AF - 47301�
s
City of Fridley, Minn..
$431. University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
t)ate: T„� � , o�,
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QW�: - Tn rld iLY'1� S i m�bg Bt131d2T Tri -Co BLi 1 d s Tnr y_
�gg 7�5�,�'[��kson Street N.E. Ad�$ 756�,, V�n R�yren GtreeY,�j�
LOCATION OF BUILDING
Na 7350 S{�t � ack on .$,�-xeet._.�j..�,..,_..___..._..__�._.__._...__. Part of Lot
L6t .� 9 Block 4 ____ Addition or Sub-Division .�'�,o.S�.Y 1�..nor ,.�d Adc.�itioti
Carne�r Lot Inside Lot .___.._.X :..____..r Setback __�___....3.Q! .._..... Sid�eyard ._. 5� & 1 �� -----.-..._._
$ewer IIeval3au FoUndation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Dwe. fng �t 26 ��p� 40' Height ._._._20' sq, �, 1�040' �, F t, 20� 800'
�argge Front � Depth .r.22.� Height ._.._ll(L_ Sq. Ft ___� � Cu. Ft �S.r.9�.0 �
'1`ype of Censtruction Frg p_ Frs� Cost ...__,$Z$y.USZL�..Q.Q..�. To be Completed _�..� �. 19 71 _
Stipulations: Maintain elevation of at least 18" above centerline of street.
i�3Fi� Verifying survey required before proceeding with framing. Maintain equal
elevation all around dwelling. Provide a hard surface drive.
SEWER LOCATION: 36' North of Manhole WATER LOCATION: 46' North of Manhole and
10 feet North of Sewer
Wye Elevation: 872.53 Top of Foot3ng: 875.53 Approx.
In consideration of the issuance to me o# a permit to construCt the building described above, I agree to do
tlte P�P� work in accordance with the d�ec3ption above forth and in compliance with all provisions �
�inances o! the cfty of Fridley. �
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Ea c�ideration of the payment of a fee of $ 5�� - 0� , Permit is hereby granted to ..Txi-Cn B„ i 7�a,-S
to construct the building or addition as described above. This permit is granted upoat
the express condition 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 thereof, shall conform in all respects •to the ordinances of
I+'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
vylthin the city limits and this permit may be revoked at any ' upon violati of aay bf the provisions oi said
o�diitaaces.
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InsPecto�
CLARENBE BELISLE
NOTICE:
This ptrn�it dws not eov�� th� eonstruelion, installation for wiring, plumbeng, yas h�aNng, »w�r or wa»r. M wn to sN
fh� BuiWfn� Mq+ecfo� fo� s�parate psrmits fo� th�s� itsms.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
p��g�s �; Todd Zimba BUILDER: Tri-Co Builders Inc.
ADDRESS : 7350 Jackson St. N.E.. �pDgg,�g ; 7561 Yan. Buren St. N.E..
NO:. 'j�50 , STREET: Jack$on St. N.E.
LOT' 19 BLOCK• 4 ADDITION• Melody Msnnor 3rd Addition
CORNER LOT: INSIDE LOT: � SETBACK: 3� SIDEYARD• 5& 1'4'
�—
Applicant attach to this form Ttao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As:
House Front: 26 Depth: 4fl ' Height: 2�
Square Feet: �-�4� Cubic Feet: 20�800
�'�'� Front : �7 Depth • 22 Height : �0 �
Square Feet; 596 Cubic Feet: 5,960 �� �•; �
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Type of Construction: Waod F`rame Estimated Cost: $ 28,d00.00
To Be Completed: Se�:- 71
The undersigned hereby makes applicativn for a permit for the work herein
`�: specified, agreeing to do all work in sttict accordance with the City of
�;. Fridley Ordinances and rulings of the Department of Buildings, and hereby
� declares that all the facts and representations stated in this application
�� are true and correct.
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Tr o Builders In
DiATE : .3 S IGNATIJRE • BY = ��
(S everse Side For Additional Infonaation
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�' BUILDING PERMIT FEE SCHEDULE �p�
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SECTION 2. The Inspector of Buildings shall, before issuing permits for the �
erection of any building or structure, or for any addition to any existing � - Y
building 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 herein below set forth and in
the manner herein provided to-wit:
iTNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
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ADDITIONAL INFORMATION ��
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For the purpose of computing fees for building permits, the cubical contents{ I�''�YX
of any building or addition, is determined by multiplying the ground area �` � �
covered from a point six (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 of all proposed work.
