PRE 2010 DOCS0
Village of Fridley, Minn. __�F 6,-7 3,, --
BUILDING PERMIT Q$
Date: ....... p .......... r
Owner :p Builder • . .
Address ®....�" .. . Address .... `�.....
(�¢� ift F BUILDING
No. .. . T . Street !l ............................ Part of Lot ......
Lot.9. /..... Block ............. Addition or Sub -Division ............
Corner Lot ........... Inside Lot ........... Setback ........... 91fdoeyard .............................
DESCRIPTION OF BUILDING
o be lise asi
Frons ... Dept ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
Type of Construction .................. Est. Cost ..................... To be Completed ..................
!/��'l.!"eoJ'/s��•t9 �°--,aso •,`...ver`•® .,u.�,,,iyv��1� � � ..-... � - eG'...�'e�. — � . p��
i►di�CC.tJQ, �� r�Uel� ' � �V r
9 /o
LIP
1 41
Av—
In consideration of the issuance to me of a permit o 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 village of Fridley.
,ate • .. Wel-le4l" ............... .
In consideration of the payment of a fee of $.'/ permit is hereby granted to ..............j......
......................... 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 with-
in the village 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 construction, installation or alteration for wiring, plumW4,7gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
•
i
•
City of Fridley, Minn.
BUILDING PERMIT N? 7001
} , 6 e It
Owner: Builder
Wdress
TION OF BUILDING
No. �Staeet — Y _ _ Part of t
Lot Block Addition or Sub -Division. a
Corner Lot — Inside Lot _ e� Setback
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
T be Used as: �
s
Front — Depth Height — Sq. Ft. Cu. Ft.
Front Depth Height _ Sq. Ft. Cu. Ft.
Type of Construction Est. CO_: _ ____ 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 aboveset rth and complian th all provisions of
ordinances of the city of Fridley. A.
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 reg location, construction, alteration, maintenance, repair and moving of buildings
within city limits and s permit may be revoked at any time �upon viola, of any of the provisions of said
NOTICE:
This permit does not corer the construction, bestaWan for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building hespestor for seperno permits for thew Nems.
LOCATION OF BUILDING
No, u.j ,L— • Street Far of
Lot_% tiL Block Addition or Subdivision
Corner -Lot Inside Lot Setback Side.-
SEWER
ide-
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to.this forqp-.Two Certificates of Survey of Lot and, proposed build-
ing location drawn. on theca -:Certificates.
DESCRIPTION OF BUILDING
e used as:
nt Depth Height:
Sq. Ft. Cu. Ft.'
Front Depth Height
Sq. Ft. CU., Ft.
Type of Construction My, 1P Estimated :Cos (TCr V
To be Completed
NJ
�..
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 -ail the facts and
representations stated in this application are true and correct.
Schedule of Fee Costs can be found on the Reverse Side).
0
City oFridley, , Minn.. '��
idle y
BUILDING PERMIT w® 7397
Date:
Owner: Z6Builder
Address Address —
74T,
BU DING
No. Street a -- -- Part of Lot
Lot —--- — Block Addition or Sub -Division .
Corner Lot _ Inside Lot _ _ Setback -- Sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
be Used as:
r
Depth — Height — Sq. Ft. Cu. Ft.
C��
nt Depth �eight e � Sq. Ft. Cu. Ft
Type of ction Est. =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 �J _
ordinances of the city of Fridley. i All" _ — _ , Q /�J�,c � A., A_ _ � d`�'-�-
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
NOTICE:
This permit does net never the eondroetion, hutaiidion for whfng, plumbing, ges heating, sower or wder. Be sure to no
the Building Imspeetor for separde permits for these Bem
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
NAME Kenneth Falz
BUILDER
H. J. Blomstrand & Sons Inc.
ADDRESS
6034 -4th St. N.. E.,, Fridley.
ADDRESS.
1220 Arcade St. , St. Paul, ��06
LOCATION OF BUILDING
No. 6034 Street 4th St. N.. E. Part. of .Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback .Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant,attach..to.this form Two Certificates of Survey of Lot and proposed build-
ing location drawa'on these.Certificates.
i .
To be used as:
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft, Cu. Ft.
Type ofConstruction repair of fire damage , Estimated Cost $1,000,00
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 April 2, 1965 SIGH
Schedule of Fee Costs can be found on the ReIrse Side).
