AF - 48001c�� of F�.a�ey, inn
BZTILDIlvG PEFiMIT N� 5 9 9 7�
�
Date: ��� """ �- �,,,' --
.� .�s
Owaer: � � „- -° '� Builder . _.�_�- � ---._.�___.------_.__�.�
Address _.__ � __ Address � T _._.�. _
�
�,,, OCA��)jV O UI D NG
No. Sfreet � � .._S Parb ct€ t
Lot "��lock —... Addition or Sub-Divisio� : s P
Coraer Lot — — Inside Lot Seiback .�,�� Sideyard _-
Sewer Elevation �.—. ._ Foundation IIevation .—
DESCRIPTION OP BUILDING
T U �
.' Front �_ Depth �� Height .:��.r Sq. F't��.��Cu. Ft.�.����
Fro , Depth eight Sq. F� — Cu. F't.
Type of Construction �_—
��- '- Est. C� �'••"""� _ To be Completed �
In consfdera.tiott of the issuance to me oP a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions oP
ordinanc�es of the dty of Fridley.
�
Ea consideration of fihe payment of a fee of $..p���_..____, permit is hereby granted to
to construct the building or addition as described above. This permit is gra.nted upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part tt►ereof, shall conform in all respects to the ordinances of
� ridley, Minnesota regarding l�ation, construction, alteration, maintenance, repair and moving of buildinga
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
qrdinancea .,,.--� � .'. ."°'*t
Building Inspector
NOTICE:
7his penett does not eover ths eoaalrueHon, 6uta11eNoe far wUing, plumGieg, ges heatiag, sewer or water. Be wn fo sea
t6a Bvtldia8 Uupeetor for sepuate parmits for t6as hamt.
- - rj��:--y. � � �04 �l
- ---- -- - - ---- _ _ � r ;, r
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APPLICATIOi�T �'Ola BUILDiNG PE�IT
C%'�.'Y OI' T�+RIDLEXr �g���'A
Owner's Name • ,Builder
Address �f " �� ° �� �, Adclress ��
. a-� - '1�.�-..,,"-
LOC1�,TiON OF BUIT�DING
No,
o�E Lot
Lo� �FG � y 7- ii � 81ock �,_ ��" Addit3on or Subdiviaion �
Corner Lot �nside Lo� Setback�Side-Yard�_
SEVdE� ELEVATIOIV L'OUNDATION ELEVATTON
Appl3.cant attach to �,his �orm Certificate of Survey of Zot and
proposed building locafiion�
DE�CRIPTION OF �tTILD?.L�G
To be used aso
� � �'ront_��Depth � Heigh�t �
eS�e. C4• / (� �� �rYS rt•
Front____ Dep•�h Height
Sq. Ft. Cue Ft.
aype o� ConstruC�cion Es��nated Cos� !�,, �� =
l o be Completed /,.J�L � 1 .� ^ � � ` � , �
The undersigned hereby ma]�s applicat3on forc a permit �Eor �the wo�^k
he�cein specif�,ed, a�gree�.ng to do all work in strict accordance with
the City of Fr3dley Ordinances and ru].ing o� the Deparfisaent of Huild-
�ngs� and hereby decla�ces that all the facts. and �epresenica�ions
s�ated in this ap�lication axe true and correct.�
D�� � ,�.,� � s� i � G � �t�A�t� � ��� �°P _ � .��.,r.,�
(SchedulhJ of Fee Cos�s can be xound on the Reverse(✓Side).
•�- _ _� _ �.
