PRE 2010 DOCSCit of Fridl�
City y
SUBJECT
13682
AT THE TOP OF THE TWINS
BUILDING P E R M I��?
i �
COMMUNITY DEVELOPMENT DIV.
ffo2(6&u./
r PROTECTIVE INSPECTION SEC.
1
66�
= �
1 /""1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
-"' 612-580-3450
910-F15
8/5/76.
JOB ADDRESS 6380 Squire Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
9
4
Harris bake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
The Rottlund Company, Inc. P.O. Box 32082, Fridley, Mn. 571-2060
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 El - REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK--IMPORTAN
Construct a 26' x 42' Dwelling and a 28' x 24' Garage
SEPERATE P`E`RaMIT,9 REQUIRED FOR WIRING, DIVISION REGARDIN
9 CHANGE OF USE FROM HEATING, PLUMBING ANDOSIGNS
slCCl91 ws
AT DRIVEWAY OPE
STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before
capping. Provide sod in the front and side yards. Provide truss design -
Soil borings and/or compaction tests may be required.
SEWER LOCATION: (Approx. 8 feet deep) 10' S.E. of Manhole (Inv. 880.14)
WYE ELEV: 880.09
TOP OF FOOTING: 883.09 Minimum
WATER LOCATION: 23' West of Manhole, 85' South of Water Box on Lot 8
WARNING
THE CITY OF FROLEY DOES NOT GUARANTEZ THE
ACCURACY OF UTILITY LOCATIONS AND ELEVATIO, -% Before digging call local utilities
T:•,tS DATA IS FOR INFORMATION PURPOSES ONLY AND TELEPHONE - ELECTRIC - GAS Etc,
PERSONS USING IT SHOULD VERIFY THE INFORMATIOhJ REQUIRED �d
�®
ON THE SITE, m�
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
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
R-1
1152 + 606 22,352+6060
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I 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
$36,700
$18.35
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE 1
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRU TION OR THE PE FOR ANCE OF CONSTRUCTION.
$113.65
$350.00
PLAN CHECK FEE
TOTAL FEE
`� /� 0 >°'i`�A• �`'� °a
—J1- 7
28.41
$510.41
SIGNkUREOF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
~
BLDG. INSP DATE y
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
01
r-
ENGR,
CURB
CEMENT
ZINGS.
CITY -OF FRIDLEY
mai, m t6.-o—
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDITION, OR REPAIR BUILDING PERMIT
OWNER'S NAME : 4,e
�F>0 717)- e6 m i ct,.
BUILDER:�*e
-/70i
ADDRESS:
ADDRESS :_
®
9 ®)( .32-
D S' -z'
NO:/, 3 9 0 STREET : 5 6 o ' v -e-j°' _
LOT: BLOCK: V ADDITION: 1.4 kr 597 -AA, -S
CORNER LOT: INSIDE LOT:_SETBACK: s SIDEYARD:iL'`�- /,5 i
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: S'IAr,91.® FAM+/ Y
Front: Z.6 Depth: Z Height: /6 /
Square Feet: //52- Cubic Feet: 0%2,� C5.3114
(!Ao 1- • f -e- Front • 2 Cal Depth • 2 X Height
4506
Square Feet; Cubic Feet: 60 ra
Type of Construction: FwAAA le- Estimated Cost: $ 46 z-F�
To Be Completed: o v I y 2_177 � ��✓ ��� o0
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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.
8,� e�`"� °F, � d .'*7.. �u �e of � - � • .
/DATE: :Z %k SIGNATURE: xvvrs
(See Reverse Side For Additional Information.)
5,71,®d -i4,4-71 O� t
a-�
� -� V 6f 2��u"��
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:
VIEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1000 cubic feet
PLAN CHECK: 25 percent of building permit fee.
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 averagee
height of the roof surface of the main gable of a pitched roof.
For-r-1pairs 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.
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 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.
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER:7"�i F' l�n7 l �v� �^G'.V P . DATE
SITE ADDRESS: y1.3 09 S 6) ci / Y D Y, PHONE:
CONTRACTOR: T;, 0 7 7 - t10 A e
Determine working square footage of each
1.
Total exposed wall area......
?o4Z _ZZ
sq•
ft.. x
.17
2.
