PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N® 4 317
Date: -----._._....____.__--•--__........._.._._..._.__._ _..._-
6 �
Owner: ................................ ..... .............. — -...._... __..................................... Builder ...........:.
Address....._ ............._,._..._._..._.._.._....._____ _ _..._—_. .... Address
N OF BUILDING
No...........d...,fID Street -............- .... -... - .._.........��........... Part of Lot -_..._..__._......._.._............._.._
Lot 1 - /. ...... Block . .......................... Addition or Sub -Division ..... 51deyf
-------•--
Corner Lot ....._.. Inside Lot .................. o............. Setback 3a`l....._'®.............. .. .....:.--o ...... ........................... ..............
Sewer Elevation ............. ......... .........._.._........._............._...................................... Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Vr ,fir-
_._.................... _ .....- Front ... L...'® Depth . 0 - Height.. Sq. Ft. �...r Cu. Ft
.................... ..................... ............ ..-_. Front Depth .... ............... _.. Height ........................ Sq. Ft. ..... _............ _... Cu. Ft. ..... _.................
Type of Construction..-----------..__.................................. .. Est. be Completed ........ .............................. -..........
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
Date:
Owner:
Address
City of Fridley, Minn.
BUILDING PERMIT
fi.
lOT® �4909
-407
Builder ....._......._...... ............... .... _.......... .............
_._._.....__._.._.._..---
Address_.... ..... _ _._.._.....____.._..._.._...__.
L CATQN BUILDING
No.. .. .....,._�.. Street _.. ..�.. K. ...:.��:,. .��:.:.:._ �. �...,. .......... :....,._... Part of Lot,.. _.......::...._........._........_..._.......... _.............
__
Lot ... Block . -- : _............. -............. Addition or Sub- ivisi _..... :.-- ----- .._..._........_._..
Corner Lot ........... .............. Inside Lot ... .._........ 't ck idey' d ..............
Sewer Elevation....._............._.............__...._....._............._............._..................—.. Fo dation Elevation
DESCRIPTION OF BUILDING
To Us as ` .
$
': __ ...... Front .a ... Depth .. ..:._.. Height ....._... Sq. Ft..:;._ _.: Cu. Ft.
_._.. Front ----........_ Depth ... � eight ._.�o........... Sq. Ft ..................... Cu. Ft. ..... _.........---.--
Type of Construction ............................... ....._::.......::.... Est. ost%.....:...._,..jo
............. To be Completed ......................... ............... _........
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
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
within the city limits and this permit may be revoked at any time upon violation�f any of the provisions of said
A
ordinances. ,� A
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, KMMSOTA
Address 59.) ----Address 16 ` t)L-,VD !
LOCATION OF BUILDING
No. 15 16 Street ®t /y'o S:77 N , Part of Lot
Lot —3 Block Addition or Subdivision —
Corner Lot Inside Lot �/ Setback Side• -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be
DESCRIPTION OF BUILDING
V/
/a
Sq. Ft. &5 % c/, Cu. Ft. 6 7-6/ 0
Front Depth Height
Type of Construction Estimated
To be Completed
Cu. Ft.
Cost
The undersigned hereby makes application for a permit for the work herein specified$
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representations
stated in this application are true and correct. A
DATE 7, 1 5 4? SIGNATUR9°:
(A Schedule of Fee Costs can be found on the Reverse Side.)
Sec i n JIL The Inspector of Buildings shall, before issuing any permit for the
erection of air building or structure, or for any addition to any existing build-
ing 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 fire -proof building, other than
a garage, warehouse, factory or grain elevator, or for the erection of any fire-
proof addition, for similar occupancy, to any existing building shall be at the
rate of $1.40 for each one thousand cubic feet, or fraction thereof„ in such
cubical. contents.
2.2. For any such permit for the erection of any fireproof 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 $1.25 for
each one thousand cubic feet, classified as "fireproof" by Section 502 of the
Minneapolis Building Code.
2.3. For any such permit for the erection of ate► non -fireproof building other
than a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any 'existing building. Permit $1.00 for
each one thousand cubic feet.
2./+. 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 height throughout by multiplying 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.
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 ($500.00), 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.
J
SUBJECT
PE®
RM
City of Fridley
13157
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
•COMMUNITY DEVELOPMENT DIV.
�----L -'
PROTECTIVE INSPECTION
r � � SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
8/26/75
JOB ADDRESS
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWN R MAIL ADDRESS ZIP PHONE
Lee Hofman 5816 2nd Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Coordinate Products
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
AM
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
msidential
7 CLASS OF WORK
❑ NEW C ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construct deck
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
redwood
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7OOe
• 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 THE PERFORMANCE F CONSTRUCTION.
