PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3627
Date: .� �...� .......
Owner ...... ... ... Builder ... . .......... ...............
Address ...................................... Address .............................................
LOCATION OF BUILDING
No../.. Street .. .. .. ..... .......... Part of Lot ...............................
Lot ............ Block .................. Addition or Sub -Division .......................................
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ...........................
To be Us as
. XA ..
.................... Front ........ Depth ........eight ........ Sq. �...... Cu. Ft.........
Type of Construction .. .... ]ice Cost...... ...... . To be leted ... ................
DESCRIPTION OF BUILDING
Front ) :'!? Depth ..�� - ,Height Sq. Ft. i� : I0"Cu. Ft. 5?6 .
cgl� z —r- /
b�"
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set fo and pliance wi all provisions of
ordinances of the city of Fridley. e
In consideration of the payment of a fee of $. ........... permit is hereby granted to ...................
......................... 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 city limits and this permit may be revoked at any time upon violation of any of theprovisions of said
ordinances.
............. Building Inspector
NOTICE:
This permit rdties not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sura to see the Building Inspector for separate permits for these items.
A 7 44
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
.. W'illard. A. OlsonSelf and- Carlson LaVine
Owners., Name:. Builder
Address 6257: e
Trinity Drive ' "Address
LOCATION OF'BUILDING
6251 Trinity Drive Carport
No,
'Street Part of Lot
Lot.-- Block •—Addition 'or Sub. Div.
Corner Lot Inside Lot Set Back
Applicant. attach' to this form Certificate of Survey of Lot and proposed"
building Location.
DESCRIPTION OF BUILDING.
See Note Below
To be used as
Front Depth - Height
Sq. FtCu. Ft.
Front Depth _._,..Height �.
Sq. Ft. cu. A ...
Screened Potash 1000.00
Type of Cori§truction Estimated Cost
Temporary by 1 Jan 1959
To be `complet'ed
-.Screened porch by.. summer 1959
The undersigned hereby makes application for a permit for.the work
herein specifagreeing•to do all work in strict accordance with the
City Ordinances aria ruling of the Department of Buildings, and hereby
declares that all the facts and representations stated in this'application
are true and correct.: -
Date Dec. 129 L958 Signature.
(A Schedule of Fee`Costs can be' found on the Reverse Side)
B'ote:a*Enclose Existing Carport, add Garage Door to'Front, lay
clement floor.and approach and add 810" to rear.
Work and material to be furnished by Carleen Lavine.
Enclose extension with Combination ,Aluminum Windows and
Door. Work and Material to be done by se1S.
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit
for the erection of any building or structure, or for any addition to
any existing building or structure, or for any alterations or repairs to
any existing building or structure, upon application therefor, 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:
2.1 For any such permit for the erection of.any fireproof building,
other than a garage, warehouse, factory'or grain elevator, or for the
erection of any fireproof addition, for similar occupancy, to any
existing building shall be at the rate of $1.40 for each one thousand
cubic.feet, or fra ction thereof, in such cubical contents.
2.2 For Any -such -permit -for the erection of any fireproof garage, ware-
house, factory or grain elevator, or for the erection of any fireproof
addition for similar occupancy, to any existing building shall be at the
rate of 11.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneapolis Building Code.
HOUSES
2.3 For any such permit for the erection of any non -fireproof building
other than a garage, warehouse, factory or grain eleva'to'r, oh any
non -fireproof addition, for similar occupancy, to any existing building.
Permit $1.00 for each one thousand cubic feet.
GARAGES
2.4 For any such permit for the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non-
fireproof°addition, for similar occupancy, to any existing building or
for each such building or addition. Ninety Cents for each one
thousand cubic feet or fraction thereof, in the cubical contents thereof
with a minimum of $4.00.
For the purpose of computing fees for building permits the cubical
contents of any building or addition to a uniform hei ht throughout by
multiplying the ground area covered from a point six k6) indhes below
the floor line of the -basement or cellar to the -average height of the
upper surface or to the average height of the roof surface of the main
gable of a pitched roof.
2.5 For repairs or alterations .to an existing structure, the fee shall
be at the rate of $3.00 for each Five Hundred Dollars (6500.00), or
fraction thereof in the cost of all proposed work.
2.6 In no case shall the fee charged for any permit as set.forth in
Section 2 be less than $4.00.
741
;L�.
