PRE 2010 DOCSCity of Fridley, Minn.. X9 10559
BUILDING PERMIT
Date: February 25,E 1970
owner: Burns/Fallon Construction Builder Same
Address 780 -10th Street N.W. Address Same
LOCATION OF BUILDING
No. _ 606n — Street Stinson Ra r . , Part of Lot
Lot .__ 5 �._– Block 1 Addition or Sub -Division Amber Oaks
Corner Lot _ Inside Lot X Setback — Sideyard
c Elevation _96.13 _ Foundation Elevation
Wye
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front _ _60' Depth 40&22 Height 20' Sq. Ft. 1040' Cu. Ft 25.,600'
Att Garage Front 22 _ Depth _-2-Z!- Freight 10' Sq. Ft. 48A' Cu. Ft. A, 84:.0
Type of Construction Frame Est. Cost _ $37, 000 00- To be Completed 4 Months
WATER LOCATION: Tap SEWER MAIN: 18' E. of Property Line
WATER MAIN: 8' E. of Property Line
NOTE: 16" O.C. on Truss.
In consideration of the issuance to me of a permit to constru a building
the proposed work in accordance with the description above set o and in �a
ordinances of the city of Fridley. IT1
I agree to do
Provisions, of
In consideration of the payment of a fee of $ 46.00 , permit is hereby granted to Fallon/Burns
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.
_ _ r Building Inspector
HANK MUNICH
NOTICE:
Tib permit does not cover the construction, lastallatioe for ging, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for then Items,
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER Is NAME AW Z_ 1-1/s BUILDER P -
ADDRESS �`' t ADDRESS
NO. G- 0 STREET
LOCATION OF BUILDING
1 / 5' &
LOT BLOCK 1 ADDITION OR SUBDIVISION A ly% er Oaks
CORNER LOT INSIDE LOT *-� SETBACK SIMARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front , c -A Depth?) Height
Square feet c p Cubic Feet
Front_ Depth - Height
Square feet 1 Cubic Feet
Type of Construction &AOL tICL Estimated Cost 374060
To Be Completed 0—o 4 mns,
11
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 rep septations stated in
this application are true and correct.
DATE SIGNATURE
.(Schedule of Fee Costs can be found on the everse tide.)
NOTE: A Certified Survey of the lot, showing the location of the foundation,
once it has been constructed, will be required before proceedin& with the
frami
ti
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 structure or building,.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:
Uniform Building Code: Type 1, 2, & 4 - $1.75 for each one thousand
cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5
$1.50 for each one thousand cubic feet.
For the purpose of computing fees for building permits, the cubical
contents of any 'building -or -addition to a uniform height 'throughout '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 heighht.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 $5.00.
NSSSD Connection Charges based on location - Area 1 or 2.
1.�.,J
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# 6OSO i
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� pit
i
bIU 7Tee /-l' b Ch Tl 1-11i
3-�
6 0 /. 646
Studs LA!5 16"OC (_] 24"OC Grade_"'t�..s
Block 0 Installed E Precut"
Random Q Door J
Kitchen Soffit 0 Prebuilt N1i Random
[j Norte Size_
Drop Ceilings r7 Prebuilt %,11 Random
U None Size—,_
Basement N Bearing E] Non-bearing
Height—i")" Lin. Ft-A(L—
lit Floor L7 Bearing F] Non-bearing
Height Lin. Ft.
2nd Floor 0 Bearing F] Non-bearing
Height Lin. Ft.
i ROOF STRUCTURE Lam' Hip 0 Gable
❑ Other Pitchy"
- Precut Joists Size Grade
Lin. Ft.
Precut Rafters Size Grade
Lin. Ft.
s _
Trusses Span i �' Pitch V� :>--Overhong� No. -
•e
Span:' -'_t+Pitch Y �� Overhang
a No.
Span Pitch—Overhang
No.
Gable Ends Spurtt_ _ Pitch-- §heathing B)iIt Out E] Yes ONa
Vents U esC, +( No 15'ze
ding [] Sho/
p Applied Type 1 }
Soffit Horizontal 0 Sloping [_] Open Specie. _
Shop Fabricated Random
Lin Ft.
Vents Size .__ _ Type-_
No. —,
Rake Q Closed D Open Overhang
Size
Shop Fabricated F-1 Random
Lin. Ft.
[� Vents Size -----Type
No.--- Specie__
Sheathing - __� • Plywood
No. Sheets A))
Other
Bd. Ft.
