AF - 42770BUILDING PERMIT
Village of �ridley, Minn. N° 2 5 O 1
Date '�• .�.�. � �� . . . . . . . . . . . . . . . . . . . . .
Owner �� ��. . Kf��� . � �. � ,'�` �b� . . . . Builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.. �
Address ����......� ���"�:!'�:�.�� Address .........................................
LOCATION OF BUILDING
No. ."';! �; .+��. . . . . . Street ��. . . . . . . � • �. t� . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . .
' ' �caC�� .
��r
Lot . � . .. J!.... .. . Block . .. .� .. . . . . .. . Addition or Sub-Division . . !�.��.�:�.�� :s�'d� .�. , ,'��.�, , , ,
� �r � �
Corner Lot ............ Inside Lot ...'�"�........ Setback .'lJ.�?��`�� Sideyard .��..��"'.'.':`............
To be Used as:
. i�?"�+'�...
�
DES�CRIPT[ON OF BUILDING
Front ." : . . . . Depth .�� . . . Height � �r . . .
:':����' �� . . . . . . Front . �� Depth : "�`.��"'". . Height . . . . . ,
r ��+�.r- �C
Type of Construction . :�.� �� Est Cost . �'�? . ��. . ��. . . . . . . . . . .
,
r;
�,
sq. �. ,�t� �� cu. �. . .. .. . . .
�
Sq. Ft. . . �� . Cu. Ft. . . . . . . . .
To be Completed .�. �:�.���.�..
In consideration of the issuanee to me of a permit to construct the building described above, I agree to do
ihe proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of P'ridley.
'� : . ��,�L�t . ,��� ; :'W':.i . .
In sideratio the payment of a fee of ..��. '�""'�n'�
$ ., permit is hereby granted to ..
�����t�^. �=� : ... to construct the building or addition as described above. This permit �ia granted upon
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances oP
�'ric3ley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in ihe village limits and this permit may be revoked at any tlme -upor�;�riolatio of any af the provisions of said
ordinances. ,fi '
/ ,: � .r� .r./'1 .�° �..r-
:'4�: !►. :� !!'�. Building Inspector
NOTICE:
This permit does no4 cover the construotion, Installatlon or alteration for wiring, plumbing, gas heating,
sewer or water. Be strre to see the Building Inspector for separa4e permlts for these Items.
.�. �
y y SUBJECT � 1456a
Cit of Fridle
AT THE TOP OF THE TWINS g U I L D I N G P E R M I •
r
� � RECEIPT NO.
COMMUNITY DEVEIOPMENT DIV.
r � y � PROTECTIVE INSPECTION SEC. � �7r� rj�
� � � �
1 ; �
�� � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
•"'� � ,�� 612-560-3450
910-F15 1/3/78 � �
JOB ADDHESS 6563 Fridley Street N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHEO
oescR. 6, 7 6 Oak Grove Additi.on SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Jerry Tjader 6563 Fridley Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Merle's Construction 860 Randolph Street, St. Paul 291-1169
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDING
Resi.dential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
RcamO��. �Cl'tC17..BII
9 CHANCiE OF USE FROM TO
STI PU LATION S `
SEPARATE PERMITS ARE REQUIRED FOR ELECTHICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEflIOD OF 120 DAYS AT
ANY TIME AFTEFi WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
0
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
WITH WHETHER SPECIFIED FFEREIN OR NOT. THE GRANTING OF A PERMIT S4�OOO yS`Z.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � y�`24. OO
��
���v� � PLAN CHECK FEE TO� L FE OO
� ���� . �� u �'�
SIGNATUREOF�TRACTORORAUTHORIZEDAGENT 1DATE1 E �/�IHE PROPER Y I T T IS YOUR PERMIT
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SIGNATURE OF OWNER IIF OWNER BUILDERI IOATEI INSP pATE
' • CITY OF fftIllLCY . �
' APPLIC/1TIOid FOR RESIll�NTIAL BUILDING PERI�IITS .
' ��VEW, IILTLRIITIONS, ADDITIO�JS, OR REPAIRS)
OWf]�R: J�� �Z.`o,� T� }����. � AUILll�R: �'��.,� �� � V�� �;,,
-� f� ?y
Addzess : �'��. � j�'� �17 ��/ � _�.Address : C� 6 �J �R��'C� ���, .
