PRE 2010 DOCSYMage of Fridley, Minn.
BUILDING PE113M
N° 210
Office of INSPECTOR OF BUHDINGS
Owner
Architect Fridley, Minn.,
Builder
LOCATION OF BUILDING
No. Street k3' �-� i Part of Lot
Front �, Y_j_ Del
To be used as
Block Addition or Sub -Division
'..ASCRIPTION OF BUILDING
}a � Height Storiesw2-._e
_ Manner of Construction �
E=1", To be completed .� � �` "� 'Estimated Cost
b^ '�n«,•'t;_r�'R"e�,��:4;�^,,.T'9'"��"�,,..E1,�'e`, G�.Ka 4°i �' �'.� '� ��p �...i�°`�" �-p�'Na+='lit, ,<7a�•w '�r, a@;, s'm"y���"E�'
r
Permit is hereby granted to ; x.. `.� to€ ` r✓+ 4
the building -1 j s.w�' a� =�p*,ti deReAm in the above statement. This permit is granted
upon the express condition that the V, rson to whom it is granted, and his agents, employees and workmen, in all
the work done in, around and uponaaid building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
` Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley and, being first duly
sworn, I hereby state and say that the facts stated by me and contained ' the above permit are
true as therein stated.
Subscribed and sworn to before me at Fridley, Minnesota, t g
A.D.
da . 19, ,
y :vs
Ma4t FGASCO 53 -8L -S-915.51
CHy of Fridlay
Appliceffcn for Plumbing and C-� M°11we11.; PCMIt - -
Dept. of B1dgx. Phone 360-3450
DESCRIPTIO14 OF Droit; Lova- 1220 N. E.' Mississippi Street
Nurnbar, Kind and Loce..Ken of Fixtures .b.
y
�
a
N
r
Number Fixtures ................
Z
$
N
Y
Y i
$ -•
• 2 j
yy
�
C
U
r
g
e
�
•
N
wArrA NrR.
GAS
ttfC.
se
$
Electric Watar Heater ..............
a $2.00
3 -
AS FITTING FEES:
NO. RATE TOTAL
Ist 3 Fixtures • • • • .............
x $2.00
i .
Additional Fixtures .. . . . ...... . ...
x S .75
$
Gas Range to 199.000 BTU ...........
1 x ss.00
6 5.00
Intal
aniii
i
Futuro Conaacd.-u CWnir,2%`I ` ••"•'••••, •"• •••••• Saver 0
New Flxtura. Old Openings Cc"Pool 0
PARTIAL RATE SCHEDULE
.UMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ............
x $1.50
$ -•
New Fixture Old Opening.....:....
x $1.50
Catch Basin ....................
x $3.25
$
Water Beater !L'p to 99,000 BTU1. • • •
x $3.00
$
New Ground Run Old Bldg.......:.
x $r ^5
$
Electric Watar Heater ..............
a $2.00
3 -
AS FITTING FEES:
NO. RATE TOTAL
Ist 3 Fixtures • • • • .............
x $2.00
i .
Additional Fixtures .. . . . ...... . ...
x S .75
$
Gas Range to 199.000 BTU ...........
1 x ss.00
6 5.00
City of Fridley:
The undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the C'itj Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct'
Fridley, Minn 7-17-75 19�
Owner Donald Philbrook
Kind of Building Frame
Used as Res.
To be completed about 7-21t-75
Estimated Cost, $ 100,00 -
Old-cL ouzDuilding Permit No. Permit No.
Signed
By MINNEGASGl
Business Phone No
ROUGH
FINAL 4– r- 7
DPAIRS is ALTERATIONS—Rater to Code .50 State Surcharge
Description .................. ........... .........$
TOTAL FEE i�
Class "A"T Surcharge -50¢
C
53-84-s-915.51
IVfiNNEGASCO
,Rpplb:lcn X21 Plug -219 Cld GM abs NMI*'
Dopt. of Bldv. Phone, SW -3W
DESCRIPTIOa 0: v7011r. 1220 N.. E.•Mississippi'Street
NuiTbor, r..i.nd. and LocrS on of Fixtures I'O=tiOn -
o l<
NO. RAT! TOTAL
Number Fixtures ................
