PRE 2010 DOCSCity of Fridley, Minn.
BUR DING PERMIT N® 3686
Date:.... . . � � ... ...................
Owner....................................... Builder %t" .... ........................
Address ...................................... Address .............. .............................
LOCATION OF BUILDING
i ..,•�
No. ........ Sheet ... .................... Part of Lot .....................
Lot ...0..... Block ... .......... Addition or Sub -Division ��ia0..�'` .!.� �v.� . ... .....
f Y
Corner Lot ............ Inside Lot .. �i........ Setback .:-� •. Sideyard . �� . � ../............... .
DESCRIPTION OF BUILDING
To be Used as:
0 _ r
- G / �g
.i.� R ..... Front :� .. Depth °�d.(�.®� Height f7'�. Sq. Ft. ff K -r cu. Ft.
.................... Front ........ Depth Height .... Sq. Ft......... Cm Ft. ........
Type of Construction ................... Nat Y'�.1�be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. r
a �
In consideration of the payment of a fee of $.c.! : -, permit is hereby granted to ...................
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, pldWbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
Date:
Addres
City of Fridley, Minn.
BUILDING PERMIT
N° L529?,,)
Builder
Address__
L TION f0j BUILDING
No. e Street _ __ ,� _Part of Lot
Lot _ _ ___ Block _________ Addition or Sub
-Divisin�--�_ _77 _ _41
Corner Lot Inside Lot Setback -- _ Sideyard __-:..-••
Sewer Elevation Foundation Elevation
0
DESCRIPTION OF BUILDING
To
Front Depth Height m4O, Sq. Ft. Cu. Ft Anal
-Frontes-- Depth bt _ _ Sq. Ft. Cu. Ft.
Type of Constructions V„ z, -."-i- Est Cost _ _ ; To be Completed
In consideration of the issuance to me of 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 of
ordinances of the city of Fridley.
Zo UP
In consideration of the payment of a fee of $- permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violationofiany of the provisions of said
ordinances. . -"% A 'e)>r `
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
01
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, IOTA
io 5® Builder D � O S O N
Owner's Nan. r
Address 6M ' A -VIS a r4 Address 5A. -t" g
r� LOCATION OF BUILDING
No. Street -""/S" WC, C Part of Lot
Lot
Block
Addition
or Subdivision
Corner Lot
Inside Lot
Setback
Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
M
Sq. Ft. —� Cu. Ft. A? 0
Front � f ' Height
Sq. Ft. Cu. Ft.
Type of Construction Re
To be Completed
ted Cost
The undersigned hereby makes application for a permit for the work herein specifiedv
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that the facts and representations
stated in this appl f
cation are true and correct.
(A Schedule of Fee Costs can be found on the Reverse Side.)
.f? 9 �7 7®
City of Fridley, NUmn. N° 7764
BUILDING PERMIT
Date: dune 7, 1965
owner: Ron Joon Builder Richard 31er HoT# m
Address 6760 Madison Street N. E. Addrew 8256 monroe
LOCATION OF BUILDING
No. 6760 Street Nadison Street N. E. Part of Lot
Lot 3 _ Block 5 Addition or Sub -Division Rice Creek Terrace Plat 6
Corner Lot — Inside Lot $ Setback — Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft
Type of Construction Est Cost 62430Q"-- To be Completed
Storni damage repair
Cu. Ft
Cu. Ft
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description abo set and in compliance with all�r ons of
ordinances of the city of Fridley. / ��,_� n _—(
In consideration of the payment of a fee of S 10e00 `, permit is hereby granted to Richard Miller Homes
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings
within the city ]imits�is permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen Jensen
Building Inspector
NOTICE:
M pwmk dos eel eovw the canafrocHmi, butalkilen for vtkW , plumbing, gas hosting, sayer or VMW. Be sure to as
the BaibBeg bnpeetor for sepuaM peewits for time Bens.