___..,___
Insulation Thickness i7 ". �+-._� �`j
__—
Quantity
Roofing Type -_S --O .. 4 �� _ _r,
No. Squares a\ i
Roofing Felt _Q_u_antity /5
EXTERIOR FINISH
Siding Primed El Yes �' No Prefinished 0 Yes � No.
House Type P �? - �af,• \ �7-t ,s.lt•..�1 i
Shop -applied 0 Yes D� No
�Q t
Garage Type �_C ►.x >� 1.u4_L^ �' i
Shop -applied E] Yes N No
Siding Other
Window Frame Primed [ 1 Yes �] No
p11 Y,
Type
Sash Primed Q Yes ONo
1 PIn
Glass Graded"tiSTly .LL„r
2 p p
Glass Grade
3
d
Glass Grade
Glass
Grade
Storms & Screens Yes Q No
L�
Other
Stairs< Precut F-1 Prefab (l Other--
Basement
ther_Basement Treads r y: Risers.;. *-- Stringers," 6:: $kirtsSJ _—
Lower Treads Risers _ Stringers Skirts
Upper Treads Risers Stringers_- Skirts
Hand Rails Type __— No--.- --- Length
Length
Kitchen Cabinets -. B e)aler 0 Listed on Separate Order
Vanities [ YDegler Listed on Separate Order
�.
Other Built-ins C�- y Dec Ej Listed on Separate Order
Counter Tops [- By Dealer
HARDWARE (I Bronze j Brass E] Mfc.
Lock Sets No. Passage Sets No.
Medicine Cobinet(s)----N� I
Eaar--Bch �_ �llYes j No Kitchen] Yes No Type—
Thresholds Type No.-
.. ---
`a__1y.. Size' ��� No._
Weather Stripping TYPL-. .:�.�r�'`L'�L__- .__.._. Lin. Ft.._
Nails ----
Appliances Ran' a Type_ '-i Size
Oven a _s-%.-w��Se - -- ----
Refrig Type Size
Sheetmetal
FloshingQ:!- Termite ShieldtiS
r
Gutter L--]- Dq°vkis;Cout • S ecif �-wvad— D Metal Lin Ft. --_—
PAINT (Specify)
� Quantity
Quantity-^
--__ Quantity
MI5LLLLA+NtUUJ
YIN t (i i <!•l �.
t� lr';,..((� i L•n �i� ? l-.�.„r, .. Y '.L'n: 7 ��d 9A � 1 V ( tg� cn`- �.J� i cS'� v.:.. <•5y� � �'•- a`��' , ;�
V �L_L
Itltero# Not
I.. . I. 3.'.i \... —I 1:411 w.1,r,
of Included in Quotation.
e
NET F.O.B. JOB SITE
OPTIONS I DEDUCT I ADO
LAMPERT !-TOMES-P.O. Box -370 —Annandale, Minn. Phone -274-8225
G
4 r. DESCRIPTION
* iCIAL CONDIT
�1
ICH AS REVERSE PLANS, DIMENSION CHANGES)
NDATION
'einforcing t `Siza \ i - Lin. Ft.
lock ` J i;n ��r/ / �� No.
arms 1 \ Plywood No. Sheets
o. Plate Botts Basement Sash No. Size
Ties No. Size
IOR STRUCTURE
st Floor Q Precut Pre -assembled Sticks Sheets
ludsill T Size X 6 Lin Ft. t
oist ;i�S z �1� adt+—r.y Lin. SP�t. Precut
u loo Plywood No. Sheets'
csem�_ Wood N Assembled Q Sticks Size. �•.�Tt1�
Steel Size
asement Posts Wood Size No
Adjustable Steel Size No
Iging�r._A S1,I
toor Q Precut F7 Pre -assembled Sticks & Sheets
S e Grade Lin. Ft. Precut
br w No. Sheets
her 1
I Sheeting F-] Yes
JOB_ IDENTIFICATION, t
WALLS Corner Bracing 0 YesNo
�
I n 24OC G'. de
ib OC E]"
House Plywood E Insulation Board Thk
Garage
Plywood F--] Insulation Board Thk
Front Entrance Frame
Goble Plywood [] Insulation Board Thk
Style & Size'11.a
)ht Wails H fight _ Lin. Ft.
DoorI
X�
El Yes _- No Shop -applied [:1 Yes Q No
Service Entrance Frame
on Thicknes P�- }T� Shop -applied Yes
i
�_
No
Na Shop Installed Yes
No
' �i
Hei ht ? t l!
