AF - 47765, ..
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��D�IYG PEI��.MI�' N° 3 315
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LOCATION OF BUILDINto
No. v � �. Street . . . . . . . . . . . . . . . . . . . . . . . . Part . . . . . . . . . . . . . . . . . . . . . .
?�t . . . .. . . . . !. . Siock . . . . . /. . . . . on a' Sub- . : Je�s+ .ii�w.rt.�►r . . . � T,
. . .� .
3 / �
C7a�n�er Lot . . . . . . . .. .. . I�ide Iat . . . . . . . .. .. . 3etbsck . . �?. . . .. . 3�eye�t+d .[ .�!. . .. ..��. � .+.. .. .. . .
DESCRl�PTION OF [3UILDING
1b tJssd as: �p �.-
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. . p`ra�t . �. � Dfpth �. . . e4�t . . . . . ... 3q. Ft. . . . . . � �'t� � � �
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ac . . . . . . �t. ccac.l.�:�s . .Q�?. . =° To bt co�,}ecea �.7`M4!Q.: . . ..: . . . . �,,r��
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In 000dderation o! the i�uanoe to me a[ a pertnit to c�o�ruct the buildlaQ �tribed abave. I a�,e�:;�p eb
13rE propo�ed Woa�k in acoordanae wlth the d�wslptio� sbove �et forth and in c�ao�plia�e wllh all proa�rt a[
ae�aaacea oi the dty of I�idley.
................ ......,.,
In va�dt�eration o# the pqyma�t of a Lee o2 ��., Dermit is hereby graated to ' /�
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FlridleY. i�cRa regarding location. c�etlon. 81ter8�On� IYlaintensace. repair and mrnrin$ o� builcl�s ifdth- .
� the citY � aad tb�e perrnit ma�q be ret*d�d At aonY time upon violation of att�yy c� the proviaioa�s o[ saftl
v�linanoe�. �
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NOTICE: �
ThN pa�mi! do�s. not oovsr the co�. � K ali�eation to� vidN ' binp. Oa ��+0.
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�rar or wittlM. $s wro to aa� the Bulldina �lo� si�rab p�emlb !a� " i�, _- �
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�MfE NEi�6Y :�"�Y T�IA"C T�qS �S A�#►i0 CoRR�EGT , ftEPRE�f1�iTJ�'�1015 OF A.S4�f�'i �:T1tE ` �"'�'1� °> 3
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APPLICAT.ION FOR BUILDING PBRMIT
:CZTR .UF '1�RI17��CY., M��NB$OTA .. -
OWNER' S NAME_ff �T�U /2 :� /V� l, S E'%�, BU�LDER .1. �, D!1 aQ S.
ADDRESS_��v�Q �L3���iQ$cJN S � � ?J. , AI)DRESS
LOCAT�II�N QF, BUILDING .
N0, - 6 8� o� � STREET_ �� FFc/t.s o•�/ , _ PART OF LOT l�.v�.
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LOT d�V � BLOCR Q N L ADDITION OR SIIBDIVISION� � G E G/�'E E �!' ?E 2� `
CORNER LOT INSIDE' LO'� '� SBT$AC� 3 7` SIAE-YARD_ �. fd �.�,_i 5.--
SEWER ELBVATIOTi � FOUNDATION ELBVAT�O�i
Applicant attach to this form Two Certifiaates�of Survey of Lot and'proposed
building location drawn on these Certificates.
� '! o�2.tn DA�n�,q G-�
DESCItIPTI01� OF BUILDIftG �
To be used as;
l2 v L� (="Q�w r C v U w� � ��/ S- Front`_Depth Height
Sq.,Ft. Cu. Ft.
„� , Front De�th . �$eight'
--- . ---•-,.._... ..�_.
Sq. Ft. , Cu. Ft.
Type of Construction_ FPA�r.i� R Eatimated Cost,�_�,, �,
To be comgleted_ O�^ I s i, � �
..
The undersigned hereby makes app7,ication for a pe�mit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and ruli�ngs of the D�pB.rtmeat af $uildinga, and hereby
declares that all the facts arid representations stated ia this applfcati�on
are true and correct.
DATE
(S ule Fee Costs can b�
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BO�DING PEI�IIT FSE SCHEDULB
SECTIOR 2. The Inspector of Buildings shall, before iseuing aay peranit for
the erection of � aay building or etructu`�e�, oir' for aay�` addition to any existing
building or gtructure, or for any alterationa or repaira to any exieting
building or structure, upon application therefore, require the payment by the
applicant..fo�._such permiz_.n£_feee��to the.. amount. herein below set forth and in
the manner herein provided to•wit;
2_1. For anq auch permit for the erection of any fire-proof building,
other than a garage, warehouae, factory or grain elevatbr, or for the erection
of any fire-proof addition� for similar occupancy, to any esieting building,
shall be_at_the. rate of $];.4D-.fnr Each _one thousand cu�ic feet, or fraction
thereof, in auch cubical conteats.