OWNER'S
CITY OF FRIDLEY, MXRNESOTA
ADDRESS ,- 7 G c) ADDRESS—'
LOCATION OF BUILDING
No. Street (jam 'Part of Lot.__
LOTS BLOCK� ADDITION OR SUBDIVISION
Corner Lot Inside LOT—y Setback Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot'and proposed
building location drawn on"'these Certificates.
DgS,CRIMON OF BUILDING
To be used' as t
• Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height'
Sq. Ft. •, Cu, Ft.
Type of Conatruction_ '�� Estimated Cost
To be completed- ,
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 Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
f SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
0
SUBJECT
PE.EMI-FRO...,.--'„__.
City of Fridley
% 14'-
AT THE TOP OF THE TWINS
BUILDING
PERMIT/'
RECEIPT NO. .
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
,
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY '
612-560-3450/
910-F15
6/7/78
JOB ADDRESS 6760 Madison Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
Rice Creek Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gerald D. Bethel 6760 Madison Street N.E.
571-0248
3, CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW jI ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Igo Construct a 271 x 161 Addition
9 CHANGE OF USE FROM TO
STIPULATIONS Insulate crawl space walls with R-5 or insulate ceiling to R-30 + to
compensate. Variance granted 5/23/78.
WIU NN(;
SEPSATE PERMITS REQUIRED FOR WIRING,
elfole ggft' all 10caf utilities
HEATING, PLUMBING AND SIGNS.
'.`PHONE - RECTRIC , CAS Etc.
REQUIREI) By LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST,
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood ]Tame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
432
6048
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
]-
ISTALLS 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.
$11,025
$5.51
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
CONSTRUCTION.
$24.19
STRUCTION OR THE PERFORMANCE OF
g
PLAN CHECK FEE
TOTAL FEE
1/0
1W.-45
$35.75
SIGNATURE OF CO ACTOR OR AUTHORIZED AGENT (DATE)
PROPERLY
`x BLDG INSP
VALIDATED THIS IS YO \/R ERMIT
i / 2f
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PEM41TS
(NEW, ALTE=RATIONS, ADDITIONS, OR REPAIRS)
01111ER: BUILDER: L /-
Address: Address: /��
Tel. No. %Z 0— Y -
No. (� C� Street:
s�C
LOT: � BLOCK: ADDITION: %��.���
CORI4ER LOT: INSIDE TAT: SETBACK.: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
J';V Front: Depth: I& Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:/'�� Estimated Cost: $ �?
To Be Completed: Alt. A At. 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
Fridley Ordinances and rulings of the Department of 33uildings, and hereby
declares that all the facts and representations stated in .this application
are true and correct. See reverse side for additional information.
DATE: SIGNATURE:
3 �3/�� .
Stipulations. 02 �o
& !�
L® �. 7.
' 3 ;r
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet•x $14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot -wide approach with
6 inch depth; Driveway width plus 6 feet x $17.20
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 der each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a buildingpermit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
Page 1 of 4
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER: DATE �oA) �7
SITE ADDRESS: �j s��[� PHONE: n 7/
CONTRACTOR:
Determine work i square footage of each
1. Total exposed wall area...... S i�' ® sq. ft. x I -r- _
2. Toal roof/ceiling area ...... sq. ft. x �ev 4z,
Total exposed wall area above floor =
a. Total wall window area ................................. -7-;0
b. Total door area ....................................
c. Total sliding glass door area .........................
d. Total fireplace wall area ........ ................... 0
e. Total - wall framing area (average 10%) ..................
f. Total rim joist area .................................. _
g. wall area above floor .......................... eG
h. wall area above floor .......................... '
i. wall area above floor ..........................
j. wall area above floor ..........................
Total exposed foundation area =
k. Total foundation window area....
1. Total net foundation area above grade .................
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section)
a. X "U"
b.
X
"U"
c
X
fluff
d.
X
fluff
e.
7�o X
fluff
f.