9 ___ Lin. Ft. r
Garage Size l ? k 7 Gehl017
_-
Yes E:] No r, Shop -applied YesNo
Thickness T` T e� +� -"'
t ..— --SS----- YP ��L�Shop-applied � YesC5�
No
Yes No Shop Installed Yes
E] No
;
Height ._7 � Ft.
_ -7----Lin.
Yes EJ No N By Dealer 0 By Builder
Size___
.Yes F] No Shop -applied Q Yes [X No
i Thickness lj�+-?1 Sop
-T pe_ _._ .__ -op ped Yes
b. %
Header Type
- + i v Size hy�
[] No
-_L"r �I
i
SQ. FT. LIVING AREA
EXTERIOR FINISH (Cont.)
Doors KD Pre -hung
N1 Wood Sill
Front Entrance Frame
Door -3 ; \t
Style & Size'11.a
Rear Entrance Frame
DoorI
X�
Style &Size
Service Entrance Frame
DoorQ i
Style & Sizelf,
Garage to House Frpme
Door
Style &Size
Garage Size l ? k 7 Gehl017
TYPe—` {-J
Combination Type
No.:
Sliding Glass
Size
Exterior Trim
ShutterstY�s No Size No.
Window X44 ..}-�No Size No.
Fence .Type Lin Ft.
Cupola Type _ Size _
Other --
Fascia E:J Primed n Pre -finished Sizol _ Spet,'�i•�;1 Lin Ft.`LM r;
Other Primed [ J Pre -finished Size Spec __ lin Ft.
INTERIOR FINISH --
Base Shoe Specie A k _ Style 7 //)_ Lin. Ft.�j
ti
j J /
�. _ —
Window Trim Specie . '- Style-_—;,' Lin, Ft.
MiscePassage
Trim Specie Style ✓; Lin. Ft.__✓
Doors _
e
I 9 �] KD �� Pre -hung C� Casing /)Bundled � Random
Type $pecio"J'� Style No,l�l�Sti Size
+I Pocket Type —.— No.
Doors Closet BifoJld[� By Pass Other
V _
Specie _ .a- ... 1_I.V.S Size _._.—
Jambs N Casedf� q
Other Specieli2_�__
II Closet Shelves Metal & Rod Wood Size 1 � ��, No. 11L
0 Shelf Cleat al Hook Stri;'\'✓'hods .i;,! — No._,____
FlooringDouble Floor [. ) Single Floor
33''
Underloyment'] Ve�r!s;obord EJ Plywood Size ft}_—No. Sheetq')_
II Paper Underlay Type d�atLy,r� Quantit _
Wood Wy
I� Unfinis e i ❑ Prefinished
�I TYP - v L� Gtode
r
Resilient Typo-- I (a.% S4• Ft.
Jf f I
Drywall Size andT i karZss- {—/1—��( \tn—'"1 �;� No. Sheets
14
Original
PERMIT for Power tants and Heating, Cool-
ing, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. o. /� Heating Plants W to beanstalled ltered—repaired
Make .dn.an� , Size--a-10--Q-3 //
Oil fired—, Coal fired—,- Gas fired Z; Gas Authorization No.
Remarks
Approved
Final Inspection Date , 19_
Inspector
Pest N° 4694
Fee $'22,00
Office of the Inspector of Buildings.
City of Fridley
City of Fridley, Minn. , 191a
Owner 4JJ-A5 M 1 A -,Z
Location �0 4 0
Kind of Building
How Occupied
Work to be Commenced—, 19—
To be Completed ,192@
Estimated Cost,$A1200-®o
Old- ew, uilding Permit N,
Permission is hereby granted to install--erect—use the material and devices described in the
above statement. This permit is granted upon the expre4condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the op ation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications s=thin approved application for this
permit on file in the office of the Inspector of Buildings. Inspector of Buildings
42 2M11 -67V
N? 5113
Original Permit t®r FLUMBING AND GMOF�ITTING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit I
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee $ /�
DESCRIPTION OF WORT; II
Number. Hind and Location of Fixtures
Storm
m
► O
�r U
m
t
z
O
f ON
m F
Z
m
m
m
x
ra
= m
m Y
3'
Y Z
2 7
G
w
3
N
E 2
O
O O
= 2
U
U m
3
y co
�-1
U
i s
.i
O Q
w
O
6 C
WATER HTR.
OAS
EIEC.