In no case shall the fee charged for any peYmit as set forth in Section 2 be
lesa than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a miniaaim of 24 hours fram the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedin� with the framing.
CERTIFICA'FE OF OCCUPANCY
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 pennit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued. •
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Weatherstrips Conitruction Na nsulation
_ I Guide I -
— --• — —
� ws rs P.efercnce Out Wall Int. Wall Ceilieg RooF Floor Kmd How Applted
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1'es o Yes No �, 19 •-.-- I , _.,__._
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-- � _ --- - '-'-
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\Vidth HelgAt No. of Lineal ft. Area � Wldth Hel� . ot � Llneal tL Ar�a �
No ot pane o! D��e I�ghte o[ cr • f[. � _No, Vane o p� u ot cr►ek q. ft. �
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Isht No. o[ Llne�l [t. Aro� f
o[ p�ne 11{hb o[ cruk �p. tt. �
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Net exp. �+ali �_ _` __ _ �'
lnt. wall �
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Floor
Total Btu,.�
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Wldth
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Glas�
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Net eap. wsll
Int. wall
C�iling �
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Room � L_ength •--Widch (
�ors—Crackage and Area
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/
.
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Net exp. wall
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iling
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ii
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afAT L069 CALCUI,ATIONS DEPARTMENT OF INSPECTION
wu�**�� A G� Con�tioa No.
1V�VNEAPOl.tS. �Q�1N.
ta,ulacios
� Rel�renu Out. WaU Int. Wall CeJins Roof Fl Ki�d How Applid
0 19_
Fl. m L,ensth ��Width Hei�ht Fl.� L.eagth �lidth HsiZ
�ia and Doors—Cracka�e and Area � Window� and Doors—�rackaQe a Area /�
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CSI1�iISY AND 8'1'AC� VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
l. Has been carefully examined Yes � No ( j
2. Is free from rust or deterioration � Yes �) No ()
3. Has no foreign objects lodged within Yes (� No ( j
4. Is securely supported Yes (.�. No ( j
5. Meets all current Code requirements for
size and total BTU's connected Yes �'j No O
6. Has total heating BTU's of � �
, All other BTIT � s �iC: G��O � ,
TOTAL BTU' s y/� . LJ D�
Remarks
List AZterations BeinQ Done•
HEATING COMPANY _ G p�y� 1-y,,q�j `�,e S�n �,
Signed By / �
Date _ �_ 8_ � y �
�
, HOU,�E NEATING TEST RECOR�
`ADDRESS � a- 8 �APT. FLOOR CITY �� �� R
�'-� �l s
OCN PANT � OWNE R
MEAT LOSS DkTE HTG. INST. �
SOLD BY INSTAlLEO BY � �' - j
Et.�ti��ol we.k e.. ,.,, G.s Lin. B�r v�. i 1
TYPE OF MEAT GA FA �HMI STEAM �_.SPACE HTR. UNIT MTR. OTHER
GAS DESIGN
MAKE � AIAKE OF BURlIER _
Mod.l � a �Il � �Z � '� _ � AAod�l .
S�►ial �.�Mfi � Mes. BTU Ratln� —
INPUT SS-.n� __ MAKE OF FURNACE
THERMOSTA� �
Velv� __�"�dJ1
Limir �
Limit S�Miny
Fo� S�ttiny
Pilot Typ� _�
Pilot Mok• —._.
_,_._ _. __
�CONTROLS
� j��ot PluO
CONVERSION
�l +/
V�nt Si:• ¢� V � s
KIND OF Li ' SIZE NONE
Drah Hood _ Rpulo�w
Filhrs Sis� a'` uwibr
O���n.r Lo�e�ion Insid� Owsid�
L3�imn�y ConsMVefion
Pilo� Mod�l ��;4or� CaA-'�is' S�ok� Bom! � wiriay ��
Pilot Timin9 `"" D►aft j� T�sl Teo �✓'
L.W. Cut Off `�' Doe� pr�ssur� � Li�t n� les�.
Pr�ssun .�� rtW� P��e�nt C0� —� Dot� T�st�d _ - ~
InPu� CFH_. %'�' PNe�nt 02 Co�yo�r T.s►i�9
Srock T•mp. '� P«e��t CO Na�w ei T�s�« f��
sue�ecT PE
City of Fridley � � � � �
AT THE TOP OF THE TWINS g U I L D I N G P E R M 1 T
r
� � —
� �
• COMMUNITY DEVELOPMENT DIV.
