PRE 2010 DOCS53-84-S-915.51
PARTIAL RATE SCHEDULE
MUMING FIZTMM RATES: N06 RATE TOTAL
NW nbd pixtures ................ x 38.00
Future suture V,lening .. � � a .. a ... x 31.80 �
New Fixture ®let Owning .......... x 31.80 3 -
Catch Savin .................... x $3.0 i
Water Hester `up to 99.000 BM .... x 53.00 i
New Ground Run Old Bldg. ........ x $3.2$ f
climtric Water Deter .............. s mo $
OAS FITTING FEES: NO. RATE TOTAL
lot 3 Fixtures _Z3100 $
Adationd Fixturesly............... x S .75 f!
Gat Ranp to 199,000 BTU N . .... s ....1. x $5.0 •
• State Surcharge
MWAMS S ALTERATIONS—Rafim 10 Ceds
p _
DeacripUma ....
Install ® Gas..1'°Si' s . o s ........e....� 5.00
TMAL M 8 5.00
two W , jWmv, Grgd 3,50
MI m 9 -/;z - %5
A
97 -8h-879001 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
»
PLUMBING FIXTURE RATES; NO.
0,
»
ll=ber Fixtures
i
$0.00
U
Future £+_�cture Opening •
.11
u
$
Water
x
$2.00
$
Catch Basin
x
$5.00
$
c
n
$5.00
»QIj
+
bu
14
w
$
Water Softener
Heater
$7.90
S
He-.# Ground lain Old Building
x
$5.00
$
Electric Water Neater
x
$5.00
S
GAS FITTING FEES:
04
1st 0 fixtures
x
$0.00
S
M dicional Fixtures
0
0
$
aJ
• 1A
-C
IA
•.1 2
0
+r UI
a� IA
N
UI
o
les
o
C u'
a
q
TOTAL FEE
a
x
a w
Lci
w
a x
ug
an
i 1 s t
ti.
c
n
of
dry;r
2ad
3rd
I4N
th
�
.
r
�.. (R) - Future Connection Opening
Connected with Sewer
j(•) - flew Fixture$ Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES; NO.
RATE
TOTAL
ll=ber Fixtures
x
$0.00
$
Future £+_�cture Opening •
i
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
t.Water Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.90
S
He-.# Ground lain Old Building
x
$5.00
$
Electric Water Neater
x
$5.00
S
GAS FITTING FEES:
1st 0 fixtures
x
$0.00
S
M dicional Fixtures
x
$1.00
$
.Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS d ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ , 8.00
REIN
Job Address 100 Logan Parkway
Department of Buildings
City of Fridley I
Tel. #571-0450
The undersigned hereby makes application lora permit for the work t
specified agreoing•to do all work in strict accordance with the City
and rulings of the Department of Buildings, and hereby declares that i
the facts and representations stated in this application are true And
Fridley, Mn. •8-31-77
OWNER A. Carlson
KIND OF BUILDING _ fr x e
USED AS res_
TO BE COMPLETED ABOUT 2-7-77 r
ESTIMATED COST 10.00
OLD - NEW BUILDING PERMIT N0. ... PF IT NO. '2 31A
Company J
Signed ByMINW 'a6SC0
'
Tel. No.
ROUGH INSP.
Data
FIN4L INSP.
Date
APPROVAL FOR PERMIT
MX141MUM FEE FOR ANY PLUMBING PERMIT I9 $7.50
City of Fridley
I
SUBJECT PERM14431
AT THE TOP OF THE TWINS
BUILDING PERMIT
ECrrE,IPT NO.
' • COMMUNITY DEVELOPMENT DIV.
INSPECTION
r PROTECTIVE SEC.
v
1 �
NUMBER
REV.
DATE
PAGE OF APPROVED BY
`
"1 CITY HALL FRIDLEY 55432
IL
L---- A,, ,'J
612-560-3450
910-F15
10/19/77
JOB ADDRESS " Logan Parkway N. E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
25
1
Oak Creek Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
MW Alroy K. Carlson 100 Logan Parkway N.E. 574-0494
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
11X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 34' detached garage and convert existing garage to living area
9 CHANGE QF USE FROM TO
'STIPULATIONS Provide a hard surface driveway. Owner must remove existing garage
door and render existing garage inoperable by November 30, 1977.
WARNING
SEPERATE PERMITS REQUIRED FOR WIRING, Before digging call loci
HEATING, PLUMBING AND SIGNS. TELEPHONE - ELECTRIC - GAS L�I.ri.
