$100 or �
fraction thereof, to and inctuding $2,000 �
$2,001 to $25,0(?0
- �� fOC �st �Z,000 pius: $9. for each .addi�iona! $1;000 .
- or fraiction thereaf, to aad including $25,ppp •� .
$25;001 to $50,000 � _ $252 for firs� $25,000 pins $6.50 for eacti . addittonal $1;OpQ .
or fraction thereof, tA. and including $Sp,Opp � .
$50,001 to $IW,000
�100,001 to $500,000
$500,001 t4 $1,000,000�
$1,�00,001 and up
$414.50 for first $Sp,ppp p�us $4_Sp for each additional
.$1,U00 or fraction thereof, to and including $100,000
�$639_50 for first -$1pp,ppp plus �$3.50 for each addiiionai-
$1,000 or frac�ioa thereof, to a.ad includi�ag $500,000
$2039.50 for the Cust $SOO,ppp plas $3 for each additionat
$1,000 or fraction thereof, to and including $1,000,000
$3539.50 for the first $1,ppp�ppp p2us $Z for each additionai
$1,000 or fraction thereof -
DRIVEWAY DEPRESSIpN ESCROW
(Concrete (:tirb Streets Only)
Alternate "A": Removal and replacement of curb aud gutter o,n�y _ Driveway width plus 6 feet times
$13_50_
Alternate "B": Remova( 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.
VERIF[CATION Or FOU[�iDAT[ON
E'crrnits fo'r co��st�uction �,vi(j b� is�ued a minimuat of 24 hours from fhe tune of a�plication to al(ow
for �roper revicw of the proposc;d �tructure and of tt�e cor�struction site_
A�'��f�i� °� Sun'cy of die lot, st�owing thc location of ttie foundation c>ncc it has it tias hccn
cor�st[-uc�ui will hc rcyuired t�efore proceedi�g �,vith the frdrninfi_
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NEW [ ]
ADDN []
a-T� I J
Construction Address: � �
CITY OF FRIDLEY Effective 1/1/2002
6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATION
� � � � �� ���. l�-
Legal Description: v °'
Owner Name & Address: � 1 C � � � � � '� � "�.�' Tel. # '7 � 3 -- � �o� C'� i.Sr �
Contractor. MN LICENSE #
Address: Tei. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Ce�tificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Leng� Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width HgUGround Sq. Ft
Construction Type: Estimated Cost $
1� ca�
Driveway Curb Cut V1ldth Needed: �a'Ft + 6 Ft =�Ft x �°� _$ ° 7%�
v
DATE: �- r � � APPUCANT: Tel. # 7 � � ' �C� `� � � S �
Call (763) 572�604 for PeRnit Fees if maili g in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
�
$
$
$
$
$
$
�.
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by �Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIO�
(
�
�
BUILDING PERNIIT FEE SCAEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,(�0
$50,001 to $100,000
$100,001 to $500,000
$5(}fl,001 to $1,�,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,OQ0
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,Ot� or fraction thereof, to and including $500,000
$3,233.75 for the first $SW,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,0(�,000 plus $3.15 for each additional
$1,000 or fracrion thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feef times $17.(�0.
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 Certificaxe of Survey of the lot, showing the location of the foundation once it has it has been constructed will be
required before proceeding with the framing. New Houses Onlv