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AF - 47500!�+ <.g ; City of Fridley, Minn_ BUILDING PERMIT N� 5 6 8 51 Date: �� ' �"� � CG'� �� '"� r ,s° � ; OvVnP.r: � " '' Builder - �` . y� Address ____ Address o �OCATION O ING No. � t�� Street �� F� ,4-.�lC,' s-.'''�� _ Pari of t `—�-��}-r',F�G� Lot _ Bl Addition or Sub-Division # > ,.. Coraer Lot _.. � Inside Lot ._._.- ` . Setback � ~� Si e d ar'� � � � � �--�— YaT Sewer Elevation Fo�mdation IIevation ., � DESCRIPTION OF BUILDING T�,`,,° U�fi ,� �� /'�i�1"'/" ��, h ,�' �,� '�' "�: ., _, ., �. Front �� DePth ��.,L!-� Height .s--� 5q. F� 1� Cu. Ft �� Front Depth H,eight �.�,.,_ Sq. Ft Cu. Ft Type oP Construction �� ,'}. - rr'�' Est Cost ��;� �' %��' ��To be Completed _� In consideratfon of the issuance to me of a pern�it to construct ttie bwtlding deacribed above, I agree to do the proposed work in accordance with the descrlpl3on above set forth and ia compliance with all provisions of ordinancea of the dty of Fridley. � In consideratibn of the Aayment oP a fee oP $�"� �, Perm3t is hereby granted to to construct the bwilding or addition as deacribed above. `This perittit is granted upon the express condition tha.t the person to whom it is granted and his agenta, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respect� to the ordinances of Fridley� Minnesota regarding location, construction, altera.tion, maintenance� repair and moving of buildings �� city ]imits and this perrnit may be revoked at any � po� olatiea of any of the provisions of said .� . � - '-,� Builai�is Iaspector NOTICE: ihb psrmh does eot cover the construdion, ieslall�Hoe fo� wirieg, pinmb(np, gaa 6eafiep, eewer or water, Be sun te aa fhs BuiWing lespeeta� far separate permhs for fhea Nems. ,� �4 � �;-� �:.� - � „f ' , 4 ''n _ -.'t .� APPLICATTOIT �'Ol@ BUILDIT�G PE�T CYTY O�' 1�1tIDLEY, MTI�TESO!I'A. OWi�er' B f!�k-�"�- . �,aages$ �aare$8 y�`�.r � ��..• `�a�l . LocATxo�t o� s�z.�nz�v� . , No, �� tree� „�,� Part oi Lot _.._._.._,.`...._ �,�.� . Lot f Block % Addit�on or Subdivision ''� G��"" l �.�r�� ..�+.�� '�... �.ir.��.rr � Corne� Lot �✓ �nside Lot 3etloack �� ` Side-Yard %�' �'� /� � �..+. SEVJER ELEVATZON FOUNDATION ELEVATTON ' Applicar�t a�ttac�h to this form Certi�icate of survey of �ot and propose� buildin� locatios�. DE�CRIPT30N OF BUILDTNG ^l O I0� LtSOd 88 S e� �`►"`x' (1-�� 4`�� / Frorit______ Depth i3eight Sq. Ft. Cu. Ft. �'ront_,__Dep•�h _____, Height Sq. Ft. Cu. Ft. Type of Constxuc�ci�n Estimated Cos� To be Completed ,� � The underaigned h�reby makea application for a permit �or the work hc�rein specified, a�ree�,ng to do all work in strict accordance with the Ci.ty o� Fridloy Ord3.nances and ruling o� the Dapar�cment o� eu31d- ings, and T�ereby �eclares that a11 the fac�s and represen�ation� stated in this apnlication are true a�d co�ract. _ � - (� � W (Schedule of Fee Costs ca� be found on the Reverse �ide). � � �> �_ _ � _ �uza��.v� P��aT � s�nvzE Sec�t3on 2. The 3napector o€ Build�.nr�s shall, before issuing any per��i�: �or the erec-�ion o�: ariy bu�.ld3.ng or s�ruc�use, or for any addiicion to any oxis��ng build�.ng or sf�uc�ture, or for any altorations or �cepairs �o any exis�ciny build�.ng or s�ruci:ure, upon appl3.cation i:he�cefor, require �he pay�nent hy �he applicant �o� euch pe�mit o£ rees to the aYnount he�ce3,n below set fo��h and in the manner herein ,prov�ded to wita 2.1e For any such pe�mit for the erec�ion of a� fire-p�cool building, o�lner than a garago, wascehouse, factolcy or grain elevator, or �Eor �he erec��.on of any �zre-p;roo� addition, �or s3milar occupancy, to any e�ei.s�ci�g bu3lding� s]na11 be at the ra�te of $1.40 for each one thousand cu�ic �eet, or �rac�tion �chereof, iai such cubical contents. 2a2. �or any such p�rmi�t �or the erect3on o�E any fire-proor garage, vaarehouse, cacicory or gsain eleva�or, or �or the erect3on or ar�y �ire- proo� addition, fo�c sim.ila�c occupancy, �o ariy existing bui].ding shall be at the ra�ce or $1.25 ior each one thousand cubic feet. c].assified as '°�iaeproo�" by Sec��.on 502 0� the Minneapolis Building Co�e, �OUSES 2.3. For any such permi� for the erection of any non-fireproof build- �.ng o�her than a garage, warehouse, fac�ory or graatn elevator, or any non-rireproo� addiic�on, fo�r similar occupancy, to any exis�ing build�.ngo P��'mit $1.00 for each one thousand cubic feet. r�GEs 2e4. �'or any such perrait for the erection oi any Aon�fireproo� garage, warehouse, �acto�y or gra�.n eleeato�c, or £or the erection of ariy non-�ireproof acidi�ion, ior similax occupanc�*, to any existing build�.ng or for each such building or add3.tion, Nin�ty Cen�ts �or each one fihousaaci cubic �eet or fraction �chereo�, in the cubical contents �thereo� wi�th a min3.