PRE 2010 DOCSCity of Fridley
SUBJECT
P
AT THE TOP OF THE TWINS
.13955
PERM
r
BUILDING
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
3/23/77
JOB ADDRESS
6190 Starlite Boulevard
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRES
ZIP PHONE
L 1e Gene Flet and 533 -10th Avenue NW New Brighton,
MN 633-2737
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
House & Garage
7 CLASS OF WORK
IX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
NMg ;Construct a 24' x 40' Dwelling and a 20' x 24' Garage
SE'MA'M PERMITS REQUIRED Fit WIRING„
9 CHANGE OF USE FROM j*ATINCa PLUMBING AND SIM
STIPULATIONS DIV. REQUIRED FOR CURB
1. Hard Surface Driveway REMOVAL AND IMP LACEMENT
AT DRIVEWAY OPENINGS.,
2. Sod in front and side yards.
3. Driveway (16 + 6) x 11.75 = $258.50
SEWER LOCATION: (Approx..8' Deep in Street) 62' South of Manhole (Inv. 837.00)
WYE ELEV- 837.87
TOP OF FOOTING: 840.87 Minimum
WARNINS
WATER LOCATION: 13' South of SM Sewer Service.
IKE CITY OF FMDLEY DOES NOT GUARANM. THE
Before digging Call local utilities
ACCURACY OF UTILITY LOCATIONS AND ELEVAT110w.,.'
TELEPHONE - ELECTRIC - GAS Etc.
i' -4S DATA IS FOR iN'FORMATtON PURPOSES ONLY ANI.+
PMONS . USING IT SHOULD VERIFY THE NFORMAii M
yr 4 !E I R ED BY LAW
SEPARATR I EOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Frame
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
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARK NG
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
$31,070.00
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
_
/{
PLAN CHECK FEE
TOTALFEE
774.54
54
RACTOR OR AUTHORIZED AGENT (DATE)
PROPERLY VA.1 THIS IS YOUR PfRMIT
81GNATUREOFCON
BLDG. iNSP
DATE
S TURE OF OWNER(IF OWNER BUILDERI (DATE)
To Be Used As:
r r
�LiDSZ Front: Depth: ( 0 Height:
Square Feet: Cubic Feet: ® A goo
Front: �� Depth: �� ' Height: 10
Square Feet: -5-36 Cubic Feet: ,'�q- a40
Type of Construction: Estimated Cost: $
-To Be Completed:
/Alt. A A t. B
Proposed Driveway Width If New Opening Is Desired I1p! $ $
OL(SEE REVERSES SIDE EOOF 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 Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: �IO SIGNATURE:
Stipulate
6;0 zrgl
le
e I
dAWC
16 +,rd.. 7,5r
a
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING
PERMITS
�5
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER:
BUILDER:
Address:
-[G�je.�•w Address:✓✓
Tel. No.
'P
1? 0 Street: xal 8 6Zc�
T:
BLOCK: ADDITION:
CORNER LOT: INSIDE IAT: X SETBACK:
SIDEYARDS:
tO
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:
r r
�LiDSZ Front: Depth: ( 0 Height:
Square Feet: Cubic Feet: ® A goo
Front: �� Depth: �� ' Height: 10
Square Feet: -5-36 Cubic Feet: ,'�q- a40
Type of Construction: Estimated Cost: $
-To Be Completed:
/Alt. A A t. B
Proposed Driveway Width If New Opening Is Desired I1p! $ $
OL(SEE REVERSES SIDE EOOF 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 Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: �IO SIGNATURE:
Stipulate
6;0 zrgl
le
e I
dAWC
16 +,rd.. 7,5r
a
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 $11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach withO
6 inch depth; Driveway width plus 6 feet x $15.
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 per 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.
VERIFICATION OF FOUNDATION
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.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued. I
i�
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
M
NO.
RATE
>,
m
.9
o
x
'
m
Future Fixture Opening
Water
Q
$
New Fixture, Old Opening
x
m
$
E4
A 0
m
Q
m(d
N
p¢',
w
100,000 BTU to 199,000 BTU
x
Heater
+1
N
rtig�,
$7.00
q
m
x
4
$
34
.0 A
R N
Q
GAS FITTING FEES:
W
1st 3 fixtures
x
'$3.00
$ v�
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
49 vi
b y
a
$
r`i�
State Surcharge
3
iySi
Q w
$
U iaa
9
O'd
V
a
�
as
lec
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00.
