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City of Fridley, Minn. �T° 9'7 61
BUILDING PERMIT
Date: . �Y 23, 1968
p�r; Robert DeGardner g��r Same
Addreas 2010 17th Ave . N. ____ Ad� Same _
LOCATION OF BUILDING
No. 538 S�t _ Rimbal l St . N. E.� �._.. Part of Lot
Pt of 51 5'}� �` 53 � / Riverview Heights
Lot _._.. • .�. lock — Addition or 5ub-Division .�_
Corner Lot —_ Inside Lot — Setback �_ Sideyard
Sewer IIevation �— $.5� •46 ...._ ��8 46
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwel ling �t 36' Dep� 25' 6" Height —20 � Sq. F't. 918 �, � 18�360
Front Depth ._.._. �Teight � S9• Ft. Cu. F't.
Type of Constructton _._..��ame ��, �_..�1�,., QQ_Q.,_Q_0 __ To be Completed
�"� SEWER LOCATION - 136' N. E. of Manhole
/"1
WATER LOCATION - 146' N'. E. of Manhole
In cansideration of the isauanc+e to me of a perm4t to canstruct the building descrihed above I agiee to do
the proposed work in acc�rdance with the descrlption above set forth and in compliance with afl provIaions oP
or8lnancea oE the dty oE FrYdley.
_����� ,� �����
S�00 00 Sewer Connectiott Char�e
In consideration of the payment of a fee of $ 28 •�� , permit fs hereby graat�i to Robert
DeGardner to construct the building or addition as described above. Thispe rnoit is graated uPon
the express c�ndition tiiat the perafln to whom it fa granted and his agents, employees and workmen� ffi all work
done in, around and u�n said building, or anypart thereof, st�all c�nform in all respects to the ordinances of
Fridley, Minneaota regaz'ding location, construction, elteration, maintenance, repair and mcviag of builaln�e
within the dty limit� and this pern4it may be revoked at ar�y time upon violation o of the provisions of eaid
ordivancea °
�-�,���`
Glaren,ce ael�sle
NOTIC�
Thb psemh do� iro1 eover �hs eoosfrueltoe, lus�allatioa te� widne. plumbEne, �a heaNng, sswar or wats�. B� soro to a�
the Buildirt0 lespedo� Po� mparata parmhs fo� Hroas Naea.
APPLICATiON FQR BUI.LDI�NG PEP�MIT
CIZ`Y OF F'RT�E'Y � � M�I�E50TA � . ._ _ �
OWNEa � S � . . . � �. , ; , • ; . �L�'i.I.DER��' '��i�.,L -e /�
ADD}AESS , . .s , ., r : ' . . _ . . . . .. i�1HU1tESS���� v,,,_. �-��
� � � LOG�TI01�' OF BUtLD3NG' ' � � ' ' . . � .,
' � . �� . . . :c
� � : .. ' � STRBET_� � '�'�
;��► �� � .
r�.oa��_���Ba�ocx��,,�� � . •anDf�ioN oR � 5osb�vis�o� ' - � � ��
CORT�ER LOT �NSIDE LOT . . ` SETB�Git'' • ' � , ��'SID��'i�i3D ": •+ �. `� �._-,,,._-
_____._. --�--- �----
SEWEIt ELEVATION �SS • � �_iTOP OF FOaTiNG � � � ' �J� e
i3 � ( •� . �`�h•� ' -,,. .., .
p�li��at attach �o �this :fc�ran b� Certiii�a'testi�of Survep. `o,f �"�ot �
building location�dzawa '�f�t,hese C��tificates:f': `'�� '�' ��`, '�' ^ ''
��—�e'�: /'e.l� � 7� � , .� . ,
, . a��:'"� .,
. � � DESCR� �N� 0 ''B ING . � �
and propoaed
. M .. . �
To Be Used Ass �
� �� � �
FrQnt_,,,,' �,:�- � Depth� � �eight_ � �
� Square ieet � Cubic Feet-1""„T""'� �
� �F�ont . .. -� . � . . . �ep�h Height
Square feet � Cubic Feet
Tqpe of Construction Estimated Cast
To Be Ccmpleted _
The undersigaed hereby makes application for a permit for the work herein
$peci€ied, agreeing to do all wosk in strict accordance with che City of
Eridleq Ordinances and �ulings of the Department of Buildings, and hereby
declaree that all Che facts and representatioas stated in this applicatfoA
are true and correct.
