PRE 2010 DOCSVillage of Fridley, Minn.
N® 1803
BUILDING PERMIT
Date: ....................
Owner Builder .
Address...................................... Address .. .��....f/. h . � -. 5
N} �� LOCATION OF BUILDING
No. . 11.� Street .. N.. ......................... Part of Aot ......
Lot ... ..... Block ..... ;2 .......... Addition or Sub -Division . ...... .
Corner Lot ........... Inside Lot .. ... Setback ... 314-. Sideyard ... ...................
DESCRIPTION OF BUILDING
To be Used as:
1. ........ ........
Front Depth w Height Sq. Ft. Cu. Ft.
..................... Front ........ Depth ........ Height ...... Sq. Ft. ........ Cu. Ft. ........
Type of Construction Est. Cost . / jg�:�/...... To be Completed ..................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in
compliance with all provisions of
ordinances of the village of Fridley.
..
.................. ......'v!
In consideration of the payment of a fee of $ .`....., permit is hereby granted toC;�i /?' .....
l
.. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon' violation of any of the provisions of said
ordinances.
Ji✓r
' ...... .................. Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
ME
SUBJECT
P dvH`
City of Fridley_
16118
AT THE TOP OF THE TWINS
BUILDING P E R M I T
r
l"Ic
RECEIPT
• _ COMMUNITY DEVELOPMENT DIV.
SEC.
7/
L✓ PROTECTIVE INSPECTION
c ,
_ ✓ "1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910—F15
4/14/81
JOB ADDRESS 6221 Trinity Drive N.E.
1 - LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
18
2
Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Morgan Lind 6221 Trinity Drive N.E. 571-3648
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Robert Starr 10416 Partridge Street N.W. Coon Rapids 757-4281
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 ❑ ADDITION ❑ ALTERATION [A REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
reroof
9 CHANGE OF USE FROM TO
STIPULATIONS
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 BO 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
700•
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
50
ST TION OR THE PERFORMANCE OF CONSTRUCTION.
• J
PLAN CHECK FEE
TOTAL FEE
8.00
T
X_ / > gI
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
_ PROPS LY L DATED THJS IS YOW1 ERM IT
BLDG INSP DATE'
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
ME
CITY OF FRIDLEY
APPLICATIO:d FOR RESIDENTIAL BUILDING PEIU41TS
• (New, Alterations, Additions, or Repairs)
• OWNER: WLCI�
ADDRESS:
TEL NO: 7/
BUILDER:
ADDRESS: JM,16 PGS iJ.'.. S�. stow ,
6"'.jfWS,
TEL 1.10: 7s 7 - 'fu=
IIUJLI)Ih1G I'f;lil4JT FEE SCaIf:I)UI_E' �
J;IaCTXON 2. - '.I')iZ 7n%;pector. of: )3ui.l0.i.tjU : :;Jl tl1, )�e 'Orr. i:;�ru9iig pcnnit•;s for the crection
of u»y huilcl.i.r►,) or .;truct:ure, or foa: piny addition Lo ally exi:;ti.ng ),wilding or structur(..',
i)r liar. any al.t.c.•r aLi�,n or. rct,aa rl; to any cri..ting hui.l.di.ng or structure, upon application
thcrefor.e, require thQ payment by the applicant. for !;uch per of fee; to t)ie area+ant
hrru.i.n below scat forth jvid in t)tc manner: herein provided to -wit:
VVI.1.1 COIISTRuciri : Single Family homes and Garages: y4.00/7.,000 cubic feet:.
PL70i CII):C1;: 25 percei,t: of building permit fee.
DRIVIWAY DEYP.L•'SS20Id: .(Concrete. Curb I"trects Only) '
Alternate A: Rnmoval and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $13.50
Alternate B: Removal and replacement of concrete curb and
• gutter and install •a 3 foot aide approach with
• 6 inch depth; Driveway width plus 6 feet x $15.75
• —ADDITIONALIhFORMATIO��
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 sir. (6) inches belo;•r 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, theafee 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 FQU,NDATION
•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 OCC ICY
Application for a Certificate of Occupancy shall be mads. ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure hall not be used or occupied until a Certificate of Occupancy has
been issued.
SUBJECT -
PERMIT .-•--_-..,.
