AF - 41617�
sue�ecr PERMIT N _ = _ e
City of Fridley .�,.12,�� ,;
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � CEIPT � . �
� `L _ _._ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �Q I
1 = �
� /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�----� � �'� 612-560-3450 910-F15 9/4/74 � �
JOB ADDRESS 600 Ely Street N.E. •
l0T NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. 41-44 V Riverview Heights Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Dale A. Dickson 265 Northdale Boulevard, Coon Rapids, Minna '$',� � y�)
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Martin Homes 6901 West Old Shakopee Road, Bloomington, Mn.
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASSOPWORK � N� ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK �nstruct a SQ' x 28' & 27' Dwelling and a 27' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway. Provide a verifying survey before
capping. See attached waterproofing and flood plain elevations.
SEWER & WATER LOCATION: 48.9' from Manhole (Broad & Ely) to lot line with
sewer 10' west.
(2nd Service) 60.5' From above with sewer 11' west.
Garage wali sill 2.47�
+ above bench mark in street.
SEPERATE PERM�TS REQi1fRED FOR �UtRIiVG,
H�ATING PLU�IBING AND I
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, �ood Frame
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING Sa. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R 1 1354 & 1330 26, 888
OR WORK IS SUSPEWDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $29�6�2 14.5�
WITH"WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $C,O.00 S3OO.O0
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
�,�� $364.8�
SIGNATUREOFCONT CTORORAUTHORIZEDAGENT IDATEI W EN PR PE Y ALI TED THIS IS YOUR PERMIT ��•� A'
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SIGNATUREOF WNEfl11FOWNERBUILDERI IDATEI BLDG INSP �ATE ��
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�vi�LiArwo,.CARLSO�,PRES. , CE�TI�ICAiE O� �U���1(
2324 WEST 1104h STREET , � � � � � � � �
888•2�34
5E431 ' ' � ,"„��`� � ��S30y SAFETY CONTROL ZONE"
�i�J PJOT PLARIT OR PLACE ANY-
" ili�i4G IPI 7HIS ARFF1 WITHOUT AP-
LAND SURVEY(?RS'l'�vy~L OF, TWE CITY OF FRIDLEY.
Sl1FtVEY FOR: �����sed� �nsured d� �o�dsd
DALE D ICKSON � 9p.9 "
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L�GAL DESCRIPTION: LOTS �� �42'4'3 AND ��� B�OCK V� R�dE�V��� H�B�t���°
�IE F4ERESY CERTI FY THAT TH I S 1 S A TRUE AND CORRECT REPRESENTATI O�!
p�' � SURVEY OF THE BOUPiDAR1ES OF THE LAND ABOVE DESCRiBED AND OF
T�� LOCAT i ORl OF ALL BV 1 L.D ��GOR ON SA i D LAND �o1�S SURVEYED�BY � USE
�NCROACHP.�ENTSo IF �4NY' FRO
THIS �BTH DAY OF AUGUST� �97.4w
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_� - 564—$....._.
RA I NN. REG. NOa
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AP.PLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION B�ILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:��4LE As �IcJ�goN BIIILDER: %�%!�'fi�� e�`�����
� BSNo�e.rN/�,�}L,� �LVA 6q�A UIi:��' OGD SHAiKOl��� (�0,
ADDRESS : Cdpi� l�.4�Id� ,M� ��3,� ADDRESS : 3�ool�l,y�,��tJ�. MN .�3 y3�
NO : . C OD ? STREET : �L �
LOT :�// YZ 5�3 Y'/ BLOCK : I/ ADDITION s R d VER [/lEW bi�l ���".�
CORNEIt LOT: � INSIDE LOT: SETBACR: SIDEYARD:
Applicant attach to this form Two Certificates of Surve9 of Lot aad proposed
building location drawn on these Certificates. - i
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HESCRIPTION OF BUI�LLING -'� `��'� .��� -� � � ' '�
To Be IIsed As s
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S/�GL� FAP9/�- A��'ront : .�0� Depth : � S �� <-�` � Height : ��
,� -.. . . ,
,1.. �„ A '
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s-
Square Feet:_ �_35��, �-' �Cubic��Feet: � � __ �� �
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� Front: � Dspth: Height:
Square Feet; � � � Cubic Feet:
�pe of Construction: I_-UaaD___i'-2t�1'�r Estimatecl Cost: ,����C3f�
�
To Be Completed: ��J�%5
The undersigned hereby makes applicativn for a permit for the wosk herei:n
specified, agreeing to do all work in st.=ict accordance with the City of
Fridley Oxdinances and rulings of the Department of Buildings, and herebg
� declares that all the facts and representations stated in this application
are true and correct.
