PRE 2010 DOCSVMage ®f Fridley, Bonn.
BUHMING PERDUT
No 4"72
Office of INSPECTOR OF BUMDINGS
it
-4
Owner
Architect
Builder
Fridley,
LOCATION OF DING
No. 00' Street Part of Lot
Lot Block Addition or Sub -Division
DESCRIPTION OF BUILDING
i
Front Depth. !1 height �-!- _�) Storie
Manner of Construction—
To be used as 0,To be completed Estimated Cost Z L 0
Permit Is hereby gFanted to to
the building
described in the above statement. This permit is granted
upon the express c6ndltloit
n that the person to whom it is granted, and his agents, employees and workmen, in all
the work done in, around and upon Jaid 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 upon violation of any of the provisions of said
ordinances.
Inspector of Buildings.
AGREEMENT AI"TD SWORN STATEMENT
In consideraiion of the issue and delivery to mle by the Inspector of Bufldings of r, ridley of
the above permit, I hereby agree to do the proposed worh in accordance vnth 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 by me and contained in the above permit are
true as therein stated.
Subscribed anA sworn to before me at Fridley, Minnesota,is xx
day of A.D. 19-1—t .
�J
�J
Village of Fridley, Minn.
BUILDING PFAWr
N? �48 Office of INSPECTOR OF BUHMINGS
II
Fridley,
LOCATION OF B ING
Street Part of Lot,
Block M. Addition or sub -Division
/1-11[ DimcRipnoN OF BUILDING
C
lrrontDcpth�,.- �L�' Height- Stories Manner of construction
To be used
as To be completed Estbnated Coat
4
is
Permit is herebyd,to
If
the building— described In the above statement. This permit Is granted
upon the express condition that the person to whom it is granted, and his agents, employees and workmen, In all
the work done I around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of FrldleyI, Minn., regarding the 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.
_.'!_-=1aspector of Buildings.
li
I
f
AGREEAUMNT AND SWORN STATEMENT
In consideration of 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 by me and contained in the above permit are
true as therein jIstated.
Subscribed aid sworn to before me at Fridley, Minnesota this
1 1
day of A.D. 19-L-7-
s /5-j
City of Fridley, Mian.. No 0 i Q 0
BUILDING PERMIT
Date: June 12, 1970
Owner: _ Terzy Hes Builder Same
Address _ 7600 Van Buren Street Address Same
LOCATION OF BUILDING
No. 7600 Street Van Buren Street N.E. – Part of Lot
Lot R Block 2 Addition or Sub -Division .__ Schafers Subdiv. #1
Corner Lot _ Inside Lot ..._..X Setback —-- Sideyard
Sewer Elevation _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 20 Depth 22' Height 10, Sq. Ft. 440' Cu. Ft. 4400'
Front Depth _ _ Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est Cost T $l,_500=0_0__ To be Completed 4 Months
Provide Hardsurfaced Driveway
Maintain Grade equivalent to existing slope between street and dwelling.
In consideration of the issuance to me of a permit to const
the proposed work in accordance with the description above set
ordinances of the city of Fridley. i
I above, I agree to do
with all provisions of
In consideration of the payment of a fee of $ 9.00 ( , permit 4 hereby granted to Terry Hess
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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the condtruction, installation for wiring, phnabing, gas heating, sewer or water. Be sura to as
the Building inspector for separafid permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S //as 5 BUILDER: ,S q M 6—
ADDRESS : 7,�( 14A) BUZEA) SF—, ADDRESS: SAM e
NO:.. 26 O STREET • V A N Is"
LOT: BLOCK: ADDITION:� /
CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYARD:
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 As:
ARA6E_ Front • ® Depth: —Height:
Square Feet: 11,V O Cubic Feet:
Front: Depth: Height•
Square Feet; Cubic Feet.-
Type
eet:Type of Construction: FkA-v?E_ Estimated Cost: $
To Be Completed: �o
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 all the facts and representations stated in this plication
are true and correct.
DATE:' SIGNATURE:—
(See Reverse Side For Additional Informati It
r
N.
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.
City of Fridley, NUmn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
111U"ING PERMIT
Owner: Mx !rerr3; Hass Builder Same
Address - 7600 Van_8uren_St-reei- N.E. Address Sams -
LOCATION OF BUILDING
I 7hnn Street an B rAn qt1pet Part of Lot
Lot .8 Block - 2 Addition or Sub -Division - Shaffer's Subdivision #1
Corner Lot Inside Lot X Setback —..... Sideyard _
Sewer Elevation Foundation Elevation _ --
DESCRIPTION OF BUILDING
To be Used as:
Addition Front 9 Depth
10' Height 10' Sq. Ft, 90' Cu. Ft. 900'
Front . r Depth Height . Sq. Ft. . Cu. Ft.