/
Tel . No . : �.� � — I � � �� '
No. : �`J� �� 5treet : �T? , 1.111 �� �J� \ � , .
� . -
LOT: BLOCY.: � ADDITION : ���[, ��� y�- ��� a
CORNER LOT: INSIDE IAT: SLT}31�G:: SIDEYARDS:
Applica'r�i. attach 'to L-his form ZWo Certiiicates of Survey of Lot and proposed
bui.lding location drawn on these Certificates. .
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: � � Height: -
Square Feet: Cubic Feet:
Front: Depth: � Height:
� Square Feet: Cubic Feet: �
Type of Construction: � 1T(',� �� ('r'�,(j,�� i� Estimated Cost: $�I��� ��
-� -
Zb Be Completed: �`�� �'� Alt. A Alt. B
Proposed Drivetivay Wid� If New Opening Is Desired $ $
(SE� 22�VERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all �vork in strict accordance with the City of
Fridley Ordinances aiid rulings of the Deoartment oi Buildings, and hereby
declares ihat all the facts and representations stated in this application
are true and correct. See reverse side far additional information.
� � �
D��: _ I ' � — �'�-' SIGNATURE: �_
Stipulations:
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BUILDI(�G PERI�71T FEt SCHEDULE -
SECTION 2. The Inspector of Huildings shall, before issuing pexmits for the erecti��n
of any buildin� or structure, or for any addition to any existing building or struct:iz�e,
or for any alteration or repairs to any existing building or structure, upon applicatian
therefore, require the payment by the applicant for such permit of fees to the amou:�t
herein below set forth and in the manner herein provided to-wit:
NEW CON5TRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete C� rb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus .6 feet x$� ��'���
Alternate B: Removal and replacement of concrete curb and
qutter and install a 3 foot wide approach with
• 6 inch depth; Driveway width plus 6 feet x���2•�d
_ ADDI TIONAL I NFOR�1AT I ON
For the purpose of computing fees for building permits, the cubical contents of an1
building or addi�ion, is determined by multiplying the ground area covered fror� a
point six (6) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the roof surface
of the �►ain gable of a pitched roof . •
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 �ier each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
„ _VERIFICATIO� OF FOUNDATIOf�
NOTE: Permits �or construction will be issued a minimiun of 24 hours from the time
of agplication to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedi.r.g with the framing.
: : � '=►
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued. .
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sue�ecT PERMIT NO.
City of Fridley 2 0 6 0 3
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� �
, � �`1 � �3
� `v ______ COMMUNITY DEVELOPMENT DIV.
f � � PROTECTIVE INSPECTION SEC.
' i '
� /"�1 � CITY HALL FRIDLEY SS43Z NUMBER REV DATE PAGE OF APPROYED BV
�""'� � �'� 612-571-3450 910-F15 9/27/90 / /
JOB ADDRESS 6563 Fridley Street N.E.
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Ei r% 6 Oa.k Grove Addition SHEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Classic Renovations 4355 Vicksbur Lane 1 559-1314
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW f� ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a, 1Q` x 22' Garage Addition
9 CHANOEOPUSEFROM TO
STIPULATIONS
See notations on plan. �'�ovide a liax'd sur�ace driveway,
�R�IHC
SEPARAiE PER�ITS Before drggi�r� ��II f6�
WIRING, HEATIi�iG, PLl1M (IiVG D �FOR �!t '���i� �c���si��t�
A, Y� ���a \�a ��r� � !