Basement
let
2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
Permission is hereby granted -A,PA .I -23 1 BVYI 1 to do the plumbing and
gas fitting in the building described in the statement hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date w ,i
Inspector.
42 IM -6.64-v
City of Fridley
Owner LA 1-Y�
"r 104
Kind of Building A AM&2
Used as
To be Completed �� ,19.20
Estimated Cost $_ Z, 6 0
O -�Vew- Building Permit No.
Date
Inspector of Buildings.
V
City of Fridley, Minn.
n.
IPWi �
BUILDING PERMIT
Date: October 9 1970 r
Owner: Brent B. Birkin Builder Same
Address 6060 Stinson Address Same
LOCATION OF BUILDING
No. 6060 Street StinsonBooulevard -- Part of Lot
Lot Block 1 Addition or Sub.Division . _Amber Oaks
Corner Lot _ Inside Lot —.. X. Setback __._ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
'7-7
g,
N°" 10853
To be Used as:
Remodal Basement Front _ _ Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost ....... � 1, _� 0 Q,_0 0 ___To be Completed .. ,.. Nov. - Ls f�_7 0
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinanoes of the city of Fridley.
In consideration of the payment of a fee of $ 9.OQ , permit is hereby granted to—Brent Birkin
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
Fridley Minnesota regaz ink lacation�,gconstruyction, alteration, maintenance repair amend moving ordfinangosf
within the dty limits and flus permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This penult does not cover the construction, Installation for wiring, plumhtng, pas heating, sewer, or water. Be am to we
the Building Inspector for separate permits for these Items.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:, A- e,v %` ,e. -BUILDER: - \1 "e- /f
ADDRESS : d D 4 6 ,5 o N ADDRESS:
NO:. 49 1 STREET
d4a
S t --'N-Sd N
LOT: �r BLOCK: / ADDITION: o
CORNER LOT: d INSIDE LOT:_SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Ysed As:
Front• Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
,z48
Type of Construction: Estimated Cost:_
To Be Completed: /Z/® -N / <g VG
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: _ /e�9�`?�' SIGNATURE: !�
(See Reverse Side For Additional Information.)
(A �
�o
r
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require the.payment by the
applicant for such permit of fees to the amount herein below set forth and in
the manner herein provided to -wit:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
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 $5.00.
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 Certified Survey of the lot,.showing the location of the foundation, once it
has been constructed, will be required before proceedint with the framing.
CERTIFICATE.OF OCCUPANCY
Application fora 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 Odcupancy has been issued.
PLOIMEIBIG Fly i`�'®RE RATES-
O. TO ALU
�
Number Pixtums ....... .........
x SZe�'�
3
"ure Fixture Opening .... a ......
x $1.50
;
New Fixture Old Opening..........
x $1.50
:
Catch Basin ....................
x $3.25
�
Water Heater '.Up to „99.000 BTUI • • • •
x $3.00
$
New Ground Bun Old Bldg. ........
x $3.25Electric
$
Water Heater._ .... . . . . . .. e .
a $2.10
$
GAS FITTING PEES.
NO. RATE TOTAL
lot 3Fixtures ..•,.••••••.•.•:••
x$22.00
$
Additional PUturesz
$ .�76f
Gas a to 199.000 BTU • . �..... a ...
x $-W
!:
•
State Surcharge
$ .50
REPAIRS & AL TIO fer to CedeDwai
_
ption 0B•..•O.O,•...A 0.. •.. aA. \.•.•8...••..••.M.
1..•
TOTAL FM
City of Fridley:
°1°'ihe undersigned hereby snakes application for a permit for the work herei,
specified, agreeing to do all work in strict accordance with the City Ordinance
and mUng of the Department of Buildingsi and hereby declares that all the tact'
and representations stated is this application {are true and correct r�
Fridley. M9n IS /
Owner v
Kind of Building
Used as
To be completed about
Estimated Cost. $
®fld ew. Building Permit No. Permit No.
