The URL can be used to link to this page

AF - 37745City of Fridley, Minn. BUILDING PERMIT .: . , �. ,,' - �,,"" • • � / E' s.� . _ _. �e.� . � �� .� / N° 6044 LO TI��BU LDING No. .�(,1� Street .�� Part ot ,��,/ � Lot _��►-+`� Block ^�— Addition or Sub-Diviai�n .�?��'j,.w„� r Corner Lot � Inside Lot �"""�" Setback ��-- Sideyard �L�_,�'�,.�— Sewer IIevation _____ _ Foimdatlon IIevation DESCRIPTION OF BUILDING To Used as: ' �� Fmnt .'�'�� Depth .�� Height � S4• F't� .��r � Cu. F't ��!,��' Front �,� Depth H'ei8ht ��- S4• Fk _�r �� Cu. F't. _�T '�' � �,,r �.. Type oP ction � .i�.:_. Est, Co �..+� �o be Comll�ted � In conaideration of the issuance to me of a permit to construct the bu3lding described above, I agnee to do the proposed work in accordance with the description above set forth aad in compliance with all proviaiona of ondinances oP the dty of Fridley. � In con�fderation of the payment of a fee of $��, permft 9s hereby granted to to oonstruct the bwtlding or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and lus agents, employees and worl�en, 3n all work done in, around and upon said building, or any part thereof, shall conform itt all respects to the ordinances of Fridley, Minnesota regarding location, conatruction, aiteratio� �repair and moving of buildiugs �� dty limits and this permit may be �voked at ar�y upon � � n of aay of the provis�tona of said Bt111din8' Inepector NoncE: Thts p�emtt d� eot eoru ths coestrueHen, testa0�loo fer �ru�ny, Ph�mb�n�, oa 6.axea swinr er wat�r. B� sms to sM �h� Bu(Idlne lesp�ete� fer aparah p�rmhs Poe t6a� ft�ms. � . � ,� �..�.� ;t•. ' .�. � � -•� APPLICATION FOR BUILDI�tG PERA'LLT CITY OF FRIDLEY, MINNESOTA Owaer's Neme Builder � Addreas Addreas LOC�STION OF BUILDING No. Street ParC of Lot Lot Block Addition or Subdivisioa Corner Lot ineide Lot Setback Side-Yard �EWSR EL�VATION � �'OUrIDATION ELEVATION Applicant attach to Chis form Two Certificatea of Survey of Lot aud proposed buildiag location drawn on these CertificaCes. To be userl as: DESCRIPTION OF BLTTLDTNG Front Depth Height Sq. Ft. Cu. Ft. , Front Depth Height_ Sq. F�. Cu. Ft. Tyge of Conatruction Eatimated Cost To b� Completed The uadereigned hereby makes application for a permit for the work herefn specified, agreeing to do all work ia strict accordaace with.the City o£ Fridley Ordiaances and rulings of the Department of Buildin�s,.aad hereby declarea that all the facts �nd representations etated in this applicatioa are true and correct. . i DA1'S SIGNATURE � (Schedule of Fee Coets can be fouad oa the Reveree Side). � . _� ^ � .. , t •► e BUILDING PERMIT FEE SCHEDULE Section 2. �he Inspector of Buildings aha11, be�ore iaeuing anq permit for the esection of any building or structure, oa for any addi�ion to any exist- in� bu3.lding or atructure, or for any alterations or repairs to any existing building or'se�:uucture, upon applic�tion therefo�, require the paymen� by the applicant for guch permit o£ fees to the amount herein below set forth and in the manner`herein provided to-wit: 2.1. Eor any such permit for �he erection oi any fire-proof building, other Chan a garage� warehouse, factory or grain elevator, or for the erectioa of arby fire-proof addition, for similar occupaacy, to any existing buildiag shal�. be at the rate of $j..40 for each one thousand cubic feet, or fraction �hereof, in such cubical contents. 