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Frame
VENTILATING OR AIR CONDITIONING.
wood
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
R-1
816
8160
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1'..
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
$5,907
$2.95
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-
$32.64
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$35.59
SIGN RE OF CONTRACTOR ORAD J ORIZEDAGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DATE
SIGNATUREOF CWNER (IF OWNER BUI DERI (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING.PEMI.TS .
'(NEW, ALTERATIONS,...ADDITIONS, OR. REPAIRS)
OWNER: 6 CA �5_6 A BUILDER:
Address: //00
Tel. No.
No. Street: }
LOT: BLOCK: �_ ADDITION: aa
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
"_j
Front: Depth: 3X41 Height:
?Front:
Square Feet: / Cubic Feet: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: Jj)(] mQEstimated Cost: $ 690'J. 8'
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict 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. See reverse side for additional information.
DATE: SIGNATURE:
Stipulations:
/,.9's
19 ';� 2,
3,
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
m
PLUMBING FIXTURE RATES: NO.
>.
w
m
Number Fixtures
o
$3.00
K0
Future Fixture Opening
Water
u1
tl
m
41
m
rl
ao
E
N
$2.00
w
E
G c1
.I (du
q
x
N
.11
4J
m u
W
w
w
rp
$5.00
Heater
100,000 BTU to 199,000 BTU
x
r.
N
Water Softener
c
$7.00
$
o
x
$5.00
$
Electric Water Heater
$44
0 Atli
C
.0
- 4
1
3
1st 3 fixtures
U
$3.00
$
U
Additional Fixtures
cul
$1.00
$
co
U
$
ca
c�
vii
3
a w°
v[i
g
U r
s
Id
$5,00
0
o
as
lec
$2.00
$
State Surcharge
$
.50
TOTAL FEE
$
O . o o
1st
I
2nd
3rd
41—h
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$4:0.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5,00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$
.50
TOTAL FEE
$
O . o o
REINSPECTION FEE
($10.00)
Job Address 1.4'" / "f 1 °" '+ y-
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
J Fridley, Mn. —I ^?_, 19
OWNER % oL
IL C4 d Al
KIND OF BUILDING (S
USED AS J/
TO BE COMPLETED ABOUT ., J ® ^ / T
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By /1C�
Tel. No.
ROUGH INSP.
Date
FINAL INSP. �
Date 'ttf���'
APPROVAL FOR PERMIT 4
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PkLOAL4
JOB ADDRESS OO LO �1N1N L,
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $ D DO representations stated in this application are true and correct.
(Side Vent — Fill Out Back) I [ — a, 11998
Gas Piping (Needed with new furnace) $10.00 $ AL
OWNER AcL s O 2
Gas Range $10.00 $
BUILDING USED AS
Gas Dryer $10.00 $ pO
ESTIMATED COST 2'00 PERMIT NO.
*Air Conditioning All Sizes $ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $ No. of Heating Units % Circle One (Steam) (Hot Water) arm Air
Trade Name TZm p STA I2.., Size No. �a
Commercial/Industrial BTU Imp, ���� HP EDR
1.25% of Value of Appliance or Work $ Fuel T— Total Connected Load
State Surcharge $ .50 Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE
RIVER CITY SHEET METAL, INC.
HEATING COMPANY joim LINNET ST. NW
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION COON RAPIDS, IVIN
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. -2.4-'l
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE FOR STA VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
RIVER CITY SHEET METAL, INC.
10105 LINNET ST. NW
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:
1.
Has been carefully examined
Yes- (+ No ( )
2.
Is free from rust or deterioration
. Yes -(V� No ( )
3.
Has no foreign objects lodged within
Yes (V� No ( )
4.
Is 'securely supported
Yes (V� No ( )
5.
Meets all current Code requirement; for size
and total BTU's connected
° 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 (V) No ( )
8.
Has combustion air been provided for water heater
Yes (')No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
RIVER CITY SHEET METAL, INC.
10105 LINNET ST. NW
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1999 �a
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
State Surcharge $ .50
TOTAL FEE $-215�--z5llo
MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Burner Trade Name
BTU
HP
Size No.
EDR.
HEATING CO ANY E i ®c Ns- E KT Ni G ;t
Signed By Y. Tel No. � 2 - AQn
cx
Approved By Rough -In Date Final Date 8 21-00
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
written permission from adjoining property owner.