$ G G)
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
'$3.00
$ v�
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ /.
REINSPECTION FEE
($10.00)
C
Job Address tic' (l �J CL� A
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this lication are true and correct
�jFridley, Mn. , 19-9/)_
OWNER � i � -
KIND OF BUILDING �U
USED AS
TO BE COMPLETED
r. /
ESTIMATED COST _� V C)
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By j�•L �-� :: A1" yy ,' ^ J
Tel. No. { /V , U-
ROUGH INSP.
Date
FINAL INSP. - / - °7e
j Date
APPROVAL FOR PERMIT /
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF
1
FRIDLEY
APPLICATION FOR POWER PLANTS
AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEME
I
60o 3 1-p a t A L rl �e L
GRAVITY WARM AIR:
RATE
TOTAL
Job Address -
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department o£ Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
$12.00
specified agreeing to do all work in strict accordance with the City Codes
Furnace Shell & Duct Work to 100,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby -declares that all the
each add. 50,000 BTU
7.00
$
facts and representations stated in this application are true and correct.
Replacement of Furnace
Repairs & Alterations -up to $500.00
7.00
4.00
$
$
A)
Fridley, Minn. ► 9
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM:
OWNER
_ d
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING u L,
each addn. 50,000 BTU
4.00
$
_
Boiler only up to 100,000 BTU
7.00
$
USED AS
�;,
each addn. 50,000 BTU6.00
$
TO BE COMPLETED ABOUT A"o ce e2�,��'
OIL BURNER- to 3 gal. per hour
$10.00
$
C uc:)
each add. 3 gal. per hour
10.00
$.
ESTIMATED COST
/)
PERMIT NO. PERMIT NO.
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ 73.60
OLD - NEW BUILDING
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
v.
1st 3 Fixtures x
$ 3.00
$ .V
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00•
$
HEATING or POWER PLANTS, Steam, Hot Water,arm Air No.
AIR CONDITIONING
$
Trade Name Size No.
FAN HEATING SYSTEMS
T See Fee Schedule
VENTILATING SYSTEMS
$
$
n
I>3C,,tn r aB � , D �/ l
Capacr r - CC)C) Sq. Ft. EDR BTU �� HP
ALTERATIONS $ REPAIRS
State Surcharge
$
$ .50
Total Connected Load Kind of Fuel
TOTAL FEE
$e� S��
BURNER -Trade Name Size No. •
ROUGH INSP. REINSPECTION FEE
Capacity BTU HP
Date (.$10.00)
FINAL INSP. '/-A/ -
Company
J
Date
Signed By
C.
APPROVAL FOR PERMIT
Tel. No.
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
Permit Fee $
APPLICATION FOR MECHANICAL WARM AIR HEATING -
AIR CONDITIONING 'u VENTILATION — PERMIT
No. P
Job Site �,�r
Owner Address lam , �. fi nW_' Vb
Address _ -33 --tz6.)- /V °C 4 Minneopolis, Minn. 197
Director of Inspections:
The undersigned hereby makes application for a permit for the installation, alteration, or repair of a heating,
air conditioning or ventilating system, as, herein specified, agreeing to. -do a11, such work in strict accordance with
the City Ordinances and ruling of the Department of Inspections and the specifications set forth in this applica-
tion as approved and filed in the Department of Inspections, and hereby declares that all the facts and represen-
tations stated in this application are true and correct.
Kind of Building I How occupied
Work to be started , 197 Work to be completed 197
Estimated Cost
DESCRIPTION OF WORK
Installed ❑ Altered ❑ Repaired ❑ Replaced ❑
Mechanical Warm Air Heating System:
Make Input B.T.U.
Heat Loss B.T.U. 3 31 4W • Output B.T.U,
Air Conditioning System:
Make Heat Gain B.T.U. Capacity B.T.U: C.F.M.
Ventilating System:
Make Cfm
Explanation of work to be done:
Approved by:
.Plans with permit (yes) (no) File Draw. Plan No.
