PRE 2010 DOCSVillage of Fridley, blinn.
BUILDING P T
lel ® 3 s Office of INSPECTOR OF BUELDIINGS
Y
Owner
Architect Fridley, Minn., '190
v.
Builder,e^
LOCATION OF BUILDING
No.0 Street_.°E�:. fit, Part of Lot
Lot Block Addition or Sub -Division
DESCREPTION OF BUILDING
Front" Depth Height ;� Stories Manner of Construction
Permit is hereby granted to
the building m described in the above statement. This permit is granted
upon the expr ah, condition th the person to whom it is granted, and his agents, employees and workmen, in all
the work done) -fn, areound and upon said building, or any part thereof, shall conform in all respects to the•,ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may be revoked at any time u olation of a y rf tie provisions of said
ordinances. ,.
Inspector of Buildings.
AGRE�MF2-iT AND SWORN STAITMENT
In considerationof the issue and delivery to me by the Inspector" of Buildings of Fridley of
the above permit, 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 l✓yv� and contained in the above pe��riit are
true as therein stated.
Subscribed and!isworn to before nae at Fridley, I�Il net t
day of .D. 19-11,21
g.
A
SUBJECT
P IT NO.
City of Fridley
1324
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R'V.CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION
PROTECTIVE SEC.
I . �
CITY HALL FRIDLEY 55432
IL
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L---- f %•j 612-560-3450
910-F15
10/6/75
JOB ADDRESS
150 Talmad a Wav N.E.
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 6, %
1 Elwell's River Heiahts SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Beal 150 Talmadge Way N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
McCall r_nmqjnmni-jnn Co- lqndalta Wrenzie South
-5435
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION [R REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
En Re -roof Structure
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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.
$ZsCOO
1.30
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-
$18.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
-t�A �'aj� 5—
$19.30
SIGNATURE ONTRAC o AUTHOROE DAGENT (DATE)
HEN PROPERLY VALIDATED T IS IS YOUR PERMIT
cta dV.46/1�
BLDG INSP ATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: BUILDER :
ADDRESS: A-6 ZZ4_ a144 64"24- ADDRESS: ice, sa .
NO:. STREET:
LOT:
BLOCK:
ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two,Certificates of Survey of Lot and propose
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front:
Depth: Height:
Square Feet:
Front: Depth:
Cubic Feet:
Square Feet; Cubic Feet:
Height:
Type of Construction: A�� f _�,,rc Estimated Cost:
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stiict 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: 2 S— SIGNATURE:
(See Reverse Side For Additional Information.)
d
~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 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.
v
t�i c't Ui= rtilliLir'I
97-84-879001 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
MIMING ING FIXTURE RATES:
NO.
RATE
e
R=ber Fixtures
x
q
m
Future Fixture Opening
x
$2.00
U
New Fixture, Old Opening
x
d
, $
Water
et
$5.00
m
o
x
$5.00
a
C -.
e
a
$
-4
J
`4 ,
$7.00
New Ground kin Old Building
Heater
�+
u
a
x
C
rn
E
. a
x y
W
u
u
W
A c
6 0
0
a
$
Additional Fixtures
H
$1.00
$
Gas Range to 199,000 BTU
s.
7 V.
C
,C
-+
X
C C
$
p
U •.i
C
ti
$
0
State Surcharge
U
$ .50
q
t
S
a w
vii
rk
tai q
ta
tai
o
gas
1ec
lst
d
li
er
an
i
sta
1
1 #10-
D
U
e
tad
3rd
t.l
4-h
(R) = Future Connection Opening
Connected with Sewer
(°) - New Fixture. Old Opening
Water
PARTIAL RATE SCHEDULE
MIMING ING FIXTURE RATES:
NO.
RATE
TOTAL
R=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
$
Slater Softener
x
$7.00
$
New Ground kin 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
s
$10.00
S
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
REINSPECTION
FEE
($10.00) .
Job Address 150 NE Talmadge Way
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 Cedes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true land corre,,
Fridley, Mn. 2-13-78 , 19
OWNER HAMS BEAL
KIND OF BUILDING BRICK
USED AS COMMERCIAL
TO BE COMPLETED ABOUT -20-78
ESTI14ATED COST $ 120.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By MINNEGASCO
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PEP.1412 IS $7.50 pLUS $.50 STATE SUFE
A
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
-AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
U
4.00eplacemen
�.-up
7.00
$ .00Repa$
to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
$12.00
$
each addn. 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
$ 16.00
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$
Additional Fixtures x
$ 1.00
$
as to 199,000 BTU x
$10.00
$
AIR CONDITIONING �b�C®��
S /®-OCA
S �+', o./n..�,� LL
VENTILATING See Fee Sche u1d'e �%C�'
$
SYSTEMS
ALTERATIONS $ REPAIRS S
$
State Surcharge
$.50
TOTAL FEE
$2 ?. SO
ROUGH INSP. REINSPECTION FEE
Date ($10.00)
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 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 CcdeS:.
