PRE 2010 DOCSCity of Fridley, Minn.
WELDING PERMIT 11T° 3 5 7 8
Date: ... ..... �... �... .....- . ...... ..... ....... .
Owner ........................................ Builder?'s' ✓ ......
Address...................................... Address .............................................
LOCATION OF BUILDING
No. . c .... street.... . . ..... Part of Lot .... ..
Lot ....... Block .... ............A dation or Sub -Division
Corner Lot ..A ........ Inside Lot ............ Setback,?C—. "O .... Sideyard '.
DESCRIPTION OF BUILDING
To Us as:
g /' a/ d� p of /� g %,�' d ` q 1946 / "ir ►
Front De th 6 Hei ht S Ft. .. .. Cu. Ft.
...... ... Front .1 ..� a Depth ''�'? . Height ®..o V Sq. Ft. -1171. Cu. Ft.,!F 0! 4? V
Type of Construction ................... FAt Cost.. ��. ��' ...... To be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
X
....................................................
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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. i _
! ' Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
,:;2 �F'u a
City of Fridley, Minn. N° 8126
BUILDING PERMIT
Date: July 6, 1965
Owner: LaRue H. Cooke Builder Zuehlke Construction Co.
Address 716 Mississippi Street N. E. Address 6495 MUMMA Pierce St. N. E.
LOCATION OF BUILDING
No. 716 street Nississippi Street N. E. Part of Lot
Lot 2 _ Block 1 Addition or Sub -Division . Christie Addition
on
on orae
Corner Lot _ Inside Lot g Setback_ Sideyard ig'l l
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Oris. Home Front 62! Mu Depth9,At&36t Height _ _ 81 Sq. Ft. Cu. Ft
Att. Garage Front Depth - Height Sq. Ft Cu. Ft.
Type of Construction Frame Est Cost 44,9000-00 To be Completed
Orig. Home, Att. Gar. New add. 14 x 27 * 378 Sq. feet
r, & j, -, � / "� , "L e, L, 7
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 compliance with all provisions of
ordinances of the city of Fridley. &
44-A 9.
In consideration of the payment of a fee of $ 10 *00 , permit is hereby granted to Robert B. Zuehlke
to construct the building or addition as described above. This permit is granted upon
the eupress condition that theSbull
done in, around and upon saiFridley,Mina�ota within thedty ]imits�t may be revoked at any time upon violation of aay of the provisions of said
ordinancce.
Allen Jensen
NOTICE
Uh pemb don no eowr the cons racHonr tastaMen for whtng, plumbing, an hsafte, sewer or water. Be sure to me
the Building hupsetor for separate pwmhs for thus hams.
Date:
July 6, 1965
City of Fridley, Mian..
BUILDING PERMIT
Owner: LaRue H. Cooke
Address 716 Mississippi St. N. E.
-Py70'6
N° 8127
Builder Zuehlke Construction Co.
Address 6195 Pierce St. N. E.
LOCATION OF BUILDING
No. 716 Street Mississippi Street N. E. Part of Lot
Lot 2 _ Block 1 Addition or Sub -Division Christie Addition
3�1Corner Lot _ Inside Lot _ _ Setback 351 Sideyard oan
n aR'a e
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Att. Gar. Rebuild Front Depth Height Sq. Ft. Cu.. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost �__,:_020!00 _ To be Completed
includine house
Att. Gar. Rebuild
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 compliance with a'll provisions of
ordinances of the city of Fridley. 1/) // ,q "? 15pJ _ q/j
In consideration of the payment of a fee of $k.00 ,permit is he granted to Robert Zuehlke
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= 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 t� permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen Jensen Building Inspector
NOTICE:
Ibis poendt deft not eoror t6 eondMC110n, bntai6Mion for Whb& phmbing, on 6fttbig, ftwa or waist. Bo n to fto
the Bsilding bnpaater for ftpwr pwmih for t6fts Nona.
.APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME CAtiU1 BUILDER7/7
ADDRESS r ADDRESS _ XYFS- ece o
'LOCATION OF BUILDING
No. , Street ' t Fart of Lots_
Lot All, Block -Addition or Subdivision
/�.� ✓�
Corner Lot Inside Lot' i( Setback 3 S Side Yard.; 3gi .�,, �
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed`build-
ing. location.drawn on`these.Certificates.