�, •
2F.2_ For any, such �erm�t �for the erecti,on of any fire-proof garage,, .
ware�ouee, f-e�ory or g�cain` elevator, or for-the erection of any fire-proof
addition, for similar osCN�an,�y., to auy eaisting building ahall be at the .
rate of-$1.�5 for eaeh oue t�oueaad cubic ieet, clesaffied ss "fireproof"
by Section 502 of, Che.Minaeapol�is. Buildi�g Code. . ,
80IIS8S
2.3. For any such permit for rthe ere,c,ti�pa of any non-fireproof
building, other than a garage, warehouse, factoiy or g=siri elevator, or
any non-fireproof addition, for aimilar occupancy, to any esisting build�.ng -
peranit $1.00 for each one thousand cubic feet.
GARAGE� . . .__ . . . ' _ . � .. .
2.4. For anq such permtt far tha erection of anq non-fireproof garage,
warehouse, factory or grain elevator, or for the erection of any noa-fire-proof
addiEi-ou; for similar�occupancy, to anyr eaistiag buiidisg or for each such
building or addition -�i,nety�ceats ($0.90) for each one thous.and cubic feet
or fraction-thereof, iri the cubical contents thereof with the minimum of $4.00.
For t�e purpose of-computing feea for buildf�tg�permits, the cubical contents
of any building or additioa to a uniform height throughout by multiplying khe
ground area covered from a point-sfx (6) inches belo�v the floor line of the
basement or cellar to the average hetght of the upper surface or to the average
height of the roo# eur�a�e,of thQ;�a�n.,gable of a pi,tched roof. .
2.5. For repairs or alterationa to an.existing atructure, the fee shall
be at the rate o:f $3.00 par� e,aCh' Five Hund'red DoYlars ($5�00.00) or fraction
thereof in the cost of all proposed �iork." �
2.6. In no case shall the fee charged ior any perarit as seC forth in
Section 2 be less than $4.00. .
STORM RSPAIR DAMAGE FEES:
Residen�ial;
Commercial;
s• a
Bstimated Coat of work up to $500.00 -$5.00
Estimated Cost of work over $500.00 -$10.00
Estimated�p st of wor� up Co�'$5A�.00 •$10�Q
Bstimated' �st of work over $500.00 - $20._J
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Arthur Gneiser
6820 Jefferaon Street N.S.
Fridley, Minnesota
July 15, 1965
Fridley City �ouncil
�idley, Minnesota
Gentlemen
Tea�orary Addresa:
155� 2Y►ird Street N. W.
New Brighton, Minn.
I have no objection to the addition of txo (2) feet to the
garage of the dWelling to be built at 6810 Jefferaon St. N.E.
This garage roof, on the side adjacent to my property, shall
have an overhang of not more than two (2) feet and at no point
be closer than one (1) foot to the lot line between 6810 Jeff-
eraon N.E. and 6820 Jefferson N.E.
/'�
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Yours truly
.\
(�i Lt.�-�.�
Arthur Gne er
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j f� i� Richard L. Weimar
� 6810 Jefierson Street N.E.
e`��� Fridley, Minnesota 55432
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Jtily 15, 1965
Fridley City Council
Fridley, Minnesota
Gentlemen
T�nporary Address:
5701 Central N.E., Apt. 20
Fridley, Minnesota
Phone 788-2771
l�y neighbor� Mr. Arthur Gnei�er, arner of the property located
at 6820 Jefferson N.E. has indieated in writing that he has no
objection to fi.he two foot extension of my garage to be located
adjacent to his property.
The garage was 16 feet xide and Was 5 feet from the lot line
betveen our tvo p roperties. This �xtension �+ill bring the wall
of the garage 3 feet frorn the line and the t�o foot roof overi
hang xill be 1 foot from the lot line.
The increase in the Width of ►qy garage is necessary to protect
the cost of the improvements I plan to add �hen rebuilding the
house. Improvement� consist of two feet added to the f ront
two bed roo� and an equal increase to the rear bedroom. I a�aao
plan an addition, 10� x 20 � to the dining and kitchen area plua
a change from an end entry to a center hallway plan.
Your prompt and affirmative action will enable me to start
rebuilding in F ridley xhere �r fsuaily and I xant to remain.
6810 Jefferson Street N.E.
Lot 2� Block 1� xice �Creek Terrace �Lt
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Richard L. Weimar
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City of Fridley, Minn.
