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AF - 35734BUILDING PERMIT Village of Fridley, Minn. N� 2 4 � 2 Date � �! � ��. .�.� . . . . . . . . . . . . . . . . . . . . . � Owner p0'�`�."v°'�'�.`! . �.�*.'�'° .%� . . . . . . . . Builder ..r!': ''" ':•.'� :� . . . . . . . . . . . . . . . . . . . . . . . . . . Address /. �!y�.c . :'�.': f �� !.�'•'".'�. �. . .��. .� Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . LOCATlON OF BUILDING No. ./p��........ Street .��fi.7!�'K ............. .................. Part of Lot ............... ...... LQi �! �. �"?. . . . Block . . .�!�! . . . . . . . . . . Addition or Sub-Division ��:'�'!"t.�! . . . . . . . �!':� Corner Lot ............ Inside Lot ............ Setback ............ Sideyard .......................... DESCRIPTION OF BUILDING To be Used as: f�s� . . . . . . . . . . . . Front '!��. . . . Depth .%�. . . . I-ieight . . . . . . . . . Sq. Ft. .9 � y. Cu. Ft, . . . . . . . . i!• . . . . . . . Front �.�. . Depth � �,,,� ..t Height . . . . . . Sq. Ft. � ��y, Cu. Ft. . . . . . . . . � � ' �ir Type of Construction �'�r� . . . Est. Cost . jl7. !!�' : � . . . . . . . . . . . . . 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 village of Fridley. _ �"�_ / _ . . ,� . �v: R .-. : . . rr .> .�ww.r .r. r. . . . . . .'7�.�. . . . . . . . . . . . . . In ratiori of the payment of a fee of $.l.�'. .., p�r t is hereby granted ta .... ... ... .. . �':`"'��. ........ to construct the building or ad di o as described above. This permit i5 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 �'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit rnay be revoked at any time u�n v'plation any of the provisions of said ordinances. �i ,� t _:....-�� . .� �� i�+'f•�L!/iAF�. : / Building Inspector NOTICE: This permit does not cover the construCtion, instalfation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. - � • 0 sus�ecT PER City of Fridley 15 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ' REC O: � � • COMMUNITY DEVELOPMENT DIV. q � � L / 3%� r � � PROTECTIVE INSPECTION SEC. G y i � � l___-�; ��1,,� CITY HALL FRIDLEY 55432 NUMBER � REV. DATE PAGE OF APPROVED BV i 612-571-3450 910-F15 7/18/79 � � �oe A�oaess 6411 Able Street N. E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N� 23 2 Moore Lake H].CjYl�.dYl.(�S• SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Mik.e Baglio 6411 Able' 5treet N.E. 3 CONTFACTOR MAIL ADORfSS ZIP PHONE LICENSE NO. Francis AhQrn 6 Sk line Drive Mankato MN 345-3516 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEEF MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS �PfRATE PERM�TS REpurRE� 1�R ,i��Rt� I��aTlNG, Pwt�8t1�� Ai�D arG�, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, NEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NUIL 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 WQRK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPUCATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREW OR NOT. THE GRANTING OF A PERMIT 2 OOO �..00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1TFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON- STRUCTION Oii THE PERFORMANCE OP CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE � ,'L��, � i $13.00 SiGNATUREOFCONiRACTORORAUTHORIZEDAGENT IDATEY � _. �� A/HEN: PROPERLV VALIDATED THIS IS YOUR PE MlT A � � � SiGNATUREOFOWNERIIFOWNEABUILDEFI.� � � IDATEI � - BLDG �NSP � pTE. CI7Y OF FRIDLEY - AP-PLICATION �OR RESIDENTIAL BUILDING PERMITS � (New, Alterations, Additions, or Repairs) � � OWNER: BUI LDER : �/t�� G�-�°�-�� ADDRESS: �p�/i � - �C ADDRESS: � � G� �%�-4 ��%� TEL N0: TEL N0: ..