AF - 46885City of Fridley, Minn.
BUILDING PERMIT
Date: _.._._�._�.�_._�._� ..� _'�'"` � .4�.__
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Owner: .....:�` .:::�'1.:._. . --
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Address .: .I.�.�._.{t...�.'.."."....�'"..J�.._.f"', .� �-`�..-r-'�'..�.' w.��•_�..�.._.
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Builder _..._.... ... y._....._.._...___.�. ��.°..�� �'
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Adclress _ --....�...�.�,�.'.��__�"�_.._._�:._ _..�..�.�-�.,��r--__--..
LO TION F BUILDING
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""' � � .. Part of Lot . �--- __.._.._
No .-- --- •-----. Sfreet _..� ..- � _ �__-"`._..._..----- . - -. ._------_._._—......_..__._.__
Lot ��� ,r =
:. ""r�[�'..'.�t�Block ...._...... ..:_�...._ .............-- Addition or Sub-Division .....��""'�L��,f-�:t�a.¢��--:--�--�-'-----
���` �
Corner Lot --� .................._........ Inside Lot ....._...�..�.`. �.. -..... Setback ....... . -•�.-•--•--....._........ Sideyard ------....�.�--......._......-•--�---�----�-�----•----
Sewer IIevation
To i� Used as • �
F ��
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....--- �
Foundation Elevat3on
DESCRIP7`ION OF BUILDING
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..--�-�==. Depth _�...� Height .�•..�_.. Sq. Ft. ._.��^,r�-� Cu. F't. .�G�:��.�...�.,��
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Type oP Construction
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Depth .................. . Height ............... Sq. F� .- ._.......:....._.. Cu. F�
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�" �`.. E s.-�� ����. ..... To be Com leted ._...---------------..
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In conaideration of the issu ce to me of a permit to construct the building described above, I agree to do
the proposed work in accor e with the description above set forth and in compliance with all proviaions of
ordinances of the dty of Fridley.
-�---��-------.._....._-------- ------ —�_��..
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In consideration of the payment of a fee of $..�/ .._.._.........---_...., permit is hereby granted to..-•--••-•--•------•------- -•
_..___�._._._...__._____..._.__.._..._.... to construct the building or addition es described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
F'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
withia the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. f�` _ , ^�? ,�
Building Inspector
NOTICE:
This permif does no1 eover the eonstruction, installation for wiring, plumbingt gaa heating, sewer o� water. Be sure lo see
fhe fluilding Inepeetor fm separafe permifs fo� these items.
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:BUILDINCa'PLAIyB EBTABLI$HED 1928 ; GtTY' LOT Bt/RV@Y�Nti ,
�ANO Sh6CiPICl4T10N8 . _ . � PLA'1'f1Nii -. �
+" F'ARM SURVEYINC3 '
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M. J. E�ERSCHEIQ
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PHONE PARKWAY 4•4598
$644 TWENTY�66COND. A1fENU� SAII'Flf
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APPLIC�TION FOR HIIILDING PERMIT
CITY OF FRIDIEY, NQNNE.SOTI
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Owrier's Name °�° � '�`�' Builder �. �,
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�aar8B8 eaarees �
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LOCATIORT OF BIIILDING
No. �.� �� Street �-�6�-���.� �°��.o� ���� Part of Lot
Lot � �� � � � � Block � Addition or Subdivision ,/�/I�����H i��
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Co�ner Lot � side Lot � Setback �`� Side-Yard
S�WER. ELEVATION FOUNDATION ELEVATION
�ppl3cant attach to this form Certificate of Survey of Lot a,nd proposed buildiag
location.
To be used as:
� °� DESCRIPTION OF' BIIILDING �
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_,
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�-��+ �� � tth�nth � % Height � �
Sq. Ft. � � � Cu. Ft. �� � ��
Front epth Iieight
�. �. Cu. Ft.
� � �, :�.
Type of Construction ��--.-�.� Estimated Coat �!
To be Completed �� � , �� �
The underaignecl hereby makes appl3cation for a permit for the work herein specif3ed,
agreeing to do all work in strict accorde.ace with the City ardinances and ruling of
the Department of Bu31d9.ngs, a.nd herebg declaxes that a11 the facts and repreaentations
statad in thia appl3ca.t3on are true and correct.