City of Fridley, Mian.. N° 10353
is BUILDING PERMIT �f
Date: 7-31-69
E
owner: Steven Most Builder Floodmaster Eng.
Address 6 034 4th St. N. E. Address 1545 Selby Ave . - St. Paul
LOCATION OF BUILDING
No. 60.3.x._._ Street __-_ 4th St. N._ E. _ Part of Lot
Lot 9 & 10 __Block 4 Addition or Sub -Division .__Hyde Park Addn .
Corner Lot --- Inside Lot — Setback --- Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Reside House Front Depth Height ._ Sq. Ft. Cu. Ft.
Type of Construction
Front Depth _ _ Height Sq. Ft. Cu. Ft.
Est. Cost1 0`�0 - �0 _ 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. , „ 1
In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Floodmaster Eng.
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 reg location, construct�fon, alteration, maintenance, repair and moving of buildings
within the dty lianits and tit permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
1� Inspector
Clarence Belisle
• NOTICE:
This permit dose not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to can
the Building inspector for separate permits for thew Mama.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNE&'S NAMEf-�-����� BUILDER r `�''
ADDRESS 3� / / ADDRESS
s
LOCATION OF BUILDING
NO. X03 Lt STREET
LOT q 4- / 0 BLOCK `/ ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK
SEWER ELEVATION TOP OF FOOTING
SIDEYARD
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front Depth
Square feet
Front Depth
Height
Cubic Feet
Height
Square feet Cubic Feet
Type of Construction-&� A2,
Estimated Cost ACI- ®t
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 a lication are true and correct.
DATE SIGNATURE
'h '71
(Sc Jule f Fee Costs can be found on the Reverse S(de.)
•
D
City of Fridley, Minn.. ! 11175,
6431 University Ave. N. E., Minneapolis, Minn. 55.432
BUILDING PERMIT
Date: Sept. 9: 1971
Owner: - _Stewen Mast Builder dwaiatAlum- Id- Ing -
Address ___104- 4th Street N.E.
Address 244 South Fairview, St- P „1
LOCATION OF BUILDING
No. 6034___ _ Street 4th Street N E Part of Lot
Lot _910__.__ Block __._ 3 4 Addition or Sub -Division .__ Hyde Park Addition
Corner Lot ___ .._.___ Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
House Add; ion F. Al er J cont .— Depth Height Sq. rL Cu. FL
____...._ Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost V. 000 To be Completed xau _ 1 1971
In consideration of the issuance to me of a permit to construct the building de~ above I agree to do
the proposed work in accordance with the description aboveand in an with aril provisions Of
Ordinances of the city of Fridley. t
)SOS
- -A
In consideration of the payment of a fee of s 3 6 R -ML, permit is hereby granted to Midwest Alum _ Ind.
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
wyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of Wd
ordinances.
LBuilding Inspector
HANK MUNICH
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNERS NAM: ST Q6AJ h✓I DQi BUILDER :
ADDRESS :„&0Z � �L -9-TA),e ADDRESS: 9?4 4 � . LGA 4eaz¢f�
NO:. STREET:
LOT: BLOCK: ADDITION • a z,®le- palef-v
CORNER LOT: INSIDE LOT: t/ SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
3
DESCRIPTION OF BUILDING
To Be Used As:
D V S f= jib 42.7
2Fr t: Depth • Height
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: '$���ie %
To Be Completed: .12 AV
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all Mork 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.
D&TE:,=1 Q `1 t_ SIGNATURE
(Sea Reverse Side For Additional Iaformation
mss°
q
x
Lc;,* 1 0
AYNE- L. 1OGE:
.=d JV
1025. Se
t "4U11 .. "HIS 1A
Pro g
L 0 TS 9,acl 1® 13LOCK-4
I—IYOE PARK
FRI OL- f—=%(
r
:� h`ereby 'certify that thij survey, plan. or
report was prepared by me or under my direct
supervision and that I am. a duly Registered
Land Surveyor under the laws , of the date of
Minnesota.
