AF - 47885� �"-' � �
Caty of Fridley, Minn.
^ BIJILDING PERMIT NA 7 o s 7
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,Addresa - Address
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LO TI O UILDING
No. �J....L� Street ,�����G���� __�� Part t
Lot ..��...__ Block � Addition or S�b-�viAsion , s �
Coraer Lot _ Inaide Lot � Setback �' .� Sideyard __��
3ewer IIevatian �� ,7� �� _�E-Eleva on ��� l- d
�. �.r i a ,
DESCRIPTION OF
To Used
�Yont � Depth �� Height � Sq. FL �� Cu. F'L��
Front Depth _C� Height � Sq. F� Cn. Ft
Zj►pe of Conatructio e�� FF�t. �t � _� To be Completed
In consideration of the issuance to me of a permft to construct the buildiug descrlbed above I agree to do
th� proposed work ffi accardance with the diescription above set forth and in co�liance �th a'it provlsfona oP
vrdinances of the dty of FrTcIIey. � �� ➢ _
��
In conafderation of the payment oP a fee of $���—permit hereby grauted to
to cronstruct the buflding or addition as described above. This �ermit is granted upon
the expr�s condition that theperson to whom it is graated and his agents, employees and worl�en, fn all work
do�e in, around and upon said huilding, or any �art thereof, shall conform fn all reapects to the orainance� of
Frialey, Minnesota regardiig location, construction, alteration, maintenance, r+epeir and mov3ng of bufldinga
wio��� dty limits aad thia permft may be revoked at aqy ti�e u� �llolatYo�qf any oE the Provi�tona of said
/ ) // / /
�.-iy�
Nonc�:
il� pemdt doss eet eevsr fhs co�eueN�, testallMfea Po� wlrleo. plumbiee, ea 6affi�g, wvr�e e� wNs�. 8� wro to �s
16a &rildin0 i�ttee for aparaN p�rmtfs foe t6a� k�ms.
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APPLICATE'ON FOR BUILDING PEit�I,T ;.��, ,.; ;�,�; ��,., .�-
, _ r . � . . ,�. , . e- .
: CIT'Y OF IgRIDI.EY, .MII�SOT,A �; ; ., , _ � . .
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. �� t�� � . , . . , '�O ✓%� • `Il' ..�., i'^ .��'j�{ /% '�
• - _ �- -_ ��f��i
• • - . ' - ' ':i '
Ann�ss ',. � �' % �' ,��� � , _ %l� �_ � � n�ss_,,,LL;
, . , ., � ... .. • _ , ..�r• .. .. , .. ..
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. LOCATION OF BO�LDING
� . . _ �.-. : _
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No.
S�reet . - � ,; ,:Part- of Lot
Lot �`.. � Block: �' ;.� � . . y ,
� �
� �,_ � . �Additian or: Subdivision � + „, "�,��� ��� ,/��=����j��c
- _ . .„ ,
., . ,.
'• • • e ... . � ,�' : . ,. " . _. S p
Corner Lot�Iaside Lot�_Setback . Side=Yard :
.
SLWER ELEVATIUN FOUNDATION ELE9ATION . �,,�
, Applicant atCac'� Cas��Gl�ia .form Tiao ;Cer;ti•fica�es of Surveg, of- LoC.: anci p�op�ed build-
ing location dr.awa on these Cer�tificat�s . � .. ._ , , _ . . �: , . �
_ .. �,;A. r.,,�;� ,-_�; ;,�:s-;.
DESCRTPTION OF BUILDING �
�,� .
To be usefl. as : - • . _ + .
1��,�/ � i',M���� T��...�:. . . , Front_ , _ � Depth ' F�eigh�; ;f� �
. , . - . , , � � . , ._ _ , + �.: ..
� • . . . �q� F�t. Cu.. Ft�:` ;; , w �. .