DA� �- � . � �I � � SIGNgTUR� �� �
(A Schedule of Fee Gosts can be found on the Reverse Side.)
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3ect___ ion �; The Ins�ctmr of �il.dings eha].1, bafore issuing as�y permatt £or the
erection of e�y lsuilding or �atructur�, or for eny addit3on f,o., eqy. �s��ing build-
ing or �truct,ure, or for any slterations ar regairs to aa�r e$3stit� building or
structure, upon application therefor, r�uire the payment by the gppZicetit for
suah pea�3.t of feee to the amount here3a below eet forth and in tdie �et� herein
provided �to-�ri.t:
2.1. For any such permit for ths ereation of any f'ire-prcof building, other than
a gerage, warehouee, factoiy�or grain elevat�r, or for t,he erect3on of any fire-
proof acld3tion, for eimilar oc�upe,ncg, to e� e�.atin� build3.ng she11 be� et the
rate o�f �'l..�A for eaah one thous�nd cubio feet, or fract�.on thereof; in such
oubical contente.
2.2. For a,n,y �uch perm3t for the erect3on of any f3reproof garage, warehouee,
factory or grain elevator' or for the eseo�ion of sny fireproof e�ciditioa' for
9im�.a� o��u��, ��� �.8��� �a.a� 8� � at the �te o� �.zs r�
ea,ch ane thausaad cubio feet� ciassi�isd as "firepTCflf" by Section 502 of the
Minne�apolis Buil.ding Cade.
: c� �
2.3. For a�sy such pQrm9,t for the
than a �ara�e, wesehous�e, factory
edd3tiori, far simi].ar occu�,noy,
each one thoua�ad cubic feet.
f#�RAG�E.4
erection of aay non-Fireproof bu3lding eth�r
or grain el�vat.or, or eay non-fireproo�'�
to ammy existi»g bui].d3ag. Perm�.t �]..00 Eor
2.�,. For e,r�,q such permit for the erect3on of any nor�-firepro�f gerage, �terehou�e,
factory or grain elevator, or for the erection oP any noa-fireprooP addition, for
similar occupaxicg, to eny existing buildin� or for eech suoh building or addition.
Ninety Cents for each one thousand cubic P�et or f'reation thereaf, in the cubi�l
confi,ents thereof w3th a minimum of �I..00.
For the purpoae of computing fees for bu�llding permits the cubica7. conteata oF sAq
building or �.dd3tion to a uniform hei�ht throughout by multiplyin� the grouad area
covered f�om a point six (6) inchee below. the floor 13ne o$ the basement or cellar
to the avera�e height of the upper surface or to the evera�e height of the roof
surface of the main gable of a pitched roof.
2.5. For repairs or alt�rations to an exieting structure, the fee she,l]. be et ihe
rate of �3.00 for eaah Fiee Huncired Dollars (�50D.00), or Practiaa thereof in �he
co�t of all proposed work.
2.6. Iu no case ahall the fee csi�r�ed for any parmit �.s set �o='th in Seat�.on 2 be
less than �►4.00.
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City of Fridley, Minn.
BUILDING PERMIT � N° 4 9 2 3
Date: __---._._... � �'�'. �,5 � ,,,.�, �^t
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Owner. -�.---- v -�-----;--------_.. _ _.-----.��:��_ "'--_----.._ Builder _ ..,�:::.ir �,...__� .:� .._._: . _._.�� ...__._��____��
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.� � � _____..:�k._.. `�,+_w Address '•`•-•-----�'� '� . � � �' � •. } �.�°z�° �:___.__
Address ..� ' � �.� °�' �..._.:� w � �
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._....-- -..__ . _... _._...__._.__..._.�..�_....� ..
, LOC�TION QF, BUILDING
No .,�+' „�'� � Street �'�' ° �'� �°
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. �,,.. .� f � "�.�._.....� .Y.-- T- -..:i...�.._ Part of Lot __ �
Lot �.�_..".".��.'_`.�_ 81ock ....._. -�.� _.-----..., Addition or Sub-Division ---- --��..��� _'----,r�.....t.:�� "� . �f.::.:� ._..