REQ6�I��t� �3� ��,�'
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE HEOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONIN(3 SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS 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 COMPUED $3,273 $l.Fa3
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $63 e OQ
�STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKfEE TOTALFEE
l k'ire SC $3 $67, 9Q
�SiG TuaEOFCONT r ORIZEDAGENT IOA7Ei EN PRO ERL V LI A THIS IS YOUR PERMIT
� � � ,��% !-_ �—o�'�—�!" C�
SiGNATUREO OWNERiiFOWNERBUILDEfi� IDATEI ��G �NSP r/l.TE
NEW [ ] Effective 8/16/90
ADDTT [ ] R-1 AND R-2
ALTIIZ [ ] Building P+ermit Applicatioai
CorLSttuction ,�a,�,�c; D � la � _ �� e ���
�,r
Legal Description: �O � S �o�, �L�JJ �' � , �f�C' � �b (�� ,�fu�D G\J
Owiiex Name & Addr+ess: � � �� � �a� o �� Te1. � � �� k� I � °�.s
Cbr�t�actor: ��ar,� � �d �� d� �'L�4 S� � � '��- �a�'� o��
� ^ '� '� � Tel. # S'�"9 �3/`i
��: , L/ 3 �' S° �l, � �'� 6 � � � ,C � e �i � •� .� .s'�'�� G�
Attach to this applicatiar►, a Certificate of S�vey of the
Yot, with the proposed oo�ucti� drawn an it to scale.
�TI�i �F IN�'l�VII�I'
LIVIIJG ARF�i: TpT�� Width Height Sq. Ft.
Q�iR�iGE ARF.�i: Leng�th �. �. Width �� Hea.c�t � Sq. Ft. ��
DEGR AREA: iength Width Hgt/Gratu�d sq. Ft.
O�• .
Corner IAt [] Inside 7nt [] Ft. Yd Setback Side Yard SetbacJcs �
'�e of Construction: Fstimated Gost: $ �� ��
-�..�rox. C�pletion Date:
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
w Width + 6' See ffick Page
n�: �S'° �� �zc�tar: � . � z�e1. # �; ��� �'� ��
Permit Fee $ �
Fire S�arge $
State SuYr,harge $
SAC Charge $
Driveway Escrow $
Park Fee $
sewer Main C�arge $
• v � /. 1'� -
S`1'IPULATI�LS :
CITY IISE ��II,Y
Fee Schedule a�► Reverse Side ,
.001 x Piermit Valuation (1/lOth �)
S.SO/Sl,000 valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Abave
Fee � bY �l��J
Agr�nt NecessazY [] Not N�saYY I]
� _,
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i:�i1i��� ;,�'���+��y�4���+�_4:��+�_��i+�
Zhe Ctiief Building Official shall, before issuing �r++;ts for the erection of ariy
ta,; � ditig or structure, or for any addition to ariy existing building or structure, or
for any alteration or repair to ariy existing buildirig or structur�e, upon ap�lication
therefore, require the payment by the applicant for such ��+;t of fees to the anwunt
herein belaw set forth and in the manner herein provided to-wit:
� '1�OTAL VAI.I)E
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
I��+�-�
$15 (Mininnun Fee is $15 plus su�chazge)
$15 for first $500 plus $2 for each additio�nal $100 or
fraction thereof, to arid including $2,000
$45 for fiYSt $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction the,reof, ta and incl�ding $50,000
$414.50 for first $50,000 plus $4.50 for earh additional
$1,000 or fraction thereof, to and includirig $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to arid includirig $500,000
$500,001 t.o $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and i�cludirig $1,000,000
$1,000,001 arid up $3539.50 for the fizst $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWP,Y DEPR�SSIOTT FSC.EmW
(Concrete Curb Stz�eets On1Y)
Alt�rnate ��p,�� : Remaval arid repla�nent of curb and gutter only - Drive�ray wicTth plus
6 feet time.s $13.50.
Alternate "B": Remaval and replac�ment of curb arid gutter and install a 3 foot wide
approach with 6 inc-h depth - Driveway width plus 6 feet times $15.75.
►'/�; ��1 �+: � �)� • � �� 11�i�,�_M �;�
Permits for vonstruction will be issued a miniTmnn of 24 hours fz�n the time of
a�lication to allaw for pzopex review of the proposed structure ar�d of the
construction site. �
A Certificate of Survey of the lot, shawing the location of the foau�dation orice it has
it has be�n constructed will be required before proc�eding with the framislg.
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SUBJECT
City of Fridley
AT THE TOP OF THE TVdINS g � I L D I N G P E R M I T
r
� •
� �• COMMUNITY DEVELOPMENT DIV.
�' PROTECTIVE INSPECTION SEC.