� .. , � . _ .. � . �, . ' � . . . � . " . ... �Y`. . �� � .. . _ i .� �
Front Depth Height
� , . :! .[ ' ' . '� . . '; ' .,
. . ._ � . Sq. 'Ftti. � - Cu�. FC,'': ,
� . . . _ . , w.:.;
. . .. .: � : , •, ... t
Type af .Constructioa � �� . EstimaGed ,Coat :
. ,
To be Completed - � . � :_ , . _>;� : ., _.- .
. . . � . . . . . . . . � ' . . � . . . ., _ . ' k .. . _ . . . , �.
Tha undersigned hereby makee application for a=permit fer the work her�in specified,
agreeiag to do all work ia.etrict accordaace with the Citq of:Fridley Ordinances and
ruliags vf the Department of $u3ldiags, �tnd�hereby declares tirat all�ehe,�a�ts aad
representations stated in this application are �rue:aad'oorrect�. -- .
DATE SIGNATtIRE
�Schedule of Fee Costs cea be found on the Reverae Side).
�: ,.. , � f� _ , , r . -- .
- -. -
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BUILDING PERMIT FEE SCHEDULE
Section 2. The�Inspector of Buildings shall, before issuiag an� permit for
the erectioa of anq building or structure� or for any addition to anq exist-
ing buildin� or structure, or for any alterations or repai=e to any esisting
buildin� or structvre, upon application therefor, require the gayment bq tbe
applicant for such permit af fees to the amount hereia below set forth and
in the mamner herein provided to-wit:
2.1. For any such perm�tt for the erecCion of any fire-proof buildin�, other
than a garage� warehouse, factory or grais elevator, or for the_erection of
aay fire-proof addition, for similar cccupancy, to aay �xi�ting building
ehall be at the rate of $1.40 for each one thousand cubic feet� or fraction
thereof, ia such cubical contents.
2.2. For any.such permit for the erection of any fire-proof garage, warehouse,�
factory or grain eleqator, or for tbe erection of aay fire-praof addition,
for aimiiar occupancq,�to any ex3sting building shall be at'the rats of $1.25
for each one thousaud cubic feet, clasaified as "fireproof" by Section 502 of
the Minaeapolis Buildiag Code�
HOUSES
2'.3. 'For any`such permit for the erection of aay aon-fireproof buildiag ather
than a garage, warehouse, factory or grain elevator, or any aoa-fireproof
addition, for s3milar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GABAGES
2.4. For any such permit for the er�ctioa of any aon-fireproof garage,
. warehouse, factory,or grain �levaCor,_or for the erectioa of any nan-fire�roof
addition, -for-similar occupancy, ta anq esisting building or for_esch such
_. build3a� ar addition'- aineCy cents ($0.90) for each one thou8and cubic feet
or fraetion thereof, in the cubical contents thereof with a minimum of $4.0�.-
For th�e purpose oi compuCia� fees for building permits, the cubical coatents
of any building or addition to a uni£orm.height ehroughout by multiplying the
ground area covered from a point si�c (6) iachea below Che floor line of rhe
basement or'cellar Eo ehe average height_ef the upper surface or to the
average heighC of the r@of surface of the mai� gable of a pitched roof.
2.5. For repaira or aleerations to su euieting structu�e, the fee.sha.11 be
at the rate of $3.00 per each Five Huarlred Dollars ($500.00) or fractioa
thereof ia the cost o€ all progoaed work.
2.6. In- no case. ahall the fee,,_char�ed, for -.aay -permit, a�s set forth in
Sectioa 2 be 1'ess. than $4.D0. . ,.
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- � _ __� ^ ,.,`d
Residen�e
Wrn. L.Voi
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& Associates Inc. �f,�g : .1
5809 Pearson Drive 7312-42nd Ave. No. :
tNtnn�po��s 22, M�nn. REGISTERED L�ND SURVEYORS �innea�o�is 27, Minn.
i�ona� Ke.3r6246 Minnesota Registration No. 5522 Phone' Ke•?-604T
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for ��'AYNE C�RLSOI�
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I her�by �er�ify ��at this is a tru� and corr�c� repres�ntation
of a gurvey of LOT�'4; and 5, BLOCK O,RIVERVIE�.' H�IGHTS,
As �urveyed by me thi� 3rd �.ay of j�ne :A.D.1�J<�1�.