DA1"E _ _ .� _ � ^ _ �SIGNATiJRE _,. _ , _.._ _ .
(Schedule of Fee Coeta can be found on the Reverse Side).
� ;, � , _ ,�
� � ��r � ` a�'' � �. _ �,�- �'' `�
�
:�
� ��--- � a,, � <� � � �
,.. .� _ - /"1
� .,_ . . . . , .
� .- ;
` BUII.DIN(� �E1�T FEE SCHLDULE ` �
SECTION 2�: The.Inspector:of $uildings shall, befQre issui�g permits�for
_,.the ere�tion of �ay buildir,�g or strucCure, or for.a�y addition to any
existing structure or.building, or �er any aleeration or repairs to`any '
existing building or st�ucture; uipoa application.�tt��re£ere, require the
the payment by the applieant�•€tsr sueh �iermit of T�es to the amount h��ein
_ belaw set forth and in the mauner herin provfded to-caits.
. _.. . ,�.
, 3 .
, .. `• ' ,:�,
IIniform �uildin� Codes � Type l, 2, & 4- $Y.75 for'each_ane thousand-cubic
feet,, er frac�ioa thereof, in such.�.cubical con�ex}te-. ,.�'ype 3� S-. $1..50 for
ea�h ,one �thoueand cubic. feet . � ° � ' " `' � •�• . � �� ° •
F�r the pur�ose ef ct�puting. fees for build�a� perm3;�s,,` t�e� cubicai'�'� �'Y �
conteats ef aay buildiag o� additiou t� a uaniform height `fhraughout �by' '��'-
muitfplyi�g the ground area cove�red frqm, a, poin�t =,�ix (6) inches below the flocr.
line •f the basement cr the-celiar'�te'the average�height oi the upper �urface
ar to the average height of the ropf surface of the main gable.af a,
pit�hed roof . � . . ��=: : = � , ,
F�r. re�airs or� $lteratioiie to an existiiig `"s�tructure,� the fee shall b�-a� the
rate of_$3,0� p��.•each �ive hundred dollara �$500.00) os fraction thereof
in�the cost of all p�oposed.work; �- ��
In,po case _sha1l''tiie' fee c�arged for anq perm�tE as set forth ina S�ction 2 be
Leas than $S.�D...� .. � _
NSSSD Cenneetion Ghar,ges base,d •ou locatiea- Area 1 or �.
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WGA�1l1'�T[p! , � ��� ° COASM1L�lOD NO.
Windows I''t)oara Itefereace Out. Wall Int. Wall Ceiling Rcaf F7oor Kind
Yea,-,� o Yes—No 1 q�
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\Vldth fIefBht ATO. oL Y.laoal f. Area Wddsh %3etght PJa�
1�1'a of pane o[ Dene llghee oP ezack eq. t� A4o. ot 8a�@ 03 n��e6 14g
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''Totai 8tu. ' i'atal �tu.
Required,:aq: ft. �.1�.R. oa s�e iaes. �V.A. Leader area Reqte�ed �, ft. E.1D1Z. ar esa. ina, WA. L.eader ana °� �
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3,. � . Qtoo�e fl..ength ,� l�iidti�s �Te�st 0,,. Fl.l �- �� i I:eagth Width HeiBhi ,,
: �WIDt�OWB 8pd �603B--LT8��81� 8�4a AiCBI Bfieeidodvs°'a�m�d �ors--�Crackage and Area �'��
Wldth Eials�t ATO. 01 fl.insa9 t2. Arem 1Rqidth �a16a4 3�8a a! Y.lasal ft. Area �
.�'1VO. �., ot pans 'of psae Pt8h4e o4 craole �4. tt ' No. ot pasae ot paa� 15�hts o! crack eQ. tt. °�
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City of Fridley, Mian.
