AF - 41094City of Fridley, Minn..
BUILDING PERMIT
N° 499'7 �
Date: ....-�1�.._��..�t�....:._.__'�..�� _......�__....._.....__ 6
1 �
OwneT' ._.... ' :'�
`, . � . ... Builder . � _._..._,.
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Address ? ; r' °,- °'
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-� �'�. Address � .._... x�`' .. ._.� _._.____.__.._.._......_._..__•--.y_._._._...
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� �� ' �r�' r., , OCATION. 1� ��1 II�V -
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No. ... .. ._... .�. .
� . .. .... Streei _---.�1 -... ._�.--L:�'''�F , :... . �',�..�_....:. .:_ .............. Part of Lot .•------...------,�..__.. �,. .,.�-. _...
Lot �` :`�:"'.� . . -,:
. Block .---- r�......... ��Addition or Sub-Division �- .._ ... . . .._. _.� .�!:.�������'.��1
Corner Lot -----.._........---........ Inside Lot ....__...:..._._.....-- -._..... Setback ....._�'�'"�---- .............._�Sideyard ._!/...t�l........._......._............
Sewer IIevation
Foundation IIevation
DESCRIPTION OF BUILDING
To i�e? Used s• ,r
' '� � ' ° ` f
. ,. ; / �
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•- %��`- --- _._ Front ---- ----.-L__.. Depth ......,,�,� : Height . ��.. Sq. F£ .�,1,,,�.. ;�'� Cu. F't. ��`��
...._...- -----� - .................... _. .......... Front ....._............._.. Depth ........... 4�`:.. �iei�ht ................ Sq. F� ....._............._.. Cu. Ft
=--f' �'-' �. ,�,� C�.. .
Type of Construction ..'�"'.R-"�cde4.�.,r.F�:� ..:....... Est. Cos�'���...�... �.�'.�.�''..� .�.�. To be Completed ............._....._.....
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment oF a fee of �.._ 'i`"�� , permit is hereb
$_ ��/._:..__.._....-- Y brranted to----------------....__.-----.....--- -
......_..
_..__._.----_.....___------_--...._.___.._ to construct the building or addition as described above. This �rmit is granted ugon
the eaipress condilaon that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part �hereof, shall conform in a]i respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limit� and this pernrit may be revoked at any time upon violation -o€�y of the provisions of sa.id
ordinances. `" fi, �.,�' �
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�;�'�`.,'�`�,, �. /__<,,�!'�_:�.�;=�$uilding Inspectc
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NOTICE: �
This permit does not cover the construeNon, ins�allaHon for wiring, plumbing, gas heafing, sewer or water. Be w�
the Building Inspector for separate permifs for fhese items.
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APPLIC�TION FOR BIIILDIlQG PE�MIT
CITY 4F FRIDIEY, M�SOT�
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��aner's Name Builder
lddresa Adc]ress � 7-�� �-.+�� e.� A��,�
LOCATION OF
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No. ��� L"�' 7 3treet �C/T���el //i�r o Part of Lot
Lot � � ��� Block ° � Addition or Su'�liviaion ° �
.��
Corner Lot Inside Lat � Setbaak 3`� Side-YarB
SE'WER ELEV�TION FOUNDATION ELE`VATION
�pplicant attach to this form Certificate of Survey of Lot and proposed building
loca.tion.
DESCRIPTION OF BIIILDING
To be used as:.
��' � � Front�Dep�th � Height �2 �
Sq. Ft. � .� � f� Cu. Ft. � � �' �
Front Depth Aei�ht
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost„���
To be Completed
The und.ersigned herebg makes application for a permit for the work herein specif3ed,
agree3ng to do all �aork in at�rict accord�nce with tP�e City� Ordinances arid ruling of
the Depeactment of Bu31d9ngs, and hereby declares that a11 the facta and represente.tiona
stated in this applica.t3on are true and correct.
�� _- - f� -
(�,Schedu].e of Fea Costs caa be found on the Reverse Side.)
