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AF - 36482� ,;\ , �.: '� �....... �'�a�e of �.sll.ey,l6�.nn. �U �TG P��_ 328 : o��a o� ��o� o� ��n�G� �' � o�ner � a� �. �"%� � ► �., Architect �, I'rld?ey; Niinn. �"�'°`� � � , 18� } Builder te `��'.�. �x ��.�� & No. reet—Ulvo��`� �:��Q1t'f/1?>I� � art oP Lot � e�-� Lot BIock Addition or Sub-Division '` -- � To re usea � - � �n�`�a �� .: . �� ' ��aD��r Storaes� Manner oi Conatru _ To be coa��pleted�'� '�°� ��m � `�� y},� .,{� � � � � #� � h F+� : �FC� �.�f'°'u£� � n "�� , . �, 4 �-;< .,�� . ��.�.� Estimated Co� e�� § . . . . ..., , . .�:: .� n ylpy" + +��,�Z F<'' Y y v, . Permit is hereby gra.nted � � $ �� a ,,,�+� �":�" #,a �� y�.�'" �'��'�,�'� . . � � � � � f '� E . T�"+� —�--- a c� f.he building 5�� '�►"''�. }%.�� `� .: described in the above statement. Thie permit is grastted upoa the express condition that tha p�son to whom it is granted, and his agents, employees and workffien, in a11 the work done in, axound and upon ict buildfng, ar an.y part thereo% shmLl conform in all respects to the ordi- nances oP I`rirlley, Minn,, regarding the construction, alteration, maintenance, repair a.ad moving of buildings witk�3n fihe city ]imits; and f,hfs permit may be revoked at a.ny time upon vioIation of a,ny of the provisfoas of saici ordinances. _ � � d >: " � "''�� '°` s ector of Buildin�s. r �, AGR,E�I�T'l` Ai�3 ��IO�%1�T S'�'ATEI��NT - In consicie�a,tio� �f the i.�sue and delivery to �.e 'by the I�s�ector of U�aaldin�N of �idley, of the above permit, I hereby agree to do the prop�rsec� work in acec�rcta.�xce v�ith the c3escription above set forrth �,n,nd. accox�ding to the provisioxis of tTi� o�dina.nce� of �idley, a�d, io�ing first duly �"sworn., I hereby sta,te �,nd say that the facts sta.ted by ane and contaizaed in the above pex�a.it are true as therein sfia.ted. .. -�: �"µ �� . �°�x �� =�z: �m �q � �� + Subscri'bed and.�worn to before me at �ridley, �l��ewota, �l�ia '�. � � � �' � da,y of.� �� "�o� P .D. 19�. � ��- ., � t ��:� . . � .... �i �-�. �� I■ City of Fridley, M��r- 6431 University Ave. N. E., Minnea�lis, Minn. 55432 � � � � r ��; _ Sentember 13. 1971 PERMIT p�; Walter Jacobv g�� Same :� - - � � � � ,�►ddresB —6�Si� nn 1 Road N Addresst --Sa.me .__ .. __._...._._.. LOCATION OF BUILDING No �.�h2�. S1a�eet Ch anr e � Ro ad N F Part of Lot � � •$i� Addition or Sub-Division Aud. Sub. �21 ��' �t �� Setback Sideyard '�� Foundation IIevation DESCRIPTION QF BUILDING To be Usea as: -B�-RO°f Front Depth Height Sq. F� Cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construckion �Aspha7_t ��, �� ,�,�00.00 To be Completed Done 0 Ia consideration of the 3ssuance to me of a per�mit to construci the building described above, I agree to do �i►e proposed work in. accordance with the des�Yption above set forth and in compliance with all, provisions oP Orditiances of the city of Fridley. ��° .°'_. .50 State In consideration of the paymeni of a fee oP $ 5. 00 � pe�t is hereby grattted to W. Jacoby to construct the buiiding or afldition 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 �vyorg done 3n, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances oi I�iidley, Minnesota, regarding location, construction, alteration, maintenance, repair and 2noving of built7i�tgs �� at3' 7imits and tdus permit ma.y be revoked at any time upon violation of any of the provisions of saitd '=�� ""��-��t�-�--- �° �-% ,�' � �uilding Inspector ('T.ARFN('F FT T T $ NorocE: ihis permtt doas nof eover the