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. if aeR. 19
OWNER ( f /i/J,t( 1. 4- -A 4 ry
DESCRIPTION OF FURNACE/BU
HEATING or POWER PLANTS, Steam, Hot Water Wa AiY- No.
Trade Name Size 2
Capacity Sq. Ft. EDR BTU HP -6
Total Connected Load Kind of Fuel G
BURNER - Trade Name' Size No.
Capacity Sq. Ft. EDR BTU HP
Company 6
'.,,;-"GOLDEN VALLEY AIR CONDITIONING
Signed BY jUr
Tel. No. 5182 WEST BROADWAY
CRYSTAL,Mg. 5
5r�6.2�Op
CITY OF FRIDLEY
APPLICATION FOR HEATING REPLACEMENT '
CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION /90 M DATE
OWNER ZADDRESS ,
The uWrsigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodged within
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Hea i ng BTU
6/� .
11 0 he� f(15.
TOTAL
REMARKS
SIGNED
Licensee
by r..ns n�ri vns ! �v nsQ rnn+n�rinnnn�r_
RICFI: ,:: HD SONS ELECTPJC CO.
Address c,1,3? VJFIIT rianAU&Ay
Telephone
CRYSTAL, PAN. 55429 HEATING PERMIT # us -4=
j
Fridley City License
SUBJECT
-ILNO.
PERM
,.
City ®f Fridley2
/
0 9 5 6
AT THE TOP OF THE TWINS
PERMIT
BUILDING
0
r
' v
i4 COMMUNITY DEVELOPMENT DIV.
_
L PROTECTIVE INSPECTION SEC.
NUMBER
REV,
DATE
PAGE Of
APPROVED BV
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/23/91
JOB ADDRESS 150 Talmadge Way 'NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
Pt 6, All
2
Elwell's. Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rodger Rollef's. 150 Talmadge Way NE 561-3051
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Eden Construction 150 E 107th.St Cir. Bloomington 55420 888-3015
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 XfJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a,12' x 20'.Porch.Addition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan.
WARF.1
Beforedigging Call for SEPARATE PERMITS REQUIRED FOR
all utility locations WIRING, HEATING, PLUMBING AND SIGNS.
REQura�®°� Y LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$5,450
$2,73
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
S NO RESUME TO GIVE AUTHORITY TO IOLATE OR CANCEL THE
PRC N OF ANY OTHER TATE OR LO ALILAW REGyLATING CON-
STRUCY'10 OR THE PERFO A C� OFC NS�RUGTIO
$63.0.0
Fire SC $5,45
PLFEE
AN CHECK
TOTAL FEE
JJJ
tea✓ 3
7
$71.18
SIGNATURE OFC NTRA 'TOR OR AUTHORIZED AGENT. IDA EI
WHE OPERL V if E T IS YOUR PERMIT
LDG INSP HATE
SIGNATURE OF OWNER IF OWNER BUILDERI IDATEI
CITY OF FRIDLEY Effective Date May 1. 1989
AV,
APPLICATION FOR POWER PLANTS
AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
r�
AIR CONDITIONING SYSTEMS AND DEVICES
m
m
RATE SCHEDULE
tESIDP.t`TiAL RATE
TCYNAL
Job Address
~
r
M
Furnace Shell and Duct Vork,
20.40
`��
So�V
Department of Buildings, 6411 university Ave. H.E., Fridley. HN 55432
-�
Burner (Also raplacwent furnace)
city ®e Fridley
city
Gas Piping $ 10.00
Tel. #571-3450
(piping nailed with tris furnace?
S
The undersigned hereby sakes application for a pecslt for the work herein
Gee Range $ 10.00
specified agreeing to do all work in strict accordance with tlr+a City Codex.
$ 10.00
$
and rulings of the Department of Buildings, and hereby declarAs th.st all the
Gas Dryer
facts and representation& stated in this application eras true and correct.