� ��
r ; -- -;
� . ,
� i �""1 � CITY HALL FRIDLE� 85432 NUMBER REV DATE
�""� � ,'� 612-571-3450 910.F15 10/5/90
JOB ADDRESS 6563 Fri.dley Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
oesca. 6, 7 6 Oak G�oae Addition
2 PROPERTY OWNER MAIL ADDRESS Z�P
Jerald/Patricia Tjader 6563 Fridley 5treet N,E.
3 CONTRACTOR MAIL ADDRESS Z�P
Minnesota Extexiors 295 Hic�hv�ay #56, P,O. 68, H�n1el, MlV 55340
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER
8 USE OF BUILDING
Resi dent ial
7 CLASS OF WOF;K
MAIL ADDRESS
PAGE OF
� �
PERMIT NO.
2061
O.
�3 �� � �
APPROVEO BV
SEE ATTACHED
SFIEET
574-0102
PHONE LICENSE NO.
478-2075
PHONE LICENSE NO.
ZIP PHONE LICENSE NO.
❑ NEW � AODITION ❑ ALTERATION �J REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwellin� and Re�lace Bedxooln %Tindows
9 CHANGE OF USE FROM
TO
STIPULATIONS
One windpw i�. ea.ch_ b.edroczzn znus.t m,eet S.ta,te Egx'es.s x'equirements .
a
TVPE
SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONI
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO.
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALL
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEq�
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
IG ATURE OF CONTRACTOR OR AUTHORIZ AGENT IDATEI
K G�G� /� ' S � �l
�Q SO. FT.
DWLG. UNITS
1 STALLS
ATION
$7�QOQ
IIT FEE
$g�.QQ
ICHECKFEE
xe $7,0¢�/
IOUP OCCUPANCVLOAD
CU. FT.
�FFSTREET PAFKING
IGARAGES
SURTAX
$3,5�
SAC CHARGE
TOTAIFEE
$10Q.50
HIS IS YOUR PERMIT
SP'��\�f�
NEW [ ] Effective 8/16/90
ADL�T [ ] R-1 AND R-2
AL'I�R ,�]� Buildir�g P�xmit Applicatioai
�.��_t_K_ .� i.,. i-�
� ���� ��
� � , �.� ��' � 3 �
' I I '
Legal Description: I�t�O � S '�
awner Na�oe & Address: ��eva (c� ��a l � vcc a�� �\ CeJ � e t� Tel. #� 7S! 0/4 Z.
C�tractor: ,�ll 1 V1 Vt �� o�� L�� c� ! � v�S Tel. #(/1 - 4/7� -aO 7 S
�.�: :� 9.� 1-� 4� �� s� t�� o� I�� C� � l-lc� �► e(,/i/�,U ss 3 y v
Attach to this application, a C7eYtificate of Survey of the
lat, with the proposed vo�ction drawn � it to scale.
D�CRIPTI�1 OF II�OVH�fl'
IIVIIJG ARE�i: Length Width Height Sq. Ft.
C�R�,GE AREA: Ie�i Width Heic�t Sq. Ft.
DDCR AitF��l: IP.Y1C�tI1 Width Hgt/Gro�u�d Sq. Ft.
O'1'i�R: �e s i'� ��- i v� St'u l L 1U2c1 �o� l o� i V� �oc ° L
Corn�r L�t [] Inside Ipt [] Ft. Yd Setback Side Yard SetbacJ
Zjipe of Constxuction: Estimated Cos-t: $ �� C� �l �
Approx. Caanpletion Date:
Praposed Driveway Width If New Opening Is Desired: Ft• $ $
W'dth + 6' See Back Page
n�: ��- S-�j� �cArrr: a� ' �. # s� y_ a�a i
P�ermit Fee $ � P , C> �
Fire Surrharge $ � • p�
State S�ur+charge $ � . �.�
SAC Clzarge $
Driveway Escrow $
Park Fee $
se�rer 1Kain cx�rge $
�, $ l o a , �.7a
�+MrK a : M •,���
CITY IISE �II,Y
Fee Sc�iedule an Rever�.�e Sid+e
.001 x Pexmit Valuatioal (1/10th �)
S.SO/S1,000 valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" �bave
Fee Detexmiried by En4ineering
Agreemnent N�sa�Y L l N� xe�ssaYY L]
4
!-'-�rr . .�. �:�;+��y :��� _ «:��,..�i -
'Ihe Chief Buildirig Official shall, before i���;m permits for the erection of any
building or structure, or for ar�y addition to aziy existing �ilding or structtu�e, or
for ariy alteration or repair to ar�y existinq bui,lding or structure, upon ap�lication
therefore, r+equire the payment by the applicant for such ��; t of fees to the ana�unt
herein belaw set forkh ar�d in the manner her+ein provided to-wit:
� 'It7I'AL VALIJE
$1 t�o $500
$501 to $2,000
$2,001 tfl $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
i �a.