Z
f
Future Fixture Opening ...........
x $1.54
8� d.
K< I i
7 z
7
I
N
WATER MTIt.
GAS
RIC.
Bsse
New Ground Run Old Bldg....:....
x $3.25
S
Moctric Plater He,atar...... ........
Z $2.00
$
ZA.S FITTING FEES:
NO. RITE TOTAL
Ist 3 Fixtures ...............
x $2.00
$ .
Additional Fixtures ................
x S .75
$
Gas R=ze to 159.000 BTU ...........
Uot
$
Ins
tal
L s6ac
atF43
2
ku
o
a C-35--
-7
_
%d
• Future, Coa: oc•S^a Opordn s
e Naw Fixture, Old Opoairm.,
PARTIAL RATE SCHEDULE
$ocsar
PLUMBING FIXTURE RATES:
NO. RAT! TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ...........
x $1.54
New Fixture Old Opening ...... — - *
x $1.50
Catch Basin ....................
x $3.25
$
Water Beater 'Up to 99.000 BTU) • • • •
x $3.00
$
New Ground Run Old Bldg....:....
x $3.25
S
Moctric Plater He,atar...... ........
Z $2.00
$
ZA.S FITTING FEES:
NO. RITE TOTAL
Ist 3 Fixtures ...............
x $2.00
$ .
Additional Fixtures ................
x S .75
$
Gas R=ze to 159.000 BTU ...........
x $5.00
$
City of Fridley:
a
The undersigned hereby makes application for a permit for the- work here!
specified, a,^,reeing to do all work in strict accordance with the Cid C:dira :ce
and ruling of the Department of Build.'ngs, and hereby declares that all the fact
and representations stated in this application are true and correct
Fridley, B'.iaa 8–IJ4-75 19_
Owner Donald Philbrook
Kind of Building Frame
Used as Res.
To be completed about 8-21-75
Estimated Cost, $ 10.00
Old—building Permit No. P.rai o.
SigneBy d d�
MINNEGASCO
Business Phune ro
ROUGH
P.SPAIAS*k ALTERATIONS—Refer to Code .50 State Surcharge
Desczipt#osi ..Instas1al. Slips. BfS@T..................5
5-nn--
5.50
.n5—SO .
C
ass -.N.. Surchaf9e 50Q
Pr, %'o / -, . . .
SUBJECT
PERM
City of Fridley
®13084
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.n/�
INSPECTION
r i � PROTECTIVE SEC.
Cs'
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�l "1 CITY HALL FRIDLEY 55432
I.J 612-560-3450
910-F15
7-10-75
JOB ADDRESS
1220 MISSISSIPPI STREET N.E. FRIDLEY MINNESOTA
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
MOORE LAKE HIGHLANDS 1ST ADDITION SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
DON PHILBROOK 1220 MISSISSIPPI ST. N.E., FRIDLEY, MINNESOTA
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
S MP 1850 COMO AVENUE
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW M ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
ROOM ADDITION, 16 X 8 X 8
9 CHANGE OF USE FROM TO
STIPULATIONS
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
ZO GII�
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS CQMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HA E READ AND EXAMINED THIS APPLICATION
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TR E AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNIN THIS TYPE OF WORK WILL BE COMPLIED,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,900.00
$1.45
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL EOR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS NS OF ANY OTHER TA OR LOCAL L REGULATING ON-
STRU ION OR THE P FORM OF CONSTRU N.
$17.40
r �
%/d ��
PLAN CHECK FEE
TOTAL FEE
$18.85
SIGNATURE OF CONTRACTOR4 RAUTHORIZ AG NT (DATE)
HEN PROPERLY VALIDATE THIS IS YOUR PERMIT
JULY 10, 1975
BLDG. 'NSPDATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
Pr, %'o / -, . . .
•APPLICATION FOR RESI'DENTIAL., ALTERATION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
. •
OWNER'S NAME: lawPlt&�o_,BUILDER:
ADDRESS: ADDRESS:
STREET:
LOT: BLOCK: ADDITION:
CORNER LOT: ✓ INSIDE LOT: SETBACK: _SIDE -YARD:
Applicant attach to this form 1%.7o Certificates .-f Survey . of Lot and .proposed
building location prawn on these Certificates.
