PRE 2010 DOCSCity of Fridley, Minn.
BURDING PERMIT
AddressOwner: ad 0-0, AA, Builder
Address I
LO TI OAF B NG
No. Z� Street P oP Lot
Lot — _L___� _ Block _ _ Addition or Sub -Division >
Corner Lot ��Inslde Lot . _ Setback _Nd___- Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
Used
/.�CU. Ft
112
-Front Depth Height Sq. Ft. cu. FtTM Of E�ls t.. .4 LIM he Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in complispoe"Wilp all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $� , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
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
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any tune upon violation of any of the provisions of said
Building Inspector
NOTICE:
This pwndt don not emm the contraction, lnstallatlon for wbin& plumbing, gas he*&& sewer or water. Bo sure to see
the Building Inspector for sepmft parmbs for these hone. T
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ........................... 8.00 $�
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................ 5.00 $
Repairs* Alterations each add. $500.00 ............... 2.50 $
NECK. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ p dlJ
each add. 80,000 BTU ....................... 2.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam .....
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..
8.00
$
k
$
Gas Range to 200,000 BTU ...........
Each add. 200 sq. ft. EDR Steam .......................
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal, per hour 5.00 $
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ y
GAS FITTING FEES:
NO RATE
1st 3 Fixtures ......................
x $1.50
''TOTAA�L,,
$
Additional Fixtures . ...............
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
ROUGH
� 4ow
, i
Dept. of Bldgs. Phone SU 4-7470
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn k - /'Z „ 19
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $-
Old-(!ew. uilding Permit No. "' / permit No.
DESCRIPTION OF WORK
HEATING or POWEERRPLANTS—,Steam, Hot Water, Warm Air—No
A
Trade Name_- Size No-
Capacity
o Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load ���`/ 9�/c- Kind of Fuel
BURNER. — Trade Name Size No
Capacity Sq. Ft. E.D.R,�% BTU H.P.
67
' '�BfBRI3AN
METAL
Signed U -,I l y
By MINNEAPOLIS 32, MINNESOTA i
Jaz 2M Business Phone No
(REMARKS -OVER)
r
Windows and Doors—Crackage and Area
--- -
��VJ
6
HEAT LOSS
CALCULATIONS DEPARTMENT OF BUILDINGS
' '
FRIDLEY, MINN.
Weatherstrips
Infiltration�-
A.S.H.V.E.
Guide
Construction No.
Glass
Insulation
Windows
( Doors
Reference
Out. Wall Int. Wall Ceiling Roof
Kind
How Applied
Yes—No
Yes—No
Exp. wall
19_
L�L
Net exp. wall
/ F1.I �J
Room I Length >/r/� Width % ' Height d moi)
II / FI.I _
=� Room I Lenath_9/ A Width// li Heurht 0
Windows and Doors—Crackage and Area
--- -
Width Height No. of Lineal it. Area
No. of pane of pane lights of crack sq. ft.
6
r zg
/ /i � l l/
r
' '
Coef. Btu
Coef.Btu
Infiltration�-
Glass
Btu
Glass
%
Net exp. wall
Exp. wall
Int. wall
s
Net exp. wall
p
Floor
Int. wall
Exp. wall
Ceiling
Net exp. wall
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
---
Windows rackage and Area
--- -
Width Height No. of Lineal ft. Area
No. of pane of pane llghte of crack eq. ft.
Il/ r
r zg
/ /i � l l/
r
' '
Coef. Btu
Infiltration , U
Glass
Btu
Exp. wall
Coef. Btu
Net exp. wall
r,� Lj
Int. wall
Ceiling
p
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ Fl -1 k�;,/ f.♦$oom I Lenstth-9 Vidth // ,, Heiaht
Windows and Doors—Crackage and Area
Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No4 of pane of pane lights of crack sq. ft.
Il/ r
r zg
/ /i � l l/
r
' '
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Btu
Int. wall
Coef. Btu
Ceiling
Floor
r,� Lj
I btal Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Windows an
Doors—Crackage and Area
Width Height No. of Lineal ft. I Area
No. of pane of pane lights of crack sq. ft.
.D
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Coef.
Btu
Infiltration
Coef. Btu
Net exp. wall p
D .�
Glass
Ceiling
p
Exp. wall
Exp. wall
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
/D
cJ°rja
Floor
#eaE:
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
r--
) Fl.l _0_/_ al/l/ORoom I Length A '.)Width Z v "THeight P,!
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. I Area
No. of pane of pane lights of crack sq. ft.