Toal roof/ceiling area ......-
//,5-Z_
sq.
ft. x
.05
= S%•
Total exposed wall area above floor =
a. Total wall window•area.................................
b. Total door area ....................................... p,
c. Total sliding glass door area ......................... �7 bE-q
d. Total fireplace wall area.
e. Total wall framing area (average 1006) .................
f. Total�jim joist area .1l�l5�d��J:fid.......................
g ���Sul�P wall area above floor.. .. ............ !'J• _S3
h. Grp wall area above floor. ;R*A11! ................ 34 e n
i . 5:2 -6 N e, wall area above floor ... .................. / 3 n. e� o
'ii
j. 0AV-,-- wall area above floor ........................ :AV 2'1-.00
Total exposed foundation area =
/a er �pbr. (
k. Total founWdation window area ..........................
o•rK
1. Total net foun a/non area above grade ................
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section) �, a
a.
X
$full
X
91U"
C.
d.
i X
flUff
a =
j.s • y 9
e.
l S9 y x
fluff
f.
X
fluff
g-
7/2-5-1 X
„U"
, O G )' _
59 6 3
on X
$full
62
X
Stuff
te6
1,77
k.
X
,.U,.
s -
3
1.
W, 3Y X
$gu„
e7
3 . .............................
Total
if item #3 is the same as,
or less than iters #1, you
have met the intent of
SB 6006 (c) 2.
WALL SECTIONS
Use 10% of opaque wall area for
frame construction
FRWM- WALL
FSG. 03,
. • r -
Page 3 of 4
Construction R -Value
1.
Interior air film
0.68
.2.
3%Z
NsU1A77a�,
3.
r, -Am I A1 y
• 3S
4.
a' z icy-- Yi7
2, 04
5.
S' slug
J. 1 �f
6.
Exterjor air film
0.17
6.
Exterior air film
Total C� . ?':
.113 U.
1. Interior air film 0.68
2.
3. 3'/2 j"WSUl.47Tio!!
4. �',2 Mill i' - y e Z•,6
s.
6. Exterior air film 0.17
Total 1,5- J-0 �?
•06SU
1,
Interior air film
0.68
2.
3%Z
NsU1A77a�,
0.68
2.
3
S— •r s7-
4• '7
�.57,�
?/2
Z' o
6.
Exterior air film
0.17
6.
Total 14-'V7 q /?
. O Z51 U
•. total. �. � , ,
• • f� t
s
e-
1 _ N
FIG. #4
• << �t l — � � =x roc ;- ..• ���' .
NOTE: Indicate type, "R" 'value, deptli and
nlar_ement of insulation.
WA((
U'/ iY1.1'k 0 t-
1.
Interior air film
0.68
2.
3
3.
?/2
Z' o
6.
Exterior air film
0.17
•. total. �. � , ,
• • f� t
s
e-
1 _ N
FIG. #4
• << �t l — � � =x roc ;- ..• ���' .
NOTE: Indicate type, "R" 'value, deptli and
nlar_ement of insulation.
Exterior Envelope Average "U" Computation
Total exposed roof/ceiling area
m. Total skylight area.............................
n. Total roof/ceiling framing area (average 10%)...
o. Total, net insulated roof/ceiling area........... &
Determine "U" value for each roof/ceiling segment
M. X °'U'° =
n. /l3'. 2 X "Ulf . e)3/, - 6. /
4 ...................... a .... Total = _ 3 12 . g'
Page , 2 of 4
If total of #4 is the same as, or less than #2, you'have met the intent of
SBC 6006 (c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #�2.�
77
6AYA yQ w n t (_
C/N7_ AY --A
•aez v RIA (L4e-
/oC' �, o
AlY
r--I (^A
T�/Sa1411 .4
L/I
• 069 U
•aez v RIA (L4e-
/oC' �, o
AlY
r--I (^A
' ROOF/CEILING
Vented
P -eat flow
up
FIG. #5 °
4 s
VA
vz• t
s
L
01'
6 LG)
Heat floi'1 up .•vented
FIG.
-30 4 05
f
' �.I --S' �'r J�4S e'er• ).