X
"U"
_
g.
� X
fluff
h
X
"U"
lee) =
i.
X
"U"
_
�. X "U"
-3 Ay- z -
k. X "U" _
1. X "U" _
3 . ............................. Total
If item #3 is the same.as,
or less than item #1, you
have met the intent of
SBC 6006 (c) 2.
Exterior Envelope Average "U" Computation
Total exposed roof/ceiling area =
r
Page 2 of 4
m. Total skylight area ............................
n. Total roof/ceiling framing area (average 10%)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
M. X "U" _
n. X "U" _
o. X "U" _
4 ........................... Total =
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 (c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. + 2. _
3. + 4. _
WALL SECTIONS
NOTV:• Use 10% of opaque wall area for
frame construction
FIG. #1 TOPVIEW OF
FRWIE VALL
♦` ', "\ IJ
FSG. #3
Page 3 of 4
Total
V
�c( t, .• . �` . � /fir^ � �' (.
FIG. #4 /
6 �/(
!!( p
• /I ( � it r - !�r
NOTt:.: Indicate type, "R" value, depth and
placement of insulation.
Construction
R -Value
J
1.
Interior
air
film
0.68
2,
J
3.
4•
5.
6.
Exterior air
film
, 0.17
Total
1.
Interior
air
film
0.68
'
2.
3.
4.
5.
6.
Exterior
air
film
0.17
®
Total
1,
Interior
air
film
0.68
{3
2.
�
3.
_.
4.
=
5.
6.
Exterior
air
film
0.17
Total
-03.
1.
Interior
air
film
0.68
v
2.
3.
4.
5.
6.
Exterior
air
film
0.17
Total
V
�c( t, .• . �` . � /fir^ � �' (.
FIG. #4 /
6 �/(
!!( p
• /I ( � it r - !�r
NOTt:.: Indicate type, "R" value, depth and
placement of insulation.
VEITT
Vented
Page 4 of 4
ROOF/CEILING
tiI �`1 .
Heat flow
up
FIG. #5
1. Interior air film 0.61
2.
3.
4. Exterior air.film (still) 0.61 .
Total
}:eat floe up ;vented
_.FIG. #6' - 1. Inside air film 0.61
-- 3 - --- 7 4 5 - 2.
4.
5. Outside air film 0.17
�y�,.'a ��;�- ' � � • �_��,Total
Note: Use additional sheets if more space is
needed fordetails and calculations
• ' Heat '.
f low up .
mr,. *7
Construction -R-Value
1. Interior air film 0.61
2.
3'
4. Exterior air film (still) 0.61
1� - �-,- -•�
Total
tiI �`1 .
Heat flow
up
FIG. #5
1. Interior air film 0.61
2.
3.
4. Exterior air.film (still) 0.61 .
Total
}:eat floe up ;vented
_.FIG. #6' - 1. Inside air film 0.61
-- 3 - --- 7 4 5 - 2.
4.
5. Outside air film 0.17
�y�,.'a ��;�- ' � � • �_��,Total
Note: Use additional sheets if more space is
needed fordetails and calculations
• ' Heat '.
f low up .
mr,. *7
a
SUBJECT
ERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
Ir I
`y COMMUNITY DEVELOPMENT DIV.