BUILDING PERMIT
nate: _� 20, 1265
N° 8245
o�: �►�a,Txv� a�a� B,�,a� aoa� �. �a�s co�sT.
p,�r� 6820 deffersoa St. N.S.� � 1949 R�.cs Crssk B�ad
Fridle�, Minnesota
1�Ta 6820 stc�eet
� 1 ___ � 1
Ca�ner Lot ___r...� Inside Lot
_ • a � ti�: " '—
To be Used as:
Type oi Uonstructios�
LOCATION OP BUILDING
�N 3Tl�EET N. L. ,� part ot 7.ot
Aedditim or
sim . BICS (�SSK TERRICE
t
_._..___ Sideyard --• 10 �
Eleval3on
�RIPTION OF BUILDIN� �"
� o;� . �.�eh..►�.-�E' � P� �S'
Depth Height .— �� �� Sq. F't Cu. Ft
Depth � Height ._..._ Sq. Ft. Cu. F`t.
__. Es� Cost _...�6.��!� ...._ To be Campleted _._
REBUILD �JE �0 3TOR�i DAt+iAGE
�{� rf l+� V i'� I 1► w 1[ i� 1 i 1� �'i 1�b'i i�'F i � i�1;� ! 1 I�i'V �•l'� !�{ r�1.� i���.� 1 1 1� 1.{l i�l'1 a�,I ���
_ . . _ _ _ ._. __._ _. :
a��xov�n sY co�rc�i a� ,lurar i9, _i965 _
In oaodderaUon o! the iswe�noe to me oi a permit to caistruct tbe buitding de�cribed abave I agi+ee to do
t1� p�opored wnrk in acooidsnae wlth the descriptioa ebo�ve aet �oTth and in oompltanoe wlth a�l pro�viaions a!
ae+�inaaoa a! tbe dty � Fridley►.
------�--
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In coodd�atlm ot t�e payment o! a!ee o! �._10.00 � p�t ��y �� tn dtiTFiRtTR QrI�IEZER
to oonstraet the building or additioa as desaribed abo�ve. Thispern t is �ranted u,�l
tt�e e�+e� 000�ttiaa tl�at tnepe� to wwhoin tt is grantea s�a his agenta ei'nployeea and v°i.v.rka,e�, in au w�k
dooe in� around ar� upon said buildin�� oz auYp� thereof, shall oonfa�m in a11 i+�pects to the o�dinanc�es o!
��'Y, Minnewte� a�1� locatiaq aqos�tructioq alteratian, maiatenati�e, repair and mo�vitig o[
w►i� diy limibn�aad t]�3a permit may be re�voksd at aqy time upan violatio� oi any oE the pa+�vldoos�
_ .�IZEN G. J�TS'�N B� �
- ,
NOTICEe
1N� �ewM dw �N Nwr tiN ee.Me�NN, � ta w� �wW�p. Ns IM�Ny, s�ww K wwr. M wn te �
� � I�M� ter �pr�N �wib /er tiw Ilw.
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ADDRESS
N0,
APPLiCATI� FUR BUILDING PBRMIT
, GTTX: QF; FR7DibBi[, ,MINNSSOTA _ , . -
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bOCATIO�i OF BUILD�NG
/ � `
PART OF LOT�
LOT�''1k� BLOCR �`�sZ ADDITION OR SUBDIVISION�,Gf�? � .2�vz- ,
CORNER LOT INSIDE � L(3T '� SgTBACR ,3 % STDE-YA�tD ll% ��..
SEWER ELEVATION FOUNbATI�T L�LEVATIQN
Applicant attach to this form Two Certificates of Survey of Lot and propoaed
building location drawa on these Certificates.
DBSCRIPTION OF BUII.D
To be used as; �
Front Depth Height
Sq. Ft. Cu. Ft.
. Front Dept � Aeight
Sq. Ft. Cu. Ft..
ly
Type of Conetruction Estimated Coe � �:��
To be completed -
.�—
The undersigned hereby makea application for a permit for the workAi�erein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Dep�rtmeat of Build�rigs, aad hereby �.'
declares that all the facts and representations stated i.n this app].icat�,qn.
are true and correct. � , ,., _,
(
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ule �c� Fee Costs can be f�iund 94
V //, , . .
the Reverse. Side).
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. BttILDING PF,KMIT � FEB SCHEDOI.B .