Type of Construction Frame Est. Cost — 850x-00 To be completed May, 1972
In consideration of the issuance to me of a permit to construct the b escri 6d ove, I agree tq do
Abe proposed work in accordance with the description above set fa with all provisions of
ordinances of the city of Fridley. .
.50 State Su c
In consideration of the payment of a fee of $_5.-_00 ,rmit is herkby granted to Terry Hess
to construct the building or addition 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
ftdley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
Within e city limits and this permit may be revoked at any time upon violation of any of the provisions of said
/f
CLARENCE BELSSLE
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to No
the Building Inspector for separate permits for these items.
V
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: XBUILDER:
ADDRESS: ADDRESS:
5� �NOJ. STREET: �/ CJ`)
LOT: BLOCK: o? ADDITION:��ttf F/C�� �S�
CORNER LOT: INSIDE LOT:%SETBACK: SIDEYARD:rte
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 As:
Front : Depth: Height: 1j_Gvy—e_ ao-
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: n, 'estimated Cost: $���-�
To Be Completed: 7-Z
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 reby
declares that all the facts and representations stated tllis�a cation
are true and correct.
DATE: SIGNATURE:
G
(See Reverse Side For Additional Information.
9_') --�' ,may rr _r
.04
BUILDING PERMIT FE`S 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 azolid i.
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 ® $1.55 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.
do 7-
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5
Tl ,� 7-0
14
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316
Y / / /
SUBJECT-
P MIT Nrp O.
City of Fridley
® 14016
AT THE TOP OF THE TWINS
BUILDING
PERMIT
EC PT NO.
COMMUNITY DEVELOPMENT DIV.
1 t PROTECTIVE INSPECTION SEC.
t . �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
4/21/77
JOB ADDRESS 7600 Van Buren Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
2
Shaffer's Subdivision #1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Terry Hess 7600 Van Buren Street N.E.
786-7328
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 1j ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Construct a 23' x 10' Addition with basement
9 CHANGE OF USE FROM TO
STIPULATIONS
REQUIRED F#. MIS
WARNING
SVRAPERMITS
®afore ftft Cd MW a ties
HEATIN'�E
EATIf�G. PLUMBING AND SiGN�.,
TELEPHONE - EUCTRIC US Etc.
REQUIRED RY LAIN
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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 BE COMPLIED,
$4,000
$2.00
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.
$24.00
PLAN CHECK FEE
TOTALFEE
$26.00
SIGN UREO ONTRACTOROR T RIZED T(DATEt
HEN PROP RLY VALIDATE THIS IS YOUR PERMIT
hLDG INSP
DATE
" SIGNATURE OF OWNER (I OWNER BUILD R)
Y / / /
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: 4F-1 BUILDER: �7 e_-�
Address: 7(o d Q V �� �j,�,vti �,,` , Address:
Tel. No.
No. �(�, o -V Street •
LOT: 7r BLOCK: ADDITION: o -i -4 IJi(it.Pr s /
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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 As:
��✓� Front: 3 Depth: 10 Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: /Ll�- �Estimated Cost: $ 27-1
To Be Completed: Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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 representatiorg, stated i this application
are true and correct. See reverse side for Aditional ormation.
DATE: /-7 % SIGNATURE:
Stipulations:
r
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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $15.40
jul""Sunjimma•• •
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 $7.50 plus $.50 state surcharge.
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 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.
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.
rage i OX 4
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER: DATE
SITE ADDRESS: 6'° '� d l� I fJ PHONE:
CONTRACTOR:
06
Determine working square footage of each /
1. Total exposed wall area...... V® 9 , a sq. ft. x .17
2. Toal roof/ceiling area ...... 4:�)sq. ft. x .05 =
Total exposed wall area above floor =
a. Total wall window area ................................. �®
b. Total door.area ............. 3 �°
c. Total sliding glass door area
d. Total fireplace wall area .............................
e. Total• wall framing area (average 100) ..................
f. Total rim joist area .................................. f
g. wall area above floor ..........................
h. wall area above floor..........................®a
i. wall area above floor ..........................
j. wall area above floor......... ..................
e. X "U"
/713 X fluff
h. I? X fluff
i. X "U" _
j. X "U" s gee = /
k. X "U"
1. X "U"
3. Total
d
3f tem #3 is the same as,
o less than item #1, you
ave met the intent of
SBC 6006 (c) 2.
Total exposed
foundation area =
2
14
k. Total foundation window area
........................... �e
1. Total net
foundation area above grade .................
Determine "U"
value of each wall segment
(e.g. window,
door, each separate wall section)
a.
! X,
fluff
b.
X
fluff
V
�g
C.
X
"U" _
d.
X
"U" _
e. X "U"
/713 X fluff
h. I? X fluff
i. X "U" _
j. X "U" s gee = /
k. X "U"
1. X "U"
3. Total
d
3f tem #3 is the same as,
o less than item #1, you
ave met the intent of
SBC 6006 (c) 2.
Exterior Envelope Average "U" Computation
Total exposed roof/ceiling area =
M. Total skylight area ............................
n. Total roof/ceiling framing area (average 10%)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
M.
X "U"
n. X "U"
o. X "U" _
4 ........................... Total =
Page 2 of 4
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 .(c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2-
1. + 2.
3. + 4. _
WALL SECTIONS
NOTE: Use 10% of opaque wall area for
frame construction
FIG. #1 TOPVIEW OF
FRAME WALL
talphe a1
7 1
E3G. #3
y %
Page 3 of 4
n Construction R -Value
V
1. Interior air film 0.68
2.
3.
® 4.
. 5.
Q 6. Exterjor air film 0.17
Total
1. Interior air film 0.68
2.
3.
.
4.
S.
6. Exterior air film 0.17
Total
40
-.0 1. Interior air film 0.68
2.
3.
-�- 4.
- 7)
6. Exterior air film 0.17
Total
.- .
��. 1. Interior air film 0.68
v..
2.
3.
4.
5.
6. Exterior air film 0.17
Total
a v,
Tit
.�„ .• i .. ��..
Fir; #4 !!( t� • • • O r /Il
�u Y
• /�(= ��/ -• Int f.
NOTP.: Indicate type, "R"•value, depth and
placement of insulation.
- _ ....
TIM.
cuvw ft UL q
ROOF/CEILING
Construction R -Value
1. Interior air film 0.61
2.
3*
4. Exterior air film (still)
0.61
VEJJT
Total
Vented Heat flow
up
FIG. #5
1. Interior air film 0.61
2
3.
4. Exterior air film (still) 0.61
Total
L-J\Iil L-�Zj L-� jj L -U+
Pleat f 101.7 up .•vented
•FIG. #6.. 1. Inside air film 0.61
2.
3.
tQ
4.
5. Outside air film
0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
Heat
flow up
Pxr,. 07
SUBJECT
P IT NO.
City of Fridley
2 6 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
I L PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/23/98
JOB ADDRESS
7600 Van Buren NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
2
1 Shaffer's Sub. #1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Donna Hess
539-0212
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Milton Johnson Co. 525 Lowry Ave NE Xpls 55419 781-9548
2083
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE N0,
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION N REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK Shed, and lean-to garage,
Reroof house and garage 20 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building
Code.
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
1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1668
.83
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 PERFORMANC OF CONSTRUCTION.
$54.00
Fire SC
$1.66
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
1$61.49
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHE®Nyp��PROPS VALIDATED THIS IS�YYOJU"RA/PERMIT
a'6/ -1
B DG INSP
GATE
_
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW Effective 1/l/97
ADDN [ CITY OF FRIDLEY
ALTER [XI SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 7600 Van Buren N. E. 1,6
Legal Description:
Owner Name & Address: Donna Hess (same) Tel. # 539-0212
Contractor: mi i ton Johnson Co. MN LICENSE#
Address: 525 Lowry Ave. N.E., Mp1s. 55418 Tela#
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlVIPROVEME\TT
2083
7819548
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width H Ground Sq. Ft.
Roof house, shed, garage,
Construction Type: and lean-to on gararagEstimated Cost: $ 0
(Fee Schedule on Back)
Driveway Curb Cut .Width .Needed: Ft. + 6 Ft = Ft x $ - — $
161656
DATE. 223 APPLICANT: Tel. # 7-81-954-8
CITY USE ONLY
Permit Fee $ ay0Q Fee Schedule on Reverse Side
sire Surcharge $ �, �v .001 of Permit Valuation (1/10th%)
State Surcharge $ L2 $.50/$1,000 Valuation
SAC Charge $ $950 per SAC Unit
License Surcharge' $ S-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 [ J
TOTAL
�'r11'ULATIO,NS:
N
BU11,n1NG PEWMIT FEE SCHEM.11.1,.