DESCRIPTION OF BUILDING
To be used as: %
Front Depths �� Height
sq. Ft. Cu. Ft,
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction �� Estimated Cost 0406116 Gid
To be Completedc
The undersigned hereby'makes" application fora 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 trues and correct.
DATE 6 9 6 SIGNATURE
a
thecverse Side .
. a
(Schedule of Fee Costs
City of Fridley,
SUBJECT
P �=
AT THE TOP OF THE TWINS
BUILDING
PERMIT
4
r
`
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC'
r 1
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
10/21/94
JOB ADDRESS 716 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Christie Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Larry Rindels 716 Mississippi Street NE
574-1576
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 p
❑ NEW ❑ ADDITION El ALTERATION X REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (26 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd
.
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
SQ. 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
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,430
$.72
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-
Fire SC $1.43
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$35.00
PLAN CHECK FEE
TOTAL FEE
$37.15
SIGNATURE OF CONTRACTOR OR ITHOR12EDAGENT (DATEI
WHEN PROPERLY ALL�IAADATT�ED THIS IS YOUR P�^EERRMIT
81 DG fINSP
MATE
SiGNA RE F OW NER OF OWNER BUILDER) iDATEi
NEW [ ] Effective 1/1/94
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: A, S J
Legal Description:
Owner Name & Address: �/�/�' �/ ��"L -� Tel. #
T
Contractor: MN LICENSE #
Address: Tel # .
Attach to th*s application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width, Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: jp APPLICANT: ���� ��j Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$S Fee Schedule on Reverse Side
$ /. ..001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $800 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 [ ]
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
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Approved ByZL, Rough—In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
JOB ADDRESS (P l l SS 1 S I
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 Fumace
$ 30.00
$ ��
representations stated in this application are true and correct.
(Side Vent —Fill Out Back)
— 2 —,t ,
Gas Piping (Needed with new furnace)
$10.00
$
Lccx- r
OWNER
Gas Range
$10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
0 5ERMIT 3 W(�
ESTIMATED COST NO. /
*Air Conditioning — All Sizes
$ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (UST ON BACK)
1% of Volue pf Appliance or,Work
$
No.'of Heating Units Circle One (Steam) (Hot Water)
Trade Name Size No.3%3 D a -(a q
Commercial/Industrial
BTU 0 HP EDR
1.25° of Value ofA•ppllance or Work
$
Fuel C=> • Total Connected Load
State Surcharge
$ .50
Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE
$
BLAINE HTG. R,C ELECT., os
13552 CENTRAL AVE. N.E.
A
HEATING GOAPANX. 1\ � AL PSN 563e4
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Approved ByZL, Rough—In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
BLAINE HTG. A,C ELECT., [NO
M
CHMNEY 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 ( No
( )
3.
Has no foreign objects lodged within
Yes (pQ) No
1
( )
4.
Is securely supported
Yes No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (�o
( )
6
Has total heating BTU's of �<6
-"All'-6ther BTU's (D
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:
BLAINE HTG. A,C ELECT., [NO
M
Building
Inspections
7.63-572-3604
DATE
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
0 OWNER , bk�dNTRACTOR
Permit No.:
Received By:
Date Rec'd: � ? I
ADDRESS CITY STATE ZIP
PHONE:
COMPANY NAME:_
CONTACT PERSON:
STATE LICENSE Il n°PG(���%'�
ADDRESS: _ _ _ STATE ZIP
PHONE FAX
I)IMULE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
❑ NEW ❑ REPLACEMENT )tM,TERATION/REMODEL
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
improvement, installation or replacement of a residential fixture, excluding the f>attttres. (This should reflect only the cost of labor)
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) �(/}Sjt/6UG MODEL: (.� �C j17AW SIZE/BTU
MFG:
Equipment Installed MF(MFGIZE/BTU SMODEL:
MFG. MODEL:
SIZEBT'IJ
A/C $25.00 _FIREPLACE (GAS) $15.00. . GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL 00
_BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $100.0.0 0
_CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00
11,u1�S�:�r".'srr ,3a✓rruycyr-aa;a�x..:
Number of fixtures @ $10.00 x $10.00 =
.a.> ..Y..:.-.•,.,... _;�.r,.-: ..r.: _.,:, _.._.,:..,,...._ _.. ._._ _ .. __.