Approved 197 Signed
ALicensve)
By
Inspector
Address
Telephone
Inspectors notes:
D-20 AWOU
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTIONS MINNEAPOLIS, MINK&
Weatherstrips A.S.H.V.E, Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes—No I Yes—No 19_.___
F1.1 Room I Length Width Height II FU Room I Length Width: Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. ofLineal ft. Area
No. of pane of pane lights of crack sq. ft.
ICoef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. I
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FU Room I Length Width Heitzht
Windows and Doors—Crackage and Area
Width Height No. of Lineal rt. Area
No. or pane or pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required i
Inepectore notes:
ft. E.D.R. or sq. iris. W.A. Leader area
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION
Weatherstrips A.SJi.V.E. Construction No. Insulation
Guide
Wincbws Doors Reference Out. WallInt. Wall Ceiling Roof Floor Kind How Applied
Ye o I No 19_ ��, �i a� .
FI Room I Length q Width ` % Height II Fl.i Room I Lenath Z > Width _�z Heiaht A
1 otal btu. r
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
/ F1.1 , -7- - Room I Length / / Width /,-D Heiaht A
°Windows and Doors--Crackage and Area
/
WidthHeight No. of Lineal ft. Area
No. of pane of pane lights of crack sq; ft.
Windows and Doors—Crackage and Area
l
No.
Width lig Height of Lineal ft. Area
of e of Dane lights of crack "q. ft.
___1Coef-j
Cod, Btu
Infiltration
POVAL 3 49
e
•a
290
Glass
Exp.. wall
Z.
1 /
IC*ef-.f Btu
Infiltration
f 7 -
Int. wall
YK9
O /9 Z_
Glass
®� O.
Int. -wall
5Zo
0 Z, 6.
Exp, wall
Ceiling
Net exp, wall
® 7
Int. wall
Ceiling
s
Floor
1 otal btu. r
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
/ F1.1 , -7- - Room I Length / / Width /,-D Heiaht A
°Windows and Doors--Crackage and Area
/
WidthHeight No. of Lineal ft. Area
No. of pane of pane lights of crack sq; ft.
I
___1Coef-j
Cod, Btu
Infiltration
/< Y,
e
Glass
290
Glass
Exp.. wall
Z.
1 /
Net exp: wall
A/ 6
f 7 -
Int. wall
_ Net exp. wall
/
Ceiling
®� O.
Int. -wall
floor
1 otal titu. Z I
Required sq. ft. E.D.R. or sq. ins. WA. Leaader-area
R....... It __�L v / ar- 7, ;77 1
Windows and Doors—Crackage and Area
,
Width Height No. of Lineal ft. Area
No. of pane of/Dane Isghto of crack ,ft.
m
___1Coef-j
Btu
Coe£ Btu
Infiltration
D I "?
Glass
290
Glass
Exp. wall
Z.
1 /
Exp. wall
A/ 6
f 7 -
ant. wall
nNet exp. wau /
Int, wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A, leader area
Windows and Doors—Crackage and Area
J_
F
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of Brack sQ. ft.
0 VA I P? ;_,b
___1Coef-j
Btu
Infiltration
o 141
D I "?
Glass
1)
z o
Exp. wall
Z.
//: e
Net exp. wall
A/ 6
177Y--6
ant. wall
_ Net exp. wall
/
Ceiling
/// 41
Int. -wall
Floor
total btu. .? yeb, ,
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
/ FI.I h Room I Length / .7 Width /_? Heialtt 112
Windows and Doors-Crackage and Area
J_
F
Width Height- No. of Lineal It. Area
No. of pane of pane lights of crack sq. ft.
0 VA I P? ;_,b
Coef.
Btu
h0tration
®
1)
Glass
//: e
Exp. wall
_ Net exp. wall
/
/// 41
Int. -wall
Ceiling
Floor
7 otal Btu.
Required .sq. ft. E.D.R. or sq. ins. WA. Leader area
F1. Room I Length /,-2 Width 16
Windows and Doors--Crackage and Area
Width Height Na of Llneal ft. Area
No otpane o! pane 11!:1.4" o! crack �. !t.