�-- -
Corner Lot ------.----- :---..._....._. Insiide Lot ....__...�"":"`: . ........ Setback .-;,.�_.� __.._____ Sideyard _..._ � :''..�:.�. � .: _.._...._ ............._......__.
Sewer Elevation
To be Used as
- ---�-� ` r -- �. �. �...,�_ r' POIIt �--'-'� —=�----
,
°--�-----�----- ............._.....-=— ° -::...... 1''TOIIt --�--........._..---
ri t
of Construction •' "' � � `>..�f'� �;
T3'pe .....; �°......__..........--..........
Est.
._..._.._... Foundation IIevation ..........................._...-----_._._.
rioN�.c��--s���iN�
/ �° � '' � �, �� ,, ,
..-'�-�----��.,.. Height �...:::..� `--- �1• � ---'�'-'•=�==-
Height � �,,,..,.. Sq. F�
�"� �` �` - - -
Ct�. F�
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In consideration of e issuance to me of a germit to constri�" the building described above, I agree to do
the proposed work in accordance with the descript3on above set fo ' and in compliance with all provisions of
ordinances of the dty of Fridley.
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In considerat3on of the payment of a fee of $.�'"y.y�.:"".`�..., permit is hereby granted to._.__..__._.___...._....__.__ _._. _.
....�.� _.__�.�..___A_.. 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 worl�nen, in all work
done in, arotmd and upon said building, or any part thereoP, shall conform in all reapects to the ordinances of
Fridley, Minnesota regarding la:ation, construction, alteration, maintenance, repair and moving of buildings
within the dty limits 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 perrnh does not eove� �he eoestrueHon, inatallatton for wiring, plumbing, eas heaNag, sewer or wafer. Be sure to see
the Building Inspeefor for aeparafe permits fo� these items.
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City of Fridl.ey, i�ren
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BUILDING PE�T N� 5 z'r s�
nate: � �'�' /� u '.� � , ,.�°'?
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Owner: �� _�i-��.`�r= ,,,�' �!".'.� Builder _ ..�._ ._
Address ,�: "'° _ — Address � �� �"
L(�.C�IOiV U�➢LDi6VG
No. '� �� � Street � �,6.� „- ��� Par�.c�, Lot �
� ��'�
Lo ' '�" Black Addition or Sub-Division .��L1/�-��'/� � t-�q�,,�
Coraer Lot _ Inside t _ � Setback ��—� _ Sideyard �..C�__r'� �' �
Sewer Elevation —..— Founda.tion IIevation
�, DESCRIPTiON OF BUILDING
'�'���� � ���
T�� ` iTsed ��'' � ,�,�__ +�. FYi�
Frant �_�,.� Depth -si=—�— Height �" Sq. F� � Cu.
� :, � F'ron ���� Depth _��..� qH t�� Sq. Fk .��_.,f� Cu. Ft �C�_"'
,I� " Gr >;
Type of , nstruci3on � Esi. Cost ..,���'�" To be Completed
In consideration o4 the issuance to me of a pernut to construct the builc�ing described above, I agree to do
the proposed work in accordance with the description above set forth and in. compliance with all provisions of
ordivaaces of the dty of Fridley.
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In conaideradon of the payment oE a fee of $.��►_,,� , Permit is hereby granted to. -- --
to construct the building or addition a.s described above. This permit is grauted upon
the express condition that the person to whom it is granted aad his agents, employees and workmen, in all work
done in, around and upon said building, or aay part thereof, shall conform in all respects to the ordinances of
Fridley, Niinnesota regardiug location, construction, alteration, maintenance, repair and moving of buildings
wi� � city limits and this permit ma.y be revoked at any time upon viola.tio�t�of aay oP the provisions of said
Inspector
NOTICE:
Thfs permif doas eoT eover the eonstrneNon, iastallatioe for wirtng. plumbing,' eas heating, sewer or water. Be sure to see
ths Buildiee laspeetor for separate pem�ib fo� t6esa items.
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acrae�r's
�ddress ,
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No.