eonstruetion, installatfon for wiring, plumbing, Sas 6ea4ing, sewer or �ratee, Be snra to ses f6e $uilding Inspeeto� for sepa�ate permifs fo� theae items. � n Permit No. � (� ;1 5 '� [ � �� 71 N N�C/ �E' � 0 � O T Iath or Cover the in},er�tor of the following �nspecto� �,Ve � Building nntil �on and si �e their inspec. �� this c�.d, �P�tors commeats: c� I �F �� (� -� �e' �2 � � `� �- � � o Plumbittg Insp. Electriccal In$p. Htg., Vent., Air (And. Ins . P Bldg, �p. Foo}�ng� � �d % ( Roagh In �ina1 — CiTY pF �IDI,�y 560-3450 AP.PLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA O�INER,' S s� ` � ' - NAME : '��/%�,�`;f ,.- F�� ¢' BUILDER : A]3DRE�SS i- �-�_,,,,,,�� . ,- , �.�� /_��`�� ADDRF.SS : .° —°�, 1�0 : . S'!'REET: �� B�K: ADDITION• CORNEA L(3T; INSIDE LpT: SETBACR: SIDEYARD; ��___._.__ �pplic�tat attach to thie fornt 1�o Certificates of Surv� of Lot and proposed bvtild� locatiott dra�a on these Certificates, H�SCRIPTION OF BUILDING To Be Used As: %�4 �lit�L / � ��. i � �'1 ' P Height: Squa�e Feet: Cubic Feet: Fxomts DeP�: Heights Squaze Feet; Cubic Feet: �►P�s of Cona�ruction: � � - ``� -�� ! `��- Estia�sted Cost;_$ �� J�'� = �,� „� �- � 5 � �� "�'_.. a _.e..._,...� �o Be Completed; �e uad�zeigned hereby makee applicatinn for $�permi,t �o'� the work hereiu epec�.fied, agreeiag to do all wo�k in sttict accoadance with tba C�,ty o� �"7ridley Osdin�ace� aud ruliqgs of the Department of Bu�ldin$s, and herab� dmcl.�lree that all tLs facta aud repr�eentations stated in tLia app2icatioa ase true and cors�ect. / T�'` e��p� `/%/�9 � � —L ,�� ) r� ' ✓�� i / — /..? ~ ! �iViwiVACi i �r �4 �f L' � .. � � � "'-� �w.�.� �ii �.i��w / (Ses Severqe Sida For Additional Iaformation.� �� Do� � �� z_ �- � BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits fax the exection of any building or structure, or for any addition to any exiating building or structure, or for any alteration or repairs to any existing building ox structure, upon application therefore, require the payment by the apgli.cant far such permit of fees to the amount herein below set forth and in the tnanner herein prwided to-wit: UINIFORM BUILDING CODE: �pe 1, 2� 4-$2.15 for each one thousand cubic fee�, ox fraction thereof, in such cubical contents. Type 3� 5-$1.85 fox each one thousand cubic feete ADDITIONAL INFORMATION Fox Che puxpo�se of camputing iees for building permite, lthe eubical contente �f auy building or addition, ie determined by multiplying the ground area covsxe�d frcm� a paint six (6) inches below the floor line of the basement mz �k�e cellar to the average heights of the upper surfac� or to the average� hei�ht of the roof aurface of the main gable of a pitched roof. For repaixs or alterations to aai existing structure, the fee shall be at the xa�e Qi $3.00 per each five hundred dollars ($500.00) or fractioa thereof in the cost of all proposed work. In ao case ahal� the fee charged for any peranit as set forth ia Section 2 be lesa thaa $5.00. V�iRIFICATION OF FOUNDATION I�DTE: �'e;rm�ts fvr eonstzuction will be iseued a mini�wm of 24 houxe fram the Ci�e of applicatioa, tv allow.for proper review of the proposed structure a�ad of the aonstsvctiom eite. A Cexti,�isd Survey of the lot, ahawi�ng the locatian of the foundation, oa►ce it haa been canstructed, will be required before proceedinr� with the framiag. GERTIFICATE OF OCCUPANCY Application for a Certificate of Oceupancq eha11 be made teu (10) days prior to the use or occupaacy of �y atructure for which a builditig parmit