PRE 2010 DOCSa1
,I
BUILDING PERMIT
I
i,
F -age of F alley, Minn.n. No 2288
nate�p w .. .+
.................
��� ®• � �� 'Builder •
Owner... ,'y� .... .... .
Address Address
LOCATION OF BUILDING
NO. .. Street .'' t .. .... ................. Part of Lot
Lot.. .A,,,,.. Block Addition, or Sub -Division
Corner Lot ........ Inside Lbt
....... Setbaek..:`...... Sid
eyard�•r%� ..............
DESCRIPTION OF BUILDING
To be Used
it s d i
• � . �Front Depth �
. He
ight . � .... Sq. Ft......... Cu. Ft.
... Front .... Depth ...... I4eight Sq. Ft......... Cu. Ft.........
... ..... ..... ..... ..
Type of Constructio . '.. Fist. Cost ,:.. .... ....... To be Completed :.. ....
II i
In consideration of the issuance to me of a permit tot construct the building described above, I agree to do,
the proposed work,i i accordance with the description above set forth and in compliance with all provisions of;!
Ordinances of theloge of Fridley.
Th consideration of the pay4,4'Ing,
of a fee of -s..;..
hermit is hereby granted to tri .,..,.,
. to cot the buildjZdj;dddition as described above. Thi that then to whom it is granted and his agents, employees and w�, in all work;
e in, around and upon said or any part thereof, shall conform in all respects to the ordinances of
PYIdley, Minnesota i eginxiing loca on, construction, alteration, maintenance, repair and moving of bW.Vngs with-
in the village limits c1 this permitmay be revoked at any time upon `violation of any of the provisions of said'
ordinances.
. � .. Building Inspector?,
NOTICE:
This permit oes not cover he construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. a sure to seethe Building Inspeetorfor separate permits for these items.
Date:
Owner:
Address
City of Fridley, Minn.
BUILDING PERMIT
N. 4918
Builder ...............
_
_..._
TZ
Address _....._._.
AOI TIO BUILDING
No.......... Street ...•. __..... L[. ...�._._........._......._....
Lot ....._.ya .��d .....--------- Block .... ......... -----.._..----- Addition or Sub
Corner Lot ................................. Inside Lot ............ iback .. :....._
Sid
SewerElevation ........................... ............. _.................................. ........ ......... F dation Elevation ......... ........................................ _.......................................
DESCRIPTION OF BUILDING
To b Us ,:
- ,�` ---- Front ..-.. Depth .... Height ....°.._.. Sq. Ft. ..� Cu. Ft..
_.............._.......... .......... Front ...................... Depth .................... Height .............. ... Sq. Ft. ...................... Cu. Ft. ............ ...........
Type of Construction - Est. Cosh. To be Completed ....._......_....._.._........_.
.t -
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 u p violation � any of the provisions of said
ordinances. ,l J
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.
0 4 is
— — , ai.
APPLICATION FOR BUILDING PERMIT
CITY OF FR.IDIEY, MINNESOTA
Owner's Name
C �a
Address%Address`f=
LOCATION OF BUIIAING
No. Street Part of Lot
Lot ' Block Ei�, Addition or Subdivisio
Corner Lot Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey df Lot and proposed building
location.
DESCRIPTION OF BUILDING
o �
To be used as:
Front/ S Depth 2 Height
Sq. Ft. Cu. Ft.
Front -DepthHeight
Sq. Ft. Cu. Ft.
Type of Construction Pim Qg%-LQ Estimated Cost f � 49 L/ �!, _
To be Completed C��,:i 4 r-5
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.
DATE :- � C:, - C SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
0
9 0
'
SUBJECT I
City of Fridley
31974
AT THE TOP OF THE TWINS
?-,
BUILDING P E R M I T
RECEIPT NO.