1 PROTECTIVE INSPECTION SEC.
(� a
J(
r
v
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/14/95
JOB ADDRESS 6760 Madison Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
5
Rice
I
Creek Terrace Plat 6 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jerry Bethel 6760 Madison Street
NE 571-0248
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 27' x 14' Deck in Rear Yard
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARNING
Itefore digging call for
all utility locations
454-0002
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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 CERTIFY THAT 1 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
$3,080
$1.54
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC $3.08
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$63.00
PLAN CHECK FEE
TOTAL FEE
$67.62
IGNATURE OF CONT OR OR A RIZ AGENT IDATEI
E PROPE LY PALIOAT THIS IS YOUR PER IT
W � 0
o
ByDG MTTATE
SIGNATU OFDWNERoF OWNER BUILDERI IDATEI
a
NEW
CITY -OF FRIDL E
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: e % _
Legal Description: 0 / I CSC , IC 46
Effective 1/ 1/95
A _/ '!!�'
0
-Owner Name & Address: Tel. #T-77
Contractor:'- L F .'MN LICENSE #
Address: Tela #
Attach to this application, a Certificate of. Survey . of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECD AREA: Length Width Hgt/Ground U/la Sq. Ft.�8
OTHER:
Corner Lot [) Inside Lot [vr' Ft. Yd Setback
Type of Construction: .
Approx. Completion Date:
Side Yard _Setbacks
Estimated Cost: $ 900(C-70
s7hfx 9 51, = 3 ®0, 70
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: /� J un � �� APPLICANT:
,1 �i� �� Y. � � � � Tel. # 5 71--V I 1/
CITY USE ONLY
Permit Fee
C/0
$ �. _
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/ 10th % )
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$850 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
/
TOTAL
$
STIPULATIONS:
SUBJECT
Pa88
City of Fridley
THE TOP OF THE TWINS
BUILDING PERMITR
rAT
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
3/30/98
JOB ADDRESS 6760 Madison Street NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
5
Rice Creek Terrace Plat 6
I
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Jerry Bethel 6760 Madison Street NE
571-0248
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION [JR REPAIR
O MOVE ❑ REMOVE
B DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and have inspection of same.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 50 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2,100
$1'05
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI OF ANY OTHER STAT OR LOCAL LAW REGULATING CON-
$74.75
Fire SC $2.10
STRUCTffi OR THE PERFO MA OF CO RU TION.
PLAN CHECK FEE
TOTAL EE
License $5.,00/$82.90
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN eROPUX ALIDATED HIS IS YOUR
4iE A
A FLIW-INSP
/PERMIT
�''}
63
DATE
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
r
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -2O
S
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: Tel. #
Contractor: ) G,O.e -5Z-, -MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF RUPROVEMENT
Tel. #
LIVING AREA:
Length
Width Height Sq. Ft.
GARAGE AREA:
Length
Width Height Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:
r
Estimated Cost: $���
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATED- APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
$ % V 75'
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ,®
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$ A Coll/o
. STIPULATIONS:
SuBjECT
PER MI . XO�
City of Fridley
3 3 2 3 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
NO.
COMMUNITY DEVELOPMENT DIV.
j� 1 � ______
PROTECTIVE INSPECTION SEC.
II(
�
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
763-571-3450
910-F15
11/4/02
JOB ADDRESS 6760 Madison Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
1 Rice Creek Terrace Plat
6 SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Jerry Bethel 6760 Madison Street NE
763-571-0248
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK o
❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 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 CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 ISTALLS
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
$3,242
@
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1.62
DOESN PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROV 10 S OF ANY OT ER STATE R LOCAL LAW REGULATING CON-
ST, CTI PE
$97.25
Fire SC $3.24
N OR THE ORM NC F ONSTRUCTION
PLAN CHECK FEE
FEE
7
�� �
)7TAL
$102.11
S'GN4 RE OF COWAACTOR OR AUTHORIZED AGENT iDATE,
H N P
LY VALID TED THIS IS YOUR PERMIT
_
s--o�
SIGNATURE OF OWNERJF OWNER BILLOERi DATE�
OG SNS
nArE
NEW () CITY OF FRIDLEY Effective 1/1/2002
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: Ji f2 y %ff�Z Tel. #
Contractor.ffPlIx � � -,� r MN LICENSE #
Address: - &-)�1 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
/c
OTHER: e l0ege, Al /o P- -L e�l/R &8 -
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #
Call (763) 672.3604 for Permit Fees if mailing In application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 2., "L/
$ /.
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. 'B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ /021// STIPULATIONS: