PRE 2010 DOCSe
City ®f Fridley, Nffim
BUILDING PERMIT N® 6888
Date: � �� 1 � l� �
Owner:C/o 6LA:t-114—
Builder
Address Address
L TION OF BUILDING
No. Streeta�lz ®® Part of t
Lot —�.__ Block �®® _ Addition or Sub -Division
Corner Lot Inside Lot Setback S eyard
Sewer Elevation _ _— _ — Foundation Elevation
DESCRIPTION OF BUILDING
TorUsed as• � '`g r
t Depth Height _ _ Sq. Ft. Cu. Ft
Front DepthHeight Sq. Ft Cu. Ft
Type of Construction Est Cost/�j-�- To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set✓✓II fo a�}dance with all provisions of
ordinances of the city of Fridley. .I�. / /�^ r 2-^m
In consideration of the payment of a fee of $ . , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
V1,71 ir, i M7p-r-7'M1r.Ta
NOTICE:
lhb permh does not cover the construction, installation for wiring, phmbing, gas heating, rower or water. Be sure to as
the Building Inspector for separate permits for them hems.
s
APPLICATION FOR BUILDING PEMUT
CITY OF FRIDLEY, MINNESOTA
OV=R' S NAME C /f9,6WCc- 7- BUILDER cam- /a%Q-t 5-Av o (-6
ADDRESS S792Lrf"& /3611,0 R E S S
LOCATION .OF B ILDING
No. -'mart of Lot
Lot 16 Block Addition or Subdivisi
Corner Lot Inside Lot Setback Side;Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front Sapth Height
Sq. Ft. Cu. Ft.
Front Depth Height,
Sq. Ft. Cu. Ft.
Type of Constructioncw,*,vGE Ile,,I. �- � � , Estimated Cost ®.
To be Completed
The undersigned hereby makes'application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE / - - 6 SIGNATURB X, .
� ,.
Schedule of Fee Costs can be found on the Reverse Side).
A
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any ezzist-
ing building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, 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:
2.1. For any such permit for the erection of any fire -proof building', other
than a garages warehouse, factory or grain elevator, or for the erection of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or ,fraction
thereof, in such cubical contents,.
2.2. For any such permit for the erection of any fire -proof garage, i#arehouse.
factory or grain elevator, or for the erection of any fire -proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof buildirr; ether
than a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any existing building - permit $1.00 fore
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erecting c t ar:s< n,)n-f i s, epron f gag -age,
warehouse, factory or grain elevator, or rel� cif•= any non -fire
addition, -for--similar occupancy, to arT e� : � �:,r�r, �,, . n.s� • eo or for each such
_ . - building or addition - ninety cents eco_`d one thousand cubic feet
or fraction thereof, in the cubice l t.;zey poll with a minimum of $4.00. -
For the purpose of computing fees fc•r bt,". ding pernit,s, the cubical contents
of any building or addition to a tilroLghout by multiplying the
ground area covered from a point six (6) i.-irLps b-� a ov the floor line of .the
basement or cellar to the average height of L;pper surface or to the
average height of the roof surface of the main gaule of a pitched roof.
2.5. For repairs or alterations to an existing structure, the•fee shall be
at the rate of $3.00 per each Five Hundred.Dollars ($$00.00) or fraction
thereof in the cost of all proposed work.
2.6. In no case shall the fee_charged..for-.any permit•" set forth in
.Section 2 be less. than $4.00.
i
SUBJECT
RMIT NO. _
City of Fridley
26494
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
~ - PROTECTIVE INSPECTION SEC.
1
_395�
NU MBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
'� 612-571-3450
910-F15
7-8-98
JOB ADDRESS 6260 Starlite 11ath(e Blvd NE
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
4
Sylvan Hills - Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
ffin Khan 6260 Starlite na,6k Blvd NE
571-6349
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
C. Salaam Enterprise PO Box 11987 Mpls MN 55411 308-3305 20141269
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 Cf REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Roof Replacement (18Sq) house and garage - tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State
Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 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
1
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
$1501
.7r5
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 REGUL TlNq CON-
$51.25
Fire Sc $1.50
STRUCTION OR THE PERF MANCE OF CON RUCTION.
2/p/08
PLAN CHECK FEE
T AL FEE
.
License c
1SIGNAT
$5 0
$58.50
REO CONTRA TOR OR AUTHORIZED rGENT (D TEI.
N R
ey VALI D THIS IS YOUR P RM1,-
L BL INSP
K:Z t2
f1AT
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
i
NEW Effective 1/1/98
ADDN[ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
a
BUILDING PERMIT APPLICATION .
�q q�
ConstructionAddress: 46/ 6__/).Y;
Legal Description: f (z
Owner Name & Address: Tel. # S21/ — 6 3 � f
Contractor: MN LICENSE
Address:. A0, 0, InIld �atjTel. # 3 6 iY ^e b
LIVING AREA:
GARAGE AREA:
DECK AREA:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
µ DESCRIPTION OF E%IPROVEMENT
Length
Length
Length
Width
Height
Width
Height
Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
(Fee Schedule. on Back). .-
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tela # O d 0
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ /s ,!rb
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$ . 75
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$®y
$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:
_a BUILDING PERMIT FEE SCHEDULE y"
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.
sueiE�r
ERMIT NO. �-
City of Fridley31632
AT THE TOP OF THE TWINS
BUILDING PERMIT
-
r
RECEIPT NO.