• .. , f hent ,
f low up .. "
PIG. 07
Page 4 of 4
Construction R -Value
1. Interior air film 0.61
2. `% S 7"r0 r • 5%
4. Exterior air film (still) 0.61
Total 3/ 7 9 fi�"
.031 U
1. Interior air film 0'61
2. �/t15 ul Y�dv �• v r v S o i5 T I .0 0
4. Exterior air film (still) 0.61
Total d -7-51
R
o36 0
1. Inside air film 0.61
2.
3.
4.
5• outside air film 0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
tum -Y n cm
sties C,
arm 6rKVIaDoratorL& Irm
662 CROMWELL AVENUE
p+wvlw "4„ T ST. PAUL, MN 55114
PHONE 612/645.3601 . •+,` ..
REPORT OF: EXCAVATION INSPECTION
RES Ef--itARM-5- E ESTATES
PROJECT: 80 SQUIRE DRIVE N DATE: August 12, 1976
I:fli:E;�-; -P9-If�}NE-SA�f
REPORTED To: Rottlund CO Inc FURNISHED BY:
P 0 Sox 32082
�. COPIES TO: 1} Federal Housing Administration
Fridley, MN 55432 Attn : Mr Norm Lucas
Attn: Mr Roy Lund
LABORATORY No. 9_7184
INTRODUCTION
This report concerns our recent inspection of the soil conditions at the site of the pro-
posed residence. Our work was performed at the request of Mr Roy Lund. The purpose of
our inspection was to assure the earthwork operations were conducted in accordance with
the Federal Housing Administration Data Sheet 79G -"Land Development with Controlled
Earthwdrk".
CONCLUSIONS
Based on the results of our excavation inspection and density testing, it is our opinion
the earthwork operations were accomplished in accordance with Federal Housing Administration
Data Sheet 79G. -
BACKGROUND INFORMATION
The proposed structure will be a single family residence having a walkout five course
basement. The overall dimensions of the house will be 42' x 54', which includes a 24'
x 28' garage attached to the northern portion of the house. The top of the masonry wall
will be 30" above the centerline of Squire Drive. We have no information regarding
the actual building loads, but assume the foundation design was based on allowable
bearing capacities of up to 1500 psf.
The reports -of a preliminary soil investigation conducted at the site by Soil Explora-
tion Coon September 27, 1974, were available for our use during the inspection. The
report indicated the generalized soil profile consisted of fill and topsoil or swamp
deposits overlying coarse alluvium. The fill, topsoil and swamp deposits extended to an
approximate depth of 4' below the existing surface grade in this general area. The under-
lying coarse alluvium was deemed as suitable from which to place compacted fill and/or
footings.
The foundation plan is to mass excavate the inferior soils from throughout the proposed
building area and then refill the excavation in a controlled manner to bottom of floor
slab elevation. All footing areas will then be trench excavated to the designated
grades.
INVESTIGATION METHODS AND RESULTS
On August 9, 1976, we performed an inspection of the excavation. The exposed soils were
visually classified in accordance with the Unified Soil Classification System, and estimates
AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR-
IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL.
tupin cuts. testiq
anct engoneenng iaDarawr"irm
662 CROMWELL AVENUE
a' *y ST. PAUL, MN 55114
PHONE 612/645-3641
REPORT OF: EXCAVATION INSPECTION
p 4
DATE:
LABORATORY No. 9-7184 PAGE:
INVESTIGATION METHODS AND RESULTS
cont.
l)
August 12, 1976
2
were made of their strength properties. Several shallow hand auger borings and hand
penetrometer probes were placed to further determine local subsurface soil conditions.
The penetrometer is a manually operated instrument -calibrated against the relative
density of cohesionless soils and the unconfined compressive strength of cohesive soils.
During our inspection, we verified the building area was excavated of all inferior
soils. The floor of the excavation was relatively level with a depth of 4' to 7' below
the surrounding -surface grade, or approximately 6' below the centerline of the street.
The exposed soils in the bottom of the excavation consisted of gray and brown, fine
grained sands. All of the soils encountered were in a loose and wet condition. In fact, the
ground water table was observed in all of our borings within 1' below the floor of the
excavation. The encountered soils in their present state were deemed as suitable for
supporting relatively light loadings. However, we suggested construction activities
be minimized in order to avoid "pumping" or soil disturbance.