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Caty of Fridley, Minn.
BUILDING PERMIT ���c �
N° 7220
,� ---
Dat�: � �� � �
�
ovQner: suilaer
AdBresa ____w__ Address
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/ L CA 1 N F BU LDING
No. ~� Stseet -� T� v � Part of t
Lot ��� Block ____.� Addition or Sub-Di an . ` rL
Coraer Lat _ Ins3de Lot �� Setback Sideyard �'; �
Sewer IIevation � Fo dation IIevation
DESCRIPTION OF BUILDING
T V as:
Front �� neprb �.'f - xeight �� sQ. �-t. ��� cu. b-t.��i�.+�'
Fro t Depth � ITeight �_ Sq. Ft Cu. F't.
7.'ype of Construction �r�_____ F�t. ������f _ To be Completed
In consideral3on oP the issuaace to me of a germit to construct the building described above, I agiee to do
the proposed work in ac:cordance with the drescript3on above set forth and in comp with all provitsions of
ordinances oP the dty of FrYdley. .. t ��.: 01
In camsideration oP the �yment oP a Pee of $�'� , permit fa uereby granted to
to construct the bufiding or addition as d�cribed above. Thisp�� t fs granted upon
the express condition that the person to whom it ia granted and hfs agenta� employees an� worl�en, in all work
done in, around and upon eaid huild4ng, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minaesota regardiag location, construct[on, alteration, maiatenaace, repair and moving of bufldings
within the dty limits and this permft may be revoked at any 13me upon violation of any of the proviaiona of said
Ol'�IIBII�. s+a A i1
Bll��n$ IDB�'CtOY
NOTICEs
TWs penett d� no� eovs� H�s westwetioe, lestall�ltee fe� rrMna, pinmbiee, 0a 6udeo, aqra� or w�er. B� wn te as
fhs Bnildte8 I�r far pparab psrm6s fer f6a� �.
� _ ., �
APP�ICATTON FOR BUILDING PERMI� �
_ ,
CITi�- OF FRTDLEY, MINNESOTA; . , ,
- -,
. • _ •.. _ . �. . ,, . ..
OWNER' S NAME_��'�!,/i�/.� l'-�AAfi�%T BUILDER ���1✓��� .;� G��:C. _� C� �
,�T. . , ,.. . . . � . ... .. . .�� .. . : � ,
ADD$E,SS f .r`�S ,i��'�1�� �L. ,��3 . .ADDI�ESS , , / /�-�r'_' � G��" � �.�:rdF ��
.. � . . . . _ �- , . ,
. . „ . ' LOCAZ'ION QF BUILDING , .- ._ . . � _.
Np. Street Part � of .ioC
Lot. . , . ., ; . • �
_Bl4ck ,.,;,. Addittop ar Subdixiaion �� ���
Coraer Lot`Inside �,ot�Setback Si,de-Y�'d; � � -
SEWER �LEVATIOAI FOUNDATION ELEVATION
Appli.�amt �ttachFto thi� �orm Two Cert,ifi,catea of Surv�p.;of-�ot aad propased build-
ing.locat�o� d�'gwa on these,Certificates.. : � ,. -
DESCRiPTION OF BUILDING
To be used as;
.:1. �..�.,._ �.
� (.� �' . . Facont D�pth a� � . � geight .
, , , .� � _
.. ,; Sq. Ft,., , Cu. Ft.
' _ � Front �� � Dapth Height
: . � Sq. � FC,. . Cu . Ft , . ,
Type of Constructioa ' �� � Esti�aated Co$t
� �. . .. , i . .