�
� ..-
BUILDICNG BERMIT t�EE S�DULE
Sec�cion Z. The Tnspector of Buildin�s shall, be�oYe issuing any
pe��ai� �or the e�cec��ion o£ any building or atructure, os for any
addit3.on to any �x3st�.mg building or s�ruc�ture, or for any alterations
or repa�.rs to any oxis�ing building o�c struc�ure, upon application
�horefor, require the payment by the applicant ;or such perYait o�
tees to the amount herein belaw set �orth and 3.r►,the manner herein
p�ovided to-�wits
2.1. For any sucY� pe�n�.t for the erection o� axiy fire-proo� build3ng,
oflzer than a garage, waTCehouse, �actory or grain eleeato�t or for �he
egec��.on of any S�.re-p�oo� addition. for s3milar occupancy, to any
exis��r�g building shall be at the rate og $1.40 for each on� thousand
�ic feet, or �raction theteof, in such cubical contents,
2,; 2. For a.a�y such pormi� �or the erec�ion of any fire-proof garage,
warehouse, factorcy or grain elevator, or �or the erecti� or any fire-
proo� ad�itioa, zor si�nila�c occupancy, �o any existing bu�ilding shall
be at the ra�e or $1.25 �or each one thousand cub ic feet, class�.��.ed
as "�ireproo�" by �ection 502 oe the M�.rruieapolis Buildirig Code.
HO�
2.3. For any sueh permi� for the erection oi ang non-firegroo� build-
�.ng other than a garage, warehouse, �ac�ory or grain elevater, or any
aon-�3rep�coo�E add3.�ion, for eimilar occupancy, to any. exis�ing building o
Pe�mit $1.00.for each ono thousand cubic feet. �
GARAGES
__.___
2�.a. For any such �ermit for the erection o:� any non-fireproof
garage, warehouse, �ac�ory or grain eleva�tor, or for the er�ction of
a�y non-f3reproo£ add�.t�.on, �'or similar occupancy, to any ex3sting
building or �or each sueh building or addaLtion. Ninoty Cen�s for each
one �housand cubic �eet or �raction �che:�eoi, in t�e eubical contents
the:reof wi�h a miniimum o� $4v00.
For iche pu�pose o� computing fees for building permits the cubical�con-
tents o�E any buil�ing or addition to a uniform height t�roughou� by
multiply�tng the ground area covered •;rom a point eix (6) inches 1aelow
�he floor line o� the basemen� or �aiia�c to the average he3gh� of the
upper aurface or to �he average helgh� of the roof aurface of the maiu
gable o� a pitched �oof.
2.5, �or repairs or aiterations to an existing structu:re, the ree
shall be at the ra�e oi $3.00 per each Five Hundred Dollars ($500.00�
or •�raction �thereo•r" in �the cost o� all proposed wor]ce
2. ..�n no case sha11 the fee charged �or any pesmit a$ set foscth in
Section 2 be less t?�� $4.00. �"� z��., _ __-
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LA1+�D SURVEY4RS �..� �
Mc�ic�, Mi�a+�sc�a
_ �
C'�RTi�lCAT� O� SU�tV�Y. .
Ralph N. Lvnd 719-117-�3,�� -
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RIVF�tVI�i FiBI4�iTS . , ; �,-� F° �!,,
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J!i�ltY- ClRIIFY TNAT TliS' l3 A T#UE At� Ct�lECT IIE/'�E1�RATfOl/ Of A StJ�VE'Y Q� 'F►�'�,�v�`�r �.:, �� :'
ial5CW6ED {,/�tiR. J1ND TNE. LOCA?t4t�F OR Akl bU�iG3. Tli�l?N, l� AtE YiSaftE B�fCR4lt4�i�A�{� i� AN1'. �'��y�; �,t .- .�-��
I.AMD. ._ � -
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HFAT LOSS CALCULATIONS DEPARTMENT OF BiJILDINCS ��,, %'�'� ��I�, NIINN.
Weatherstrips �•S.H.V.E. Construction No. Insulation
Guide
' dows I oors Reference Out. Wall Int. Wall Geiling Roof F1oor Kind How Applied
y s— o No 19_
Fl•� M�� P Room � Length •,�` �� Widt}f'" ���� Height �`` Fl.� a�� Room Length ,p''i�"�'• Width - Height '"
Windows and oors—Crackage and Area , Windows and Doors—Crackage and Area
�Vldth Helght No. ot Llneal f. Area Wldth HetBht No. oi Llneal ft. Area
No. o[ pane of pane llghte ot crack eq. tt. ' •� No. o[ pane ot pane Ilghte ot crsck eQ. tt.
s�► "� m �' ,�' ,� ,/ ° � �, .� �'� � � � � /C � �.
