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AF - 47494City of Fridley, Minn. BUILDING PERMIT .:- f - � ,%�` , .�•,- � � . �� :' ��' .- .�s � .,.� -�. �.. «� N° 5816 CATION IL INlG No. � Sfseet �_�.�� Part of t Lot _ Bl Addition or Sub-Div�to�y; . � r �" Corner Lot � Ina�tde Lot Setback "� � Sic�yard Sewer IIevatton _._._ � Foundation IIevation DESCRIPTION OF BUILDING To Used • � � Front y� Depth !�� Height -.d�- S4. F't. �� Cu. Ft�-,�� Fro Depth � eight Sq. F't. Cu. Ft �pe . of ConstructIon �'��..— F�t. Cost ,��.,�� '�" To be Completed In consideration of the �tasuance ta me of a permit to construct the building described above, I agree to do the proposed work in accordance wlth the description above set forth and in compliance with all provlsions of ordinaaoes o� the dty of Fri�IIey. � In consideratlon of the payment of a fee of $..�.,��, permit is hereby gra,ated to� to construct the bufldfng or addition as described above. This permit is granted upan the express canditioa that tiie person to whom 3t is granted and his agents, employees and worl�nen, in all work �ione in, around and upon said building, or any part thereof, shall coffiorm in all respects to the ordinances of Fridley, Minnesota regarding locai3on, construction, alteration, mafntenance, repair and moving of buildinga within the dty ]imits and thia permit may be revoked at any time upoa �on of any of the provisions of said orclinance�s. ,�'i� .�°' Bufldin8 Inspector NOTICE: This permh daes eot eover ths _ eoastrutlioa, teata0adon for wlriep, plvmbtng, gai heatiae, aewee or wa�er. Be sun ro tea �6s Buildlnp lespee�or for separata parmits for fhaw Items. �, 4 _ -- '`1- r --- v-r1c �� .. � .�i� A � � — i. APPI�ICATIO�T �O�@ BUII►DING PERMIT C�TY OF I`RIDLEY, M��S�A Owne�c's Name Suilder � �"�'' `�� ° �iddress Addlcess ��'�1' ��``"`'�''�`� ��"""'�l• LOCl�TTON OF BUI�DING No e C�'� "� _ treet fi��a^� Part o� Lot !�� . Lo�t S Slock / Addition or Subdivis�.on�� Corner Lot ins3de Lot � Setback 3J_ Side-Yard ,�/ f�/f ` SEWEBt ELEVAT�ON FOUNDATIOL�T ELEVATIOI�T Appl�.cant a�tach to �this �orm Certi��.cate of Survey of Lot and proposec� building 1oca�ion. DE�CRIPTTOI�t OF B'UII,D2NG l0 1�e used aso � � � � �� 'ront Depth He3ght Sq. Ft. Cu. Ft. ��orit__._____ Dep•�h kie3.ght Sg . Ft . Cu e �'t . 3'ype of Construc�t3�n Est3.mated Co�•t To be Completed The undersignecl here�Oy makes application �or a permit �or the wo�ck herein speci.f�.ed, agree�.ng to do all work in striet accordance with the City o� Fridley Ord3nances and ruling of the Deparf�nea�t o� Build- ings, and hereby declaros that all the fac�s and �epresenra�ions s�atecl in this ap�lication are truo and corroct. Dt�TE / - S `" � `� SIGiiTATiJRE � (Schedule of Fee Cosfis can be xound on the Reverse Sicle). . _a �'"� ^� _. � � .- .. �UYLD�NG PER1�tTT �EEE SCi�EDUIrE sec�iorn 2. The z�apector o� Buildi��s shall, before issuing any per�ni�: �or the e�ec•��.on o� any bu�.ld�tng or structure, or for any addition to any ax�sic�.ng building or s��uc�wce, or for an�r alt��ations or repairs to any oxis�ing build�.ng o� s�ruc�cu�e, upon appl�.cation i:horefor, require �he payment by �he a�pliC�it� a".o1C such permit of rees to �he amoun� he�e3.n below set �orth and in the mannea� here� p�ov�ded to-wito 2.1. For any such permit �or the erection o� any fire-p�coo� building, o�her than a garag�, waacehouse, factory or graia elevato�c, or for the erec'cion or any �ire-;�roo� add3.tion, for similar occupancy, ta any e�eisic�ng buildi�g sl�all be at the rate of $�..9�0 for each ono thousand cubic �eet, or �Erac�cion thereof, in auch cubical contents. 2.2. For any such parYnat �or the er�ction o� any fire-proof ga9cage, warehouse, factory or gra�.n elevator, or �or the erection or ar,y �ire- prooz addi�tion, �ox sifmilaic occup.ancy, ,to any existing bu�Zding shall �e at the ra�a oy $1,25 for each one thousand cu�iic feet, cla�si�iecl as "�iseprooi" by Seci:ion 502 of the Minneapolis Building Code. . gIOUSES 2.3. For any such perm�..t for the erec�ion oi aay non-fiTCeproo� build- �.ng o�her than a garac�e, warehouse, �ac�ory or grain e].evaicor, or any aon-rixepscooF addi��on, for similar occupancy, to any exis�ing build3ng Permit $1.00 �oY each one thousand cul�ic feet. Gt�AGES , 2ea. For any such permi� for i:he erection os any noa-fireproof garage, warehouse, �actory or g�ain eleva�or, or for the erection of any non-�ireproof add�.