To be Ccrmpleted ° ; . . � ,
The undeisigned hereby mgkes applicati�on for a permit faz tk�e work t�ersin epecified,
agreeing to do all work in atrict accordaace wi.th the Citq of Fridley OrdYnances and
rulia�s qf � Che. Department, of _Buatldiags, .and,,l�ereby .declares, that �11 the fact� and
representa[ions seated in this appiicatioa are true aad �orrect.
DA�E � r, � SIGNATURE �
�Schedule of Fee Costs caa be found on the
�
e Side).
�_ .� n
=r�:. �..�
a
SUILDING PE1iM[T FEE SCHEDULE
.
Section 2. The �Inspector of Buildin�s shall, before issuing any per�it for
, the erection of any building or structure, or for any addition to any exist-
ing build'ing or structure, or for any alterations or repai=s to aay esisting
building or atructure, upon application therefor, require the payment bq the
applicant for such permit of fees to the amount hereia below set forth and
ia the maaaer herein provided to-wit:
2.1. For aay such permit for the erection o,f any fire-proof building,�other
_._than_a garage� warehouae, factory or grain elevator, or for the erection of
a,ny fi=e-proof addition, for s3milar occupaacy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, ia auch eubical coaCenta.
2.2.` For any auch permiC for the erection of any�fire-proof garage, warehouse.,_
factory or graia elevator, or for the erection of any fire-pr�of addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cu6�.c feet, clasaified as t1fireproof" bq Section 502 of
the Minneapolis Buildiag Code.
HOUSES.
2.3, For �a►y such permit for the erection of any non-firepsoof buildiag other
than a garage, warehouse, factory or grain elevator, or any aon-firepraof
addition, for similar occupancy, to any existiag building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erectioa of any aon-fireprqof gasage,
warehouae, factory or grain elevator, or for the erection of-any non-fireproof
addi.t3.oa, �£-o�-s�milar occupancy, to any existiag buildiag or for each such
_�...-building or addition - aiar�ty cents ($0�90') for each one thouaand cubic feet
or fr��tion thereof, in the cubical cantents thereof with a minimum of $4.04.-
For the purpose of computing fees for building germ3ts, the c�abical coatents
of any.building or additioa to a uniform height throughout by muLtiplyin� the
ground area covered fram a point si� (6) iachea below the floor line of_t.he
basement or cellar to the average height of the upper sur€ace ar to the
average height of the rQOf surface of the maim gable of a pitched roof.
2.5. For repairs or alCerations to aa eacistiag structuxe, the fee shall be
at the rate of $3.Op per each Five �nadred Dollars ($500.80) or fraction
thereof 3n the cost of all progosed work.
2.6. In no =case shall the fee�.cl�ar�ed.#or.�np-pes•mifi_ -a� set forth in
Sectian 2 he less. thaa $t4.D0.
�"`� �_a '"'�
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sus�ecr PERMIT
City of Fridley 15 4 5 0
AT THE TOP OF THE TWINS � U I L D I N G P E R M I T
r
� � R CEIPT NO.
� ; L __���_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC: a
1 i �
� �'�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�'----� • •�� 612-571-3450 910-F15
9/13/79 � �
JOB A�DDRESS 655 Kimball Street N. E,
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. ��S 0 Ri.vezview Hei.ghts SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Dennis Hamre 655 Kimhall Street N.E. 784-8923
3 CONTRACTOR MAIIADDRESS ZIP PHONE LICENSENO.
5ame
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
� � � �
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface drive�zay.
waR1�rN�
SEPERATE PERiMIiTS REQUIRED FOR WfRfi�tC, Bei�te di�ina cafl IccaJ utilities
�LEPMONE • EIECTRIC - G��S Etc.
k-IEATING, PlUM81NG ANp ��{aNS. REQU�RED BY LA04V
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. TATOOCI FidIIl@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING Sa. 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 6560
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEiiEBV 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 $5490 yi`2. %r'J
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GIiANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON- $26.24
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$28g99
S ATUREOFCON7RACTORORAUTYORIZEDAGENT IDATEI WHEN PROPER�,Y yALIDAT�,D THIS IS YOUR PERMIT
����n 1 �n / �
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SI NA UREOFOWNERiIFOWNER8UILDERi iDATEI BLDG iNSP �p
CITY OF FRIDL•EY •
�
APPLiCATION FOR RESIDENTIAL BUILDIP�G PERMITS
(New, Alterations, Additions, or Repai'rs)
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BUILDER: . ��°.�C.�
ADDRESS: � �}/y� e. ,
TEL N0: �� f7�' �
' Construction Location
��L� JJ A L� � cS,� —
- ST�T NO : STREET: , � �" ""
y LOT: �'•-� BLOCK: � ADDITION: • ' .