S8� 2. The I�epecto��of �uild�.nga shall, before iaeuing any permit for
the erection of any building or"e�ructure, or for anjr addition to any exiating
building or structure, or for any alteratione or repaira to any existiag
building or etructurey upon application therefore, require the payment by the
applicant .for s.uch permit_of.feee to the amaunt her.ein below set forth and in
the manner herein provided �o�wit; � �
2.1. For anq sueh permit for the erection of any fire•proof bullding,
othar thgn a garage, warehouae, facto�q or grsia e�evator, or for the ersction
of any fire-proof addition, far si�miias occupancy, to any esieting building,
shall be at the rate of�$1.6Q-far each ane thousand cubic feet,.or fraction ,
thereof, in such cubical conteats. . •
2�.2 For aay.such permit for the erectioa af aay fire-proof garage,
warBha�; fac,�or3�- ar gra�n e}�eve�Ee-=�-�-tt3a erect#on-a# any fir��proof
addition, for similar.oc.�ppancy., to an� �asieting building ehall be at the
rate of $3..25 €or each one thousand cubie feet, c].asaiffed as "fireproof"
bq Section 502 0#_ the MinneapoX,is Buildin,g Code. �
SOIISB5 .
2_.3., For any such permit for,the.er�ctioa of any non-fireproof
building, other than a garage, warehouse, factory or grain elevator, or
any nou-fireproof additiom., for similar. occupancy, to any enistiag bui,ldiag -
permit $1.00 for each one thoueand cubic feet. �
GARAQBS_ � _ _ _. .
�2.4. Bor any such permit for the erection of aay non-fireproof garage,
warehouse, factory or grain elevator., ox for the erection of any non-fire-proof
additioei, for simflar vccupancy, to any exi$ting buiiding or for each such
building or addition - ninety ceuts ($0.90) for ea.ch one �hous.and cubic feet
or fr�ctian thereof�-ia the cubical contents thereof with the minimum of $4�00.
For the purlsoee of;ca�nputin4g €eea for b�ti}.ding permits, the cubical contents
of any buildiag. or. addition to. a uniforaa height throughout by �ultiplyiag Ch�
ground erea cwered from a point a3x (5) i�hea belo�► the floor line of the
basement or cellar to the average height of the upper surface or to the average
height of the roof su�facg o�_th��in g�b1a 9f_a_pi��hQd �o�f.._ __ _ _
2_5. Por repairs or_alteratione to an ex�sting atructure, the fee,shall
be at the rate of $3.00 par,escfl Five Hundred Dol�ars .($500.00) or fraction
thereof in the cost of all gropoeed work.
2.6. In no case shall the fee charged for any pex�it as set forth in
Sectian 2 be less than $4.00.
�
STORM 8$`PAI� DAMAGE FEES: .
Residential; Eatimated Coat of work up to $500.00 -$5.00
Estimated Coet of work over $�,00.00 -$10.00
. Vy
C�o�me��ial; Eetimate�Coet of work up to $500.00 -$1Q�00
Bati.aoat( �ost of work over $500.00 •$f 100 -,.^ "`'
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���
sue�ecr PERM
City of Fridley o 19 3 8 8
BU ILDING PERMIT "
AT THE TOP OF THE TWINS '
� � RECE
� �
� `L _____ COMMUNITY DEVELOPMENT DIV. � ��^
r j � PROTECTIVE INSPECTION SEC. j
�
� . ,
�
l-.-. � ��'��;,, CITY HALL FRt�LE� SS43Y . NUMBER NEV. OATE PAGE OF AVPROVED BY
L J\ 612-571-3450 910-F15 4/12/88 / /
JOB ADDRESS 6820 Jeffersan Street N.E.
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 1 1 Ri,ce Creek Terrace Plat 4 SHEET
2 PROPERTVOWNER MAILADDRESS IIP PHONE
Jerry Reitter 6820 Jefferson Stxeet N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LI ENSE NO.
Richard xasti�s Contr. 6331 Riverview Terrace N.E. 574-9966�
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL AOpRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
RE S 1CIP11t181
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION L� REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof D�velling (_l9 Squaxes �
9 CHANOE OF USE FROM TO
STIPULATIONS '
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL, P�UMBINCa, HEATING, TYPE OF CONST. OCCUPANCY aROUP OCCUPANCY LOAD
VENTILATING OR AIH CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO 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 ], STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ,OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $g50 $. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE C�RANTING OF A pERM1T
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS Of ANV OTHER STATE OR LOCAL LAW REGULATING CON- �j`17. SO
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION.
� LAN CHECKFEE TOTALFEE
y �Z �� $18.00
SIGNATUREOFCONTqACTORORAUT •RIZEDAGENT IDATEI WMEN PFIOPER V
� :
L VA TED TNIS IS VOUR PE MIT
SiGNATUREOFOWNER�IfOWNERBUILDERi IDATE� BIOG �NSP � `
aiE
NEW [] City of Fridley Effective 4/1/86
ADDN. [] R-1 AND R-2 �
pLTER. [ ] Building Permit Applieation
Construction Address: ��Z° S�'F�CRSon/
Legal Description:
Owner Name & Address : �� �� � �� � ��'� Tel . �
Contractor • � � �� R � n � �5 �� �� S Tel . � S 7`f - 9Y��C
Address: L33( tZ��Q��i� � �'�cZ
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draWn on it to scale.