�
Air Conditioning Call sizes) S 10.80
�
S 10,
idle). Minn. �^ t✓I _� 1 e 19
m
r—
All Others/Repairs and Alterations
OWNER
11 of value of Appliance or work
S
KIND OF sUZLDI
`
i
COKKnCIAL INDUSTRIAL
USED AS
IS of Yalo.e of Appliance or Work
$
To BE cUHPLEm ABOUT.117
N)
ESTIMTeo COST (7 -
State Surcharge
SSD
410 -NEM suiLaiNc PEREiLT ea. _ Pewrr NO.
TD?]1I. !EE
ReinapeCtian Pee ($•15.00)
$
DFSCRYP?IUti OF FUAMJU':VBUAZR
4
ytarw Al
Rough Insp.
Data
NZATING or POWER PIAMS, Steal. not hater.
Trade Name ®� / A�! Size no.
Final Insp.
Date
UP
Capacity Sg. Ft. EDR BTU ..
r`
-.J
��
Approval
Approval for remit _ I��—
Total connected Load Kind of Pwsl
L>
• G r
SUIMR - Trade Hama Site No.
rs
Capacity_ Sri. Ft. EOR 8(41------ RP
KIN IJWN FEE FOR ANY UEATING PERKrT IS $15.00
easy .
'
co
PLUS $. SO STATE SURCUARGE
y
signed. ey
C,
Tei. No.
':-n
-Air OondLtionRrs can not be placed in side yard without
70 -
written permission Eros &4joinirg neighbor.r�
Fill o,t back side for stack verification on replacesent Furnaces
r y
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes K)
2.
is free from rust or deterioration
Yes 7\f
3.
Has no foreign objects lodged
within
Yes ( }
4.
Is securely supported
Yes
5.
Meets all current Code requirements for size and
Yes
total BTU connected
r�
(�
6.
Has Total heating BTU's of
All other BTU's
TOTAL
No ( )
No ( )
No
No ( }
No ( )
Company
Signed E
Da to
11
kr�
HOUSE HEATING TEST REC61RD
�,_ �1.1
t1
R " l.(� `a :`
� APT...___,a_FLOOR CITY SUBURB`'
ADDRESS
; _ _
OCCUPANT
w OWNER
HEAT LOSS—�,�„_ '��
DATE HTG. INST._"��
a
SOLD BY �
INSTALLED BYrtti�����-
Electrical Work By
Gas Line Bye 4
TYPE OF HEAT GA"_
—FA AL_HW
STEAM ti`" SPACE -.HTR. UNIT HTR. OTHER
--GAS
DESIGN
CONVERSION,
MAKE
MAKE OF BURNER
Model���' '
�"A p'� o_
Model
Serial
_
.t v,
Max, -BTU Rating
INPUT
MAKE OF FURNACE `
Model
�^k
CONTROLS
;9 `
THERMOSTAT � 3 1 HeatylPlug
Vent -Size
Valve
c
dy
KINB OF LINER ti ®�)-- SIZE NONE
Limit
�`' f
--- Draft Hood - - Regulator
Limit Setting?
Filters Size 6�a i� l' a Number
Fan Setting "_
iS�
� .
Chimney Location. Inside 4 Outside
Pilot Type
h.. P'?1cT
Chimney Construction
Pilot Make���
Pilot Model
S
Smoke Bomb Wiring oda
Pilot Timing
Droft 0 l Test Tag' >
L.W. Cut Off a—
Door Pressure Lighting Inst.
'7
Pressure
cr <;
Percent CO2 ` `� Date Tested ]
Input CFH
p
Percent 02_ Company Testing 60LA
Stock Temp.p �� Percent CO Nome of Tester
Form 235
MW [ ] Effective 1,/1/91
ADM [ ] I -i AND R-2
AL'Illt [ ] Building Permit Applic;aticn
construction Address:
Isgal D - cript,ian. T
owner Name & ' e- /= S Tal.
Mitracctor: -�Si �/G� �o� Tel. #
Address: /-f -V i� - / 0 74p, - G fA -L-4
Attach to this application, a Certificate of Survey of the
lot, with the proposed oanstruction drawn an it to scale.
�C�TIGl� GIF II�
LIV3 G AMM: length Width Height Sq. Ft.
GRFJM ATMA: length Width Heir at Sq. Ft.
Me= AMM: Iength Width Hgt/Graudd Sq. Ft.
GTS: �- L se,, �—�
Corner Lot [ ] Inside Lct K] Ft. cdladbjadk Side Yard Setbacks
Type of Construction: n \ ( v .Estimated Cost: $
Approx. Completion Date: _ �- v�G� 71 5Ga
Proposed Driveway Width If New Cpening Is Desired: Ft. $ $.