�� J 3�� 3S %� Construction Location STR�ET NO: Cv ��/ STREET: !'! - �- � � LOT: �%�ji �,� BLOQC: �_ ADDITION: Corner Lot: Inside Lot: � ^ Setback: Sideyardss Applicant attach to this farm two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTiO�J OF CONSTRUCTION Front: Depth : H eight: Squ�e_ Feet: Cubic Feet: Front: Depth: Height: Square� Feet: Cubic Feet: .� Type of Construction: ��i�� Estimated Cost: $ o�DDo Zb Be �mpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET , The undersigned hereby makes agplication for a permit for the work herei.n specified, aqreeing to cb all work in strict accordance with the City of �rid).ey Ordinances and rulings o€ the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE : l � S IGNATU RE z C��r�e�/ � Stipulations: � 'f � . l)C� , . 1, �� . ��--�� . � � 3 , pb . --- - . a�- �"' C�'v � � , ' - �yg;�� . _ • BUILDI(�G PER��IIT FEr SCNEDULE S�CTION 2. The Inspector. ot L�uildings shall, be£ore issuing penniL-s for the erection of any building or sL-ructure, or ior any addition ta any e3cisLing building or structure, . or for any alteration or repair.s to•any existing building or structure, upon application L-hex'efore, require the payment by the applicanL- for. such permit of fees to the amount herei,n below seL• forth and in the manner herein provided �o-wit: • NEW CONSTRUCTION: Single r�unily Homes and Garages: $4.00/1,000 cubic feet. PLAN CiiECK: 25 percent of building permit fee. DRIV�WAY D�P�SSION: (Concrete Cur.b Streets Only) ' ' Alternate A: Remaval and replacement of concrete curb and gutter only; Driveway width plus 6 feet x�'2�.75 Alternate B: Removal and replacement of concrete curb and .� gutter and install a 3 foot wide approach with ' � 6 inch depth; Driveway width�plus 6 feet x$17.85 � ADDITIONAL IL�FORMATION £or the purpose of computi.ng fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a , point six (6) inches below the floor line of the basement or th� cellar to the average heights of the upper surface or to the average height of the roof surface of the riain gable of a pitched rooi. For repairs or alterations to an existing structure, the fee shall be at the rate . of $3.00 �ier each five hundred dollars -($500.00) or fraction �hereof a.n the cost of all proposed work. � In�no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. ' � VE.3,IEICgTIO�I OF FOUNDATIOfV "�NOTE: Permits for cQnstruction will be issued a minimum of 24 hours from the time of applicatian to allow for proper review o€ the proposed structure and of the . construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with tihe framing. CERTIFICATE OF �CCUPANCY ' Application for a Certificate of Oceupancy shall be made ten (10) days prior ta the use or occupancy of any s�ructure for which a builc3ing pernlit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issuec7. . _:. � . . � �. . CITY OF FRiDLEY INSPEC71f)N DiV. 6431 University Ave NE Fridley, M N 55432 572-3504 ' Stcries Floor 1 " '� �� Fioor 2 '��=� ' ;,�:,... ��. Floor 3 � ' �, v. �: F{cor 4 `" - ; �:.:.F � '�+t;k;li�: `r+!u PLUM6ING FIXTURE RATES: � ■ MARK EfHective On August i, 1995 .-- APPUCATION FOR PLUMBiI�iG AND G�1S FlTTING PERMIT f.