PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 7131
LOCATIOI�'OF UNG
No. Street Part of Lot
Lot ��—__ Block Addition or Sub Division
Corner Lot Inside Lot Setback -- � _ _ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
Used I
Mill
I
Front Depth s Height ,J. Sq. Ft. Cu. FtJl,"
n Depth f eight b Sq. Ft. Cu. FA
Type of coon 967 Est. __ To be Completed
In consideration of the issuance to me of a permit to c
the proposed work in accordance with the description above
ordinances of the city of Fridley.
In consideration of the payment of a fee of $-0,
—.�' ,
7 above, I agree to do
with all provisions of
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 time upon violation of any of the provisions of said
ordinances. n
Building Inspector
NOTICE.
Thh permk does not cover the construetion, lm taWon for wl&& plumbing, on henttng, w war or water. Be cure to an
the Wding Impeder for seperab perm8s for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY., 14012j2ZOTA
Twner Is „ Builder -,e-
Address Address
No.
Lot
Corner Lo'G LnS3.ae .LOZ V .7ieZQaCK cJ _71ae-rata ,-o —u
LOCATION OF BUILDING
SEWER BLEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To *. asr
00,
Type of
To be Co:
DESCRIPTION OF BUILDING
Sq. Ft. , /o_ry Cu. no
1_ 4 2n nen+l, -:24, r) ue4 EPU+
Sq. Ft. �/S — 6 Cu. Ft.
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 a the facts and reproentations
stated in this applicotion ape true and correct. "y
DATE --% % A�41— SIGNAT
(A Schedule of Fee Costs can be found on the Reverse Side.)
Land f'lonn;rr
� CI
Soits IPS%ll)] r 9 era
l./V�l ti Alt/ns.p.71 tJr�,•' :,'..J.•�+
a -" Jrve� p 6p r <
��
C'r9 �.+., , l✓r.�+r -a r..:�4:uv 4....� L:✓".� '.�.,:.� ` t !�'i rLa e.V b a a .' }-,s� oaf a
�� � 2. FiP9} Cleor ¢1• 1.5 ,F-':, oC.eve C� ou�Ac1
�1
.;,� how 5.. Corv�ew5
NOTF-
3�. 37r ., 5,`,° 'may ✓J` �� i_..
L °o / l -k'. -I 275".
/ "/_
f
O J--Ii:No-r s IRON DF-110TE 5 DRAINAGE 4 UTILITY
(1:11nokct Coun4Y — Mirinq-c-,a •o)
;'!yc'Z/ ccrh y .Mai this is a Prue and carred-epresenb k,7 o�a sbrvey elhe hwndrrles q'¢hc abo r dcu bed 'and, aad
and a!/ risrb/e wamc irnrn¢t , i! e. , frau or a7 soid /ate! As surveyed by tet® flus _ �c7
April A.9I5 62.
SU5 UP SAN LrMC71 dEE1?IN6 ,. INC.
L-noincer-•s 6 surraprs
SCALE 1-= 30'
- ' N
1705 -CI _
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
07
I
Y F
t6ji
QC Z
Z
O
w
go
U' K
?
� n
U' O
•
P
•
N
WATER HTR.
GAS
ELEC.
Base
1st
2nd
3rd
_
4th
• Future Connection Openings
* New Fixture, Old Openings
I
Connected with
Sewer �
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................7 x $1.50 $T
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ g.2s
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ A•S®
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
� REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $-.L6-- -,4"a
City of Fridley:
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 application are true and correct.
Fridley, Minn—
Owner
inn Owner 0`/�
Kind of Building �-
� e
Used as
To be completed about
Estimated Cost, $ '/. �®®
Oluilding Permit No d Permit
Signed
By
Business Pho
ROUGH
FINAL
.031�0.42 2M
Application for Power Plants and Healing, 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 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
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. EDR Steam .....
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
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 $
GAS FITTING FEES:
1st 3 Fixtures ......................
Additional Fixtures ...............
Gas Range to 200,000 BTU ...........
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
NO RATE TOTAL
_ x $1.50 $
x .50 $
_ x 2.00 $
See Fee Schedule
TOTAL FEE
Dept. of Bldgs. Phone SU 4-7470
�Z / -
City of Fridley: U
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 Prue and correct.
Fridley, Minn � "� � 19 L
Owner
Kind of Building 5; ,
e
Used as
To be completed about aa �Z ,
Estimated Cost, $ �.
Old New. Building Permit No. e3 Z Permit No. % �)
DESCRIPTION OF WORK
HEATING or POWER PLANTS—.Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
SigneRAY N . WE LTE R HEATING CO
4637 CHICAGO AVE.
By
0
42 2M Business Phone No
Application for Power Plants and Healing. 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 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
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. EDR Steam .....