U •
�� : SIGNAT[JRE •
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(See Reverse Side For Additiona.l Information.) � ��� `�
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�UILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing pexmits for the
erection•of any building or structure,. or for any addition to any existing .
buildi.ng or structure, or for any alteration or.repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount t�erein below set forth and in
the ma.nner herein pravided to-wit:
tJNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5�- $1e85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point si.x (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average:�
�height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost af aZl proposed work.
In no ca.se sha11 the fee charged for any permit as set forth ia Section 2 be
Iess than ,fi5.00. .
VERIFICATTON OF FOUNDATION
NOTE: 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 eonstruction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has heen constructed, will be required before proceeding with the =raming.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for wtlich a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
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JAN-30-20�1 12�12 FROM CITY OF FRIDLEY TO 6512810358 P.03iO3 �3
.e
_ l
COMMON VENT�VENT CONNECTOR _AND COMBUSTION AIR VERIFICATION °
When replacinq an existir�p furance, the undersigned hereby venfies that the
venting has been examin�d and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where r�equired. � Yes (�tj No ()
The venting system is plastirJPVC and meets all current codes and manufacturer
specifications including sizing, length, nurttiber of elbaws and termina#ion. Yes () Np �
The undersigned afso verifies that the replacement unit is a listed assembEy
and meets the current codes and manufacturers specifications_ This does
include AGA-GAMA Categcry I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the current codes
and manufacturer's specificatlons,
When required to insiai6 a new combustion air, it will l=e sized and installed
to meet the cur�ent codes and manufac�urers sgecifications.
Yes �(� No ( )
Yes (yj No ( )
Yes (�r7 No ( )
When installins� a new ventin4 system, the undersigned hereby verifies that
it is a listed assembly and mEets the w�rent todes and manufacture�'s
specific2tions. This does, in�ude AGA-GAMA Category I Gentral Fuma�e
Venting Tabl�s for fan assisted and natural draft applian��. Yes () No ()
ls the common vent and vent connectors sized and installed correctly after
an apptiance has been removed from the common vent and vented
separately as per current codes.
Yes( )No( )
BTU {n ut TS. ��° Fan Assisted or Na:� "" '�""--
Appliance #1 Type 1�'o7wl�L - P — -
Appliance #2 Type BTU (nput � Fan Assisted or Nat !„�.
Appliance #3 Type �, ___ BTU ln�ut _ Fan Assisted or Na#
Total Appliances T_ Total 6tu Input .___
Common Vent Type Vent Height _ Diameter _— inches
Appliance #1 Vent Cornector H�ight ft Length ft Diame#er in Typ�
Applianc� #2 Vent ConnectoF Height ft Length ft Diam�ter in 7ype
Applianc� #3 Vent Connector Height , ft Length ft Diameter in Type
ALTERATIONS: Describe
HEATINC CO:
Signed By:
TOTAL P.03
_
CITYOF
FR[DL�Y
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 8, 2002
Dale Dickson
600 Ely Street NE
Fridley, MN 55432
Re: Final Inspection at 600 Ely Street NE
Contractors: Bonfe's Plumbing & Heating Services, Inc.
Dear Mr. Dickson:
A mechanical pemut was issued on February 2, 2Q01, to install a furnace at your address.
According to the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the
work authorized by this permit. As of this date, no inspection has been called for.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Code. 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 pemut "no inspection called
for" 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.
