PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT
Date: ...... .....:::_. ..._._.... _...........................
Owner: ... ..... ... ::..er ................. _ .._ y ....._._._...._._... _..._..__.......
Address "". _.: .... '.. _ _. .... ...__.....__......._.
�... .�' _ .. � Address ...--•--.....,,.: ... ......
r t6 a.r►� w r ioa
No. ..... .._°... Street ... d. _..._.... _ ...........
Lot ........... .. .............: Block .- _ .......:... ......._......._........ Addition or Sub
Corner Lot ..... . ................... _........ Inside Lot .---------------------------------- Setback
SewerElevation ..... ....................... _..................._............._......._............._.......;.:.... Founda
Part of Lot ....._.....-.
.:. ....... _._...:.. f.:f
L.................... Sideyard .. e�............. .............. -....... ..... -----------
Elevation................................... ........... ................................ .............. _..
DESCRIPTION OF B
ILDING
To ---- Height Useda1s: f
I
�. ?`, ._:::....:....... Front ...-� Depth .. .. g
}
�? ...:._....... Sq. Ft. Cu. F 26. �
- -------_._.... .........- ....... _.............. Front ........................ Depth ........---.......jelght-
_....Sq. Ft......_................. Cu. Ft......_.......
Type of Constructio . .:. " , . ,Est. Co ..,. :.
............... To be Completed ..... _............. _............. _.......
In consideration of the issuance to me of a permit to cons
ct 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.
.........
.............. __...__....... _ _._._ _._.._.._...r.._._..._..._ ........__....._....
1pa
...
In consideration of the payment of a fee of $.cam/ _. ' permit
is hereby granted to. .... _............. .............. _....................... ..
_. _.___._.--••--•---.._..._..._..._....._........ to constructthe building or addition
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, sh
Fridley, Minnesota regarding location, construction, alteration,
conform in all respects to the ordinances of
maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any
ordinances.
e upon 'olatioi o any of the provisions of said
_
_ ..... .. _. uiIding Inspector
NOTICE:
This permit does not cover the construction, installation for wiring,
plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for theses items.
4
.- ..
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder
Address Address
i
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block Addition or Sub.Div.ed-tf°
Corner tot Inside Loth et Back �� Side -Yard.._._........._-..
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front Depth � Height -/f
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of. Construction _ Estimated Cost
To be
0
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 representa-
tions stated in this application are true and correct.
DATE 12 SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
pli
Application for Power Plants and Heating. Coaling. Ventilation. Reh igeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
-Repairs &-Alterations each add. $500.00- ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU ..
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $ 8.00
2.00
$
5.00
$
5.00
$
2.50
$
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 $ 5.00
GAS FITTING FEES:
NO RATE
TOTAL
1st 3 Fixtures
x $1.50
$
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
$
14.50
REMARKS:
Plan R-1
Dept. of Bldgs. Phone SV 4-7470
Location 830 Rice Creek Terrace
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.
Owner
Fridley, Minn May 25 190—
Paul
90Paul Schwartz Const. Co. 195—
Kind of Building Frame 195—
Used as Residence
To be completed about June 25, 1960
Estimated Cost, $ 450.00
Old—New. Building Permit No.!g
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Westinghouse size No GDE 170
Capacity.
Sq. Ft. E.D.R 100M BTU H.P.
Total Connected Load 45,631 Kind of Fuel Gas
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
signed FRED VOGT &
HEATING 0 Alit CONO@T
By-
6530 es ® .
11 PosT IM -12-58 Business Phon .*@his Park, Minnesota
City of Fridley, 1.
BUILDING PERMIT
Date:
Owner:
r
Address
Builder -- - - -- - —
Address --
L® 10 0 - -BUILDING.
No. Street 1.0 A A Part Lot
Lot _ _ _ Block Addition or Sub-Divusion
Corner Lot _.__W_... _ _ Inside Lot _ _: _ Setback ._ � Sideyard
Sewer Elevation
Foundation IIevation
DESCRIPTION OF BUILDING
To,.rbe d y
Front Depth _ Height Sq. Ft. cu. Ftjr
's
Front Deptht • Sq. Ft _ Cu. Ft
Type of Construction w` Est.,! "" To be 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 compliance with 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 time upon viola gu4 any of the provisions of said
ordinances. -"'01A 1,
Building Inspector
NOTICE:
This permit does not ',cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PE'B1UT
CITY OF FRIDLEY, IOTA
Owner's Name �! �1��/�LC�2��_ Builder
Address Address
LOCATION OF BUILDING
No., C3 Street Part of Lot
Lot Block _T'� Addition or Subdivision�l»��--roA _
Corner Lot _ Inside Lot .� Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front c2 ZX�,ZDepth Height
IV Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft.