� � '�- �a `� *' Q � � S
�'" � ��'� �! �
,� �` �'� � %'�.�.'�► (1�,t1 Coef. Btu Coef. Btu
In6ltration � ;�� � � � Infiltration � � �,� ��� �
Calass , �'"`�, �
Esp. wall � � �' ",�' ._
Net exp. wall ,�� � �
Int. wall
Ceilin8 a� � X � � � �R �" � „ �,�' � '��`
Floor ' ,': -� � � 'R"`
Total Btu. �,,
Required sq. ft. E.D.R. or aq. ins. W.A. Leader acea '
Fl.� ,� '� Room � Length �° Width '�► ,� Height
Windows aad Doors—Crackage and Axea
Wtdth Helght No. oL Llneal tt. Area
No. of pane ot pane llghte of crack eqr ft.
� � �l A` l,�► � ��' ,: � _'� ,4
In6ltratioa ,/ ;�{ �f"
Glaas � ;�
Exp. wall ,� ". �,�",
Net exp. wall � /�' �
Int. wall
Ceiling �+',�'"
Floor �' � *�"
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A: Lzader area °-
Fl. ,�► Room � Length a�, ,,, Width `
Wiadows and Doors—Crackage and Area
Width Helght No. oL Lineal it. Aree
No. ot pane o[ Dane Ifghte ot crack eq. ft.
� '� � ,r O''.� �..� �°'. � /'��
In6ltration � ,�= �`
Glaas � ,� �`s
Exp. wall .m� �' ,�" _,� �'
Net exp. wall �"�j
Int. wall
Ceilin$ ��. ti ,�i+� /� �%�e "�°�' ,C,T
1� loor � �y �°
Total Btu.
Required aq. ft. E.D.R. or aq. ins. W.A. l.eader area -
Glass
Esp. wall �'
Net esp. wall
Int. wall
Ceiling ,,J" A
Floor
Total Btu.
I
�
i
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl.l ,�t , Room ( Length R Wid �
Windows and Doors—Crackage and Area
Wldth Helght No. ot Ltneal tt. Aree
No. ot pane ot pane lighta ot crack eq. [t.
� �`, �� � °°� !'7.� �� .
Btu
" � '� Infiltracion
3��? Calass
Eap. wall � � �.�'
�
� Net eap. wall
Int. wall
� �� Ceilin8 j '� ,� ,
`� � Floor
0
!� Total Btu.
BtU
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�
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���
��
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L'J � -
�
Required aq. ft. E.D.R. or sq. ins. W.A. Leader area
FI y,� ,,�� Room I Length "�' Width /
Windowa and Doora—Crackage and Area
Wldth HelBht No. of Ltneal ft Area
No. of pane ot yane Ilghte ot crack eQ. tt.
.,, �r' � �► � �% _
d� ''� �r `'�`r,� � � e� /a"� �
,l1�' '� � !If �". '� �l °'� � . _ `r¢
Eap. wall � - .� �
Net exp. wall
Int. wall
Ceiling � �,�+ ,�
Floor �-
1'otal Btu.
m�
Btu
Kequired sq. tt. t..U.K. or sq. ins. WA. Leader ana ` ��! '''
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City of Fridley, inn N° 8760
BUILDING PERMIT
Da�; APRIL 12, 1966
Ovvner: DARRELL C. BENSON' g��r SAME
�� 560 7,AFAYETTE ST. N.E. Aaare�
FRIDLEY, MCNNESOTA 55432
LOCATION OF BUILDING
No. 560 g�t LAFAYETTE STREET N.EI� part of Lot
�_ 46 .47. �i�8lock D Adaftion or Sub-Dfv9sian urc�uVT�W--��6�0
Coraer Lot _ Inaide Lot X Setback Sideyard
Sewer IIevatlon � Foimdation IIevation
DESCRIPTION OF BUILDING
To be Use@ as:
D. Garage �t 20 Depth 22 Height � Sq. Ft �4�_ Cu. F't �,.�sDII.
Front Depth ITeight Sq. Ft Cu. F't
Type of Construction Frame �, �__ �1,30Q,�__ To be Completed
In consideratfon oP the fseuaace to me of a permft to construct the building described above I agi�ee to do
the proposed work 9n accordance with the d�scription above t forth and 9n compliance�vith afl provisfona of
ordinances oP the dty oP Fridley. /)'
�
In co�deration of the payment oP a fee of � 4�00 , permit fa hereby granted to D�+L C. BENSON
to conatruct the buiidiag or addition as described above. Thfspe rmit ia gi�anted upon
the eupress cnnditlon that the perean to whom it is grented aad hfa agente, employees and worlQnen� 9n all work
done fn, around and upon said building, or anypart thereo$ ahall conform in aII respecte tfl the ordinancee of
FrirIIeY� Miauesota �eg locatlon, canatruct[on, alteration, maintenaacx, repair and moving oP bufldinge
wl�� dty liaofts and� permft may be revoked at any t�tme upon violation of any of the Provieions oE ea�d
ALLEN G. JENSEN �� �
n NOTIC�
16b p�emh dea �rot eo�nr t6� aona�roaHoe, ImtallaHaa �or �rlrieo, pinmbtne, oa h�aHe�, aw�� or wat��. B� �un to a�
1h� enlidieo In�a1e� fo� apartlr p�naHa /er Nun Nw.
APPLICATION FOR BUTLDING PERNNUT
. CITY OF' FRIDLEY, I�NIl�TESOTA
� I" I' / .% _ �� � 'r�� , i � 1 31' ���� � �. �'� J . :.
I l' ,, f � z � � � � , ,� � � �i � �� �
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LOCA7.'IOAT OF BIIILDIDTG
N0. ,j� � STREET �_ t���� � ,� PART OF LOT
LOT BLOCK ADDI1'ION OR SIIBDIVISION
CORNER LOT INSIDE LOT � SETBAQR . SIDE YARD
SEWER ELEVATION � FOUNDATIQN E�EVATIOft
Applicant attach to this form Two Certificaees of Surveq of �,bt and �dropoaed
b�ilding locatio�i drawn on tiHese Certificates.
DESCRIPTION OF BUILDIftG
To be used as;
n.7 . � / �
Front �L9 Depth�Height ��
` Sq. Ft._ ��4 Cu. Ft. L �" �
Front � Depth Height
Sq. Ft. Cu. gt.
Type of Construction ����L.�t,yr� Eatimated Coat .�3 /� �
To be completed �
The undersigned hereby make's application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ord3nances and rulings of�t�e Degaxtment of Buildings, and hereby
declares tiiat all ehe facts and rep�esentationa stated in this applicat.ion
are true and correct.
DATE� � �� � lo,�_ SIGNATIIRE / �
(Schedule of Fee Coats can be found on the Reverse Side).
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BIIILDING PERMIT FEE SCHEDt1LE
SEC7.20R 2. The Inepector of Buildinga shall, before isauing any permit for
the erection of any building or etruc�ure, or for any addition to any existing
building or structure, or for any alterationa or repaira to any exiseing
building or structure, upon application therefore, require the payment by the
applieant for such permit of fees to the amount hereia below s.et forth and in
the manuer herein provided to-wit:
2.1. For aay auch permit for the erection of any fire•proof building,
othei than a garage, warehouse, factory or grain el'evator, or for the erection
of anq fire-proof addition, for eimilar occupaacy, to any esiating building,
ehall.be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2 For any such permit £or the erection of any fixe-proof �arage,
warehouse, factory or grain elevatflr, or for the erection of anq fire-proof
addition, for similar occupancy, to.any.eaisting building ahall be at the
rate of-$1.25 for each one thousand cubfc feet, ciassified as "fireproof"
by Section 502 of the MinneapoTis Building Code.
flOIISES
2.3. For any such permit for the erection of any non-fireproof
building, other than a garage, warehouso, factorq or grain elevator, or
any non-fireproof addition, for aimilar occupancy, to any existing bui�.ding r
permit $1.00 �or each oae ehousend cubic feet.
GARAGES �
-_ � .