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..
8.00
$
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 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $1.50 $ ✓
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
FINAL
Dept. of Bldgs. Phone SU 4-7470
0Z
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 ar true and correct.
FrrAley, Minn f a / 19
11
Owner _1.19 —
Kind of Building
� � e
Used as
To be completed about w 4 L z' 61./ '
/ p "
Estimated Cost, $ 42e�
OldCNew!)Building Permit No. Permit No. --A-
DESCRIPTION OF WORK
HEATING or WER PLANTS—Steam, Ho%t;W�a Warm Air N//o / /�
Trade Name A_4_ � Size No- hy /,
CapacitySq. Ft. E.D. RrB� �d� BTU H.P.
Total Connected Load U Kind of Fuel.
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
S N.WELTER HEATING CO.
4637 CHICAGO AVE.
uiNNrwpe s !7, w�NEserw
By�TQ,7 eco-T-64i�r:. _ �,� � . ��.
4 Z 2M Business Phone No
Date:
&y z6, 1965
City of Fridley, Minn. NO. 7562
BUR DING PERMIT
Owner: R. Mathisen Builder Dawn Const. Inc.
Address _7'.36]. Xamaz7 Tana Address 2W Webster Ave.
LOCATION OF BUILDING
No. 7361 Street Memory Lane Nt E, Part of Lot
Lot 1 Block 1 Addition or Sub -Division MelodyiOT 2nd. Add.
Corner Lot _ Inside Lot
Setback
Sideyard
Sewer Mevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. cu. Ft.
Type of Construction Est. Cost -a L�00 _ To be Completed
Stow Ramage Repair
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 conUWance with 21 provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $-I=—, permit is hereby granted to Dawn Constanes
to construct the building or addition as described above. This permit is granted upon
Ltbny
sricity limits and this permit may be revoked at any time upon violation of any of the Provisions of said
Building Inspector
NOTICE
Uh peen@ die: not eoner the coestruetion, hnatallatlon for t AWm plumbing, gas heatho sewer or water. Be sins to ae
the BWMIng hapeetar for apmft permhs for thea isms.
0
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MIIJNBSOTA
OWNER'S NAME `
ADDRESS_%VG/ tI4WO/ 4 kh)vZ-- ADDRESS 4l'W2��l Z_ -7R '
LOCATION OF BUILDING
No. StreetX/" dpi blwl� .,f, Lftrt.. of Lot
LOT BLOCK ADDITION OR SUBDIVISION X14',,& ,
Corner Lot 'Inside LOT_ Setback Side -Yard
SEWER ELEVATION FOUNDATIOR ELEVATION.
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as:
DESCRIPTION OF:BUILDING
Front Dept h Height,
Sq. Ft. Cu. Ft,
Front Depth Height
Sq, Ft. Cu. Ft.
Type of Construct ion_5_ fM/77 Estimated Cosec �
To be completed
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.
021.r -L - s
(Schedule of Fee Costs can be found on t e lievers
r �,
SUBJECT
City of Fridley
r,rn
7 010
AT THE TOP OF THE TWINS
BUILDING PERMIT/
r
`
l
REC-E T NO.
_ COMMUNITY DEVELOPMENT DIV.D
PROTECTIVE INSPECTION SEC.41
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
8/3/98
JOB ADDRESS 7361 Memory Ln
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
1
Melody Manor, 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ron Scherye 784-1659
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Midwest Roofing, Siding, & Windows 18979 Gladstone Blyd Maple Grnva 99311
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
416-4804 20010277
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION RX REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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. 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1918
.96
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.
$62.25
Fire SC $1.92
PLAN CHECK FEE
TOTALFEE
License SC 5.00
70.13
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN FIR QPERLY 1DAATTEED THIS IS YOUR PERMIT
�
4J ryATE
-BL INSP P
SIGNATURE OF OWNER OF OWNER BUILDER( IDATEI
_.EES --25--1997 14-"125
NEWt
A ON' f
ALTMt[ 4
CITY UF 1-;KIU F-
MY OF M D1SY
SINGLE FA MMY ANO iD UMA R -t AND R-2
BENT GING F UCA'1 LOON
ccmumamwAm c= . 73 (D i
Iaa1 Dwedption:
Ln
baid V n �:+wr r.t0a••1ffs�
EM-etive 1/j/97
VO AL
w ti,J'ii 1:. f
62-a an &VOM 3w
"c" int
$5.00 +(tte Mmind RoMeadal Cmnwwa)
Alt. "A" or AIL "B" Above
�. • AOD ' n Plan Rem
$ r by
..