DESCRIPTION OF BUILDING
;To a Used As:
Front: Depth:• eL Height:_k
Square Feet: v Cubic.Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: a,
To Be Completed: !1 ! CSG
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.
DATE: ;7— /0 r. 7,r 'SIGNATURE:
(See Reverse Side For Additional Information.)* '
cru - 0. d
,14P rj
D��
MEMO TO: Richard N. Sobiech, Public Works Director
MEMO FROM: Steven Olson, Environmental Officer
DATE: July 21, 1977
SUBJECT: Complaint on Number of Cars Located, and People Living
at: 1220 Mississippi Street
An inspection was made today, with no one at home. A card was left
requesting the resident to call the office. The inspection found
two cars and a boat parked in the driveway and one car and a
pick-up truck in the street. The only thing physically wrong with
the residence was that the yard needed mowing and there were a
few extra tires in the yard.
Mr. Steve Klick (tenant) (571-1403) called the office and indicated
the home is owned by a person working for Northeast Realty located
on Silver Lake Road and Mississippi. There are three people living
there full time and one stays there over the weekends and works in
Duluth. Of the four people involved, there are seven vehicles
and they do some of their own maintenance on their vehicles.
Mr. Klick stated that they would try to maintain their yard so
there are not extra auto parts left lying about. Their yard is
mowed by a young person in the neighborhood and he indicated he
would contact him to have the yard mowed in the near future.
SO/jm
N 7j�_ 1p i
-l".
DBS -2722 (9-85)
PZ -02722-02
- I `F� i, _ ,�
SATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
ST. PAUL. MINNESOTA 65101
Date
City of Fridley
Zoning Authority
6431 University AVe. N.E.
Street Address
Fridley, MN 55432
City State Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject: a
me of Day Care Home Applicant
Street Address
City el'
State Zip Code
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity 4_9 42
Phone No.
This is to inform you that we are in receipt of an application for
licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as
the Public Welfare Licensing Act and the rules of the Department of Human
Services.
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi -family residential use of property for
purposes of zoning.
If we do not hear
will consider the
your local zoning
Sincerely,
from you within
above-mentioned
code.
WorkerLicensing
Street Address
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNITY HEALTH & SOCIAL
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
Name of Agency/Organization
City State Zip Code
AN Fn IAI nPPnRTUNITY EMPLOYER
N
5 ATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
_ ST. PAUL. MINNESOTA 55101
Date
City of Fridley
Zoning Authority
6431 University AVe. N.E.
Street Address
Fridley, MN 55432
City State Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject:
Name, of Day Care Home Applicant
o A F
Street Address
City 19tate Zip Code
/',� r&�e ,aw
DRS -2722 (9-85)
PZ -02722-02
/, -,-I, f-ek
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity ,n-„
Phone No. S7 4 - ( o% 11,
This is to inform you that we are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2), Family Day Care and Group Family Day Care
this license is subject to compliance with the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, known as
the Department of Human
You should note that under Minnesota Statutes, Section
3, a licensed day care facility serving 12 or fewer
considered a permitted single family residential use o
purposes of zoning. Subdivision 4 of the same section
licensed day care facility serving from 13 through 16
considered a permitted multi -family residential use
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
Kathy Speggen/pf
Licensing Worker
Street Address
245.812, Subvision
persons shall be
f property for the
indicates that a
persons shall be
of property for
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNITY HEALTH & SOCIAL
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
Name of-Agency/Organization
City State Zip Code
?. STATE OF MINNESOTA
COUNTY OF ANOKA COMPLAINT (OFFICER'S COPS
tai
The undersigned, being duly swom states as follows that on
rs;ONTW
M
at (Locatio
Name of (Addre:
nae►, n.+ -
FOR COURT
USE ONLY,,
DISTRICT COURT
CRIMINAL DIVISION No 612-28-8
Citylrownship of f
(/. VPM
DAY r AM
9 at TIME
j2W ,� i f t Ag --)j
did then and there commit the following offense:
Iq Al+ In violation of Local Ord. No. State Statue No.