Measurements were made of the excavation to verify an adequate lateral oversize was
provided. Based on the building and footing locations provided in the field by the.
contractor, the minimum required 1:1 lateral oversize was achieved.throughout the
excavation.
After the excavation was approved for fill placement, the excavation was refilled to
bottom of floor slab elevation. Three density tests were performed at random locations
and elevations throughout the required 4' of fill placement. The test results., which
are attached, indicate the fill material was compacted.to at least 95% of the maximum
density as attained by the standard laboratory procedures, ASTM:D698-70 (Standard
Proctor).
COMMENTS
It must be recognized that Twin City Testing and Engineering Laboratory Inc does not
practice in the field of surveying; therefore, we must rely on staking by others. If
the construction is redesigned or otherwise moved subsequent to our inspection and
testing, we should be informed so our firm can assess if additional inspection work
is required, or suggest sound engineering alternatives.
TWIN CITY TESTING AND EN I EERING LABORATORY
Michael O'Donnell
Civil Engineer
MOD/TKS/rs
homas K Smith, P.E.
i
t m1. ■ a'iM1ll tYi sti1■ IY
... Brod angirmenm inbwaxorq, oroc.
662 CROMWELL AVENUE
ST. PAUL. MN 55114
PHONE fit 2/645.3601
.,� REPORT OF: DENSITY TESTS OF COMPACTED FILL
HARRIS LAKE ESTATES --
PROJECT: 6380 SQUIRE DRIVE NORTHEAST DATE: August 12, 1976
FRIDLEY, MINNESOTA
REPORTED TO: Rottlund Co Inc COPIES TO: (1) Federal Housing Administration
P 0 Box 32082 Attn: Mr Norm Lucas
Fridley, MN 55432
Attn • Mr Rny I Ilnd
LABORATORY No. 9-7184
TEST NUMBER:
1
2
3
DATE TAKEN:
August 11, 1976
August 11, 1976
August 11, 1976
UNIFIED SOIL CLASSIFICATION•
Sand, fine
Sand, fine
-Sand, fine
(Moisture -Density Sample
grained, light
grained, a little
grained, trace of
Number)
brown (SP -SM) -1
gravel, light
gravel, light
Method "A", (-#4
Basis)
brown (SP -SM) -1
brown (SP -SM) -1
LOCATION:
151N of SE corner
25% & 21'W of SE
10'W of SE corner
13..7
of building
corner of building
of building
DEPTH BELOW FOOTING ELEVATION:
6"
1.51
31
DEPTH BELOW EXISTING GRADE:
611
1.51
31
FIELD DENSITY DETERMINATION:
Method
Density in Place By Sand -Cone
Method, ASTM: D1556-64 (44 Basis)
Dry Density
(pcf) 110.5
112.5
101.5
Moisture Content
M 1.1,1
8.4
8,1
Plus #4 Material
(%) None
7
4
LABORATORY MOISTURE -DENSITY RELATION OF SOIL:
Method
ASTM:D698-70,
Method "A", (-#4
Basis)
Maximum Dry Density
(pcf) 107.1
107.1
107,1
Optimum Moisture
W 13.7
13..7
13.7
COMPACTION TEST RESULTS:
Compaction (%) 103 105 95
Specified Compaction W 95 95 95
REMARKS: The above test locations were selected by Twin City Testing and Engineering
Laboratory Inc. Compaction meets specifications in the above test areas.
AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR-
IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVEDPENDINGOUR WRITTEN APPROVAL
Twin City Testing and nginee , ng Laborat y, Inc.
CITY OF FRIDLEY di
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
RATE
Nunher Fixtures
N
e
Future Fixture Opening
x
$2.00
New Fixture, Old Opening
x
X
0)
x
Water
Water Heater - to 99,000 BTU
� x
$5.00
Ay
x
$10.00
Water Softener
[ .[i
N•
G
x
4J
O,
D,
0
Heater
J.
L
J.�
.%1
E
N
EF
1 14
$4
ti
U JUI
C
C
•�
y
x.1
C C
CEJ
3
O
U• i
O 4
U
0
0
•.i :J
0
0
+� N
4j N
to
w
U a
Q 3
cs
U
O
as
131ec
lst
a -
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
j*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
RATE
Nunher Fixtures
CN/0.