LIVING AREA: Length
GARAGE AREA:
DECH AREA:
OTHER:
DESCRIPTION OF IMPRQVEMENT
Width Height
Length Width Height
Length Nidth Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
Type of Construction: ���o � % 9 , Estimated Cost: �-���''�'�'�' �O—
Approx. Completion Date: �! /sa 9� � °U
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: � �
See Back Page for Explanation
.
DATE: � Z- a� 8 APPLICANT: Tel .# S7 `� ^9��,�
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY IISE ONLY �
E �/� �� Fee Schedule on Reverse Side
� 25� of Building Permit Fee
� � � �.50/a1,000 Valuation
� E �5Q per SAC Unit
a Fee Determined by Engineering
E
�8 �� Agreement Necessary [ ] Not Necessary [ ]
a
� b �
BIIB.DING PERMIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure� or Por 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 Oaluation
=1.00 to �500.00
�501.00 to �2,000.00
�2,001.00 to a25�000.00
a25,00,.00 to �50,000.00
E50,001.00 to a100,000.00
�100,001.00 and up
Feea
�10.00 (Minimum Fee is �15.00)
�10.00 for the first �500 plus �1.50 for each
additional �100 or fraction thereof, to and including
�2,000.
a32•50 for the first =2,000 plus �6.00 for each
additional �1,000 or fraction thereof, to and
including �25,000.
=170.50 for the first �25,000 plus �4.50 for each
additional �1,000 or fraction thereof, to and
including �50�000.
a283.00 for the first a50,000 plus �3.00 for each
additional �1,000 or fraction thereof, to and
including �100,000.
�433.00 for the first �100,000 plus �2.50 for each
additional E1,000 or fraction thereof.
DRIVEiIAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway Width plus
6 feet times a13•50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approaeh With 6 inch depth - Drive�ay 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 atructure and of the
construction site.
A Certificate of Survey oP the lot, showing the location of the foundation onee it
has been constructed will be required before proceeding With the framing.
^� -� M
sue�ecr P AM}�•-M0- .
City of Fridley � � � � 2 � ,
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT NO�
� `L_�.__� COMMUNITY DEVELOPMENT OIV. � - r��
r � � PROTECTIVE INSPECTION SEC. ,�
� � �
, ' ����1 � CITY HALL FRIDLE� SS/32 NUMBER AEV DATE PAGE UF APPROVED BY
�----�•� ,'' 612-571-3450 9�0-F�5 6/3/96
/ /
JOB ADDRESS 6$20 Jefferson Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED
DESCR. 1 1 Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Jerry Reiter 6820 Jefferson Street NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Richard Hastings Contr 6331 Riverview Ter NE, Fridle 55432 574-9966 4051
a AqCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDF;ESS 21P PHONE UCENSE NO
6 USE Of BUILDING
Residential
7 CLASS OF WORK
CJ NEW ❑ ADDITION ❑ ALTEFiATION �1 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Garage Flat Roof (Tear-off)
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRE� FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI7S OFFSTFEET PARKING
I HEREBY CERT�FV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COA4PLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING OF A PERMIT �isOOO �.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING coN- �34. %S Fire SC �1 .00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/ PLAN CHECK FEE TOTAL FEE
� �d�t� 6 j % License SC $5.00 $41.25
SIGNATUFlEOFCON'RACTOAORAUTN iZEDAGENT �OATEi WHEN PiiOPERLY ALIDAT D THIS IS YQUR PERMIT
! G��9'6
$�GNATU�7E Of pWNEAi�F OWNEABU�IOEAi �DATE� � 8l0 �NS� qqtE
rrEw
ADDN
ALTER
i]
[l
��
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Appiication
ConstructionAddress: � � Z a S �' �t�'� ,'CSo ,q S� ,
Lega1 Description:
Effective 3/1/96
Owner Name & Address: �� ��,� y,�� f�,� 2 Tel. #
Contractor: `I�; C�, A� p f�4S7'� f n� G S MN LICENSE # �/a S�
Address: � 3 3 I t`� ��� R � i��-✓ T� i? Tel. # S 7 Y^ 99l.G
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTHER:
Attach to this application, a Certificate of Siuvey of the
lot, with t� proposed construction drawn on it to scale.