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BUII�ING P�NQT FEE SG�DOIE
Section 2. The Inspector oP Bu3ldings sha7.l, before issu�.n� aay permit for the
erect.j.on of ar�r building or structure, or for a�y a�idition to ar�r euisting build-
3ng or.structure, or for any alte�rations or repair� to any ��dst3.ng build3ng or
structure, ugon application therefor, require the �ie,�ment by the appl3cant for
such permit of fees to the amount here3n below set forth end in the m8nner hereia
provided to-wit:
2e1. For a�a� such perm�.t for the erection of an� fire-proof buildin�, other tl�an
a gerage, warehouse9 factory or grain elevator, or for the erect3on of' eny fir�-
proof addition, for similar occupaneg, to aay exj.stin� buildin� �ha11 be at the
rate of �1eL�0 for each one thousand cubic feet, or fraction thereof� i.n suoh
Qubical.contents.
202. For a,n� suc� perai� for tks er�ction of an�r fireproof garage, ��tsrehouse'
factary or grain elevator, or ior �h� e�ection of any fireproof �ddition, for
s:i.�i].ar occupancy, to an� existing build3ng shsll be at the rat,s of �1.a5 ��
e�.�h one thousand cubic feet,, classified aa "fireproofn by Sect�ioa �2 of �he
Minneapolis Building Code,
��II�
2�3a For any such pernit for the
tu:�.�a a garage, wwsrrehouse, facto
ac�diti on� for sini].ar occupa.ncy,
oa,ch cn� thouvand cubic fest,
G.�RAGE�;
erection of a�r non-fireproof bu3�.d3ng oth�
r�r or grain elevator, or aay non-f3reproof
to eny eidst3ng bu�ld3ng. Permit $]..00 Yor
2a1�, For any such permit for the erection of any no�-fireproof garage, werehouse,
factory or gra�.n elevator, or for the erection of ang non-fireproo� eddi�%n, for
s�.m3.]_ar occupancy, to a.ny existing building or for ea.ch such build3n� or edditiori,
Ninety Cents for es.ch one thousand cubic fest or fract3on thereof, ia t�he cubia�l
confisnts thereof w3th a minimum of $4o00e
For the purpo�^ of computi�; fees for bu3lding permits the cubic�. eontenta of eny
building or addition to a uni."'ora hei�ht throughout by multiplying,the ground a�es
covered from a point aix (6) 3nches below tha floor 13ne of the b�as�ent or cel].ar
to the average Height of the upper surface or to the average height of tbe roof
svrface of the main ga,ble of a pitched roof.
2e5e For repairs or alterations to a.� existing structure, the fee ahell be et the
r�te of �3.00 for each Five I�undred Dollars (�500e00), or fraction thereoP in the
e�s � of e,].l proposed worka .
2a6, In no case shall the fee charged for any permit as set forth i�rl Section 2 be
less than �1�.00.
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( HEREBY GERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATIOM OF
A SURVEY OF:
LOTS 4� 5� 6� 7,AP1D $� BLOCK 6� SPRiht(i BROOK PARK
AS SURVEYED BY ddE THIS 2%TH DAY OF JULY� 1960.
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HEAT LOSS CALCULATIONB ;,� -^ - �. � a� '� �" �'.
DEPAATMENT
Weatherstrips A.S.H.V.E. Construction
Guide
Windows �lovrs Referenc�e Ou� Wall Int Wall Ceilin�
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ce
-` �--No a` Yes--Na 19........
��' FL I ., • y° Room I Length � S'` �Width �' � Height
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` Windows and Doars—Cracka,ge and Ar�a.
Widt3t Height No. oE Lineal f� Area
No. 04 pane oE pane llghts oY crack sq. ft.
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- �-� 3 .. `°�' - � � ., �7 � ; i: � $ � �,�:�.
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CO�i. $tll
In81'trafilon F ` y °
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GlaSS . ��,. ' � r,� �.` `
EXp. WSll � '�:�. �' � �'ha
Net exp. wall y �` fi ^�,
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.�'*..
