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City of Fridley, Minn. N9 9434
BUILDING PERMIT
Dale:
SEPTEMBER 6, 1967
Owner: FRANCIS Cf. ELLERBUSCH Builder SAME
Address 7507 University Avenue N. E. Address
Fridley, Minnesota 55432
No. 7507 ____ Street
LOCATION OF BUILDING
UNIVERSITY AVENUE N. E. Part of Lot
Lot 16 _ Block 2 r
Corner Lot Inside Lot X
Addition or Sub-Dividoi
— Setback
Osborne Manor
Sideyard
Sewer Elevation Foundation Elevation
To be Used as:
EXTEND GARAGE
Type of Construction
DESCRIPTION OF BUILDING
Front 8 Depth 23 Height 10
Front Depth Height
FRAME Est. Cost — $600.00 _
VARIANCE - BOARD OF APPEALS - August 30, 1967 -
APPROVED BY COUNCIL - SEPTEMBER 5, 1967
Sq Ft. 184
Sq. Ft.
To be Completed
Cu. F , 8400
Cu. Ft.
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 atli provisions of
ordinances of the city of Fridley.
�.�-����.e�s� � ��� Biu �✓
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to FRANCIS E.
ELLERBUSCH 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 pari thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE
Building Inspector
NOTICE:
lots permit does not ewer the eondroction, hotallation for whdng, p1w&1ng, gn heating, sower or water. Be son to see
the Botidws Inspector for separate permits for these items.
Ani ,1CMYrZi FOR M-11 D'ZNG
CITY OF i� i{.1.A1:� 1', N Mill' SOTA
OWNER'S NAME_,; =''f �f�S � /J�'� BUr?,DuR
ADDRESS &&LP&Z_ &,, E. V ADDRESS
LOCATION OF BUILD11%
N0. STREET PART OF LOT
LOT_ BLOCK ADDITION OR SUBDI'VISI'ON .Q5
CORNER LOT INSIDE LOTSETBACK SIDE -YARD r
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
2'K1�r.��aet�
To Be Used Ad:d:"
Front- a Depth Height
Sq. Ft.
Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of ConstructionA�V�G� Estimated Cost ® ®. '
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City'of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE — /% % SIGNAT
(Schedule of Fee Costs can be found on the Reverse Side).
C/
SECTION 2. The
erection of any
building: or s tr
or structure, u
for such permit
herein provided.
BUILDING PERMIT FEE SCHEDULE
Inspector of Buildings shall, before issuing permits for the
building of structure, or for any addition to any existing
.acture, or for any alteration or repairs to any existing building
Don application therefore, require the payment by the applicant
of fees to the amount herein below set forth and in the manner
to -wit:
Uniform Building Code: Type 1;2, & 4- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contents. Type 3 & 5 - $1.50 for each
one thousand cubic feet.
For the purpose of computing fees for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches below the floor line of the basement or
cellar to the average height of the upper surface or to the average height of the
+oof 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.
NSSSD Connection Charges based on location- Area 1 or 2.
. -
SUBJEDT
City of Fridleyr?
2 8197
AT THE TOP OF THE TWINS
g U I L D I N G P E R
M I TC
572_-3604
RECEIPT
♦V -_--� COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
�
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I
I le -1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/13/98
JOB ADDRESS
7507 Universitv Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
2
Osborne Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Emil Lorenz796-9762
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Ea leview ConstInc.-
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 0 ADDITION ❑ ALTERATION j REPAIR
0 MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage 20 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the 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
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 RE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1714
$.86
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
$56.75
Fire SC $1.71
___7
PLAN CHECK FEE
TOTAL FEE
�l "It
License SC $5.00
1$64.32
NATUR OF CONTRACTOR OR AUTNORIZEO AGENT iDATEi
PROPERLY "Ll THIS IS YOUR PER�M�IT////fir
4&WHEN
9� �NSO
OATS
SIGNATURE OF OWNER,IF OWNER BU0.DER1 iDATE,
0
NEW '
[ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -Z
BUILDING PERMIT APPLICATION
ConstructionAddress:�b
Legal Description:
Owner Name & Address: Cat i l Ca4 c -ley Tel. # Te, '�'7, g r,
Contractor: MN LICENSE # 076c Z.3
Address: %3 % % %'Ke--- - Laos 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
Height
Width
Height
Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Tyre: fZ P� 6 e—ye Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: jh�/?J/APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
$ �56. %E-
Fee Schedule on Reverse Side
Fire Surcharge
$ 4'7/
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 00
$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 $1,000,000 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.
NEW [ ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: AJld e ' <
Legal Description:
Owner Name & Address: �L L �%� y 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 Cost: $
*'XDriveway Curb Cut Width Needed: /0 Ft. + �t = AFt x $
r
DATE: APPLICANA-. Tel. #
CITY USE ONLY -
Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1100 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:
114V9 I
I I
ADDN
'ALTER. ,
• .:
OwnerNam $1 Addre;
Cor�ctor: UU
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTR;
1.1 1 T lJP t'IK I IJLG T ®49 g-__ ®® � Z r . u,,L rJ4
CITY OF FRIDLEf— EffSectiiiVe 4h/2004
6431 University Ave NE, Fridley, MN 55432 (763) 57244 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R.2 (763) 571-9287 Fax
BUILDING PERMIT APPLICATION
2
4- L
LICENSE #
- Tet. #-19
Attach to this application, a Certfiicate of Surrey of the
bt, with the proposed construcOon drawn on it to scale.
DESCRIF TION OF IMPROVEMENT
Lerma Width -� Height Sq. Ft
Length Width Height Sq. Ft
LWO Width Hgt/Ground Sq. Ft
Construction Type: n Estimated Cost $_ 1 ° 0 0
WidthN
Driveway Curb Cut S FL + 6 Ft p-
x $ = S
f/
DATE: APPLJ+"�INT: Tel. 1112
�i
Cal! (M) 67244 for Permit Fees If mailing In appikation. Fax to 763.5714287 if using credit card and are will cau
you for card number.
CrrY USE ONLY -
Permit Fee
$
Fee Schedule on Reverse Side
Plan Review
7
65% of Permit Fee
Fire Surcharge
$
.007 of Permit Valuation (1/10th%)
State Surcharge
$---Z—LLL
$.50/$1,000 Valuation
SAC Charge
$
$1350 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Curb Cut Escrow
$
AIL "A" or AIL "B" Above
Erosion Control
S
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
ment Necessary [ J Not Necessary [ 1
TOTAL $
i��
OCT -18-2004 10:00AM FAX:
STIPULATIONS:
ID:POMERLEAU PAINTING PAGE:001 R=100%:
Building
$3 .vZ�
BUILDING
Permit No.:
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
Surcharge
OF FRIDLEY
Date Rec'd:
DATE
oZ 00 6 Y UR E-MMA� IL'�9 � pile S
a- e
_ADDRESS
SITE ADDRESS 50 �f Z U G✓ iJ /� ivoF
$
THIS APPLICANT IS:
❑ OWNER )(CONAACTOR
$
PROPERTY OWNER/
Nom; t, 1 4- jL cL L"e_pt qt-�7
$
ADDRESS: `7 S8 Q—;ZyUT%/Ps —$ ` CITY >OCVI
STATE
TENANT`<
Fee Determined by Engineering
PHONE: � 7e6 '' 76e,4—
$
CONTRACTOR
Nom; roclA P164o —Lr -';Z-
$ C .i
SUBMIT A COPY OF
STATE LICENSE # U 07 ®"02� EXP DATE ®a3 7
6dVJSTATW46a
YOUR STATE LICENSE
'�` C�
ADDRESS: 3 -i3ZT �j CITY E�
✓+
WITH APPLICATION
PHONE 3 5 .Sot FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ROOF ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
QNEW ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: Gi-LqkA
VV
SIZE OF IMPROVEMENT L GTH WIDTH HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES I
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2• Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS, & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. 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 WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �)g I I — OCCUPANCY TYPE
Permit Fee
$3 .vZ�
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fite 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 $21= $
! Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ C .i
Make checks payable to: City of Fridley Attach
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 applica' n 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 war ich requires rev' oval of plans. , / Cl -L1. -D
SIGNATURE OF APPLICAN ,, � PRINT N(6—doll_ v ATE