APPLTCATION FOR BIIILDING P�T
CITY OF FRIDLEY, M�NNESOTI
LOCATION OF BIIILDING
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of Lot
Lot�' .�3",� �� °'��Block � Add3tion or Subdivision
Corner Lot Inaide Lot L� 3etback Side-Yard
SEWER ELEVgTTON FOIINDATION ELEV�TION
�pplicant attach to this form Certificate of Survey of I�t and propoaed buildin�
loca.tion.
To be used as:
DE5CftIPTIQN OF BIIII�ING
Sq. Ft. Cu. Ft.
P
Front � ° Depth .� � Height � �
Sq. Ft. Cu. Ft.
Tarpe of Construction ��'/�,%'�tl Eatimated Coat
To be Completed ___--
The undersigned hereby maDces application for a perm3.t for the work herein specif3ed�
agreeing to do all work in si',rict accordance with the City� ardinances and ruling of
the Department of Suildings� and hereby declares that all the facts and representationa
stated in this applicat3on are true and correct.
Dg� � '��� � � t
SIC�TA
(g Schedule of Fee Costs c�n t�e found on the Reverse Side.)
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BIIII�ING PERMIT FEE SCHEDULE
Section 2. The Inspector of Build3.ngs ahall, before issu3ng any permit for the
erection of any building or struature, or for any add3tivn to any existing build-
3ng or atructure, or for anar al.terationa or repe,3.x°s to any exist3ng building or
structvre, upon application therefor, requare the pa,yment by the applicant for
such permit of feea to the �mount herein below set forth ancl in the mex�ner herein
provided to-wit:
2.1. For an�r auch permit for �the erection of any fire-proof buildi.ng, other than
a. garage, �arehouse, factory or graia eleeator, or for the erection of �ny fire-
proof add3tion, for similar occupancy, to any existing bui].ding shal]. be �s.t ��he__
rate of �]..L,.O for each one thousand cubic feet, or,-fraction thereof, in such
cubical contents. '�-
2.2. For any sueh� permit for the erecti�on of en� fireproof gerage, �rarehouse,
factory or grein elevatflr, or for the erect3on of ariy fireproof addition, for
sim3lar occupancy, to any existing buiTding sha13 be at the rate of �7..25 for
each one thousand cub3c feet, classified as "fireproof't by Section 502 of the
Minneapolis Bu3ldirig Code. �
HOUSE.S
s
2.3. For an�r auch permit for the erection of ar�y no�fireproof build3.n� other
than a garage, warehouse, factory or grain elevator, or any nor�fireproof
addition, for sim3lar occupsney, to any existing building. Permit $]..00 for
each one thousand cubic feet.
GARAGES
2.4. For ex�y auch permit for the erection of any non-fireproof garage, warehouse,
factory or grain elevator, or for the erection of any non-fireproof addition, for
similar occupanc�r, to any exiating building or t'or each such building or addition.
Ninety Cents for each one thousand cubic feet or f{rection thereof, in the cubical
con�ents thereof with a minimum of �4.00.
For the purpoae of computing fees for bu3lding permits the cubical contenta of ar�r
bu3ldin� or addition to a uniform height throughout by multiplying the ground area.
covered from a point six (6) 3nches below the floor 13ne oF the basement or cellar
to the average height of the upper surface or to the average height of the roof
aurface of the ma3n gable of a pitched roof.
2.5. For repairs or alterations to an ex3sting structure, the fee shall be at the
rate of $3.00 for each Five Iiundred Dollars ($500.00), or f'raction thereof in the
cost of all proposed work.
2.6. In no ca.se shall the fee charged for any perm�.t as set forth in Section 2 be
leas than �4.00.
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INti PLANS ESTABLIBHED 1828 CITY LOT 8URVBYING
pND SPECIFICATIONS PLATTING
� ' F/lRl4 SURVEYINO
������
� M. .l. BERSCHEID
� �lu�i�Ct �d �'�� � ,
PItoNE PARKwAY 4-4593
3644 TINENTY-SECOND AYENUE SOUTH
MINNEAPOLIS 7. MtNN.