2.2. For any such permit for �he erection of any fire-proof garage, warehouse, factosy or grain eievato�r, or for the erection of aay fire-proof additioa, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thous.and cubic feet, ciassified as 01fireproof" by Sectiou 502 of the M�.naeapolis Buildiag Code. , LOUSES 2.3. For any such permit for the erection of any noa-£ireproof buildiag other than a garage, warehouae, factorq or grain elevator, or any non-fireproof addi�ion, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. Fos�any such permit far the erection of any non-fiseproof gara�e, warehouse, factory or grain elevator, or for the erection of aay non-fire.proof addition, for .sim3lar occupancy, to any existing building or £or each such buildirig�or addiCion - aine�y cents ($0.90) for each one ihousand cubic feet or fraction.thereof, in the cubical contents thereo€ with a minimet� of:$4.OQ. For the purpose of camputing fees for building permita, the cubical..coaten�s of ataq building or addttioa �o a uniform height throughout by multiplying the grouac� area covered from a point six (6) inches below the flaor line of the basemeat or cellar to the avar�ge he3ght of the upper eurfaGe or �o the average height of the roof.surface of the main gable of a p3tched roof. 2.5. For repaira or alteration� to a�a exis�ing seructure, .the fee atiall be at the rate of $3.00 Per each Five Hundred Dollara ($500.00) or fractfon thereof 3n the cost of all proposed work. 2.6. In no case ahail the fee charged for any permit as set forth in Section 2 be less th�n $4.00. � �� , � - p � �4��_ 4 �� „ . `w Lorrd Plvnnin9 LQnd Surveym9 Soils Testin9 Civii b Municip,vl En�ineer;n9 � � 687s-N;yhnoy =cs NE. Minneo�v/s 21, EN G I NEE R i N G, I N C. �'%nnesafo S!/nsef 4-60b& � , — En9ineers � Surve�ors , ce�rts�icate o� s�,tve �o: wa��e �'u �� . T g�, 002�� ;. . , r 't�j.�Z �. -r , �l � rr� It'�✓1 ` �� z�,•,�; 1�i,. , , �� e. ' • ✓ � '� �� - � r� Z 1`,� � ' � a 1 C) ...� . 0 X �' � `,, �1� o �� a s� , � � � �� °' 9. O � `,� r.=� Q / �'G d "r ” o 4� � u. � ,,` �u^ ' � ' dN! 1 0� 0 Q �� + ` , � f � g;A -- � �C°'� ��. a , ii 'y4 � e, `�i1 ��a� � 0 8 o � �`, M '� '�J .—•-�'� ��> Qt �- Q'e' � �� G� �� J �� i �,��°� � �.C� 5. 13, �4 ANQ 15, ��.oG►< w� iZ►vEC�V�Ev�r H�IG�ITS Ar,ck� co�,�,�� Nt�r,r�. d .� z 0 � r� r- � � o ^�- J �fi - � /. � , 0 � � Ir�n� Iv S.Gf�LE � �� O. / he�rby �rfi�y lhof� fh�s �s a frr�e m�d �cf repi-esenfotuorn o�'a survey �'f/u b�,ido�es �i/re abo� �I�d /and, c�d �ilr /oc�fion o�'o// �vildin9s, f�a� , m�d d/ risible �nrovchmenfs ,��'am�, �n or ar�sord /on�d. As surreyed Gy me � _ c(� � J�J/u _" A.D�'. SUBURBAN ENGIAlEE2/IVG, /NC. � �ineers �` S'urreyo�s _ by � �'�`, � �I�,,�� ,�� `�r, ;� 27ri�� _ s � � �` �9' --- � „�.