BUILDING PERMIT
Date: November 17, 1969
�, � y����.
N° 10503
pwaer; William �orman g�� Sussell Company
Address 538 Rimball Street N.E. Ad� 1850 Como Avenue, St. � Paul
LOCATION OF BUILDING
538 Rimball Street N.E.
No. .� Str,�t Part oP Lot
' '�s E Riverview I3ei hts
Lot .5.�.�.__ Block Addition or Sub-Divfsion .r g
Coraer Lot — Inside Lot g
Sewer IIevation
Setback _ Sideyard
__ Foimda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
Garage �t 20 � Depth 22 � Height 10' �. � 440 �� 4400'
, Front Depth I�eight 5q. F'� Cu. Ft
7.�pe of Construction Frame �� $2,300.00 To be Completed 90 days
Provide hardsurfaced driveway.
In canaideration of the issuance to me of a perinft to construct the building described above, I agr+ee to do
the proposed work ffi accorda.nce with the descrlption above set forth and in compliance with all provisions of
ordinances oP the dty of Fridiey.
� �, _
In consYderation oP the paqment of a fee of $ 7• �� , permit is hereby granted to Sussel Company
to cronstruct the bufiding or addition as described above. Thia permit ia granted u�n
the express candition that the person to whom it 3s granted and hia agents� employees and worlmnen, in all work
done fn, around and ugon said building, or any gart thereof, shall conform in all respects to the ordinaaces oP
Frld1eY� Minnesota regarding location, construchon, alteration, maintenance� repafr and moving of bufldings
wltbin the dty ]im�its and this permit may be revoked at any time upon violation of any of the provf�tons oF said
ordinancea
�.n ,l� ! � �a„�i� �
�3ANK MUHICI3-Building Official
� NOTICEa
'flds pennti dea no� eerar the een�teudton, tnataUaHoe Po� �rirtag. plambine, en 6eaHne, iew�� er wmr. B� sun to ses
�In Bnildiu0 Inspeeto� ter aparaf� parmhs fo► t6as It�ms.
.. _ .�
..- � _ _` �
APPLICATION FOR BIIILDING PII�MIT
CITY OF FRI�LEY, MINNESOTA
OWNg'i 'S NAME `ee� ��/�,��.,° ,!-� �+t :�a-�� BiTILDER c-��� SS° �` � C'`�9
ADDRESS _,�.�5� � ��-e 6�.., ADDREoSS //�•�' �' C'-d'tin a�c'-t�, ��� ���,
LOCATION OF BTTILDING
NO . �� � STREE'i' �.e.,,�1C, � �
LOT �/ ����i��LOCR ADDITION OR SIIBDI4ISION � ' � °
CORNER LOT INSIDE LOT�SETBACK SIDEYAFtD
SEWII3 ELEVATION TOP OF FOOTING
Applicaut attach to this form Two Certificates of Survey of Lot aad
propoeed building location drawn on theee Certifiaates.
DE.SCRIPTION OF BUILDING
To Be IIsed As: .��� �c��,Q �, � m.��
�� Front �- �- Depth Height � d
. Square feet �`-�d Cubic Feet �� � D C�
Front Depth Height
Squa�re feet Cubic Feet
Type of Conetruction ���•�.c_ Eetima.ted Coet �- 3 o u�'- `=
To Be Completed
The undereigned hereby makea application for a permit for the work
herein epecified, e,greeing to do all work in etrict accordance with the
City of Fridley Ordinances and rulinga of the Department of Buildings,
and hereby declares tha,t all the facte and repreaentatione stated in
thie appliaation are true and correcte
DATE _ �%o e...� - CQ `% SiGNATIIRE,�.�-�--�� C�� �- /�e-r ��Q
(Schedule of Fee Coets can be fourid on the Reverae Side.)