$5.00
PLAN CHECK FEE
TOTAL FEE
$ 5.50
SIGNAT CONTRACTOR OR AUTHOR4176 AGENT (DATE)
T
Y V TED T IS IS Y P77,
�
=INSP
BLDG DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
J
APPLICATION FOR RI:SI'DENTIAL., ALTL'RATION.,
• OR ADD.ITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S -NAME: BUILDER:
ADDRESS:__5P_ o ADDRESS:� ®®®
NO:
STREET:dal� AW_ >7,j& -
'r
LOT: I BLOCK: ADDITION:
&.
CORNER'LOT: INSIDE LOT:SETBACK: SIDEYARD:
Applicant attach to this form 'Ttuo Certificates .-if Survey.of Lot and.proposed
building location c:.:awn on these Certificates.
DESCRIPTION OF MILDING ;
To Be Used As:'
Front: Depth:• Height:
Square Feet: Cubic.Feet:
A Ll 'Front: Depth: Height:
-09
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:_$ 1100.440
To Be Completed
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 application
are true and correct.
DATE:
SIGNATURE:
.(See reverse Side For Additional Information.)'
Building
]BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
OF FRIDLEY
DatREG�}dAPR 5 200
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE
y
SITE ADDRESS L>-. d `4
THIS APPLICANT IS:
WNER ❑CONTRACTOR
PROPERTY OWNER/
ADDRESS: �� 1 `^ �L CITY F.- '
STATE MA�IP !;�l f
TENANT
PHONE: fa1Z—
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
ILY/NEW CONSTRUCTION SIZE
TWO FAMILY N STORIES
PERMIT TYPE
❑ADDITIONGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
OME CONSTRUCTION ❑ ADDITION
'.MAIN CE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING ❑ HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
I. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List
of structural members to be used,
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS & PORCHES SUBMIT:
❑ Vinyl
❑Soffit
1. Site Plan/Survey showing the existing structures
❑ Aluminum
1:1 Trim
and proposed project.
❑ Other
❑ Fascia
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 CUS'I' OF LABOR AND MA IEtUALS:
(USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION 3_,g % i OCCUPANCY -
j TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
-ft +6ft= ftx$21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
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 ;inagc=cor
ota Co traction 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 on site; that the work will be ce ith ed plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICA PRINT NAME �� �-, -Z �< DATE
APPROVED BY DATE
From: 763,544 8898 Pale: 1/2 Date: 411512008 12:18:21 PM
From: City of Fridley To: 9528886677 Page: 2/3 Date: 411512008 9:43:32 AM
Building .__.� ..
Permit Fee
� � BUILDINGInspections
m _
Back Page for Fee Schedule -
Plan Review
$
RESIDENTIAL RESIDENTIAL APPLICATION
Received Sy:__
763-572-3604
0 I� .001 times the total job valuation
CITY OF FRIDLEY
D � °JAPR r5 200
763-502-4977 FAX
License Surcharge
$
C5 $5.00 (State Licensed Residential Contractors)
SAC Charge
FECTIVE I.IAS
$1825 per SAC Unit (Plans to MWCC for determination)
DATE_Q tS _GS YOUR E-MAIL. ADDRESS v15@_1� oC ^ q Cc �c C
SITE ADDRESS �-..._.N�
-�
THIS APPLICANT IS:
0 OWNER .ONTRACTOR
PROPERTY OWNER/
TENANT
NAME: i1C OARS _ _
ADDRESS' %%�(5 / / Y �>ot S STATEMu_ZEP�,3-
4
$
-107%Q -- - -
CONTRACTOR
NAME: r �•r �z fit's"' �s *R/� - -- -
- --- �t'7-�� —��
SUBMIT ACOPY OF
STATE LICENSE �Q�� Z EXP DATE/—
YOUR STATE LICENSE
AND CERTIFICATE OF
y�,��
ADDRESS. f I g(d/ f 11 STATE' r�+LIP
INSURANCE
5�- � � ---CITY
CZ '7 Z'-6Aff_" 7 �
PHONE z" -2- 2- ff6"-�+" FAX
PROPERTY TYPF.
❑ S F Y/NEW CONSTRUCTION SIZE
TWO FAMB Y ONSTRUCTIONi STORIES
PERMITTYPF.