� ;L------ , a� (3°�
r � � PROTECTIVE INSPECTION SEC. r�
, � /"�1 � CITY HALL f RIDLEY 5S43Z NUMBEA NEV DATE �PAGE OF APVROVEO B�
�"'"'�'� �'' 612-571-3450 9t0-F15 5/30/96 / /
JOB ADDRESS 7350 Jackson Street NE
t LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
oESCa. 19 4 Melody Manor 3 Addition SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE
Todd Zimba 7250 Jackson Street NE 786-7499
3 CONTqACTOR MAIL ADORESS ZIP PHONE IICENSE NO.
Top Gun Roofin 5014 Parrish Ave NE Ro ers MN 55374-099U 428-4559 3388
A AFCHITECT OR OESIGNER MAIL AOORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LtCENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (25 S ) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVIOAD
SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHOFIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTHUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOfiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPlIEO
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT �2aOOO �I.00
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR THE PEfiFORMANCE OF CONSTRUCTION. �G2. ZS Fire SC y�2.00
PLAN CHECKFEE TOTALFEE
License SC $5.00 $70.25
S�GNATUAEOFCON'AACTOAOAAUTM0�71ZEDAGENT IDATEI WHEN PROP �Y VALIDATED THIS IS YOUR PERMIT
�� /
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S�GNaTUREOFOWNEAiIFOWNERBUIIDERi �DATE� 8 G �NS� qFTE
NEW
ADDN
ALTER
[l
I]
[]
ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 '
Building Permit Application
Effective 3/1/96
. /
��
Legal llescnption:
Owner Name & Address; 1�(�� Z�YY�,K�- Tel. #
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
� / 1S�o -- < �f
�toP MN LICENSE # ���
- �5� �4 � �� Tel. # 'i�p �('� �!
��is application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width � Hgt/Ground Sq. Ft.
Comer Lot [] Inside Lot [] Ft. Yd .S� -,-.> Side Yard Setbacks
.. �-� �
Tyge of Construction: � � Estimated Cost: $ _.. � - e1 ��� �
Approx. Completion Date: �0 � ��.
(Cost on Back)
Driveway Curb ut Width N
DATE: APl
Permit Fee (�' �• �'1$
Fire Surcharge �?• � �' $
State Surcharge f� � �'$
SAC Charge � $
License Surcharg� $
Driveway Escrow $ �
Erosion Control $
Park Fee $
Sewer Main Charge $
Ft x $
TOTAL
STIPULATIONS:
� r'�'—""��
i % ji`
�_. __ � - __
-��
CITY USE ONLY
_$
Tel. # �} � � `
F� Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$900 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 [ ]
ti� o
BUII,DING PERMIT 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 applicatio�,therefore, require the paqment by'the ag�licant for such permit of fees to the amount
herein below set forth and in the manner herein provid� to-wit:
$1
$501
T�� Vt�,LUE
FEES
to $500 $21 (M' ll lus surchar e
� ..�'� P g )
i A t,:.�'+?�" �` :L �
t0 �2,�00 V ,;� ��
$21 for first $500 plus $2.75 for each or
fraction thereof, to and including $2,000 ��
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or iraction ihereoi, to and- inciu�iing $25,OQ6 -
$349.75 for iust $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for fust $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $SQd�000 • $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000
$1,000,0p1 and up
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
_ __ _ (Concrete eut`'ti �treets Unly)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "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.
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 the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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U�:jU AA LJ/ 11/lU/yy HOae uepot S
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rage 1 e�
FAX INSTALLER JOB SUMMARY COVER SHEET Date: 11/10/1999
Page: i
FROM: THE HOME DEPOT, INC.
STORE 2801: MAPLEWOOD
2360 WHITE BEAR AVE NO
MAPLEWOOD MN 55109
FAX: (651� 773-4766
PHONE:(651) 770-9600 Ext. 473
T0: KCJ ENTERPRISES INC FAX: (612) 551-2555 Ext.
KCJ ENTERPRISES INC PHONE:(612) 551-0555 Ext.
INSTALLER # 50023733
2800 CAMPUS DR.
SUITE 40
-- --�t-�fM0t1Tf-��4i�1-5�4�-- _ _ — ---
TOTAL NUMBER OF PAGES TRANSMITTED: Z
IF YOU DO NOT RECEI�JE ALL OF THE PAGES L.�S�'€f? €rBf}�iE,
PLEASE CALL THE SPECIAL SERVICES DESK -
(651) 770-9600 Ext. 473 - IMMEDIATELY!