� �
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BIIILDING PEftMIT FEE SCHEDIILE
SECTION 2. The Inepector of Buildi.nge ehall, before issuin� permits
for the erection of any buildi_ng or etructure, or for any addition to any
exieting atructure or buiTding,.or for any alteration or repairs to any
existi.ng building or etructure, upon application therefore, require the
payment by the applicant for such permit of feee to the amount herein
below eet forth and in the manner herein provided to-wit:
IIniform Buildi.ng Codee Type 1y 2, & 4-�1a75 for each one thoueand
cubic feet, or fraction thereof, in such cubical c.nn.tents. Type 3& 5-
$1a50 for each one thousand cubic feete
For the purpoae of computi� feea for building permits, the cubical
contents of any 'buildi.ng'aY�-addition to a uniform heig�rt �throughout �by '
multiplying the ground axea covered from a point eix (6) inchee below
the floor line of the basement or the cellar to the average height.of
the upper surface or to the average height of the roof surface of the
main gable of a pitched roof.
For repairs or alterationa to an existin� atructure, the fee ehall be
at the rate of �3.00 per each five hundred dollaxs ($500.00) or
fraction thereof in the cost of all proposed work.
In no case ahall the fee chax�ed for any permit as set forth in Section
2 be lesa than $5.00.
NSSSD Connection Chaxgee based on location - Area 1 or 2.
_ �.
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MIcCo��4- ,��a�'
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�14SOCIAT�S � IKC.
C�r�.
� �i �, c�4��T�a4 E�iNU�s
Q � u►�o ��a�a�oa�
P 1�Tt 1�wrNCtt
IONI 0►/�� IOW►If.- R�011.� k91aN. SS4li
3� N�. M�in St.• Mu�chi�n� Mlnn• S61g0
�urv�y For: T N E S U S S� L C 0.
,, � a��'
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� Denotes Iron Monumentg
�_
Scale: I"=�0'
, - o �� � �, ��
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I hereby certify that this is a true�and correct�representation
of a survey o.f the boundaries of:
All of Lot 51, and that part of Lots 52 and 53, Block E, River-
view Heights, lying Northwesterly of the Southeasterly 20.00
feet thereof.
And of the location of a11 build�ngs, thereon, and all visible
encroachments, if any, from or on said land. As surveyed by me
this lOth day of Novembes, 1969.
,
� ` �
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� Land Surveyor, Mi;n. Reg. No. 7979
� ' � ,.- � . �. �
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NAME
� 1 � � 1 +��1 �t
BLOCK - ADORE33
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ADD'N. AREA
�c� � ►� �,� af
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4��<s.5i° �,�
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SIZE
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VALUE
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TYPE
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i+�,e?. � ! a,a � ti. �" .�`�"
R° 4. +� cm� �6: `m B-'.�_.a�'�. � �+70 • ► �- a�. °+� � ,� 1�„r�� �i � A� �'�e^' �
�� 1 � � � %��+�'.�� e� `� �i�.t �*�:af � �
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'd•°O�[�`s �i��A�.� 1 `i` �, 9 cm.� �. ,�t''►� '� i
� � + � �s^' � _ e � t� � ^*rti. ^ c�l �
� �i�i �, �: eaec � Fi...4 `�.,..� R��� F�"'- '�C �+r�� �s.r `"i°' � � Wa e� � �f �u � �u
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�' Ms !%C? U'� �•
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H SE HEATING TEST RECORD
ADDRESS ���' �'��n�" ����^ APT. F OR C UBUR �
OCCUPANT OWNER � � _ � �
i�� �'_� -a'.=°��-
HEAT LOSS DATE HTG. INST. GAS C0. METER BAD #
SOLD BY INSTALLED BY `
Electrical Work BY Gca Lins By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS ESIG�1 ' �,� CONVERSION
MAKE ��-�-�-� �6� �� _ MAKE OF BURNER
M°d°� � � � Model
�ia� �•'���� �-� �c� Max. BTU Rating
INPUT ;,�� MAKE OF FURNACE
Model
�,., CONTROLS ��
THERMOSTAT Heat Plug Vent Size � - � �
Valve �-�-�� � /�— KIND OF LINE ` IZE�NONE
Limit ��� ��-�J � Draft Hood Regulator
Limit Sstting � Filters Size uumber
Fan Setting i� �'�� r Chimnsy Loeation Insids �--� Outside
Pilot Type 4�imney Construetion
Pilot Make
Pilot Model / �Z � Smoke Bomb Wiring ��
Pilot Timing <'`� '� Draft -- �� � Test Ta� ��
L.W. Cut Off Q A��` ��o� Pressure— Lightinp Inat. �
� .�. �
Prossuro � Pe�r nt CO Date Teated ^' �
Input CFH !� � Pefe6��� �� �' �C�mpony Testing
Stack Temp. Percent CO �� � Name of Teater
Form 235
sue�ecr Np.