In such case made and prow ed. ��/) �/ /�-,'have
I
I promise to contact the Violations B a�'E &e (if I h e aquestions), The undersigned further states that he has just and reasonable grounds to d
or appear at the time and place shown below: and I understand if I fail to do believe, and does believe, that the person named above committed the
_. so a warrant for my arrest may be Issued. offense herein set forth, contrary to law.
i, SIGNATURE
. Violations Bureau address: Anoka County Courthouse
325 East Main Street Anoka MN 55303 i a r of Complainant
} Phone: 422-7 �^
Court Date: ourt Time p.m. edge o. and artent Date
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287
July 25, 1997
Mr. & Mrs. Allan Golubowicz
1220 Mississippi Street NE
Fridley, MN 55432
Re: Deck Construction Without Obtaining a Building Permit
Dear Mr. Golubowicz:
You were notified on July 15, 196 and December 2, 1996 that a building permit
needed to be obtained for the deck that you were constructing at your address. As
of this date, you have failed to obtain a building permit for this work.
If payment is not submitted to the City by August 1, 1997, the building permit fee will
be assessed against your property taxes and an additional $50.00 processing fee will
be added to the total amount.
If you have any questions concerning this matter, you may contact me at 572-3603.
Sincerely,
/'� zl-�' /'✓ / i
ARRY/�IESCH
Building Inspector
BR/mh
ENC: Copy of 12/2/96 letter
106-106.3.1
1994 UNIFORM BUILDING CODE
,ECTAON A4061 PERMITS
._ Except as specified in Section 106.2 of this section, no building or
structure regulate by this code shall be erected, constructed, enlarged, altered, repaired, moved,
improved, removed, converted or demolished unless a separate permit for each building or struc-
ture has first been obtained from the building official.
106.2 Work Exempt from Permit. A building permit shall not be required for the following:
1. One-story detached accessory buildings used as tool and storage sheds, playhouses and simi-
lar uses, provided the projected roof area does not exceed 120 square feet (11.15 m2).
Fences not over 6 feet (1829 mm) high.
3. Oil derricks.
4. Movable cases, counters and partitions not over 5 feet 9 inches (1753 mm) high.
5. Retaining walls which are not over 4 feet (1219 mm) in height measured from the bottom of
the footing to the top of the wall, unless supporting a surcharge or impounding Class 1, 11 or III -A
liquids.
6. Water tanks supported directly upon grade if the capacity does not exceed 5,000 gallons
(18 927 L) and the ratio of height to diameter or width does not exceed 2 to 1.
7. Platforms, walks and driveways not more than 30 inches (762 mm) above grade and not over
any basement or story below.
8. Painting, papering and similar finish work.
9. Temporary motion picture, television and theater stage sets and scenery.
10. Window awnings supported by an exterior wall of Group R, Division 3, and Group M Occu-
pancies when projecting not more than 54 inches (1372 mm).
11. Prefabricated swimming pools accessory to a Group R, Division 3 Occupancy in which the
pool walls are entirely above the adjacent grade and if the capacity does not exceed 5,000 gallons
(18 927 L).
Unless otherwise exempted, separate plumbing, electrical and mechanical permits will be re-
quired for the above -exempted items.
Exemption from the pennit requirements of this code shall not be deemed to grant authorization
for any work to be done in any manner in violation of the provisions of this code or any other laws or
ordinances of this jurisdiction.
106.3 Application for Permit.
106.3.1 Application. To obtain a permit, the applicant shall first file an application therefor in
writing on a form furnished by the code enforcement agency for that purpose. Every such applica-
tion shall:
I. Identify and describe the work to be covered by the permit for which application is made.
2. Describe the land on which the proposed work is to be done by legal description, street address
or similar description that will readily identify and definitely locate the proposed building or work.
3. Indicate the use or occupancy for which the proposed work is intended.
4. Be accompanied by plans, diagrams, computations and specifications and other data as re-
quired in Section 106.3.2.
5. State the valuation of any new building or structure or any addition, remodeling or alteration
to an existing building.
