PRE 2010 DOCSQ
City of Fridley, Minn. N9 9402
BUILDING PERMIT
Date: August 17, 1967
Owner: guentin Watts Builder Lumber King Co.
Address 6340 Van. Buren S t . N. E. Address 4047 Vincent &v -,.e South
LOCATION OF BUILDING
No. 6340 Street Van Buren Part of Lot
Lot 6 & 7 _Block 5 Addition or Sub -Division .....u. Florence Park
Corner Lot ._ Inside Lot x Setback _.__ Sideyard -3 17
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 201 Depth 24' Height 10, Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Frame Est Cost —_$20.00 - 00 _ To be Completed Oct- 1967
Variance - Board of Appeals Meeting 8/16/67
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 corn Wee th afl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ Z-�Qg , permit is hereby granted to I.3m,ber King- Co .
to construct the building or addition as described above. This permit is granted upon
the eress crondition that the person to whom it is granted and his agents, employees and workmen, in all work.
done around and upon said building, or any part thereof, shall cronform in all respects to the ordinances of
FdlFy6nnesota regardhin inances.
CLARENCE BELISLE Building Inspector
NOTICE:
ids pomdt does not cover the construction, Installation for whine, plumbing, oas heatiae, sewer or water. Be sure to sae
the Building inspector for soparats permits for them items.
Ate' LIC T .r q FOR Bz ILDIN1G
C1 s of I� ic► i3:1E �, r,"INNiESO'TA
OWNER'S NAME 'L L �'"d U� BUr:i -DER
ADDRESS n J/ �_ A?DDR SS a
LOCATION OF BUILDING
110. (D 3:v STREET PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION��s'�'-e
CORNER LOT INSIDE IAT L SETBACK SIDE -YARD
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
To Be Used AA:
4
Front,rQ U Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
_Sq. Ft. Cu. Ft.
Type of Construction 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 - 1 -� `" .
(Schedule of Fee Costs can be found on the Aey6rse Side).
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of structure, or for any addition to any existing
buildingor 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- $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
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.
NSSSD Connection ,Charges based on location- Area 1 or 2.
City of Fridley
AT THE TOP OF THE TWINS
u
SUBJECT
BUILDING PERMIT
P
6 7 5 6
r
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
612-571-3450
RECEIPT NO.
NUMBER
910-Ft5
REV
DATE
7/22/98
PAGE OF
APPROVED BY
JOB ADDRESS
6340 Van Buren St NE
1 LEGAL
DESCR.
LOT NO. BLOCK
Pt. 6 7 t.8 5
TRACT OR ADDITION SEE ATTACHED
1 Florence Park Addn. to Fridley SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mr & Mrs Ervin Sahl
574-0136
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Four Seasons-
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20138780
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION IX REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove and Replace 21 Sq of Shingles
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with 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 80 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
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
1
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 HIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO VE AUTNRITY TO VIOLATE OR CA CEL THE
VALUATION
$1751
SURTAX
$.87
PERMIT FEE
SAC CHARGE
PROVISIONS O NY OTHER STATE R LOCAL LAW REGUL ING N-
STRU 'TION HE PERF N OF CONSTRUCTION.
M.1714 $56.75
Fire SC $1.75
y� �
PLAN CHECK FEE
icense SC $5.00
TOTAL FEE
$64.37
SIGNA uREOFCONTRACTORO AUTHORI2EDAGEN7 IDA I
WHEN PROPERLYYALIDATED THIS IS YOUjq PERMIT
JV -
ge it; GA T[TEE
SIGNATURE OF OWNER OF OWNER BUILDERI tDATEi
NEW Effective 1/1/98
ADDN [ ] .; CIfY,,OF,FRIDLEY
ALTER [ ] SINGLE FAMILYy AND DUPLEXES R-1 AND R-2
BUILDING HERMIT ,APPLICATION
• `' �i3� .dtr,Fe+:,de 4I
ConstructionAddress:
e
Legal Description:
Owner Name & Address: /X_r 1/l 1� �JA'{'i�. Tel
Contractor: f5U t1( S e -as cTn 5 0,6±1330 nl &M.MN LICENSE # AD/ 387
Address: °7c? 3 d U n t U e4rS 14-u g u f 911 Fr- Tel. #
Attach to thisapplidatioift';r a Certificate of Survey of the .
lot, with the. proposed; construction drawn on1t. 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: iYYI ^%, /�p 'Cc.0 -� o Iy C� C S h a nc, /CfA
Construction Type: Estimated Cost: $ / ?S_/
(Fee Schedule, on Back)..
Driveway Curb Cut Width Needed: Ft.' +'6 Ft = Ft x $ = $
DATE:. �'l PLICANT;. TeL '? • Y .. -
TfT
CM
Y, USE ONLY r
Permit Fee $ C�-. %' Fee Schedule. on Reverse Side'
Fire Surcharge $ .001 of Peraut`Valuation (1/10th%)
State Surcharge $ $.50/$1000'Valuation
SAC Charge $ $1000 per. SAC Unit
License Surcharge $ $5.00 (State Licensed Resideiati�l Contact„r,��r
p. �T �if h rf'aaG 4w. «�
Driveway Escrow $ .+`°�A1 "A" or Alt ��B" Above 9 ���;�,r
4 ' �� Y .1
Erosion Control $ P $450.00 Conserv4tion Plan Review.
Park Fee $ Fee` Determined by Engineering
Sewer Main Charge $ _ `Agretmient .Necessary [: ] ....Not. NecessaryJ],I MU
ri�K
t: •
TOTAL $
4i h rS 1 - s . ',• ii,� WFC, �i �w L' `Y1R UP,
.t.ANI, ?§,T1w�yM,r4
STIPULATIONS:
Building.
$
BUILDING
See Back Page for Fee Schedule
Permit No. -4q 1
Inspections
RESIDENTIAL APPLICATION
Received By: �
763-572-3604
CITY OF FRIDLEY
Date Rec'd: gca'
DATE ® -07
E- "ADDRESS
.0005 x Permit Valuation Minimum $.50
3ITE ADDRESS
!2YOUR
f3 VA eV Er- OA, U
PHIS APPLICANT IS:
❑ OWNER 1ACONTRACTOR
$
PROPERTY OWNER/
NAME:
Curb Cut Escrow
TENANT
ADDRESS: 3 O - U v �6�p Cr
STATE,01,6PJ-J �! �2
Erosion Control
PHONE:
CONTRACTOR
NAME:
$
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # a.10 6,5 EXP DATE 3
ADDRESS: y�o ^. /,4 1 !/ll /1✓O CI'I'Yl'STATV ZIP
WITH APPLICATION
PHONE SO.P -' 3 36l FAX -A
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION
SIZE
/Mpa .040
TWO FAMILYINEW CONSTRUCTION
STORIES
PERAM TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
OTHER
❑ SWDODAING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR LM REMODELING
DESCRIBE WORK BEING DONE: ,13-Y,rt dvc w
SIZE OF IMPROVEMENT 0 S LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING
V ❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor pian
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
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
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 $ 6'000,00 OCCUPANCY S/r r,4 TYPE #* USC
Permit Fee
$
j//• ';R j
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
P, so
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 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 _
$_
/Mpa .040
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 w ' Yre uire revs and approval of plans. / ,,/�'
SIGNATURE OF APPLICANT PRINT NAME -.I i� r,v ' UN DATE ~ ��
Page 2 - Building Residential Application
BUILDING PERNHT 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 I' $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$39125 for 1- $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$663.75 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 1s' $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 1' $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 1 ' $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
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CODE
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Building
PLUMBING
Permit No.: `
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
ILS
DATE r ® / YOUR E-MAIL L ADDRESS
SITE ADDRESS
THIS APPLICANT APPLICANT IS: ❑ OWNER 0 --❑CONTRACTOR
PROPERTY
NAME:
OWNER/
ADDRESS: (0 3 ® CITY STA1%_ZIP 9
TENANT
PHONE: j (,:P J - 5-74- 0/3G
CONTRACTOR
NAME: osd o M'd bi t t 4
STATE LICENSE ,# / EXP DATE 2
ADDRESS: i Lf t4 '� � CITY t b A 146 V'&ATE� ZIP J 5�-?j
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
PHONE 7j'3- 799 ' „�&V- FAX -7(0'
APPLICATION
PERMIT TYPE
A3INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT
DETAILED DESCRIPTION OF WORK Irb
PERMS 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 URE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV _FLOOR DRAINS SHOWER _ WATER PIPING
_
—BATHTUB —GAS PIPING (Nia:n ri77irc•EN.S*r:) SWIMMING POOL _ WATER SOFTNER ($35)
_
—CLOTHES WASHER —KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15)
_
_ DISHWASHER _ LAUNDRY TRAY HEATER ($35) FOR IRRIGATION
_WATER
WATER METER OTHER
11171-- VIN -0 44-11 TOM
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
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 anapplicati 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 cas al ork which req ' es eview and Tans.
�INT
SIGNATURE OF APPLI ME DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977