City of Fridley -,- � � �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
�
� � ECEIPT
� �
COMMUNITY DEVELOPMENT DIV.
r j y � PROTECTIVE INSPECTION SEC. ��
�
1 i �
� /"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
���-�� � ,�� 612-571-3450 910-F15
5/4/83 � /
JOB ADDRESS 538 Ki.mball Street N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt.51,52,5 E Ri.verview Heights SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
John Olson 538 Kimball Street N.E. 786-8554
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE N0.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Resid ential
7 CLASS Of WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
X
8 OESCRIBE WORK
Construct an 18' x 18' Deck on back of dwellin
9 CHANGE OF USE FROM TO
STI PU LATION S
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. Tred'tef3 WOO
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED 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 CEFTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S1 � 7OO �`. HS
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��X $ZS.00
PLAN CHECK FEE TOTAL FEE
�. $35. 85
SIG RE FCONT�TORORAUTNOFiI2EDAGENT �DATEI W EN PR PE Y A DAT D THIS IS YOUR PERMIT
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SIG UREOFOWNERIIFOWNERBUILDEFi IDATEI � G INSP pq7E
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• CITY Or FRIOLCY E�ective �►ug. 1, 1981
APPLICATIQ� FOft RESIOLNTIA� BUILOIifG PCt�{1TS
(NE+,►. Alterations. Additions. or Repairs)
ONr�ER: _ �; � h �, � � � �,� BUi LDER : � ��tr- � � ( �-�-�_
—
ADDP.ESS: `_ � � � !�� ,M, �
�.�/ AODRLSS: -- S'� � 1��r��-�
_
TEL M0: _ i`d C� � 5 5`� ' TEL t�0: 7`� ����"
• — -
. , Construction Location
• 6TRIST N� s ��� 6 TJtEET: �< I(h ��J�-�
2A'1's _ � ( ' .`� � HLODCs `_.� JIDDITIOAI:
Corner Lot: � Insiae Lot: � 6etback: __ Sideyar�:
Ap�licant attach to t)�is foz�a Lw� Certificates of R�rvey of lot and
pzoposed building location drawn on eeztificates to scale.
DESCRIPTIOit OF COIiSTP.UCTiOr�
1J��-_ Front: �`� Sj-'� fiDePth: 1'� �--�' Neight: �-'�
bquare Feet: �� Qibic Feet:
, Front: DepLh: Hefght:
�� Square Fest: A�bic �eet:
3n��C S.�o s! � ra -� l7�'"�
Zype of Cbrstzuetion a_ �� �e,�,°�' ��� cX Esti�nated Cost: S �O �
7b Be Cbr.�plcted: 1 ,M� �,-��cr�
I11t. !1 7►1 t. 8
Prop�sed Dzivc��ay i+idth If New Openir�g Is Des3red: f' S
.__ ..__
, . . 6E� R?.VERSE SIDE OF SHi�T
1S�e undessi ned here mn3:es a lie�tfon for a •
9 b'Y PP pencit icz the ���ozk herein specified,
a9=��ing te do ,all vork ti, strict eccordsr�ee With the City of Fridle�� Ozdinances e»d
ruliugs of the Del�►�stancnt of Duildings, and heseby declazes that all t]�e fact� ana
represc�tistiens stated in this application are true and cozrect.