Width + 6' See Hack Page
DATE: � �- �'/' / APPLSCAI : Tel X--
Permit
t
Permit Fee $
Fine Surcharge $
State Surciharye $ o 0
13
SAC Charge $
Driveway Escrow $
Park Fee $
Sesser Main Charge $
TOM $
mss`
STIPU7ATIQZS:
1044 it
IL
Fee ale an reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Daterm; ned by RVineer ng
Agreement Necessary [ ] Not wry [ ]
The Chief Building Official shall, before issuing permits for the erection of any
building or struabire, or foo` any addition to any existing building or structure, or
for any alteration or repair to any wasting building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the a nue t
therein below set forth and in the manner herein provided to -wit:
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$15 Wininum Pee is $15 plus onm ha e)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or Section thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1, 000 or fraction thereof
EPZVENM CENUMICK ZSCWN
(Concrete Club 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.
Permits for cxxis xucticn will be issued a minimmm of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
oan~+tivction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has
it has been cKx= mucted will be required before proceeding with the hmmirg.
rAl
SUBJECT
PERMIT NO.
City of Fridley
i
AT THE TOP OF THE TWINS
BUILDING PERMIT
4
r
jf(
ECO..
COMMUNITY DEVELOPMENT DIV
r PROTECTIVE INSPECTION SEC
0
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 150 TALMADGE WAY
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
]
2
ELWELL' S RIVERSIDE -ADD -19P -IAN-- HEIGHTS SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
ROGER ROELOFS 150 TALMADGE WAY FRIDLEY MN 55432
571-7220
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
f7 NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
xx
8 DESCRIBE WORK
REROOF AND ENLARGING EXISTING GARAGE
2nd LAYER
9 CHANGE OF USE FROM TO
STIPULATIONS
SEE NOTATIONS ON PLANS
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
I
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
6237.44
3.11
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-
124.75
FIRE SC 6.24
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
S
134.10
SI f ATURE OF CONTRACT OR AUTI�- RIZED A T (DApTE)
T
WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT
BLD NSP
GATE
' -g6WATURE OF OWNE OF OWNER BUILDVI (DATE)
rAl
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit. Application
Construction Address: % Y e ca / ",,, a wr,„Q w
Effective 8/l/95
Legal Description: —
Owner Name & Address: v e 0 Nr �,) Tel. # 71 7; ;
Contractor: -y' / C. _ MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
- MNG AREA: Length . Width Height Sq. Ft.
GARAGE AREA � Length 1 � Width Height 9.9 ` Sq. Ft. ,3 S'a
DECK AREA: � t Length Width Hgt/Ground Sq. Ft. 1/
OTHER: "V'pcv -r o o ®u F • `s 1 ` �� –
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks 8 ql
Type of Construction: tzzo v - Estimated Cost:
Approx. Completion Date: / Z g s .
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: APPLICANT:
Tel. #
TOTAL $ /�
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ 4 ' `�
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$� /% —
$.50/$1,000 Valuation
SAC Charge
$
$850 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 $ /�
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 $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 $1,00,000 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.
A
THIS JOB COPY SHALL BE
AVAILABLE ON THE JOB
SITE FOR THE FRAMING
AND FINAL INSPECTIONS
BUILDING OFFICIAL REVIEW AND
AUTHORIZATION REQUIRED PRIOR TO
CHANGES. MODIFICATIONS OR ALTERATIONS
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Effective On January 1, 1998
MA"M NUMULK
Of- FIXTURES TO
BE INSTALLED
ON EACH FLOOR
1Naiec' Bath>
Ti„:
za<::'
Wash
D►iik':'>?
Fbor Gi3Cclj''. Auto. Ges ::: Gas Misc:>:
Water Heater
Stones Closet: Unna Tub.b.; Shower
;`:•;,
Sin ::;
Tray
.:-,.::
Eo n(:;::.:
'' ..::..
;::ri;::.
Drain BsSIn< Washer A ” Range Fixh
$ 7.00
Gas Elec
Basement
Water Heater -Electric
$ 7,00
+:
Gas Range*"
$10.40
GaS Dryer'*
$10.00
BackFlow Preventer Required ( )Yes
Type
Floor 1
Floor 2
Floor 3
`vi:: --.:.:.•
Ji'i::::j
:�� -: }
': ):i+t��-j.
_'•}.?:?i.':;.:. •i}:{`... it:.:jl.El
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00®
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Oft Basin
$ 7,00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7,00
Water Heater - Gas**
$10.00
Gas Range*"
$10.40
GaS Dryer'*
$10.00
BackFlow Preventer Required ( )Yes
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance 'I -A
Slate Surcharge 3 .50
TOTAL FEE $�
JOB ADDRESS_ % - t) F_
The undersigned hereby makes application for a permit tot -the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
1998
Owner
Building Used As `A 6 UNt_�
Estimated Cost PERMIT NO.