O --
Y
CH—f of Pvidloy
Applieeslaon for Piarrbbig Cnd Gas mina Permit . _
'Dept. of Bld4a. Phone SM -3450
DB3CP.IPTIOIi OF VlO1;P�•` �'����
Numbar, Kind and LacrIlon of fixtures I'°zIItt"n
• Furwa, Ccanoc•..cn C-, rnirL•n
t Mao rh:.uro. Old O-yanires
...... So -war
Ccc.pool
PARTIAL RATE SCHEDULE
LMABING FIXTUI?E RATES:
NO. RATE TOTAL
Number Fixtures ................
x V 00.
$ D o
Future Fixture Opening ...........
x $1.50
I
New Fixture Old Opening.....:... •
x 51.50
Catch Basin ....................
x $3.25
$
WATER HT%.
M
C!<
w
New Ground Run Old Bldg.........
,z7
$
i l
I
N Z N
8 1
3<
7�$
W
7<
7 Z
Y
►
•
N
r,Ai Mc.
$
j
I
6
j
N
l
G V
< 3
D<
•
f
•
�f ►
G►
.
$952
IA—
1
ITt
_
2nd
—
3rd
4th
• Furwa, Ccanoc•..cn C-, rnirL•n
t Mao rh:.uro. Old O-yanires
...... So -war
Ccc.pool
PARTIAL RATE SCHEDULE
LMABING FIXTUI?E RATES:
NO. RATE TOTAL
Number Fixtures ................
x V 00.
$ D o
Future Fixture Opening ...........
x $1.50
$ -•
New Fixture Old Opening.....:... •
x 51.50
Catch Basin ....................
x $3.25
$
Water Beater IUp to 99.000 BTU) • • • •
x SZ -00
$
New Ground Run Old Bldg.........
x $3.25
$
rlectr'.e Prater H•atar. . ............
: $2.00
$
ZAS 77TTING FEES: r
NO. RATE TOTAL.
Ist 3 Fixtures . .. . ...... a ......
x $2.00
$
Additional Fixtures .. . . . ...•.. ....
x $ .75
$
Gas Range to 199.000 BTU . .... . . . ... _—
, x $5.00
6
City of Fridley,
The undersigned hereby makes application for a permit for the work her el
specified, agreeing to do all work in strict accordance with the Cita Ordinance
and ruling of the Department of Buildings, and hereby declares that all: the fad
and representations stated in this application are true and correct'
Fridley. Minn 19—
Owner Z
Kind of Building
Used as�P To be completed about
Estimated Cast, $ e�
Old -New. Building Permit No. Permit No. v
Signed
By
Business Phone No
ROUGH
FINAL
i'.r'PjlI:i3 k ALTERATIONS—Rater fo Coda .50 State .Surcharge
. De"-riytlon ..... • .........:........ s...............$
• TOTAL FEE
sueJEcr
PER IT
City of Fridley
® 4344
AT THE TOP OF THE TWINS
BUILDING
PERMIT
•
i
`
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION
r SEC.
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
9/6/77
JOB ADDRESS 6034 - 4th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9, lO
4
Hyde Park Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Sandra Zak 6034 - 4th Street N.E.
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Sussel Company 1850 Como Avenue St. Paul, Mn.
55108 645-0331
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RXIM Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 20' x 22' Detached garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
WMNINCP
Before digging calf JeCat utilities
TELEPHONE - ELECTRIC - GAS Etc.
REQUIRED BY LAW
SEPERATE PERMITS REQUIRED
FOR WIRING
HEATING, PuiraNG AND SIGNS, '
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
1
ISTALLS 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
$3,185.60
$1.59
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.
$17.60
PLAN CHECK FEE
TOTAL FEE
e -
$19.19
SIGNATURE OFCONTRACTO OR AU RIZE AGENT (DATE)
_ WHEN PROPERLY
BLD N P
VALIDATED THIS IS YOUR PERMIT
J -
DATE
SIGNATURE OFOWNER IIF OWNER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS,.OR REPAIRS)
OWNER:(Lcp . �¢ BUILDER:
Address : y Address:
Tel. No. 0 �r
No.: (00 Street:
. LOT: BLOCK: �_ ADDITION: GC / f7� � MAIJ -
CORNER LOT: INSIDE LOT: Y" SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
'2-0
DESCRIPTION OF BUILDING
Front: Z Z Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ����� Estimated Cost: $
(50
To Be Completed: ?4 5 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 representations stated in this application
are true and correct. See reverse side for additional information.