Glom
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins.. W.A..
area
Height 8;
Btu
z�
j
u>sd '
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION
Weatherstrips � Construction No.
uide
Windows Doors Reference Out. WaU Int. Wall Cedifug Roof i Floor
No
I -Cf—No 19_
Fl.l -)-Poom I Length 10 Width 3 Height ,
Windows andboors—Crackage and Area
,
�3-
3
No.
Width Height No. of Lineal ft. Area
of pane of Dane lights of crack pg. ft.
�
Co4j Btu
Infiltration
Btu
Glass
Exp.. wan
) ®�
Coef.
Btu
Infiltration
s
o
Glass
Net exp, wall
Exp. wall
Net a -p, wall
Z8-1' j,
Int. wall
Int. wan
Ceiling
Ceiling
Floor
150,
Floor
2, 660
�.
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Height.
'Windows and Doors---Crackage and Area
,
�3-
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
S 3 Cf
Co4j Btu
Infiltration
Btu
Glass
Exp.. wan
) ®�
Net exp: wall
Int. wall
Ceiling
Floor
1 otal 13tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader -area
Fl.l Room I L.enath Width VW&ht
Windows and Doors—Crackage and Area
,
�3-
Width Height No. of Lineal Lt. Ares
No. of pane of pane !1 hts of crack sq, ft.
S 3 Cf
Coef. Btu
Infiltration
Btu
Glass
Exp. wall
) ®�
Fret exp. wan
Int. wall
Floor
Total
Required q. ft. E.D.R. or sq. ins. W.A. leader area
MINNEAPOLIS. MILAN.
Insulation
Kind How Applied
Room I Length y Widths V Heiaht
Windows and Doors—Crackage and Area
,
�3-
Width Height No. of Llneai ft. Area
No. of pane of pane lights of crack eq. ft.
S 3 Cf
Coef.1 Btu
Coef.
Btu
Infiltration
Lv
) ®�
Glass
Int. -wall
Exp. wall
Floor
Net exp, wall
q 7
Z8-1' j,
Int. wall
Ceiling
Floor
2, 660
Total Btu. flqll (0,
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FU Room I Length Width Heinlit
Windows and Doors--Crackage and Area
Width Height • No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. -wall
Ceiling
Floor
-1-otal Utu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. Room I Lennth Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal tt. Area
No. of pane of pane lights of crack sq. tt.
Coef-I Btu
blltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor . E-1
1 otal tstu.
Required sq. ft. E.D.R. or sq. ins.. WA. Leader area
)ril 24, 1978
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
TELEPHONE ( 612')571-3450
Lyle Flatgard
6190 Starlite Boulevard N.E.
Fridley, MN 55432
Re: Final inspection at 6190 Starli to Boulevard N.E.
Dear Mr. Flatgard:
A final inspection was made on April 21, 1978 of the above address and
the following items were noted which must be completed before the
structure can be finaled out;
1. Provide house numbers on structure by April 28, 1978.
2. Provide scuttle hole door by April 28, 1978.
3. Provide sod in the side yards by October 15, 1978.
We will expect the above items to be completed by the scheduled dates
when reinspections will be conducted to determine compliance. If you
have any questions on these items, please contact me at 571-3450.
sin ely
RON HOLDEN
Building Inspector
RH/mh
10
SUBJECT
MIT NO.
City of Fridley
29530
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
r
�
RECEI O.
v -_____ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
f : PROTECTIVE
I
=
I "'1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE24
PAGE Oi
APPROVED BY
612-571-3450
910415
5 99
JOB ADDRESS
6190 Starlite Blyd NF
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
3
Sylvan IMIS Plat 2
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
David & Connie Rivard
586-0588
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
MCR Roofing 829 20th Ave NE M is MN 55418
788-5749 5023
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
❑ NEW ❑ ADDITION O ALTERATION XX REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage 26 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 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
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
d
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2228
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER TATE OR LOCAL W REGULATING CON•
S U TION OR THE PERFORM E OF NSTR C ION
$83.25
Fire SC $2.23
!