$� A tmd N _ `_-_r%i Not Necesmy
�Y ® —12
'OLA'110.24S: /11
Building
MECHANICAL
PemutNo.- 7
Inspections
RESIDENTIAL APPLICATION
Rmeeiive�dBy:
20 7
Dat eMPR12
763-572-360
CITY OF FRIDLEY
DATE 0 C>-1 YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER CO CTOR
NAME: l9 ��
PROPERTY
OWNER/
ADDRESS: CITY / ST ZIP
TENANT-�
PHONE:
CONTRACTOR
COMPANY NAME;__
_
CONTACT PERS(! : L 410 WEST
SUBMIT A COPY OF
MN 55408LICENSE
029�214-
YOUR STATE
STATE LICENSE Ii
STATE ZIP
WITH
ADDRESS:
APPLICATION
PHONE FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
❑ NEW INVLACEMENT ❑ ALTERATION/REMODEL
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
fixtures. (This should reflect only the cost of labor)
improvement, installation or replacement of a residential fixture, excluding the
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X .05
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) SIZFJBTU
Equipment imWied MFG: MODEL:
SIZFJBTU
MFG: MODEL:
MFG: MODEL: SIZE/BTU
�&C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
NEW GAS GRILL $10.00
_AIR TO AIR EXCHANGEER $15—FIItEPLACE (WOOD) $35.00
$35.00 GAS UNIT HTR $10.00
_BOILER $35.00 _FURNACE
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
PIPING $10.00 VENTILATOR $15.00
DUCT WORK $10.00 GAS
Permit Fee $ 146fter of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00= $
$ Number of fixtures @ $25.00 x $25.00 = $�
TOTAL DUE
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Total =
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 C' of Fridley and with the NImnesota Construction Codes; that I understand this is
the
not a permit but only an appli '. ' n for a permit w its not to start without a permit; that the work will be in accordance with
approved plan in the case of w evi and approval of ans. 114-0�
�/Yl
V ATE
SIGNATURE OF.
City of Fridley
Building Inspections 1}eparttnent
6431 University Avenue NE, Fridley,. MN 55432
763-572-3604
FAX: 763-502-4977
L'r�_W1 ,
Building
0 UUUUYAINUY '1'YYE
BUILDING
$ 11, 9.2
Permit NO.:
Inspections
$
RESIDENTIAL APPLICATION
Fire Surcharge
Received By:
763-572-3604CITY
Surcharge
OF FRIDLEY
.0005 x Permit Valuation Minimum $.50
D'F F R 1 2008
DATE �� -��
YOUR E-MAIL ADDRESS J,?_an A Q JW S 1,4fytod
eel f .Ceram
SITE ADDRESS 1�& I
M ffifi r A M A)
Curb Cut Escrow
THIS APPLICANT IS:
❑ OWNER I6ONTRACTOR
Erosion Control
PROPERTY OWNER/
NAME: .&n + 6a.'Q r r i 'S h e v v -P
Park Fee
TENANT
ADDRESS:151olPIMOYL4 Iry NF CTI'Y Ad lfN STAT L IP2_
Sewer Main Charge
PHONE:1 1017D1 S � 110, "Cf
Agreement necessary ( ) Non Necessary ( )
CONTRACTOR
NAME:`rh Q W I ndou, 15�o rf LLC
Make checks uavable to: Citv of Fridlev Attach Stinulations
1
STATE LICENSE #:1,01, S -q s° EXP DATE ?� -7j 1- 0 8i
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:q a o -1 S . <ho r --e (1, Ire 3 u � �CITY
STATI IP SSi1q
WITH APPLICATION
PHONE U FAX
PROPERTY TYPE
WINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED DKVINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEw ❑ ADDITION
❑ MAINTENANCE/REPAIR 04EMODELING
DESCRIBE WORK BEING DONE: rCJt*JrJ 119I rTJ 1)1 hrJe)1,t 9 I nS2 f +5
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ATTACHED GARAGE
1.
2.
Existing Floor Plan
proposed floor plan
PROPOSED SIZE:
11 DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS Wes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF 2GQ Ydo Wt
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS 1
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TU'1'AL JOB VALUATION $ —1 OC70. 0
0 UUUUYAINUY '1'YYE
Permit Fee
$ 11, 9.2
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 1 Z) 0
.001 times the total job valuation
Surcharge
$ 23 15 0
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ 5',G 0
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 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
$ I,!; U -1 S
Make checks uavable to: Citv of Fridlev Attach Stinulations
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; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans. L!!
A
SIGNATURE OF APPLICANT lJ" � PRINT NAMEA� �� Ol C,$ t) P 1 S n DATE�i I L!! I o a