Type of
To be Completed
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 all the facts and representations
stated in this application are true and correct.
(A Schedule of Fee Costs can be found on the Reverse Side.)
suedEcr(,FrE-RMITNO.
City of Fridley
29353
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
`L _----COMMUNITY DEVELOPMENT DIV.
j PROTECTIVE INSPECTION SEC.
1 � �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L J` 612-571-3450
914415
4/29/99
JOB ADDRESS 830 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
4
1 Brookview Terrace 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Eugene Oniel 830 Rice Creek Terrace
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Jayson Lindsay Roofing & Ext Inc 2638 Clearview Ave, Mounds View MN 55112
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
792-1887 20172717
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (27 Sq) Tear-off; Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Call for
building wrap inspection before covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,813
$3.90
DOES NOT PRESUME TO GIVE AU RITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CMA E
PROVISIONS OF OTHER S TE R LOCAL LAW REGULATING CON-
137.25
@
Fir Ci $7.81
S RU TI NOR THE PERFOR NCE F ONSTRUCTION
HE
pp
�►r
PLAN CHECK FE
TOi EE
,
L se C 5
153.96
SIG ATURE FCONTRACTORORAU RiZEDA ENT IDATEi
EN LI THIS IS Y U
G iNSP OArE
SGNATURE OF OWNER OF OWNER BUILDERi iDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: _
Owner r
Contract
Address:
Effective 1/1/99
MN LICENSE #-2L[ r? a 71'1
Tel. # 7r a - 49 f
Attach to this 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.
Fee Schedule on Reverse Side
GARAGE AREA:
Length.
Width
Height
Sq. Ft.
$.50/$1,000 Valuation
DECK AREA:
Length
Width
Hgt/Ground
Sq. Ft.
$5.00 (State Licensed Residential Contractors)
OTHER:
r
S
S c� r eS
.
$450.00 Conservation Plan Review
Park Fee
$
U %jConstruction
Sewer Main Charge
$ .
Agreement Necessary [ ] Not Necessary [ ]
Type:
A K)S I-, 4_3 (AR
•
Estimated Cost: $
(Fee Schedule on Back)
�o f
.Driveway Curb Cut
Width Needed:
Ft. + 6 Ft =
Ft x
_ $
DATE: Lj r a7-7(
Tel. # 7Q �66 �S'
STIPULATIONS:
CITY USE ONLY
Permit Fee
v�
$ /-��~
Fee Schedule on Reverse Side
Fire Surcharge
$ c5 l
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ U
$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 [ ]
TOTAL
STIPULATIONS:
Building
MECHANICAL
Permit No.:
Inspections ��
RESIDENTIAL APPLICATION
Received By:—i�
763-572-3604CITY
OF FRIDLEY
Q: ® o7
DATE A -C►-0 I YOUR E-MAIL ADDRESS
SITE ADDRESS '930 r e e V- —Ge r NE
THIS APPLICANT IS: ❑ OWNER ]CONTRACTOR
PROPERTY
NAME: e
OWNER/
ADDRESS: , C G N�ITY I° m L �..� STATE�lNLIP 5 fS
TENAN
PHONE:
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
SUBNIIT A COPY OF
CONTACT PERSON: JOANN 7INKEN
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON'"RAPIDS sTATEMN zIP55433
APPLICATION
PHONE 763 — 757 — 6202 FAX 763-757--6701
PERMIT TYPE
LISINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW MIU LACEMENT ❑ ALTERATION/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 fixtures. (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)
Equipment Installed MFG: LaL`T 'r v r- MODEL: '5'TC T R®'-7 CD SIZEBTU "'000
MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZE/BTU
_A/C $25.00 FIREPLACE (GAS) $15.00 _; GAS RANGEIOVEN $10.00
—AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 UNIT HTR $10.00
_GAS
_CHMOgEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
9
-Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 1 x $35.00 = $-a5--
State Surcharge = $ .50
Total = $ 3 S . SD
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 NAME ROGER HOFFHEIN DATE 1'7- - Lk - 01
City of Fridley
Building Inspections' Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building PLUMBING Permit No.•;?ooj --6,; q� I
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY� 0�
DATE / YOUR. E-MAIL ADDRESS
SITE ADDRESS __ SANAL �s ®wr.ear
THIS APPLICANT IS: 0 OWNER *ONTRACTOR
Eugene Oneil
PROPERTY
NAME: 830 RICE CREEK TERRACE N.E.