-� �_� � b �, � � � � � .. Ir 0 3 � N � � r � � � � x �a y � � o �� xxx� � � � O �� x � � � � � --„�, � � � o � � � � bi 0 � � ��"� � � .. � W c�i � m k �� o � � � y N ��. �. o�. o : �:: � . : �a �a ,a o N � 0 o p � �f} iiS �Ci3 � O � N � � � i � � � � 0 H C1 °. w �. �. o� � � � D � � m o 0 � � ,� �d � � � °. ro �� P � ro � � � � � � � a 0 0 0 0 0 � � 0 0 tn O r � � � �H w� � w � � � �� : �. �: � • m: �� •: m � � � � ro � � � � � 0 � � � �� o � `z 0 � � w 0 0 � � � b x° 0 M 0 � � �� °°x w n� x u�' „0,� oo�� .y � � a-h �i= C' � � �.� � g��. � �� Q � p o � 8��,� � : � � : : � � � � o � . . �,. �' : ' � � : : � : N � � � en v� o c 0 0 0 0 t» �» tn v3 � � w 8 � y � � � �� ✓� o � � �o 0 a� W 0 � � �. g � �°�� '�� ° � 0 0 � � � � � � m��o� ��: �� . � � � ' � � 0 � '°g � ' o � . : o � : : : � t� w ca w o0 o °o °o °o °o v� �w ro� O Q I a �% � o � bd � � � � M . �- L � � � � � = ! � , m � r+ �-. m ,�o � � � � �� , � � � � ��o�, a o � � �� ' � � � O ; �, � . . �. �•°: : o g . : o . . °o : : : N � � � � ea o 0 0 O O O p � O t� � �� .a� y �� M ��`° � � �'� � � � o ��'"' ��o� �� !� p �`4 � �°�� . � m� � � �� :� N � o�� p ma �a�°a �� '� � � �`��w a a' � s�� m�� o tr �' �o �. � r� �� > � � � � m N _ m C r m d » °.,. a � a � a a � 0 -g � �. � � � � �� _ � �� .7 � 0.� A � �� A • � 3. � � � . ii. ! � � �M � ~ ri � �� "�pz��z�zc�i � .. A � � @ � �' w x � 8 � x � � t" a�� °p n � ''r�'i � � � � bC p � O} � �' � � � m � �y . � '� � � �� a' ; � �o � � : x � � : � � b ¢ o � �' :i ��: � `�:��:' °° � � : m � � : � g: �� • M � . � . . O : O . . . . �1 . . . . : �' : : : : ~� � : : : .C.� • • m . . . . . . . . . � . � . � � V N NN � � �a iE aa "�a a: iC iC iS �a � � � � � � � � � � � � � � � 6�i "8 t�n' o o $ � r 9! � fA �fi9 tA ifl H! 4!i � O OO "� � ' � � � o � � n � � �° h � p tD 0 I � bd ��. �- � � 0 m � � � � D � � � m � � 2 m C r m � � � a �' ~ � � ,' a �' � StorY� � � WATER �_ � � � URINALS enni O � � e�s�n� � � I H S�NKS �, � , W,� � � �- T�,� �� 8 8 M � ❑ b � o N � � � �. � fD � o � � � a � bd Q ro �; � �* a a a. o�a t� � � � g � � : � DRINK. FOUP�T. SFi\MRS. FLOOR DRAINS GTCFI BASINS �uro W�MIE� GAS MPL GAS RANGE GAS OPENINGS a • Z • �y In D m A � � ��b � aa� � � � � � � �' `� � �. �ro�� o � �' �' �e � �o � � ��o� � � � � ��a�a ��ro� � �� w � b � �� `�°�� D � p �' m o rno��a°p �'�,o ti ��w 'p � � o�� y �� w e~h Op� �O'1 � }!. � F+ � � � i ro � 3 `� �• e �' � �� a R� &� p � M � �, �i � � W -p � �i � � /�� y � -'w � W � � � a � � � � rt � ». � �a � ro ip 0 �m � n� �� CA c�' � N � � �� . � {"'� . . �� w • 1.r. u �;+ �' I CO 1 � . R1 r• � �✓ c1 i: •1 n�storie� ' � � x �' � ' --- • rw� � • • � � � �i f1�'%� 1 f .r '� � 'J. � n J � J= �'' � ° — t�.' ��,, ~ � � � ° � E � � ° � � �.�wu � C � (1 � � � p M � � � � �i �w�.� � , u ':'� ... '+ i: nros � � f p it "q �'. o �+ x �,'. .