DATE: SIGNATURE: go
Stipulations:
()UGC 62ND YEAR
Vs
IION Of THE
SUSSEI 6ANES SUSSEL COM ANY, INC
Permit by
Legal Description
Lot
Blk
Add'n /T y 75o 'a '
Value
Type Cost y( /
S_ AB:
By SUSSEL
❑By Owner Approx.
❑In
2-S TING POINTS ONLY
�^ S.P.L. Alley
S.S.P.L.1 House /
R.P.L. 1 . F. Street
J2 -r- ! : a /Al n.t,
"Square With_/� < <�
❑Rods •534 flesh
od Rem. - y;���.5_
ElB
5 -Bag Mix 6 -Bag Mix
❑ amping o Tamping
.B.U. _
�QGrade Point
Conduit
oc s By wne el
s OR
Q eight on
IGP Gf��
Bbtk-S1TVT op -course)
4"
Wal4-Height other than 8'
me with u eight
so4-9R--•-
❑ cu studs as'_ required for
0
1/1O.H. Dr Offset '2 -
LA -t3LA -D.
. Location
E -1 VM -lows
❑ Att Gar Roof Tie-in
Drawn on attached pictures
Existing garage: No
❑ Detached ❑Attached Yes ❑
Size of existing:— x —
Existing garage will be:
❑ Left as is
❑ Converted to L.S. - By owner
❑-Removed By: Owner[-]
Sussel I-]
Junk Must. Removed By Owne
—T— P
- Or owner - trees, bus7res6tc.
how approx. dist. garage to
house and all prop. lines ,
Stakes visible - M Yes >00
urvey available - C7 Yes �o
Special instruction f 'r
owner:
P-3
WORD. ORDER �;, f1�392
HOME PHON
NAME�9 AL012A Z K BUS. PHONE:
JOB ADDRESS
BLDG CODE AREA �� y
SALESMAN �/q/�� CE�CONTRACT DATE— SIZE"--d-'W
FOR OFFICE USE ONLY
[CONTRACTOR X12 u '��-7— JOB #
/VOUSE
PURCHASER'S INITIALS:—
X
Z CChI tiil�
t
F
1. A,/
ROOF: GABLE REVERSE GABLE HIP
QUA 62ND YEAR EAVE OVERHANG:
SUSSEl6A8A6ES SUSSELDI
ICOMFANV INC RAKE OVERHANG:
1" x 8" Ridgeboard 240# SEAL DOWN SHINGLES WITH PLYWOOD
,1c- ROOF SHEATHING AND 15# FELT
�— — Rafters Plywood Sheathing
--J-- l- 240# Seal Down Shingles
` 2" x 6" 3/8" Plywood
Cross Ties I Gussets
1" x 6" W -Bracing 2" x 4" Double
when applicable Top Plate
per Minn. State Code
NOTE:
1) Trusses set 48" O.C. (Gusset - 3/8" Plywood).
2) Intermediate rafters are 2" x 6" 's braced with 2" x 6" collar ties.
�) /Vn 18';81id narroweerr caraaes--e4minate tka-W-braciraQ-d7icico-Ilar
4) Roof approved by Minn. State Building Dept. as meeting Minn.
State Code Requirements of 30# snow load. Refer to State
Building Code Letter Number 35.
:ip ro consist 2" x 6'�fters, 2�c 6'�ss ies 4&"\0 C.,
hr afters an lywo gGssets d used.
RAFTERS: " x 6' 16" O.C. (-24" 0. j
STUDS: 2" x 4�' 1 O.C. 24" O.C.
WALL SHEATHING:
SIDING: 14. i3. ? xI
OVERHEAD DOOR HEADER: Double 2" x 12"-vAth wrthou�-steel
plate.
Slab on grade construction approved per Minnesota State Code. Refer
to State Building Code Letter Number 11.
SLAB: 4" WITH MESH 6" x 6" #10 Gauge
45°
14-
Trim
Fascia
1" x 4" Sub
Fascia
Soffit
3/4" Cove
2" x 4" Studs
Siding
%" x 7" Anchor Bolt
per U.B.C.