JOB ADDRESS 100 J-® Ct, A GV ?A
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner -
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace
$ 30.00
$
representations stated in this application are true an correct.
(Side Vent - Fill Out Back)
,1998
Gas Piping (Needed with new furnace,
$10.00
$
but not replacement)
OWNER -A L &d
Gas Range
$10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
�v
ESTIMATED COST Z..�S� � PERMIT NO.
*Air Conditioning - All Sizes
$ 25.00
s2,5
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs $ Alterations (UST ON BACK)
f% of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/Industrial
BTU HP EDR
1.259/o of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge $ .50
TOTAL FEE $-215�--z5llo
MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Burner Trade Name
BTU
HP
Size No.
EDR.
HEATING CO ANY E i ®c Ns- E KT Ni G ;t
Signed By Y. Tel No. � 2 - AQn
cx
Approved By Rough -In Date Final Date 8 21-00
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
written permission from adjoining property owner.
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CHD INEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:
L
Has been carefully examined
Yes ()
No ( )
2.
Is free from rust or deterioration
Yes ()
No ( )
3.
Has no foreign objects lodged within
Yes ()
No (: )
4.
Is securely supported
Yes ()
No ( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()
No ( )
b
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 Being Done:
HEATING CO:
Signed By:
Date:
O
GNOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
August 9, 2000
Alroy Carlson
100 Logan Parkway NE
Fridley, MN 55432
Re: Final Inspection at 100 Logan Parkway NE
Contractor: Residential Heating and Air
Dear Mr. Carlson:
A mechanical permit was issued on June 14, 1999 for the property located at
100 Logan Parkway NE for an air conditioning unit. According to Section 305(a)
of the 1991 Uniform Mechanical Code a final inspection shall be performed on
the mechanical system. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
-1 /
pop
susJEtr
PER278477
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
IPT NO.
'REM��®
`- _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r � �
c%72-360455432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910 -FIS
9/17198
JOB ADDRESS 100 Logan Pkwy NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25
1
Oak Creek
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Alroy Carlson
574-0494
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Allstar Construction 3315 N Hwy 100 Minneapolis 55422
593-5325 3247
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house & garage (26SQ) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED 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
$2,228.00
$1.11
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 -
$74.75
Fre SC $2.23
STRUCTI0 R TME PERFORMANCE OF CONSTRUCTION
�j% ?M
PLAN CHECK FEE
TOT FEE
Lic SC $ .00
$83.09
SIGNATURE OF CON' OR OR AUTHORIZED AGENT iOATEI
EN ROP VALIDA
B G iNSP
THIS !.& k UR PERMIT
,
GATE
S-GNATUBE OF OWNER IF OWNER BU4DER1 (DATE,
-1 /
pop
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
z
ConstructionAddress:
Legal Description:
Owner Name & Address: � ��,. C Tel. # �aW 0Wd
Contractor:
Address:
MN LICENSE # 3-,r),4/%
_Tel. # 5 9.3- "z;�3S7
of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEIVIENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: �rr �L Q a � r ar �Q
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Typ Estimated Cost: $ 0E�r-----23
(Fee Sched le on Back)
Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $ _ $
DATE: —/ N8
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT Tel.
$ 5-0c)
CITY USE ONLY
Fee Schedule on Reverse Side
1 of Permit Valuation (1 / 10th %)
$3041,000 Valuation
$11000 per SAC Unit
$;.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
F50.00 Conservation Plan Review
F e Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
rAI
01,
SUBJECT
�
City of Fridley
33304
AT THE TOP OF THE TWINS
BUILDING PERMIT
�
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
1 CITY HALL FRIDLEY 55/32
i A
�;'�
L _--- J` 763-571-3450
910415
12/24/02
JOB ADDRESS 100 Logan Parkway NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
25
1
Oak Creek Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Alroy & Josephine Carlson 100 Logan Parkway NE 763-574-0494
CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Custom Remodelers Inc 474 Apollo Dr, Lino Lakes, MN 55014 651-784-2646 1748
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
D NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGE OF USE FROM TO
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. Caulk and flash all
exterior openings.