hae been isaued; and said etructuxe shall not be used or occup�ed uatil a CertiFicate of Occupaacy hae beea isauedo � �� . HOUSE HEATING TEST RECORD ADDRESS � �� APT. FLOOR CITY SUBURB ` ' '��--� OCCUPANT OWNER �e � HEAT LOSS DATE HTG. INST. ��f � /li'0, � 7 � ' � � SOLD BY INSTALLED BY Eleetrical Work By Gaa Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CQNVERSION MAKE r '� AAAKE OF BURNER Model 3 Model Ssriol �—�� Vo��6� % Max. BTU Rating INPUT �rd �� MAKE OF FURNACE Model CONTROLS �� THERM ST T � H^,q a Plu Vent Size � Valve � �aiA= N�� Q %'�� KIND OF LINErR�_ �� SIZE�g.�—NONE Limit �� Draft Hood s7 � Regularor Limit Seftiog � `� Fi Iters Size Number Fan Setting ` Chimney Location �In1si�le Outsida � Pilot Type �� 0°'� 0 Chimney Construction !JI_'�t � � I �. _ _ Pilot Mcke � ''� Pilot Model �� " Smoke Bomb Wlring Pilot Timing �� Draft Test Tag L.W. Cut Off / Door Pressure Lighting Inst. Pressure �� Pereent CO � Date Tested ' `� Input CFH— � Parcent 02 7 Company Testing Staek Temp. `� Percent CO � � Nome of Taster Form 235 �� DHS-2722 (9-85) PZ-02722-OZ r�`'�.�c��--� �'�� L� ,�- 9° .�1� STATE OF MINNESOTA DBPARTMENT OF HUMAN SERVICES 444 LARAYBTTE ROAD � �� sT• PAUL. MINNESOTA ss101 Date . . ing Author' ��' �z��%,��'��.�� . S reet Address City State Zip Code RE: ZONING 1VOTIFICATION OF APPLICATION FOR LICENSURE Subject: Name of y Ca Home A� cant �� v� . Street Address . � City State Zip Code Type of License: Family Day Care Group Family Day Care Licensed Capacity �p-�� Phone No . _ �� `�� This is to inform you that we are in receipt of an application for licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of this license is subject to compliance with the provisions of Minnesota Statutes, Sections 245.781 to 245.812 and 252.28� subdivision 2, known as the Public Welfare Licensing Act and the rules of the Department of Human Services. You should note that under Minnesota Statutes, Section 245.812, Subvision 3, a licensed day care facility serving 12 or fewer persons shall be considered a permitted single family residential use of property for the purposes of zoning. Subdivision 4 of the same section indicates that a licensed day care facility serving from 13 through 16 persons shall be considered a permitted multi-family residential use of property for purposes of zoning. If we da not hear from you within 30 days after receipt of this letter, we will consider the above-mentioned day care home to be in compliance with your local zoning code. CONtii�li�lo�'� ��aL�� e:��:y;�,L SEfiVEC�� D�P�!�1 11;��1T Sincerely, COUNTY OF ANOKA COURTHOUSE, FOUR7H �LOOR ANOKA, MINNESOTA 55303 Licensing Worke Name of Agency/Organization Street Address City State Zip Code �, � i �• � � , i / � � �� _/' �� _ _ � � :�. AN EDUAL OPPORTUNITY EMPLOYER Building Inspections 763-5'�2-36�4 '763-502-4977 FAX DATE O�� I3 SITE ADDRESS I THIS APPLtCANT IS: YKUYL:RTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IMPROVEMENT BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-09 YOUR E-MAIL ADDRESS _ �Iy1�j�PI� �% ��1'��4'� A/Fr{ S'n�r3� ❑ OWNER J$�ONTRACTOR Permit No.: Received B Date Rec' d; Af� �a�A9AA6� ADDRESS: (p(c�Z� C�F;{�A1ea1�,L �� CITY F�2Y�1�� STATE M�ZIP Fi�3Z PHONE:_ a76`�j ° �°�'I' 4�I6� NAME:_ ��N t64TPa►� °I�O�QP.�ie� {� ��jVGT!