Floor � .� �,}� � .�� '`, � ,�fi>.� � �;�
Total Btu. ' � � ' '. ��>
Required sq. fC. E.D.R. or sq. ins. W.A. I.eader ar�
� Fl. I ` � ..,, . ��;�Room I Length ,�" Width �r .�?_ Height `�.�=
Win.dows and Doors—Cra.ckage d Area
Width I3eight No. oE Llneal PG Area
No. oY pane oP pane lights o4 crack sq. Yw
,° � .r �a �c— e �j7 .
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f �� f J� �yJ� � �
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m
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Net exp. "' � � a -
Yllt. W� .
Ceiling `�
Floor � "� ':� �t ,�',� �
H Q. ,
Total B .
Required sq. ft. E.D.R,, or sq. ins: W.A. I.eader area
� Fl. I�» •'"��� �_ � Aoom I Length ,�: ;,rp Wi�
Windows and Doors—�rackage an� Area
Width Height No, oE Lineal ik Area
No. of pane of pane iights I oE crack sq 1't.
}� �_�� �� � �-_.
�
�'Height `::;.:
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� ��
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�FloOr � ° ti" �` 4�' � � �; '� ir, ` 9` :�.
Tota1 Btu. � V 4°:, _�
, Required sq. ft. E.D.R. or sq. ins. W.A. I.eader aze'a
�
u��; . �c'. ,��� a'rv ��.
oF suu.nuv�s v° �oe .� ' �� �' �_ �,
LVo. Insulation
_I RooE I Floor Kind I How Applled
FL I�' �= Room I Length�.': Widtli ���"Height
Windows and Doors—Crackage �nd Area
Width Height No. oE Lineal ft. Area
No. oY pane oY pane lights of crack sq. fk
� � � P a .s. � � �� 4 � 1� �� _
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CceP. Btu
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Glass >� ,�-��:..,
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��
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Ceiling
Floar ,� �t` ,� � rg ...-- � .:.. �F* � �,�
Toial Btu, , .,°.
Require3 sq. ft. E.D.R, or sq. ins. W.A. Leader at�a
� Fl. � � ��'� t� Room I Length .-�" " �,+�'Width � Height `.�. �
.� 6-,� .
�ows and Doors—Crackage and Area
No. Width $e1ghC No. of Llneal ft. I Area
oE pane oi pane lighta oE crack sq, ft. '
_ �::. t,p ��
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Caer. Btu
In81'tratlon ;;::'.�
Gla�s � � " ����
Exp. v�atl �;,° � .»� % , '; �
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C�iling ��
Floor �; � - ,q '"
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� � ( ° ' ::�:h.�..�n�R.00m I Length �',_ ° Width,s` , �`Height;..`�-
Windows a,nd Doors—Cracka.ge and Area �
Width Height No. oE Lineal Yt. Area �
No. oi pane oP pane lighte oY crack sq. ft. .>"
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a'u - _ ._���"¢
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In81trat3on
Glass
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;
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In�, wall
�Ce3ling
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~ � w ���.
v. ` _ � f''� Fro �a
,..anents of North Central Public Service Co., �
_ cirv
HT,AT LOSS CALCULATIONB DEPARTMENT OF BUILDINGS VLVLA4E
Weatherstrips A.S.H.V.E. Conslructian No. Insulation
Guide
Windovvs Doors Referenc� Out. Wall Int Wall Ceillng Roof Floor Kind How AppHed
Yes—No Yes—No 19........ I I � I
FL I�;.°.° , a�,� w�Room I Length ,�' �j Width �� "Height ,: �`�`' FL I Room I Length, Width Height
Windows and Doors—Crackage and Area Windows and Doors--�rackage and Area
No. oEVpt ane oE pane llghts oE cer�ackt� sq. ft. No. oEVp1 ane oYepane llghta oY�ckt� sq. ft.
