P - 48355Build ;ng
It�spectior�s
763-572-3604
763-502-4977 FAX
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-2011
DATE 0�+� �20 / YOUR E-MAIL ADDRESS
SITE ADDRESS '7 /% q �� �/GR- "'T"� Q-Q-i�C.G �' R i fl[-y yr) � 1J , y'S y 3 Z
TH[S APPLICANT [S: ❑ OWNER [$�ONTRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
STATE LICENSE #
Permit No
Received By: /�
Date Rec'd: � � l
i v-�,� ✓�.c. c� T.ea/�,ac�ciTV �R��l��/ STATEw1.^� ZiP
— 6 y� '�
ADDRESS: � 5 % K��`T'KE i2.
PHON '�6 3 ?� �- 2( �
f2i'SINGLE FAMIL MEW CONSTRUCTION
❑ TWO FAMILYMEW CONSTRUCTION
PERMIT TYPE ❑ �DITION
❑ BASEMENT FIN1SH
❑ DECK
TY.PE OF WORK: ❑ NEW HOME CONSTRUCTION
❑ MAINTENANCE/REPAIR
,D CERT NUMBER
CITY_�'��vt�/1., STATE ►M.A�IP��
FAX k'J
SIZE �
STORIES
❑ ROOF ❑ DRAIN TILE
❑ SIDING ❑ OTHER
❑ SWIMMfNG POOL
�' ADDITION
❑ REMODELTNG
DESCRtBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH /�o � WIDTH / Z-� HEIGHT f'L� SQ FT
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE: I�o �(' iZ
PROPOSED HEIGHT: �
SIDING
� Vinyl
❑ Aluminum
� Other 6�.
WINDOWS
IN EXISTING OPENINGS ❑Yes� o
OR FOR NEW OPENINGS-DESCItIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED I�
ALL FEES ARE BASED ON
COTAL JOB VALUATION ;
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$
$
❑ HOUSE ONLY
2f HOUSE ARA E >/S/t�
❑ ATTACHED GARAGE
�DETACHED GARAGE
❑So�t
❑ Trim
O Fascia
LOCATION OF
NUMBER OF
BASEMENT REMODELING SUBMIT:
!. Existing Floor Pian
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTfON (NCLUDiNG DECKS,
ADDITIONS. & PORCHES SUBMIT:
L' Site Plan/Survey showing the existing swctures
and proposed project.
2. Two seis ofconsWction plans
3. Energy Calculations
FOR WINDOT r�,����DE U-VALUE AND
MANUFAC k �1�V�T�
� �� �IY
�ALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
USING THE 1997 U.B.0 FEE SCHEDULE)
�� . OCCUPANCY TYPE
$
$
$
$
$
$ 0
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $5.00
$5.00 (State Licensed Residential Contractors)
$2230 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$25=$
$450 Conservation Plan Review
Fee Determined by Engi�eering
Agreement necessary ( ) Non Necessary ( )
Make checks uavable 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 acknowledge 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 rmit and r is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all w w i eHiew and approval of plans. ,�b/ /
SIGNATURE OF APPLICANT PRINT NAME ��'OrJ /C�L�/� DATE D'%/!�/?�/�
�esi � # 38084 �° _ --.�
. � . a �� ���
�� Here are the wall configurations for your design.
Illustration May Not Depic�All Options Selected
�
aable Front View
1) • NON-INSUL RIBBED M5EST 8X7 EXTSN
�
�
.
.
�,,� �., c w
u�� u C� �r�
d�� �
c� �
��' ���-s�` �t��
�
t �+ � �
��'' �-�'� ��s •
Pa e2of2
11712011
.— ----_�
�ave Front View
...
- 3uiltling Size:12 feet wide X 16 feet long X 9 feet high
;�pprozimate Peak Height:l2 feet 6 inches (150 inchesj
� _
Y�IV
��
�
��
�
�� � ��k
i}�x?�, 7���G�� �
�t/l-trl3 2�. st � �
�' c�. .
— .— --- — — �.
�C�c` '
.�'�—�_
Eave Back View
.� r� ;.,�,�,� � 5�3C3 J T
� L ��� �
� G �
(�-�.�,5 � Pc�,�� s�
,
.
�— .0 � IN �� S _ _ ( (Q � .
��
TH[S JOB COPY SHALI g�'
AYAfLABl.E ON 7NE ,,�U�
�ITE FOR THE FRAMIPdG
AND �II�At INSPECT(t�NS
-�enards providetl material estimates are intended as a general construc6on aitl and have been calculated using typical construction meth s. Because of the w�de vanable in
, rcodes antl site restrictions, all final plans and material lists must be verified with your local zoning office, architect andlor builder for building design antl code compliance.