.D
Coef. Btu
Infiltration
Glass
v
Exp. wall Ad
Coef. Btu
Net exp. wall p
D .�
Int. wall
Ceiling
p
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area I
) FI.I Room I Length/� '�,, Width /ti �) Height G 'j
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft.
Wt No. ocfypane of pane lights of crack
Area
sq. ft
Coef. Btu
Infiltration
Glass
Exp. wall
d
Net exp. wall
Int. wall
Ceiling
/V
#eaE:
Floor
Iota[ Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area I
City of Fridley
Application for Plumbing and Gas Fitting Pere*
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... 7 x $1.50 $ 16, s a
Future Fixture Opening ................ x 1.20 $ q 0
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... x 3.25 $
Water Heater (Up to 200,000 BTL) ...... x 2.00 $ ® o
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $___L -570
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $�_sa_ZC
City of Fridley:
joO."i
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this applicg_tioij are true and correct.
Fridley,
Owner i1
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New. ding Permit No ® Permit N .
Signed z
By
Business Phone No
ROUGH
FINAL
42 2M
1943
0
7-7
pZ
6z
O5
J
(9
U'
z
t
•
WATER HTR.
U
0 a0
R
N
GAS
ELEG
�
Base
R
0
1st
l
2nd
3rd
4th
• Future Connection Openings
Connected with
e New Fixture, Old Openings
I
Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... 7 x $1.50 $ 16, s a
Future Fixture Opening ................ x 1.20 $ q 0
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... x 3.25 $
Water Heater (Up to 200,000 BTL) ...... x 2.00 $ ® o
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $___L -570
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $�_sa_ZC
City of Fridley:
joO."i
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this applicg_tioij are true and correct.
Fridley,
Owner i1
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New. ding Permit No ® Permit N .
Signed z
By
Business Phone No
ROUGH
FINAL
42 2M
1943
0
7-7
City of Fridley, Ninn.
BUILDING PERMIT
Data: iw 26, 1965
e., f.•I o='1 I -
&=dam Inc.
�'s '7563
LOCATION OF BUILDING
No. 7h20 street K@IQ Y Drive N. E. Part -of Lot
Lot 1 Block Addition or Sub -Division KelQdy Manor 2nd_ Addition
Cormer Lot — Inside Lot — Setback — Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
DMI 133 ilg— Front Depth Height Sq. Ft. Cu.. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction 's Est Co 17,000-40_ __ To be Completed
Storm Damage Repair
In consideration of the issuance to me of a permit to construct -the building described above Ito do
the proposed work in accordance with the description above set an in n ance wi ;Jl provisions of
ordinances of the city of Fridley. / /
In consideration of the payment of a fee of OWL—, permit is hereby granted toRandom Inc.
to construct the building or addition as described above. This permit is granted upon
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 put thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits andhist permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
I& pens& don sof serer fbs construction, hwhilmlon for vrir M plumbing, gn 6athM nwor or water. Be sure to as
tbs Building Ingetor for separate pwaft for tbns items.
A
APPLICATION FOR BUILDING PERNIIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
ADDRESS ADDRESS- /,
LOCATION OF BUILDING
No._ :� StreetxFa e/ Part- of Lot
LOT BLOCK _ ADDITION OR SUBDIVISION
Corner- Lot �Ins ide LOT Setback Side -Yard
c
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attac to this fo Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To b used
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
To be completed -
s
The undersigned hereby mares 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 fhis'avolication are'true'and correct.
DATE s `o
(Schedule of Fee Costs can be
found on the Reverse Side).
V , V
97-8b-879001
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIkTURE RATES: NO.
RATE
TOTAL
:'=.!: r Fixtures
Y.
$3.00
$
ca=•_re Fixture Opening
M
b,
$
Water
x
m
m
Catch Basin
x
$5.00
►+
c+
m
A
$
. 4i
++
ri
_.
w
$
Water Softener
Beater
$7.00
$
New Ground Ran Old Building
x
$5.00
$
Electric Water Heater
X
$4
$
Hros+
a
0
••+
x
c c
38
-�o
C
u
Ms
w
n
.,
ro
s+0 0
.c
.•+
1
ro ro
o ro
c
m
U
u
�
m
12v�
3
�.
w
w
� w
a 3
c�
o
as
• lec
i1st
ry
r
�2:3!
Brd
I
(ai = Future Connection Opening
Connected with Sewer
(*i m New -Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIkTURE RATES: NO.
RATE
TOTAL
:'=.!: r Fixtures
Y.