• Corner Lot: Insicle Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Suzvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOtd OF CONSTRUCTION °
. o� � l
Front:
�,�� , Squane. Feet: `Z
��.s ,,� � x�,
Front:
Square� Feet: �02
� �/� �
Depth: �� Height: v
Uzbic Feet: _ ���� '
Depth: Heig . � �
Cubic Feet:. ��o
Type of Construction : l�J(�d,� `���"1 �
7.b Be Oompleted:
Estimated Cost: $ e� � 9� • ��
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $� $
, . SEE REVERSE SIDE OF SHEET .
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of k'ridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in fhis application are true and correct.
DATE: .5�� �.3 SIGNATURE:
Stipulations:
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� - ---- - - - --�
• BUILDII�G PERI�IIT F�k. SCfiCDULE� ,
S�CTION 2. The Ins��ector oL 13uildinc� , �}ia17., bet-ore issuing penniL-s for the erecL-ion
of any bui7.ding or :�L•ructure, or for. any addit9.on to any exi��ing buildiny or strucl:ure,
. or for any alteraLion or repairs to•any exi.ting building or sL•ructure, upan application
'ihereiore, requirc L-he Payment by tlie ap�licanL• for sucli permi� of tees tio, L•he amount
herein be].ow set fori:h and in the manner herein provicled to-wiL-: •
. NJsW GONSTRUCTION: Single T'ami].y IIomes and Garages: $4.00/1,000 cubic iee�. .
PLT�N CIiL•'CY.: 25 percent of bui.lding pexmit fee.
D12IVE��7AY D�PI2�SSIOIJ: (Concrete, C�rb SLreets Only) �' �
• Alternai:e A: Removal and replac�ment o£ concrete cuxb and
qutter only; Driveway width plus 6 fee� x Y15.75
Alternate B: Removal and replacement of eoncrete curb and
� .' gutter and install a 3 foot�wide approach with �'
' ,. 6 i.nch depth; Driveway width �lus 6 feet x$17.85 �
; Il � � . 1 �' ' �l
For the purpose oi camputing fees for building permits, the cubical. contents of any
building or addition, is determined by muli:iplying the ground area covered from a
point six (6) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the x�oof suriace
oi the raain gabl.e of a pitched rooi.
For repairs or alterations to an existinq structure, the fee shall be at the rate
of.$3.00 per each five hundred dollars-($500.00) o"r fraction thereof in the cost
of all proposed work. . '
In•no case shal.l the fee charged for any pexmit as set forth in Section 2 be less
than $7.50 plus $.50 sta.te surcharqe. ' �
V�RTFICATIOV OF FOUtVDATION
NOTE: Permits �or cons:trucL-ion will be issued a minimum of 24 hours from �he time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Suxvey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedinq with the framing.
L�� : �. � t 'G1
Applica�ion for a Certificate of Oceupancy shali be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been a.ssued; and
said structure shall not be used or occupied until a Certificate �f Occupancy has
been issued.
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Residence � � 7312-42nd Ave.No.
R GE ISTERED LAoND SURVEI�ORS Minneapolis 27, Minn.
5809 Peorson Drive Phone� Ka• 7-6047
Minneapolis 22+ Mi�^• Mi���ota Registration No. 5522
Phone� Ka.3-8246
qo
for �``�Yl� �HRLSOtd
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I hereby cer�ify that this is a truA and correct representation
of a 5urvey of LOT� k; d�d 5, �LQCK O,RIVERVIEI��; H�I��iTs,
As surveyed by me this 3rd day o`' 3'�n� �'•�•1��`*'
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' ' ' � SUB�ECT . � ' � .