�ior►, �Eor sirn3.lar occupatzcy, to any ex3sting building or �or each such building or adclitione Ninoty Cen�s �or each one fi.housand cul�ic seet or fract3on tchereo�, 3n the cubical contents thereof with a min3.Ynuin oi $4,0p. �'oac �he purpose o:c' co�►pu�cing fees for building pegmit� the cubicai con- tenfis o� any buildi�g or addition �to a uniform height throughouic by multiplying the ground a�ea covered �:rom a po�.nt aix (6) inches b�law �the floor 11ne o� �the basement or cellar to the average heigh� o� the upper surface or to 'che average helgh � of the roof aurface of th� main gable o� a pitched rooi. 2.�. Far repairs or alteratione to an existing structure, the fee shall be at �he rate o� $3 .00 per each Ftve �Iundred Dollas�s (; 500.00j or �ractio� �hereor in �he cos� of all pro�osed �vork. 2.6 q r.n r�o case shall the fee charged for any permit as �ot for� in Section 2 be less tI?�a �4.pp. � � � x,� � � x � , � , c ��dM»�`3�i r dM C�, '�35 -' . �✓- _ [4►ldPAarx�n� r.�,�s�,.,,�� c�� a ep� m, � „� �� . � ,! �� '`'4 �; � � '` 'J7} 3��"#. ��{� " � x�t'� _� �S i . . . . ;z_.i �{k �� . . .. . �.��. � � � b W �..,.., t �. i` �..� � . � . . . � ?. ��J� � �'�f''� � , ,�.� '� u• � ENG�NEER,�f�IG, ��C�. �� - �� , _ .��.� �� — En�tneers E Sut� ve�t/ors C!.'i�!'#i�� , ��s N� M DEVELOPMENT Ca, c� . \ � � �J �...�� 1Y I + ! �� I .r� �- T � . � � � . � � � r — �3ti: 7 / „- � w � 1-- � Z O � W 1�. li.. W "7 ' L O T 3,�3L OC�c'' /, L l'NDALE r9U/,COE�PS 7�,�oo�r�o�r , /Ii�mriely ca�i�'y fl� � �s a 1rr�e and Qarrrcf �senfi�an �('o .sw� �'il�t �r�is�s.,�'�ir �6wir abr�r�i�,�+�d,�ad " �'N�t /�/�ioni e�l�tl' b�wtaln�s, �laewr, �adMt►�si�hk axr�arh�v�er�s ,�'wrf. �i �r �nt�d 6od. As ser�r�ed 6�r� ��_ a6r/ . �('�t�kz�:,us�'s{�,,. A.R dt�ol. ; SU8UR8�W �NGfNff.lTi�.,� �IC. `�` �=� � _� ,SCA G ,E /� ,3�' �y � • � � � ` ° ` #y t �A - � . � - C"�' �' _ r�. \ . �' . _ i . . 1 . }�':� - 6 `f` _ '�£ .. 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'i� _ � .�`". � tA �, � vt e � � � �i 70 i. � � a ; � � �' <_ -_ � - � 1YJ6 � s �—s — �.s HEATtLOSS CALCULATIONS DEPARTMENT Weatherstrips A.S.H.V.E. Construction N� Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Yes—No Yes—No 19— << " Fl. '� Room � Length `"Width � HeiBht t Windows a Doors—Crackage and Area Wldth Helght No. oY Llneal f. Area No. of pane oP pan Ilghte o[ crack aq. ft. "s/ F✓ ��0� • 4'� / V �i°`� /�/ / � � E� � h/ / � �y� _ ° / �(,�, ( , � Coef. Btu Infiltration � �02�,� Glass � ��',��d Exp. wall � . Net exp. wall � /Q /�� Int. wall Ceiling %� � Q Floorf Q� ` / ;�� Total Btu. �� / � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F7.� Room � Length Width Height Windows and Doors—Crackage and Area Wldth Hefght No. of Llneal ft. Area No. o[ pane ot pane lighte ot crack eq. ft. � � G ,7 „� � -��1 � L / //. 5 Coef. Btu In6ltration � f �' r c�aSB � /, Exp. wall Net exp. wall �`%` � l / Int. wall Ceiling � o Q Floor Total Btu. Required s. f E.D.R. or sq. ins. W.A. Leader area F1. � Room � Length / i Width //' P Hei Win ows and Doors—Crackage and Area Wfdth Hetght No. ot Lineal ft. Area No. of pane of pane lighte o[ crack aq. ft. ,�" /le �/� / •� � In6ltration � �/ � Calaas � � Exp. wall � /o?� Net exp. wall �' Q /, Int. wall Ceiling ��p� f� � loor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area OF BUILDINGS �,��, / 7�L, �. Roof F1oor Kiad � FI.) ". -" t, Room 1 Wiadows and Doors—Cr+ Wldth Hefght No No. of pane oY pane lig � i � Infiltration Glass E�ap. wall �" /� �! Net egp. wall Int. wall Ceiling Floor Total Btu. Required sq. k. E.D.R. or sq. ins. W.A. Leader area FI.I , Room I I-en8th // Width Windows and Doors—Crackage and Area Wldth Helght No. a! L1nea1 tt. Area No. ot pane of pane 1f6hta ot crack eq. ft. � �, J .� ( s�y��,��1-�'s� f NIINNEAPOLIS. MINAI. Insulation How Applied i � � " Width •' '� Height ,�/ e and Area Ltneal ft. Area of cra�k eq. [t. r c�ass Exp. wall Net egp. wall Int. wall Ceilin� Floor 'fotal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F7. , oom I Length/, ` Width �� Hei Windows and Doora—Crackage and Area Wldth Height No. ot Lineal ft. Area No. of pane ot pane Iighte ot crack eQ. tQ Btu �� Infiltration �� Glass Eap. wall , � � Net exp. wall Int. wall ��' Ceiling Floor �J � � I Total Btu. Btu �� JO Coef.