4- x
$3.00
Future Fixture Opening
x
$2.00
New Fixture, Old Opening
x
$2.00
Catch Basin
x
$5.00
Water Heater - to 99,000 BTU
� x
$5.00
100,000 BTU to 199,000 BTU
x
$10.00
Water Softener
x
$7.00
New Ground Run Old Building
x
$5.00
Electric Water Heater
x
$5.00
GAS FITTING FEES:
1st 3 fixtures �_ x $3.00
Additional Fixtures x $1.00
Gas Range to 199,000 BTU x $10.00
REPAIRS $ ALTERATIONS
First $100.00 $5.00
each add. $100.00 or fraction $2.00
State Surcharge
Job Address
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 Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
/Z /. ( i ley, V-1. I2z,-)— , 19 4
OWNER �� // /-
.ti
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO.
Company _
Signed By
Tel No.
ROUGH INSP.
Date
FINAL INSP. .Z � `� 6
Date
APPROVAL FOR PERMIT Yfs
PERMIT NO.
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
TOTAL FEE $ 3; 1 sI
v
REINSPECTIQN FEE mei
($30.00) �g_
CITY OF FRIDLEY 4 '�p G 4
A
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
$
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
$
Boiler only up to 100,000 BTU
7.00
$
_
g '�
GRAVITY WARM AIR:
RATE
TOTAL
Job Address -s-
Furnace Shell & Duct Work
$12.00
$
each add. 3 gal. per hour
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
$
GAS
Tel. #571-3450
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
$12.00 $-'°
each add. 50,000 BTU 4.00 $ u d
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:
ROUGH INSP. REINSPECTION FEE
Date
FINAL INSP. ✓ ,26 _ 2
Date
APPROVAL FOR PERMIT e�
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
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
OWNER /2-, �� /`' � C,, a�f
KIND OF BUILDING
USED AS "ems ��/ ' e;s /
TO BE COMPLETED ABOUT ® Z V �� y
ESTIMATED COST �� H
OLD -BUILDING PERMIT NO. PERMIT NO. / (03
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name �Y+� •✓ Size No.
Capacity Sq. Ft. Ed `~j ETU HP
Total Connected Load - ,Y Y -2 1-13 Kind of Fuel a-. '-
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company
t f !. e 11. s et6aned Byev
1( 011 XEN11A_ LTi 3 1.
-Tel. No.
Boiler & Lines up to 100,000 BTU
$12.00
$
each addr.. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
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
$
(over 199,999 BTU see Fee Schedule)
$
GAS
FITTING, FEES:
1st 3 Fixtures j x
$ 3.00
$ -3-
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
AIR
CONDITIONING
$
FAN
HEATING SYSTEMS See Fee Schedule
$
VENTILATING
r
SYSTEMS
$
ALTERATIONS
$ REPAIRS ,
$
State Surcharge
$ .50
TOTAL FEE
$-2 E. S-0
ROUGH INSP. REINSPECTION FEE
Date
FINAL INSP. ✓ ,26 _ 2
Date
APPROVAL FOR PERMIT e�
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
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
OWNER /2-, �� /`' � C,, a�f
KIND OF BUILDING
USED AS "ems ��/ ' e;s /
TO BE COMPLETED ABOUT ® Z V �� y
ESTIMATED COST �� H
OLD -BUILDING PERMIT NO. PERMIT NO. / (03
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name �Y+� •✓ Size No.
Capacity Sq. Ft. Ed `~j ETU HP
Total Connected Load - ,Y Y -2 1-13 Kind of Fuel a-. '-
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company
t f !. e 11. s et6aned Byev
1( 011 XEN11A_ LTi 3 1.
-Tel. No.
7 VaR� peJG 1A
HEAT
LCSS CALCULATEC3 TING AM MONING CO. MINNEAPOLIS. MINN.
Weatherstrtps A.S.H.'v.E. ConsYt g�a :`
Insulation
Windows 'i Moors Guide Out tali a Int. Wali
Reference e : @ i Roof=accr.t How .Applied
Yes–No i Yes–No yg C i
r 1 _
s
FI. �°b,1 ROCt't 1 Length tv,dth FI.®� d` Room Width Height
Window's and Doors–Crackage and Area Windovhs and Doors–Cra.i�nge and Area i
No, ! ir, N He1ghf _. i L : tt >3 _t
et of Cane 4-PtT75 o` :.acyk 1 ss. °t. IV o. ft. Area
sq. ft, ;?r
01
s- I j.- f ;2 Y 11 1 1
Infiltrator
Glass
Exp, wall �2
Net exp. walI
Int. wall
Ceiling
Floor
Total Btu.