---�� "- ��. BER Ofi F1XTtJRES TQ BE INSTAL.LED ON EACH FI.QOR /� �� s"_ Wash Floor '��' �. " � � Auto. � w Gas - --' ; � Water Heater ; ' , ... . : . ' TraY .i. Daain :. �' Washer � _ � �� Range } � Gas Elec NU. RATE T07AL JOB New Fixtures $ 7.00 Oid Opening, New Fixture $ 4.00 Beer Dispenser � $ 5.00 Blow Oif Basin $ 7.00 Catch Basin �$ 7.0p Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7,00 Water Treating Appliance � ' $i0.00 VNater Heater —Electric : _� $ 7,04 Q G° Watet Heater — Gas** � $10:00 Gas Range** � ;., $10.00 Gas Dryer** $10.00 Back Fl�w Preventer Required (}Yes O No • TYPg � $i5.00 Reinspection Fee $42.00/H��: � ALL OTHERS ANDJOH REPAcIRS AND ALTERATtONS 1.5% ot Vatue ot Finture or.:Appiiance � State Surcharge 0 The undersigned he�eby rnakes appqcation for a permit for ths wor3c herein spec�ed agreeing to do aN work i� strict accordance with the city codes and rulings of the Building Division, and hereby deciares that all the facts and representations stated in this application are true and correct. Owtte► Buitding Used As X� Estimated Cost � Q PERMIT PLUMBfNG COMPANY . „.. SICNED ��/� ... _ � . � . �. � � � �� , ..L� 1f i�' � r, , , , �� °U , U �. a Apprcved By Rough—In Date Fnal Date ; 50- �j MINIMUM FEE FOR ANY PRUMBlNGJGAS PERMlT IS S20 00 � TOTAL FEE . $�Q PLUS THE 5.�0 STATE SUR�HAR�E **COMBUSTfON AIR SHALL BE PRO�/IDED PER UMC SECTION 504(Aj AND TABt.E 6—A. MINIMUM SIZ'E 9 SQ INCH�S. . . . � �li° � ,N � . � JJS � . . . �c.�,�,, � � . P p <� � sue�ecT MIT NO. City of Fridley 2 7 416 ' , AT THE TOP OF THE TWINS B U I L D I N G P E R M I T RE � � � � • COMMUNITY DEVELOPMENT DIV. ,� r � L � PROTECTIVE INSPECTION SEC. � � � � � v � � /'��1 � CITY HALL FRIDLE� 55132 NUMBER � REV. DATE PAGE OF APPROVEO 8V �"""�' �'' 612-571-3450 9t0-F15 � / 8/26 98 JOB ADDRESS 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Mike Ba lio - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NQ. Timmers Constructio - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO. B USE OF BUIlD1NG Residential 7 CLASS OF WOqK ❑ NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOFK Reroof house and ara e 21 S Tear-off 9 CHANGE �F USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTfiICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV IOAD VENTIIATING OR AIR CONDITtONING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTqUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. UWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO G1VE AUTHORITY TO VIOLATE OR CANCEL THE pERMtT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR �OCAL LAW REGULAT�NG CON- STRUCT�R THE PEIiF NCE OF CONSTRUCTION. C� � �� PLAN CHECK FEE TOTAL FEE � ��,�� SiGNAiUQE OF CONTFACTOR OF AUTNORIZED AGENT �D TEi P OPER DATED HI IS Y P MIT � SiGNATUAEOFOWNEAUFOWNERBU�LDER� IDATE� BLD WS� paT NEW ADDN ALTER [� [] [] ConstructionAddress: � Legal Description: Owner r Contract� Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION LNING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1 / 1 /98 � �� Tel. #��=�f`� MN LICENSE # �Q� 3 Tel. # �,s�l — �,��' � of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height I.ength Width gt/Ground /Jo�� l�,•.�,� e _.. ,�. � „� �� 9, � � Sq. Ft. Sq. Ft. Sq. Ft. ��r2 �� - � � - � � _.._.____. ��r� Ca�nstruction Type: Estunated Cost: $ , � � � __ _.._ � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � `/i� DATE: � APPLICANT: �,�� Tel. # �`J � '� �s�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ ��o- %� Fee Schedule on Reverse Side $ . '7.5� .001 of Permit Valuation (1/lOth%) $ � % $.50/$1,000 Valuation $ $1000 per SAC Unit $ � -Of� $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 [ J � � -�7 � M BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 , $25,�1 to $50,000 $349.75 for iirst $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,OOQ,OOl and up $574.75 for %rst $50,000 plus $6.25 for each additional $1,000 or �raction thereof, to and including $100,000 $887.25 for �rst $100,000 plus $5.00 for e�ch additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue�ecr P T N O. City of Fridley 2 8 9 51 AT THE 10P OF THE TWINS g � I L D I N G P E R M I T r ; � RECEIP _NOQ. ' • COMMUNITY DEVELOPMENT DIV. y � � V� � l� � r � � � PFiOTECTIVE INSPECTION SEC. 0(O 1 � � ' � �"�1 • CITY HALL FRfOLEY SS�32 NUMBFR pEV OATE PAGE O� APPROVED BY �.