PRE 2010 DOCSVillage of Fridley, Minn.
BUILDING PES''"
No 10"8
office of INSPECTOR OF BUILDINGS
Owner
Architect Fridley, Minn , ,
Builder
jll LOCATION OF BUILDING
� III �
No. �_: Street Part of Lot
Lot _ 'I Block Addition or Sub -Division
I,
i" DESCRIPTION OF BUILDING
Front Depth Height Stories Manner of Construction
To be used as # ¢`- To be completed Estimated Co6.
st
I'
Permit is hereby wanted
to'
= - described in the above statement. This permit is granted
the building
upon the express condition
that the person to whom it is granted, and his agents, employees and workmen, in all
the work done in,
wound and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley,
iminn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits,
and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
.7nsnector of Buildings.
I
AGREEMENT AND SWORN STATEMENT
In consideration
of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above perm]
Vit, I hereby agree to do the proposed work in accordance with the description
above set forth'and
according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby
state and say that the facts stated by me and contained in the above permit are
true as therein
tated.
7
Subscribed an
sworn too before me at Fridley, Minnesota, this k .•-
clay o �_ ��
Y
� .D. 19v' �°
-7 ��:.
SUBJECT -
PER
City of Fridley
® i4490
AT THE TOP OF THE TWINS
BUILDING PERMIT
RW�NO.
COMMUNITY DEVELOPMENT DIV.PROTECTIVE
INSPECTION SEC.
1 � ,
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
11/28/77
JOB ADDRESS 6630 Stinson Boulevard N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
2
Moore Lake Park 1st Addn. SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE .
Ronald L. Newport 6630 Stinson Boulevard N.E. 571-1546
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Sime
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. -
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
x
8 DESCRIBE WORK
Construct stove chimney
9 CHANGE QF USE FROM TO
STIPULATIONS
SERATE PERMITS REQUIRED FOR MIRING,
HEATING, PLUMBING AND SIGNS,
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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS.SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION,
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,
$350
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$8.00
SIGNATURE OF CONTRACTOR OR AUTH IZED AGENT (DATE)HEN
PROPERLY VALIDATED THIS -IS YOUR PERMIT
21.1 /®
�7
t/ ll-fig-7�
SI AT RE OF OW ER (IF 0 NER ILDERI DATEI
BLDG. INSP DATE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PEMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: /�1BUILDER:
Address: /„ z _fin �°�;��„� X1vJ W.-- Address:
Tel. No.
No.:
Street:_
, .,.a 14L.
LOT:
2
BLOCK:
ADDITION:���e
CORNER
LOT:
INSIDE
LOT: 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:
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
> cam.
Type of Construction: ,Xe 4 e- Y4 C . Estimated Cost: $
To Be Completed: Alt. /�
-r-��-�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.
-r7
DATE: �— SIGNATURE:
Stipulations:
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 with
6 inch depth; Driveway width plus 6 feet x $15.40
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 laer 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.
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 occupies? until,a Certificate of Occupancy has
been issued.
1rq
SUBJECT
PERMIT NO.
City of Fridley
5 0 4
AT THE TOP OF THE TWINS.
BUILDINGr PERMIT
ECEIPT
�
i COMMUNITY DEVELOPMENT DIV,
yy
r PROTECTIVE INSPECTION SEC.
®. 5?®
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/2/79
JOB ADDRESS 6630 Stinson Boulev and N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
2
Moore Lake. Park lst SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ronald Newport 6630 Stinson Boulevard N.E. 571-1546
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑X ALTERATION ❑ REPAIR ElMOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS goof can be second but not third roof. Install ridged galvanized
valleys.
SEPERATE PERMITS REQUIRED FOR 'WIRM
HEATING, PLUMBING AND SIGNS.
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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS I 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
$9001-
$.50
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.
$7.50
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
��,gg
✓`'�'' vU l,�
�hOX 0
SI N TURE OF OWN II OWNE BUILDER)(DATE)
.BLDG WSP
CITY OF. FRIDLEY
APPLICATION FOR RESIDCNTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
• OVINER: LIT
ADDRESS: I J
TEL NO:
BUILDER: a i -n e,
ADDRESS:
TEL NO: '
Construction Location
- STREET NO: STREET: - 'a 6 r ,o -y Cy,
LOT: -BLOCK: ADDITION: fie La kie c i
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
n.
Gu* S Front: Depth: - Height:
Squane. Feet: Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
Type of Construction: [ Estimated Cost: $ (� %�
7b 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 stateCd� in this application are true and correct.
DATE: - % / SIGNATURE:.
Stipulations:
O c7
t3UI LDI INC t'LIMIT FCC SCHEDULE'
SECTION 2. The Inspector -of l3uildings uhall, before issuing permits for the erection
of any building or structure, or for any addition to any existing building or structure,
6r for any alteration or repairs, t -o -any existing building or structure, upon application
.'therefore, require the payment by t:he'applicant• for such permit of fees to thb amount
herein below set forth and in the manner herein provided to -wit:
NRW CONSTRUCTION: Single family ]fomes 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 Y1.5,75
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 $17.85
_ADDITIONAL INFORMATION
Tor 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 sir. (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.
' _..._ ..
VERT FICATIOV OF FOUNDATION F
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 i:t,'
has been constructed will be required before proceeding with the framing.
o
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.
�V
• 01
011
SUBJECT
City of Fridley
31840
AT THE TOP OF THE TWINS
BUILDING
P E R
M I T
r
�
ECEIPT NO.
v ...... COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC,
2®3604gcleo
1-5
1 "1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910415
5/22/01
JOB ADDRESS 6630 Stinson Blve NE
I LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
2 1
Moore Lake Hills 1St
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Stephen Gladwill 6630 Stinson Blvd NE
763-571-6472
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW 0 ADDITION 0 ALTERATION REPAIR
0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Sq) 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 OFCONST,
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 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
r
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
$2,147
$1.07
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$83.25
ire SC $2.15
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
OTALFEE
I
$86=47
NATURE OF CONTRACTO R O IZEQ AGENT IDATEI
HE PR
LY VA ID ED THIS IS Y R PERMIT
X;I
S,lGN TU EOFOWI R NE 8UIL0ERI I ATEA
5O
QAtE
011
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: C (,3,(b (2-r,UfJ
Legal Description:
Owner Name & Address: G(.A-Zt c�L Tel. # `5 ? t
Contractor: - MN LICENSE #
Address: Tel. #
__._.._ ... 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 With H t/Ground Sq. Ft.
OTHER: SQLkAtf s &'w
Construction Type: 1� Estimated Cost: $ e /7'
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: c6sl0 l0 \ APPLICANT: ck9aG Tel. # (-�'z.')
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ �- /S� .001 of Permit Valuation (1/10th%)
State Surcharge $ /, 0 $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ CS
STIPULATIONS:
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 $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
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. New Houses Only