Q'''om
BtJ
Required sq. ft. E.D.R. or sq. ins, W.A. Lead area
.jFIj(I*'1r&4r1V Room Length �� Width Height
Windory s and Doors–Crackage and Area
Coef, Btu
No. w;Mh Height No. of Lineal ft.
of Dane of pane fights of Crack
%rea
s`q. ft.
1
/ !
f
®®
Coef Btu
Coef, Btu
lnfiltration.
1
4
`wl
Glass
®®
iCoef Btu
Glass
10a
Exp. wall
Exp. wall
Net exp. wall
Infl uratic^
15/7 a,
Net exp, wal I '
®
Glass
Int. wall
Ceilingzv �
Exp. wall
®�
Tx
Floor
Net exp. wall
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
Lent—
Fl. Room i Length 74 Width Height
FI / Born Length Width Height
Int. wailN
Windovis and Doors–Crackage and Area
No. Height No. of Leen, f;- sc.
of p=n: of pane lights of crack -
Vd�^... 1 Hey ht .,.�. c� Lineal ft. Area
No' I et p �4 ? Lf pgne *„*75 7 of to
sq, ft.
Ceiling
i
Coef! Btu
Floor
lnfiitratior�
Infiltration
Total Btu.
i
Fes:
Exp. wall '
Required sq. ft. E.D.R. or sq. ns. W.A. Leader area
Net exp• vv -i;! f
I
–I
Net exp. vyir!i
nt. wva I 1
JFI. Joe i Le- gth �� Width
Height
_
Floor
Windtnis and Doors–Crackage and Area
Total Btu.
r
R 6
�".P,t�!PPf! C`7 4 Ln—no
No. >,4 -"t -'r, Height I Nn ` Lineal ft. 1 Area
of ca^_ of pane 7 Itgihts of crack sq. ft.
Coef Btu
Coef, Btu
lnfiltration.
Infiltraticat
Glass
®®
Glass
10a
Exp. wall
Exp. wall
Net exp. wall
Net exp, wal I '
Int. wall
Int. wall
Ceilingzv �
®�
®�
Ceilinca
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
Lent—
Fl. Room i Length 74 Width Height
FI / Born Length Width Height
Windows and Doors–Crackage and Area
Windovis and Doors–Crackage and Area
No. Height No. of Leen, f;- sc.
of p=n: of pane lights of crack -
Vd�^... 1 Hey ht .,.�. c� Lineal ft. Area
No' I et p �4 ? Lf pgne *„*75 7 of to
sq, ft.
i
1 i
i
Coef! Btu
Coef Btu
lnfiitratior�
Infiltration
Glass (
i
Glass
Exp. wall '
Exp, wal I
Net exp• vv -i;! f
I
–I
Net exp. vyir!i
nt. wva I 1
Irit. wall
Ce i 1 I ng
Floor
Celiingv v 4,
_
Floor
Total Btu-/ � �
Total Btu.
RequiredS•�. ft. E.D.R. or sq. %ns, W,A1 Leader are;
R 6
�".P,t�!PPf! C`7 4 Ln—no
GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD���
ADDRESS 6-320 A &4"A,.& 0,AjCITY
OCCUPANT v OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY `. `� dp
Electrical Work By Gas Line By 41
TYPE OF HEAT GA_ FAo/,' HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE
Model(/>�O �—
Serial
INPUT
CONTROLS
THERMOSTAT 7'824A Heat Plug
Valve d1 _ $09
Limit ®.1-®6 YA
Limit Setting /g®
Fan Setting
Pilot Type d �-
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off s .�
MAKE OF BURNER _
Model
Max. BTU Rating —
MAKE OF FURNACE
Model
Vent Size - ',-"C ®1
KIND OF LINER &4 SIZE C� ei NONE
Draft Hood�����$ Regulator
Filters Size 1616 sVN mber i
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring
Draft o ef Test Tag
Door Pressure Lighting Inst.