2.4. For any such permit for.the erection of anq aon-fireproof garage,
warehouae, factozy or grain elevator, or for the erection of any non-fire-proof
addition, for aimilar occupancy, to any esiating building or.for�each auch '
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of computing fees for buildiag permita, the cubical contente
of any buildiag or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inches 6elow the floor line of Che
baseffient or cellar to the average h2ight of the upper surface or to the average
height of the roof surface of the main gable of a pitched roof.
2,5. For repairs or alterations to an exfstiag structure, the fee shPll
be at the rate of $3.0� per ea�ch Five Aundred Dollars ($500..00) or fracti�,n
thereof in the cosC of all proposed work. �
2.6. . In no case sha11 the fee charged for any permiC as set forth in
Section 2 be less than $4.00.
STORl�i REPAIR DANlAGE FEES t _.. .
Residential: Eatimated Coet of work up to $500.�� A r�.�0 .
Estimated Coat of wo��.a�r $5��:�� °::� , ,;,;_, � , C0 .
Comm,€�^c��l,; E�timate�"'eoat of work L�-�. t: � "'-: _ , .���'' �� :f?;�'`�� - - °' �
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City of Fridley, Mirm..
6431 University Ave. N. E., Minneapolis, Minn. 55�132
BUILDING PERMIT
��; July 2�4 1972
pwaer; Da.rrell C. Benson g�a� Sa.me
Address _�.�.Q_L�����tte StY' - t N-F - Address S mc�
/ - ,��y,,��l
- _.
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LOCATIOiV OF BUILDING
No. ___.��iQ_ Street Lafevette Street .E. p� og ��
Lot 4.EL,47�48 Block _i—A .._._ Addition or Sub-Division Rivervie Nei�,}yts
Corner Lot .._.__...._..� Inside Lot � Setback � Sideyard
Sewer IIevation _ Foundatton IIevation ___
DESCRIPTION OF BUILDING
To be Used as:
Additio,�ta ouse __.�. Front ��._ Depth � Height �_ Sq. Ft. _��. Cu. Ft 1360
�
Front .+ Depth Height Sq. Ft CtL Ft.
Type of Construction _ Wood Fra.me ��, ��`616 . 00 To be Completed 6 months
Stipulations: Provide 5/8 inch
soffita on-�� wall facing
/ x/ S ��Z°�y � � d aj `�
J'
type X Gypsum firewall to roof boards and fireatop
.
/� c`�t�'�"/c�. �
In consideration oP the 3seuance to me of a permit to constrvct �the buildiug descr3bed above I agree tp do
f1�e proposed work in. accordance with the description above set forth and in compliance with a�]. provisions oP
Ortlinanc�es of the city of Fridley.
� �
.50 St e Surcharge
In cansideration of the payment of a fee of $ 5.00 � p��t is heTeby gran.ted .to narrPl 1 R[�n�nn
to constiuct the building or addition as described above. This permit 3s granted ugan
the express condition that the person to whom it is granted and his agents, employees and worl�nen, 3a all Vvork
done in, around and upon said building, or any part thereof, shall conform ia a]i respects •to the ort]3nanCes oF
Fridley, Minnesota. regarding location, construction, alteration, maintenance, re
��� city limits and this permit may be revoked at any time upon violationof �of the provle% s o�said
�
CLE�RENCE BELIS �
NOTICE:
Yhis permit do� nof eover the wnatruetion, insfallaHon fo� wirfne, plumbing, gas heafing, sewer or wete�. Ba suro to �
46e Building inspeeto� for separate permifs for theae items.
AP.PLICATION �OR �ESIDENTIAL, ALT�RATION,
OR AllllITION BUILDING p��jl�
CITY QF FRIALEY, MINNESOTA
owr�� s�ar� =�A R t��. � 1 C_�., ��rv.�D�BUiLn�: S�'A ��' s_.�,�....,
Anrntt�ss : �� � �q�1 }�� i 7-e .i%�/1/� nnn�ss : ''
�i0: i 'J�CcO STREET • � �"i �1 1/C� %"% c� �.�%. /%� � �
.