__.Jl: '•� 612-571-3450 9�0-Ft5 2/26/99 / / JOB ADDRESS 6411 AUI2 Street NE t LEGAL �07 NO. BLOCK TRACt OR ADDITION SEE ATTACHED DESCR. N� 23 2 Moore Lake H1gY113I1dS SMEET 2 PiiOPERTY OWNER MAtL ADORES$ ZI� PMONE Make/Mary Jo Baglio 6411 Able Street NE 571-9639 3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO Timmers Construction 2604 Baile Ct, Ne ort, MN 55055 459-4568 3033 � ARCHITECT OR OESIGNER MAII AODRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII. AODI±ESS tIP PHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION �1 REPAIR O MOVE O REMOVE 8 DESCAIBE WORK Re lace 19 windows 9 CHANGEOFUSEFROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the dwelling. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAO SEPARATE PERMITS ARE REOUIRED FOR ELECTRtCAL. PIUMBiNG, HEATING, VENTILATING OR AIR CONOITIONING TMIS PERMIT BECOMES NUII AND VOI� IF WORK OR CONSTRUCTION ZONING SO. fT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS. OFi IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONEO fOFi A PERIOD OF 120 OAYS AT ANV TIME AfTER WOqK IS COMMENCED. NO DWLG. UNITS OPFSTREET PARKING I MEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICA710N 1 STA��S GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECi. ALL PFOVIS�ONS Of LAWS VA�UATION SUR7AX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WHE7MER SPECIFIED NERE�N OR NOT. THE GRANTING OF A PERMIT �7 � 423 �3. 71 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OFi CANCEL THE pEpMIT f EE SAC CMA E PROVISIONS OF ANY pTMER STAT LOCAI LAW REGULATING CON- STRUCTION R THE PERf CE Of CONSTRUCTION �1.37.25 F1T kSC �7.�F2 /'� PLAN CNECK fEE TOT FEE � License $5.00 53.38 $IGNATUpEO�C •A�CTOQOQAUTHOQIjED�GENT iO�T � EN P OP O MIS IS Y UR PEQMIT l✓ -�6'� S�GN�tUaEO�OWNEA�rtOWNEA8U40EA� �O�TE� BIOG NSo q�}E - NEW ADDN ALTER [l [l [l ConstructionAddress: Legal Description: Owner Name & Address: �---, Contractor: Address: �� LIVING AREA: GARAGE AREA: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 / 1 /99 �� a �. g�0 Tel. # ,51/�-- �� ' MN LICENSE # �C�.33 Tel. # �� .i� Attach tfithis 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 Sq. Ft. Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ( � ,CJ.�D�S `- Construction Type: Estimated Cost: $ � � � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �`� _ �� `,�- DATE: APPLICANT: Tel. # �f �T � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL � STIPULATIONS: CITY USE ONLY $ ��?_ �S~ Fee Schedule on Reverse Side $ . � .001 of Permit Valuation (1/lOth%) $ �. 7/ $.50/$1,000 Valuation $ $1050 per SAC Unit $ � � QO $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 [ J $ /s.�.�° BiJII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or struc�ture, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100, 001 to $500, 000 $500,001 to $1,000,004 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for iirst $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width pius 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the f�aming. CITY OF FRIDLEY INSPECTION DIViS1ON Effective On January 1, 2002 6431 University Ave NE fridlsy, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRiGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS ��%/ / �� • ��• --� � OWNER Residential Rate TOTAL � Furnace Shell and Duct Work, Burner • BUILDING USED-AS 't-% Also Replacement Furnac'e $ 30.00 $ �0� � ( (Side Vent, - Fill Out Back) ESTIMATED COST '�o�,�`DD - d0 PERMIT N0. fJ �%L-�� Gas Piping (Needed with new furnace, $ I0.