Pressure Percent CO 'Z -,Q %® ? 0 Date Tested-
.j® 7
Input CFH /®.� Percent 02 7 9.0 `, 4 Company Testing
Stack Temp. ® -110 Percent Name of Tester
Form 235
53-81,_9915051 CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE•SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Nur,ber Fixtures
x
$3.00
$
Future Fixture Opening
K
0
$
Water
u
L
$
ao
x
$5.00
to W
a .ca
ro
y
w
q
H
u
ro H
p,
P,
$10.00
$
Water Softener
Heater
$7.00
$
.a
H
N
$
N
•'I
41
N
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
$4
J ul
C
.0
••1
$1:0.00
$
[
3
O
U ••a
O .0
U
N
•.-1
iJ
N
C
N
•'1 O
O
O
•4l N
UI
N
N
N
.0
• lec
w
u M
a :3:0
:4U
0
as
lst
I
connecL
r,
n
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(�) = New Fixture, Old Opening
Water
PARTIAL RATE•SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Nur,ber Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater -
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
.Gas Range to 199,000 BTU
x
$1:0.00
$
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
Job Address ()-A80 SOUTRE DRTUE
? 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 Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correc
Fridley, Mn. 12-10-76 , 19
OWNER RPTTLUND COMPANY
KIND OF BUILDING'.. mo
USED AS res*
TO BE COMPLETED ABOUT t2-17-76
ESTIMATED COST 10,()0 % <�
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company. �g"
C7 6rs�
Signed By MINNE'' 70
Tel. No.
ROUGH INSP.
Date
FINAL INSP. %� 2• ? - %
Date
APPROVAL FOR PERMIT i
$5.00 $
$2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
State Surcharge $ .50
TOTAL FEE $ 8.00
REINSPECTION FEE _
($30.00)
City of Fridley
J
SUBJECT
PE _.
f
-0294
AT THE TOP OF THE TWINS
� � � � �
,�'�
� � � �
r
� � �
� �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
=
1 /---1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
.910-F15
8/17/77
JOB ADDRESS .6380 Squire Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Harris Lake Estates
SHEET
2 PROPERTYOWNER MAILADDRESS
ZIP PHONE
Gerald F. Waldorf 6380 Squire Drive N.E.
571-2136
7—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
Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
C" struct a 10' x 121 Wood Storage Shed
0
9 CHANGE OF USE FROM:, TO
STIPULATIONS Shed must 49on permanent foundation or tied down permanently with
ties.
EMITS REQURED 'FOR WIRING,
S EPERATE
PLUMBING AND SIGNS.
HEATING,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
WOod
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
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.
$400
$.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
`THORIZEDAG2
$8.00
31GN'A, Ut EOFCONTR bn0 (DATE)
HEN PROPE
BLDG IN
LY VALIDATED THIS IS YOUR PERMIT
tcb"j e49-
70L -
DATE
SfGNA URE OF OWNER IIF OWNER BUILDERI I A E)
U
l
CITY OF FRIDLEY I
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS,,OR REPAIRS)
OWNER: 1g e p& a' q� /�t� h 13UILDER: �Ce ivy Q
Address:
Address:
Tel. No.: 1� 3
No. _A 1 Street: ()�LKr1-11�1��
LOT: Q BLOCK: ADDITION:
q
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:_
0
Square Feet: �_ Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed: cl`/ 7 7 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 0o par addit*onal information.
DATE: l �` 7 SIGNATURE:
Stipulations:
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: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feetx $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 INFORIMATION
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.
Ca
SUBJECT
PERM-LT-NQ
City of Fridley
: y ,
24401
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV
_____
r PROTECTIVE INSPECTION SEC
NUMBER
REV
DATE
PAGE OF
APPROVED By
/-'-1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/29/96
JOB ADDRESS 6380 Squire Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Barris Lake Estates
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gerald Waldorf, 6380 Squire Drive, Fridley, MN 55432
571-2136
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Gerald Waldorf (same address)
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 N REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Roof repair
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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
MOT.
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
I
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINAN ES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,400.00
Fire SC $1.40
WITH WHET SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NO R SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS F ANY OTH ST OR LOCAL LAW REGULATING CON-
$45.75
StateSC $
STRU I R THE PERF R CE OF CONSTRU TION.