City of Fridle� 32019
AT TME TOP OF THE TWINS Q�J � L D I N� P E R M I T
r
� �
RE PT NO.
� `y _ COMMUNITY OEVELCPMENT DIV. ���0���� ��
r � � PROTECTIVE INSPECTION SEC.
� . �
� � �"�1 � CITY HALL FRIDLE� SS132 NUMBER pEV DAT@ PAGE Oi APPROVEO BY
ti.__.1l-� '•� b12-571-3460 9�aF�s 7/23/01 / /
10B ADORESS 655 Rimball Street NE �
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. /{,5 0 Riverview Heights SHEET
2 PFOPERTY OWNER MAIL AOqR�S$ ZIP PNONE
Denni� Hamre 655 Kimball Street NE 763-784-8923
3 CON7RACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Same
d AHCMITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO,
5 ENGINEER MAIL AODRESS 21P PHONE LICENSE NO
8 USE OF BUIl01NG
Residential ,
7 CLASS OF WORK
O NEW � AODITION O ALTERATION � REPAIR O MOVE - O REMOVE
8 DESCRIBE WORK
Reside House
9 CHANOE OF USE FROM TO
STIPULATIONS �
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
SEPARA7E PERMITS ARE FiEOUIfiED FOR ELECTRICAL, PLUMBING, FIEATING. TYP� OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR Alq CONOITIONING
TMIS PERMIT BECOMES NULL ANO VOID IF WQRK OR COIySTpUCT10M IONING SO. FT CU fT
AUTMORIIED IS NOT COMMENCEO V�!ITHIN 80 OAYS. OR IF CONSTRUCTION r
OR WORK IS SUSPENOED OR ABANQONED POR A PERIQD OF 12p OAY$ A7
ANY TIME AFTEfi WORK IS COMMENCED. ' NO DWLG. UNITS OiFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED TMIS APPLICATION 1 S7AlLS GARAGES
AND KNOW TME SAAAE TO BE TF1UE AND CORRECT. ALL PROVISIONS OF LAW$ VA�UATION SUq7AX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL Q� CpMPLIEO
WITH WHETMER SPECIFIED MEiiEIN OR NOT. TME GRANTING OF A PERMIT �3�000 �1.SO
OOES N07 PFiESUME TO GIVE AUTMORI7Y TO VIOIATE OR CANCEL TME pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTNER STATE OR LOCAI LAW REGULATING CON-
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION �53.25 Fire SC �3.00
PLAN CMECKFEE TOTA EE
S�GNATUpE OF CON7NACTOp NOp�ZED AGENi � �D�TE� EN P OPE LIDA7 THIS $5 OUR PERMIT
r v�� �. „
$�GNOTUR O� OWNEA��� OWNEN�URDEAi IDAIE� . ' Bl0 �NSD ' ' f�p�t
NEW []
ADDN [j
ALTER [ ]
Construction Addre
Legal Description:
Effecfive 1/1/2001
CITY OF FRIDLEY (763) 572�604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Owner Name & Address:,��V! /� ��G�� 7'el. # �'I�-,3 ' i�� � ,� -�J-�
Contractor. � � G� MN LICENSE #
Address: Tel. #
LNING AREA:
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 Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft.
pECK AREA:
OTHER:
Length Wdth HgUGround Sq. Ft.
`� � �e�� -�o ���
.
Construction Type:_������ � Estimated Cost: $_�� O���� C�
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: J�G APPLICANT: �,��f� �;i-���� o Tel. #����
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (763) 572-3604 for Permit Fees if mailing in application
$ ����5^Fee Schedule on Reverse Side
$ ,Db .001 of Permit Valuation (1/10th%)
$ /. �.�0 $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ _ Alt. "A" or Alt. "B" Above
E�
Park Fee $
Sewer Main Charge $,
TOTAL $ � / e�
STIPULATIONS:
$450.00 Conservation Plan Review
Fee Deter.mined 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
$100,001 to $500,000
$5�,001 to $1,000,0�
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,0(�
$69.25 for first $2,Ofl0 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0�
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,0(?0 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 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 $15.50.