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HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS VILLAGE OF MOUNDS VIEW
WEATHERSTRIPS �•H•�•E TYPE OF CONSTRUCTION INSULATION
Guide
Windows I Doos Referones Out. Wel) I Int. Wall I Giftng I Roof I Hoor Kind I Ceiling I Wall
Yea — No Yes — No 19
� FL I•oy.� Room I Length � Width � Height � FI. I e Room I Length �' �dth '� Hefght
�lVINDOWS and DOORS — CRACKAGE end AREA WINDOWS end DOORS — CRACKAGE end AREA
Width HeiqM No. of Linoel H. Araa Width He1gM No. oi Llnael ft. Area
No. of pane of pan� Iiqht� of craek sq. if. No. oi pane of pane itqht� of crack u�. H.
� �0�0 a2 �( o� ! I � 1 o�-U C � % �
S� 1 // ;�0 3� l � �
3� ` r8 `� c.°f�6'OZ �� o� Cl
Coef. Btu. Cosf. Btu.
N►indow� � � Infiltrotion �ndow� —}i
In�11t1'ation Doon `� ' L► Q Doon
6p. Wall � 6cp. Well �O�
61au �u� S,S 1� Gleu l ,� l S
Nst Gp. Wall :Z 6 I / '� L � (. Nsi 6�p. Wall ' � / / � �
t�. Wall Int. Wa0
Ceiltng T s`� r1 , � y�i� Giling or Floor /,S'� / S^ �j
Total Btu. � � � Total Bfu. �,
Rsquired aq. it E. D. R or aq. ina. W. A. Leader aroa Required sq. H. E. D. R. or sq. ins. W. A. Leader area
p. (�'a � Room I Lsagth �C� �dth C b Haight � FI. I� Room I Length �r' Width ,S�f Height
WINDOWS and DOORS — CRACKA6E �nd A�REA WINDOVI/3 and DOORS — CRACKAGE and AREA
No. �Wldth Hetqht No. of Un�el M. Ars� Widih Hefqht No. of Lineal k. Aree
af p�ane of pane Itghf� of erorJt sq. H. No. ot pene oi pana IigM: of vac& cq, ft.
� I�.�F � � le� t c� l a� I 6 2 S— S�°
Infiltretion
ficp. Wall
Glau
Nat 6cp. Well
I�. Wall
Ceiling or Floor
Totel Btu.
Cosf.
/�
i�v � l5
� p. I� s 8�d Room � Length /� Width /� Height
WINDOWS and DOORS = CRACKAGE end l�REA
Width Hetght No. of Lineal H. Aree
No. of pa�e of pana Itqhls of veek sq. if.
� a�f 1` � l0 1�
� � �°r � G c �
InAltretion p�
�. Wall
61au
N�t brp. Wall
Int, Wall
C�iling o� Floor
Required sq. f► E. D. R. or sq. ins. W.
RT�l00•6-39
� � I�iltraHon Doan � � �� ��'�'
Wall �,
�i ,� Glaa �j' S � � %�
% 7o Net Exp. Wall � /� d
I�. Well
s`D� Ceiling or Floor � � �� ��
' � Total Bfu. �
Required sq. it. 6 D. R. or sq. ins. W. A. Leader erea `
� FI. I ° " p Room I Length � Widfh � Height �
WINDOWS end D ORS — CRACKAGE and AREA
Width He1pM No. of Lineel ft. Aree
No. of pane of pene Iighfa of aack sq. ft.
1 -1 ,g� .�' ��
Co.f.l Btu.
� S�
� //
3�
area
� " Infiltrefiion � - " - �-�-�'"
Doon
Esp. Wall � �
� �f� 61aa / �/ u��S� � �.�
� Nat 6tp. Wall ,�� / % ,�
lut. Wall
�' � catitag o� Fioo� �% J� ���.�"
Total Btu. � �
Rsquired sq. ff. E D. R, or sq. ins. W. A. Leedor area
3 6RANp TOTAL—
� ��`� ` � �,�-t i
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS VILLAGE OF MOUNDS VIEW
WEATHERSTRIPS �•H•�•E TYPE OF CONSTRUCTION INSULATION
Guide
Windovn I Dooe Rsferones Oui. Wall I Int. Wall I Giling Roof I Hoor Ktnd I Ceiling I Wall
Yes—No Ye:—No 19
FI. I Room I Length Wld+h j�/ Height FI. I Room I Leng4h �dth Height
YVINDOWS end DOORS — CRACKAGE and AREA WINDOWS and DOORS — CRACKAGE end A�REA
No. IWidth Heipht No. of Un�al ff. Aree Wtdth Height No. of Lin�al ft. Area
of pene af pen� I Ilqhh I of vaek I �q. if. Ne. ot pan• ot pane Ilqht� of erack I sq. R.
