AF - 477041 �.-" -
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� _ - y' e af Fridl.e ��'Iinn. :
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i :� - � , BIT�DIIV�G PER�IT : �°- 1 �08
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Date: ���'r.�`�' �,�.. . !!�. .``"" _
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awner i.o�:.��.. �''.r3r�:'�i�f:�?�gt: .. Builder .«r�:.. t�':" . - �t"° ,
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,�, ,�� i�QCATI�3A1 OF BUI�IiVG � `
Np. . � �f . ��: � Street 1�:7�`r�7�►:'P , ��� . Pari of Lot . � .
Lot . Bl .,� Additian or Sub-Division . . , . .. .
Corner I;ot �nside 7�.ot Setback �'i�.� .Sideyard ,�������':�:' "°"
,.
DESCRIPTION OF E3Uf�DING `
To �e I����� ' �� F . ;
�...
. �'�. `� � .�.� Front�.�.:: Depth ��: . . Height�� � Sq. F't � Cu. � ......
,�X� ��
. . , i+'roz�t ;;�.�. -Depth ��,+!:'. Height Sq. ;F�. ;Ctt. Fi:
: , a;,,� -
- Type of Cansiruction : ..... ,.....:... Es�.:�ost ..��l�� ....; ... To be Completed . _
_ � _ ���� ��
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7�t consic3eratiozi o$ the iseuarsce. t� me of a permit to construct ihe building; :described above, x a$ree to do
the propose� wark in accordance with the des�gtion above set forth, and 9n comgliance with allt p��f
oxclinanees of #he viliage of .�ridley. ' ��:_
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� _ cbnszd _� of fhe LL ent cif a fee oi `'" : ;
i��'�t. , $.�iy,�t�r.�l..., p�rmit is hereby granted ta�:....:....'.,....... �.; '.
�� Ya eori�truet the .builciing or addif�on as described abave. This permit is �rapted upon `�
� e express �ondition that the _pe�snn to whom it is'geanted and his agents, ermpl.oyees and worlunen, izi aIl work �
don� in, arottrcti and upon said -builduig, or l� '
, � ai►Y �rt thes�of� shali ` canform izt ' all r�apc� to the �rd3ns�nc�s oF �-�
= 1+ ridley,.112innesota regarding location, con�fia�uchi�, alteratioa�, mai�itettance, rep�tr� and moving of bui�dings .�vith-
: i in the village. li�rrits and this. Peirxnit m,ay be xevok� st an� time upon, vio2ation�` , ai�' of the ' pravisipris of said `
� Qrduiaz�ces ��- .�.'A i �
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'. NOTICEe -; . - : -,;. � _ : . ,�: : ; i ;
Thls permit does no# noirer the Cansti�ucltan, installation or alteraEion for wlrin�, plumbt�g, gae, heating,
. �'
sswer ar water. Be sure to see fi�uilc{ing trispector for separafe �ermits for �e ttems. r.': �
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Ca.ty of Fridley, Minn..
BUILDII�TG PERMIT
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OVQaer: FStL1. L8T30A Builder �OP�S }�13�d1@2`8 -
Aaares� .�_�Sl._JeFf�sr�.cm�..�+t, �: aaaress 262i KQie Av�e. No.
10CATION OF BUILDING
No �_ st�eet �eff�rson 3t. bT. F• Part of Lot
Lat _1,9 Block 5 Additton or sub-vivfsion ��ie Atl�dit3oll
Coraer Lot Inaide Lot Setback — Sideyard
Sewer Fdevation — Foundation IIevation
To be Used as:
DESCRIPTION OF BUILDING
F'ront Depth FIeight
Sq. F't. G1. Ft
Front Depth I�eight 5q. F't Cu. Ft
Type oP Conatruction ��. c�c __ �,��32.0o To be Completed
Hspa3r Sto�m Dama�e
In conaideration of the fssuanc� to me of a germ�ft to construct the building described abave I agree to do
the ProP�d work in accordance with the d�scription above aet forth and cbmpliance with a�l provis�tona of
orciinanoes oP the dty of FYldley. �
In co�afderation oP the payment of a fee of �� 10•00 , permit is hereby granted to-�Pk Hlde •
the express conditlon that the pe� on to whom�it�is ��anted and�hfa aget►ts�, empl yees and�w rt ia granted upa�
lmnen, in all work
8one fq arowid end upon said building, or anY� thereof, shall coffiorm in all respects tfl the orair►anc�es oP
FrYd1eY� Mfunesota g location, const.ruction, alteration, maintenence, repair and mov7ng of bufldings
wlthin the dtY limits��aa�this permit may be revoked at aqy time upon violation of a�► of tine provisiona oP se�d
ordinanc�s.
/ � r
Huildin8 InBpeCtor
�-., Nonc�
16b p��mb doa � wwr ths eoadrae�toe, �estallatlon fer �rhie6. P�+�6. o+� �Y, � or wat�r. B� sun ro aN
fin Batldln8 I�a� tor aParal� �rm6s fo� fha� h�os.
