PRE 2010 DOCSCity of Fridley
SUBJECT
PER _
1403'7
AT THE TOP OF THE TWINS
PERMIT
BUILDING
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
_ ^�
PROTECTIVE INSPECTION SEC.
1
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
4/29/77
JOB ADDRESS 6230 Starlite Boulevard N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
13
4
Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Walock 5942 - 2'i Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Olympic Investments Inc. 7400 42nd Avenue North 533-2529
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
CX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑,MOVE ❑ REMOVE
8 DESCRIBE WORK ARNI
G
Construct a 24' x 42' Dwelling and a 25' x 22' Garageoeto��
-c-aT low
SEPERATE PERMITS REQUIRED , ELECTRIC-
FOR. TELEPHONE GASIEt
9 CHANGE OF USENEATING, PLUMBIND AND SIGN-d-)).
REQUIRED BY LA
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. All fill material below
footings must be removed and replaced with clean fill, compacted, and tested
before footings will be approved.
SEWER LOCATION: (Approx. 6' Deep in Street) 12' South of Manhole (Inv. 839.20)
WYE ELEV: 839.09 TOP OF FOOTING: 842.09 Minimum
WATER LOCATION:.24' South of Manhole, 12' South of Sewer Service
DRIVEWAY DEPRESSION: "Alt. A", Owner wants depressed curbing to north property
line. 14' x $11.75 = 164.50 ) DAY NOTICE TO CITY ENG.
THE CITY OF FRIDLEY DOES NOT GUARANTEE THE DlV. REQUIRED FOR CURE
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS:
MDATA IS FOR INFORMATION PURPOSES ONLY ANv ;REMOVAL AND REPLACEMENT
SOW USING- IT SHOULD VERIFY THE INFOWMATION T DRIVEWAY OPENINGS,
ON THE SITL
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
1063 + 544
26,260 Total
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
$32,585
$16.29
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.-
STRUr.TION OR THE PERF RMANCE OF CONST UCTION.
$105.04
$375.00
PLAN CHECK FEE
TOTAL FEE
26.26
522.59
SIGN RE OF CONTRACTOR OR AUTRIZ AGENT (DATE)
WHEN P OPERLY VALIDATED THIS IS Y�(
�yODURPEERMITL.011/7
BLDG INSP DATE I
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) ♦
CITY OF FRIDLEY
v�
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: .S GY-)'�t
Address : Meyl x4f 'z S
No.: LZ E Street:
BUILDER:
Address*: -7` 0( 2- cl( L
Tel. No.:- (�-3 �3 --2-
LOT:
2
LOT: 13 BLOCK: ADDITION:
CORNER LOT: INSIDE LOT:_ SETBACK: 3 S SIDEYARDS:
Applicaht 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:
-Front: % Depth: : ��
� p Height:
�j Square Feet:
`UCL rFront: 2 V --
Cubic Feet:
Depth: Z '2--- Height: 16
Square Feet:Cubic Feet:
(
Type of Construction: LoC'C d �6- of m-, A Estimated Cost: $
To Be Completed: C ( Alert. A. Alt. B
P oposed Driveway Width If New Opening Is Desired ;7-0$ b' $
(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 Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additi nal 'nformation.
DATE: _ Z % 7 SIGNATURE:
Stipulations:
M�'
6-, d 1
��.q.
f
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: (ConcreteA
rb Streets Only)
Alternat 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 with
6 inch depth; Driveway width plus 6 feet x $15.40
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.
E. Determine the ''U" value -of each segment.(1-9) and multiply by the area as follows:
1@
91
X
"U"
.55
= 50.05
2.
39
X
"U"
.55
= 21.45
3.
40
X
"U"
.55
= 22.00
4.
56
X
"U"
.071
= 3.98
5.
117
X
"U"
.133
= 15.56
6.
1,059
X
"U"
.071
= 75.19
7.
132
X
"U"
.064
8.45
8.
49
X
Il Ull
.55
= 26.95
9.