� � N lt '� 1� !c�
C
In$Itra#fon
s
Cosf.l B+u. II I I I Coef.l Btu.
Nsf 6�p. Well � � � �'
t�. Wali f �
CsiUng o� Floor % Y a3 �,� c�
Total Btu. �
Requfred iq. if. E. D. R. o� aq. tin. W. A. Leade� aroa
�, I Roon� I I.�ng+h 1Alidth Heiqh+
WINDOWS and DOORS — CRACKAGE and A�REA
I Wtdih I HatqM No. of Lin�al tl. Area
No. of pene of pene IIQhh of erack iq. H.
In�iltrefion �
Di
6cp. Wall
Glau
Nat fxp. Well
I�. Wall
Csiling o� Floor � �
Total Biv.
Rsquired �q. i+. E D. R or :q. ins. W. A. Leader area
�. I Room I Langth Wtdth Height
WINDOWS end DOORS = CRACKA6E end A�REA
Wtdih He1gM I No. of Unaal H. Aree
No. oi pan� of pena Ilqhh ot aack sq. it.
Co�f.
In4ilhation
Ero. Wall
Glan
N�t 6cp. Wall
Int. Well
Ceiling o� �oor
Total Btu.
Requtrcd :q. ff. E. D. R or tq. ins. W. A. Leade� erea
xT.soo-e-ss
Btu.
Inffitration wmaowi I
Doen
6ip. WaR
Glaa
Nat Exp. Wall
Int. Well •
Giling o� Floor
Total Btu.
Required aq. ft. E D. R. or sq. ins. W. A. Leader erea
i�. I Room I Length Wid+h Height
WINDOW3 end DOORS — CRACKAGE and AREA �
Cosf. Btu.
le$Itra#ioa �ndowa
Doon
6e. Wall
Glau
Nei E:p. Wall
lat. Wmll
Ceiling or Floor
To+al Btu.
Required sq. f1. E D. R. or sq. ins. W. A. Leeder area
FI. I Room I Length �d+h Height
WINDOWS and DOORS — CRACKAGE and AREA �
— Infiltretioa Doors �
Gp. Wall
61ass
Nef 6cp. Wall
Ir►t. Wa0
Cetliag or Floor
Total Bfw
R�quired :q. ff. E D. R. or sq. tns. W. A. Leedar aree
�. . � �
6RANp
Cosf. Btu.
I
City of Fridley
aT TNE TOP 0� TME TwINY
L-------� COMwt!►11TY DEV[L,ONAENT QIV,
i MCTECTIVR NM►ZCT1pN 0�/T,
�.--- ; pTr MA�.� s1u0t.�r iM�
►�I `.� �q' b�0' 3 NO
Job Address
ner
Contractor
520 N. E. Ironton Ave.
TnTilliam L. Benson
d of Building
Frame
p etion Date
11-15-73
�� . i. � i � � i n
�
53-8l�-S-915. �,1
PLUMBI�Vr, PERf1IT APPLICATI�►d
-��+�BH L„ u � L� J
Ad ress
ress
Use
Res
�����
rnone
78l�-06�0
---1 — - --- -- --10. 00
Plumbing Fixture Rates; N0. RATE TOTAL
Number Fix turea x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Basin 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 Fess:
lst 3 Fixtures x $2.00
Additional Fixtures x $ .75
Gas Range-199�000 BTU 1 x$5.00 5.00
Repairs � Alterationa
See
Deacription: Code
State Surchart�e .50
fGfa�s �°��" �urcharge ,5a�
TOTAL FEE $ . 0
The undersigned hereby makes application for a permit
for the work herein specified� agreeing to do all work
in atrict accorda.nce with the Citp Ordinances and rulin
af the Department Qf �ui�dinga, aad hereby declare that
a1l�the facts and represantationa atated in thi�
applica�rue and �orre�t.