T+0'1'e �� '- KJ BLOCK: ADDITIONi �i� d��/%���° /il% /�`°/C-'/� h�
��
CORNER LOT: INSIDE LOT:�SETBACR: SIDEX�RpII,�
Applicaat attach to this form Z�o Certificates of Survey of Lot and pxopc��e�d
building location drawn on these Certificates.
BESCRIPTION OF BUILDING
To Be IIsed As:
AG�G�� T• a� � �%a u S _ Front • � ` Depth : � 7 ` fleight : �� '
Square Feet: ,� Cubic Feet: ����
' Front: Depth: Height:
Square Feet; Cubic Feet:
',L�rpe of Construction: �I�iD 0 G� �RAM P Estimeted Coet: $ 02��40..�
����
�o �e Campleted: (o /V%n � / � , c`-�,
The undersigaed hereby makes applicativn for a pes�nit �or ti�e .wc�xl� ����,9A
�pec�,��,ed, agreeing to do all work in sttict accordance with tiie G��► �p,�'
F��d�eir 0=dinances and sulinga of the Department of Buildings, and �e��abT
de�cla�es that all the facte aad representationa stated in thia appi�,����,p�
a�re true and correct.
��; �l v�V � !�� / 9 7� sicrtA�vx�: � �,�,P.� G' ��, :��
� �,��
(Sep Reveree Side For Additioaal Iaformation.) �� p�% ��� �- ��
� c� � � s � �� � � � -� �,� � �1 � -�-� � � o � �= �3 � � 2
:. � � 1� � � s � �-- �� ?� s
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$UILD�NG PERMIT FEE SCHEDULE
S�C1'�ON 2. The Inspector of Buildings shall, before issuing permits foz the
ezectioa of aay building or structure, or for any addition �o any existin$
build3ag or atructure, or for any alteration or repairs to aay ex�.sting
bui,lding or structure, upon application therefore, require the payme�t by �he
�ppl�.cant for such permit of fees to the amount herein below set forth aRd �.0
the manner herein pravided �o-wit:
UNIFORM BUILDING CODE: T�►pe 1, 2� 4-$2.15 for each one thousand cubi,c
�s��, or fractioa thereof, in �uch cubical contenta. Type 3� 5-$1�.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
I�'or the purpose of computing fees for buildiag permits, the eubical contenta
of any building os addition, is determined by multiplying the ground area
covered fram a point six (6) inches below tt►e floor line of the basement
or the cellar to the av�rage heights of the uppes surface or to the average�
height of the roof surfaee of the main gable of a pitched roof.
For repairs or alteratione to an existing atructure, the fee shall be at tt}e
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
T.n ao case shall the fee charged for any pesmit as set forth ia Sectiat� � bea
less than $5.00.
VERIFICATION OF FOUNDATION
1�1pTE; Permits for eonstruction will be issued a mini�um of 24 hours fxo�R th�i
�ime of application, to allow for proper review of the proposed structuze atid
q�' the conatructioa site.
4� Ce7ctified Susvey of the lot, ehawing the location of the foundat�,p��, pRae� ��
has been coastructed, will be required befo�e proceeding with the f�caat�np,�,
CERTIFICATE OF OCCUPANCY
Application for a Certificate.of Occupaacy shall be made ten (10) days,p7C1�A�
�p the use or occupancy of any stsucture for which a building permit k►a� b��R
iseued; and said atsvcture ehall not be used or occup�ed until a Certificat�a
o� Occupancy has beea isaued.
,
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c�. C. c�o�u��1 a�1� �� t
�
LAND SURVEYORS
Anokc, ".1,n;�esota
CERTI�ICATE OF SURVEY:
Nal�h ?; . Z. uZ�
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Telephone 42i :6340
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�.7n�;-� ".���t;.� � ...;A��t�
f HERE&Y CER?IFY TH4T TM15 IS A TRUE AND C�RPECT vEoFESEN'4�lC'+ :;F a. 5!�RvcY OF THE BOU•UDARIc'S OF TH[ ABCVE
DESC�JBED LAND, AND THE LOCATION OF ALL BURDIN�S, THFR[CN, et�p :,�� •.t5;g�f ENCR^,,,�ACHMfNTS, If �rIY, FROM pR ON SAID
LAND.