Permit Inspection Cards
Will 119 M811611
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED 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
1
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
$79296
$3.65
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECKFEE
TOTALFEE
Licee SC $5 0
$169.20
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WH P LY VALI TED THIS IS YOUR P
2MIT
B INS OAf
SIGNATURE OF OWNERJF OWNER BUILDER- IDATEI
rAI
01,
NEW ( ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 6
Legal Description:
O*ner Name & Address: Tel. # -7 b 3=6`7 c(' ®HU
Contractor:
MN LICENSE # 17
Address: S S^LV Tel. # 65-1 `'I gLf—AY- r 4
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: �' Estimated Cost: $ q e (J
YP .T--
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Fix $ _ $
DATE: ��' o did— APPLICANT: Tel. #
TT
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge $
11
TOTAL $ �.�
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
IRA
Building
BUILDING
Permit No.:�
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Da 'd:
763-502-4977 FAX
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
EFFECTIVE 1-1-08
$5.00 (State Licensed Residential Contractors)
DATE C./� YOUR E-MAIL ADDRESS
$
SITE ADDRESS a(9 �[� (l�0.C� /C/•
Curb Cut Escrow
THIS APPLICANT IS: kOWNER ❑CONTRA
ft + 6 ft = ft x $21 =$
PROPERTY OWNER/
NAME: ?i 40
$450 Conservation Plan Review
ADDRE : o CITY
STAT ZIP
TENANT
Sewer Main Charge
PHO!(.
Agreement necessary ( ) Non Necessary ( )
Total Due
NAME:
Make checks payable to: City of Fridley Attach Stipulations
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
® SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ROOF ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCEI&EPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: ?,
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES i'HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3. List of structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS
& PORCHES SUBMIT:
❑ Vinyl ❑Soffit
1. Site Plan/Survey showing the existing structures
❑Aluminum ❑Trim
and proposed project.
❑ Other ❑ Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
POSING H 417 UBCFEE SCHEDULE)
TOTAL JOB VALUATION $ �(� -� � (p® OCCUPANCY TYPE
Permit Fee
$v
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with 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 permit and work is not to start without a
permit on site; that the work will be in accor ce with the approved in the case of all drk which requl s review a d approval o ans.
SIGNATURE OF APPLICANT t.11P NT NAME Pz'S DATE4�
APPROVED BY DAT 1 G a
;_
i,
CITYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
Y9 understand that the State of Minnesota
requires that all residential building contractor , remodelers and roofers obtain a state
license unless they qualify for a specific exempti fropn the lic711�p-
requirements. As
the owner of the property at, Fridley, I
am exempt from the state licensing q iremnt only if not building or improving
this property for purposes of resale. By signi g this document, I attest to the fact that I
am improving this house for my own use and o not intend to sell it. I hereby claim to
be exempt from the state licensing requireme is because I am not in the business of
building or remodeling on speculation or for r sale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that be use I do not have a state license, I forfeit
any mechanic's lien rights to which I may oth rwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hi ng independent contractors to perform
certain aspects of the construction or improv men t of this house and I understand that
some of these contractors may be required t be licensed by the State of Minnesota. I
understand that unlicensed residential contra ting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.
Nam
Date (� `e
Building
BUILDING
Permit No.: VO qq
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
EFFECTIVE I-1-08
DATE
YOUR_1�,ILIDDRESS
SITE ADDRESS
WE
'
THIS APPLICANT IS:
OWNER ❑CONTRACTOR ,
PROPERTY OWNER/
NAME: / � '
ADDRESS: d `/CITY
STAT IP
TENANT
PHONE: _
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYNEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
P NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELING
DESCRIBE WORK BEING DONE:F.
1
L t `
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT S 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 structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS.
& PORCHES SUBMIT:
❑ Vinyl
y
[]Soffit
1. Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project.
❑ Other
❑ Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
TOTAL JOB VALUATION $ C (USG THE UBC E SCHEDULE)
�� OCCUPANCY TYPE
Permit Fee $9.�-26
See Back Page for Fee Schedule
Plan Review $ rj' • 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ l .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ H01-1 A Make checks payable to: City of Fridley Attach Sti ulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with 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 permit and work is not to start without a
permit on site; that the work will be in a d ce w0h4e aw9ved pll in the case of all work which requir r iew and oval f plans.
SIGNATURE OF APPLICAN PRINT NAME DAT>
APPROVED BY DATE
SURVIEVORA
"�l 741S WAYZATA aWlL E F 1 twMAmu.
Es A�. 1 R7 j
N
s CERTIFICATE Of SURVEY.
Foe ANDY GAWEL
L 06AN PAR/fW4Y. NI.E .