SUBJECT
PER -
City of Fridley
12340
AT THE TOP OF THE TWINS
BUILDING PERMIT --
r
RECEIPT NO.
RECEIPT
1 ,
___ COMMUNITY DEVELOPMENT DIV.
�ti: - --
INSPECTION
�a
r PROTECTIVE SEC.
1 �
_
FRIDLEY 55432
NUMBER
REV.
&U/ 4
PAGE OF
APPROVED BY
6112-560 3450
910-F15
N
JOB ADDRESS 6251 Trinity Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
21
2
Sylvan Hills Plat #3 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
John C. Handrickson 6251 Trinity Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Leslie Tranby Roofinj & Siding Co. 6917 Valley Place Crystal
4 ARCHITECT OR DESIGNER M ILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION JJ 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,
Shingle
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR, CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1100
55
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$9.55
SIGNATURE OF CONTRACTOR ORAUTHORIZED AGE (DATE)
N PROPERLY HIS IS YOU PER IT
BLDG WSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
APPLICATION FOR RLSIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF 1-1:1 DLLY, MINNESOTA
OWNER'S NAME: _ �'�' /V C //Fx/nX/c/f-, dA/BUILDER: % S
ADDRESS f / ,/ Y ®� 6 Cc
,� �� � e° %1� ADDRESS Z f/ 7 Vd X Z_ E V CC
NO : S TREET • a ®�l ay
LOT : j -BLOCK: ADDITION: �Qi�4 ,91V 14114
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buildixig location drawn on these Certificates.
.DESCRIPTION OF BUILDING
To Be Used As:
(1pq-, Front: Depth: Height:
Square Feet:
Front:
Square Feet;
Cubic Feet:
Depth: Height:
Cubic Feet:
Type of Construction: Estimated Cost: $ Zoo, a
To Be Completed: // - // - /9 7-?
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that .i11 the facts and representations stated in this application
are true and c orrve t .
DATE:1,972 SIGNATURE: ',7�14,111
(Seo Reverse Side For Additional Information.)
.4.
BUILDING PERIMIT FEE: SCHEDULl1
SECTION 2. The Inspector of Bzzi.ldin,gs shall, before issuing permits for the
erection of any building or struc Lurc,, or for ani• addition to any existing
building or structure, or for •_uiy .41terati.on or repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such permit of fees tc thu amount herein below set forth and in
the manner herein provided to -wit:
UNIFORM BUILDING CODE: Type 1, 2 & 4 -- $2.15 for each on(: 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
cowered from a point six (6) inches below the floor line of the basement
or the cellar to tho 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 ease shall the fee charged for any permit as set forth in Section 2 be
lass than. $5.00.
VERIFICATION OF FOUNDATION
NOTEI 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 Certiiicate 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.
>° w
'j
7
SUBJECT
P
City ®f Fridley
20586
AT THE TOP OF THE TWINS
BUILDING PE MIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
_
v PROTECTIVE INSPECTION SEC.
C /�
NUMBER
REV.
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
ILA
�r'�';
e---
L A 612-571-3450
910-F15
9/24/90
�
JOB ADDRESS 6251 Trinity Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
21
2
Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAILADDRESS PHOE
ZIP 574- 9224
John Hendrickson 6251 Trinity Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (15 Squarest
9 CHANGE OF USE FROM TO
STIPULATIONS
On all new roofs or tear-offs and replacement roofs,
State Code requires that 2 layers of 15 Ib. felt,
mopped together, be installed to a point 24 inches
up from exterior wall line, or the use of other
approved underlayment membrane.
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 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
$750
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$21.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
i.re $.7
$22.25
SIGNA RE OF CO RSO RAAUTHO IZED AG NT DATEI
PROP RLY LI E THIS IS YOUR PERMITf
(��j
Xz
k,,,JWHEV
.. tF2—
s7r .. 9 G
BLDG INSP
iGNATUREOFOWNE IF WNER BUILDERI (DATE
'j
7
NEW [ ] Effective 8/16/90
ADDN [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address:
legal Description:
• .. � � � � �tt�`r �i ` � //ilk Lam.: �� �
• — • •• •� a •• w • • • • r. —
LIVING AREA: length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Len Wi Hgt/Gro`und Sq. Ft.
Corner int [ ] Inside Lit [ ] Ft. Yd Setback' Side Yard Setbacks
Type of Construction: Estimated Cost: $ �]
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Wil + 6' See Back Page
e
DATE: /PrZ-/
APPISCANT: Tel.