DJ/ls
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ADDRESS
PIN
LEGAL DESC
PERMTT TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�63) 572-3604 FAX: (763) 571-1287
: 600 ELY ST NE
: 033024320107
: UNAVAII.,ABLE
: LOT BLOCK
: BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
PERMIT N .: 20��00790
DATE ISSUED: 05/27/2004
VALUATION : $ 14,296.00
NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATI�R RESISTIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THI5
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WI�N TI� SIDING IS AN
APPROVED WEATI�R BARRIER VINYL SIDING IS NOT A WEATI�RPROOF COVERING UNLE5S TI�
MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. REROOF HOUSE & GARAGE; RESIDE HOUSE & GARAGE.
STATE LICENSED CONTRACTOR
APPLICANT
WEST'LTRN ROOFING/SIDING (20155566)
9700 13 AVE N 2ND FL
PLYMOUTH, MN 55441-
� ./� �
DICKSON DALE A& SHARON L
600 ELY ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construcrion
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
applicarion and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating cons chon or the pe rmance of construction.
Ann .,��� Date��/o�
Bldg Insp_
SEPARATE PERNIITS REQUIRED
BUII,DING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 13948
WORK OTI�R THAN DESCRIBED ABOVE.
m
251.25
14.30
7.15
5.00
277.70
NEW []
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY ����°� Effeative 4/1Y1004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION �f I�
�, �, z1 s C`le' � j G�
� /
r
Construction Address: � � � ��1� �j -
Legal Description:
Ovmer Name 8� Address: S«�,P,�� � c��to � Tei. # 2��- ��'� 49��
Contra�tor. �� sT �i'' MN UCENSE # ���a�i ��-� �
Address: �'�O v j� f� ��rt .�`� Tel. # 7� �- S¢� -���
LNING �AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Wdth Hgt/Ground Sq. Ft
T' .,
Construction Type: C av
G ,fi;di i" Estimated Cost: $��� 9� �°
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: ��,,� APPLICANT: Tel. #
Call (763) 572�604 for Pertnit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
.--
� a�� Od ��S
�
$ /� , C�
$ '�� �=S
$
.� � � ���,�
$
�
�
$
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering �
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 4 ����. � � STIPULATIONS:
�
BUII.DING PERMIT FEE SCH�DULE
The Chief Building Official shall, before issuing permits for the erection of any build.ing 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 $5�
$501 to $2,�
$2,�1 to $25,�
$25,OOlto $50,000
$SO,ODl to $100,000
$100,001 to $5�,0�
$500,001 to $1,000,0�
$1,�0,001 and up
FEES
$23.50
$23.50 for�first $5� plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,�0 plus $14.00 for each additional $1,�0
or fraction thereof, to and including $25,�0
$391.25 for first $25,0� plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,0� plus $7.00 for each additional
$1,�0 or fraction thereof, to and including $100,000
$993.75 for first $1�,�0 plus $5.60 for each additional
$1,� or fraction thereof, to and including $500,000
$3,233.75 for the first $5�,�0 plus $4.75 for each additional
$1,000 or fracdon thereof, to and including $1,0�,�
$5,608.75 for the first $1,�,000 plus $3.15 for each additional
$1,0� or fraction thereof
CURB CUT ESCROW
(Concrete Ci�rb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
ra.te
Permits for constcvction 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.
VERIFICATION OF FOUNDATION
A Certificate of Si�rvey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMQN VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
�
When replacin� an existinct furnace, 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 () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cuRent codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existin combustion air is sized and installed to meet the current codes
and manufacturer's specifications. �
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installinca a new ventinA svstem, the undersigned hereby verifies that
it is a listed assembly and meets the cuRent codes and manufacture�'s
spec�cations. This does include AGA-GAMA Category I Central Furnace
Yenting Tables for fan assisted and natural draft appliances. Yes ()
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.