:
v __���_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
���_� 604
r � �
CITY MALL FRIDLEY 55432
NUMBER
REV
DATE
WAGE OF
APPROVED By
612-571-3450
910415
7/10/01
1
JOB ADDRESS 524 53 1/2 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
15
2
Temple Terrace 2nd SHEET
2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE
Richard Jasper 524 53 1/2 Avenue NE 763-571-6439
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
K -Designers 3810 W Hwy 13, Burnsville MN 55337 952-894-3600 20138685
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 O ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
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
SQ. 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
$10,244
$5.12
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-
$195.25
Fire SC $10.24
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
Licens SC #5.0
15.61
SIGNATURE OFCONTRACTOR ORAUTHORIZED AGENT IDAiE)
M PRO VALIDAT.Ejlr THIS 1PERMIT�
LOG INSp MATE
S-GNATURE OF OWNEROF OWNER BUILDER) IOATE)
1
01
NEW [ J Effective 1/112001
ADDN [ ] CITY OF FRIDLE'.Y (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:9J2LA 53t 2
Legal Description:
Owner Name & Address:
Contractor:
Address:lC
Tel. #To3-C0q3q
MN LICENSE #ZC) cie5
_Tel. # Q52-EPU - ZLoM
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Heiclht
Length Width HgtiGround
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 1 APPLICA Tel. P�W-axei
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application
Permit Fee $ ���' Fee Schedule on Reverse Side
Fire Surcharge $ to . 2LI .001 of Permit Valuation (1/10th%)
State Surcharge $__5 ' 12- $.50/$1,000 Valuation
SAC Charge $ $1150 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: / / (��y 1
v � S
FA
K<<DIESIGNERS
:.,, r z
HOME OWNER INFORMATION
NAME:
BUILDING PEIMUT
MN LICENSE # 20138685
WI LICENSE # 242382
1 OL\S
CITY, STATE, zj?:r SS`421
TELEPHONE: uO-Z)
IN / WINDOWS
(CIRCLE ONE)
VALUATION:"L1u-7 TEAROFF: YES / O
PERMIT COST: 2�_� WINDOWS: REPLACEMENT /NEW OPENING
PICK UP PERMIT AT:
PRE INSPECTION: YES /NO FINAL: YES / NO
CALL FOR FINAL: YES / NO PHONE #:
INSPECTORS NAME:
NOTES:
jqe$.25
Lb, sLA
=3=41-95. k7 -
HAVE A GREAT DAY!'.
3810 West Hwy. 13 0 &=wAr, K wes= SS337 0 bMt lir— 920138685 0 (952) 8943600 • FAX (952) 894-09W • (800) 530.5932 0 www_k-dest r
SUBJECT
V
City of Fridley
3204
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.®��®�
r PROTECTIVE INSPECTION SEC.®
NUMBER
REV
GATE
PAGE OF
APPROVED BY
I i r---1 CITY HALL FRIDLEY 55432
�a 612-571-3450
910-F15
8/16/01
JOB ADDRESS 524 53 1/2 Avenue NE
I LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
15
2
Temple Terrace 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard Jasper 524 53 1/2 Avenue NE
763-571-6439
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
K -Designers 3810 W Hwy 13, Burnsville, MN 55337
952-894-3600 20138685
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 ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Install windows within existing openings
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997
Uniform Building Code. Caulk
and flash all exterior openings.
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
SD. 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 WH ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$12,770
$6.38
DOES N RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROW ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON•
T U ION OR THE PERFO CE OF CONSTRUCTION
$223.25
Fire SC $12.77
PLAN CHECK FEE
OTAL FEE
Lice e C $
0
$247.40
+anTUAE OF CON TRACTOR OR AUTHORIZED AGENT IDATEI
HE P
VA ID ED THIS IS YOUR PERMIT
_
d -LOA INSP 4FQat{�
`YY
/
r'0 46+/���71F-
S,GNATURE OF OWNEROF OWNER BUILDER, IDATEI
A
NEW I l Effective 1/1/2001
ADDN [ j CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
i
Construction Address: �� �Z e- Fit d � MM 5573 z
Legal Description:
Owner Name & Address: l zc�crct ucs,al' C Sa v.-� Tet. #_2 U 5 71' &,q39
Contractor: k" ,,es,5NR-s MN LICENSE# 2O 1 3gL2 T-5 _
Address: D W• Nw!A 13 ; &-ni-Y.ite. MN -5S33`7 Tel. # iSz) 991- 3tgLz
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: ".'kms s Estimated Cost: $_ (2+ -7-70 ' ®�
Driveway Curb Cut Width Needed: E. 6 Ft = Ft x $ _ $
DATE: , t, Jo I APPLICANT:
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Tel.#5J5-Z 8'K- 3&cad
Permit Fee $ .`'a3.�S^ Fee Schedule on Reverse Side
Fire Surcharge $ %7 7 .001 of Permit Valuation (1/10th%)
State Surcharge $ .30 $.50/$1,000 Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ OU $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 $ 1 / 6
STIPULATIONS:
NEW [ j
ADDN [ ] CITY OF FRIDLEY
ALTER { ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Effective 5/26/93
XOwner Name & Address: /GTel.