ROUGH
iiNAL '7 - i
Business Phune
ORD SUSURB
TEST REC
- HOUSE HEATING FLOOR�cITY
APT• �
OWNER BADGE#
AS Co. METER
ADDRESS T, INSTALL -ED By ER
OCCUPANT DATE H)NS
TG. Gos Line BY UNIT HTR• _BOTH
HEAT LOSS — SPACE HTR• CONVERSION
SOLD BY STEAM
HEAT y GA F AI—
Electrical or BURNER
TYPE OF GAS DESIGN MAKE
Model
Lgnptf8 1 Max• BTU Rating
MAKe110— OF FURNACE
MAKE t
Model gg70 ppii B Model �+tpVAL NO,
Serial 11� a es-bae SIZE
INPUT Vent size �D
COWTROLS LINve tray. Regulator
at Plug KIND OF 11 umber
y�g Draft Hood Size 2gtt$42 Outside
THERMOSTATS TOR
inside Yt16
Camta� FL Filters �eta11
Valve Ch►TnneY Location
Limit
�Q� C►Timn®Y Construction
Limit Setting .0001 Wiring Y
Fan Setting Ct1a 1e 4g Test Tag X88
Smoke go"1bhtin9 lost.
pilot TYPe Lig
Draft
Pilot Make Door Pressure �.9 ,10
pilot Model 42 Secaude
Timing 7 g 0 Date Tested
pilot any T®sting
L.W. Cut Off �ttgQ aC o pereent CO2 md1 _Comp ..f Tester
3o�i°� i
pressure percen ..2- ® Ut'
CO
ja i percent
input CFH e]15o y
onTE PAGE OF APPROVED BY
Stack TemP•
8/8/97
-y10-F15
Form 235
avb0 Stinson Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
1 1
Amber Oaks
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
John Lingston 6060 Stinson Blvd NE
571-0743
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Right Way Roofing 16475 45 Ave N, Plymouth MN 55446 557-8678 3999
d 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
Reroof House & Garage (24 Sq) Tear–off
9 CHANGE OF USE FROM
TO
STIPULATIONS Underlayment must X W 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
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
` $V 2
1.00001
W
$
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-
$74.75
Fire SC $2.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$82.75
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
,
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
BLD )NSP
r1ATE
NEW [ )
ADDN L ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 6060 Stinson Blvd Fridley MN
Legal Description: Single Family Residential House and Garage
Owner Name & Address: John Lingston 6060 Stinson Blvd
Contractor: Right Way Roofing
Effective 1/1/97
Tel. # 571-0743
MN LICENSE # 3 9 9 9
Address: 16475 45th Ave N Plymouth MN 55446 Tel. #557-8678
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION OF E%IPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Tear off and reroof on House and Garage. 24 Squares
Apply ice and water shield
Estimated Cost: $ 2 , 0 01 .0 0
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 8/6/97
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT• Karen Oberg Tel. ## 557-8678
CITY USE ONLY
$ 74.75 Fee Schedule on Reverse Side
$ 2.00 .001 of Permit Valuation (1/10th%)
$ 1.00 $.501$1,000 Valuation
$ $950 per SAC Unit
$ 5.00 $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 [ ]
$ 82.75
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 $125,000
$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 $1()0,000
$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
Nv*!] Kz required before proceeding with the framing.
Building MECHANICAL
Permit No.: � ��'�'
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604C ITY OF FRIDLEY Date Rec'd:
DATE ! ®`%� 04✓ YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY NAME:J �
OWNER/ ADDRESS: (L)OWC)
TENANT
CONTRACTOR
COMPANY NAME:
SUBMIT A COPY OF
CONTACT PERSON:
YOUR STATE
STATE LICENSE #_
LICENSE WITH
ADDRESS:(49 2
APPLICATION
,,,,, .,_ 111CtV7
PERMIT TYPE (SINGLE FAMILY ❑ TWO FAMILY
TYPE OF WORK: ❑ NEW PLACEMENT
FY ICj � STA
EXP DATE
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK , `Utl I RLUA 2—'/2 -h6
ATEIP,
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)nn������ MODEL: U ��� SIZEBTU ZI
Equipment Installed MFG: 9 — SIZEBTU
MFG: , MODEL: SIZE/BTU
MEG; MODEL: GAS RAN IZE/BTN $10.00
J_A/C $25.00 _FIREPLACE (GAS) $15.00 NEW GAS GRILL $.10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _GAS �•r HTR $10.00
BOILER $35.00 _FURNACE $35.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15 00
Permit Fee $
...... _ ....
Number of fixtures @ $10.00
x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00
x $15.00 = $
TOTAL DUE $ �_•2
Number of fixtures @ $25.00
x $25.00 = $
Number of fixtures @ $35.00
x $35.00 = $
State Surcharge = $ 50
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinance dc es of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an appl' tion r 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 ll w quires review and approval of plans.
SIGNATURE OF APPLICANT E TnP�DATE O OI —Co
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977