PRE 2010 DOCSCity of Fridley, Minn.
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BUILDING PERMIT
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Date: NOVE SER 15 21965
Owner: DEAN HOSKINS
Address 4952 - 3rd S t . N. E.
Fridley, Minnesota 55421
Builder SAME
Address
N° 8599
z�/%,-Y
LOCATION OF BUILDING
No. 4952 street 3rd St. N, E. part of Lot
Lot 17 _ Block 3 Addition or Sub.Division Carlson's Summit Manor, South Addition
Corner Lot _ Inside Lot — Setback —_ sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Det. Garage Front 22 Depth 24 Height 10 sq. FL 528 Cu, Ft 5,280
Front Depth Leight . _ Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost M 1 100 To be Completed
In consideration of the issuance to me of a permit to c et the building described above I agree to do
the proposed work in accordance with the description above orth and in compliance with ail provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 5 00 , permit is hereby granted to WEAN HO_ SI�LNS
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, Wz mesota 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.
ALLEN G. JENSEN Building Inspector
NOTICE
Tab pm* don sot cam the condmcdon, finkWon for w1rhM pWmbiag, gn heating, awor or water. Be nom to no
the BoBdhig laapoetor for apm to pormHa for dme Noma.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME D 5— /l/ f`tt' .�/i' I BUILDER :5 /f M &
ADDRESS_ qq*%f s1 7? "' -' .3— r &A 10, ADDRESS
LOCATION OF BUILDING
N� Street Part of Lot
LOT / BLOCK ADDITION OR SUBDIVISION C WR L So %/� ��' .�'as ��I�DD 'i Ta
Corner Lot Inside LOT Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATI0N
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:
al Front X1i Dept Height Ad
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Construction_ JK' ,e M Estimated Cost 0 41
To be completedi 0 -,- y
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.
(Schedule of Fee Costs can be found on the Reverse Side).
SUBJECT
City of Fridley
26216
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT
I?
_ COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
' 612-571-3450
910415
6/11/98
JOB ADDRESS 4952 3 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17
3
Carlson's Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Dean Hoskins 4952 3 Street NE
572-8688
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 J] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (18 Sq) Tear -off; Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
Install building wrap and call for inspection of same.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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 80 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,501
$1.75
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-
STRU N OR THE PERFORMANCE OF CONSTRUCTION.
$87.25
Fire SC $3.50
�+
PLAN CHECK FEE
TOTAL FEE
1 $92.50
SIGNATURE OF CO TRACTOR OR AUTHORIZED WtENT (DATEi
S Y UR PERMIT
WHEN PROPERLfYALIDATED THIS I4&61
&, A�/
BLD INSP
i
gaTE
SIGNATURE OF OWNER OF OWNER BURDERi iDATEi
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: V,7,5;2 - 3 2 -D -(�7t– 'v r --
Legal Description:
Effective 1/1/98
Owner Name & Address: /V —Tel. #s77,2 - F 6 2Z
Contractor: �� MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
Width 4gt/Ground
)',�_ s/ Q r_
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft = _
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost: $l� z0
(Fee Schedule on Back)
Ft x $ = $
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
$ Z
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 [ ]
TOTAL
$
STIPULATIONS:
Building
Inspections
763-572-3604
763-502-4977 FAX
SITE ADDRESS _'Lf &.1
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING DC
SIZE OF IMPROVEMR-rr
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE.
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
❑ OWNER ❑CONTRACTOR
Permit No.: 061 GW*SZo
Received By: •
Daft: A P R 6 20'
ADDRESS: CITY STATE ZIP
Van*kM.
PRONE K LP c1/0 q& FAX - -. SI 7 — �
STATB LICENSE #'.__Z % EXP DATE /
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION SORA
❑ ADDITION ❑ GARAGE/SHED ❑ WIIVDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHM
❑ SWIN[MING POOL
❑ NEW HOME CONSTRUCTION O ADDITION
❑ MAINTENANCE/REPAIR ❑ lkEUqDELING
WINDOWS
ING OPENINGS ea ONo
OR FOR NEW OPENINGS- CRIBS SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE TNSTAT T lin
ALL
TOTAL JOB VALZ
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
❑ HOUSE ONLY
❑ HOUSE & GARAGE
O ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
O Fascia
LOCATION OF WINDOWS
BASED ON VALUATION, INCLUDING TSE COST OF
/I 4 06 (UPM TSE 1997 UBC FEE SCHEDULE)
OCCo
BASEMENT REMODELING SrTTtr rrr•
1. Existing Floor Plan
.2. Proposed floor plan
3. List of etruatural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS,&PORCHES tBb�TI
I. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy CalculstioM.
'%. O S See Back Page for Fee Schedule
$_ 65% of Building Permit Fee
$ • Z a .00i times the total job valuation
$ • S C7 .0005 x Permit Valuation Minimum $.50
$ D O •$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 ( )
r I Attach Sti
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building petit 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; thdt I tmdersland this Is not a permit but only an application for a petit and work is not to start without a
permit on site; that the work vn1l be m ce wit the p the case of all work which requires ew d of lana.
SIGNATURE OF APPLI PRINT NAME DATES U
APPROVED BY
DATE j