� Btu � � � � Required sq. ft. E.D.R. or sq. ins. WA. I.eader ana � � ., ,. �.`� � ' _ i D�S6 � s s�e.� .� HEA1' LOSS CALCULATIONS DEPARTMENT OF BUILDINGS NIINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall C,eiiing Roof Floor Kind How Applied Yes—No I Yes—No 19— Fl.� � Room � Length /� � Width/,� ` Height �. "'� FL � Room Length . Width �� ` H Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vldth Helght No. of Llneal ft. Area Wldth Helght No. of Llneal ft. Area No. oP pane of pane lighte of crack eq. ft. No. ot pane of pane Ifghte ot crack e. f4 � �'� / �2L< <�� a � . / �3,�. / , . � /' �— ��° � �� / � — /� ;�" � �c' Coef. Btu Coef. Inhltration ��/ ��' /�/ Infiltration Glass % O Glasa " .��x �; Eap. wall / ` % ,�2 F.sp. wall ' ,�" ° Net exp. wall � � �f�' Net esp. wall �? /� � Int. wall Int. wall Ceiling / ��' �,� Q Ceiling Floor Floor Total Btu. � �.,��' Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required aq. h. E.D.R. or aq. ins. W.A. Leader area Btu � F7.� Room � Length ��' Width Height � �,� Room � Length Width Height Windows aad Doors--Crackage and Area Windows and Doors—Crackage and Atea Wldth Hefght No. of Lineal ft. Area Wldth Helght No. o! Lineal [t. Area No. ot pane of pane Itghte of crack aq. tt. No. of nane ot pane lighte ot crack eq. [t. In6ltration Glass Exp. wall Net egp. wall Int. wall Ceiling Floor Total Btu. Windows and I Wldth H No. of pane of f Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Coef.� Btu or sq. ins. W.A. Leader area im � Length ` ° Width � —Crackage and Area No. ot Lineal ft. Area Ilghte ot crack eq. ft. Coef. Btu .� /� � �� /� f7fJ Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area 3� Infiltration Glass Eap. wall Net exp. wall Inc. wall Ceiling Floor Z'otal Btu. Requued sq. ft. E.D.R. or sq. ins. W.A. Leader area F7.� Room I Length Width Height � Windows and Doors—Crackage and Area Wldth Height No. of Ltneal ft. Ares No. of pane of pane IlBhte of crack eQ. it Inhltration Glass Eap. wall Net exp. wall Int. wall Ceiling Floor 'fotal Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader ana Btu � M d y � � �. � o � p � : 7i . � : �, : M : o . � . m �J : � : � � tA t�n � � � N � � �� w z � � � � � ►►��{{ � � � � q .. � � O ' O ' O � . O . . 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M •.��'o �O.�p ��°'� H ��m � ��,� �� j��M �� o � .. � �. m m�� I � � �� D _ . � D -� r � � • � � y _ � m � v _ � c m � � � � ` d � � •¢ - 3' . � . �tn. � , � Vl . s ~ �� i p Q� r ' �, v < `�, � �• � V O � � � � � a ' A � A � , 0 . � — � 5� i�. � �� sue�ecr RMIT N City of Fridley o 17 8 7 4 AT THE TOP OF THE TWINS g U I L D I N G P E R M i T r ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. �� i Ly �� r � � PROTECTIVE INSPECTION SEC. 1 = � � /'�'1 � CITY HALL FRIDLEr 55432 NUMBER REV. DATE PAGE OF APPROVED BV !"""� � ,�� 612-571-3450 9t0-F15 3/19/85 / / J08 ADDRESS 5872 Jefferson S�treet N. E. t LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Lyndale Huilders 7th Addition SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE Andrew rzada 5872 Je�fers.on Street N.E. 571-7537 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDHESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDINO ' Residential. 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 0 REPAIR � MOVE ❑ REMOVE X 8 DESCRIBE WORK �eroo� Dwellin 9 CHANGEQFUSEFROM TO STIPULATIONS Roof c�.n he the 2nd layer but not the 3rd, Insta.11 ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OH AIR CONDITIONING. �P��-t THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED $]_�SOO $.%S WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`2rj.00 STRUCTION OR TME PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE $25. 