2" x 4" Treated Bottom Plate
Grade Line
jf7A 1;qC-yE
(612) 545-5544
SO R VE Y I N 6 & ENGINEER NG CO 10700 HWY. 55 WEST. MINNEAPOLIS, MINNESOTA 55441
SURVLY FGR: SLISSCI , '._Gmiany
SUR _Y C)F: _7, T j; lis, together with the adjacent East half of
511 4, HYDE PARE ADDITION,
plat thereof, Anoka County,
'o
•
S
Ln
F e n c e-
135.07
3.7
L
Ln
j
izzoo
Cn
Fence-
rV ft. drivZ
y )<
5.3-7
"o" - Denotes Iron Monument
I
Scale: 1 - =
I hereby certify that this survey, plan, specification or report was prepared by me or
under my direct supervision and that I am a duly Registered Professional Engineer
and Land Surveyor under the laws of the State of Minnesota.
9235
-%i IL Date August 30 977R-1—eg. No.
ame s Ii. Parker
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
September 29, 1992
Gordon Hedlund
1255 Pike Lake Road
New Brighton, MN 55112
RE: Final Notice of•Noncompliance of the.Fridley City Code on
Vacant Lot between 6020 and 6034 - 4th Street N.E.
Dear Mr. Hedlund:
On September 28, 1992, a second inspection of the vacant lot
between 6020 and 6034 - 4th Street N.E. confirmed that the
following items still do not comply with City Code:
1. Discontinue outside storage of brush, fencing, and assorted
materials located on vacant lot.
A final inspection to determine compliance will be conducted on or
about October 12, 1992. You should arrange to complete an approved
plan for compliance before that date. Should this inspection
confirm that this deficiency still exists, legal action will be
approved. If corrective action cannot be completed by this time,
contact me to coordinate a schedule to complete this requirement.
If you have any questions regarding this matter, please contact me
at the Fridley Municipal Center, 572-3595.
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -92-489
SUBJECT
City of Fridley
26473
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.
...
INSPECTION SEC.
7-1PROTECTIVE
,y
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-FlS
7/2/98
JOB ADDRESS 6034 4 Street NE
i LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9110
4
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Rick Clieuck 6034 4 Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Heiderschied Bros Construction 716 198
Ave NE, East
Bethel, MN 55011 434-4578
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20060354
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK a
❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (12 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the 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
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 E LIED
$.50
WITH WHETHER SPECIFIED HERE T. HE GRANTI A PE IT
$1,000
DOES NOT PRESUME O G1V AU TY VIOLATE CANCEL HE
PERMIT FEE
SAC CHARGE
PROVISIONS OF A OT T R L AL LAW LATING N-
T P F C STRUCTI
$34.75
Fire SIC $1.00
P CHECKFEE
TO LFEE
41
Licen SC
$5 0
$41.25
SiGNA URE OFCONTRA CTOR UTHORiZEDAGENT - (DATEP
HE PRO
B G iNSP
/PERMI
VALI AT THIS IS YOUR
v�IAT
SIGNATURE OF OWNER of OWNER BUILDERI IDATEI
NEW [ ]
ADDN [ ]
ALTER [ l
ConstructionAddress: —(�
Legal Description:
Owner Name & Address:
Contractor: a E
Address:. 71(o I C
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY -AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
0 3;
Sq. Ft.
Sq. Ft.
Sq. Ft.
C
Construction Type: TU Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = , Ft x $ __ I ,moi
DATE: APPLICA.
Permit Fee $ 3V S
Fire Surcharge $ /_ D
State Surcharge $ �®
SAC Charge
$
License Surcharge
$ J 0
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ °' 5—
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. °°B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
I
CITY OF FRIDLEY INSPECTION
• t431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
DIVISION x_7,°0
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Effective On January 1, 2000
JOB ADDRESS (00-31f — LfT)1 S+ u E
OWNER Wen -DIA C„ 14
Rate TOTAL C1 1
$ 30.00 $ 90-00 �
BUILDING USED AS W R A (i ro
/
ESTIMATED COST \R00 • 06 PERMIT NO. 'LI Q
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating Units i Circle One (Steam) (Hot Water) Warm Air
$ 10.00 $ Trade Name CAdLRI a X— Size No..5SwAxjoo— I
BTU_ (A. 000 HP EDR
$ 25.00 $ Fuel_ N A►t. %,ks Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner 20
AA wlm-k* t
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
reps,tt�Qns�dbi� ?Relication are true and correct.