�nnu�n oi $4,00 0 �'or the purpose oc corn�u�ing fees �or'building pexm�.ts the cubical con- ten�s o� any bu�.ld��g or addition to a uniform'7aeight throughoui� by multiplying the g�ound area covered �rom a point six (6) inches belaw �he �loor line or the basement or cellar to the average height of the upper surface or ico fche average heigh� of the roof surface of the ma3n ga'�le of a pitched roo�. 2.5. For repairs or alterations to an exist3.ng structure, the �ee sha].1 be at �the ra�ce o� $3.00 pex each .Five Hundr�d Dolla�s ($500.00) or �ractior� �hereo:c 3.n the cos� o� all. psoposed worke . 2.6e 3n no case sha11 the fee charged ior any ,permit as set forth in Section 2 be less tla� $4.00. � a� : � y �I '. .e a_� . ,� _ , - � ;,, � ;�. : � _ �,,.....�.� - , �-� �q G � �"r-C �� _ , " Lqi►dPlaimi� _ _ , : 6875-Niqfi� +�'S AI.E. c�s�y;� Mm�pn/� z�, :.��STstm,� � EN G I NEE R I N Gr, t N�, ��,��f4 Civil b �+lun'rdpivl ` . _ SUnseE�16Q66 . : . �yj� -- En Eneers � SurvecJdrs — � .� certi�ic�te of ssi�e . �o: � H � � Q��c�� - � , �� j_ . b 1 59 r" AV��I�� .�. - _ �.�.� �� _ � _ -v, � . J O. . . � i � r,t, ' �. y � �., � � � �� . � � � � ,�':.� f ' � r� ' ' � , { � � t �'°- ' - �+ � Sil � I �� . .� . � : . �, � � . , � � t �o , o. � � � � ,-►.'r` "��°, - 1 ''' ; �- . � � �,�' ' : � `� � -� — /34 �� — � I `� � � ' � 0 T % L�' �;;� � �` � � - . �� ``I: M Di 1 .G.� � � �RJ''`/.L i��i��..� � .f �.�ii �.s`� f�� if�Y�� ,�,r; t�_�. i� , ! ��, {/ .. ��:,.- .: , ';��. ,� �,,�i� .. ,.. , . � . lba�by cerf��y f1� lhis K a lru� and aorr�cf rep,te.se�otian o�'a sr�vey q�'�e ban,deries �'!/�e ol�o,e afescn►6�ed lm,0, ond : . . o`'/l� loco�l�on o�'o// dovildm�s,1/�rieon , oradar/ risib/e �xroaJimenfs ,�'�, �a�ri ar ansmd 1aad. As sra�yeyed brf, nne � _ d, �t t � �ebruer_�_.___- __ A.D.�.. � , SU'6UR$AN E/KGINEE2/l�lG, /NC, SCA�.,� f "'- 3Ci' " � �� s�-�� . ors � y � '.•��-��'�� . _ - - - !�1 �, � -• ;� . 6 af� j�� ^ �; - - , . . . ; .. M � � 3 a � N � 0 � � � �� N � � � � � a p m � Q � x r�� a x x � � C" �'ij O � � w � �. x � � � o a��z � � � � N `��' � � � H � Hy t' m � <li �� M w a � y �, �, .� � � W � o� v � � � � � � � O � � !.l� � � 0 o � O � • O • � : : pe x � O N � °o 0 0 � {f! �fl � � �y r � � � I � � � � 0 C i17 �� w � � � � • � � � �� K W � � � ro � y � � � � �o � Q � 0 0 0 0 O � � 0 r b� � C � M I W oa �`' w � �� M � r�' y yCy O � � � . A � � • �: �� E: �. � � °o 0 {/> {� � I� � � � � ►�f 0 � � .� � o � � c� � �� 8 � � o � o- '��" � � °x M 0 � Cs' �' a a w� 00 � � �� x� ° � � � M ' � � � m N m � x ts' y � � � � � � �' � � �°o � � � x � � N N � � cn en o 0 0 0 0 0 i!� i/J {fl � � � � � A � 0 �\ � � bl m � 0 \ �1 ' W � � � ,, I� � � n � � � g C � � � ,d ,� � !' �' �� .� .; � R° R� �, � � � ��'�'� "" ° �t�� o�ro � � Fn � O e� lD �f! p � O � A7 � O O �. R7 . � �, m � : o a � � � o : ' � p � : : O O 0 � . : : � ��,�� o °o o° °o °o � � I � W � � � y � "! � �' � . � � '�d b P1 . � �� A � � � o � � w ~' R° �' 0 p � � � � �, � � o � a � � � � �w . . � . . e�i� ,°o : : O 0 . . Gp . . G . . . N � � � � e�, o 0 0 p O O O {fd F9 O � a. a�.� � � �� y � � r � w � � p�� o�p�' � � d�� o O �¢� �Df ti � � p � �� oQ� � � �� .� , o�� a p��•� �w�p �V �.�b �� b a fD �� o �� . m � � �� D � i � � m � 2 m C r m d M M � � � � b �. � V O � � • � � �� ` I w� = � � ,a ... � `�y . � � � � 0.:� 'Y � <• � � • �i �i � � � 0. �.- - � ---� ► , - - �: - , '� � �S� y'�5 �iG/_; �D-16 � v �� HEAT LOSS C CULATIONS ,�j�� EPARTMENT OF BUILDIN MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide 'n ws . s Reference Out. Wall Int. Wall Cxiling Roof Floor Kind How Applied Yes No I e o 19_ �° " Fl.� ,� . n � Room � Leng ''' Width � Height ` Fl.� f Room Length ��`Width Windows and Doors—Crackage and Area Windows and Doors—�rackage and Area �Yidth Helght No. of Llneal f. Area Wldth Height No. oE Llaeal ft. Area No. oP pane oP pane Ilghte o[ crack e9• ft. No. of pane ot pane lighte ot cra eq. [t. . � ..�.0 • � � ✓.� . 2� � /�; .,� i � v�`n r�,, ��'� .�� Infiltration � J�' ��'" ,��2ljJ,� Glass `� � .� O Exp. wall _ , , �j Net exp. wall ,� /� . �� Int. wall Ceiling �� Floor / (J�/ ` ° L Total Btu. / /� Required sq. ft. E. .. or sq. ins. W.A. Leader area F1•� � 2° Room ( Length P`� Width l� Height � Windows an Doors—Crackage and Area Wtdth Helght No. o[ Ltneal Pt. Area No. ot pana ot pane ltghte ot crack eq. tt. � !