CITY USE ONLY
Permit Fee Fee Schedule on Reverse Side
Fire Surcharge .001 x Permit Valuation (1/10th %)
State Surcharge $ S'7� $.50/$1,000 Valuation
SAC Charge $ $600 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Suer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TUML s,
STIPULATIONS:
I:41Pate) a,: !i�g"JvIIY :Y 34_
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:
$1 to $500 $15 (Minimum Fee is $15 -plus surcharge)
$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
DRIVEWAY DEPRESSION ESC ff
(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 tines $15.75.
0 31' r• . . . 1 11 .)
Permits for construction will be issued a minimum of 24 hours freer 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.
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
JOB ADDRESS M-5-1
The undersigned hereby makes application for a permit for the work
Rate TOTAL herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
$ 20.00 $ �' that all the facts and representations stated in this application are
true and correct. 9-3-9 ,1991
$ 10.00 $ �p�
OWNER g I:n nL(,1�1,i-
$ 10.00 $
$ 10.00 $
$10.00 $ /(�-CCn
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $
CommerciaUlndustrial
1 % of Value of Appliance or Work $
State Surcharge $ .50_
TOTAL FEE $ S C�
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
v �
BUILDING USED ASA
ESTIMATED COST �s' PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) arm it
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
Richmond & Sons Elec., Inc. dba
Golden Valiay Mg. & Air Cd
HEATING COMPANY 9J'921".IPSi Rrlft"V
Cr1_n ;.'�i'ti 55429
Signed By Tel No.
Approved By Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
0
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes No ( )
2. Is free from rust or deterioration Yes No ( )
3. Has no foreign objects lodged within Yes (✓) No ( )
4. Is securely supported Yes No ( )
5. Meets all current Code requirements for
size and total BTU's connected Yes No ( )
6. Has. total heating BTU's of Z-1-9 /G
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
Vrlio�, Htp.. F. ,Air I'd
11 `
City ®f Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
M I T
P
2 6 0 6 4
I q
LCOMMUNITY DEVELOPMENT DIV.
d _ PROTECTIVE INSPECTION SEC.
1 i
CITY HALL FRIOLEY 55432
ti____ 1`.' '•� 612-571-3450
NUMBER
910-F18
REv
DATE
5/19/98
PAGE OF
APPROVED BY
JOB ADDRESS 6251 Trinity Drive
I LEGAL
DESCR.
LOT NO.
21
BLOCK
2
TRACT OR ADDITION
Sylvan Hills Plat 3
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
Gale Hendrickson, 6251 Trinity Dr., Fridley, MN 55432
ZIP
PHONE
574-9224
3 CONTRACTOR MAIL ADDRESS
Midwest Roofing & Siding, 18979 Gladestone Blvd, Maple
ZIP
Grove
PHONE LICENSE NO.
55311 20010277
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
416RdiM4 LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Re -roof (tear -off)
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must meet State Building Code.
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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$1,918.20
SURTAX
$.96
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-
STRUCTI OR THE PERFOR CE OF CONSTRUCTION.
$62.25
Fire SC $1.92
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$70.13
siDNATURE OF CONTRACTOR OR AUTHORIZED AGENT tDATEi
WHEN PROP
re
DG NSP
"JY ZALIDATED
THIS IS YOUR PERMIT
� OATE_
S,GNATURE OF -OWNER OF OWNER BUILDER) iDATEi
NEW [ ]
ADDN [ l
ALTER [ ]
ConstructionAddre;
Legal Description:
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION r„®�
Owner Name & Address:Tel. # -5 -Y- ids r
Contractor: r� ! � u-�S �, 6�0o Tiy� & f - S 1 Y7 6 MN LICENSE # t�9 %2
Address: G %aeAe oyic (?Ivd , M,dlr
6 r'ot'e , !/Gl �, �s'�% Tel. # V"' - 0V
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E%IPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
o)3s 1r�� �
Estimated Cost: $ / `
(Fee Schedule on Back)
Ft x $ = $
DATE: % r�� APPLICANT: 2:&
Tel. # -Z.