75 SIGNATURE OF CONTRACTOR OR AUTMORIZED AGENT IDATEI g-- WHEN PROPERLY IDATEO HIS IS YOUR PE MIT i�=CX_(/ ✓✓ // [ c � — l 7 ' O J , / cd -- SIGNATUREOFOWNERIiFOWNERBUILDE IDATEI ' � ' LDG INSP � �aT NEW [ ] ADDN. [ ] AI,TER. [ ] City of Fridley R-1 AIiD R-2 Building Permit Applieation Construction Address: S ��a �l� ��'s � ��` � � • Legal Desoription: Effective 4/1/84 Owner Name & Address: j'��h� � F� � uy�ZCt Gtg _ Tel. #�S 7/-7S �% Coatraetor: � t-u Vi � (°' Tel . � Address: `s� n"'� Attach to this application, a Certificate of Survey of the lot, �ith the proposed construction draWn on it to seale. DESCRIPTIOH OF II�IPxOYEI�NT LIVING AREA: Length iiidth Height Sq. Ft. GARAGE AREA: Length Yidth Height Sq. Ft. DECH AAEA: Length _�_ Yidth _ Hgt/Ground Sq. Ft. _ OTHE :R Corner Lot [] Inside Lot [ j Ft. Yd. Setbaek Side Yard Setbaek Type of Construetion: /ts�j%1Q/� Estimated Cost: ��S6 d� a d Approx. Completion Date: a w�� t'�.S Alt. A Alt B Proposed DriveWay Width If NeW Ogening Is Desired: � � See Back Page for Explanation DATE : '3 - / Q - g s APPLICANT : �.�I�-e•�- � ` Tel . � �7 / - 7cS 3� CITY DSE OALY Permit Fee � �"� ��o Fee Schedule on Reverse Side Plan Check � 25� of Huilding Permit Fee State Surcharge � �� .50/�1,000 Valuation SAC Charge � �425 Per SAC Onit Park Fee a Fee Determined by Engineering Se�+er !�lain Charge � �� Agreement Necessary [ 7 Noti Neeessary [] ?OTAL # STIPULATIONS: BDII.DING PERMIT FEE SCABDIILE The Chief Building Official ahall, 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 euisting building or structure, upon application therefore, require the payment by the applicant for sueh permit of feea to the amount herein below set forth and in the manner herein provided to-Wit: Total YaluaLioa =1.00 to =500.00 �so,.00 to a2,000.00 �2,001.00 to a25,000.00 �25�001.00 to �50�000.00 �50,001.00 to a100,000.00 �100,001.00 and up Fees �10.00 (Minimum Fee is �15.00) �10.00 for the firat �500 plus �1.50 for each additional �100 or fraction thereof� to and including ffi2�000. �32•50 for the first �2,000 plus a6.00 for each additional �1,000 or fraction ther�of, to and ineluding �25,000. �170.50 for the first �25�000 plus �4.50 for eseh additioaal �1�000 or fraction Lhereof, to and including �50,000. - �283.00 for the firat �50,000 plus �3.00 for each additional $1,000 or fraction thereof� to and including �100�000. ��33.00 for the first �100,000 plus �2.50 for each additional a1�000 or fraction thereof. DRIVEIiAY DEPRESSION ESCROiI (Concrete Curb Streets Only) . Alternate "A": Removal and replacement of curb and gutter only - Drive�►ay 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 vidth 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 a11oW for proper reviex of the proposed structure and of the construetion site. A CertiPicate of Survey of the lot, shoW3ng the location of the foundation onee it has been eonstructed xill be required before proceeding With the framing. �_ ,� ,.._..� SuBJECT City of Fridley � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � � 1 y_�_��_ COMMUNITY DEVELOPMENT DIV. r � � PHOTECTIVE INSPECTION SEC. i--_-� �"'�,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE i 612-571-3450 910-F15 4/11/86 JOB ADDRESS 5g�2 Jefferson Street N.E. 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION DESCR. 3 1 Lyndale Builders .� 7th Addition 2 PROPERTYOWNER MAILAODRESS Z�P Andrew Aurzada 5872 Jefferson Street N.E. 3 CONTRACTOR MAIL ADDRESS Z�P Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P 5 ENGINEER MAII ADDRESS Z�P 8 USE OF BUILDINCi Residenti.al 7 CLASS OF WORK ❑ NEW Q ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE B DESCRIBE WOHK Construct a 9�' x 10' Garage Additi.on PAGE OF � � 1837; CEIPT NO �40�� APPROVED BY SEE ATTACHED SHEET PHONE 571-753 7 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. 9 CHAN�EOFUSEFROM STIPULATIONS Provide a hard surface driveway, TO ��ARA`�� R�ITS REQUBREb �°0� IJ�1�1�9�, HE,4TING, PLU�1�9�� fVD ��. TYPE OF SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL. PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DN I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUAT ES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED UNITS AND ORDINANC WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1�200 DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PEHFORMANCE OF CONSTRUCTION. y�2O. SO SIGNATURE OF CONTRACTOR �Ai1THORIZED AGENT IDATEI �,._O_ e _ _ �,..�-�— � � /% /s, "6�(��/",y'17' ,�;, �`_ tJb�iN�'�f�� V(� qt„ °w .��t.r? ��i�� ,� , +� r � � � � .; � ��e+��,y °��A� ; . � "+rp� �,1� a-� �., �1( r�1�; p� F� ;e� �-��; y �=� ��`` � �:w.