PLUMBIN -OMPANc
SIGNED
�
TEL NO._S�%S7
Approved By Rough -In Date Final Date ��AA
JG�
MINIMUM FEE 'OR ANY PLUMBING GAS PERMIT IS $20.00
PLUS THE $.50 STATE SURCHARGE
"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 80 INCHES.
CITY OF FRIDLEY INSPECTION DIVISION
Effective On January 1, 1997
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING
SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
�L'Xn
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00
$
representations stated in this application are true and rrect.
(Side Vent — Fill Out Back)
6 /'qc
,1998
Gas Piping (Needed with new furnace) $10.00
$
OWNER kl--e
Gas Range $10.00
$
R
BUILDING USED AS
Gas Dryer $10,00
$
(� 0 �, `
ESTIMATED COST � � ®� PERMIT N0. f
*Air Conditioning — All Sizes $ 25.00
$ XJ'
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Wate (Warm Air)
Trade NameA-I V-4 C, Size No.
Commercial/Industrial
BTU 1!r, o o HP EDR
1.25% of Value of Appliance or Work
$
Fuel YL *" *�IA Total Connected Load
State Surcharge
$ .50
Burner Trade Name S/w-ta..vc.az Size No. G U c ®y
TOTAL FEE
�6
BTU q5" do ® HP EDR
LL�
HEATING COMPANY_ 4 , ( &ce-A
MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION
Signed By P 14o4wr Tel No. q 77 —(qR
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
12
Approved ByfRough—In Date Final Date �' /I/ NO
*Air Conditioners can not be placed in a side yard without
FILL OUT BACK STACK VERIFICATION ON
written permission from adjoining property owner.
REPLACEMENT F
cEnNN Y AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
L Has been carefully examined Yes ( ) No ( )
2. Is free from rust or deterioration
3. Has no foreign objects lodged within
4. Is securely supported .
5. Meets all current Code requirements for size
and total BTU's connected
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:
List ALTERATIONS Being Done: -
HEATING CO:
Signed By:
Date:
Yes
No
Yes
No
( )
Yes ()
No
( )
Yes ( ) No ( )
Yes
No
Yes ()
No
( )
WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota aYB.n,')1gZ44
.H 135722
County Name WELL AND BORING SEALING RECORD Sealing
Minnesota
Unique No.
AWKA Minnesota Statutes, Chapter 1031 or W -series No.
(Leave blank if not known)
Township FRIName Township No. Range No. Section No. Fraction (sm. i Ig.) Date Sealed Date Well Boring Constructed
13 4 0 i4 4Y 1 � 1998 1950,
Numerical Street Address or Fire Number and City of Well or Boring Location
150 TALMAGE WAY Depth Before Sealing ft. Original Depth 'g ft.
Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL
in section grid with °X°. location, showing property ❑ Single Aquifer ❑ Multiaquifer
lines, roads, and buildings.
N WELL/BORING ❑Measured [I Estimated
W
❑ Water Supply Well ❑ Monit. Well
❑ Env. Bore Hole ❑ Other 40 it. ❑ below ❑ above land surface
E CASING TYPES)
❑ Steel ❑ Plastic ❑ Tile ❑ Other
w mile
CASING
Diameter Depth Set in oversize hole? Annualar space initially grouted?
t S m)1e-6
in. from to ft.
'r-
❑ No F-1 Unknown
--�- - -+
in. from to ft.
❑ Yes ❑ No ❑ Yes
❑ No ❑ Unknown
-- - -t -1-1
-1-
❑ Water Supply Well ❑ Monit. Well
❑ Env. Bore Hole ❑ Other 40 it. ❑ below ❑ above land surface
E CASING TYPES)
❑ Steel ❑ Plastic ❑ Tile ❑ Other
w mile
CASING
Diameter Depth Set in oversize hole? Annualar space initially grouted?
t S m)1e-6
in. from to ft.
❑Yes ❑ No ❑Yes
❑ No F-1 Unknown
in. from to ft.
❑ Yes ❑ No ❑ Yes
❑ No ❑ Unknown
PROPERTY OWNER'S NAME
in. from to - ft.
❑ -Yes -- - ❑ No ❑ Yes
❑ No ❑ Unknown
Property owner's mailing address if different than well location address Indicated above.