.70
PLAN CHECK FE
ALFEE
,,,SIGN URE OF CONTRA AUTHORIZED A ENT IDAT I
N P
LY VALID T THIS IS YOUR PERMIT
OG INS
d
BATE
_
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
Ca
MILTA
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: �2
Legal Description:
Owner Name & Address:
Contractor:
Address:
Effective 3/1/96
Tel. #� �(
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Comer Lot [ ] Inside Lot E ] Ft. Yd Setbaa Side Yard Setbacks
Type of Construction:
ted Cost: $
Approx. Completion Date:
, 7
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE:
APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
$ 4�;7 % f'
Fee Schedule on Reverse Side
Fire Surcharge
$ /, -510
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ;70
$.50/$1,000 Valuation
SAC Charge
$
$900 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
$
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.
SUBJECTIT
NO.
City of Fridley
29696
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
�
RECEIPT NO.
`- -____ COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
3 s�
r �
1 . �
CITY HALL FRIDLEY 35432
NUMBERAEv
DATE
PAGE OF
APPROVED BY
L 612-571-3450
s10415
6/16%99
JOB ADDRESS
6380 S uire Drive
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Harris
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gerald & Bonnie Waldorf571-2136
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW XX ADDITION ❑ ALTERATION XX REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 12' x 14' paxtz porch; Construct a 6' x 14'
deck; Reside 3 sides of
house - vinyl
9 CHANGEOFUSEFROM TO
STIPULATIONS
See stipulations on plan.
4
WAUgg
Call for building wrap inspection before covering.
km digging
all utility fts
RgQUIR B Y LAW
SPARM PERmrm REQviRm FOR
.
WIRINGo HEATING PLUMBING AND SfGfft,
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 Ip 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
WITH WHE gPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT
6972
$3.48
DOES N P E ME TO GIVE AU RITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI N O ANY OTHER S TE LOCAL LA E,GULA G CON-
ST UCT O THE PERF M C ONSTR c
$139.25
Fir SC $6.97
PLAN CHECK FEE
TOT EE
,--)
- /
9.70
SIGN E OF CO •RA O OR 4uTHORi2ED AGENT iDATE.
H
THIS IS UR fA54fT�VALID
DAiE
SIGNATURE OF OWNEROF OWNER BUILDER. -DATE
NEWT ] Effective 5/10/99
ADDN CITY OF FRIDLEY "
ALTER pq SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 1�3
BUILDING PERMIT APPLICATION a
J
f
Construction Address: "x, 1`,
Legal Description: zrl e I -r �4 66 G A' S ki Aa 0- 71 % 59
Owner Name & Address: ,nd r / # � E���,�� ��r�®�- Tel. #6 /,.2
Contractor: MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE ARE-:
DECK AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
ESCRIPTION QF IMPROVEME
Length v Width
1,engtV Width
Height Sq. Ft.A�4 X 7-7,/ �
Height Sq. Ft. ' m
r Hgt/Ground ,�" Sq. Ft. ZS -2— X
OTHER: 3/$,
Construction Type: �, 9 0 Estimated Cost: $
cl' ! e, 0 r ¢? 0 P. , I1g40 r�� f J-4 sr 4i�v
a
Ul
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. #�ZX S-7
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ze, 7D
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$10,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
12;41,v
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$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
$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.
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Land planning sfdffWI(I n 6875 Highway No 65 N 1.
Land Surveying
ir,ff��r inrupolis,
Soils testing ����7������(%� •%��• MnMinn S5432
Civil Engineering / , Telephone 784-6066
,Municipal Engineering Engineers ok 8urveyom- Area Code 612
Mortgage Loan Survey for ��f'..i G 11AJ CD,
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This iso true and.cortect representation of a survey,of the boundaries of the land above described and of the
location of all buildings, if any, thereon, and all visible encroachments, it tiny, from of on so id land This survey is
made. only in connection with a mortgage loon now being placed on the property and no hob•Iity is assumed
except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is
understood and ogre" menunrebf+ are be`1�°°}}placed for the purpose of establishing lot lines or boundary
corners. Dated ehts _'- day of u : A O 1•�
' -SU gURBAN ENGINEJERINGG,�IjN' C. C 40t
D¢►a>�es d►ufa2 a u�,�,>{y fwset>aeafs by a
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