Contractor: MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length.
DESCRIPTION OF IMPROVEMENT
Width
GARAGE AREA: Length, Width
DECK AREA: Length Width
OTHER:
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Cornu Lot { I Inside Lot [ j Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: + Ft ,L:�Ft x $
DATE: APPLICANT:
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$750 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
Conservation Plan Review $450.00
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary { j Not Necessary { ]
TOTAL
$
STIPULATIONS:
Tel. #
CITY OF-►FRIDLEY INSPECTION DIVISION Effectivu .ianuary 1, 2003
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR DOWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND JDEV�ICES FAX (763) 571-1287JOB ADDRESS(/ `-�[ 5_!� II c�( ��/10
RATE SCHEDULE
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
Rate
$ 30.00
$ 10.00
$10.00
$ 10.00
$25.00
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.
TOTAL
cl
OWN
BUIL
ESTIMATED COST 1�1/ 00 PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units—L- Circle One (Steam) (Hot Water (Warm Air
Trade Name, Size No.
BTU lip EDR
Fuel —1CQ S _Total Connected Load
Burner Trade Name Size No.
BTU _ HP EDR
$ 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
$tbsb representations stated in this application are true d correct.
DATE
HEATING CO
Signe TEL #� c
FAX #
Approved ByI Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
r•nl4 MQN VFNT- VFNT nNNFGTnR ANn MMRI ISTInN AIR RIFT _ATIM
When _plao'"a an existing Mramp, 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. YesVNo ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. YesyNo ( )
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 (KNo ( )
The pY�=^n cnmisis*rnn Sir is sized and installed to meet the current codes
and manufacturer's specifications. YesNo ( )
When required to inctall a new cnmh"etinn air it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes`' No ( )
When inntalliDQ a new venting no m, 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. YesNo ( )
Appliance lypeend Si7PjCnmmnn Vent and Vent rnnnectnr Infonnaunn l
Appliance #1 Typ BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input 10M Fan Assisted or Nat
Appliance #3 Type BTU Input _ Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type C I ftS Vent Height 6 Diameter inches
Appliance #1 Vent Connector Height __.Lft Length _2_ft Diameter in Type C -
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
HEATING
Signed By:
Date : =1 (I I /�)
de
C17YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
City of Fridley Inspection Division
6431 University Ave NE
Fridley; MN 65432—
763-572-3604 Effective January 1, 2002
NOTICE TO MECHANICAL CONTRACTORS REGARDING
PROPER VENTING PRACTICES
No permits for heating will be issued until the information on the permit
application is filled out completely on both sides. Any incomplete permit
applications will be returned and you may resubmit your application when
completed properly. It should provide the Inspection Division and the
mechanical contractor with enough information to correctly size the entire
venting system and satisfy the intent of the Code and the manufacturer's
installation instructions so the end result would be a safe and dependable
installation.
� Cyi�ic�� T#/Uri✓�7�` {y�FC
C2
PERMIT#
H USE HEA TEST REC
ADDRESS ' C
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST. INSTALLED BY
ELECTRICAL WORK BY
TYPE OF HEAT GA _ FA HW _ STEAM SPACE HTR. UNIT HTR. OTHER
KIND OF LINER
WIMMALKid
CONTROLS
SIZE NONE
FELTERS SIZE I to Xg NUMBER
PRESSURE 3 c ►► PERCENT CO2 fl
INPUT CFH _ PERCENT 02
INPUT _�®► �J JCD
STACK TEMP 34e
1J1�11i1V
SERIAL 3 l' S y.-/ 7-16-
INPUT(BTU)
COMPANY TESTING
/lp -1
NAME OF TESTER
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
763) 572-3604 FAX: (763) 571-1287
ADDRESS : 524 53 1/2 AVE NE
PIN 233024430102
LEGAL DESC TEMPLE TERRACE 2ND ADD
LOT 15 BLOCK 2
PERMIT TYPE BUILDING
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE GARAGE, DETACHED
PE 0.:2004-01166
DATE ISSUED: 07/22/2004
VALUATION : $ 21,225.00
NOTE: CALL GOPHER STATE ONE AT 651454-0002 FOR UTILITY LOCATIONS.
PROVIDE HARD SURFACE DRIVEWAY. SEE NOTATIONS ON PLAN. REMOVE EXISTING GARAGE. CONSTRUCT A 40'
X 24' DETACHED GARAGE.