The Chief Building Official sliall, 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 S62.25 for first S2,000 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 $1()0,000
$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.tthe first $500,000 pias $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.
f ternate "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
crrnits for construction will be issued a minimum of 24 hours from the time of'application to Off" w for proper
:view of' the proposed structure and of the construction site. .
e:rtiticate of Survey of the lot, showing the location of"the foundation once it has it has-been constructed
h., required bCi()rC Xvith the frtmin-
WELL OR BORING LOCATION
MINNESOTA DEP TMENT OF HEALTH
WELL AND BORING SEALING RECORD
Minnesota Well and Boring
Mating a unique
H--164691
Water Supply Well LJ. Montt. Well
❑ Env, Bore Hole ❑ Other _..
County Name
-�- -i-- - --
i
Minnesota Statutes. Chapter 1031
Well No.
or W -series No.
E
CASING TYPE(S)
- �-- -i-- -;--
iL�UwdtItMiii—)
Steel ❑Plastic ❑Tile ❑Other
Anoka
1�mife
CASING(S)
Diameter Depth Set in oversize hole? Annular space initially grouted?
Township Name
Township No.
e No
Section No.
Fraction Ism. -t. Ig.)
Date Sealed
Date Well or Boring Constructed
Frid1e
30
1274
11
NE N`E N
7-12-00
of perforator
❑ Other
Numerical Street Address or Fire Number and City of Well or Boring Location
_
7600 Van Buren
NE, Fridley
Depth Before Sealing 25
ft.
Original Depth
ft
AOUIFER(S)
STATIC WATER LEVEL
-St
Show exact location of wen'or boring Sketch map of well or boring
in section grid with `X-.
location, showing property
Single Aquifer ❑ Mulhaquifer
�,
N
lines, roads, and buildings.
Measured ❑ Estimated
WELL/BORING
S
f note
'
PRO ERTY OWN9-P
Gonna NAME Hess
li
Water Supply Well LJ. Montt. Well
❑ Env, Bore Hole ❑ Other _..
� 2 It. N below. ❑ above land surface
-�- -i-- - --
i
-'
. W
E
CASING TYPE(S)
- �-- -i-- -;--
--�--
Steel ❑Plastic ❑Tile ❑Other
1�mife
CASING(S)
Diameter Depth Set in oversize hole? Annular space initially grouted?
I
t
S
f note
11-4 in. from 6 to 2 2 ft. ❑ Yes :j No ❑ Yes ❑ No ❑ Unknown
in. from to h. C] Yes ❑ No ❑Yes E] No ❑Unknown
in. from to ff..❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown `
PRO ERTY OWN9-P
Gonna NAME Hess
Property owners mailing address if different than well location address indicated above.
3 3 5 S h e r w ood C t
Circle Pines, M Ni 55014
SCREEW/OPEN HOLE
Screen from 22 to 25 It Open Hole from to ff.
OBSTRUCTIONS
❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill CKNO Obstruction
Type of Obstructions (Describe)
Obstructions removed? ❑ Yes ❑ No Describe
WELL OWNER'S NAME
Wen owner's mailing address if different than property owner's address indicated above.
PUMP
Type
' ElRemoved [X Not Present ❑ Other
GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO
FORMATION
If not known, indicate estimated formation log from nearby well or boring.
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
_
o Annular Space Exists
❑ Annular space groutedwith tremie pipe
❑ Casing Perforation/Removal
in. from _ to ft. ❑ Perforated ❑ Removed .
_ in. from to h. ❑ Perforated ❑ Removed
Type
of perforator
❑ Other
_
GROUTING MATERIAL(S) (One bag of cement = 94 lbs., one bag of bentonite = 50 Ibs.)
Grouting Material Nt Cmt from 6 to 25 N yards 1/ 2 bags
_ from to ft. yards bags
from to ft. yards bags
from to-- ft. yards bags
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
OTHER WELLS AND BORINGS
Other unsealed and unused well or boring on property? ❑ Yes X] No How many7
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or borinn was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is
true to the gest of my knowledge.
Mork Well Co., Inc. 7 02658
Contras r BusinNarne ® License or Registration Pio.
7-12-00
Authorized Ra esentative Signature Date
Ron Danielson
(MINN. DEMI: OF HEALTH COPY
11 q
Name of Porson Sealing WeN or Boring
HE -01434-05 IC# 140-0423 4/99 R
CITY OF FRIDLEY PERMIT NO.: 2004-00472
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 04/12/2004
572-3604 FAX: (763) 571-1287
ADDRESS : 7600 VAN BUREN ST NE
PIN : 113024110064
LEGAL DESC : SHAFFERS SUB NO 1
: LOT 8 BLOCK 2
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE.