$3.00
$
ca=•_re Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
:cater Heater— .to 99,000 BTU
X
$5.00
$
200,003 B_J to 199,000 BTU
x
$10.00
$
Water Softener
X
$7.00
$
New Ground Ran 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 $
Cas Range to 199,000 BTU x $10.00 $
REPAIRS & ALTERATIONS
First $100.00 $5.00 S
each add. $100.00 or fraction $2.00 $
State Surcharge S .50
TOTAL FIX $ 8.00
REINSPECTION FEE
($$10.00)
Job Address 71120 NE Melody Curve
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
tho facts and reprosentations statod in this application are.true and ocrrect
Fridley, Mn. 12-22-80 19
01WNER
KIND OF BUILDING fraena
USED AS res.
12-29-80
TO BE COMPLETED ABOUT
ESTIMATED COST 50.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO. Rq9 l
Company
MINNEGASCO
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. 10r;
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERf4IT IS $7.50 PLUS $.50 STATE SUR=. -CE
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE
SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
New Fixtures
$ 5.00
Future Fixtures
$ 3.50
Old Opening, New Fixture
a
Beer Dispenser
Water
$ 4.00
Slow Off Basin
$ 5.00
Catch Basin
$ 5.00
C
e
$ 5.00
e
u w
$ 5.00
W
a
$ 5.00
Heater
$ 7.00
Not Water Heater
$ 5.00
Gas Range
$ 10.00
Gas Dryer
$ 10.00
ALL OTHERS AND/OR REPAIRS AND
ALTERATIONS
It of Value of Fixture or Appliance
State Surcharge
a4
U)
.oi U
j�p
O
OII
�vyi
00
N
3
Q W
3
C7
C7
O
leC
1st
2nd
3rd
4th
Li
Lit
(R) - Future Connection Opening
Connected with Sewer
(*) . New Fixture, Old Opening
Water
RATE
SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
New Fixtures
$ 5.00
Future Fixtures
$ 3.50
Old Opening, New Fixture
$ 1.50
Beer Dispenser
$ 4.00
Slow Off Basin
$ 5.00
Catch Basin
$ 5.00
Rain Water Leader
$ 5.00
Hydraulic Valve
$ 5.00
Sump or Receiving Tank
$ 5.00
Water Treating Appliance
$ 7.00
Not Water Heater
$ 5.00
Gas Range
$ 10.00
Gas Dryer
$ 10.00
ALL OTHERS AND/OR REPAIRS AND
ALTERATIONS
It of Value of Fixture or Appliance
State Surcharge
Reinspection Fee $
($15.00)
TOTAL
FEE
TOTAL
S
Job Address •/ ° op y � l
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
Fridley, Mn. IJ � . 19�
OWNER aL• P r at) I H F✓ //jh 1Y Al
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT IL ol C ®®
ESTIMATED COST Q
OLD - NEW BUILDING PERMIT NO. PERMIT NO. C9 fn
ROUGH INSP.
Date
FINAL INSP. / q -�
Date /
APPROVAL FOR PERMIT �[
MINIMUA-4 FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
unroF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
November 21, 1990
Johanna Gunnemann
7420 Melody Drive N.E.
Fridley, MN 55432
RE: Property at 7420 Melody Drive N.E.
Dear Ms. Gunnemann:
A recent inspection revealed that the trees along the north side
of your property appear to be creating a visual obstruction at the
intersection of Melody Drive/Ballet Boulevard. Although these
trees are not near the intersection itself, they restrict a clear
sight path for motorists northbound on Melody Drive looking west
on Ballet Boulevard.
Please trim these trees to eliminate this visual obstruction. I
will be reinspecting on or shortly after December 10, 1990, at
which time compliance is expected. Feel free to call me at 572-
3595 if you have questions or wish to discuss this further. I
would be happy to meet with you at your residence to further
examine and discuss this problem. Thanks for your cooperation!
Sincerely,
Steven Barg
Planning Assistant
SB:ls
C-90-1056
Are
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
December 7, 1990
Johanna Gunnemann
7420 Melody Drive N.E.
Fridley, MN 55432
RE: Vision Safety at Melody Drive/Ballet Boulevard
Dear Ms. Gunnemann:
This letter is to confirm the information which we discussed when
we met at your residence on December 5, 1990. At that time, I
instructed you to remove the lower branches of the trees closest
to Melody Drive, and I granted you an extension until January 7,
1990, to complete this work.
I will reinspect this property on or shortly after January 7, 1990,
at which time compliance i -s expected. Please call me at 572-3595
if you have questions or wish to discuss this further. Thanks for
your cooperation!