6. Be signed by the applicant, or the applicant's authorized agent.
1-4
1994 UNIFORM BUILDING CODE 106.4.4-107.6
i.A
time required by this section for good and satisfactory reasons. The building official may extend the
time for action by the permittee for a period not exceeding 180 days on written request by the per
mittee showing that circumstances beyond the control of the permittee have prevented action from
being taken. No permit shall be extended more than once.
106.4.5 Suspension or revocation. The building official may, in writing, suspend or revoke a per-
mit issued under the provisions of this code whenever the permit is issued in error or on the basis of
incorrect information supplied, or in violation of any ordinance or regulation or any of the provi-
sions of this code.
SECTION 107 — FEES
107.1 General. Fees shall be assessed in accordance with the provisions of this section or shall be
r
as set forth in the fee schedule adopted by the jurisdiction.
107.2 Permit Fees. The fee for each permit shall he as set forth in Table I -A.
`-a"
The determination of value or valuation under any of the provisions of this code shall be made by
the building official. The value to be used in computing the building pennit and building plan re-
view fees shall be the total value of all construction work for which the permit is issued, as well as all
fir
finish work, painting, roofing, electrical, plumbing, heating, air conditioning, elevators, fire -extin-
guishing systems and any other permanent equipment.
1073 Plan Review Fees. When submittal documents are required by Section 106.3.2, a plan
E
review fee shall be paid at the time of submitting the submittal documents for plan review. Said plan
,h
review fee shall be 65 percent of the building permit fee as shown in Table 1-A.
The plan review fees specified in this subsection are separate fees from the permit fees specified
1 `:
in Section 107.2 and are in addition to the pen -nit fees.
When submittal documents are incomplete or changed so as to require additional plan review or
I
when the project involves deferred submittal items as defined in Section 106.3.4.2, an additional
I,
plan review fee shall be charged at the rate shown in Table 1-A.
107.4 Expiration of Plan Review. Applications for which no permit is issued within 180 days
1 Fw'?
following the date of application shall expire by limitation, and plans and other data submitted for
review may thereafter be returned to the applicant or destroyed by the building official. The build-
ing official may extend the time for action by the applicant for a period not exceeding 180 days on
request by the applicant showing that circumstances beyond the control of the applicant have pre-
; : W.
vented action from being taken. No application shall be extended more than once. In order to renew
action on an application after expiration, the applicant shall resubmit plans and pay a new plan re-
view fee.
107.5.1 Investigation. Whenever any work for which a permit is required by this code has been
commenced without first obtaining said permit, a special investigation shall be made before a per-
mit may be issued for such work.
e "An investigation fee, in addition to the permit fee, shall be collected whether or nota
.
pe' 'ml tl. t rs then or subsequently issued. The investigation tee shall be equal to the amount of the per-
'
mit fee required by this code. The minimum investigation fee shall be the same as the minimum fee
'"•taT�"•''''
set forth in Table I -A. The payment of such investigation fee shall not exempt any person from com-
pliance with all other provisions of this code nor from any penalty prescribed by law.
107.6 Fee Refunds. The building official may authorize refunding of any fee paid hereunder
which was erroneously paid or collected.
The building official may authorize refunding of not more than 80 percent of the permit fee paid
.
when no work has been done under a permit issued in accordance with this code.'.
1-7»,r`
'
16B.66 CERTAIN INSPECTIONS.
The state building official may, upon an application
setting forth a set of plans and specifications that will be
used in more than one municipality to acquire building permits,
review and approve the application for the construction or
erection of any building or structure designed to provide
dwelling space for no more than two families if the set of plans
meets the requirements of the state building code. All costs
incurred by the state building official by virtue of the
examination of the set of plans and specifications must be paid
by the applicant. A building official shall issue a building
permit upon application and presentation to the official of a
set of plans and specifications bearing the approval of the
state building official if the requirements of all other local
ordinances are satisfied.
HIST: 1984 c 544 s 71; 1986 c 444; 1994 c 634 art 2 s 6,10
16B.67 APPEALS.