�, �,�� OCCUPANCY GROUP I OCCUPANCY LOAD SQ. FT. CU. FT. OFF8TREET PARKING STALLS GARAGES SURTAX $.60 TOTALFEE $21.10 D THIS IS YOUR PERMIT NEIti' [] City of Fridley Effective 4/1/84 A�rt;. [ 7 �R-1 AKD R-2 � pLTER. [ ] Building Permit Applieation Construction Addre Legal Description: „� Owner Name & Address: � � • 9 t�.' � � Tel. � S %/ --7; �7 Contractor: T-el. # Address• Attach to this application, a Certificate of Survey of the lot, With the proposed construction draWn on it to scale. DESCRIPTIOA OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. � I GARAGE AREA: Length I'a- Width � Height Sq. Ft. � DECR AREA: Length Kidth Hgt/Ground _ Sq. Ft. OTHER : ____ k � � ��` � a�-� � � � �� Corner Lot [] nside ot [ t. Yd. Setb c Side Yard Setback Type of Construction: ��Pr, �� 1�� Estimated Cost: $ � -- Approx. Completion Date: � !�� Alt. A Alt B Proposed Driveuay Width If Ne� Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICAhT: Tel. # S^ �� % CITY IISE ONLY , Permit Fee $ � Fee Schedule on Reverse Side Plan Check $ "�� 25`� of Building Permit Fee s State Surcharge a �,°"-'`�y 5.50/�1,000 Valuation SAC Charge � �425 per SAC Unit Park Fee $ Fee Determined by Engineering Sexer Main Charge � �,� Agreement Necessary [ ] Not Necessary [ ] fDTAI. � STIPULATIONS: . " ,.'!'.�" 0 s :� _ A BOILDII�TG PERMIT FEE SCHEDIILE The Chief Building Official shall� before issuing permits for the erection of ar.y 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-xit: Total Valuation =1.00 to �500.00 �SD1.00 to a2�000.00 Fees � 510.00 (Minimum Fee is a15.00) �10.00 for the first a500 plus �1.50 for each add�ttional �100 or fraction thereof, to and including �2,000. 52,001.00 to �25�000.00 a32:50 for the first �2�000 plus a6.00 for each additional �1�000 or fraction thereof, to and including a25,000. 525,001.00 to �50�000.00 550,001.00 to $100�000.00 �100�001.00 and up �17Q.50 for the first add�tional �1.000 or including �50�000. �25,000 plus �4.50 for each fract3on thereof, to and a263•00 for the first a50,000 plus a3•00 for each additional �1,000 or fraction thereof� to and including �100�000. a433.00 for the first �100�000 plus �2.50 for each additional �1�000 or fraction thereof. DRIVEHAY DEPRESSION ESCROW �Concrete CurD Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway uidth plus 6 feet times S13•50 Alternate "B"; Removal and replacement of curb and gutter and install a 3 foot wide apF�aeh With 6 inch depth - Driveway width plus 6 feet times �15.75 VERIFICATION OF FOUNDATION Permits for construction xill be issued a minimum of 2�1 hours from the time of application to a11oW for proper revieW of the proposed structure and of the construction site. A Certificate of Survey of the lot� shoving the location of the foundation once it has been constructed will be required before proceeding vith the framing. . � �_� � � � �� 6�� - _ _ � ��t�� [vnd Plonn�ny [;�nd Survey�ny Sn,�s leslmc� C�wl b A�unicipal En9ineeriny a� �d � �. � �'�^�irC i v V V / / 6B'i'3-Nr�fin� +�t5 it/E. Mmnao�lis 2l, EN G I NEERI NG, I NC. '��n��'° SUnsef 4-6066 En ineers � SurvecJo�s 9 c erti�icaie o� susve �o: �-� � M c� � �� r �_ � �� ;�s �� •a��. T �j I ir. �.v _ /=�e c� � _ , - I u . � 's. I �\ �� W i-� � I �� `� � �, I � � �� I o � i r I � �..`� � �� ,�_� . � ,. -- � �-r: � � I � � � i�: ,� � l.ii � � � � � � � � � L 0 T.= , GJ� C� ��' � �, ,L YN0.9L ,� �(//�C DE,��:�, 7 rHAC�I>'/7"/G'/1 f, l he�'eby cerfi�y �� ;5 �5 a��e ��f �ePresenfafran o�'a su/'✓elJ Q��l/t baundories �'�P obo,� �6�d im�e, and n�'�lae /ocvfion o�al/ buildm95 ,1��on , and oll ns'ib/e �w•ovdimtnfs ,�`ora�, �m or' ar�.soid /ond. As surveyed � me lhis - cb/f �' Fcb r��r� l.t A.0 ��1. SUB URBAN ENG/NEE21NG , INC. 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C � � � � ID � A � O � 0 x j D \ � O 3 A1 y � � � m � � � D A m � � O � � td 0 �� 0 Z D C� 3 �t D n 0 � 0 7 7 (C] I D m N � � N v � 1 � p1 N � � 7 (Q � n � � � N -+ � U� O O °o °o °o � �s �s tfl cfl s � � _ O � � O � � � m � � m g Z o � �� 00 � z c � o � � � � � 3 fl; � � cQ c � � _ � n h N 0 � m � � � � � o "° 2 O � m � � � 3 � m � � � � m � � 6 � -� � � m � � -i Z O � � \ W c � v_ Z � C � m v D � Q L� D�� A� N � (H tn p � � � ^ 37 � �D �°• � � �D �: � � p� � m A Z � � � (p � 3 � Q� .�r Q. n. � � v � O � ° S '�' =n G � � W �- O � n � �� m � 3 m � � i � � � w O O � b o 0 0 � � � � O � � � -• v, —� ��•�m� m cg �- � m �' m � Q m � � � � S �p � o �u � cQ , � W 4. m y — � Q � a� �- � � � �� v o .