150 TALMAGE WAY
SCREEWOPEN HOLE
FRIDLEY HN, 55432
Screen from 77 to 80 ft. Open Hole from to
ft.
OBSTRUCTIONS
WELL OWNER'S NAME
SAM
❑ Rods/Drop Pipe ❑ Check Valves) ❑ Debris
❑ Fill ❑ No Obstruction
Well owner's mailing address if different than property owner's address indicated above.
Type of Obstructions (Describe)
GEOLOGICAL MATERIAL I COLOR FORMATION
If not known, indicate estimated formation log from nearby well or boring.
Obstructions removed? ❑ Yes ❑ No Describe
PUMP
Type J=
FROfd TO ❑ Removed ❑ Not Present ❑ Other
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASINt
❑ No Annular Space Exits
❑ Annular space grouted with tremle pipe
❑ Casing Perforation/Removal
In. from to ft.
In. from to ft.
EMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
G LWY FROM.-UNIVMSITY & 0319
WATER LEVEL IV ABOVE WELL, -401
DATE WATER LEVEL TAKEN. -06/24/
QUAME-11
D Type of perforator
❑ Other
GROUTING MATERIALS)
Grouting Material PMTLAW from 80 to ft.
from to ft.
from to ft.
from to ft
AND BORE HOLE:
❑ Perforated ❑ Removed
❑ Perforated ❑ Removed
OTHER WELLS AND BORINGS'
Other unseated and unused well or boring on property? ❑ Yes ❑ No How many?
yards bags
yards bags
yards bags
yards bags
NS REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The Information contained in this report is
true to the hest of my knowledge.
Contreetor Business Name M License or Registration No.
Authorized Repre3tentative Signature Date
KEVIN 0 SC IT IN/KEVIN HOPPE
LOCAL COPY H 1357 2 Name of Person Sealing Well or Boring
HE -01434-03 2197 R
SUBJECT
PE IT
City ®f Fridley
616
AT THE TOP OF THE TWINS
BUILDING
EMIT
RE
1 46COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
1 � �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L J` 612-571-3450
910-F15
6/8/98
10B ADDRESS 150 Talmadge Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
2
1 Elwell's Riverside Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Roger Roelof 150 Talmadge Way NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Roelofs Remodeling & Renovation 11900 Wayzata Blvd #212 Minnetonka MN 55305
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
512-0110 1095
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK q�
❑ NEW g ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
A
8 DESCRIBE WORK
Construct a-24' x 5' Addition; Interior remodeling of
1st floor
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
11ANNG
Before digging call for
all utility locations
TE RR"�S
454-Oif02
REQt11 RE® BY LAW
R
��• .N�4T1NG, .FPR
PLU�t1tRl:p
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
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
81' 000
$4Q, 5O
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-
$768.50
Fire S $81.00
STRUCWN OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL F
�2/// fOP
License
5.00
$95.00
..r SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IDATEI
PR PAE11DATEDSIS YOUR PERMIT
BLOC NSP
PATE
SIGNATURE OF OWNER OF OWNER BUILDER( IDATEI
NEW [ ]
ADDN [✓j CITY OF FRIDLEY
ALTER [✓f SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: —/5a
Legal Description:
Owner Name & Address:���-
Contractor: - k� k r<,t �-
Address: f 19�� �
1 . v ��-� -Klin . A !:)/Z
12
Tel. #
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCREMON OF TMPROVEMENT
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Lenoth
OTHER:
Effective 1/1/98
Tel. # —0//0
Width �G Height J Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
Construction Type:% Estimated Cost: $ 9'f ,
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: /$'�j�' APPLICANT: Tel. #�2 D//®
CITY USE ONL�
Permit Fee
$ S O
Fee Schedule on Reverse Side
Fire Surcharge
$'jl. OC>
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 3P. S6
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ �^. 8 a
$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
$ "J -
STIPULATIONS:
r ,
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.
CITYOF
HaDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
Roger and Marilyn Roelofs March 27, 1998
150 Talmadge Way
Fridley, MN 55432
Dear Mr. and Mrs. Roelofs:
On March 25, 1998, the Fridley Appeals Commission officially approved your request
for a variance, VAR #98-05, to reduce the side yard setback from 10 feet to 4.4 feet to
allow the reconstruction of existing walls and to allow a 5 foot addition on Lot 7, Block 2,
Elwell's Riverside Heights, the same being 150 Talmadge Way.
You have one year from the date of the Appeals Commission action to initiate
construction. If you cannot begin construction during this time, you: must submit a letter
requesting an extension at least three weeks prior to the expiration date.
If you have any questions regarding the above action, please call me at 572-3599.