`%�, L�ir STATE LICENSE #_�fJ� j��°�, EXP DATE ��J i�'' �,Q� � ADDRESS: �� { d�,�� CITY �Lf�lav � STATE �i`IZIP rj�%�1 PHONE �g � ° ��i ° �"I�� FAX �Z�D�J ` �T J� J �I '� L�SINGLE FAMILY/NEW CONSTRUCTION g�ZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADDITION �GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE � DECK ❑ SIDING ❑ OTHER ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE: �9 iC � �j, PROPOSED HEIGHT: �i� H SIDING � Vinyl ❑ Aluminum ❑ Other :%�� iE�e�➢ �� 0 HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE �.DETACHED GARAGE � � b� � BASEMENT REMODELING SUBMIT• 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, OSoffit ADDITIONS, & PORCHES SUBMIT• ❑ Trim l. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project. 2 WINDOWS . Two sets of construct�on plans IN EXISTING OPENINGS �Yes ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS-DESCRiBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDpWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 199�F�E SCHEDULE) COTAL JOB VALUATION $-��'� OCCUPANCY TYPE_ Permrt Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Fscrow 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 payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all wo which re ires view and approval of plans. SIGNATURE OF APPLICANT �� G�—� PRINT NAME �/Of57'�/�1 :7A%u`tAN �D DATE O�JJ � Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any build�ng �ox , structure, or for any addition to any existing built�i�g o� s�uctur�, c�r fore�.n}� ai�iarationo�r �i�epair to any existing building or structure, upon application there�ore, 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 FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for lg` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for ls` $50,000 plus $7 for each additional $1,000 or fraction to and includin $ ] 00,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1g` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraction 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 Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 - ,, � �� COfdSTRUCT10Pf, IP9C. Project _ ��Z� �� Sheet No. �r��Dl.�`� �'1t`� ��j� Job i�lo. Re By Date � � � � � `� i �-o � � � � ; E � j ' � ` i ; � ' ' f ' � ' � i ; i ( � � I i� i j � � : f � , ; , � E � : , —� � - --�—�-____-.i i -E._--_r___.�____i � i ' _ _ ' ' ___�__-___' _ � _ ' ; � � , �._ . , , � s ��, , 5--- t-- ; —. � --f r— s -.._.. .� . . _�_ . ...._.'y_. i i � % ' � � � _�.�� _ � ,� ' ._. �. —w. . _:__--.—. ;._._. . ` � � � � " , � �� ti___� : � � � � ; i f i . f _'_ � --'t— —�_ ' ' � ' i � t . i t � �� 3 � � ' i 3 _ ! _ _�.____ j � �i _'� '�— -��--� a�.� � � I 1 ; 4..______ �__� � � .: � s � � t f �. _. � �_._ _,� _ __i__ _ _� _ 3 I i 3 x � ! } � ' .�. �_� ..�. � '��...�; # t i.. � � � � � �j � � �� ` � ' �� V� � � '� —�— -� _... � � ! i � !---�--' H ; ; �..�._.:; �' 4 ' s ! ,z . " � ° _' � � �`-- —� --- � , � _ y � i �--..._.. f i � i � � �._. _ !----- �._ ,�, =�---� ' E—.-_.,.a._. ��_��..�. � � ' r � r f � � g i t i--°---� � } � f ' --�__—__;._---�---.-¢-- . J"'"'� k i �-• , { �—'-- `-----p----._.�. 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I j � � 1 � � � � � � � � = i ! ___�---�- � _. � ; � � � i � � , , f E � � � � ' f i � { 71 E 9 3 9 st Avenue N., New Hope9 MI� ��2'� �(i6�) 5�6m9200 � F� (�6�) �3b-�20� � � ' - Page 2 of 2 si n # 88156 . . _ = g �� . _. � . . 4t�120 Here are the wall configurations foryour design: - ------ - ---- - -- _.�� IIlus�a�onMa�NotDepict�IlOption�_Sele�ted---- --------------- -_ ___ . iy' �� .,. _4� ble Front V'iew � � 16' X 8' . 