PRE 2010 DOCSSUBJECT
City of FridleyAT
THE TOP OF THE TWINS
PERMIT
BUILDING
D!TN!O
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
812-560-3450
910-F15
5/16/77
JOB ADDRESS 6210 Sunrise Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION `•, SEE ATTACHED
DESCR.
27
2.
Sylvan Hills Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Albert Michalik 6210 Sunrise Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
SAme
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 12' x 18' Shed in back yard
9 CHANGE OF USE FROM TO
STIPULATIONS Shed to be on a permanent SiNmr.foundation or tied down permanently with
ties. Shed to be 15 feet from rear property line, 6 feet from north
property line and 20 feet behind the garage.
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMOING. AND SrGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Metal
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
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
$600
$.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 OFCNTRACTOR OR AUTHORIZED AGENT (DATE)
- WHEMP E RLY VALIDATED THIS IS YOUR PERMIT
BLDG (NSP DATE
GNATURE OF OWNER (IF-OWNERBUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OW14ER: BUILDER:
Address: Address:
Tel. No..
L
No.: `poy2 f° � Street: :�
LOT: BLOCK: C� ADDITION:
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: /2 Depth: IS' Height:
61— Square Feet: Cubic Feet: J 1 6
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: �� Estimated Cost: $ Z/'
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.
DATE: SIGNATURE:
Stipulations:
6yl'1 Ax.s c -O P_QIt"'
C.c
s C 20 -�
SD
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 ger each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no caseshall 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.
0111
sueiEtT
PERMI
City of Fridley
2 913 0
AT THE TOP OF THE TWINS
I I( DING
BUILDING
P E R AA I j
t
`
v L
1r,
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
L __-___
r e PROTECTIVE INSPECTION SEC.
167-1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L J` 612-571-3450
910415
4/1/99
JOB ADDRESS
6210 Sunrise Drive NE
/LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
27
1
Sylvan Hills Plat 1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Al Michalik 6210 Sunrise Drive NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Richard Hastings Co 6331 Riverview Ter NE. Fridley.
MN 55432 574-9966 4051
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION Xp REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof House & Garage 25 SO 2nd Laver
9 CHANGE OF USE FROM TO
STIPULATIONS Roofing can be the 2nd layer but not the 3rd.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CON T.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
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
$.80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,609
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-
Fire SC $1.60
TRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$54.00
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$61.40
SIGNATURE OF CONTRACTOR OR AUTHCfZED AGENT (DATE,
WHEN PROP
810G NSP
LY VALIDATED THIS IS PYYOUR199 PERMIT
T1ATE
S-GN4TURE OF OWNEROf OWNER BUILDER, IOATE,
0111
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 62-U) �o
Legal Description:
Owner Name & Address: L A L Tel. #
Contractor: 4'k s r MN LICENSE # S
Address: 4 3.3 I d u 0 2-u ?—E R- Tel. # S 7 q- �7 Fe 4
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Len th Width Ijgt/Ground Sq. Ft.
(9k -
Construction Type: \ Z!T P, o Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. # S ��
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ J'7. (�C
Fee Schedule on Reverse Side
Fire Surcharge
$ ®
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$ 60
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ _ OL)
$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:
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 -wits
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 $x: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 $.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
Building
MECHANICAL
Peru No. -
Inspections
RESIDENTIAL APPLICATION
Received By
763-
CITY OF FRIDLEY
��
4' a72-3644
DATE - Z 7 - � � YOUR E-MAIL ADDRESS P -1- C. v 1 n r C � rA 01, Cc� �
SITE ADDRESS to l 0 S L'�_n T I S �2.- V r t'V e...
THIS APPLICANT IS: la OWNER CONTRACTOR
PROPERTY
NAME: /AcL `' 16 -, K M i G h A.i .' K
�1
ADDRESS: 6 Z 10 S� r S 9 Q- 6 �' t V Z CITY d I eq STAu t N npGS 32
OWNER/
TENANT
PHONE: -1&,-3 G`71 1 13(a
CONTRACTOR
COMPANY NAME: CECLS i-'?_, e- +-h ijeo -.'h. n� + A - i r
CONTACT PERSON: C t -XO t'� r1 cL rd
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
STATE LICENSEIt_ EXP DATE ��yy Vt
ADDRESS:1 o o ofW o 0 d- h N CITY0 a - r— G ro V e- STATE `� ZIsso l I
APPLICATION
PHONE -7 4- 3 °13 4 11 C1 0 FAX 7 (o 3 434 11,2 -ss,
PERMIT TYPE
YSINGLE FAMILY 0 TWO FAMILY Ei TOWNHOUSE
TYPE OF WORK:
EI NEW VREPI.ACEMENT ALTERATION/REMODEL
t�O
DETAILED DESCRIPTION OF WORK � 1A C e- ,' v1cL C e -
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)
Equipment Installed MFG: MODEL: SIZEJBTU
MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZEJBTU
__AJC $'x..5.00 ' _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00
TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_AIR
BOILER $35.00 FURNACE S35.00 _ GAS UN'I T HTR $I0.00
E
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 PROJECTS FOR UNDER $500
PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $ 35_.00
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $I5.00 = $
TOTAL DUE $_-15 .50
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 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 -Aithout a permit; that the work will be in accordance with the
approved plan in the case of all w-4) k which reNufiaswie and approval of plans.
SIGNATURE OF APPLICANT PRINT NAM C_h6" DATE 4 - '2-Z —0
-0_-+P. no.r-d
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUIL DING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 UniversiU7 Avenue NE, Fridley, MN 55432
763-572-3604
]FAX: 763-542-4477