, s� � = �°
- ��
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Caef. Btt;
Infll'tra.tion � � --' `�? .� � R
Gla�s `�� � �""'� � ,�'p i�
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Net exp. wa,ll ,�' -
Int wall
Ceiling
Floor � m ,� �:: 4w � �;r �, -
4' I f
Tatal tu.Y- - � _
Required sq. f� E.D.R. or sq. ins. W.A. Leader area
Fl. I Room I Length Width Height
Windows and Doors—Crackage and Area
No. I o pide I o pane � llghts I oY�cra.� I s4 it
� � � CoeL Btu
TnSltration
Glas�
Exp. wall -��'
Net exp. wall
Ynt wa]1 '
Ceiling
Flaor
Total, Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FL I Room I Length Widrh Height
Windows and Doors—Crackage and Area �
In81'tration �
Glass
Exp. wall
Net exp. °wall
In�, wa11
Ceiling I
FIQOP
Total Btu. '
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
TnSI`tration
Gla�
Exp, wall
Net exp. wall
In� wall
Ceiliug
Floor
Total Btu.
Ccef.l Btu
R.equired sq, ft. E.D.R, or sq. ins. W.A. Leader area �--
Fl. I Room I Length Width Height
Windows and Doors—Crackage and Area �
I
Infll'tration
Glass
Exp. wa11
Net exp. wall
In�. vva11
Ceiling
Floor
Total Btu.
Caef.l Bi:u
Required sq, ft. E.D.R,, or sq. ins. W.A. I.eader area I
FI. I Raom I Length Width Heighi
Windbws and Doors—Crackage and Area. �
Btu �
In8ltra.iion
Gla�s
F�p. wall
Net exp. wall
Int. wall
Ceiling
FIOOP
Total Btu.
CceP. � Btut
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SAI`IGREI`IE DRII`ITII`IG • �121-622o sozaa,-s
- ------------- ---------- --------- ------------ ✓
FORM , - 66208
INITIAL COMPLAINT REPORT :" oEP-r. Fridle No.
135'� 1405 M CLEARED 1415 M DATE 10-8-76
TIME REC M TIME DISP M ON SCENE
RADIO IN PERSON BY PHONE MA�L
Jon Oulman ADDRESS 7969 East River Rd
COMPLAINANT �
LOCATION vacant lot north of above address PHONE NO.
786 7835
OFFICER ASSIGNED Chubb
TYPE ordinance violation
COMPLAINT of �a.rba�e bein� dum�ed at the above location. Suspects the resident at
FIN
ANi
ITION
305 Lon fellow St. Not contacted.
r��.
. ORIGINAI:
t__�_T__��.____ ---
od/�/ab
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Chubb la
REPORTED TO
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CfII1VINEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (�) No ()
2. Is free from n�st or deterioration Yes () No ()
3. Has no foreign objeets lodged within Yes () No ()
4. Is securely supported Yes () No ()
5. Meets all current Code requirements for size
and total BTU's conne�ted Yes () No ()
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ()
8. Has combustion air been provided for water heater Yes () No ()
Remarks: .
List ALTERATIONS Bein Done-
HEATING CO: '��
Signed By:
Date:
�._
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M t T
i �
i �
� ; � __��� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
�, -._.� �"'�.� CITY HALL fRIOLEV 55432 NUMBEP AEv
� 612-571-3450 910-F15
J08 AODRESS 7969 East River Road NE
1 LEGAL LOT NO. 9LOCK TRACT OFi ADDITION
oesca. 6, 7, 8 6 Spring Brook Park
2 PROPERTY OWNEii MAIL ADDRES$
Charles Pereda 7969 East River Rd NE
3 CONTqACTOR MAIL ADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
6 USE OF BUILDINQ
Residential
7 CLASS OF WORK
� NEW ❑ ADOITION O ALTERATION
B DESCRIBE WORK
Reside House (Ma.sonite)
9 CHAN(iE OF USE FROM TO
DATE PAGE OF
10/17/97 � �
ZIP
ZIP
ZIP
�ERMIT Nd`�,
25�11
APPHOVED BV
SEE ATTACMED
SNEET
PMONE
792-0734
PMONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
C� RfPAIR O MOVE O REMOVE
I STIPULATIONS
Install building wrap and have inspection of same.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, HEATING. �'" ��• ��••�•.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOFiK IS COMMENCED. NO. OWLG. UNITS
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO $2OO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OP A PERMIT
DOES NOT PRESUME T IVE AUTHORITY TO VIOLATE OR CANCEL TNE pERMIT FEE
PROVISIONS OF THER OR LOCAL LAW REGULATING CON-
STRU E PER RMANCE F CONSTRUCTION �21.00
� 5� TUA O O TH OR R H IZEDA NT IDATEI
S�GNATURE OF OWNER �i� OWN R BU�IDER � IDATEI
� ,�
SO.