W
,, :•r sae .
22.
�}• r ..._ 2r a �
SCALE: 1650 p•5=' O�/Jtp
°
/OD, pp �-�--•w �,'; �/row s4
DESCRIPTION1- Lost 25, Block 1, OAK CREEk ADDITION
We hereby certify that this is a true and correct representation of
the botd-daries of the land above described and of the loca
-if any, thereon, and all visible encroachments, if
Dated this
14` tL,..day of October
F Ile No.j. 5855
..�aa
i
CITYOF
FRIDLEY
FRMLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIALEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
1, alw Punderstand that the State of Minnesota
requires at a I residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a specific exemption m he lice . g require
ments. As
the owner of the property at ®� o (,� _ , Fridley, I
am exempt from the state licensing re ement 6nly if I not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it.. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.
Name
Date ��
Building
BUILDING
Permit No. �-0i-5197
Irispecfions
RESIDENTIAL APPLICATION
Received By:, MA
763-572-3604
CITY OF FRIDLEY
DREMAUG 2 6 2008
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE
YO E-MAIL ADD S
SITE ADDRESS VL16ae,
e2 �
THIS APPLICANT IS: 14O R ❑CONTRACTOR
PROPERTY OWNER/
NAME:
ADDRES !V CITY
��e
STAT) ZIP
TENANT
PHON �!
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
IFSINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISHf� ROOF ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ M CE/REPAIR 4 - JrPEyPqFLrNG
DESCRIBE WORK BEING DONE: o r (,:; 11 11; �
SIZE OF IMPROVEMENT
LEN TH HEIGHT S FT
ROOFING
❑ HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
I. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List
of structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDINGADDITIONS
Vinyl
Soffit
& PORCHES SUBMIT:
1. Site
Plan/Survey showing the existing structures
99 Aluminum
Trim
and proposed project.
❑ Other
Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�(IJSTHE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ / OCCUPANCY TYPE
Permit Fee $ JCC CO- n See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ okz) .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 =$.
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Q L4 t� . -1.Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minnesota Construction Cod ; that I understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the work will be in accor w' the app ed plan in the case of all work which requir s r view a prov I of plans. Q -
SIGNATURE OF APP PRINT NAME �!� DATE&
:��c• �� : :%/moi/�y�/� - �.
Fff
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
1, 4Z w .570
understand that the State of Minnesota
requires t t all residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a tecific exemptio, fro the lice sin equirements. As
the owner of the property at, m �� e , Fridley, I
am exempt from the state licensing req rement only if I rM not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.
i
Name
Date �iG U
Building
BUILDING
Permit No.. "
Inspections
RESIDENTIAL APPLICATION
Received By:V
763-572-3604
CITY OF FRIDLEY
D %'AUG 24 2008
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE YOUR E- L ADDRESS
SITE ADDRESS
THIS APPLICANT IS: )V
WNER ❑CONTRA OR
PROPERTY OWNER/
NAME: d TJ
TENANT
ADDRESS -ON CITY %
STATV�ZIP �
PHO
N
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
19 SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHEDWINDOWS
❑ BASEMENT FINISH 11ROOF DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ADDITION
❑ MAINTENANCE/REPAIR REMODELIN
a 1
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ 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 structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS & PORCHES SUBMIT:
❑ Vinyl ❑Soffit
I . Site Plan/Survey showing the existing structures
❑ Aluminum ❑ Trim
and proposed project.
❑ Other ❑ Fascia
2. Two sets of construction plans
WINDOWS n
IN EXISTING OPENINGS ❑Yes dNo LOCATIQN OF
3. Energy Calculations
'WDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ -60 OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
-ft +6 ft= 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 permit and I acknowledge 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; that I understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the work will be in accor ante w' i the appr pla ' the case of all work which requi eview a pprov 1 of plans.
SIGNATURE OF APPLICANT PRINT NAME 6 W DATE
APPROVED BY DATE
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
-ft +6 ft= 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 permit and I acknowledge 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; that I understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the work will be in accor ante w' i the appr pla ' the case of all work which requi eview a pprov 1 of plans.
SIGNATURE OF APPLICANT PRINT NAME 6 W DATE
APPROVED BY DATE
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
G
understand that the State of Minnesota.
requires t t all residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a s ec�c exemptio o he lice n quirements. As
the owner of the property at � !� I , Fridley, I
am exempt from the state licensing re 'rement only if I not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property.