No ( )
Yes ( ) No ( )
Appliance Tvpe and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Ap�liances ___ _Total Btu I�ut _ ______ _ __ ___
Common Vent Type � Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliancs #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describe)
� - � tI/! � .i� �� �
HEATING CO���,�l� ��g� � /�S'�e���'/�1.1� � s�v,3 z.-
Signed By: �d ,�� /' Date : �- f� �
..
Bu�lding BUILDING Permit No.: ' —0 �
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604
763-502-4977 FAX CITY OF FRIDLEY vate xec'd:
EFFECTIVE 1-1-08
DATE S/ZD /O � YOUR E-MAIL ADDRESS i a�► s C the de�-k s� �� •%l C�/
SITEADDRESS �oo �1 � sf: �O.E: F� IDLEY, � � ���a
THIS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY OWNER/ Np�: Sl� a r-nn�S �n
TENANT pDDRESS: �QQ� �( y ,s� /�%� CITY F/`� �, STATE:�%� ZIPS3'y3�.
PHONE: 7�0 .3 �� % S4 — OTT B
N�: e CO. C
CONTRACTOR ADDRESS:� DO �,S/ ST � 5�U/T1� / D U CITY STATE,�/ZIP,SSi -�
SUBMIT A COPY OF pHONE q,�?`�f 3Z-/BQ$ X/�.3 FA7c 9SL -� 3Z -�oy D
YOUR STATE LICENSE
STATE LICENSE # S'�oS� EXP DATE 3 3� �OD %
PROPERTY TYPE �SINGLE FAMII.Y/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE � �DTI'ION ❑ GARAGE/SHED ❑ wn�tnows
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
�ECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: � NEW HOME CONSTRUCTION �ADDITION
❑ MAINTENANCE/REPAIR � REMODELING
DESCRIBE WORK BEING DONE: N fi� EC K R@ t� /� U�
SIZE OF IMPROVEMINT J O� X � LENGTH �D � WIDTH / Z� HEIGHT / 0� �� SQ FT �Z � FT
ROOFiNG ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: � DETACHED GARAGE 3. List of structucal membeis to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vin I ADDITIONS. & PORCHES SUBMIT:
Y ❑Soffit 1. Site Plan/Surve showin the e�tistin structures
� Alnminum ❑ Trim 3' g g
❑ Other ❑ Fascia and proposed project.
2. Two sets of construcrion plans
WINDOWS 3. EnergyCalculations
IN EXISTING OPENINGS OYes �No LOCATION OF WINDOWS
OR FOR NEW OPENIATGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
♦ r 7 LTcL�o • nr. �s . c'�r. r �
t�a�L1LLUA1\L' Lt1UL`L Vl\ ♦tfLVtil1V1\�11\I.LULII�IV 111L' I.VJl VC LAIfUj(t�1rLNjt�jJJj(jAL,:
_ , _(USING THE 199'�riT��EF,,.iSCAEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Stucharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$
$
$
$ . _,
OCCUPANCY
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuarion Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 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 Fridle_y Attach
IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building pemut 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 Construction Codes; thaY I understand this is not a pernvt but only an application for a permit and work is not to start without a
permit on site; that the work will be in accordanc with the appmved plan in the case of all work which requires review and approval of plans.
SIGNATURE PLICAN PRINT NAME ��//L! cS�L L/N��2.. DATE � (J
APPROVED BY � DAT���' �
PLEASE NOTE: SEPARe�TE P�,RMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK
Q
� � � � �
l �'
The Deck & Door Compan�
69001515` Sireet W. Suite 100, Apple Valley, MN 55124
952-432-1888;952-498-2311
E-Mail info@thedeckstore.net
August 20, 2008
City of Fridley
Building Pernuts & Inspections
6431 University Ave NE
Fridley, MN 55432
To: Building Permits Department
I am enclosing an application for a deck permit at 600 Ely Street NE.
If you have any questions, please call me.
Thank you,
Jan Sellinger
AutoCAD Designer
952-432-1888 ext. 103
ians C�thedeckstore.net
The Deck Store/ The Deck & Door Company
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