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 $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the tune 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. New Houses Onlv
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57"L-36U4 l+'AX:
: 655 KIMBALL ST NE
: 033024220128
: UNAVAII..ABLE
: LOT BLOCK
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALTERATION
571-1ZIi7
PERNIIT NO.: 2004-01471
DATE ISSUED: 09/Ol/2004
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSLTE DATE. INSTALL SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114-
OWNER
HAMRE DENI�TIS L& VEROIVICA J
655 KIlVIBALL ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This pemut becomes null and void if work or consh�uction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
applicarion and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC PERNIIT FEE - NIlN (RESI)
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 117431
�r,raxa i� r�xivil i ��tluut�l� rux wUx1t U�1 t1�x �1 HAN li�5(;Kll3�D .�3UVE.
20.00
0.50
20.50
Building
Inspections
763-572-3604
SITE ADDRESS _
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERNIIT TYPE
ad
: I 1 I� !�
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
�. L SF -�r' �
❑ OWNER �ONTRACTOR
L
Permit No.: � CU'�
Received By:
Date Rec'
��� SS^�3 1
NAME: D O-- tJ T"3
STATE LICENSE # � 7 EXP DATE
ADDRESS: 6 3�. / i'N� ��L+� S� � CITY ��i�(//�' STATE��IP .S S 7 3
P ONE �r Z �.. FAX
INGLE FAMILY/NEW CONSTRUCCION SIZE
TWO FANIII.Y/IVEW CONSTRUCTION STORIES
� ADDITION ❑ GARAGFJSHED O WIlJDOWS
❑ BASEN�NT FINISH OOF 0 DRAIN TILE
� DECK SIDING ❑ OTf�R
❑ SWMIIvIIlVG POOL
TYPE OF WORK: I � �' �
❑ MAIIJTENANCE/REPAIR ❑
DESCRIBE WORK BEING DONE: ���( UtJ�e► f�►YL /1.e1-b-p
SIZE OF IIVIPROVEMENT
NU1v�ER OF SQUARES I �S
GARAGES
PROPOSED SIZE:
PROPOSED F�IGHT:
SIDIIVG
❑ Vinyl
❑ Aluminum '
❑ Other .
LENGTH WIDTH HEIGHT
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
�DETACI�D GARAGE
OSoffit
O Trim
O Fascia
wwnows
IN E3QSTING OPIIVINGS DYes �Ato L�ATION OF 6VMDOWS
OR FOR NEW OPENINGS-DESCRIBE StZE OF
OPENWG CHANGES &
I.IihTl�l�
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plen
3. List of structural members to be used
Ft.
FOR NEW CONSTRUC770N IIdCLUDWG DF,CKS,
ADDT!'IONS. & PORCHF� SUBMIT:
1. Site Plan/Survey showing the existing strucdues
and proposed project.
2. Two sets of conshvction plans
3. Energy Calculations �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING E 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ .`� % OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surchazge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Dne
$ �`7, U.� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ J� (;' .001 times the total job valuation
$ � i � .0005 x Permit Valuation Minimum $.50
$ , � L��� $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 APPLICATION 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
percnit but only an ap�lication 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 revi w and approval of plans.
� ,.� - J
SIGNATURE OF APPLIC � PRINT NAME DATE���Y �020 d rJ
Page 2- Building Residential Application
BUII..DING PERNIIT FEE SCHEDULE
�'�'Iie Ctiief 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, upoa applica.tion 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 ea�h additional $100 or fraction, to and
' includin $2,000
$2,001 to $25,000 $69.25 for 1�$2,000 plus $14 for each addifional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for ea.ch 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 including $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
fi-acrion to and including $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
a11ow for proper review of proposed structure and of the construction site.