4' e Front ��ww �RC� � lt'z. E�+t�ir►�rR�'b '�-rtµ4SE5 _ ._ GableBackVi�►r u:� ` oo - � oa oa 2'-8" T-10� 3' X 2' 2'-8° X 6'-8° Eave Back Ifi�► : r: / -10°- proaided �rrateria! e�imates are ir�end�l as a general �ns�uction �d and hauebe�n c�lau�t� usp�g typical c�n�ru�ion methods. Because of thewide �ariable in codes and c�ons, all final phans�an� material ri�is mu� �ve 'r�'i�i u�th your lacal zonu�goffice, archh�e,ct andlorbu�derfor�d' d�ign and code campHance. Menards is a supplierof ui a ion materials and does n� assume %abiMy for de�gn; engineamg or tt� camp�ten�s of a�t ntater�l 6sts provid�l. d�ground elech�c�l, phone antl gas rnes should be nd marked before your build'mg plans arefinal'¢�I. Rememl�rto ��r eqwpmer� mclud'mg du� masks and sight and f�ri� prote�#ion dunng constnichon to ensure � building ezpenence. ��, e Z/Z d Z£L5 6SL E9L «�9L6£SL£4L 91�p9Wt11d S 9 W 9lYZ ZO-80-600Z Building BUILDING Permit No.: O�I,'b �� Inspections RESIDENTIAL APPLICATION Received By: ��( `t�� 763-572-3604 CITY OF FRIDLEY vat��ctAl1�; �. �� 763-J��2-49%% FAX EFFECTIVE 1-1-09 DATE O�� l�� YOUR E-MAIL ADDRESS J H=aT 1�( A� � ysd L�) b1 ��j,� � b/g� g I�� ,�j�, SiTEADDRESS ��Z� C��woaEL R'� ��s�� , �°i� �a5+�3 Z. THIS APPLICANT IS: ❑ OWNER I�ONTRACTOR PROPERTY OWNER/ NAME: ST�v G � TENANT ADDRESS: C�foZS CFOA^rafE.L �i� CITY ��t�LE°� STATE ��ZIP �� PHONE: %�oaa-�j�ji'I" r-il�j� CONTRACTOR rt.a1�: N,.ier��a�vE t`�aw�a�o..�� '�?e�a�s..� L�� SUBMIT A COPY OF STATE LICENSE # Zf7 (o� S�"7 Z EXP DATE v�s I� I �� 6�. YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: �O ��X 6d 9�� q� CITY �� A�� STATFp'�� ZIP �� INSURANCE PHONE �12 ^�-3�'6° �I �� FAX � �� `l � �$ • ��Z PROPERTY TYPE ❑ SINGLE FAMILYMEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑�DITION ❑ GARAGElSHED � WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN T[LE ❑ DECK O SIDING ❑ OTHER ❑ SW[MMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 0 MAINTENANCE/REPAIR ❑ REMODELING DESCRIBEWORKBEINGDONE: �EMO �h�'1BN� �,�p��,e,�� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING ❑ HOUSE ONLY g,qSgMENT REMODELING SUBMIT• NLJMBER OF SQUARES ❑ HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ,�DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 V�►Y� OSoffit ADDITIONS. & PORCHES SUBMIT• ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures � �eC ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS �Yes ONo 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: (U5ING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ � 5C� C7 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due � a� � e'�� 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 (Sta.te Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ °,a� � r(� Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all k which ires •eview and approval of plans. SIGNATURE OF APPLICANT `�"" sr�— p�T NAME`��YTy/`; �"lFAI^N'�r"t t/`� DATE d'$I �� f�� Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building O�cia1 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 FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1S` $500 plus $3.05 for each additional $100 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for ls` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 15` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for constntction will be issued a minimum of 24 hours from the time of application to a11ow 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 Uzuversity Avenue NE Fridley, MN 55432 763-572-3604 Fa}c: 763-502-4977 d .n�,� � . tG,.' e P a r � ..'..'. .� a � '`.y't....;�, � ♦ , '9 ov ;3� . o • � . �. ., . , . 4' 1` y