OWNER/
TENANT ADDRESS: Fridley, MN 55432 ZIP
PHONE: 7635711982
CONTRACTOR NAME:
SUBMIT A COPY OF STATE LICENSE # $'1JS" EXP DATE
YOUR STATE ADDRESS CITY �' isr STATE �/�LIP S_�O�
LICENSE WITH PHONE —X03 FAX 4tLZj%7 — 7I Z_
APPLICATION -
PERMIT TYPE SINGLE FAMILY a TWO FAMILY- 0 TOWNHOUSE
TYPE OF WORK: ❑ NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK L021
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 fixtures. CMis.shouldreflect only. the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
'•FO"� ROJEM. WHERE LABOR EX*CEEDS'S500',- EES ARE BASED ON $10.00 PER FIXTURE; EXCEPT- V4 -i E'IgUTEO .:FIXT4.Z ES,�.. INDICATE TQTAL
NUMBER OF EACH BELOW)
_ BATH SINIVLAV _FLOOR DRAINS SHOWER _ WATER PIPING
_ BATHTUB GAS PIPING (NM)CnTucmm) —' SWIMMING POOL WATER SOFTNER ($35)
_ CLOTHES WASHER r_ KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_DISHWASHER _ LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surchar a .50 Number of fixtures @ $15.00 x $15,00 = $
TOTAL DUE $ Number of fixtures @ $35.00 �_ x $35.00 = $ 36'.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 City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an ap on 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 rk equires review and approval of plans. //
SIGNATURE OF APPLIC PRINT NAME Je A1dek'DN7 DATE /Z /3 1,67
NO
town= MM,
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
AND MATERIALS:
BUILDING
(USING THE 17
�5
Permit No.: ` 3
Inspections
-
RESIDENTIAL APPLICATION
Received By:
763-572-3604
See Back Page for Fee Schedule
CITY OF FRIDLEY
Date Rec'
763-502-4977 FAX
Fire Surcharge
Surcharge
$ Z'
$ ! g 4
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ 4,5
EFFECTIVE 1-1-2010
SAC Charge
$
DATE 'zf) YOUR E-MAIL ADDRESS
y
SITE ADDRESS
n
Erosion Control
THIS APPLICANT IS:
❑ OWNER >aVONTRACTOR
Park Fee
PROPERTY OWNER/
NAME: ,e, 1_
Sewer Main Charge
TENANT
ADDRESS: �°�C°� �i .c -e-. Ca- -Taste
CITY t STATEN�IP�
$ /j 7ZF.
PHONE: 9 CP3 ^ 571 1 °C 19 �
CONTRACTOR
NAME:.i
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # 'Z� °S `f 0 '7S
EXP DATE�-
E
AND CERTIFICATE OF
ADDRESS: 33'3 Co �e' Ce�s� C�
R-
CITY f CtiCn'�-� STATEIZIP
INSURANCE
PHONE Z — �t c-
FAX `7& ZC1
PROPERTY TYPE
GLE FAMILY/NEW CONSTRUCTION
SIZE.=��Ls
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK �'$IDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
Q HOUSE ONLY
❑ 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:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
1 ❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum "1
e ❑ Trim
1. Site Plan/Survey showing the existing structures
and proposed project
jD Other
E3 Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF
MANUFACTURE STICKER ON WINDOW.
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 17
�5
U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
-
OCCUPANCY TYPE
Permit Fee
$ a
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
Surcharge
$ Z'
$ ! g 4
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ 4,5
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ /j 7ZF.
Make checks Davable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowle a that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of of Fridle d with the Minnesota Construction Codes; that I understand this is not a
permit but pnly an application for a pe wort ' o start without a permit on site; that the work will be inT/dance with the
approved plan in the case of all work eview and f plans. SIGNATURE OF APPLICANT PRINTNAME Ci (`Ch DATE l