132
X
"U"
.47
= 62.04
G�
ADD 1-9
FOR TOTAL
WALL SEGMENTS
=
Item III 8
F. Determine the "U"
value of
each
segment (10-12)
and multiply by
the area as follows;
10.
0
X
"U"
.04
.00
11.
140
X
"U"
.04
= 5.60
12.
1,268
X
"U"
.04
= 50.72
ADD 10-12
FOR TOTAL
t/
ROOF/CEILING
SEGMENTS
=
Item IV 2
G. If Item No® III is the same as, or less than Item No. I, you have met the intent
of State Building Code 6006(c)2.
H. If Item No. IV is the same as, or less than Item No. II, you have met the intent
of State Building Code 6006(c)l.
I. Add Item No. I 291.55 + Item No. II 70.40 - 361.95
� . Item 341.99 56.32
J. Add Item No. III em No, IV -
K. If the sum of Items III and IV are less than Items I and II, you have met the
intent of the code for total envelope system.
The undersigned, as applicant for a Building Permit,,
hereby affirms the above .information has been prepared
and submitted by himself or under his direction,
hereby acknowledges the information to be correct and
accurate; and hereby presents the information with
required plans in support of the Building Permit
Application.
Bate 11-,Xk-7`7
ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
PLANNING AND INSPECTION DEPARTMENT
CITY OF BMWXKXNL, MINNESOTA,
FRIDLEY
This supplement is provided to assist the applicant in computing
EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This informa-
tion is required so the BUILDING OFFICIAL can determine that
submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA
of the STATE BUILDING .CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper
DESIGN CRITERIA in the plans; submit product specifications, if
needed to support the "R" and "U" factors used; and to assure
construction is per approved plans.
JOB LOCATION 6230 Starlight Blvd., Fridley, Mn
OWNER(S) ODIC INVESTMENTS INC. PHONE 533-2529
CONTRACTOR QLYMPIc INVESmgws ,iNC. PHONE 533-2529
A. Determine the Total Exposed Wall Area as follows:
1. Total wall window area
91
2. Total door area
39
'3. Total sliding glass donor area
40
4. Total fireplace wall area
56
5.. Total wall framing area (average 101)
117
6. Total net wall area above floor
1,059
7. Total rim joist area
132
Subtotal: Total exposed wall area above
floor
1,534
8. Total foundation window area
49
9. Total net foundation area above grade
132
Subtotal: Total exposed foundation area
181
GRAND TOTAL EXPOSED WALL AREA
1,715
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X
.17 -
Item I 291.55
C. Determine the Total Exposed Roof/Ceiling Area
as follows:
10. Total skylight area
0
11. Total roof/ceiling framing area
140
12. Total net insulated roof/ceiling area
1,268
GRAND TOTAL EXPOSED ROOF/CEILING AREA
1,408
D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING
AREA X .05 =
Item II:4
P11 Form No. 1-B (continued other side)
CITY OF FRIDLEY
J�- '7 -3t, -?L
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
.AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
each add. 50,000 BTU
4.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
$12.00
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
r
each addn. 50,000 BTU
6.00
$
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ 0,00
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
lst 3 Fixtures �_ x
$ 3.00
$ 3, 0.0
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00•
$
AIR CONDITIONING
$
FAN HEATING SYSTEMS see Fee schedule
$
VENTILATING SYSTEMS
.ALTERATIONS $ REPAIRS
$
State Surcharge
$ .50
TOTAL FEE
$'s—"go
ROUGH INSP. REINSPECTION FEE
Date ($10.00)
FINAL INSP.
Date '
APPROVAL FOR PERMITS//�
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
Job Address 6 v,3 O 1.,/,' 6�-c / v
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 Cedes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. , 19 7
OWNER ® /' �i /� % G ✓�✓ 7- 'mLa -,z
RIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT '7 - / e 7
ESTIMATED COST 0,57 S_> C3 ) _
OLD UILDING PERMIT NO.