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Stipulatio�s: -
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BUILDZNG pERMIT FEE 6CHEDULE
The Iaspectos oi buildfnqs shall, befoze issuing pezmits for the
•r�ction oi any building oz struetuze, or toz any addition to any
•xistinq buildiAq or stzuetuse, os for aay •ltezation oz zepaiss
to any •:istinq buildinq oz structuze, npon application therefoze,
sequize the paysent �y the applicant tor such pezmit oS tees to the
asouat Ltseia belov set tozth aad in the sannez hezeiA provided to-vita
9'OZ'71L V1ILUATIQd
ti. oo tic isoo.0o
:SO1 !D :2r000�
:2,001 t� i25,000
=25,001 to SS0,000
tEES
i10.00 Minim� Fee 515.00 plus surcharge
i10.00 toz Lhe first 5500 plus 51.50 for each
additional 5100 oz fraction thereof, ta ar�d
ir►cladit�g 52.000
i32.50 foz tJie fir�t S2.OG0 plus 56.00 foz each
•dditional 51�000 or izaction th�seof, to and
inclyding 5�5,000
5170.50 foz the first S25,0�0 plus 54.5� foz
each ad8itional 51,000 or fzaction thereof, to
and including t50,000
i50,001 t� 5100,000 :283.00 tos tbe firct 550,000 plus S3.OD foz
each additional 51,000 oz izaction thereof, to
ana in�iva�� sloo, o00
5100,001 ard up 5443.00 for the fizst S100,000 plus 52.50 for
each aclditional 51,000 oz iraction thereof
P7.1W �C7C: 25 percent of Duilding permit iee
DRIVF�tAY DEPRESSION ESCR�W: Concrtte Q�rb Streets �ly
111ternate ']►"s R�ov�al and zeplacemer�t of cvzb ar�d gutter only ,
Drivevay vidth plus 6 feet s s13.50
111ternate 'B": Reooval ar�d zeplaceAent of curb ar,d guttez ane install a 3 foot
vide appzoach vith 6 inch depth
Dziveway vidth plus 6 feet s 515.75
VERIFICATION OF FOUNDATION
Pe�its for constzuctio�ri vill Le issued a minim�n of 24 hours fran the time of
application Zo allow tor proper seview of the pzoposed s tructuze and of tAe
constrv ction site.
71 Cert3ficate of �zvey of the lot, ahvr+ing the Iocation of the foundation once it
has been o�nstsvcted vill be zequized before proceedi with the frami�g.
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A440� 1 AT E 4� I N�. � �oNi e►�ai t�rnr. qn�. a�••. �uit
. � 3� Ih. �laM +� • l�nlshi�l� i� Min4 • S'i1li
Surveu F��: �i N E� U S S E l� 0. �
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I hereby certify that this is a true�and correct representation
of a survey af the boundaries of:
,
�-'All of Lot 51, and that art of Lots 52 and 53, Block E, River-
view Heights, lying A1ort�westerly of �he Southeasterly 20.00
feet thereof. � �
And of the location �of all buildings, thereon, and all visible
encroachments, if any, ft� or on said land. As surveyed by me
this lOth day of Idovember� 1969. �
,
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sue�ecr PER
City of Fridley _ 19 6 2 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � ECEIPT NO.
� `y ______ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. � Q O� �
, i , �o
' /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE � � PAGE OF APPROVEO BY
�.._.� • •'� 612-571-3450 910-F15 8/11/88 � �
JOB ADDRESS 538 Kiunball Street N. E.
i LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. P't. 51,52, 3 E R].V2ZV'].@W Heights SHEET
2 PROPEHTYOWNER MAILADORESS ZIP PHONE
John/Sheila Olson 538 Kimball. Street N. E. 786-8554
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADORESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK -
Reroof Dwelling (20 Squa,xes )
9 CHANOE OF USE FROM TO
STI PU LATION S
Roaf can be 2nc1 layer but not 3rd, Install ridged galvanizecl valleys.