Sir ,4ereg ok
Planning Coordinator
SH:Is
Please review the above action, sign below, and return the original to the City of Fridley
Planning Department by April 10, 1998.
Con r with action taWK
96'
NEIGHBOR'S
CERTIFICATE OF SURVEY FOR: SHARON JOHNS
N
S
1 INCH = 40 FEET
* DENOTES SET IRON MONUMENT
• DENOTES FOUND IRON MONUMENT
r
:r
1r %,CCo
Lot Six (6), Block Two (2), Etwelis Riverside Heights, amnOng. to the plot thereof
an file and of record in the Miles of the Registrar of Titles, Anoka County,
Mknnesola, EXCEPT that part described as logo%":
Cernmerroing at a point on a One between Lots Six (6), and Seven (7), distant
276.7 feel southwesterly from the northwest carver of sold Let six (6), thence
South and paragel with the East One o1 Lot One (1), Black Two (2), sold
subdivision, to the center of Oak Glen Creek, thence westerly along sold creek to
the One between Lots Six (B) end Seven (7), sold Subdlvislon thence northeasterly
along sold One to the polnts of beginning.
I hereby certify that this storey, plan, or report was prepared by me or under
my direct supervision and that 1 am a duty licensed Land Surveyor under the Laws
of the state of Minnesota.
f�� n
Signed the OR day of AD., 19 9 u
Mark kAA.P`ett-eerrsoonn
Minnesota Ucenee No. 15252
For Balton & Monk, Inc. BOLTON & MENK1 INC.
Alterations to this drawMg we probMited without the CONSl&MM ENGINEERS tt UM SURVEYDRS
express written pemnteskm of Men R Us* Im w life ow Millie 111, el11w" Ol NW 011117 6110 91101
Copyright 11191, Bogen & Menk, kna 01M OrrM N PIAM M. ►N • SLEM EYE, MM•
. MAWAO. MN •AMM K
JOB #TS95.0075 FILE N1756
Form for use with Minnesota Rules part 7670.0475, Subp. 2
1 & 2 Family Residential "Cookbook" Method
SITE ADDRESS
CilJr
A
2=A&
9--
BUILDER
PAfV
Date
Minimum Criteria:
Rim Joist: R-19 insulation Foundaton Windows: Insulated glass, 1/2" air space, wood or vinyl flame
Entry doors: 1% inch solid wood with storm or better
STEP 1 Window & Door Area
Total Window & Door Area in Sq. Feet
WINDOWS (including foundation windows):
Dimensions Qnty. Area
Total Area of
Window & Doors
Total Wall Area in Sq. Ft.
Wall Total Perimeter Height Area
Total Area
STEP 2 Calculate area as a percent of wall
Box A (window & door area) divided by Box B (total
wall area) times 100 equals the window and door area
as a percent of wall area (Box Q.
Box A C? I-/ x 100= . 7Q/C
BoxB
STEP 3 Design Features
ASSEMBLY OPTION
FRAME WALL:
STANDARD FRAMING
ADVANCED FRAMING
CAVITY INSUUTION
SHL4ng TG: I ESS THAN R-5
R-5 OR MORE
WUVDOWS (except foundation windows):
U-FACMR I U.
From the table, determine the maximum percent window
& door area for the design options selected and enter the
value in box D below:
IR. 8- D
V.
Box C must be less than or equal to Box D
Building BUILDING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Date Rec'd:
DATE 3 2 V !C YOUR E-MAIL ADDRESS G a - �' �+' •, �' �' lc s C e �,
t
SITE ADDRESS 15—d rc .40" et e1r, .4 Gx�cL
THIS APPLICANT IS: 'OWNER ❑CONTRACT R
PROPERTY OWNER/
NAME: A F *� .c. Ale r P. -V
See Back Page for Fee Schedule
TENANT`
ADDRESS: /S e� � �i9 �
_
ITY n �� STATF IIP -J .2
Fire Surcharge
PHONE: 74 3 ^ J71- 7d,;--?