PERMIT NO. 08a 8
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. ell
Trade Name
r'a7 yr a Size No. (; l Y 0 L-
Capacity Sq. Ft. EDR BTU �L 0410 HP
Total Connected Load L/ Ly Kind of Fuely"
BURNER - Trade Name
Capacity
Size No.
Sq. Ft. EDR BTU HP
Company
Signed By �L
n- 17'
iq �. _;. - J.
�(;��.-.e ; ;4,N �..�_. -Tel. No.
4 5 J 61—k
AOP
HEAT LOSS CALCULATIONS H E/Z, TAWRG &AOITIN CO. MINNEAPOLIS, MINN.
Weatherstrips A. S. H. V. E. Construction No. Insulation
WindowsDwrs Guide Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied '
Reference
Yes -No Yes -No 19
I -/.'I, Room Leng4h Width eight. FI. Room Length ®� Width ®Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
No Width Height No. of Lineal ft. Area Width Height No. of Lineal ft. Area
n
of Pa le— of pane lightsNo_ of crack sq. ft, of pane of pane lights of crack sq. ft.
? z 2 3 J
Coef Btu Coef Btu
Infiltration Infiltration
Glass Glass Str
Exp. wall Exp. wall y�
Net exp. wall �. '`7 Net exp. waI I r�
Int. wall Int. wall
Ceiling T r!� "� Ceiling ®Z kj-L-
Floor Floor
Total Btu. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
�1.'e�r Room Length j�, Width //Height FI. Ye Room Length 0 Width Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft. No• sq. ft.
g of pane of pang lights of crack
D4
Coef Btu Coef Btu
Infiltration ® .5-_7C) Infiltration
Glass(� cj Glass S
Exp. wall = Exp. wall
Net exp. wall `' C" "? Net exp, wall
Int. wall Int. wall
Ceiling 6)(1/ _ l � Ceiling X 99 tn.
Floor v> Floor
Total Btu. S 9 t^ Total Btu. y'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
*FI. '��s Room Length Width �, Height; FI. I./,-/ r_ �Room Leng4h �/ Width _)Height
—=--- —
Windows and Doors—Crackage and Area Windows and Doors--Crackage and Area
N„ Width Hoight No, of Lmeal h. Area Wuith Height No, of Lineal ft. Area
�( pa n�_ of pane lights of crack s .ft. No. of pane of pant• lights of crack 'q .
ft. •�
Coef Btu Coef
y I tration Infiltration L ��
E Glass Glass
` Exp. wall r Exp. wall �G
Net exp. wall Net exp. wall
Int. wall Int. wall
j Ceiling i�.�'(m Ceiling -2
Floor Floor
Total Btu. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Btu
City of Fridley
SUBJECT
N O
�® 1515.
AT THE TOP OF THE TWINS
PERMIT'
r
�
BUILDING
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
�.
PROTECTIVE INSPECTION SEC.
1 . �
-'1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
5/1/79
JOB ADDRESS 6230 Starlite Boulevard N.E.
1 LEGALLOT
NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
4
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Walock 6230 Starlite Boulevard N.E.
571-6712
3 CONTRACTOR MAILADDRESS
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
x
8 DESCRIBE WORK
Construct a 16' x 16' Garage (attached)
9 CHANGE QF USE FROM TO
STIPULATIONS
Provide a hard surface driveway. Use 2 x 6 rafters 24 inches on center
or trusses.
SEPERATE PERMITS REQUIRED FOR WIRINC4
HEATING, PLUMBING AND SIGNS.
WARNI
Before digging call local utilities
TELEPHONE - ELECTRIC - GAS Etc.
REQUIREP BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
256
2560
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
'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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,800
$1.07
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONSOF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIO OR THE PERFORMANCE OF CONSTRUC ION.