PLAN CHECK FEE
TOTAL FEE
R License SC
$5.AO
$91.59
SIGN TU EORORAUT O EDA ENT DATEi
HEN PROPERLY A IDAT D THIS IS YOUR PERMIT
BLDG I. SP
o
r)Ayk
S.GNATURE OF OWNER,IF OWNER BUI I tDATE,
NEW [ -]
$ ec-2,3
Effective 5/10/99
ADDN [ ]
SAC Charge
CITY OF FRIDLEY%
ALTER [ ]
SINGLE FAMILY AND DUPLEXES R-1 AND R-2�
Driveway Escrow
$ ^. (0 d
BUILDING PERMIT APPLICATION
Construction Address:
Park Fee
$
Legal Description:
Owner Name & Address:
e
V;asr-C4Tel. # ®Sy
Contractor:
MN LICENSE #
Address: 2 Z -c)
Z -of 4 IiSJ
//
�- 0)--'� Tel. # �W%—
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.
OTHER:
K�
Construction Type:
(I
Estimated Cost: $ _
Driveway Curb Cut
Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: 512-" ` —I f
Permit Fee
Fire Surcharge
$ ec-2,3
State Surcharge
$ Z/
SAC Charge
$
License Surcharge
$
Driveway Escrow
$ ^. (0 d
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ �S
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
Tel. # %e Ob_ ok'l
.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 [ ]
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to -wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the 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 it has been constructed will
be required before proceeding with the framing.
Building
BUILDING
Permit No.: XD
Inspections
RESIDENTIAL APPLICATION
Received By:
Date Rev'd:(
763-572-3604CITY
OF FRIDLEY
DATEYOUR
E-MAIL ADDRESS
SITE ADDRESS (p i go
S-Farh Ay i C)I J NE
THIS APPLICANT IS:
DOWNER -BCONTRACTOR
PROPERTY OWNERC
NAME: Oil e e S K h a 400 0
TENANT
ADDRESS: &yq6 S -f Arlio it Bl ! l til CITY Fir i A 4f -c A� STATE I&W-15-
PHONE:'3 -
CONTRACTOR
NAME:
STATE LICENSE P _a- OJ ::7 2 to R? EXP DATE O
FR (OL
i=ZA STATE fi�L1P 3 3�
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 11 3011 t�dV ROE 51 /VC CITY
WITH APPLICATION
PHONE %(n 3 - 502 ' & 76-7 FAX
PROPERTY TYPE
D SINGLE FAMILY/NEW CONSTRUCTION SIZE—
13 TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
D ADDITION 11 GARAGE/SHED ErWINDOWS
❑ BASEMENT FINISH D ROOF D DRAIN TILE
• DECK D SIDING D OTHER
D SWIMMING POOL
TYPE OF WORK:
C NEW D ADDITION
D MAINTENANCEIREPAIR D REMODELING
DESCRIBE WORK BEING DONE: t'(10.2c) L) V yZ e J2 10 ro
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHTS . Ft.
❑ HOUSE ONLY
REMODELING SUBMIT:
N F SQUARES
D HOUSE & GARAGE
BASEMEN'!'
1. Existing Floor Plan
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
D DETACHED GARAGE
3. List of struetoral members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADI7IONS
& PORCH—S SL1BM.
D Vinyl
OSoffit
D Trim
1. Site PIanISurvey showing the existing strictures
p AlumVinyl num
D Other
13 Fascia
and Proposed P%1�
.
2. Two " of corrsttuctixux plans
WIIVDOWS
3. Energy Cakutations
,
IN EXISTING OPENINGS Wes El No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
.�..... �T- r A
nnn A NM
RNA n VIlIA1i Ce
ALL FEES ARE BASED ON VALUATION, UNC:LUVINU rn& %- 0a Or
(USING THE 997 U.B.0 FEE SCHEDULE)
TOTAL JOB__VALUATION $ 1 `� f d OCCUPANC
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary { )
Make checks payable to: City of Fridley Attar
• svw rai.a� .a..
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Due
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby applyfo ut c Mg p t and I acknowledge that the information above is complete and accurate; that the work will be in
conformance ' the ordinances and c es of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but onli an ap 'cation for a perms work is not to start without a permit; that the work will be in accordance with the approved
plan in the case f all rk which requires evie w nd p oval of plans, tt �/
SIGNATURE OF APP 4
PRINT NAME-/ Ivn I� I�( DATE �U F