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pWNEB' S`' N�I►!B_�
�nn�nss �� 3 8�1
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- - - ,. �;
`� APl'LIC�ITION FOR``$'IJILDING PERA�T
� - CITY 'OF'� FRIDLE�i, NlIl�11�i50TA "5 � . _ - .:
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�l�Gc�f Q.�ie�d�. : . . BUILDE1t s / 10`�-� C. �:. � +��'
. � . h � � �D�SS a6�- �� . . , � �. � �
. ,. . � � . . . _ ,
. • . . . �,DCATION OF SUI�.IITNG , . . `
' . . ' , . . . . . ' . y ' � � i � '. �� � - . � . • _
No. �� 4 � ' c�'h. oi � Street } ' . , ' part of �,ot' , ,
LOT BLOCR�,_,�ADDITION OR SUSDIpISIOR .� fi .�j�� � p e
Corner'Lot_,. -, Ineida` L`OT� Se'tback - � . Sirle Y�rd --
6EWER E�B�V�TtON � _ . . �OU'i�A�A�"tOT�I' E�E9ATI�N '
, �� . � . . _
Applicabti �tta�h t� ehie form �wo Certifieates cif Survey of Lo� an� proposed
buiidin� �orat�oid drawt► bn thege Certificates. �-' '
- � To' be used as;
n�S�RIPT�ON � 0�' St�.D'$JG ' . _ ` �
, .
Frant Dept ` e3��►t
Sq. Ft. Cu. Ft.
� . . . I�ont : Depth• � � Height , � :-_ . �,
. _ , , , �.. ,,. , � .
.. '. � .� � �7 i..�Ft• � .. ._ .., . . . �• �C�`�.'��. .. ' ,�.. ,i.�.i.l�..
v ' . ... . . _ . . ' - . � . ' , . . �P, . . � � �. _." .. - ,
Tqpe of �a�t�truation :��, �� Estimated Coet��,�l��, cs--�
To be completed , ' , -, . . � .
The undersigned'�ierebp makes applicatio�t fo'r �a�permft`for Che�work�herein speeified,
agreeing to do all work in strict accordance �aith the.City of..Fridleq Qrdinancea
and ruliaga of �Che Departmerit� of'Buildings� aad he�ebq declaree that all the facts
and representatioas � stated = in this � �pplic�t'3oa � are �r'u'e �aud `correct . ` � y" ` Y
(Schedule of Fee Costs can be faund on the Reverae Side),
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- : HOI'�DING PERI�T FEE, SCHEDUi,E
SECTION 2. The Insgector of Buildin�s► sh�I�� before issuing anp germit for the
erection of aay building or structure, or for any additioa to any esistin� build-
in� or structur�, or for any alterations or repairs to aQq exieting building or
structuse, upon ap.�l�ication.therefore, requ�re the�payment bq the appl3cant,for
sucl� permit o€ fees to the�amount hereia below set forth and in the manner herein
provided to-wit;
2.1. For any such permit for the erection of any fire-proof buildin�,
other than a garage, warehouse, factory or grain e2evator, or for the erection
of any fise-proof addition, for aimilar occupancy, to �ny e�ist�.ng bui�.ding,
shall be at the rate of $1.40 for each one thousaud.cu,bic feet�, or�fra�tion
°�t}sereof, in su�h cub�cal contenCs:
--� , , � , ',` ° �
2�.2_ �` ` J� For��any such permit for the erectioa of any £ire-proo� garage, �
Warehouse, factory or graia elevator, or for the erecti,on of any ffre-proof
addition, for similar occupancy, to any existing building shall be at the rate
of $1.25 for each oae thousand cubic feet, classified as "fireprooi" by
Sectivn 502 of the Minneapoli� Buildiag Code.
80USES
2.3. For any such permit for t�s_erection of any non•fireproof building,
other than a garage, warehouse; factory or grain elevator, or any non-fireproof
additian, for similar eccupaacy, to any existing building • permit�$1.DO for each
one thousand cubic feet.
GARAGES
__._—
2_..4. For any suoh g�rmit for the erection of anq aon-fireproof garage,
warehou�e, factory or grain elevator, or.for the erection of anq non-£ireproof
addition, for s3milar occupancy, to a.nq exieting building or for each such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fracCion Chegeof, in the cubica2 contents thereof with the minimum of $4.00.
For the purpose of camputing fees for building permite, the cubical conCenta
of any building or addition to a uniform height throughout by multiplying the
ground area covered fram a point aix (6) inches below the floor line of the
basement or cellar to the average he3ght of the upper surface or to the average
height of the ropf surface of the main gable of a pitched roof.
2�5; For regairs or alCerations to aa existing structure, the fee ehall
be at the.rate�of $3.00 per each Five Hundrad Dollars ($500.00) ox fractioa
thereof in the cast of all proposed work.
2! In no case sha11 the fee charged for any permiC as aet fosth in
Section 2 be less�than $4.U0.
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Hois�rai�ix$e x��rse a�i�
���1N� HE4TING HOUSE HEATING TEST �iECORD
AIR CONDITIONING
AND ELE�TRIC, INC.