� a � �' � N O � A� ? O � A � � � \ � � � � m =. � � � �. �: m�� m o 0 � � � � m � � � � � o � n' " `° 3 A � O � �' �' O1 3 ti� � � � O � � � � � m � (i � � o (Q O � m Q � m Q.. N � � � 3 � � � � � n m C � O W b � 0 � m � � a r v � � n N Q W -j ' � i 'C � '� j � ° � <' � Z � � � � � m N � � . Z Z m �' � m c� -_1 O Z v < � y �� rnn � � -i O O � Z � Z 7� v� D �� O � Z -fl v_� _� Z z� z� � �� n = ma � � � G) � � m0 m� �� < m z -i � z � m � � O � � � A � j � ( ) o� ( ) sa� ( ) oN ( ) sa� — -- t }-� { } s�A :a�EQ :�fg Pau�is O� JI�II,Ld�H :auoQ utag SNOIZd2i�,I.'I� �sT'I , :sxi�uzag ia��aq ia�En� io� papinoid uaaq ne uoi�snqLUO� seg •g ia�eaq .�a�enn .zo3 papino�d uaaq .�auTi e s�H ' L S�nig �ioi S�l1.LS �a�� ii�d 3� S�f 1.Lg �m��t i�� H 9 - $��aa�� .li�,� t�� azis io3 s�ua�aannba.� apo� �uaun� i�e s�aay� ( ) oN ( ) sa� pa�oddns �iam�as sI • � () oN () sa� ua�ins pa�poi si�afqo u�iaio3 ou s�H '£ () oN () sa� uou�oua�ap io �sni iuoi3 aaz� sI • Z () o�i �) Sa� pauituexa �Ctin�a.n� uaaq s�g • j :x��s io �amut�� m�s�xa a� �� sai3uan �qaiay pau�tsiapun auZ I�iOLL�'�I.�IRI�A �I��'ZS Ql�i�' 1i�l�IIAIIH� 'S s�e�ecr RMIT NO c�ty of Fridley � �. � ��6 . AT THE TOP OF THE TWINS gU I L D I N G P E R M I T r � � RECEIPT O. � • COMMUNITY DEVEIOPMENT DIV. ' ; L �'�� r � � PROTECTIVE INSPECTION SEC. 1 � � � ' � /'��1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE VAGE OF APPROVED BY �'""'� � �� 612-571-3450 910-Ft5 10/7/96 � � JOB ADDRESS 5872 Jefferson St. N.E. t LEGAL LOT NO. BLOCK TRACT OH ADOITION SEE ATTACHED DESCR. 3 1 LYndale Builders 7th Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Ellis, 5872 Jefferson St. N.E., Fridley, MN 55432 572-5439 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Gary Ellis (same as above) ' 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AODHESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION C� REPAIR ❑ MOVE O REMOVE 8 DESCRIBEWOR�e-side and install new windows. 9 CHANGE OF USE FROM TO STIPULATIONS Egress windows in sleeping rooms. Smoke detectors on all levels and in all sleeping rooms. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GAFiAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �],O � OOO.00 State SC �S . OO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF NY OTHER STATE O LOCA AW REGULATING CON- � 162. 2S Fire SC � I.O.00 STRU OF E PERF MANCE CONS CTION. PLAN CHECK FEE TOTAL FEE � ��,� $177.25 SIGNATUR CON'RACT ORAUTHO i AGENT IDATE� WHEN PqOP VALIDATED THIS IS VOUR PERMIT _ G�i, �� l�-1�� SiGNaTUREOFOWNEAiIFOWNERBUILDERi iDATE� 8 G�NSP DFTE ,Fy�: .:,. �k NEW j] Effective 3/ 1/9b ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 �` j��- Building Permit Application `�r ConstructionAddress: �� f ,�'�'��Sc�� S 7'— Legal Description: 0 Owner Name & Address: ,� ,�/��/ �� C J � Tel. � ,S'- % �—,5' �,�� Contractor: Address: Y.IVING AREA: GARAGE AREA: DECB AREA: OTHER: MN LICEIVSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IlVIPROVEMENT Width • Height Width Height Width Hgt/Ground Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot Ft. Y Setback Side Yazd Setbacks • Type of Construction: �' S iz. .� �, Estimat� Cost: $��, GQ D�'.. ��f'� Approx. Completion Date: � �?�' ' � . _ (Cost` on Back) . _ Driveway Curb Cut Width 1Veeded: ` Ft + 6 Ft = Ft x$ _$ DATE: � APPLICANT: � Tel. # S� %� � j�/J?� CITY USE ONLY -�` �c�� r�.(� ��./�_��-'-`^ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Drivew�y Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � �� l�� $ �— � $ $ $ $ $ $ /�� Z`� Fee Schedule on Reverse Side �� /��/ � ,�� e��v �c"�'�- `= .�1 of Permit Valua.tion (1/lOth%) � � �� z 5 $.50/$1,0� Valua.tion " S-,� ,`�. �i�✓,�- 5�� $900 per SAC Unit �� J $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 aiteration 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,�1 to $1(�,000 $100,�1 to $500,0� 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,OtT0 $62.25 for first $2,0� plus $12.50 for each additional $1,000 or fracdon thereof, to and including $25,� $349.75 for first $25,000 plus $9.00 for each additional$1,000 or fracrion thereof, to and including $50,000 $574.75 for first $50,0� plus $5.25 for each additional $1,0� or fraction thereof, to and including $1(}0,000 � $887.25 for first $1�,� plus $5.