Sincerely,
Steven Barg
Planning Assistant
SB:ls
C-90-1083
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
PERMIT
17440
r
' • ______ COMMUNITY DEVELOPMENT DIV.
r L PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
612-571-3450
NO.
D
57
NUMBER
910-F15
REV
DATE
8/27/98
PAGE OF
APPROVED BY
JOB ADDRESS
7420 Mel dv Drive NE
1 LEGAL
DESCR.
LOT NO.
1
BLOCK
4
TRACT OR ADDITION
IMelodyManor, 2nd Addition
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Michael Fitzgerald
717-2063
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
America Building Contr. Inc.
-
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 CRX REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (27 S Tear -off
8 CHANGE OF USE FROM 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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
MOT.
CU. FT.
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
1 HEREBY CERTIFY THAT 1 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 HEREIN OR NOT. THE GRANTING OF A PERMIT
2251
$1.12
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.
$74.75
Fire SC $2.25
PLAN CHECK FEE
TOTAL FEE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
EN ROP
B G INSP
VALID THISIS y,QUR PERMIT
LATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
ELI
AUG -25-1998
•.••• l J
G DN t ]
ALAR
ConstructionAddress:
Legal Description:
09:16 FROM CITY OF FRIDLEY TO
Owner Name & Address:
V
Contractor: XM PH r,
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMMY AND DUPLEXES R-1 AND R-2
BUILDING PERNUT APPLICATION
7079925 P.01✓02
trlect:ve w/98
�b
0_
G1 Tel. #
MN LICENSE # bl
A V . L3_33 i'/ Tel. # 7_07-6
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length width Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $ _
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT:
Tel. #
TOTAL $
. � 3 - 12
STIPULATIONS:
CITY USE ONLY
Permit Fee
L ,
$ 7 q
Fee Schedule on Reverse Side
Fire Surcharge
$ ,� .
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.501$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
_License Surcharge
$ 00
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary j ]
TOTAL $
. � 3 - 12
STIPULATIONS:
Building
BUILDING
DD �00 � 1997
UBC FEE SCHEDULE)
Permit No.: $
Inspections
RESIDENTIAL APPLICATION
Permit Fee
Received B
763-572-3604
See Back Page for Fee Schedule
Plan Review
$
i
Fire Surcharge
$
CITY OF FRMLEY
.001 times the total job valuation
Surcharge
Date Re
763-502-4977 FAX
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
,!F.06
$5.00 (State Licensed Residential Contractors)
SAC Charge
EFFECTIVE 1-1-08
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
f ' U G
ft + 6 ft = ft x $21= $
DATE 1
% YOUR -MAIL ADDRESS
$450 Conservation Plan Review
SITEADDRESS ao '
$
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
$
PROPERTY OWNER/
NAME:
$
/ 0 . ;T
TENANT
ADDRESS: CITY
STATIMn-ZIP SS3 a
PHONE. -?&-5-7/7— 'J 4/
NAME:
CONTRACTOR
ADDRESS:
CITY
TATjZIPSSoI
SUBMIT A COPY OF
PHONE r' .2 FAX
YOUR STATE LICENSE
SPATE LICENSE # EXP DATE
PROPERTY TYPE
SINGLE FAMILY N SIZE
❑ TWO FAMILYMEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
WS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: Ai L
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT S FT
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
EASEMENT
REM
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:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit ' �t C LR. �' j2,k .. ,
ADDITIONS
& PORCHES SUBMIT:
❑ Aluminum
❑ Trim Z —
1.
Site Plan/Survey showing the existing snuctures
❑ Other
❑ Fascia
a d -• uil 2 w
2.
and proposed project
Two sets of construction plans
WINDOWS
IN EXISTING OPENINGS;6Yes ❑No LOCATION OF WINDOWS U
3.
Energy Calculations
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:
DD �00 � 1997
UBC FEE SCHEDULE)
TOTAL JOB VALUATION $
�`
OCCUPANCY TYPE
Permit Fee
$
`j 7.
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
41.4.6
.001 times the total job valuation
Surcharge
$
'2' 06
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
,!F.06
$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
$
/ 0 . ;T
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 info ion above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and •th the Minn to Construction Codes; I understand this is not a permit but only an application fo a permit and work is not to start without a
permit on site; that the wo . will be in= cc with the appro Ian in the case of all work which requires ew an f p
SIGNATURE OF P ICANT PRINT NAME DATLO
t� �' !!�I
I']