� . rt i �'� �"'� r M :� r � -�• K � G � i. Wrtis i " � « �'0 M � ' ' � ^ c ty � a v c o � . � •. -p � s�..e� � .. � � � r • �. � • L � � • � ? ;^ r l� " ' Mw. N d �� . � • q � N � Q p^ � „�, • � � • �n� ,t •MYS i�l • • • 4 ' '� � � N �� M �i� reuu. S� � • • • �f • i� � � . • Oi ifs • 7� � • � (� /OwR. �y U � � � • ' • ' � . . : q � • '� • r � s.�.v. P � . . . ., . . . • - �7 .. . . . • . . � . ' . . . ��oo• " O . � . . . . . . . D, n � � : . . • . . � . . . . � • c+ oaw�Hs . ' . . . •, . . . . � O y CASCM .� • � • • • • • • • • � �� '3 � . . a . . . . . . • n awsuas � . . . •. : . • . . . b e� � • • • • • . • • . � tl w /WIO p ti '�i vrAWll O � S� ,, -- -� .. � � :� m �, M,�. . . � �, . � W 1 � 1 � � � N � .c �� G� - 7 �. ' y � . •�►.cc a •... O r i�a' M • 'Yl . o • m �.� � N x x x x x x • K. x x o�iK�►r: (�• N �� N •� � �C.�i w �i r . � w � . o . ' � �' . i �a' ��,' v S c�n o$ u M � — U - t. d, . z � ' =Z . A N !'� N N N ~ N N - sC,� , � � f � > H =• �C1 "' ^ •"�d � O v � . � ! � s ` � Z °a'i I y _.. I �� c E� r I 1 r � � r �-�i ,,zr . • ��' . �� • • : . , . • . t� . . . . , . ..� � � .• = N . ,� � m . . . • . . ~ O x [ � a r x � . � • 1 .• . Q N ° � y � - ' � c . a a ,-`+, � � u' ' � M ••i .,� a. •°a °° L� . fl � a. � � A y a a aa .• � N � N � w F CD � •+. ' �1 U1 cn 7. � • � O � � � � N � 7 o O � L� c°� C , �f A ' x 0 " ro . • • f a . . ; : . . . • � �� cs � ' A y �• � ac.� �e }; ,� � ` � � � � � o s� �t ts ''' ra ~ o �rf •t p` Q' w. :� o` Q � . � �1 . � A� w r, •i ..r � r+ .. • • � x � y � - � . O A � � � � � �S'� � � h -� ;� [1 7 O� o C% � .L O «�i �"�d � :1 � � p, rs � �, n � ..3 � � � � � � , � w� . � � � M 'r O p �. „ M .� � „ pX� . � E. p �, I�' b � c_ EL �: v � ��'�= � . � r� � m � - r.. t� °' n o O� p � ^ � ' � 7 0 � • . � � �z � � c��.+ � ° � n . a'�� . a„�.: • �� a�T� . �� M A 1 _ �► q '� . r_ 4 ' • . � ��K ' . � � � 7 Building Inspections 763-572-3604 763-502-4977 FAX na� �l• • � SITE ADDRESS CP CP THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMTf A COPY OF YOUR STAT'E LICENSE PROPERTY TYPE PERNIIT TYPE TYPE OF WORK: DESCRIBE WORK BEING D( SIZE OF IMPROVENIENT ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl O Ahmilntun � Other ■ • .t�! : BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY �r-�c� i-i-os PHONE ,�(�1 STATE LICENSE r � �i •��• I i � '�� -=� '� � :�.�rt�!�� .� , ' ' ��.� -�i��r� �'SINGLE FANIII,Y N ❑ TWO FAMII.Y/NEW CONSTRUCTION ❑ BASEMENT FINLSH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWININIING POOL � NEW HOME CONSTRUCfION � ADDTITON '�'�fAIIVTEI�T�INCElREPAIIt ❑ REMODELING 's: �� vr+-o.r�.�- Lu-c�+.��./,�'l,u�a LENGTH WIDTH ❑ IiOUSE ONLY _ ❑ HOUSE & GARAGE WINDOWS IN EXISTING OPENIN(iS S'es ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTAi.r.Fn � �S� . Permit No.: Received By: Date � � C1TY�([�I.tqpSPGsYed STAT'��7itJZIPcS� FAX EXP DATE 3 3/ D ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ?j ��-� ❑ Trin, j �,�,V t�.� . O Fascia �.,�-�.�..