DESCRII'TION OF IlVIPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width HgtJGround Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Ty�Ze of Construction: �'�,g,� ���= d2 � Q�oo � q�4 R. Estimated Cost: $�bv o
Approx. Completion Date: 7��5��,�
(Cos t on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � .� � � APPLICANT: � _ ����� Tel. # S > 4r ' ��d�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Gharge
TOTAL
STIPULATIONS:
$ �� . �
� �! o 0
$ •��
$
$ ��CX�
$
$
$
$
� �// �S"
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$900 per SAC Unit
$5.00 (State Licensed Residenrial Contractors)
Alt. "A" ar Alt. "B ° Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
r�.. _ _
BUII.DING PERMIT FEE SCHFDULE
The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or shucture, or for any alteration or repair to any existing building or
sttucture, 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
$SOl to $2,000
$2,001 to $25,000
$25,001 to $50,000
r..� $50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,OOO,d01 and up
I� . ,
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to aixi incl�ding �22,000
$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,U00 or fraction thereof, to and i�luding $500,000
$2887.25 for the fust $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and inciuding $1, 000, 000
$5012.25 for the first $1,OOa,f�00 plus $2.75 for each addidonal
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb 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
Pemuts 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 constiuction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has be�n constructed
will be required before proceeding with the framing.
t_
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CHIMNSY AND STACR VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (� No ()
2. Is free from rust or deterioration Yes (� No ()
3. Has no foreign objects lodged within Yes (� No ()
4. Is securely supported Yes (�') No ()
5. Meets all current Code requirements_for
size and total BTU's connected
6. Has total heating BTU's of 80,� ao�
All other BTU's
TOTAL BTU's
Remarks
o3s� ao�
l�% �
_ Yes ( �' ) No ( )
List Alterations BeinQ Done:
ff cr/�.,1�'� � sC.r1�c c�' �
ENTER
14505 - 2tg1t vn
P�YY�����
...�. _ .
HEATING COMPANY
Signed By
Date
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M E NEATNiP TEST REtORO
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sue�ecT PER
.._ __.
City of Fridley =��� � � � 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f '
� �
� �; L_ COMMUNITY DEVELOPMENT OIV. ? NO.
� � � PROTECTIVE INSPECTION SEC. � �a--
� �
' � /���1 � CITY HALL FRIDLE� 55432 NUMBEF pEV OATE PAGE UF pPPROVED BY
�""�' ,'' 612-571-3450 9t0-Ft5 6/21/96 / /
JOB AODFESS 6820 Jefferson Street NE
1 LEGAL ��T NO. BLOCK TRACT OFi ADDITION SEE ATTACHED
oesca. 1 1 Rice Creek Terrace Plat 4 SHEET
2 PROPERTV OWNER MAIL ADORESS ZIP PHONE
Jerome/Elaine Reitter 6820 Jefferson Street NE 571-4553
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEEii MAII ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
CJ NEW ❑ ADDITION [a ALTERATION O REPAIR O MOVE O REMOVE
R
8 DESCRIBE WORK
Construct a 25' x 18'6" Deck on to of flat roof ara e
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZpNING SQ. FT CU FT.
AUTHOFI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOF A PERIOD Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTiiEET PARKING
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TiiUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1 �%OO �. SS
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEF;M1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL REGULATING CON-
STRUCTION O THE PERFOFMANCE O ONST �oN $54. OO �ie SC � 1.%O
PLAN CHECK fEE AL FEE
56.55
5 N UREOFCON'RACT AUTH Dn IDATE� pq V VA D D THIS IS Y UR P R T �
� . � � 2�` �j�' � - � _
�
GNnTUREOFOW �iFOW RBU� DEAi �DATE� 8 G�NSP� q6TE
NEW
ADDN
ALTER
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ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
,
�a
e '1' j
��s � S f . /V Tr
Effective 3/1/96
r
i � � � �
la� I� i %��'Cr �` rP-�! %P✓r, /-� lo'�
Owner Name & Address: � f,Pr� r�o � E,�, i�,.e l�Q• � Tel. # ��%/— `�S"S �?
Contractor: _ S.P � � MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRII'TION OF IlVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length w�ar� Height S.�Ft.
DECB AREA: Length � S� Width �� HgtlGround 6��q. Ft. S�O
OTI�R:
Comer Lot [] Inside Lot � Ft: Yd Setback Side Yard Setbacks
Typde of Construction: �'j..P� /� Estimated Cost: $�Q d
Approx. Completion Date: � k ��, % �-r
/t'Ctps t on Back) „ „ �
Driveway Curb Cut Width Needed: .+ Ft =
DATE: �"2 � q � ApPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Gharge
TOTAL
STIPULATIONS:
$ �'`%�'C�
$ /. %G�
$ � ��
$
$
$
$
$
$
� ��S�.S �
CI1'Y USE ONLY
Fee Schedule on Reverse Side
_$
_ Tel. #_ �7/—`�-r�3
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�. -� �
BUII,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$lOQ,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minunum 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 fust $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 fust $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb 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 be�n constructed
will be required before proceeding with the framing.
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sue�ecr PER
City of Fridley � 4'� � 4
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
� � RECEIPT NO.