APPLICANT BUILDING PERMIT FEE 349.25
DANIEL J WHITE PLAN CHECK FEE 227.01
524 53 1/2 AVE NE FIRE SURCHARGE 21.23
FRIDLEY, MN 55421 STATE SURCHARGE, VALUE 10.61
TOTAL 608.10
PAID WITH CHECK # 7651
OWNER
DANIEL J WHITE
524 53 1/2 AVE NE
FRIDLEY, MN 55421
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 worts
will be complied with whether specified herein or not. The
granting of a permit does not pres to give authority to
violate or cancel the provisions of y of r state or local law
regulating construct' o or the pe orm of constructio .
Applicant ate
Bldg
SEPARATE PERMITS RfOUII(ED FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW I
ADDN A
ALTER H
Construction Address:
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Legal Description: L(3+ —1 ie�jijC K a Tvm oty -T C ��
Owner Name & Address: b AW i to � W W,+P- Tel. #.9 ie� S
Contractor. S -e_� MN LICENSE #
Address: J2Li ��% :J:Q,,A eto 1,jn Tel. # Z Z4�Z
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
r
LIVING AREA:/, --Length r Width Height Sq. Ft.
GARAGE AREA!/ Width e. Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
1
Construction Type: Estimated Cost: co®
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 7-1-),
APPLICANT: .`� �_� 'x - T I. #
r
Call (763) 572-3604 for Permit Fees if mailing In application. Fax to 763-571-1287 if using credit car
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$
Fee Schedule on Reverse Side
$ . ®
65% of Permit Fee
$ 3
.001 of Permit Valuation (1/10th%)
$
$.50/$1,000 Valuation
$
$1350 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 [ ]
$ 18to STIPULATIONS:
1 --------------------------------------------------------------T
1 �
1 1
� 1
Daniel John White 612-290-6890
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AVAILAP[ F. Of!
j SITE FOP 'Ii -1t: FIi,''.:',1iIN, C 1
1 AND FIN;'\L IN.-WECTiONS i
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Tear down existing garage.Removal of existing tree. Put rebar in existing slab every 2 ft. to carry new
slab (new slab 19'9"x24' and 5'9"x 20'3" .edges of new slab will be 1ft.w.X 1ft.d.with 2 rebar around
edges. poured with 3,500 lb. cement. and 16in. anchor bolts in slab.
one course of 6" block around entire garage. bottom green treated plate. framed with 2X4's 16in. on
center.I garage door,1 window ,2X10 headers,stamped trusses from mena.rds (will supply spec's) 2ft.
on center. 1/2in. sheeting on all exterior walls -2la.yers.of- "D" grade paper. 7/8in weep track with gal-
vinized self furring lathe. cement for walls will be 3/4in thick.
alluminium sofits.
will use existing electricial in current garage. / s� s�
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24
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12in.
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40'
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S*J�OB CONY SHALL
41 ABLE ON 71 f J108
TE FOR Tw I R.A.I`•11NG
ANAL TIONS
questions- call
Daniel hite-612-290-6890
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� cis r 06" slab edee
LwiLndow I
12in.
1
40'
- - U y
S*J�OB CONY SHALL
41 ABLE ON 71 f J108
TE FOR Tw I R.A.I`•11NG
ANAL TIONS
questions- call
Daniel hite-612-290-6890
R, 7/12/2004
design #71882 •
*** Take this sheet to the Building Materials counter to purchase your materials.
You selected a garage with these options.0
24' Wide X 40' Deep X 8' Nigh
Gable roof W/ 4/12 pitch trusses 2' O.C.
20 Wall framing Material
12" gable/12" eave overhangs
1/2" OSB Wall Sheathing
1/2" OSB Roof Sheathing
White Vinyl 4" Double lap Siding
23 yr. Supreme, Estate Gray Shingles
White Aluminum Soffit & fascia
White Aluminum Regular Roof Edge
Pine overhead door jamb
THIS JOB COPY SHALL BE�
AVAILABLE Oid T E JC,' -
SITE FOR THF FJA-f-[a,ir-1fi
AND FINAL INSPECTIONS
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Today's cost for materials estimated in this design: $ 4793.45
Base garage Without options: $ 3039.93
*The base price includes: 0" Eave/0" Gable Overhangs, Framing Materials,
7/16 OSB Roof Sheathing, 20 yr. Fiberglass Classic : Onyx Black Shingles,
Pine Fascia, Galvanized Regular Roof Edge, 8" Textured Vertical Hardboard Siding,
No Service Doors, No Overhead Doors, No Windows, or Any Other Options.
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