� I �� r'� � G°�� �� c6� �� .�v��� �I . - _ ., ��_.
'Si�nature Date
f�Y,�� �2 � �3 " 7 il
1
.
sue.,ecr ER .
c�ty of Fr�a�ey 3536 `
AT THE TOP OF T,ME TWINS g U I L D I N G P E R M I T
�
; � RECEIPT NO.
� ; y ����� COMMUNITY DEVELOPMENT OIV.
r � � PROTEC7IVE INSPECTION SEC. ��iq�
1 . � `.
i.--•�; �'�',•; CITY NAI,L FRIOLE� SS�J2 NUMBER NEV OATE vAGE OF �PVqpVED BY
L 763-571-3450 910-F 15 5/ 21 / 03 � �
JOB ADDRESS ,�20 Ironton Street NE
1 LEGAL �OT NO. BLOCK TRACT Oii ADDITION SEE ATTACMEO
DESCR. SS,56,57 G Riverview Heights SNEET
2 PROPERTY OWNER MAII AOORESS ZIP PMONE
3amie Noslund 520 Ironton Street NE 763-783-0797
J CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Same
4 ARCNITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADORESS ZIP PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION O ALTERATION �1 FIEPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) Tear-off
8 CHANCiE Of USE FROM TO
STIPULATIONS
Underlayment must comply with the Sta�e Building Code.
SEPARATE PEfiMITS ARE REOUIqEO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
VENTILATING Op AIR CONDITIONING
TMIS PERMIT BECOMES NULI AND VOID If WORK OR CONSTRUCTION 20NING S�. FT CU FT.
AUTMOR12E0 IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOFi A PERIOD OF 12p DAYS A7
ANY TIME AF7Efl WORK IS COMMENCED. NO DWLG. UNITS OfFSTFEET PARKING
I HEREBY CERTIfV THAT I HAVE READ AND EXAMINED TMIS APPLICATION 1 STA�LS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORiiECT. ALl PROVISIONS Of �AWS YALUATION SUR7Alt
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED MEREIN Ofi NOT. THE GRANTING OF A PERMIT �3�OLO �1.51
DOES NOT PRESUME TO GIVE AUTHOqITY TO VIOLATE OR CANCEL TME pEpMl7 fEE SAC CMARGE
PROVISIONS OF ANY OTMEFI STATE OR LOCAL LAW REGUTATING CON- @
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION �9%.2S Fire SC y�3.O1
PLAN CNECKFEE TOTALFEE
�1�1.%%
OTUAE 0 CO TpACTOA 0 TMOA�Z 4GENT iD�rE� MEN PROPERIY VALIDATED TNIS IS VO R PE MIT
�GN uaE O w Ep ��O NE ui� Ep� �� E� �
G �h r�� E
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effective 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: '° ��
�
Legal Description: –�
Owner Name & Address: �YY1�P Q� i� �! �— Tel. # ��� % � �J �� Z�
Contractor. MN LICENSE #
Address: Tel. #
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length �dth _ _ Hgt/Ground �� Sq. Ft.
Construction Type: Estimated Cost: $ �� � o
Driveway Curb Cut �dth Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � �f v � APPLICANT: �%IL� (�, �liu � Tel. #��0��� G��
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
7 as_
$
$ .�/
$ f. �(
$
$
$ �
$
$
$
,
$ v �
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 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-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
'
$25,001 to $50,0�
$50,001 to $100,(�0
$100,001 to $500,000
$500,�1 t� $1,000,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $1� or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional$1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,(�0 or fraction thereof, to and including $100,�
$993.75 for first $100,0� plus $5.60 for each additional
$1,0� or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1, 000 or fraction thereof, to and including $1,�,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.�.
Permits for constiruction will be issued� a minimwn of 24 hours from the time of applica.tion to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing
proceeding with the framing. New Houses Onlv
�
foundation will be required before