City of Fridley
10758
AT THE TOP OF THE TWINS
BUILDING PERMIT
1R
�• COMMUNITY DEVELOPMENT DIV.
-------, PROTECTIVE INSPECTION SEC.
3 9 i q
o �
1
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 6221 Trinity Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
18
2
Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Violet Lind 6221 Trinity Drive NE 571-3648
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Manions Master Roofing 3841 Hayes Street,.Coluinhia Heights 55421 781-7228
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑X REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (15 Squares) Tear—off
9 CHANGEOFUSEFROM TO
STIPULATIONS
on all new roofs or 'tear-offs and replace,
.rmt roofs.
State Code requires that 2 layers of 15 113, felt,
mopped together, be installed to a point 24 incheS
up from Werior wall line, or the use of other
approved underlat;aembtane.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 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
1
STALLS GARAGES
VALUATION SURTA
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$780' $' 78
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE SAC GE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$21.00 Fire S $$ , 50
STRUCTIOY OR THE PERFOR NCE OF CONSTRUCTION.
PLAN CHECK FEE TOTALFEE
y_
$ .28
SIGNATURE OF CONTRACT OR AU HORIZED AGENT iDATEi
WHEN PF&OPERL D T S IS YOU PERMIT
s
BLDG INSP OATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ 7
ADEN [
ALTER [ ]
1-1 AND R-2
Building Permit Application
Effective 1/1/91
Legal Description:
Owner Name & Address: y� 'Tial.
Contractor: j' "l.�l�'`�( r, ,�� 1?✓a J--✓�i Tel • # �'% a-'- �{
Address: L3 ? yj e& MS a o c- c -r- S, ej IJ - --5--r Lf �?.j
Attach to this application, a Certificate of Survey of the
lot, with the prcposed construction drawn on it to scale.
r 1R F' 1 IPTIM OF TI U S N 7VF1�II TD
LTVIIdG AREA: Iength Width Height Sq. Ft.
GRP -AM AREA: Length Width Height Sq. Ft.
DBM AREA: TP*gth Width Hgt/Ground Sq. Ft.
OTHM:
t
Corner Lot [ ] Inside lot [ ] Ft. Yd/��ck Side Yard Setbacks
Type of Construction: `//l� ha�.a �'! sf(_ Estimated Cost: $
Approx. C7ampletion Date: �V-� ' 9f ✓ �.
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: APPLICM: Ynu. Tel. #
Permit Fee
Fire Surcharge $
State Surcharge
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
STIPU=CNS:
CI'PY USE ONLY
Fee Schedule on Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ l
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 waiting 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:
$1 to $500 $15 Minim= Fee is $15 plus m rClorge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional. $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $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
ERIVERRY DEMMMICT ESCWW
(Clm=ete 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.
Permits for construction will be issued a minim= of 24 hours fthe time of
application to allow for proper review of the prgposed strucbu 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.
SUBJECT
ERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
P C D A A I
C "'v 1
� t
• COMMUNITY DEVELOPMENT DIV.
��------. SEC.
r � � PROTECTIVE INSPECTION
1 /---1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910415
5/7/99
JOB ADDRESS 6221 Trinity Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
18
2
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Violet M Lind 6221 Trinity Drive NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Richard Hastings Contr. 6331 Riverview Ter NE, Fridley, MN 55432 574-9966
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
4051
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW O ADDITION 0 ALTERATION REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof House & Garage (18 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 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
$1,542
$.77
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
�.• 5 ill
PLAN CHECK FEE
Lice s C
$5.0
TOTAL EE
8.56
SIGNATURE OF CONTRACTOR OR AU IORIZED AGENT (DATE,
6�E/]N/�R__
BL G INSP
�VALIDA D Hljs IS YOUR FT
gAtE
SIGNATURE OF OWNER,IF OWNER BUILDERi IOATEI
NEW [ J Effective 1/1/98
ADDN . [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 rL
BUILDING PERMIT APPLICATION �-
ConstructionAddress: / a A� d
Legal Description:
Owner Name & Address: ' a c L L 6 Tel. #
Contractor: \o L iz b 14 ik S 1y MN LICENSE # V05 0
Address: �J II ��� . Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
Construction Type: '7"—FA Z iFiz o o F Estimated Cost: $ /-5y'12
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. # 5 4�4
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$l jjr
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$1,000 Valuation
$1000 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 [ ]
to
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.