Permit Fee $
Surcharge $ 50 Number of fixtures @ $15.00 ,� x $15.00 = $ /. . DU
TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State.Surcharge = $ .50
Total = $ /K'. Co
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. // /
SIGNATURE OF APPLICANT ' � PRINT NAME f� its -DATE (�—l10 "_P1 o
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropanoUGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a_ Gas appliances 1FGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction TMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603 .2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
Building
BUILDING
Permit No.: o0 - 7f%
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
DaA MAY -14 200;
CITY OF FRIDLEY
DATE L 1 1 �v�
YOUR E-MAIL_DDRESS bi sarsaw `
CQOY 1
SITE ADDRESS
Yr 5 S i SSi j e
��
THIS APPLICANT IS:
❑ OWNER ONTRACTtOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: CITY
STATE_ZIP
t r / -
PHONE.�G5 — S�`I ^ S� 1p
NAME: Renewal By Andersen
CONTRACTOR
SUBMIT A COPY OF
STATE LICENSE # 1920 County Road "C" West
YOUR STATE LICENSE
ADDRESS: Roseville, NIN 55113
STATE ZIP
WITH APPLICATION
PHONE
❑ SINGLE FAMILY/NFLicense #2 0130983
PROPERTY TYPE
❑ TWO FAMILY/NEW C 651-264-4777
❑ ADDITION ❑ GARAGE/SHED INDOWS
PERMIT TYPE
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: I
❑ NEW ❑ ADDITION
NTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
j rcvo
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGH Sq. 14.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS_
& PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structure
❑ Other
❑ Fascia
and proposed project
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
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:
(USING T TOTAL JOB VALUATION $ j a , `t aa' U.B.0 FEE OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ j .001 times the total job valuation
Surcharge $ (D ,a \ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1550 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 Fridlev Attach Stioulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I ackn wledge that the information above is complete and accurate; that the work will bet
conformance with the ordinances d codes of th 'ty of Fridley and with the Minnesota Construction Codes; that I understand this is not
permit but only an application r a permit and is not to start without a permit; that the work will be in accordance with the approve(
plan in the case of all work wh' epfii es, reA approval of plans_ /
SIGNATURE OF APPLICANT
Building
BUILDING
Permit No.:00
Inspections
RESIDENTIAL APPLICATION
Received By:. °
763-572-3604
$
CITY OF FRIDLEY
'off
$
DATE
ADDRESTHIS
ZE-MAILADPUSSSITE
APPLICANT IS:
❑ 0 COCTOR
PROPERTY OWNER/
TENANT
ADD S: CITY
—STATE—ZIP-
TATEZIPPHONE:
PHONE:2A. VAL. 15261
CONTRACTOR
NAME. �
SUBMIT A COPY OF
STATE LICENSE # A /73 EXP DATE 3 ..4/ 0
YOUR STATE LICENSE
ADDRESS: SS•SB L� iN-e-- CITY STATE ZIP 5531,
WITH APPLICATION
PHONE qSZ • 935 ' gtp4, 9 FAX -?SZ-,?–R5- 9$1fq
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
Q ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ F ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ ❑ ADDITION
AIR Cl REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq - Ft
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Pian
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIWNG
FOR NEW CONSTRUCTION
INCLUDING DECKS,
grVinyl ❑Soffit
❑ Aluminum ll lliim
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
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:
(USING THE 1997 UAC FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
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)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridley Attac
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 p it 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 r irewev' w da�vof ans.kS
SIGNATURE OF APPLICANT T NAME >i/�/, V DATE—V/
$
G�
$
$
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)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridley Attac
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 p it 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 r irewev' w da�vof ans.kS
SIGNATURE OF APPLICANT T NAME >i/�/, V DATE—V/