� ; y_.____ COMMUNITY DEVEIOPMENT OIV.
r � � PROTECTIVE INSPECTION SEC. ��C� (
� � �� � I
i
' � ����1 ' CITY HAIL FRIDLE� 55432 NUMBEA NEV DATE �AGE UF APPROVED BV
�"'"'� � �'' 612-571-3450 910-F15 7/16/96
� /
JOB ADDRESS 6820 Jefferson Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 1 Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PFIONE
Jerry Reiter 6820 Jefferson Street NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO
Richard Hastings 6331 Riverview Ter NE, Fridley 55432 574-9966 4051
4 ARCHITECT OR DESIGNEF; MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION � REPAIR O MOVE O HEMOVE
8 DESCRIBE WORK
Install aluminum soffit/fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPAFiATE PERMITS AFE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFiM1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED Of± ABANDONED fOR A PERI00 OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WOfiK Wlll 8E COMPLIED
WITH WHETHER SPECIFIED HEfiEIN OR NOT. THE GRANTING OF A PERMIT �isSOO �.75
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �[�H. SO Fire SC � 1. SO
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION.
� PLAN CHECK FE T TAL FEE
_�_.�/� �: 7 � �_ Licen SC .00 $55.75
� SiGNATUAEOFCON�RACTOAOAAUTM i2E0AGENT �D TEi N P �Y VALI D THIS IS VOUR PERMIT
�/ �
SiGNATURE OF OWNEA ��F OWNER BU�LDEFl� �OATE� iN p6TE
�, v
V�
NEw
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[]
CI1'Y OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: (o � Z. o ���r�,�SpN
Legal Description:
Effective 3/1/96
�3! � /
Owner Name & Address: ��'?� y �� ;�'�� Tel. #
Contractor: (� � c� ,� R p t� �'t ;�!'� s MN LICENSE # yo S� �
Address: � ,�3 � � � v�� v; ��� � � , Tel. # S? �( � p�`'�'
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlVIPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Typ� of Construction: �k,sn � SoFr���7' � FAc� � Fstimated Cost: $ l S o o � o�
Approx. Completion Date: _ ����g,�
(Cost on Back)
Driveway C�rb Gtiut Width Needed: Ft. + 6 Ft = Ft x$ —$
DATE: 7 6 6 APPLICANT: ��,..,� ,,� Tel. # S'? �^��',S
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPUI.ATIONS:
$ �8_ S �
� /, S�D
� 7S_
$
� S. �
$
$
$
$
� ��75�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$900 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 [ ]
�.� �
��
BIJII,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$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 fust $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for fust $100,000 plus $5.00 for each additional
$1,400 or fraction thereof, to and i�luding $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
(Co�rete 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 constiuction site.
A Certificate of Survey of the lot, showing the locarion of the foundation once it has it has be�n constructed
will be required before proceeding with the framing.
r--� 'tiY
Building BUILDING Permit No.: ._ t' c�- �'
Inspections RESIDENTIAL APPLICATION Received By: �
763-572-3604 Date Rec'd: % '
CITY OF FRIDLEY
DATE j� !L� N Z�% . ZC7 U% YOUR E-MAIL ADDRESS V b 5 5 �i 1'r 1 s �i -(.cS TA� �� ��i , rt 27�
sr[� a.nDxESS lo S ao .}e #�er5a.-, Sfi 1VE
THIS APPLICANT IS: �WNER OCONTRACTOR
PROPERTY OWNER/ NAME: �'Gt�t.� v��'nr T ll b5 S
�N� �D�ss: � S a r� .�e� L��1 ��. Le � STATE�'1I�P s S Y 3
r C Uir� 5 t rvc.�T� � �'
PHONE: %(� 3— S 7/ "� SS 3
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
STATE LICENSE #
EXP DATE
ADDRESS: CITY STATE ZIP
PROPERTY TYPE Ii�SINGLE FAMILYMEW CONSTRUCTI(
j ❑ TWO FAMILYMEW CONSTRUCTION
PERMIT TYPE
TYPE OF WORK:
❑ BASEMENT FINISH �'ROOF O DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
O SWDvIlviING POOL
�t ❑
DESCRIBE WORK BEING DONE: IC e— l�0 0
SIZE OF IMPROVEMENT
OF SQUARES ��
GARAGES
PROPOS�D SIZE:
PROPOSED HEIGHT:
SID
0 Vinyl
❑ Aluminum
❑ Odter
LENGTH
❑ HOUSE ONLY
❑ HOUSE & GARAGE
O ATTACI�D GARAGE
❑ DETACHED GARAGE
OSoffit
❑ Trim
❑ Fascia
WIIVDOWS
IN E3QSTING OPENMGS OYes ONo LOCA7'ION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENMG CHANGES 8c
TYPE OF WWDOW TO BE INSTALLED NUMBER OF V
WIDTH HEIGHT
BASEMENT REMODELING SUBtvIIT:
1. Existing Floor Plan
2. Proposcd floor plan
3. List of strucdual merr►bers to be used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. Bc PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed projecL
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 E SCHEDULE)
TOTAL JOB VALUATION S___��� a��� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Total Due
S
$ !1
$
$
$
$
$
$
$ �L '1 .