✓ � / •O� � � � - �� Coef. Btu In6ltration �. ��' Glass ��O Exp. wall �'Q` " � Net esp. wall � � / �-p Int. wall Ceiling /� - � � � Floor Total Btu. �� Require s: t. E.D.R. or sq. ins. W.A. Leader area FI. Room � Length '' Width /` Height �'> Win ows and Doors—Crackage and Area W1dth Helght No. o[ Llneal pt. Ares No. 01 Dgng of pane I1Rhte ot cre�Ek na_1t. , BtU Infiltration � �/ � C,lass � Exp. wall � Net exp. wall � Q � Int. wall Ceiling ��-. ' /� � Floor -- Total Btu. Requi�ed sq. ft. E.D.R. or sq. ins. W.A. Leader area Infiltration Glass Exp. Wall � ' � �. Net esp. wall Int. wall Ceiling Floor Total Btu. � � � Coef. Btu �� O ( i � , �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.I " Room ( Length � Width //� Windows and Doora—�rackage and Area Wldth Height No. of Lineal tt. Area No. ot pane of pane lighte of erack eq. ft. In6ltratioa Glass Esp. wall �� Net egp. wall Int. wall Ceiling Floor Total Btu. �� 1` �� Required sq. k. E.D.R. or sq. ins. W.A. Leader area � � � -� ��in 7 �� '1 F7•� . �� Room I Length /,� -.,. Width /'07 -• Windows and Doors—Crackage and Area Wldth Helght No. of Ltneal ft. Ares No. of pane ot pane Ilghte ot crack ep. tt. � �� _� Coef. Btu In6ltration _� �� Glass / �-� �� Eap. wall �� Net exp. wall �� /� /�� Int. wall Ceiling " ��(o /� �� D Floor ��i �� 4� O 'fotal Btu. Required sq. ft. E.D.R. or sq. ins. WA. l.eader area �e 'x . r ° �J6 � s HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINCS MINNEAPOLIS. NIINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F10 r Kind How Applied Yes—No ( Yes—No 19_ � Fl.� �(% �Room � Length `�� Width 1�` Height ' Fl.� U ' Room Length �� Width /Q� Height � Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vldth Height No. of Lineal ft. Area Wldth Hetght No. of Llneal ft. Area No. o[ pane o[ pane lighta ol crack eq. Yt. No, of pane ot pane lighte of crack eq. ft. � ._��- /�t �% ��0. �o � . � / �- / � �� ,�� y,� . � / s f� �"� �� Coef. Btu � y' /� , � Coef. Btu Infiltration � �h'' %� � Infiltration � ,��/�' � Glass / ��'7 �Q Exp. wall ` �` Net exp. Wau � �0 9._3� lnt. wall Ceiling /� �� j Floor Total Btu. / Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area F7.� .�', Room � Length ' Width ` Height A Windows and Doors---Crackage and Area Wtdth Helght No. of Llneal [t. Area _ No. of pane of pane lighte ot crack eq. tt. Coef. Btu In6ltration -- Glasa ,_ Exp. wall � Net eap. wall — Int. wall —9 Ceiling � �p��1 Floor ��,,� Total Btu. Requir d s . or sq. ins. W.A. Leader area FI. - Room � Length ' Width �j ` Height � Windows and Doors—Crackage and Area Width Hetght No. oL Lineal ft. Area Noy of psne of pane llghte ot cracJt eq. ft. � In6ltration Glaas Exp. wall Net exp. wall Int. wall Ceiling Fl�or Tofal Btu. Coef. Btu �351 � e�- � �4 ��0 °� / o � // � ' � � � �� /oZ Requ�red sq. ft. E.D.R. or sq. ins. W.A. Leader area � Glasa F.sp. wall Ga ��! ' Net eap. wall Int. wall Ceiling Floor Total Btu. �O ��Op /O ��aZ.D Required sq. ft. E.D.R. or sq. ins. W.A. Leader area _ FI.I Room ( Length Width Windows and Doors—Crackage aad Area Wldth Hefght No. ot Llneal ft. Area No. of pane oi pane llahte ot crack ea. [t. Infiltration Glass Exp. wall Net esp. wall Int. wall Ceiling Floor Z'otal Btu. Required sq. fG E.D.R. or sq. ins. W.A. I.eader area F1.� Room I Leagth Width Height Windows and Doore—Crackage and Area Wldth Helght No. ot Llneal tt. Area No. ot pane of pane Ifghte of crack ep. tt. Infiltration Glass Eap. watl Net eap. wall ' Int. wall Ceiling Floor 1'otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. I.eader ana Btu � w d � �. ��.i F� " p � : � : x . � . � • N � O � a . m �y : r: � • � � � O �� y� � �i t+ !'� � � w � � p � � � � o �° "•' N � . o � o � : o . . Q : : x 0 N �C �7 Lv' F�+ � O Q O � 'Ei! O u � ( � � t�+ � � � � � � z x e � � e �- � � � `� fD ri x � � � aa m R� � � � � � � � O � �, o � � � � � a : � � ; � N . . � o : � � : � � . . . . O . � � • . • 0 �a �a x �a �c �a W N W F+ r+ � �J � � P � O O p � l!3 {fl {A {A {A �9.� y � e U � c � 0 � x , w � � � C � �� D '� 1'� � m N n m C r m �' � � � � � .� � � ro � �� i, p ~ � Z ,� � � � Stories 8 � WATER M @ � d.CSETS �� URINALS � enni Oemi ` 7uB5 W � � BASINS 'O R� I � SINKS � i� WASH � renrs DRINK. FOUNT. SHN/R5. FLOOR DRAINS CATCH �± BASINS � nuro w�s►iae � GAS MPL � GAS RANGE GAS � OPENINGS � � � � � N �❑ 0 C' � Q � �. � g �. � D �� Q i � � a a. � � � � � � ��. 9 � Z f � �n D A (' � � a.a� ��'! � � � � � m Q9 �y �"� � �� o�� o� � � ��-°� � �. � � � � � � O � ir'i �� b � �' b � o�� p m o �i �' o p co �' �, o M ��w � � ¢� �� ti n� . �� O � �"! y � � N � � m �� W 0 -i—+ ;� � � � �� Q. O �x �� a � °w' O� � � m � � � � � � 3 � � Q � ♦' � � � � � � � � � � � M � �i �b � o � � � � � a � A �. A V O �� /'"� � City of Fridley, Minn. BUILDING PERIVIIT Date: - 3une 15, 1965 •�s�� N° 7900 �: Thamas Matter �� G.L. M3,11er Co. �• •• 237 W. 25th St. Mpls. Adare�a Address 5896 Jeff��i-OCn/4TION OF BUILDING No. Str�et Part of Lot 1i�ot - 1 gl�k ]. Additton or Sub-Divi�anl�,yndale B1drs . 