$10.24
PLAN CHECK FEE
TOTAL FEE
$11.31
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
NATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
BLDG. INSP
�j
DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) t i
01
, s
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PE HITS
NEW, ALTERATIONS, ADDITIONS,' OR REPAIRS)
OWNER: F'' WR-10CV, BUILDER: '5
Address : _5/_/tZl o Address
® vy) Tel. No. 15- 7-/- � `7 / •'�
No.: 62,30 Street: 15 tw'<
LOT: l 3 ADDITION:
CORNER LOT: INSIDE LOT: V/ 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:
C� r� Front: 7 (� ' Depth: / & height:
Square Feet: a Cubic Feet: b
Front: Depth: Height:
Square Feet: Cubic Feet:
• ® .®0
Type of Construction: Uj Q 0 Estimated Cost: $ 1'edn' Go
To Be Completed: • / _/ �' Alt. A Alt. 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 Buildings, and hereby
declares that.all the facts and representations stated in this application
are true and correct. See reverse side for additional information, n
DATE: -f" SIGNATURE:
stipulations: ox
T(W VMb
T -0 -
So .3/
BUILDING PER141T 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 $15075
Alternate Be 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 $17.85
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.
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 building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
J
SUBJECT
IT NO.
City ®f Fridley
25943
AT THE TOP OF THE TWINS
r
BUILDING PERMIT
6���
e �
COMMUNITY DEVELOPMENT DIV.
°i ------
PROTECTIVE INSPECTION SEC.
l
e ,
e ,
NUMBER
REV
GATE
PAGE OF
APPROVED BY
`
CITY HALL FRIDLEY 55432
""'
612-571-3450
910-F15
4/17/98
JOB ADDRESS 6230 Starlite Boulevard NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
I
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Thuy Bui 6230 Starlite Blvd NE
572-2337
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
B & B Roofing 6760 Madison Street NE, Fridley, MN 55432
571-0248 9042
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
O NEW 0 ADDITION O ALTERATION Lk REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK 11
Reroof House (28 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
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 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
$1,754
$.88
WITH WHM HERSPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROV 10 SOF ANY OT STATE OR OCAL LAW REGULATING CON-
$56.75
Fire SI.; $1.75
ST CTI NOR THE PE RMANCE O ON UCTION.
PLAN CHECK FEE
TO Al FEE
L s C $5 0
$64.38
SIGNATU OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HEN O VALI ATTHIS IS UR PERMIT
BL -NSP
'D
PATE
SIGNATURE OF OWNER (IF OWNER BUILDER- IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
LvD
Effective 1/1/98
-43
t Y'51
Legal Description:
Owner Name & Address: % 77 A u T Tel. # -T-7a
Contractor: p/MN LICENSE #fir
Address:, b 7/po,:� 77 Tel. # 5 7/ -4�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTION OF E%IPROVEMENT
Width
Height
Width
Height
Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type & /—//2 ���� P Estimated Cost: $ 1/4
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: l f �1�/�- /� VAPPLICANT: i Te1.
CITY USE ONLY
?ermit Fee $�. ��� Fee Schedule on Reverse Side
"ire Surcharge $ /. % . .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $, C $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 $ (e% a
STIPULATIONS:
V
BUILDING PERMIT 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 FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 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 $13.50.
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 $15.75.
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.
CITY OF FRIDLEY PERMITNO.: 2004-01671
6431 UNIVERSITY AVENUE NE — ;
FRIDLEY, MN 55432 DATE ISSUED: 09/27/2004
F63) 572-3604 FAX: (763) 571-1287
ADDRESS
: 6230 STARLITE BLVD NE
PIN
: 153024440088
LEGAL DESC
: SYLVAN HILLS PLAT 3
LOT 13 BLOCK 4
PERMIT TYPE
BUILDING
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE
RESIDING
VALUATION : $ 8,200.00
NOTE: PER R703,2000 INTERNATIONAL RESIDENTIAL 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 OR TAKE PICTURES. RESIDE HOUSE & GARAGE.
STATE LICENSED CONTRACTOR 1
APPLICANT
PROF TOUCH PAINT & REMOD (4648)
3931 172 IN
ANDOVER, MN 55304
OWNER
BUI THUY THI
6230 STARLITE BLVD NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions f any other state or local law
regulating co clip the ��ance of constru9tion.