A person aggrieved by the final decision of any
municipality as to the application of the code, including any
rules adopted under sections 471.465 to 471.469, may, within 180
days of the decision, appeal to the commissioner. Appellant
shall submit a fee of $70, payable to the commissioner, with the
request for appeal. An appeal must be heard as a contested case
under chapter 14. The commissioner shall submit written
findings to the parties. The party not prevailing shall pay the
costs of the contested case hearing, including fees charged by
the office of administrative hearings and the expense of
transcript preparation. Costs under this section do not include
attorney fees. Any person aggrieved by a ruling of the
commissioner may appeal in accordance with chapter 14. For the
purpose of this section "any person aggrieved" includes the
council on disability. No fee or costs shall be required when
the council on disability is the appellant.
HIST: 1984 c 544 s 72; 1986 c 444; 1987 c 354 s 4; 1988 c 613
s 17
16B.68 CERTAIN PERMITS.
Building permits or certificates of occupancy validly
issued before July 1, 1972, regarding buildings or structures
being constructed or altered according to the permits or
certificates, are valid after that date. The construction may
be completed according to the building permit, unless the
building official determines that life or property is in
jeopardy.
HIST: 1984 c 544 s 73
16B.69 VIOLATION, PENALTY.
A violation of the code is a misdemeanor.
HIST: 1984 c 544 s 74
14
I,
ri
GTYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. %IN 55432 • (612) 571-3450 • FAX (612) 571-1287
September 30, 1997
Mr. & Mrs Golubowicz
1220 Mississippi St NE
Fridley, MN 55432
Re: Payment of Building Permit & Special Investigation Fees for
Construction Without Obtaining a Building Permit at 1220
Mississippi Street NE, Fridley, MN -
Dear Mr. & Mrs Golubowicz:
On August 1, 1997 a check was received from you in the amount of
$30.51 in payment for the building permit application for
constructing a deck on your property. The amount of the building
permit at this point is One Hundred Nine Dollars and 70/Cents
($109.70), which includes special investigation fees for working
without a permit which are allowed by Section 107.5 of the 1994
Uniform Building Code. This means you still owe the balance of the
fees which is Seventy Nine Dollars and 19/Cent ($79.19).
If the amount owing is not paid by November 1, 1997, a violation
citation will be issued and you will be required to appear in
court.
Please contact me at 572-3603 if you have any questions on this
matter.
Sincerely,
BARRY RIESCH
Buil
BARRY
Inspector
BR/mh
F1434
SUBJECT
PE
City of Fraley
25 55
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
v
r � PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBERREV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/30/97
JOB ADDRESS 1220 Mississippi Street NE
t LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
Moore Lake Highlands 1St
L SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Allan Golubowicz 1220 Mississippi Street NE
574-9445
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct an 8'6" x 10' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Investigation fee
was due 11/26/97 - was paid
on 12/8/97.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY 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
$759
$.50
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-
$29.25 $29.25IF
Fire -'PC $.76
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/
PLAN CHECK FEE
TOTAL/Ey
Pe .0
$A_9'.76
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
ENP O
ALIDAT IS IS YOUR PERMIT
r
SIGNATURE OF OWNER of OWNER BUILDERI IDATEI
BLD INSP r• GATE
F1434
NEW
ADDN
ALTER
ConstructionAddress:
Legal Description: _
Owner Name kAdd
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Comer Lot(2- e Lot [
Type of Construction:
Approx. Completion Dato<
Effective 3/1/96
CITY OF ftMLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 S�7
Building Permit Application
n Cwt 1
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length
Length _
Length
Width Height
Width ,(39 Height
Width l0 / _ Hgt/Ground
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
]
Ft. Setback Side Yard Setbacks
Estimated Cost: $
Driveway Curb Cut Width Needed: _
DATE: APPLICANT:
(Cost on Back)
+6Ft= Ft $ _$
Tel. #
STIPULATIONS:
!: 2 f - _f CITY USE ONLY
Permit Fee
$`��
Fee Schedule on Reverse Side
Fire Surcharge
$ %
.001 of Permit Valuation (1/10th%)
State Surcharge
$ b
$.50/$1,000 Valuation
SAC Charge
$
$900 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:
EW [ ]
,DDN [ ]
ConstructionAddress:
Legal Description: _
Owner Nair.