7th. Add. Coraer Lot — Ins�4de Lot Setback Sideyard �'� ��1�� Fo�mdatioa Eleval3on DESCRIPTION OF BUILDING To be vsed as: �ibat Depth Height Sq. Ft Front Depth ITeight Sq. Ft Type of Construction Faat. Cost _ 1, 000 To be Completed Cu. FL Cu. F't Repair Storm Damage In consideratlon oP the issuance to me of a pera►it to construct the building described above I agree to do the proposed work in acc�rdance with the d�scrlption above rth and 9a com ce with afl provlafons of ordinancxs oE the dtq oP Fridley. . � Li�%2��r� In cromaideration oP the paqment oP a Pee ot � 10. 00 ��t �� G.L.Mi11er Co. to construct the buflding or addition as described abave. Thispermf t is granted upon the express eondition tvat the person to whom ft is granted ead his agents, employees anc� workmen, ffi all work done in, aroimd and upon eaid buildfng, ��Yp� thereoP, shall conform fn all reapecta tfl the ordinances of FridleR Minnesota regarding la:ation, conatruct%n, alteratlon� maintenanc�, repair and moving of bufldinga ordinaac��. d� ]imits aad tbfa permit may be revoked at anq time upam violation oP any of the provis�tons of said A��en ,7ensen ��S � NOTICEa i� peemU doa aot corer th� eoeatr�edoe, � h� �rirtey, P�+�B. Y� ��6, awu or rrnsr. B� sues w ws tla BQIIdIno IespKror io� qparat� p�mN� for th�a t�. APPLICATION FOR BUILDING PERMIT CZTY OF FRIDLEY, MINNESOTA OWNER `S NAl►� /1% �'7? � � � l' ��: 97"�. �'° B�YLDER� ADDRESS ��C �� o''�� .� ADDRESS � ��_ LOCATION OF BUILDING ' ,' ,�.��.� No. 5treet pare of LoC � �� L�T � BLOCK ADDITION OR SUBDIVISION e � %�`��I. Corner Lot`_Inside LOT Setback Side-aYard SEWER ELEVATTON FOUNDATZOR ELEV�TION Applicant attach to this form Two Certificates of Survey of Lot and proposed buiiding location drawn on these Certificates. To be used as; DESC1tIPTION OF BIIII,DING , Front Depth geight Sq. Ft. Cu. Ft. Front Depth ^�_geight , Sq. F'C . Cu. Ft . :_. �� Tqpe of Co�aetru�tion � �r1� � �•., � Estimated Cos �� To be completed_� �,t� � .:$ The underaigned hereby makes application for a permit for the work herein epecified, agreeing to do all work in strict accordaace with the Cit� of Fridley 6rdisasnces and rul3ng� of the Department of Bu3�dinga, aud hereby declares that all the facts and representat3ons stated in Chis application are true and correct. (Schedule of Fee Costs can be found on the Reverse Side). � �� lf�� 1C � �� ,� .�� -� � BUZL,DING PERMIT FEE SCHE�II.B � SECTIOP 2. The Inspeator of Building� shall� before issuiag ang germit for ehe ere—Cion of any building or etructure, or for any addition to anq existing build- ing or stsv.cture, or for any alterationa or repairs to anq exiating building or structure, upon applicativn therefore, require Che payment by the applicant for such perha3t of fees to Che emount herein below met�forth and in-ehe maaaes hereiu_ pravide� to-wit; 2.I. For any auch�permit for the erection of any fire�proflf building, other than a garage, warehouse, factory or grain elevator, or fos the erection of any fire-proo£ addition. for eimilar'occupancy, to any existing building, shall be at the rate of $1.40 for each ane thousand cubic feet, or fraction tbereof, ia such cubical contients. . 2.2. "For any euch permit �or the �rection of any fire-groof garage, Warehouae, factory or grain elevator, or for the erection of any-fire-proof addit3on, for similar occugancy, to an�r exieting building shall be at the rate of $1.25 for each one tt�ousand cubic feet, claesified as "fireproof" by SecCion 502 of tihe Minneapoli.s Building Code. HOIISES , . 2.3. For any euch permit for the erection of any non-fireproof building, other Chaa a garage, warehouse, factory or grain elevator, or aay aou-fireproof addition, for similar occupancy, to any euisting buildiag - permft $1.00.for ea�h one thousaud cubic feet. GARA.GES " �__.. 2�.4. For any auch permiC for the erection of anq noa-fireproof garage, warehouse, factory or grain elevator, or for the erection of any non-fireproof addition, for similar occupancq, to any existing building or for each such buildin� or addition - ninetq cente ($0.90) for each one thousand cubic f�et or fraction theseof, in the cubical contents t�ereof with the miaimum of $4.00. For the purpoae of camputing fees for buildiag permits, Che cubical coatents of any building or addition to a uniform hei�ht throughout by multiplying the ground area covered frrnn a point aix (6) inches below the floor line of the basemeat or cellar to Che average he3ght of the ugper eurface or to the average height of the roof surface of the main gable of a pitched roof. 2` S. For repairs or alterations to an exi�ting structure, the fee ehall be at the raCe of.$3.00 per,each Five Hundred Dollars ($500.00) or fraction thereof in the cost of ail pr�posed work. 2.b. In ao case eha11 the fee charged ior aay permit as �et forth in Section 2 be less tban $4.00. � � � `-�- ti > �.•, � /"'\ City of Fridley, Mi.nn. BUILDING PERMIT na�: ncaroB� i . 1965 ...,a `� �� i� e � a �� 5896 Jefferston St. N'. E. Address Fridley 21, Min:nesota �� 3'C3 N� 85�2 LOCATION OP BUILDING No. 5896 g�t Jefferson St. N'. E. p� op �t Lot � _ Hl�k 1 Adaition or 3ub-Divleian LYndale Bldrs, 7th Addition Corner Lot — Ins4de Lot Setback Sideyard �� g�� _ Fo�mdatioa IIevatfon DESCRIPTION OF BUILDING To be Used as: Det. Garage �t 24 �� 22 H��t 10 �. � 528 �� 5,280 Front Depth Height Sq. F't. Cu, Ft. Type of Conetruction Frame ��_$1,584 To be Completed Ia conaideration oP the fesuaace to me oE a permit to camatruct the build9ng described above I agree to do th� proposed work in accordaace with the d�scrlp�ton above set Porth and in compliauce with afl provisione of ordinanc�ea oP the city of Fridley. ,:. A��'�� In co�aideratloa of the paymeat o4 a Pee oP � 5.�.�� permlt ia heraby graated to THOMAS MA�ER to conatruct the builciing or addit�oa as described above. Thfs�rm� t is g�anted- upan the exPress conditlon that thepe�on to whom it ieg aated and his agente, employeee an� worl�nen, 9a all work F�ridley � d upon eaid buildfag, or enY partrthereo� ahall conform fn all respects to the orflinsacee oP withia the d]9mits�aa�+�,�Q loc�tion, conatructton, elteration, maintenence, repa9r aad movla� oE build1n� ordlnanoes. � '�° �t may be revoked at aqy tlme upon violation oP any oP the Provis�tons of eald AT•T•F.AT G. JENSEN �� !� Nonce� ihts p�emN dea eo� eovu �6. conetruaH�, teaaQa�ee �er rt�, P��+a ap 6�a awar m wn.r. B. snra re a. tla &rilAtea leq�a� tor pPv+h �mh� for lhsa N�. � _ ,� � - � � APPLICATION FOR BUII.DING PERP�T CZTY 0� FRIDLEY, MINNESOTA . OW1�R'S NAME_ �l�t'�'�r-�c.� �%,% ,�,os��r. B�'ILDER .K�ia�2.� ADDRESS ,.5�'9,� � A��...� C�%. � ADDRESS e'.��c.� e- , LOCATION OF BUILDING =�� _ ��reet Part of LoC ..�.__.... L�T K ADDITION dR S17BDIVISION . --- � Corner i�ot`_�nside LOT � Setback 5ide-�Yard . �EF,IER ELEVATTON FOUNDATION Ei.EVKTI01�1.��.:.. _.._� Applicant attach to t'�is form Two Cereificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTIOAi OF BiT�DING To be used as; � �-�- Front � � Depth�� o? a_He3ght � Sq. Ft._ _ .�"� � Cu. Ft. � � � � � _, Frcmt Dept �_geight � SQ. Ft. Cu. Ft, �qpe of Caastruction ��,� � Eetimated Cost� 4` To be c�pleted_ �,�� ., � � � The undersigned hereby makea application for� a permit for the work herain ap.ecified, agreeiag to do all work in strict accordance wiCh the City of Fridley prdinances and rulings of the Departmene of Buildings, and hereby de�lares that all the facta and repres�ntaeions stated in this application are true and correct. HAZ'� �' � � � / � . ; � 1� ' � ��r.�_...� � .��'G��..ue � SIGNATURE �.' �„�� z-�.,,�, � � � (Schedule of Fee Costs can be €ound on the Reverse Side). v � _ - �`1 n — � v ,,� . . _ � .s � �.�- - a,. � -, � . � i, � � � , ' �i; ar� .�:i � :� SECTION_2. The Inspector of Buildings shal.l. before iasuiag any �rmit for the erecCion of anq buildiag or structure, or for any addition to any enisting build- ing or structure, or for anq alteratians or,.repaira to any exiating buildin� or structure, ugon applicatioa�therefore, raquire the payment bq the applicant for auch permit of fees to Che amount herein below set foreh and in the_mas�aer hare3a.. provided to•wit; � 2.1. For any suc�i permit for the erection of any fire-�proof buildiag, other than a garage, warehouae, factory or grai�n elevator, or for the erection o£ any fire-proof addition, for similar occupancy, to any existing buildin�, shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in'such cubical caatents. 2.2. For any auch germit for the erection of anq fire-proof garage, w�rehause, factorq Qs graia elevator, or for the erection of anq fire-proof addiCion, for similar occupancy, to Any existing buildin� shall be at tbe rate of $1.25 for each c�ne thoueand cubic feet, class3fied as "fireproof" by Sectian 502 of the Minneapalis Building Code. HOIISES , . ., 2_ 3. For aay such permit for the erection of any non-fireproof buildin�, othes than a garage, warehou�e, factory or grain elevator, or any non-firepraof addition, for similar occupancy, to any�exieting building - germit $1.QU for each one t6ousaad cubic feet. GARAGES 2.4. For any auch permit for the erection oi anq noa-fireproof gara$e, �aareho�use, factory or grain elevator, or for the erection of any non•f3.reproof addition, far aimilar occupancy, to any existing building or for each such buildiag or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contents t&ereof with t&e miaimum of $4.00. For the purpose of camputing fees for building permfts, the cubical conterets of any building or addition to a uniform heig&t throughout by multiplying the ground area covered from a poiat six (6) inches below the floor 13ne of the basemant or cellar to the average height of the upper surface or to the aeerage height of the roof surfaee of the maia gabie of a pitched roof. 2.5. For regairs or alteration� to an exieting structure, the fee shall be a the rate of $3:00 per.each Five Hundred Dollare ($500.00) or fsact3an thereof in the c�at of all proposed work. �� 2_ 6_ In ao case ehall the fee charged for any permit as aet forth in Section 2 be le�s than $4.00. � ' - ��.. r"'� %� �� . `�, - :� , _ .� _ _ �; r._.. �. � '�i � _ � � 3¢� t--��--..� �N�� ""`" 'J��`.u"�s„ , 0" __ '° � , : � �'�' , ; _� 132.: �:w � SUBJECT P RMIT NO. City of Fridley � � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �`s �� t � � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV f � v _-_._-, � �� PROTECTIVE INSPECTION SEC. � � ( � ��1 � CITY HALL FRIDLE� 55432 NUMBER AEV DATE PAGE Of APPROVED BY �'""� � �'' 612-571-3450 9�0-F15 10/5/94 � � JOB ADDRESS 5896 Jefferson Street NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 L dale Builders 7th Addition SHEET 2 PROPERTV OWNER MAII ADDRESS ZIP PHONE Nancy Matter 5896 Jefferson Street NE 571-7439 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION ❑_ REPAIR O MOVE O REMOVE x 8 DESCRIBE WOHK Reroof House (17 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OF AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT AUTHOR�ZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. 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 GOYERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $935 .SO DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PEFFORMANCE OF CONSTRUCTION. �LS.00 Fire SC .94 PLAN CNECK FEE TOTAL FEE 26.44 SiGNAT RE OF CONTRACTOA OR UTMO ED AGENT IDATEI y WHEN PAOPERL/y�/VALIDATED THIS IS YOUR PERMIT /�'�I iP I { . /V' ��1�-� S N TU E OF OWN OWNE BUILDERi �DATE� '� BLD �NSP qaTE NEW ADDN ALTER Il [1 �� CITY OF FRI DLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 1 / i /94 Construction Address: �� (�� p�'/ j�' /j// � - Legal Description: Owner Name & Address: /i/f�/1/G � /1/�F} T�"�,F? Tel. # .S %/ %� 9 Contractor: DI/1�/�/ �� MN LICENSE # Address: Attach to this appiication, a Certificate of Survey of the lot, with the propased construction drawn on it to scale. DESCRIPTION OF IMPROYEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: L,ength Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �C f'ba `�-.L�'%�lS � � �s�' .S��ii� 1� y�� Comer Lot [] Tnside Lot [] Ft. Yd Setback Type of Construction: Approx. Completion Date: Side Yazd Setbacks Estimated Cost: $ �3 S. , (Cost on �acxj Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �o-s- gy APPLICANT: �GG� �GCY'�. --�?� � Tel. � .S%% - .�.�i�. � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: �ITY USE ONLY $ �-� ��n Fee Schedule on Reverse Side $ • �f{ .001 of Permit Valuation (1llOth%) $ . �C� $.50/$1y�0 Valuation $ $$00 per SAC Unit $ $5.(?U (State Licensed Residendal Contractors) S Alt. "A" or Alt. "B" Above $ $450.Q0 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary ( ] $ a�,, �{� � � .r i3UiLD[NG PCRMIT FEE SCHEDULE "i'tic Ctiief i3uilding Ui-ticial st�ail, t�efore issuing pecmits for the erection of any building or structure, or lor any addition to any cxisting building or structure, or for any alteration or rcpair to any existing �)UII(�lil� or structure, u�n application therefore, rc;quire the payment by the applicant for such permit of tu:s to thc ainount iiercin t�c[<�w sct torth and in the manner herein provideci to-wit- "I'O"I'AL VAI_UE � 1 to $500 $501 to $2,000 $Z,001 to $25,000 $25;001 to $50,000 - - $S0,{?O1 to $100,000 $100,001 to $500,000 $500,001 t�o $1,000,000- . $1,000,001 and up FCF� $i5 (Minimum Fee is $15 plus surcharge) $15 for first $S00 pius $2 for each additiona! $100 or fraction thereof, to and including $2,000 - $45 for �$2,000 plus $9 for each additional $1;000 or fradion thereof, to and including $25,000 � $252 for first $25,000 pl�s $6.50 for each addifional $1;OOQ or fraction the�eof, to. and including $50,000 -. $414_SO for first $50,000 plus $4S0 for each additional $1,000 or fraclion thereof, t�o .and including $100,000 $63950 for �rst -$100,000 plus- �ii_SO for each addifional� $1,000 or fraction ttre�reof, to and including $500,000 $2039_SO for the first $SOO,Opp plus $3 for each additional $1,000 or fraction� thereof, to and including $1,000,0(}0 $3539_SO for the first $1,000,000 plus $2 for each addifion,ai $1,0()0 or fractioa t�ereof - DRIVEWAY DEPRESSION ESCROW (Concrete C�u� Streets Only) Alternate "A": Removai and replacement of curb and gutter only - Driveway width plus 6 feet times $I3_50_ Alternate "E3": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width pius 6 feet times $15_75_ VERIFICATION OF FOUNDAT[ON PermiLs for consuuction wi(1 be issued a minimum of 24 hours from the time of a��lication to atlow for proper review of thc pro�sed structuce and of the construction site_ A Certifcate of Survey of the lot, st�owing the location of the foanciation once it ha� it has heen constructeci will be rc;yuired before proceeding with (he framing_ --_ ._�,. � _ _, � ' � � SuBJECT . � ' City of Fridley AT THE TOP OF TNE TWINS g�J I L D 1 N G P E R M I T � � 5�2-36�� ; v __�� COMMUNITY DEVEIOPM�NT OIY. r � � PROTECTIVE INSPECTION SEC. � _ � � �"'1 � CITY HALL FFiIOLE� SSI$2 NuwBER �°�'�' �'� 612-57 �-3a5o 9/0-F15 JOB AODRESS 5896 Jefferson Street NE t LEGAL �OT N0. 9LOCK TRACT OR ADDITION DESCR. 1 1 Lyndale Bui 2 PROPERTY OWNER MAIL ADDRES$ Nancy Ma.tter 3 CONTRACTOR MAIL ADORESS Ownei 4 ARCMITECT Oii OESIGNEp MAIL ADDRESS 8 ENGINEER MAII ApDRE$S 8 USE OF BUIl01NG REsidential 7 CLASS OF WORK t v�cE oi � � 28230 ECEIP . �� AVVROVEO BY SEE ATTACNED SNEET 7/1—/4J7 ZIP PHONE LICENSE NO 21P PMONE LICENSE NO. ZIP PNONE IICENSE NO O NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 OESCRIBE WORK Reside garage 9 CHAN(3E OF USE FROM STIPULATIONS TO Ca11 for building wrap inspection before covering. TYP� OF CONST. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, P�UMBING. HEATING, VENTI�ATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION 20NING AUTHOR12E0 IS NOT COMMENCED V�1ITHIN 80 OAYS. OR IF CONSTRUCTION OR WOqK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AfTER WORK IS COMMENCED. NO, DWLG. UNITS I HEREBV CERTIFY TMAT I HAYE REAO AND EXAM�NED THIS APPLICATION AND KNOW TNE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL �E COMP�IEO WITH WHETMER SPECIFIED HEREIN OR NOT. TME GRANTING Of A PERMIT �I.00O DOES N07 PRESUME TO GIVE AUTMORI7Y TO VIOIATE OR CAMCEI TME pEpMIT FEE PROVISIONS OF ANY OTMER STATE OR LOCAI LAW REGUTATING CON- STRUCTION R TME PERfORMANCE OF CONSTRUCTION $3l}.75 �w�� PLAN CMECK FEE d �-� •v �f-w �; /,j JO -� 3 _ 9g S�GNATUAE 0� CON'AACTOA ON AUTMOA4 •GENT IDATE� PR S�GN4TUAE O� OWNEp �� OWNEp BU40Eiii �OATE� p� n[: � STAILS ROUP OCCUPANCVLOAD CU FT. OfFSTREE7 PARKING IGARAGES $.50 SAC CMARGE ire $1.00 TOTAL & $3 25 DATE IS IS VOUR PER IT � /. //� %�1� � NEW � ] ADDN [ l �.�R I l CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 / 1/98 ,�, ��' - `l �� ConstructionAddress: ��9� cTC��'E�S�� ST �C �"/�//� C,� y%!� SSy 3� Legal Description: G/� � A(� E Owner Name & Address: /'�/�� y ��? %%F/�' Tel. #� ��? -.�7/ - i �13 `� Contractor: �,�j /�0 e� �/� /%F j2 MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: � � (��A e � � 1 � i� � caN G�� AG� Estimated Cost: $ /v �o� �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: /u-� �-�� APPLICANT: �i'-f�''�''ps' �!�""7T�d� .��o �`�N�)Tel. #_�/,�-57/-7y.7i Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � r-l�- %S� $ /. OC7 $ • S�O $ $ $ $ $ $ $3 S CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.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 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 pemut of fees to the amount her-ein belaw-set forth and in zhe manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,0(?0 $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 $1Q0,000 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) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "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. Building pLjj�$�j(= Pe�t rto.: Inspections �S�ENTIAL ApPL�CATION Received By: 763-572-3604 CITY OF FRIDLE-Y D�� 'd��'� 3 20 7 DATE YOUR E-MAIL ADDRESS STfE ADD Saw�t � o�S (}u�i4G� THIS APPLICANT IS: ❑ OWNQt j$�corrrx�,croR Nancy Matter 5896 Jefferson Street Northeas PROPERTY �,�; Fridley, MN 55432 �� AnDxESS: 7635717439 � TENANT — • PHONE: corr�nc°roR N�:_ NORBLOM PLUM IN� GO SUBMIT A COPY OF STA'TE LICENSE #�O�O'� !R �'i1F.�TA'i�.t1'�2'� �-,_� ..,`. � YOUR STATE ADDRESS: ,C�_ STATE ZIP LICENSE WITH PHONE F G • • AI'PLICATIOAT , - PERMIT TYPE �SINGLE FAMILY � TWO FAMII.Y - � TOWNHOUSE �rjrnE oF wo�c: ❑'�w . tp��.a,c� DETAII.ED DESCRIPTION OF WORK 14t��ac.t G[JQ�G✓ /��a�G✓ PER MS 16B.665 the pennit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the improvement, installation or replacement of a residentia! fixture, excluding the fixtures. (This.shoul�reflect only.the cost of labor ) L.abor cost under $300 =$15.00. Labor cc>st between $300 tq $500 = cost of labor x.OS = �"�FUR:�ROJECFS WHERE L,4BOIt EXCEEDS�:i00;�EES ARE BASED ON 510.00 PER FIRTURE,�IXCEPTs�RE�L•):'L�i'�..�:F[�'�S:-.(It�D1GATE TQTAL NUMBER OF EACH BELOVi� � BATH SWK/LAV _FWOR DRAINS • 5HOWER WATER PIPWG BATHTUB GAS PIPING �nrEmcr�ruc.�vsE) SWIMMING POOL WATER SOFTNER ($35) r CLOTE�S WASHER _ KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER =.LAUNDRY TRAY �WATER F�ATER ($35) FOR IRRIGATION _ WATER METER _ OTHHR ,Q a Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surchar .50 Number of ftactures (`$15.00 --- x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 � x$35.00 =$ 3S. - .. State Surcharge = $ .50 Total = $ 3 . SD THIS IS AN APPLICA1iON FOR A PERMIT-NOT VALID UNTIL PROCESS� � I hereby apply for a building 't and I aclmowledge that ihe information above is complete and accurate; thaz the work will be in conformance with the ordin ces and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an ap ca on for a permit d work is not to start without a permit; that the work will be in accordance with tIie approved plan in the case ork w}uch ues review and approval of plaas. � SIGNATURE OF APPLIC PRINT NAME �QT`T O/�jvlOi�Y% DATE �Z . ,.� . . v - r�- � _ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit Ivo.: �`� �(�� Inspections RESIDENTIAL APPLICATION ' a�x:.''°� �:� 763-s�2-3604 CITY OF FRIDLEY " 763-502-4977 FAX EFFEC77VE 1-t-2010 �'✓ ; DATE I� YOUR E-MAIL ADDRESS /V d r dY�� 0�00[/ ��q, h,ov - Gevr... SI'CE ADDRESS 0 9� J e �2r' 1'HIS APPLICANT IS: � OWNER �ONTRACTOR PROPERTY OWNER/ Np�: � ,,� �� TENANT annx�ss: f!�(o �-�C��c.�n. � T�� ci� ,� � �!' � '� �l STA7'� ZIP PHONE: `1 io �a • .�� ' a-�ely � CONTRACTOR N,e,�,�: u ',,� SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # �[o .'�1��y I EXP DATE P� ) AND CERTIFICATE OF ADDRESS: ��C3� p�f l�' �rL Nw CITY (ixl�l. ?� STATF�tq c�JZIP ?6� INSURANCE pHONE " p� �O ° 1 FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCI'ION SIZE ❑ 1w0 FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ��DITION 0 GARAGF/SHED O WINDOWS ❑ BASEMENT FIAiISH -+�jROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ ANC ❑ REMODELING DESCRIBE WORK BIING DONE: v SIZE OF IMPROVII�NT LENGTH WIDTH HEIGHT S Ff �tOOFJNG O HOUSE ONLY BASEMEIVT REMODELING SUBMIT: NUMBER OF SQUARES � �PHOUSE & GARAGE 1, Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SiZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCT[ON IIVCLUDING DECKS, ❑ Vinyl OSoff►t ADDITIONS_ & PORCiiES SUBMIT: ❑ Aluminum ❑ Trim 1• Site Plan/Survey showing the existing strucUues ❑ Other 0 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISI7NG OPENINGS ❑Yes �IVo LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE S7'ICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BAti�:D ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCI�EDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Swcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Chazge Total Due $ $ $ ' $ ' �'C2�- $ $ $ $ $ $ i�l �� See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make c6ecks oavable to: Citv of Fridlev Att�c IS AN q,�PLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pe ' d�i" ,' o ledge that the information above is complete and accura.te; that the work will be in conformance with the ordinances ' d City of Fridley and with the Minnesota Construction Codes; that I understa.nd this is not a permit but only an application pe ' ork is not to start without a rmit on site; th the work will be in accord ce with the approved plan in the case of k w es review and approval of pl . ,�'�./ SIGNATURE OF APPLICANT PRINT NAME �A�s�`� �� DATE I� Page 2- Building Residential Application BUILDING 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 FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1" $500 plus $3.05 for each additional $l00 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 1� $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1� $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500 000 $500,001 to $1,000,000 $3,233.75 for the 1� $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraction 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 proposed structure and of the construction site. A Certifcate 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 Faac: 763-502-4977