STALLS
GROUP
CU. fT.
OFFSTREET PARKIN(
GARAGES
SURTAX
$.50
SAC CHARGE
Fire SC $.20
70 qL FEE
�21.%0
TNIS IS VOUR PER
LOAD
�
NE�V
ADDN
ALTER
fl
i)
Ll
ConstructionAddress:
Legal Description:
Owner Name &
Contxactor:
Address:
LIVING A,REA:
GARAGE AREA:
DECK AREA:
OTHER:
' CITY OF FRIDLEI'
S[NGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
1 /"C��-.�'/� ��
' 7— � �� ��C. � �?",Oi? r.�! � /�/✓`c�l< /�
� �i9�
Effecti�re I / 1 /97
Tel. # `79Z-67��
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scaie.
DESCRIPTION OF aVIPROVEME\rI'
�n� Width Height Sq. Ft.
�ng� Width Height Sq. Ft.
� � Width HgtlGround Sq. Ft.
n (�OcI � �'"
� o>t (
� � ���� � o
Construction T e: �/r „
yP /� � Fstimated Cost: $ --
`� � ' " (Fee Schedule on Back)
Driveway Cbrb C�it.Width Ne�ed: Ft. + 6 Ft = Ft x$ � —$
DATE• �C� ? APPLICAN'I': —_ Tel. # 2 �0 7�
Permit Fee
��ire Surcharge
State Surcharge
SAC Charge
License Surcharge�
�riveway Escrow
:POSion Controi
:'ark Fee
iewer 1�Iain Charge
TOTAL
>'('t['ULA"I'[O,\�S:
$.
$.
$_
$
$
$
$
$
$
CITY USE ONLY
��- �� Fee Schedule on Reverse Side
� � � .001 of Permit Vaivation (1/lOth%)
. .S� $.50/$1,000 Valuation
_ $950 per SAC Unit
$5.00 (State Licensed Residential Contractars)
Alt. "A" o.r Alt_ "B" Above
�$450.00 Conservation Plan Review
Fee Determined by Engineerina
Agreement Necessary [ ) Not Necessar5� [ )
� � l. `I0.
C�UlLDi�v(� l'EIZl�I["C rEE SCHEUG[.l�:
1�he Cliief Building Official shall, before issuing permits for the erectio�i oi� any building ��r structure, or ior
atly addition to any ex�isting buildiilg or struciurc, or for an}� aiteraUon or repair to any cxisting buildin� or
strucwre, upon application therefore, require the payment by the applicant far such permit of fees to the amount
herein below set forth and in the manner herein provided to-�vit: � '
TOTAL VALUE
$1 to $500
$501 to $2,000 �
�?,OUI to $25,000
$25,001 to $50,000
$50, 001 to $100,000
$iO4,001 to $500,000
�SOO,t}Ol to $1,000,000 �
:;1, 000,001 and �up
FEES
$2i (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,OU0
562.25 for frst 52,000 pius $12.50 for each additional �1,000
o� 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 ��0,000
�574.75 for first $50,000 plus $6.25 for each additional
$1,OD0 or fraction thereof, to and including $1U0,0a0
.$887.25 for f�rst $100,000 plus $S_�: for each addition�.T
$1,� or firaction th:ereof, _to and including $500,�0
$2887.25 for .tiie._first $500,000 pius $4:25� for each :additioffi1
$1,000 or_fraction ther�f, to and including $�1,(�0,000 '�
$5012.25 for the fust $1,000,0� plus $2.75 for each additional
$1,Oi� or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
�lternate "A": Removal and replacemeint of curb and gutter only - Drive�vay widtti plus b feet time's $�3:50_
�(ternate "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.