$ 30.50 `yy
9928 Bluebird St. N.W
C0®n Rapids, MN 55433 DATE I D U
I#fMWQ3Q9 Fax (612) 754-2908
Signed TEL #
Approved By 11, 4_ Rough -In Date Final
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes( No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes N No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes 0 No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes (10 No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes N No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes (�O No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes �,) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type .TJ.L) —04 <4 BTU Input Fan Assisted or Nat 14
Appliance #2 Type Aeg-� BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances 2--- Total Btu Input 7 ��
Common Vent Type Orw 4/LAO Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
NS:
t
lk,. 1 C
HEATING CO: R1 v e, V-
Signed B :
9 Y e Date:
CIIYOP
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
February 11, 2002
Rick & Wendy Cieluch
6034 4 Street NE
Fridley, MN 55432
Re: Final Inspection at 6034 4 Street NE
Contractor: River City Sheet Metal Inc
Dear Rick & Wendy Cieluch:
A mechanical permit was issued on March 7, 2000 install a furnace at your address.
According to the 1991 Uniform Mechanical Code a final inspection shall be conducted
on the work authorized by this permit. A final inspection was conducted on March 23,
2000 where the following corrections were noted:
1. Size vent and connector per GAMA tables and manufacturer's specifications.
2. Provide a listed vent cap.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We need to reinspect these corrections before we can final out
the permit.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
CinnPrnl��
DJ/mh
1
SUBJECT
PeR1RTrNa.-
City of Fridley
'i3 4 6 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
' COMMUNITY DEVELOPMENT DIV.
_
; - _____ .
� PROTECTIVE INSPECTION SEC.
a,0
�
1 �___[
NUMBER
767
DATE
PAGE OF
APPROVED By
i CITY HALL FRIDLEY 55432
763-571-3450
910415
25 / 03
4/25/03
JOB ADDRESS 6034 4 Street NE
I LEGAL
LOT NO.
BLOCK
OR ADDITION
SEE ATTACHED
DESCR.
9 1 10
JTRACT
4
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Rick Cieluch 6034 4 Street NE
763-574-1145
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 Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 12' Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS
8efora digging Pall fog,
REQUIRED FOR:
all utility locations
WIRING HEATING
450002
PLUMBING AND SIGNS
REV w BY LA
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
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
$1.19
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,384
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-
Fire SC $2.38
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$83.25
PLAN CHECK FEE
TOTALFEE
$86.82
G 4T 9 AC O OR AUTHORIZED AGENT iDATE,
EN PROPERLY VALIDATED THIS IS Y UR PE IT
0 4N L
SSG ATU O ER --F OWNER BUILDER- MATE,
a g p 1 r,A E
1
ID3
NEW [ j CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1 87 Fax U
BUILDING PERMIT APPLICATION
L +
//
� G 1�
Construction Address: �� Ll � �� o
Legal Description: rl
Owner Name & Address: ' ELy_" 4 4-A J -v 6- Tel. #��63��
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.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft. �1
Length Width 12— Hgt/Ground Sq. Ft. cX
Construction Type: fit% i Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 1�073 APPLICANT: c "rye Tel.
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Design #:12828
* Take this sheet to the
C�—=—W—P
4/18/2003
Idina Materials desk to purchase your materials.
You have selected a 12' x 1 eck 2' off the ground.
Pressure Treated Framing Materia
Vertical Decking
2" x 6" Pressure Treated Deck Boards
36" No Post Spindle Railing
2"x2"x42" Pressure Treated Spindles, Beveled 1 End
2"W' Pressure Treated Nand Rail
Poured Footings 8" Tube 4' deep
Premium Gold Phillips Drive Screws
Galvanized Framing Fasteners
�OSF eck live load
� � s
Illustration may depict o pdo
(The posts shown in this picture are not necessary and not include
lelow is a section of the railing style an
options you have selected for your deck.
- J.- - -
Joe S��4
C� iG5) �'-oon2
you selected!)
Stair Widths : 36"1 36"
For Building Material's use only:1441920240204090600050004048050200000001
Today's cost for materials estimated in this design with options: $7.77.55
Y *Base price may include: 40 PSF deck live load, horizontal decking, 2x6 pressure treated deck boards, pressure treated flaming material, no stairs,
36" 2x4 railing, pressure treated railing posts, andgalvanized box nails. * (BASE price): $724.76
1917 8912
Please bring these plans to
the cashier to purchase.