$15 (Mininnan Fee is $15 plus suYrharge)
$15 for first $500 plus $2 for each a�litional $100 or
fraction thereof, to ar�d including $2,000
$45 for fiYSt $2,000 plus $9 for each add.itional $1,000
or fraction thereof, to and incl� $25,000
$252 for first $25,000 plus $6.50 for each additiona]. $1,000
or fraction �f, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and iriclwding $100,000
$639.50 for first $100,000 plus $3.50 for each additiona].
$1,000 or fraction thereof, to and includirig $500,000
$500,001 t.o $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to arid it�luding $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each ad�ditional
$1,000 or fraction ther�of
DRIVE�iY DEPRESSION ESC[iOq
(Concrete C1irb Streets OnlY)
Alternate nAn ; Removal arid replacesner►t of c�rb arid onl
gutter y- Drive�way width plus
6 feet times $13.50.
�1t�rnate "B" s R�aval and replacemerit of curb ar�d gutter arxl install a 3 foat wide
aPpz'oach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VER�'IC�i�TIO�T OF I�I1I�IDATI�iT
Piermits for coTl��tL�lctioTl Will be issued a minimmnr� Of 24 hoU.r�' fraan the time of
ap�lication to allow for proper review of the pr+oposed structure and ag the
oon.sttuction site. •
A Certificate of S�YVey of the lot, shawirig the location of the frnuidation onc� it has
it has been c�onstructed will be required before proceedinq with the fiaming.
�
Building
Inspections
763-572-3604
DATE �P `
SITE ADDRESS �Q
1'I-IIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
� �' /'t/ �.'
❑ OWNER ��ONTRACTOR
PROPERTY OWNER/ Np�:�
TENANT .....,,..��_ i _ �
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
•rYrE oF woxx:
3TATE LICENSE
iT ! J � �/Z.
�e 3 F' S t- w 4'crrs
��°�- � � 81
� �
— - - - � •- .... ..�&iH�1DATE
ADDRESS:
PHONE ,��
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION ❑ GARAG
❑ BASEMENT FINISH �.ROOF
❑ DECK ❑ SIDING
DESCRIBE WORK BEING DONE: /—e�
SIZE OF IMPROVEMENT
. �.
❑ REMODELING
❑ DRAIN TILE
❑ OTHER
Pernut No.:
Received By:
Date Rec'd:
HEIGHT
' �S'`�� Z
ATE ZIP
Ft.
ROOFING u nvv�c vrv�. i
NUMBER OF SQUARES 2 Z �OUSE 8c GARAGE BASEMENT REMODELING SUBMff:
❑ ATTACHED GARAGE 1. Existing Floor Plaa
GARAGES 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT: �
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit ,F�DTTIONS &PORCHES SUBMIT:
❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures
p p�� ❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTII�IG OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WIl�TDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(LTSING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ o�l �o; �OCC��N�' TZ'PE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surchazge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �3•��
$
$ t� 3�'
$ o'� • °� O
$ �.�
$ �
$
$
$
$
$ �1a •3e� _
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$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 permit and I aclmowledge that the 5nformation 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 perni d 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 w' ir vi w d approval of plans. /f /
SIGNATURE OF APPLICANT pRII�iT NAME N�� �%/�J/�d�t//�'��,� l0 —� ��
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
T'he Chief Building Official sha11, 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 herei.n
provided to-wit: �
VERIFICATION OF FOUNDATION
Pernuts for constntction 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 founda.tion 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