Contractor:
Address:
CITY bF r`RIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
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
GARAGE AREA: Length
DECK AREA: Length
OTHER:
Corner Lot(2astde Lot [ ] Ft. Yd Setback
Type of Construction:
Approx. Completion Dat .
Driveway Curb Cut Width Needed: _
DATE: APPLICANT:
Width Height
Width , o Height
Width /Q / , Hgt/Ground
Side Yard Setbacks
Estimated Cost: $
(Cost on Back)
+6Ft= Ft $
Effective 3/1/96
Tel. #
TENSE #
Tel.
#
Sq. Ft.
Sq. Ft.
Sq. Ft.
Tel. #
TOTAL $
STIPULATIONS: �� ��
: %7-'/,,7y
'
CITY USE ONLY
Permit Fee
Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
o
$.50/$1,000 Valuation
SAC Charge
$
$900 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: �� ��
: %7-'/,,7y
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287
December 2, 1996
Mr. & Mrs Golubowicz
1220 Mississippi St NE
Fridley, MN 55432
Re: Construction Without Obtaining a Building Permit at 1220
Mississippi Street NE, Fridley, MN
Dear Mr. & Mrs Golubowicz:
On July 15, 1996, you were informed by the City of Fridley Building
Division that a building permit needed to be obtained for the deck
that you were building at the above noted address. An attempt was
made by Anne to obtain the permit but she did not have sufficient
information on how the deck was constructed. As of this date, you
have failed to apply and obtain a building permit for this work.
We will expect you to correct this violation on or before January
1, 1997 and a special investigation fee will be added equal to the
permit fee. If the permit is not obtained by January 1, 1997, this
matter will be turned over to the City Prosecutor for his legal
consideration.
Please contact me at 572-3603 if you have any questions on this
matter.
Sincerely,
CcGcr C w
B RY RIESCH
Building Inspector
BR/mh
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287
November 24, 1997
Mr. & Mrs Allan Golubowicz
1220 Mississippi St NE
Fridley, MN 55432
Re: Permit Fee Shortage for Deck Construction at 1220 Mississippi
St NE, Fridley
Dear Mr. & Mrs Golubowicz:
Per the meeting on Tuesday, November 18, 1997, attended by Mr.
Golubowicz, it was agreed that an additional $29.25 permit fee
would be paid and in our office by November 26, 1997. Please submit
a check for $29.25 and the building permit will be issued and the
inspections conducted on the deck.
If you have any questions, I can be contacted at 572-3602 or in
writing at 6431 University Ave NE.
Sincerely,
RON JULKOWSKI
Buildinfif Official
RJ/mh
m the
MN' 553
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P _1
SUBJECT
-
City of Fridley
29804
AT THE TOP OF THE TWINS
BUILDING
PERMIT
I..
RE�CE/IP/T�NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
CITY HALL FRIDLEY 55432
REV
DATE
OF
APPROVED BY
612-571-3450
rUMBER
910415
6/30/99
F;GE
/
JOB ADDRESS 1220 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
3
Moore Lake Highlands
1st Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Anne Golubowicz
574-9445
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Suburban Exteriors 9701 Penn Ave S Ste 107
Bloomington
55431 881-8232 4289
a 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 ❑ ALTERATION 49 REPAIR ❑ MOVE ❑ REMOVE
"DESCRIBE WORK
Reroof house and garage (23 S) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 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 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
$2010
$1.01
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-
$83.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire/)SC $2.01
f
PLAN CHECK FEE
TOT FEE
-� �c cr-y __ Ll� .
Lice $5
0 .27
SIGNATURE OF &ONTRA&OA OR AUTHORIZED AGENT IDAT I
EN
MALI A 1115 THIS IS RPE M
L _ �
_
S-GNATURE OF 0WNEROF OWNER BUILDERI
WOb INSP
_ gAiE _
i
P _1
NEW ['I
Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [c, SINGLE FANHLY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name p& Address: �JT�� Z �j ,,.X
Contractor: - J. J ," MN LICENSE #
Address: q j 0 [ 1?yrn cu"� --2. a Tel. # -� a
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 HR/Ground Sq. Ft.