;�Menards is a supplier of construction materials and does not assume liability for design, engineermg or the completeness of any material lists provitled. Undergra�ntl electncal,
_ phone and gas Imes should be locatetl and marked before your building plans are finalized. Remember to use safety equipment includmg dust masks antl sight antl hearing
, protection during construction to ensure a positive builtling expenence.
�
�esig�
# 38084
tems Selected:
aable roof wl 6112 �tch, standard rafters 16" O.C.
2' Wid Deep X 9' High
;oncrete Floor
1° Ve►tical Breckenridge Sitling
�
I x4 Pine Outsitle Corners
..- N�� l
12° gable�l2" eave overhangs
112" OSB Roof Sheathing
? r. C �,,,�utnt Sienna Shingles
'lastic Roof Vent, Brown
�ine Soffit & Fascia
Nhite Regular Roof Edge
'ine Overhead �or Jamb
�u
MENARQS`
Desi n-!t°
, . � .
Options Selected:
The options you have selected are:
15 LB Roof Felt
,.
�,,��n � v���
� �`` M�1 �`�S
� � �T� JC�'��-S
Today's estimated base price. $1,232.39
The base price includes: 0� Eave10" Gable Overhangs, Framing Materials,
7116 OSB Roof Sheathing, 20 yr. Fiberglass Classic � Onyz
Black Shingles, Pine Fascia, Galvanized Regular Roof Etlge,
8" Teztured Vertical Hardboard Sitling, No Service Doors,
No Overhead Doors, No Windows, or Any Other Op�ons.
Front View
Back View
Paelof2
71712011
// j� /\,���
:
��.
ENGIN�EREO 7RUSS DESIGNa
ANQ LAYOU7S Sl1ALL 8� M�t��
AVAlLAB�E QN THE J0� �!i`�
FOR THE FRAN1iNG INSi�e�Gfil��
__. .. , • _� ---
� `� � �
� �
�
d'�1
��. t
Today's estimated price: $2,919.07
If purchased today, you save. $9520 __
Monthly BIG Card payment; $81,98
��� Take this sheet to the Building Materials counter to purchase your materials. ���
all informatlon on this form, other than price, has been provided by guest and Menards is not responsible for any errors in the informatlon on this estimate, including but not limited to quantity, dimension and quality. Please examine
this estimate careluhy. MENARDS MAKES NO REPRESEMATIONS, ORAL, WRITTEN OR OTHERVNSE, THAT THE MATERIALS LISTED ARE SUITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE GUEST.
BECAUSE OF THE WIDE VARIATIONS IN CODES, THERE ARE NO REPRESENTATIONS THAT THE MATERIALS LISTED HEREIN MEET YOUR CODE REQUIREMEMS.
���������� � O��o� COMBINING TFiE RECORDS OF
HARVEY A. CARTV�/RIGHT J. E. HILL, Gv�� E�GINEER,
ANOKA COUNTY SUR.VEYS� � ESTABUSHED teoe
HENNEPIN COUNTY SURVEYS L!� ND S UR �'E YORS G F. SANDHOFF
MINNEAPOl15 SURVEYS � ��� CIVIL ENGINEER
64f0 SHAU�Y OAK LANE N.E. REGIBTERED UNDER LAWS OF 5�(ATE OF MINNESOTA E57ae�13HEO I�Oe�
SUNSE7 8-0G79 LICENSED BY ORDINANGE OF GTY OF MIryNEAPOLIS ,JAMES NELSON �
owr+Ea 345 PLYMOUTH BUILDING LINGOLN 8721
SURVEYOR
ESTABUSHED 1Y22 �
iN�uSTaia� - �uoicin� METROPOLiTAN LAND
BUSINE85 - TOPOGRAPHICAL _ �UCbCYOC'g �ertifieate SURVEYORS, esTAeWSHeo �9�t
UTY COTS - PLATTING . . � •
Invoice 19745
Bud Nelson �
�
�t �' - .. —
; � �' — �1 r_�'!------- - ------�U�••�-�= , - _ _ . __._ .. �
(�,� , ---- _
�` 1
�
: ''' 1
� �� �, � � ,��
, �
� � R ��.
, � ��. �1 �
,,�
r
v�
�
�� .
�J
�
��
�
�0
�
• i
� ��N
...., ._ � Q�'
.
1l� � -
I hereby certify that this is a true and correct plat of a survey
of Lot 1, Block l, Mississippi View, ":nolca County , T�innesota, as
surveyed by me this l�t�i d�t� oP `�entember, 195p�.
�I � � AJ _.� 1