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ : ' No. of Heating Units' � Circle One (Steam) (Hot Water) rm Air� Gas Dryer $ 10.00 $ Trade Name (-1�-��l Size No: ��q�'1 �/7�'?S BTU '7 5� 6tX� Hp EDR *Air Conditioning - All Sizes $ 25.00 $ oi�•6� Fuel .__ Total Connected Load �{iZ DU /S T All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name��i � Size No. 1�'Jo ofValue of Appliance or Work $ BTU '�� HP EDR '. - -� Commercial/Industrial � 1.25°jo of Value of Appliance or Work 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. $ $ .50 $ , .5D The undersigned her�by makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby deelares that all the facts and representations stated in this application are true and correct. DATE J-- I��-� �, HEATING C0 ROYALT�� Id�ATINd � C44LING ` 4120 - �5th AVENl1� Nf�RTH - Signed BROOKLYN PARK, MN �� FAX # 763-424-8333 — � � Approved By • Rough•In Date Final Date �'��db THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE ,APPLICATION WILL BE RETURNED COMMC)N VFNT� VFNT CnNNFCTnR AI`D C_OMBI iSTi(�f� AIR �/ RIFI ATlnl` When rP �n ar_inA an Pxic in� f�rance, 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 O No O The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. 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 Fumace Venting Tables for fan assisted and natural draft appliances. The pY�st�nq cembus+��n air is sized and installed to meet the current codes and manufacturer's specifications. When required to instau a r,ew ��me �� ien air,,it will be sized and installed to meet the current codes and manufacturer's specifications. Yes �(„ No ( ) Yes(�No( ) Yes ( ) No ( ) Yes ( ) No ( ) Wheft inc allin� a new v_n in��, 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 Fumace Venting Tables for fan assisted and natural draft appliances. Yes O No O 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( ) A�nlianr�yne and Si�p/Gemmen �lpn �nd �/ nt enn cter Ir�ferm� ion Appliance #1 Type ''�1 BTU Input .�S O� an Assiste r t�v C v� %~ Appliance #2 Type �e� ..c� BTU Input G Fan ssi� at �f � h t� Appliance #3 Type BTU Input Fan Assisted or at Total Appfiances Total Btu Inp�1t Cornmon Vent Type Cl��sS e— 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 _ �� k,,�. l<h tr HEATING CO: d �� Signed By: Date : �, "�,�`'d�' •, . . . �� HOUSE HEATING TEST RECORD KaDRESS --' E`�� ' APT. FLOOR CITY =.� SUBURB � !��%� f{ r OCCUPANT r i , !" 's � -�.- � � � . OIMNER HEAT LOSS DATE HTG.�INST. SOLD BY INSTAL.LEO BY El�chicol Work' By �s L�� Br TYPE OF HEAT GA FA �` HW STEAM SPACE HTR. UNIT HTR. OTHER ` GAS DESIGN CONVERSION MAKE �`��`--� MAKE OF BURNER Mod•I t � i '� 1 '/ i Mod•I SNiol � � „r. Ma:. BTU Rati�y INPUT 7%•�' MAKE OF FURNACE !►lod�l � �� CONTROLS TNERMOSjI�T •3_ `-'' •� H.at Pluy +D Valv� � �'f Limit 1 � x�/� Limit S�ttiny �i�� Fon S�ttiny Pilor Typ� '�' , Pilot Mak� __ _ P;lot Mod.l V�nt Siz• � �� KtND OF tINER E Draft Hood Rpulawr Filt�rs Siz� X > X umb�r Chimn�y Loeotion Insid��p�tsid• r Chimn�y Co�struetion _ �-�'i � Smok� somb Wiriny '''' Pilot Timinp DroFt ��: �� T�st To9 '�� L.W. Cut Off Dow Pr�ss�r� Liyhlin9 Inst. r�^- / ^� Pr�ssur� � P�re�nt CO2 Dvt� T•st.d �C '�`` c'7�^�- _... Input CFH P�re��t 0� � Compony T�sting �� l �C .. ?" •% � � , Stack T�mp. P�rc�nt CO Nom. of T•.