A Certifica.te of Survey of the lot, showing the location of the existing founda.tion 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
B�i-�it�g
Inspections
763-572-3604
DATE�I `L I_,��
SITE .�.DDRESS �
THIS APPLICAM IS:
PROPERTY
OWNER/
TEN:�'T
CONTRACTOR
� MECHA.NICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
O OWNER �,CONTRACTOR
- - e... .._s�_
V ,
• • � �:��. �
� - - - . : ��
��� ,���- � ,� � � i i
COMP�''Y N�: Anderson Heating and Air-Conditianing
SL: BMIT .A COP1' OF CONTACT PERSON: O'���C�� —
��OUR STATE STATE LICENSE � ^'/� 434� Central Ave N.E.
LICENSE VJITH r�DRESS: �
.4PPLIC.ATION PHONE ]f��°�I - �S//
_ �.� Col. Hts, Mn 55421 ��
PERMIT TYPE
TY"PE OF VVORK:
'�SINGLE FAMILY ❑'fW0 FAMILY
i
p �W �REPLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERA'i]ON/REMODEL
,�I N zip
STA'I'E ZIP
PER MS 16B.665 the permit 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 residential fixture, excluding the fvttures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FGR PROJECTS �'}-iERE LABOR EXCEEDS 5500, FEES ARE BASED ON 510.00 PER FIXTURE, EXCEPT V+'HERENOTED. FiXTU � �1;�+?�E TOTAL
`�ti1.�IBER OF EACH BELO�� � SIZE/BTU U�'�
�G: � MODEL: ��n��
�quipment Installed MODEL: _______ S���
MFG: _— SIZEIBTU
��: MODEL: GAS RANGE/OVEN 510.00
A�C SZS.OG _FIREPLACE (GAS) $15.00 _��y GpS GRILL $10.00
AIR TO AIR EXCH.A.'JGEER $15 FIREPLACE (WOOD) $35.00 G,q� �T H-IR $10.00
BGILER 535.00 ' �'UW�IACE $35.00 —p�L }�„p'['ER $35.00
CHIMNEY LINER $]0.00 GAS DRYER 510.00 —'�ILATOR $15.00
DUCT V� ORK $] 0.00 _GAS PIPING $10 00
J _ . . ... _ ._.. . .._..... .. ..�.�c._.�v.�,,:aa�S-�E� ,irn�r.a=nC'n1��,i.I2T.1.��Y:a"F1lY2r-�itn•�_t'T�:°�nV�R��50
Permit Fee $ _,�.�--
Surcharge $ .50
TOTAL DUE � �Ss�
--,.,:... _., .,..__,�.. __ _� _ .. _
Number of fixtures @ $10.00 x $10.00 =
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Swcharge = $ •��
Tota] _ $
TMS 1S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance w�ith 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 th�: case of all work which requires revi�ew and approva� of, glans. ;, ,,, ;. _,
SIGN.4TUREOFAPPLICANTC �c/�U����=P�TNAMEC �61�/1�Tt'e/�a�C�q� BATE , .
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
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`� REQUIRED lNFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS j� EXISTlMG HOME ❑ MAKE-UP AlR
REQUIRED FOR NEW/EXISTING HOMES �
1. Combustion Air (See note below� '.
a. Oil or solid fuel IMC Chapter 7 with MN Amendm.ents
b. Natzu'al Gas or Propan�GC ChaPter 3 with MN �endments •
2. Make-up Air (See note below)
a, IMC Chapter 5 with MN Amendmen.ts
3 . V enting
� Gas appliances IFCrC Cha.pter 5 with MN Amendments
b. Fuel other than gas IMC Chaptcr 8 with MN Amendments
REQUIRED FOR NEW H4MES
4. Heat loss & cooli.ng load per room
a. Required on new construction IMC 1346.0312
5. V entilation . •
a Per MN Energy Coc�e 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up ai� calculations
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