DITION C3GARAGFJSHED OWINDOWS
I] BASEMENT FINISH XROOF 0 DRAIN TILE
O DECK 0 SIDING 0 OTHER
O SIVINIMING POOL
TYPE OF WORK:
n N66V E CONSTRUCTION 0 ADDITION
PAIR O REMODELING
DESCRIBE WORK BEING DONE: A -9' 0'a 07
SIZE OF 0"ROVEMENT
LENGTH WIDTH HEIGHT SQ FT
"~0 HOUSE ONLY
NU F SQUARES
--- �� (OUSE & GARAGE
BASEMENT REMODEr Plan SUBMIT*
1. Existing Floor P
GARAGES
0 ATTACHED GARAGE
2. Proposed lloorplan
PROPOSEDSIZE: -_
�L•TACHED GARAGE
3. List of structural members to be used
ED
PROPOSHEIGfrT:
_
SIDING
FOR NEW CONSTRUt" PION INCLUDING DECKS,
ADDITIONS PORCHES SUBMIT:
0 Vicryl
D Vinyl
Alumhcr
03offit
0 Trim
I. Site Plan/Survey showing Lite existing structures
D
t7 Fascia
and proposed project.
2. Two sets of construction plans
VAMOWS
3. Energy Calculations
IN EXISTINo OPENINGS OYcs ONo LOCATION OF UTNDOWS
OR FOR NEW OPENINGS -DESCRIBE S03 OF
OPIiNINGCHANGES Sc
-....._.-
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1497 U.B.0 FEE SCHEDULE) r,
TOTAL JOB VALUATION S J '7t, OCCUPANCY TYPE
Permit Fee
S
m _
Back Page for Fee Schedule -
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
0 I� .001 times the total job valuation
Surcharge
$
— _
, .� .0005 x Permit Valuation Minimum $.50
License Surcharge
$
C5 $5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 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 Dae
$
G (p, i (n Make checks,payable to: City of Fridley Attach Stivulations
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- y of Fridley acrd with the Mirmesota Construction Codes; that I understand this is not a
permit but only an application permit and w is not to start without a permit on site; that the work will be in accordance with the
approved plan in the caseof all t whit 9t view and approval of pl
'DATE._ j
SIGNATURE OF APPAPPLICANT.- � _.-PRIiVT NAMEr��S
Engineering
WATER AND SEWER
Permit No.: 2t too
-763=572-3551
PERMIT APPLICATION
Received B .
763-571-1287 fax
CITY OF FRIDLEY
ReecodY 10 ZOU9
JUN
EFFECTIVE 6/9/09
APPLICTATION DATE: I ` 1 YOUR E-MAIL ADDRESS: P"A@l-a ) P t c a a, do-%
a
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
JOB ADDRESS: 5-1'16 2-ba 1, d�
NEW CONSTRUCTION PERMIT# (IF APPLICABLE):
PROPERTY
NAME:C -;,g'A�w - V
OWNER/
ADDRESS: 10-10 �� STATEZIP
^ CITY
TENANT
4i° _ -
PHONE:
CONTRACTOR
NAME: i
SUBMIT A COPY OF
YOUR STATE
ADDRESS: a O rr s s-, if-# 0 r,� l v a CITY STATE ZIP
LICENSE PITH
PHONE CELLPHONE: IZ— s4w- rooz
APPLICATION
STATE LIC # STATE BOND: EXP DATE:
1. Narrative/written description:
Sex,4 e,— a@ °e
f 54 f R
2. Please attach sketch showing curb line, utility line, building, etc. with distances.
�s ®`����� PERMIT TYPE
• 4I4Af.
��__
®.,� - _ _mob•
❑ SEWER CONNECTION PERMIT $50
' f ❑ WATER CONNECTION PERMIT $50
❑ WATERLINE REPAIR $40
'� saN.a•�r II
❑ SEWER
Cprea 79' fs��f LINE REPAIR $40
❑ ADD STATE SURCHARGE $.50 Q
'58v2w�1
�'��QiAb�
D SAC CHARGE @ $2000 =
jt.'0V�I� OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING
NEW WATER METER COST — SEE UTILITY BILLING
SPECIAL ASSESSMENTS — SEE FINANCE
WATER TAP — SEE ENGINEERING
NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID'UNTIL PROCESSED
I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but
only an application for a permit and work is not to start without a permit.
"" , 1 (�
SIGNATURE OF APPLICAN PRINT NAME:C'�°� DATE:
dgz�?� Gl !i9
APPROVED BY: DATE:Ellool-
COPY GIVEN: ❑TILITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINEERING
City of Fridley
Engineering Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3551
FAX: 763-571-1287