� for each additional $1,� oz fractionthere,of,..to..and including.$500,� $500,�1 to $1,Op0,� $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,�0,001 and up $5012.25 for the first $1,�0,(�0 plus $2.75 for each additional ' $1,000 or fraction thereof � DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) � Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alterna.te "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 construcrion site. A Certif cate of Survey of the lot, showing the locarion of the foundation once; it has it has been constructed will be required before proceeding with the framing. � .. • .- ., � � � � 7 O �� O w m � �ppp O' 3 � a� o m 7 'p � n -a fl. o � -° n� m � � o m � � � Q �: � O � � Z � 'D n � O Z m � 3 1 m �" �� m� � � � W < =- � -Z-I 7nC Q W �� v z "' D T m� . � � c � i�l � � � � � � y m -� � 0 z z tD— � O � w v � . � 1 � x m � Z �ii n 0 -�o Z -t 0 J � ^, O V, �� -�i. � � 7 C�. �w C � � p �• — N O 0 � -i v� O m � � c m � m � ID � � c� i �� m � A 2 `�-o �l � I �� J � O � � � fCD � o � � � � � � � � �, .�r O 3 � N 0 � N -� O Z D c� 3 � � 7 a � 0 � � � I D m N � N � � -� � N � A� 7 tp � � � � N --� � (n O O o O O � � � � �� z 0 a �D p � � 3 ?+, � � c� C � I N _ � "O � m O � � � 3 �u -- Iv o = � ' o � � � � N D v m � � � v � O � r � \ -D m � � Z O � �V \ c� W c 6 �ii c � m v D � :, Q1 N C N �' p�a �' Q "�DO �p � m � m N � Z � � � m � 3 m � � � a a � � 0 c �03� �� oo � o � Q � 3 v W c�i m � -� � � � � (�t: O O � o O � m t� �n � 0 � 0 n � -� � ,�� . _. �D N m � Q .�+ �. � �D �►, S � y ' W�. o y . 7 Q a� � � � o � � vo� 5N'�' 3� 'D � � y v � � � � � � � � � 3��. �`�� a � .a. c � p. � m �_ �, � � ' N � � a ,... m ° _ � �� s -" �, � o � � � � � � � � o N � � 1 7 Q � � d N fD �� Q � n _ m � � 0 ao � N Q. W A � � j � W `G C � � Z �. � � � � < N � , Z Z rn N -o m � � Z v < m -Dv � r m n �a � �o oz Z O Z � v -9 D O � � nrn z� � v_� �Z z� z� � �v _ �� Z �� O mZ �� rn Z � � 0 z , � I � rt ' �. ; O � D � ` c � i, � 1 c�o ., � - e sue�Etf p c;ty of F��a�ey 9624� ;` AT THE TOP OF TME TWINS g U I L D I N G P E R M I T R NO. � • COMMUNITY DEVEIOPMENT DIV. � j V ��'�� , � �,_ S� r � � PFiOTECTIVE INSPECTION SEC. 1 i . � . tJ(. `.•--� �"'�'� CITY HALL FRIOLE� SSIJ2 NUMBEF pEV DATE VAGE OF APOROVEO Br 1 6�2-5��-3450 s�aF�s 6/4/99 / / JOB ADDRESS 58�2 �efferson Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED OESCR. 3 1 L nd SHEET 2 PROPERTV OWNEFi MAIL ADDiiES$ 21P PFIONE E��1S 9 CONTRACTOH MAIL ADDRESS 21P PHONE LICENSE NO Master Remodelin n _ 4 ARCHITECT OR DESIGNER MAI� ADORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW �X ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 12' x 12' deck 9 CNAN(iE OF USE FROM TO 3TIPULATIONS See Stipulations on plan. � �� efore digging cail far all utility location� 454-Q002 R�QUIRED Bl� L.�11�.., SEPARA7E PERMITS AqE REOUIRED FOR ELECTliICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAO VENTILATING OR Alp CONDITIONiNG THIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION 20NING SO. fT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR If CONSTRUCTION OR WORK IS SUSPENDEO OR ABANOONED FOR A PERIOO OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OfFSTREET PARKING I HEREBV CERTIFY 7HAT I HAVE REAO AND EXAMINEO TMIS APPLICATION STAIIS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF �AWg VALUATION SUR7AX AND OROINANCES GOVERNING TMIS TYPE Of WOiiK WI�L BE COMPLIED WITH WMETNER SPECIFIED HEREIN OR NOT. TME GRANTING Of A PERMIT 1353 7 DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEL THE pEpMtT FEE SAC CHARGE PROVISI S OF ANV OTHER STA7E OR IOCAI lAW REGULA7ING CON• STR 10 OF TM PERF qM CE OF CONSTRUCTION PLAN CNECK FEE TOTA � �� Si ATUpE OF CON'AACTOp ON UTMOA�2E0 AGENT �OATEi N OPE L O HIS IS UA P � / � S�GN47UAEO�OWNEQii�OWNEpBU4DEAi IDATE� BlD �NS� paTE JUN-16-1998 11�39 FROM CITY OF FRIDLEY TO N�v � (� ��N [ ] crrx oF �xm�Y �-T� I l SINGLE FAMILY AND DUPLEXES R-]. AND R-Z BUILDTNG PE�RIVIIT APPLTCATION � ConstructivnAddress: � � � �, � J � �� s :�� i� o � � • ��- ; Leaal Description: 9329316 P.01i02 Effecrive I/1/98 �p � � �.�6 �7 � ,� Owner Name & Address: = � � „� � Tel. � S %/ .- �� 3 � COnLr'dCiOI': � ea �%s�� e.. � �� .�i', � �.