Qn atl new roofs or tear-oifs and replacement roofs�
State Code requires tMat 2 i�yers of 15 lb. felt,
mopped together, be installed to a point 24 iache�
up from exterior wall li�1e, or the �s� of other
approved underlaymen# membrane.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 nAYS, 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 GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-�000 S. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING coN- $25.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$25.50
SIGNAT, E FCO iRACT OR T R12EDAGENT DAT 1 EN P O A I ATED THIS IS YOUR PERMIT
� �/ f� - ,
SfG A FEOFOWNERIIFOWNERBUILDERI 1 ATEI BLDG INSP f1ATE
1��1 [ ]
�fCDIV [ ]
AL'!ER �
( �.
�nstructian Ac7dress
r �� Descriptian:_
Owr�er NaQne & Address
City of �idley
R-1 A1�ID R-2
Building Permit Application
EEfec�ive 5/L88
Tel. # `�.� -
�ntractor: T�,. #
�
Ac7dress: .
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. . . ,� . ,�: �� ..
Attac�ii to this appliG�t,��lii�., a Ce=tificate aF �uvey of the
lat, with the :�c�os�ed` coi�rtictian drawn on it to scale.
t - -� .,c,� ..�t ,:.
`��°R.�*�'° ��I.�S1t�`�P1�iQN � YI��ROV�
' " �;-" �:;:e
LIVI11� ARFA• LerlgtYl' '. ,�,��,, �� •..�>�'�' ,.�iTldth Hei. t
,.- >;�„ , .
c�i 513. Ft.
.�;,
Q�RAGE AREAs Len �i � _`, `�r''. Width � Hei t Ft
C� --;�' ., hr� � � ..%. .
'-5' �� .r" .
n�t �• r,en� �y'`" �.;��`�' wiatt� a��cro�a sq. Ft.
�� ` c� �
�brner Lot [] Insia� Lat [] Ft. Yd Setback �— Sicle Yard Setbacks
�ipe of �nstruction:
Approx. Comgletion Date: �
Estimatecl Cost : S IOC� . c.7C�
Al� A Alt. B
Proposed Drivc�vay Width If New Opening Is Desired: S �
Width + 6' See Back Page
n�: , ��ic�xr: �� T�.. 7� �`
0
Peauit Aee
Stat�e Surcharge
SAC Qisrge
Drive�ay Escraw
Park F�ee
Sewer Main Qisrge
�
3P�0l�I�:
$ ^,C��
S .�
S
$
S
q�J, �C�
t:L'TY IISE �II,Y
l�ee Schedu].e on Reverse Side
5.50/51,000 Valuation
5550 per SAC Unit
Al� '7�,° or At� "B" Above
F1ee Determir�ed by �girieering ,
Agre� Neoessary [ ] N�t Neo�essary [ ]
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7�ie C�ief Building Official shall, before issuing penaits for the erection of any
building or structure, or for any ac7dition to any existing building or structure, or for
any alteration or repair to any existing builcling or structure, u�pon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth anc] in the maru�r t�rein prwided to-wit: �
TOTAL VALUE
S1 to $500
$501 to $2,000
�2,001 to $25,000
525,001 to 550,000
���
$1.5 (Mi nimtan �E 1S $� �.1].US SUL'C�'laL'C� )
Sl5 for first 5500 plus S2 for each additional �100 or f raction
there�, to and including 52,000
S45 for f irst �2, 000 plus $9 for each additional S1, 000 or
fraction thereof, to and including 525,000
5252 for first 525, 000 plus �6.50 for each acY7itianal $1, 000 br
f raction thereof, to anc] inrluding $50, 000
550,001 to 5100,000 5414.50 for first 550,000 plus 54.50 for each adc�itianal $1,000
or fraction thereof, to and including 5100,000
5100,001 to 5500,000 .$639.50 for first $100,000 plus $3.50 for each additiona7. $1,000
or fraction thereof, to ancl including 5500,000
5500,001 to 51,000,000 $2039.50 for the first 5500,000 plus $3 for each additional
51,000 or fraction thereof, to and including $1,000,000
51,000,001 a�d up 53539.50 for the first $1,000,000 plus S2 for each additional
$1, 000 or f raction thereof
DRVE�v D����pN �
(Concrete Curb Streets Only)
Alternate "A': R,enwal and replaoement a� curb and c�tter o�ly - Driveway width plus 6
feet times 513.50.