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ ,
.001 of Permit Valuation (1/10th%)
State Surcharge
$_
$.50/$1,000 Valuation
SAC Charge
$
$1000 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 [ J
TOTAL
$ qOs
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 $1,000,000 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.
e wc5s'Z3
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 151 T r i A I Al
Legal Description:
Owner Name & Address: #� C r- Tel. #
Contractor: MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Co t: $
$\-DrivewayCurb Cut Width Needed: t F 6 Ft = / Ft x _ '�' 1 / �. 00
DATE: APPLICANT: 0.MQM Tel. # 7a��-
CITY USE ONLY -
_Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing In application
$ Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $1150 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 [ ]
SUBJECT
IT NO.
City of Fridley
3 2 5 3 4,
AT THE TOP OF THE TWINS
,
BUILDING PERM
-RrC—EIPT NO.
E • COMMUNITY DEVELOPMENT DIV.
�y ------
INSPECTION SEC.
+�
/v�1
/6
r � � PROTECTIVE
1 ;
E E �" : CITY HALL FRIDLEY 55432
IL
NUMBER
REV
DATE
PAGE OF
APPROVED BY
----A" 612-571-3450
910415
4/25/02
r
JOB ADDRESS 6251 Trinity Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
21
2
1 Sylvan Hills Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Farren Forcier 6251 Trinity Drive NE 763-502-6815
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
O NEW 0 ADDITION 0 ALTERATION] REPAIR 0 MOVE O REMOVE
8 DESCRIBE WORK
Replace windows within existing openings; Reside House & Garage; Soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions for this provision would be if sheathing is an approved weatherproof
panel or when the siding is an approved weather barrier. Vinyl siding is not a
weatherproof covering unless the manufacturer states this in their application
guidelines. Call for inspection of wrap before covering. Caulk and flash all
exterior openings. Provide soffit ventilation to meet the State Building Code.
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code.
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 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
$3,500
$1.75
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FE
TOTAL FEE
$f02.50
SIGNATURE Of CONTRACTOR OR AUTHORIZED AGE NT IDATEI
EN ROP VALID T THIS IS YO PERMIT
4t g5_
BL ,NSR RATE
SIGNATURE Of OWNER,IF OWNER BUILDER, ,DATE, -
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [X] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Addre
Legal Description:
Owner Name & Ai
Contractor.
MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construction Type: dv',✓ doW S s ,`gk; A!i Estimated Cost: $ .3 S-® ® -(:!)C3
-5ofH-4-�- cis C1'9
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: 41 aE Oate APPLICANT: Tel. # -� 63 ;�-ovL � 8 1 S— lcsrr
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will 30 (�
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
$ % ;24_
$ -3-S-6
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
TOTAL $ 16- z STIPULATIONS:
BUILDING PERM 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
$100,001 to $500,000
$500,001 to $1,000,000
FEES
$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
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be
required before proceeding with the framing. New Houses Only
-
sue,ECT
RM IT
City of Fridley
3(301,00
AT THE TOP OF THE TWINS
BUILDING
P E R M I T
NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
3A37
,
NUMBER
pEv
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
L 763-571-3450
910-F15
6/11/0
10B ADDRESS 6251 Trinity Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
21
2
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Farren Forcier 6251 Trinity Drive NE
763-502-6815
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove and replace sheetrock, insulation and vapor
barrier on all interior
walls
9 CHANGE OF USE FROM TO
STIPULATIONS
Insulation to meet State Building Code.
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 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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I 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
$500
$ .50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
$24.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
' EN PROPERLY VALIDATED THIS IS YO R P
RMIT
SIGNATURE OF OWNEP,IFW
ONER BUILDER, IDATEI
YUNIP\1rI
f
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: b i 1 i" i ✓t i +y Pr A
Legal Description: _
Owner Name & Address: F s- I eve F-ot-e r e L S� Tet. #
Contractor. 0 w .4 ef r- MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height �Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: 9-e- ikouf a Ina Re-pLce-C i , �✓1
Uoip&r bar* t e -r W kic t kup Q 6 e -
Construction Type: Estimated Cost:
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 6 / C) APPLICANT: Tel. # 763 so a 6815 -
Call
8/5'
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
Eo
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$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
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
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.
VERIFICATION OF FOUNDATION
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
gc�-6-/ Tv'vi' -� y r IV4C-
F r ct C{ [-P—Y 04 YJ I I -f 3 P-
1 110, ve- tjC,fi e6pin Flet-c�a &.nor K
Iv) c r , `� i n L(> Perm--%
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