�;� �,_ NSN L.YCENSE # ��'� � °� 9 f � Address:� �.��.��. �� a 1°� � c� �, ..a �. S� �� Tel. # ��P �'��. -�.� Itl Attach to this appiication, a Certifcate of Survey of the lot, with the propased consuuction drawn on it to scale. � LIVIN6 AYZEA: GARAGE AYtEA: AECK AREA: OTI�R: DESCRII''�'ION OF IMPROVEMENT I-ength W idth Height Sq. Ft. Length Width Height Sq. Ft. Leugth -`%fi� 'Width �;� Hgt/Ground ��'� Sq. Ft. 0�� Cons�uction Type: �� Estunated Cost: $ °�� 9 �' �� lFee Schedule on Back) Driveway Curb Ctu widsh Needed: F�. + 6 F�t = Ft x$ _$ (�� 1 �i��- �r �j DATE: � % - j' � APPI,YCANr: ��`v �Y� �� Tel. !� r�� E� 3 � `� � // Permit Fee Fire Stircharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULAITONS: $ S� . � $ 1� S $ • �o % $ $ .J UC, $ $ $ $ $ �7 �� CITY USE ONLY Fee Schedule on Reverse Side .�1 of Per�mit Yaluatioa (1/1Qth°!o} $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (5tate Licensed Residential Contractors) Alt. °A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ � ��,I �� ; �� b_� - -�, � Q.� , � �---_ � _ ._ .. _... 1� --- _ � � . ----` -- - - i , --------- - --- — ---� � i� . . _ .. ------ _ Ik ► �� i� � - , --.-.-..---- ,�� ..... . . _._ -___ .� I'� G ', C _ ___...�y��._____i!� � Q�} , j _� _ .-�� __- �i Q. ; � �� _.._._._..w.. ___ ��; �, ,� �� _� �'�O N � LL'J L`' '� �j Ry N � hi .�r�-f:. . ,., - x, 1 C._� `_, ""% �+ "' s� C:! w�� r �� N s �� - � i � h �A` C �# � �1 _,rr,�y.�n.r�'p.,,� �,�� • � �.�._. _ _._.... .-. __..._. _ _�...�--••-----rr'--- _- -' .�.�... � � o �',l � `p � � � s r x i�r# i-.� N �'1 �x"'�"rJ � N 7 �� J Ei � 7 � Q � m C � � � � � �6 iJ/ p�, ��, � � : �� ` o '�' � C � � � � � � ,� �� _� � � � � �� v � � � 1� y � � � �. �a: i� � � � ^ �� o � 8 �• �w �� o n �^ � s �, e � y Building Inspections 763-572-3604 DATE ( / — / � SITE ADDRESS �-r , THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR BUILDING l g S'� � I Permit No.: RESIDENTIAL APPLICATION CITY OF FRIDLEY � • �L l SUBNIIT A COPY OF STATE LICENSE #. YOUR STATE LICENSE ADDRESS: WITH APPLICA'i'ION pHONE PROPERTY TYPE PERMIT TYPE FAMILY/NEW ❑ TWO FAMII,Y/NEW ❑ ADDTTION ❑ BASEMENT FINISH ❑ DECK �rYrE oF woxx: o �W DESCRIBE WORK BEING SIZE OF IlVIPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDIDiG �u►Y1 0 Aluminum ❑ Other WINDOWS IN EXISTING OPEI�TINGS ❑Yes �No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WII�TDOW TO BE INSTALLED YOUR E-MAII, ADDRESS �� ❑ GARAGFJSHED ❑ ROOF �SID1NG ❑ SWIlvIlvIING POOL O ADDTfION PAIIt ❑ REMODELING � � �� LENGTH � HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF i� ip� Received By: Date Rec'd: / � STA1'�IP S�� -�, 3� ��r• CITY STATE ZIP ES o wn�mows 0 DRAIN TTT.R ❑ OTHER � r ��A'�' TH HEIGHT S . Ft. BASENIENT REMODELING SUBNIIT: 1. Existing Fl�r Plan 2. Proposed floor plan 3. List of strucwral members to be used FOR NEW CONSTRUCTION WCLUDING DECKS, ADDTTIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing slructures and proposed projec� 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND M�TERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $�(� O¢� — OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due � � f� �, � See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .` (.0005) times the total job valuarion — Minimum $.50 $ .001 x Permit Valuarion (1/10%) $ $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6.ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ ._ Make checks uavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building peraut and I l�owle� conformance with the ordinances and codes o e City permit but only an application fqr�� 't w� i� plan in the case of all work whic��i{e s re ' w d� SIGNATURE OF APPLICANT that the information � above is complete and accurate; that the work will be in �ridley and with the Minnesota Construcrion Codes; that I understand this is not a to start without a p rmit; that the work will be in accordance with the approved val of plans. � /�� xIN1' 1vAME �/ ✓��'�DATE l / — / '—O � Page 2- Building Residential Application BUII.DING PERNIIT FEE SCHEDULE The Chief Bnilding 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: VERIFICATION OF FOUNDATION Permits for constiuction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv � City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977