OTHER: -e — . f A,? - /j ( ,4
Construction Type: Estimated Cost: $ a 0. 3
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
ME
DATE: 6 Z - 99 APPLICANT: A 2&M Tel. #- Ffg,% � a
Permit Fee
$
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
�--
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
City of Fridley
SuBjECT
PT NO.
2 9 4 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
I - COMMUNITY DEVELOPMENT DIV.
Iv _____ PROTECTIVE INSPECTION SEC.
r
{ CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
763-571-3450
910-F15
7/29/02
JOB ADDRESS 1220 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DIE
3
Moore Lake Highlands 1st Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Anne Golobowicz 1220 Mississippi Street NE 763-574-9445
CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
763-542-8826 20268257
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION (j REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside House
9 CHANGEOFUSEFROM 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. Caulk and flash all
exterior openings.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$149517
$7.41
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-
$251.25
Fire SC $14.52
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
Licen C $5.
/-78.48
SIGNATURE OF CON"RACTOR OR AUTHORIZED AGE N T ,DATE,
HE PRO Y VALIDAT D THIS IS YOUR PERMIT
swr GATE
SIGNATURE OF Ow NER,IF OWNER BUILDER, IDATEI
l
NEW( ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ l SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: _� a b iYl i �vS 4S; p D i
Legal Description:
Owner Name & Address: Ann- Ga�ybbw�C�- �I ' Tel. # �b•S�• qy�
Contractor:. RMA HOME SERVICES INC. MN INCENSE #
Home Depot Installed Sales
Address: 3200 Cobb Galleria Pkwy., Ste. #200
Atlanta, GA 30339 Tel. #
A 763-542-8826 urvey.ofthe
k BC -20268257
• -- -- r --r---- -_----»-...,-• »•».• Jn.lt to scale.
DESCRUM-1 !1 NOF IN01WVEN ENT
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
&Q1Ckl RP"\J » _Uui-�n '?-,,QSi C- CAna%,rA lj � rn't ,I <�, ;A
Estimated Cost: $ 14 "$ OZ
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: a -slily - 0a APPLICANT: _ o ,c•,� Tel. #552 • 31S • i •
v
Permit Fee
$ o1S1.21S
Fire Surcharge
$ �{ •� �.
State Surcharge
$ 141
SAC Charge
$
License Surcharge
$ C)
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
�/Z�lati
SUBJECT
X.94NO.
City of Fridley
3294
AT THE TOP OF THE TWINS
BUILDING PERMIT(
�EIPT
�4
NO.
COMMUNITY DEVELOPMENT DIV.��!
16fr ______
r I PROTECTIVE INSPECTION SEC.
"�
,
I ,
NUMBER
REv
DATE
PAGE OF
APPROVED By
i 1 CITY HALL FRIDLEY 55432
"''
763-571-3450
910-F15
7/29/02
JOB ADDRESS 1220 MISSISSIPPI ST NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
Moore Lake Highlands 1st Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Anne Golubowicz 1220 Mississippi St NE 763-574-9445
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
763-542-8826 20268257
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION [I REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace 8 windows with existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
AMR Inspection Cards
Mlill Be (Nailed
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
'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
$2.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,990
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 $4.99
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$111.25
PLAN CHECK FEE
TOTALFEE
Lice a SC $5 00
- $123.74
SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IDATEI
WH N P RLY VALID TED THIS1 YOUR PERMIT
_
�� -',002-
01OG 'NSP BATE
SIGNATURE OF OVyNER,IF OWNER BUILDER1 IDATEI
NEW [ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name &Address:'Ar1h-Q. Tel. #_%p'2-1 • • 9yyS
Contractor:, RMA HOME SERVICES INC. MN LICENSE #
Home Depot Installed Sales
Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. #
Atlanta, GA 30339
A 763-542-8826 urvey.-of the
1cBC-2026825 r__r____ in -it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRI ON OF �R!OVEMENT '
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Estimated Cost: $ Li, 'I90=
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $.
DATE: aS- l4 Oa APPLICANT: Tel. # 9Sa• Sys' �y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ M."A5 Fee Schedule on Reverse Side
$ 9.99 .001 of Permit Valuation (1/10th%)
$ Q -5b $.50/$1,000 Valuation
$ $1050 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 [ ]
$ ►a3��4