� LOCATION OF WINDOWS � � FEES ARE BASED ON VAL TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge � Total Due NUMBER OF WINDOWS l � ❑ DRAIN TILE ❑ OTI�+R HEIGHT Ff BASENIENT REMODELING SUBMIT: I. Existmg Floor Plan 2. Proposed Aoor plan 3. List of struccural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, .ADDITIONS. &c PORCHES SUBMIT: 1. Site Plao/5�uvey showing the existing struct�ues and proposed project. 2. Two sets of construction plans 3. Energy Calculations 'ION, INCLUDING THE COST OF LABOR AND MATERIALS: THE 1997 UBC FEE SCHEDULE) OCCUPANCY TYPE $ /�.S •�� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ , b� .001 times the total job valuation $ �3 _ ab .0005 x Pemut Valuation Minimum $.50 $ _ -rj , � $5.00 (State Licensed Residettrial Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Deternrined by Engineering —$ -�—�� Agreement necessary ( ) Non Necessary ( ) � !,°l�°" •1 ��.� Make checkspayable to: City of Fridley • Attach THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTII, PROCESSID I hereby apply for a building pennit and I aclmowledge that the inforrffition ve ia complete and accurate; that the work will be in conformance with the ord'uiances and codes of the Ciry of Fridley aad with the Minnes Conshuction Codes; t.�at I derstand this is not a pe�mit but only an application for a permit and work is not to atart without a pemut on site; that the work will be in rdan with the approved p ttre case of all work which requirK viaw a d approval o pl SIGNATURE OF APPLICANT PRINT NAME � DATE ��•�• D F APPROVED BY �� -_ DATE � �'� J`� ! . , � ��•3� Building BUILDING Permit No.: � Inspections RESIDENTIAL APPLICATION. �Re�eived By 763-572-3604 CITy OF FRIDLEY � n y� 763-502-4977 FAX �,� I-1-0s ��. U'�.�. � DATE � • % �/ ' � YO,�i E-MAIL ADDRESS S1TE ADDRESS Co lp � . x _ �1�(. `Y) �� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR. STATE LICENSE PROPERTY TYPT: PERNIIT TYPE TYPE OF WORK: DESCRIBE WORK BEIIVO DC xtOQFING � NUMBER OF SQUARES ' G� PROPOSED SI7.E: t�RO�USEi3�T'� — �SIAING ❑ Viayl a �,�,� ❑ Other 0 �wNBR �ONTRACTOR NAA�II,+: �.�u.� � nnnxFSS: t `7'? rxo o? 3a7 - � �f / x� ADD�� '� � PHONE L.%J 'J � �i`i' r'�-�i �F � STATE LICHJSE # l `% �� • SII�TGLE FkMII,Y ❑ TWO FAMII.Y/NEW CONSTRUCTION a nnnrr�ox ❑ �a� � BASEMBNT FWISH O ROOF O DEQC O SIDII�TG NEW HOME CONSTRUCITON O ADDTITON ANCF/REPAIIi ❑ REMODELW(3 O HOUSE ONLY O HOUSE & GARA(�E 0 ATTACFIED (iARAOE 0 DETAQ�D C�ARAC�E as�a� O Trim O Fascia FAX P3� DATE — (� O DRAII�T TII E � OTHER � �VIIVDOR�S iN EXISTII�TO OPENIN(3S �l'a �To LOCATlON OF WINDOWS OR FOR NEW OPENIIV(iS-DESCRIDE SIZE OF OPENING CHANOES dt TYPE OF. WWDOW TO BE 1NSTALLED NUMBER OF WIIQDOW3 . AiL FEES ARE BASED ON VALUATION,INCLUDING THE CO3T OF LABOR TOTAL JOB VALUATION S`f, %D U�° �� 1� �C FEE 3CAEDULE) �. �� Permit Fee Plaa Review Fire Surcharge Surcharge License Surcharge SAC Charge G�rb Gwt Escrow Erosion Control Park Fee Sewer Main Charge �a �ASEMENT REMOD ttar� cT�BMTf 1. Existing Floor Plaa . 