Post anc grn)iMonsion Sheet
uVesign :12828
3 2'6"
7'
q
81(m
00,�./
— §Mcle
/
v
C q
4t
w � m
4
m O
r m
m
c
m c
c �
40 c
—
o_m
m v
w v = c
0 go
s w w
v E + w
►-
_
N
.9 m
w o
w -
w m
m
w g W 0)
i
H
O
I
}+ W
7 O
.O C
w W L
O
�
W
C �
m
� W
Op yx so�6r = /2-00 Ik
&i
Q
Illustration may delict options not included.
la #I�V/Gowr
Joist layout for Your Deck
The Scale is 1/4° : i'
Design#:12828
A C B
Mark length Description Usage
A 1119" 2x8 Green Treated ledger
B 12' 2x8 Green Treated
C 1519° 2x8 Green Treated
D 15'10-1/2" 2x8 Green Treated
Joists to be on 24° centers.
Joists to be hung from the ledger with joist hangers.
Joists to be toe -nailed to beams with 2-1/2° (8d) galvanized nails.
Rim joists to be face -nailed to joists & ledgers with 3-1/2° (16d) galvanized nails.
Blocking and bridging is not shown, but may be required by your local code.
Illustration may depict options not included.
Rim joist
Joist
Rim joist
a
N
L
EM
a
You may buy all the materials or any part at low cash and carry prices. Because of the wide variable in codes,
Menards cannot guarantee that materials listed will meet your code requirements. These plans are suggested designs
and material lists only. Some Items may vary from those pictured. We do not guarantee the completeness or prices
of these structures. Tax, labor and delivery not included.
s ivEY/^JG K :NGitv!fn:^•'G iC,
S v R V EY FC "R
(G 12) 545-55:4
10700 HVVY. 55 WEST. MINNEAPOLIS, MINNESOTA 55441
U ft:1T?. 'Jtl('fW1. `tl 11-he"
�t r ad—'acent East half of
�,� •. 71 i,: ; 'X iiYiiE PARK ADDITION,
�C('tiri�l7 ! 1',,' �i''('.•l-C71.';: 1plat thorcc)1' Anoka
Cour.t% ,
G
G
co
0 J
� S -
•Y x —r
-7
C
O
co
3C
,
"o"' - Denotes Iron Monument Scale-. 1— Z_��
I he,,eny cert f; that this survey. plan• specification or report was prepared by me or
under mN d;rect supervision and that I am a duly Registered Professional Engineer
and Land Surveyor under .he laws of the State of Minnesota.
11u:;t:: t 3C 1:'7 _ `35
.; -Date: "Reg. No.g
jartes H. Parker
i
II
I
s
'i
r � �
- - - - fi - 3.7
-4'- 003•^r
y
f
'
, a .,.
•
__3.8d_..
I�r 1t 0.56
-
~
<
7yZZ.0
ti
<• 1 1ic
� ;j ;,�
I
;n
Pnncc -,
rig
�'
fit.
Qrivc:
H ,
-7
C
O
co
3C
,
"o"' - Denotes Iron Monument Scale-. 1— Z_��
I he,,eny cert f; that this survey. plan• specification or report was prepared by me or
under mN d;rect supervision and that I am a duly Registered Professional Engineer
and Land Surveyor under .he laws of the State of Minnesota.
11u:;t:: t 3C 1:'7 _ `35
.; -Date: "Reg. No.g
jartes H. Parker
Building
BUILDING
Permit No.;Aur, -AX
Inspections
-RESIDENTIAL APPLICATION
Received By:
763-572-3604
PcDd:CITY 09
OFF RIDLEY
Date
763-502-4977 FAX
EFFECTIVE 1-1-09
DATE o i`t
YOUR E-MAIL ADDRESS
SITE ADDRESS (OCO"1'
ll �
J�� N,e ,
THIS APPLICANT IS:
(OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: v K Locvr
TENANT
ADDRESS: ( e(q 5?3' 11J' k. CITY
STATEM.-J ZIP 2
PHONE'J ,Si
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH Q'lfROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: CSO -f6– 5PO--6 LC 9OV9
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFINGHOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
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 $ OCCUPANCY 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)
$2000 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 uavable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
lations
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 ordinance d codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applicatio f a e a d work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of i ires review and approval of pi".) l
SIGNATURE OF APPLICANT PRINT NAME k4 r DATE