��, Form 235 � - �. - ...rar. • t��W tiV ��V�� Y�V 6431 Unn�ersiy Ave NE Fridley,lY1N 554g2 572-36Q4 APPI.ICATION FOR PI.UMBMIG A�ND �iAS F11T/i1G PERINT trteCave l,m .lar1 � , twu �.uw�q � pu►�: No. w►tE Torr�u. .ios �oon�ss �'-� I l C� ��. . w�r FMMw� OM �ir, N�r FiAu�r � NMr Ol�r Bbw ON �n C.aMh 9■�in Rai� 11M�I�r L�/■r su�A1�o� Ya,k 111M�►T�Ap'I�r�a 1A�� MM1r �Mic Ywi�r 1�r' GrrN �._ G� II��M" (�t Ory�" 8�da Pioir P�wM�' R��d t)Yes t? No i �.00 =1.00 i 3.00 i 7.00 = 7.06 i 7.00 i 7.00 i10.00 i 7.00 i10.00 =10 00 i�o.00 T�M i15.00 Rein�clio�� FN i47.OWfk A�.L OTF�RS MID/OR REPA�RS ANO ALl'ERAYIONS 1.5% of VaNie of Fbchx�e or /lpplirioe �� .:«, �. TOTALFEE ---�— �� Mwby n�s �o�on fb► s�it �nr 1h� wak M�Nn --.�... �P�M�rd a�rrUl� b ro ar �ak in aM�t aaoo�t�1 � c�l co�l�s .�, and �i� d!w aiig Di�Mia� a�d hr�r d�d�ra �t �M NN wol� ----.—� �d np��s �I�Md in M�is �c�lton � liw an�l ooen�t. ________ —� � 10,� __________ �f►•• � .so s �o. � - a a. ��,� � . � t � � , : 8��rp UMd M E.�.d co.� 5 a�_-C� �r No. �� t�� : - � LE� STUl.L P�UMBiNG PLtJ1�MIG CO�'MIY ) ANOKiI MN SS90g SK`aNEO BY �. 42'i*8168 TEL N0. _ � � �� r � ao�n.M o.� � oMS S� � � � r � ? � � �. T-.� ••: ( • ,c � _ � ;-, tr �,, � _ 1�) . � _ � ��,,, ;�r GUMBUSTlON AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABI.E 6-A COMMOM VENT INFO UN BACK SID� Building [nspections 763-572-3604 763-502-497? FA� DATE ( �/ � �� SITE ADDRESS fo � % TH1S APPLICANTIS- PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 YOUR E-MAIL ADDRESS ❑ OWNER �CONTRACTOR •_ -T — ADDRESS: ., .-. . . ._ PHONE � � ( — �� ' O S D STA�',E LICENSE � L3 SINGLE FAM[LYMEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION PERMIT TYPE u fwui �►vrv u �r.,cr.0 ❑ BASEMENT FINISH O ROOF � DECK ❑ SIDING TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ MA AN E/REPAIR DESCRBE WORK BEMG DONE: ROOFIIVG NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ num Other WINDOW S IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING •CHANGES & TYPE OF WINDOW TO BE INSTALLED Permit No.:7�.�'c'� `'� Received By: � Date Rec'd: � � �-� �I� C1TY��ir� �`�1 STATE��IP55 �S � CITY i ATE ZIP � �_ Fa.x �� 3 �o - EXP DATE SIZE STOR[ES :/SHED ❑ WINDOWS ❑ DRAM TILE � � ❑ OTHER NG P00 O ArDDT ION ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim O Fascia LOCATION OF WINDOWS NUNv�ER BASEMFNT RRMnT�P_LING SUSMIT: L . Existing Floor Plan 2. Proposed floor plan 3. List of structural members to bc used FOR NEW CONSTRUCTION INCLUDMG DECKS, ADDITTONS & PORCHES SUBMtT• 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: q (USING THE 1997 UBC FEE SCHEDULE) �_r�p� TOTAL JOB VALUATION $ /�O �� OCCUPANCY � C+�f` -- TYPE Permit Fee $ r<',�',� � See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ , .001 times the total job valuation Surcharge $ �� .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Chazge $ $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 O Non Necessary O Total Due � $ , � Make checks a able to: Ci of Fridle Attach Sti ulations T S IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I nowl ge that the i ormation 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 Minn�sota Co s ctio C es, tha I understand this is not a permit but only an applicati n for a permit and work is not to start without a permit on site; that the work will be in a ordanc h th p ove pl in the case -a�k which requir w an p f plan � SIGNATURE OF,Ai�.[C�NT ' PRINT NAME /�� DATEIb� � APPROVED DA Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair io�n3� exist�ng b"'1� or �r�.icture, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department _ 6431 University AYenue NE � Fridley, MN 55432 763-572-3604 Faxc 763-502-4977