_ .
AS �UPVc`!ED BY btc TH15 �_'r_II�. DAY Of ��<<=' _,,,,_ D. 19 '�
.......... _ .......... . A. , C
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" N. C. HOlUM ANO ASSOCIA; E5, I��tC. ; LANp S�rcVEYORS ��
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�'F c�.�o� �ae se �Fiusad �Ctt� so� pa6aec� aa�r av� ,.T ��'_ ssat aq Z uo �
�.��A
Building �
Enspections
763-572=36U4
�A'CE
iITE ADD S O
I'HIS APPLICANI' IS:
PROPERTY OWNER/
TENANT
CONTRACTOlt
SUBMTT A COPY OF
YOUR STATE LICENSE
�VITH APPLICATION
PROPERTY TYPE
PERNIIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATI�N
CITY OF FRIDLEY
� � Y�UR E-MAIL ADDRESS �—
- – -�/�– __C..� a /.°' f'` .D e .if .
❑ OWNER �COMRACTOR
Permit Ne�%—'
Received B
Date Rec' d: � '
ADDRESS:_ _,�� O � ry- �� IQ I�C� T/-.� �� CI7Y �AC /D�-P 1� STATE � ZIPS_�j �
�
rxor�: 76 3— 7�y 5'3 6/�
w�: � A-'(�'e � n.,� Q��.. �aE'a � � .l� .c,rlf S
STATE LICENSE #�.� �� / 6 g% EXP DATE
ADDRESS: �.-����/Jrt? �,A L L S� CITY_ _ T i�� f.�STA7'F�Z[P�� �
PHOAIE �� " �' � ° �D I,Z FAX
FAMII,Y/NEW
O BASEMMIENNT FIN1SH �' ROOF ❑ DRA]N T[LE
❑ DECK ❑ SIDING O 017�R
O SWII�IIvIAiG POOL
MAWTENANCFJREPAIIt
DESCRIBE WORK BEING DONE:
SIZE OF IIvIPROVEMENT
xwrLVC�
NUMlSER OF SQUARES � S
GAttAGES
PROPOS£D SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
O Aluminwn '
❑ Other .
�
�(HOUSE & GARAGE
❑ ATIACF�D GARAGE
❑ DEfACHED GARAGE
OSoffit
❑ Trim
O Fascia
WWDOFVS
IN EXISTAiG OPENII�iGS OYes �No IACATION OF WWDOWS
OR FOR NEW OP�i1NGS-DESCRIBE SIZE OF
OPENWG CHANGES &
NUMBER OF
L
�VVIDT'H HEIGHT
BASEMENT REMODELING SUBMIT:
1. Fxistmg Fioor Plan
2. Proposed floor plan
3. List of strucmral members to be used
F�
FOR NEW CONSTRUCTION INCLUDIIJG DECKS,
ADDITIOAIS_ & PORCHES SUBMI7':
1. Site Plan/Survey showing the existing snvotures
and proposed project
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING Tf� COST OF LABOR AND MATERIALS:
(USING TEiE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan lteview
Fire Surcharge
Surcharge
License Surcharge
SAC Gharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
� ,�°7, o? �'
$
$ �
$
$ �� FX�
$
$
$
$
$
$ � n � �a
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuaxion
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
_ i�+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary (
Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMiT-NOT VALID UNTIL PROCESSED
Attach
I hereby apply for a building permit and I aclmowledge 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
pemnit but only an application for a permit and work is not to start without a permit; that the work will be in accorclance with the approved
plan in the case of all work hich requires rev'ew and approval of plans.
SIGNATURE OF APPLICAM� �� CTC�Gt�vMre. PRINT NAME DATE ���/r� �0 �
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Buildin.g Official shall, before issuing perinifs for tb.e 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 build.ing 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
Pemuts for construction will be issued a minimum of 24 hours from ihe time of application to
allaw for proper review of proposed structure and of the construction site.
A Certi.ficate of Survey of tk�e lot, showing the location of the existing foundation will be
required before proceedin.g with the framing. New Houses Onlv
City of Fridley
Building Inspections Depariment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977