Alternate °B": Renaval anc7 replaoement af �rb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width glus 6 feet times �15.75.
�?!� " � M • � • • ;��.�1� ��� M �)�I
Permits for construction will be issued a minimiun of 24 hour� from the time of
application to allaw for proper review of the proposec] structure and of the oonstruction
site.
A Certificate of &uvey of the lat, shawing the location of the fo�dation once it has
been aonstructed will be required before prooeeding with the fravning.
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Building
Inspections
763-572=3604
DATE___'i> f �
SITE ADD �
"tHIS APPLICANT IS:
PROPERTY OR'NER/
TENANT
CONTRACTOR
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
O OWNER �CONTRACfOR
PHONE: �� 3 � SI� S� S�
'� G ��'�i��
�
�
Permit No.:
Received By:
T��' S �� 3 z.
SUBMTf A COPY OF STATE LICENSE # ZO (� EXP DA1'E
YOUR STATE LICENSE �DRESS: (� .�S . /�i �A� � S �' CITY /�f STATE�i%IPS �3 z
WITH APPLICATION pHONE Z r �/�D 2 FAX
PROPERTY TYPE
PERNIIT TYPE
�rYrE oF wox�c:
0 TWO FAIvID,Y/NEW CONSTRUCfION
O BASENN�NNT FINISH �OOF ❑ DRAIN TTLE
� DECK ❑ SIDING ❑ OTF�R
❑ SWAMRII�IG POOL
DESCRIBE WORK BEING
SIZE OF
NUMBER OF SQUARES v�0
GARAGFS
PROPOSED SIZE:
PROPOSID HEIGHT:
SIDIlVG
❑ Vinyl
0 Aluminum '
❑ Otiter .
❑ HOUSE 8c GARAGE
❑ ATfACHED GARAGE
❑ DETACHED GARAGE
OSofftt
❑ Trim
❑ Fascia
WIIVDOWS
IN E}QSTIIQG OPENII�iGS OYes �No I.00ATION OF WINDOWS
OR FOR NEW OPENWGS-DESCRIBE SIZE OF
OPENIIJG CHANGES 8c
NUMBER
HEIGHT
BASENlENT REMODELING SUBNIIT:
1. Existing Floor Plan
2. Proposed fl�r pten
3. List of struct�ual �rtembe�s to be used
Ft
FOR IdEW CONSTRUCTION IIdCLUDAfG DECKS,
ADDiTIONS. & PORCHES SUBNIIT:
1. Site PlenlSurvey showing the existing structures
and proposed projec�
2. Two setc of construcdon plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
� TOTAL JOB VALUATION $ oi �.l^ OCCUPANCY T�PE
Permit Fee
Plan Review
Fae Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
E
$ �.[�(�
� /. � 3
$ .�7 �C12�
$
$
$
$
$ .
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0003 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICAT[ON FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information 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 ch requires review and approval of plans.
SIGNATURE OF APPLICANT ��-��¢.¢�� PRINT NAME tJ T v I l� �C� � I-Pn'�'1 `��ATE„S�� 9/� �6 (
Page 2- Building Residen�ial Application
BUII..DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permifs for the erection of any bui.ldi.ng or
shvcture, or for any addition to any existing buildin.g or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicani for such permit of fees to the amoun.t herein below set forth and in the manner herein
provided tawit: '
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 Certifica.te of Survey of the lot, showing the loca�ion of the existing founda.tion will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Buildi.ng Inspections Depariment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977