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)
51550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
5450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks aavable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the informarion above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work w�}ich requires review and approval of plans. ,
SIGNATURE OF APPLICANT ( !t. / �•�%?�PRTNT NAME �a�-e r� �'►--�-- V`� DATE �' � Y" Z� U(�
Page 2- Building Residential Application
BUILDING 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:
VERIFICATION OF FOUNDATION
Permits for construction will be issued a min;mum 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
t�
,�y
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-
_
CIlYOE
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-128'7
BUILDING PERMIT APPLICANT: PROPERTY OWNER
I, ����� �� � V�S , understand that the State of Minnesota
requires that all residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a specific exemption from the licensing requirements. As
the owner of the property at (�S�a ��� so�, 5T IV� , Fridley, I
am exempt from the state licensing requirement only if I am not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, ! forFeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspe�ts of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would focfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.
Name _ --_._�_-� ,, /7 C��—�
Date ��� �f - �UlU
Building PLUM ING Pemut No.:
Inspections RESIDENTIAL APPLICATION Received By:
r
763-572-3604 � CITY OF FRIDLEY Da '
DATE �' �-U� Y+OUR &MAII, ADDRE33
SIT'E ADDRESS ZU � /7 � )�� .
THI3 APPLICANT IS: O OWNER �CONTRACTOR {Y
PROPERTY NAME:
,TENA�TT ADDRE89: � CTTY 3TA �,� �
PHONE: '
CONTRACTOR NAME: �(?� �/t1
SUBNIIT A COPY OF
� 3TATE LICENSE # Ch�P� EXP DATE 1 2—U �'I
YOUR STATE ADDRES3: CTTY sTATE ZIP
LICENSE WITH PHONE ' �o � �-
APPLICAITON
PERNIIT TYPE �a� FAMII.Y O TWO FAMII,Y O TOWNHOU3E y
TYPE OF WORK: � NEw C�PL�CEMENT
�
DETAILID DESCRIP'ITON OF WORK
PER MS 16B.663 the permit fa is a miniman of 51�.00 or S% oi the totid coat up ta SS00.00, whichcver is �rater, for the
improvement, installaiion or rcplaeeme� of a re�idential fixn. ue, excluding the fixdires. ('Thia should refleci only the oost of_labor )� -
Labor cost under �300 = S1S.00. Labor cost between 5300 to 5500 = cost of labor x.OS = ,
FOR PROJECT3 WHERE LAHOR EXCEEDS SS00, FEE3 ARE�BA3ED ON S10.00 PER FIX'IURE, EXCEPT WHERE NOTED. FIX'RJRES: (INDICATE TOTAL
NUMBER OF EACH BELOVi�
BATH SINK/LAV FLOOR DRAINS 3HOWER WATER PIPING
BATHTUB CiAS PIPIIJ(3 p� CfflLxBlvsa) 3WIMMINQ POOL WATER SOFTNER (S35)
_ CIATHE3 WASIiER KTPCF�i SINK WATER CLOSET BACKFIAW PREV. (S15)
_ DISHWASHER _ LAUNDRY TRAY �WATER HEATER (S35) FOR IRRI4ATION
_ W ATER METER _ OTHER
�
� � S ,
_ SOQ:�;
Permit Fee S .� Number of fixtures t�D S 10.00 x S 10.00 = S
Su� e .36 Number of fixdu+es @ S 15.00 x S 15.00 = S
TOTAL DUE S Number of fixtut+es � 535.00 x 535.00 = S
State Su�harge = S .50
Tota1= S
THL4 IS AN APPLICATION FOR A PERI�iFT-NOT VALID ZJN'IiL PROCESSED
I hereby apply for a building permit and I a�lmowkd�e that ttie inforn�ation above is complete and accurate; that tt� wo�ic will be in
covforn�ance with the ordiimnoes and oodes of the City of Fridley and with tire Minnesota Constniction Codes; that I unde�tand this is
not a permit but only an applicatioa for a pernnit and work is not to stazt without a permii; that the work will be in acoordance with tbe
approved plan in the case of all wo�c w' '�����w and approval of �
SI(3NAIVRE OF APPLICANf � NAM DATE
K-;,� :;
� City of Fridley ` : , `'
r Building LnspectLOns Department
6431 University Avenue NE, Fridley, MN 55432
, 763-572-3604 �i,�31 �
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