Coe
CONTRACTOR
NAME: S '-z
.0005 x Permit Valuation Minimum $.50
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY STATE ZIP
WITH APPLICATION
PHONE FAX
19 SINGLE FAMILY/NEW CONSTRUCTION
SIZE
PROPERTY TYPE
Erosion Control
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
9 ADDITION ❑ GARAGE/SHED
❑ WINDOWS
Sewer Main Charge
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
Total Due
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW IH'ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: ek c!'� e� dy- l �� ° �> �c .� Ar
SIZE OF IMPROVEMENT % d LENGTH /7
WIDTH
HEIGHT ' ✓ Sq. Ft. 1,7e'
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2• Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
[OVinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOW
OR FOR NEW OPENINGS -DESCRIBE SIZE OF Ic V f
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
(L'R NUMBER OF WINDOWS
L FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABORAND MATERIALS:
j /o's- , s® (USING1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $A c c ` OCCUPANCY TYPE �`lJ
Permit Fee
$ Qi2,-7
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ %
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ L� I I d
Make checks payable to: City of Fridley Attach Stipulations
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 without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINTNAME C ;r'� _a li /�' I� S DATE
Page 2 - Building Residential Application
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 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1St $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1St $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$391.25 for 1St $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for 1" $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for 1St $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the 1St $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the 1St $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
WN
Building
PLUMBING
Peru No.: 0
Received By-
Inspections
RESIDENTIAL APPLICATION
763-572-3604CITY
OF FRIDLEY
Date Recd:Z'vl/p�
DATE 4�', - I a? C YOUR E-MAIL ADDRESS 91P
SITE ADDRESS �� a
THIS APPLICANT IS: OWNW ❑CONTRA OR
PROPERTY
NAME: Ace -e rc o -le 0 Ir 5
STATEN�ADDRESS: 0TY ZIPZ
OWNER/
TENANT
PHONE: %0 - S 71- 79 z@ —e
CONTRACTOR
NAME: W A( -,e ,
STATE LICENSE 0 EXP DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS: CITY STATE ZIP
LICENSE WITH
PHONE FAX
APPLICATION
PERMIT TYPE
KSINGLEFAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW P(kEPLACEMENT
DETAILED DESCRIPTION OF WORK �` ` T :z W j ✓ `
PER MS 1613.665 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)
BATH SINKILAV FLOOR DRAINS —SHOWER _WATER PIPING
_
BATHTUB GAS PIPING aam cmucEvs4 _ SWIMMING POOL _ WATER SOFTNER ($35)
_
CLOTHES WASHER KITCHEN SINK —WATER CLOSET _ BACKFLOW PREY. ($15)
_ .&
DISHWASHER — LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
-)LWATER METER —OTHER
,X
7' 4 w ._+�
,i,
d 3 k` S .?. ... .,
Permit Fee. _ $ "2.0 Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ 4_ D 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 without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME P d 'P(B 7 S DATE t<- IJ- OC
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
Inspections
763-572-3604
DATE C` f a" d i
SITE ADDRESS f r c
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
t•
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
*OWNER
Permit No.:
Received By:,
Date Rec'd:
YOUR E-MAIL ADDRESS
1
WCL
ADDRESS: " / e / aa v .o CA
PHONE: a 3 S a o
CONTRACTOR I COMPANY
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERAHT TYPE
TYPE OF WORK:
CONTACT PERSON:
!a to, STATRL%'_ ZIP S`W 2,
STATE LICENSE # EXP DATE
ADDRESS: CITY STATE ZIP
PHONE
SINGLE FAMILY ❑ TWO FAMILY
❑ NEW ❑ REPLACEMENT
FAX
❑ TOWNHOUSE
QrALTERATI ON/REMODEL
DETAILED DESCRIPTION OF WORK 1 -4 _z 4 T I � N ",
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: MWICATE TOTAL
NUMBER OF EACH BELOW)
MODEL:
SIZE/BTU
Equipment Installed MFG:
MFG:
MODEL:
SIZE/BTU
MFG:
MODEL:
SIZE/BTU
A/C $25.00
FIREPLACE (GAS) $15.00 .
GAS RANGEJOVEN $10.00
NEW GAS 00
—_AIR TO AIR EXCHANGEER $15
_FIREPLACE (WOOD) $35.00
HTRGRI$ 0.0$10
UNIT HTR $10.00
BOILER $35.00
_FURNACE $35.00
_GAS
POOL HEATER $35.00
—_CHIMNEY LNER $10.00
_GAS DRYER $10.00
VENTILATOR $1500
DUCT WORK $10.00
GAS PIPING $10.00
Permit Fee $ _ [• Cf0 Number of fixtures @$10.00—x $10.00 =
Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ •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 without a permit; that the work will be in accordance with the
approved plan in the case of all work whichrequires review and approval of plans.
SIGNATURE OF APPLICANT
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
l d �S DATE
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. 1MC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a_ Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Cocke 7670 or 7672
6. Duct Design Per IMC 1346:0603.2
a. ACCA Manual D
NOTE: Center -point Energy Mechanical Code Guidelines software may be u4ed for
combustion and make up air calculations