ADDRESS � ^� �� aV�
occuaanrr S �
HEAT LOSS DATE HTG. IN3T. Ioa -o� �° �
SOLD BY + � �
Elecirical Work B1I � hhe.- �dt
TYPE OF HEAT GA FA � HW STEAM_ SPACE HTR._
\
APT. FLOOR CITY SUBURB
owN��rc�,�� ��gB�
INSTALLED BY
Gae Une By
UNR HTR. OTHER
GAS DESICiN CONVER310N
MAKE MAKE OF BURNER
Model � -- — ---11Gnda1 - -- - — - -- — - — —
Serial � � Max. BTU Reting
INPUT O MAKE OF FURNACE
INodel
THERMOSTAT
Valve
Limit
Limit Setting _
Fan Settfng _
P(lot Type _
Pflot Make _,.._
Pilot Model _
s � i�
Heat Plug Vard Size
KIND OF UNER g�g '� NONE
DraH Hood Regulator
Flitvre Siza � � Number
Chimnay Location Inside Guls�de
Chimnoy Conatruction IJ �
PilotTlming %� .�-�-�
L. W. Cut Off
Pressure � Pe►cent CO�
Input CFH Percent O� o/
Stack Temp. Percent CO
Form 235
Smoke Bomb Wi�ing � /
Draft Teat Tag
Door Pre�ure UphUng In�.
Dato Tastad �
Compeny Testing
Name of Tester
' sue��cT
City of Fridley
AT THE TOP OF TNE TWINS g � I L D I N G P E R M i T
;,
� �
� �,� _�_�� COMMUNITY OEVEIOPM�NT DIV.
r � � PROTECTIVE INSPECTION SEC.
� _ �
� �"'1 � CITY MALL FRIOIEY SS1�2 NUMBEf1 NEV O�TE P�GE OR
�'"'"�" �'� 612-571-34b0 9/0-F15 4/ 19 / 99 � �
J08 ADORESS 6381 Jefferson Street NE
t LEGA� ��7 NO. BLOCK TFiACT Oii ADDITION
oescR. 19 5 Christie Addition
2 PROPERTY �WNER MAIL ADDRESS 7�v oun�
�
29246
ECE� � �
er
SEE ATTACNEO
SHEET
Mrs Paul Larson 6381 Jefferson Street NE 571-3076
3 CONTqACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Nutzmann Bros. Construction 736 1 Ave NW, New Brighton MN 55112 628-0128
a AfiCMITECT OR DESIGNER MAIL ADORESS ZIP PMONE UCENSE NO.
20043453
5 ENGINEER MAI� ADDqESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
O ADDITION ❑ ALTERATION Ck qEPAIR O MOVE O REMOVE
B DESCFi1BE WORK
Reroof House & Garage (23 Sq) Tear-off
9 CHANGE OF USE FpOM
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAL, P�UMBING, NEATING, TYPE OF CONST
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTtON 20NING
AUTHOR12E0 IS NOT COMMENCEO Y�!ITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERIOD OF 120 OAYS A7
ANY TIME AF7ER WOqK IS COMMENCED. NO OWLG. UNI7S
I HEREBV CERTIFV TMAT I HAVE READ AND EXAMINEO THIS APP�ICATION 1
ANO KNOW TME SAME TO BE TAUE AND CORRECT. ALl PROVISIONS Of LAWS yqLUATION
AND Oi;DINANCES GOVEHNING THIS TYPE OF WppK WILI QE COMP�IED
WI7M WHE7MER SPECIFIED MEREIN OR NOT. TME GRAN7ING OF A PERMIT .�l �9]].
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OF CANCEL THE pE�M1T FEE
PqOVISIONS OF ANY OTMER STATE OR �OCAL LAW REGUL TING CON- 62.25
STqUCTIpN Oli TME PERFO ANCE OF CONSTFUCTION �
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VGI:UYqNGr GROUP OCCUPANCV �OAD
SO. FT CU FT.
OffSTREET PARKING
S7ALLS GARAGES
SURTAX Fire S�.'
$.98
SAC CMAR E
� Lice� SC $5.00
% $7 .20
V VALIDAT HIS IS O PEqyFrlj
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NEW [ J
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
Owner Name & A
Contractor: �
Address: % � 1,; -%
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
• CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
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- �
� � ,�.�.J'°Si,�
Effective 1i1/98
�a �. ��
� Tel. # � 7/�G� 7G_�
sy`� MN LICENSE # Z(�/��13�53
/� /�% S.S%I� Tel. # �v.j7��z� Gl%�'.
Attach to this appl�ation, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVENIENT
Length Width Height
Length Width Height �
I.ength Width Hgt/Ground
� ��
Sq. Ft.
Sq. Ft.
Sq. Ft.
�
Construction Type: �Z � Estimated Gost: $ ' �,� , % 9 � /
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
. ;
DATE: �-% /Ci c�' APPLICANT: ° ^ .� . -- Ce? �� Tel. # �S/ ���C�- O/Z�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ G��.�s
$_ � . � `�
$ �
$
$ � � �� �
$
$
$
$
$ %� ° �%
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 permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $S00
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1, 000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway-width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
�! _ 4„