2. Propoaed Aoor plen F-._.3. _ .. �.mem�s.�.be ussd - � � FOR NEW CONSTRUGTION INCLUDINCi DECKS, ADDTITONS &PORC�raccrinn�rrr 1. Site Plan/Survey ahowing the exisdng stuctwciv aad paoposedprojeck 2. 1�vo s� of wnstruallon plans 3. Ener� Calwlationa � �/!.�1. S- See Bacle Page for F�e Schedule � ' 65% of Bw7ding Permit Fee $ .`7 D� .�1 tim� the total job valuation $ . 3 S .OU05 x Permit Valuation M'mimum $,50 $ �' . D D �$�.00 (state Licensea Re,siaential contracrors) �$ $1825 per SAC Unit (Plans to MWCC for dete:mination) $ ft+6ft= �ftx$21=$ $ $450 Conservation Plaa Review � $ Fee Detennined by Engineering $ Agreement necessary i) Non N�essar�' () $ / , iYlake checke Aayableto: City of13r9dlep • Attach TTHIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTII. PROCESSED I hereby apply for a build'mg permit aad I aclwoyvledge d�at tha infom�a$on above is co leto aad of tha City of Fridley and wi� the Minn�o nsduction Codes; I d th�is not e� thet the work wID be in oonformancre with the ord�ances and codae PW'm�1t but on1Y � BPPliaatioa Poc a-pwudi and worl� is�uot-to �start without a perrnit on arte; that the work vn'D ba in wi9i tha wse of aA work which ieviiew d of p SIGNATURL� OF APPLIC PRINT NAME� �(��D �t�'t DATE I� � �O •D� � _ ' • " � ��1��j/%/�'��r . .. . . �v � , r 3 11 �, �s �.6 d£ �� w� // �» � la°-a � oor� �' � ��.�' ..w� /1 � � � Building MECHANICAL P�t No.: ��j,� Inspections RESIDENTIAL APPLICATION R�e'� y' � 763-572-3604 Date��"�1: 2 10 763-502-4977 FAX CITY OF FRIDLEY EFFECTNE I-1-2010 DATE S� I�� l O YOUR E-MAIL ADDRESS SITE ADDRESS ._� �j ( �� e r u � �J J t'C.c. t THIS APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY NAME: ��,�,� 1� r�c M OWNER/ nnn�ss: TENANT —6 6 1 L �n.c� v I S7" crrsr �'T� � 1 e�� STATE�Z� .�$ � �Z PHONE: �T I� �i " i. �. � � 3 7Pj � CONTRACTOR CONtrArrYNA�vtE: • �� $j��tl�� SUBMIT A COPY OF CONTACT PERSON• � � � 9�.,; ,,,,�, 9�� C. YOUR STATE STATE LICENSE # �� H�� a � LICENSE WITH pDDRESS: 1�1 a �� APPLICATION IT1' STATE ZIP PHONE ��ne . � �-1 g99 PERMIT T'YPE � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK• � ��' � �PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRII'TION OF WORK _�� G_� -��, r^� � a �� FEES ARE BASED ON $10.00 PER N7XTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI� PROVIDE HEAT LOSS CALC'S PER MANUAL J 20116 ASHRAE HANDBOOR Equipment Installed MFG: MODEL: SIZE/BTU MFG: ��«.�r MODEL: MvC.-(;(yCi SIZEBTU Fr� �OOG MFG: C �.� �«� MODEL: Zy/�p[� �Z�{ SIZF/BTU ��i � C'i G� �A/C $25.00 _FIItEPLACE (GAS) $15.00 _GAS RANGE/OVEN $]0.00 AIIt TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER $35.00 �FURNACE $35.00 _GAS i11VIT HTR $10.00 _CHIMNEY LINER $]0.00 GAS DRYER $10.W _POOL HEATER $35.0(1 DUCT WORK $]0.00 GAS PIPING $10.00 VENTII.ATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ . �.., . ., , "; ,,.