`v ------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
i� f
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
_--.�;"'f,•j
L 612-571-3450
910-F15
1/24/01
JOB ADDRESS 6260 STARLITE BLVD NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
4
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Khatoon Kouser 6260 Starlite Blvd NE
763-571-6349
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Master Remodeling Inc 32 Tenth Ave S, Hopkins, MN 55343
952-932-9311
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20012916
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
Replace 13 windows within existing opening s
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.
pe'" '"PeCtI00
1d
�11 Be A18119d
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
1
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
$3 900
$1.95
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-
$97.25
Fire SC $3.85
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TP7AL FEE
Licens C $5.0
$108.05
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT 4DATEi
HE PROP VALI A ED THIS IZYO
�RMili�
B� G NSP
Q E
$.GNATURE OF OWNER.IF OWNER SU4DERi iDATE,
JUiv—lb-1776 11 57 r-KUI9 l.ilY U�— f-kiULEI IU y32yjlb P. 01102
NEW(l 7�3 r72_ 7Yro /"c�
Cf' 7 �® 0 .� Effective 1/ 1/98
ADDN [ j CI OVFRIDLEY o,f' ,VC
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: _ (� 02 6 ® 5{40 y /'v -e /tl'
Legal Description: ,/
Owner Name & Address: d�' *I -o ®-l% /("o y'5'e e- Tel. #70-r.5-71-
Contractor:
.,, lG�o MN LICENSE # 2"/2.57/(® �� o � r,•
Address: C=d®�Csi:�. ula?aeo�mye Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn onit 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: JO 3 � r„ c�, � 4 Estimated Cost. $ 39 &729-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 5 Ft Ft X $ _ $
DATE: -�, ' ®A APPLICANT: Tel. # ✓�� -°����
Permit Fee
$ 9-7 A �-
Fire Surcharge
$ 3 -
State Surcharge
$ ( y'
SAC Charge
$
License Surcharge
$.
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
CITY USE ONLX
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ j Not Necessary [ j
TOTAL
STIPULATIONS: ` j,��� /�/G . 314
14'7
CITY OF FRIDLEY BUILDING INSPECTION �' ®� ��ffective 4/1/2004
64311Jniversity Ave NE `
`Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Approve
Rough -in Date Final Date
JOB ADDRESS ( ..QQ C T (^ a A
RATE SCHEDULE
Fee
Tata)
Residential
Owner --
1��C_1
Furnace Shell and Duct Work, Sumer &
also Replacement Furnace
$35.00
Building Used As
Gas Piping (New Furnace, Fireplace, insert)
$10.00
$
ESTIMATED COST PERMIT NO
Gas Range
$10.00
$
DESCRIPTION OF FURNACE AND BURNER
Gas Dryer
$10.00
$
# of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
*Air Conditioning - All Sizes
$25.00
BTU HP EDR
Fuel Total Connected Load
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work
$
Sumer Trade Name Size No.
Minimum Fee $15.00 for Residential or 5% of cost of
BTU HP EDR
Improvement whichever is greater
The undersigned hereby makes application for a permit for the work herein
Commercial/industriaj/institution6l
specked agreeing to do all work in strict accordance with the City Codes
1.251/1) of Value of Appliance or Work (List on Back)
$
and rulings of the Building Division, and hereby declares that all the facts
Minimum Fee $35.00 for Commercial/Industrial/Institutional
and representations stated in this application are true and correct.
State Surcharge
$
HEATING
TOTAL FEE
Signe Tel
REINSPECTION FEE $50.00/HOUR
FAX # `� `_I Date
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Approve
Rough -in Date Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes} No( }
The venting system is plastic/PVC and meets all current codes and manufacturer
Yes () No
specifications including sizing, length, number of elbows and termination.
.
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current odes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
No( }
assisted and natural draft appliances.
Yes
The existing combustion air is sized and installed to meet the current codes
Yes No ( )
and manufacturer's specifications.
When required to Install a new combustion air, will be sized and installed
No ( )
to meet the current codes and manufacturer's specifications.
Yes (}
When Instailina a new ve+ntina system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA -LAMA Category I Central Furnace
Yes (} No ( )
Venting Tables for fan assisted and natural draft appliances.
is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common, vent and vented YeSVIL4No( }
separately as per current codes.
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type ;: lAj w_L- BTU Input 0, QVul Fan Assisted or Nat
Appliance #2 Type
lyBTU Input a. e� Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input _ 410. �
iI
Common Vent Type , Vent Height Diameter_ inches
+i�7
Appliance #1 Vent Connector Height �ft Length ft Diameter n Type
.�.---
Appliance #2 Vent Connector Height ,eft Length _ c- .____
ft Diameter 1,_." , in Type _6
Appliance #3 Vent Connector Height __.__ ft Length ft Diameter in Type .
ALTERATIONS: Describe
HEATING CO:
Signed By:
Date