Bldg
BUILDING PERMIT FEE 167.25
FIRE SURCHARGE 8.20
STATE SURCHARGE, VALUE 4.10
LICENSE SURCHARGE 5.00
TOTAL 184.55
PAID WITH CHECK # 8667
SEPARATE PERMITS KEOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW [) CITY OF FRIDLEY
ADDN (] 6431 University Ave NE, Fridley, MN 55432
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 4/p_®
Effective 4/1/2004 P— --
(763) 572-3604 Bldg Insp `5���
(763) 571-1287 Fax
�1l � l
Legal Description:
Owner Name & Address: Tel. # 76Y- � 7A - -Z33 i
Contractor. �� : ` MN LICENSE #�
Address: "� 9,'?/ / 7 Z,. At 0toe 1/5;�/"10,C-"7 Tel.#3 7
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:
Construction Type: '4V ,7r timated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. # /�f% - ®�/ �•�'
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using.credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ AW. 0 -ss"
$ r�•a0
$
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ J
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Oficial 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 FEES
$1 to $500 $23.50
$501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $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
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
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.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Only
Bu rg-
AND MATERIALS:
BUILDING
(USING THE 1997
U.B.0 FEE SCHEDULE)
Permit No.; 3
Inspections
OCCUPANCY TYPE
RESIDENTIAL APPLICATION
$ Cf 1 , 95
Received By:
763-572=3604CITY
$`�— -
OF FRIDLEY
Fire Surcharge
$ s S
Date Rec'd: ` owl
DATE 4— 1 e
(: YOUR E-MAIL ADDRESS
.0005 x Permit Valuation Minimum $.50
License Surcharge
SITE ADDRESS & 2- 5®
-STAe- A. /= 11D
SAC Charge
$
THIS APPLICANT IS:
M-(5WNER ❑CONTRACTOR
$
ft + 6 ft = ft x $21= $
PROPERTY OWNER/
NAME: J— A Ll Lg� `6 u X—
$450 Conservation Plan Review
Park Fee
ADDRESS: 6. CITY F,4
/4,e &r±g�
STATE/ IP y
TENANT
necessary ( ) Non Necessary ( )
PHONE: iL. - -�7
$
Make checks payable to: City of Fridley Attach
CONTRACTOR
NAME: n w x) Q
SUBMIT A COPY OF
STATE LICENSE # EXP DATE
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
P5TNGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ THER
❑ SWIMMING POOL
G.L
TYPE OF WORK:
❑ NEW ❑ ADZDo N
13MAINTENANCE/REPAIR MODELING
DESCRIBE WORK BEING DONE: "1:7/dS-7-4,LL WA 69 r' ��
�rtJ
�J g)
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2•
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I .
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOR'S
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS n
Z
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF lo. -; I I P D04)
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OFWINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR
AND MATERIALS:
(USING THE 1997
U.B.0 FEE SCHEDULE)
T
VAI,VATION $ 60
OCCUPANCY TYPE
Permit Fie
$ Cf 1 , 95
See Back Page for Fee Schedule
J,
Plan Review
$`�— -
65% of Building Permit Fee
Fire Surcharge
$ s S
.001 times the total job valuation
Surcharge
$` j
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$Agreement
necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work wh' h requires review and approval of plans. /p �j
SIGNATURE OF APPLICANT ' /� s PRINT NAME lam( `I I J �.� I DATE (�d�/
Page 2 - Building Residential Application
BUILDING PERMIT 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' 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
FEES
$1 to $500
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$391.25 for I' $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for I $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for 1' $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the 1' $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
M"
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CITYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
1, understand that the State of Minnesota
requires th6t all residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a specific exemption from the licensing requirements. As
the owner of the property at 6 �Z�6) -577,,740, J&V A-�6e , Fridley,
am exempt from the state licensing requirement only if I am not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors maybe required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.
Name J/-�
Date / h 7