MOVE 200 AMP OVERHEAD SERVICE
# 101+ AMP CIRCUITS 14
APPLICANT
SCANDIA ELECTRIC
17491 OLINDA TRL N
MARINE, MN 55047 -
OWNER
BRIAN & ERIN, BENESCH
7600 VAN BUREN ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date.
STATE SURCHARGE, ELEC FLAT
0.50
ELEC AMP SERVICE FEE
30.00
ELEC CIRCUIT FEE (101+ AMPS)
55.00
TOTAL
85.50
PAID WITH CHECK # 2594
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
W
Building
MECHANICAL
P$IlXlkt
Inspections
RESMENTIAL AP'PLICATTON
ReOdved Oy:
�:'
763-572-3604
CITY OF FRIDLEY
Date R.eeld: l
DATE -10 `O6 YOUR EMAIL ADDRLSS __ � �TOT� K MU d! �• CGL% %1�M�1 I
SM ADDRESS � 1v � D Mt ft 1nu E% -M 5- ' . i,.3 r t
THIS APPLICANT IS: 13 OWNER ONTRACTOR
PROPERTY
NAME, MI?Af %'.b --
OWNER/
ADDRESS: " 7c too \/An loot -en. Si. me • (.rrY E r•; t} 1�-` 4� _... ,- ^ ^ 3TATG
TENANT
PHONE; % 6s'3— �7) � — A �� �
CONTRACTOR
COMPANY NAME: 'eV - ' A& d � c+ clsakrjuq Servms
S'URW A COPY O}'
It
CONTACT PERSON sowam
YOURSTATI
____
STATELICENSH#8_*944 . -4. i NNI DATE _.1�]+�1 it +f-OMW)
LICENSE WITH!
ADDRESS: S 162L For ft r+4w Oy- N) CtTY..�t}�.d STATEAW ZIP=2O
APMICATION
FAX IPS i ' 0-7 &Solo
p, T TYPE
.11901.2 FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK;
O NEW /P-1PIACFAflWrO ALTERATION/REMODEL
ESCRIPTION OF mr- A / c -
DETAILED DWORK_
PER MS 16B.665 the permit Ike is a minimum of $15.00 or 51/16 of the total cost up to $500.00, whfohever is grater, for the
improvemea. installaticm or mplacament of a residential fixture, excluding dee fixtures. (Thus should reflect only the cost of labor)
Labor cost under $300 - $15.00. Labor cost between $300 to SSW s cost of labor x .05 =
FOR PROAk7i S WHERE LABOR EXCEEDS $500, TEES ARE BASED ON $10.00 PFA FIX'1 LWE. EXCFYr WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH HEIDV T)
Equipmwl Ifs caf o MrQ Flt; ti MODEL: HIANO?5 F1Dr� 1 smawm 7C coo $TU
MEG: gel 'i MODEL: AQ K.A 10 SI2F113TU M,acs
MFG: MODEL: Size/BTU
,ZAIC $25.00 ,_,,,FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
„_,,,AIR Ta Alit BXCHANCF.FR $15 FIRUPLACE (WOOD) $35.00 NEW OA$ GRILL $10.00
GOILER $35.00 FURNACE $35.00 GAS UNIT TITh $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 _Pani. HEATER $35.00
DUCT WORK $10.00 ..GAS PIPING $10.00 _VENT.ILATOR $15.00
PERMIT FISP. PROJECTS FOR UNDER $S00
PERMIT FW POR PROJECTS OVER $500
Permit Fee $
'Number of fixtures 1 $10.00 x $10.00 = $
Surcharge $ - _ -_ SO
_
Number of ftwes @ $15.00 x 515.00 = S
TOTAL DUE 5 � _
Number of fixtares (a 525.00 = x $25.00 = S 'r
=
Number o€ftewas @ $35.00_ x $35.00 $
State Surcharge - $ SO
Total
THIS IS AN APPLICATTON FOR A PERMIT -NOT VALID UNTIL PROCE,9SM
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will bs in
con&rmance with the ordinances and codes of the City of Fridley and with the Mimmota. Construction Codes; that I wdwitatld this is
not a permit but only an application for a peruelt and work is not to start without a pannit; that the worst will be in accordance with the
approved plan in the case of al) work w i h rewires re ' vend approval of plans.
`
SIGNATURE OF APPLICANT 9 PRINTHAMS 9664 g r i 10 --0 6
PLEASE NOTE: SEPARATE Pgpjv • ARE REOMRW FOR BUILDIN EL••,EC'nWAL AAIB ArlECHAMCAL, WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
Wt/ SZ:Ob:6 6 900Z/6 W:9120 V/ :eBed umouNun :wotj