�
_
CI"iYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 16, 2001
Todd Zimba
7350 Jackson Street NE
Fridley, MN 55432
Re: Final Inspection at 7350 7ackson Street NE
Contractor: KCJ Enterprises-Mr Rooter
Dear Mr. Zimba:
A plumbing permit was issued on November 16, 1999 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 plumbing authorized by this permit. As of this date, no inspection has been called for.
The permit fee paid covers the inspector's time to make sure the appliance was installed
conectly. We also check to make sure combustion air has been installed and that the vent and
vent connectors have been sized properly.
If you would like the installation inspected, please contact us within 30 days to arrange the
inspection. If we do not hear from you, we will expire the permit and note that no inspections
were called for.
Any questions can be addressed to me at (763) 572-3603.
Sincerely,
.
.
sus�[tr .
City of Fridley 3 i 6 61
AT TN E T OP O F TME TW�NS g � I L D I N G P E R M I T
r
; ` RECEIPT NO.
COMMUNITY OEVEIOPMENT DIY.
i ♦V ��.�� � .
r � � Pt;OTECTIVE INSPECTION SEC.
� . �
� _ �"'1 � CITY NALI FRIDIE� SSIJ2 NUMBEiI REV O�7E v�GE Of ♦ v�OVEO !r
�'°'�� �'� 612-571-3450 9t0-F15 3/6/Ol � �
JOB ADDRESS 7350 Jackson Street NE
1 LEGAI �OT NO. 9LOCK TRACT OR AOOITION SEE ATTACMEO
DESCR. 19 4 Melody Manor 3rd Addition SMEET
2 PFOPEiiTY OWNER MAII AOORESS ZIP PMONE
Todd Zimba 7350 Jackson Street NE 763-786-7499
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 952-933-6300
a AfiCHITECT OR OESIGNER MAIL AOORESS ZtP PMONE IICENSE NO.
City License
5 ENGINEER MAIL AODRESS tIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CIASS Of WORK
O NEW O AO�ITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGE Of USE FROM T�
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit I�nspec#ion Cards
W��I Be Mailed
To Hameown�r To Post
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTiiICA�, PLUMBING, MEATINf3.
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTiiUCT10N 20NING S0. FT CU fT.
AUTMORIZEO IS NOT COMMENCED V�IITHIN 80 OAVS. OR IF CONSTHUCTION
OR WORK IS SUSPENOED OR ABANDONED fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DW4G. UNITS OFiSTFEET PARKING
I MEREBV CERTIfY THAT I HAVE REAO ANO EXAMINEO TMIS APPLICA710N 1 STALLS GAiiAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALl PFOVISIONS OF LAWS yAt,UATION SURTAX
AND ORDINANCES GOVEqNING TMIS TYPE Of WOpK WILI 8E COMP�IED @ ,
WITM WME7MEA SPECIFIEO NEiiEIN OR NOT. TNE GRANTING Of A PERMIT y�1S�ZSO �7•62
DOES NOT PFESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE pEqMIT FEE SAC CNARGE
PROVISIONS OF ANV OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PERfORMANCE Of CONSTRUCTION $265 . 25 Fir SC � IS . LO
P�AN CMECK fE Tp� i1EE
�7.97
S�GN�iUAEO�CON�F�CTOAOp�UTHOA�ZEOAGENT �O�iE� EN ROP ALIO MIS I OUp�pM�T�
' ' %
S�GN�TUAE 0� OWNEQi�f OWNEp BU�IOFp� 1•TEi � 8l �NSO ' �l�/f
� . �. r
NEW [ j
ADDN [ ]
ALTER [ ]
Construcdon Address:
I.egal Description: _
Owner Name & A drE
Contractor: We I���
Address: ��( ��
Effective 5/10/99
CITY OF F�tIDLEY
SI�i tGLE FAIVIII,Y A►i�iD DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
'�._.�a _3 ��
rn�.��c��
�n `131 Un .'�'��
�V'C _.AJ�
� r�,��
c_ -� �..� r i.� r i.y i
Tel. #
MN LICENSE # CPn �
�TTeI. # O
Attach to this application, a Certificate of Survey oi"'tiie
lot, with the proposed construction drawn on it to scale.