� Number of fixtures @ $35.00 x $35.Q0 = $ ' . " ` ' � State Surcharge � � � � .50 � , � �'� � � �, `� C� FEE '$35.50 Total = $ � � , � - THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building rmit and I acknowledge th e information above is complete and accurate; that the work will be in conformance with the ordinan� and codes of th City of dley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli on for a i nd wo 's not to start without a permit; that the work will be in accordance with the approved plan in the case of al rk which e �res revi and approval of plans. SIGNATURE OF APPLICANT ''NAME I � DATE S—( H' L O APPROVAL INSPECTORS SIGNA DATE �� PLEASE NOTE: SEPARATE PE RE ` FOR BUII:.DING, EL�CTRICAL MECHAriICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-502-4977 FAX DATE `] � I `T SI1'E ADDRESS ta THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BIING BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTTVE 1-1-2010 � E-MAIL rADC � /"� , '�OWNER OCONTRACTOR � NAME: STATE LICENSE ADDRESS: �SINGLE FAMILY/NEW CONSTRUCT[ON O TWO FAMILY/NEW CONSTRUCTION O BASEMENT FIIdISH O DECK NEW HOME CONSTRUCTION MAINTENANCFJREPAIIt ROOFING �� NUMBER OF SQUARES'�. GARAGES /� PROPOSED SIZE: �� PROPOSED HEIGHT: IDING a ❑ Vitryl ❑ Aluminum ❑ Other ❑ SIDING ❑ ADDITION 0 REMODELING �7 HOUSE ONLY ❑ HOUSE & GARAGE � ATTACHED GARAGE ❑ DETACHED GARAGE EXP DATE 0 WINDOWS ❑ DRAIN TILE ❑ OTHER Permit No.: '�� Received By: c, : • + rn r +a� ��R� 1��,,�i til►il, STA' STATE ZIP FT BASEMENT REMQDELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3 List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, �Soffit ADDIITONS_ & PORCHES SUBMIT: ❑ Trim 1. Site Plan/Survey showing the existing strucUUes ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS FOR WIIdDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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 TIiE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ � OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surchazge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ u�5 -�� 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) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$24=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) � Make checks oavable to: Citv of Fridlev Attac '� 1•�' •� 7'f�S ISOAN APPLICATION FOR A PERNIIT-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 t6e 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; at the work will be in accordance with the approved plan in the case of al ork whic yu'ves review and approval of pl�j pO� l SIGNANRE OF APPLICANT � nPlr.i .�/ PRINT NAME LJr i G/1 ei �o � DATE � I�� Page 2- Building Residential Application BUII.,DING PERNIIT 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 FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus swcharge) $501 to $2,000 $23,50 for 1� $500 plus $3.05 for each additional $] 00 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 1�` $25,000 plus $10.10 for each additional $1,000 or fra.ction, 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 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