VERIF[CATION OF FOUNDATION
crtiiits for construction will be issued a minimum of 24 hours from the time of application to ailow �or pro��r
.��ie«� of the proposed stiucture and of the construction site.
<�ei-til�icate of Survev c�i- tlie (ot, showin�� the location of�the f�undatian r+iice it has�it has hcen coflstr�uctic{
�E �� . I�C({UlT-CCj I�Ci(li'� t�r��_.�:�•din�� ��•iti� thc 1�r:►mii��.
- _.
:.
�
_
Cf[YOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
April 13, 2004
Mr. John Emanuel
7969 East River Road NE
Fridley, MN 55432
Re: Final Inspection at 7969 East River Road NE
Contractor: McGuire & Sons
Dear Mr. Emanuel:
A plumbing permit was issued on January 21, 2003 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final inspection
shall be conducted on the work authorized by this pernut. As of this date the inspection
has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pemut open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
/
����'� ` �
��T '
.
: � �� � �- �
DJ/mh
3uildin.g
:nspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
�ATE YOUR E-MAIL ADDRESS
iITE ADDRESS
i HLS APPLICANT IS: ❑ OWNER OCONTRACTOR
Permit
Received By:
Date Rec' d: J
PROPERTY OWNER/ Np�: �j/-j,Q,l iG �� F�24 U B�
TENAN'T a,nnxFSS: 79�0 �'-J � � �el��,� �.D#d crrv �R-/,DLE � sTA�ztr ,��32
PHONE: 7� �-7r�'�v -�/A� �PJ �D,2-%vEi �i %.�L%
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATTON
PROPERTY TYPE
PERMTT TYPE
�rYrE oF woxx:
STA7E LICENSE
PHONE
O TGVO FAMILY/NEW CONSTRUCTION
EXP DATE
O BASEMENT FINISH �ROOF O DRAIN TILE
� DECK ❑ SIDING ❑ OTf�R
❑ SWD+�MIMIl�G POOL
i�
DESCRIBE aJORK BEING DONE: 7E�t�, 0�F �° ,�� /��+�
SIZE OF IMPROVEMENT
sQu�s 1�
GARAGFS
PROPOSID SIZE:
PROPOSID HEIGHT:
SmING
O Vinyl
❑ Aluminum
❑ Other
LENGTH
❑ HOUSE & GARAGE
❑ ATfACI�D GARAGE
❑ DETACf�D GARAGE
OSoffit
� Trim
❑ Fescia
wmmows
IN EXISTING OPEMNGS OYes ONo LACATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
NUNBER OF
3�Ir
HEIGHT
BASEMENT REMODELING SUBIvIIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of strucwral members to be used
F�
FOR NEW CANSTRUCTIOAI INCLUDIIJG DECKS,
ADDITTONS. & PORCHES SUHMTf:
1. Site Pian/Survey sh�wing the existing struc4ues
and P�Pos� P*�J�
2. Twro sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING TI� COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ g f� ��.� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surchazge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Dne
$
$ I . ��
� .�a
$ � , C�
$
$
$
$
See Back Page for Fee Schedule
65% of Building Per[nit Fee
.001 tunes the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+68= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
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 perrait and I aclmowledge 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 Construcrion 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; that the work will be in accordance with the approved
plan in the case of all work which quires r ew and pr a1 of plans.
SIGNATURE OF APPLICANT �� '�����ti���� PRINT NAME �/� � ��i�s�'5��� DATE �7-' � �'�
Page 2- Building Residential Applica.tion
BUILDING PERMIT FEE SCHEDULE
The Chief Buildin.g Official shall, before issuing permits for the erection of any building or
stzucture, or for any addition to any existing building or shucture, or for any altera.tion or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such perm.it of fees to the amount herein below set forth and in the manner herein
pmvided 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 pro�sed structure and of the construction site.
A Certificate of Survey of the lot, showi.ng 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
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