- DESCRIPTION OF Il1�IPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length ' - Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OT'HER:
Constru.ction Type: I�(.'/1 E�GCP Q� �i(��`o/►�1�Lv�Estimated Cost: $ G ��
Driveway C�ub Cut Width Needed: Ft. + 6 Ft =
na�: �
�
�
��� �N�� � ��``��'
� ��
�
Ft x $ _ $ �
Tel. #_ ��� " l,��'(��
Pemut Fee $ s� Fee Schedule on Reverse Side
Fire Surcharge �� � �� $ , .001 of Permit Valuation (1/lOth%)
State Surcharge $ ,�� $.50/$1,000 Valuation
SAC Charge $ $1050 per SAC Unit
License Surcharge $ r� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosioa Control $ $450.00 Conservadon Plan Review
Fark Fee $ Fee Detemiined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessazy []
TOTAL �`g� � $ .� �S p`a .
% �- ���� ��,
s�ur��orrs: y'lJ�" G�� �'����
���� �. , � /�7�i : C, l��%��.�/-��"����u�.��J
.�� �� �?'� :��� � ���
BUII,DPi TG PERitiIIT FEE SCHEDULE
The Chief Building OfFcial 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 �lteration 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 $500
$501 to $2,000
$2,001 to $?S,OOp
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or ,fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, [o and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for fust $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional
�1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up
0
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,U00 or fraction thereof
- ��IVEWAY B�RE��IOI�FSCROW
(roncrete Curb Strects Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "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 $23.25.
VERIFICATION OF FOUNDATION
Pernuts 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 construction site. ..
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing.
. , . _ _..
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� . . . . . • .
- • . �, � � �
{:7:.J•" 1 J•"k:7:J l:ir: � k'77
MRY�-12-20@5 13 � 41
V�UU t �
�an�
a�T�R j �
Construction A�drE
�..egal t7escription:
C3wrter N�me & �
f•0.J.:�7b Wt1�
CITY � FR f DLEY �b05— (�� "7� � ' -�" "J
Cf`f Y OF FRlDL�1+
� 643? tJn,verslty Ave NE, Fridley. Mhd 55432 (7B3j �72w3� l�dp lasp
SfNts�,E FAII�(LY AND aU�LEXE9 R-f AND R-2
BUI�„pING PERMiT APPl.1CATlqN ,7� 3�.�� �� 7 7
vdr�4rt�o�: 1""' .�, . . �.. ..
i a�s • MN LtGENSE #��o ys��� yp
Addr�ss: Z �# oa s�'37 rel. # 7� 2 s�
�.11fthlG AREl�:
GA��+RQ� ARE4;
DEGK AREA:
Oi1�t�R:
�AttaCh ta th18 applicatiar►, � Cert'�iCSte Gf $unrey of th2
bt, with the proposecl ronstrue�ion drav►m o� it to'sc,ale.
dE$GR1�7f�3N QF IMpROVE�R�NT
{.e�gti� �,�� Width ,�_ N�i9� Sq. F�.
�
I.�n9� � W�J� ,�� Height Sq. F�.
�: ��
�en�th � UVidth �, ��/Ground � S9- �t
.�So4
��nsin:�io� i yp�:� l�r d,,� �— Estimated Cvst: � � o� �
�riveway Curb Cut Vllidth l�;eeded: �„Ft. �►� 6 ft =�F� x S� � ��
�AY�: __�� ( �` � � ApPUCANT: TaE. �
�f! (i63y S7�-�B04 for Pertnii Fees if m' g in applioa�an. Fax to 763-�71-128? if using creciit card as�d vwe w+�l ca�1
�t tor ca�rd n��b@r.
�%ITY USE �NRY -
'�rmit Fee
i�r1 �3view
IC8 r'�y' LiiCile�rrj. B
�te St�rchar�e
�tC GF+arg�
Gense Surcharge
urb Cui Escrow
-o��ac� Contrc�
�rk Fee
swer Ma�n Charge
70TAL
� �� 3, a5�
�
� ,50
� (� 5
$
$� ,�
�
$
�
$
� �a o0
� �
Fee Schedule� an �teverse 5ide
fi5�o of Permit �ee
.001 of P�rmlt Vafu2�tiort (1I10th°1�oj
�.501$1,OQ0 Ualuation
�1450 per SAC Unit
$S,OQ tState Lacensed Residential Contracta�s)
AI#. ��A" or Alt. „B" AbQVe
$�150.00 �onservatior� Plan Rer�i�w
Fee Determined by �rrgineerir��
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571PU r I�IQI�t7.