PRE 2010 DOCS(city of Fridley, Minn.. No 10563
BUILDING PERMIT
Date; - March 2, 1970
owner: Random Incorporated Bider Random Incorporated
Address 700_77th Street, Circle Pines Adm Same
LOCATION OF BUILDING
No. 8125 _ Street _ _ Ruth Street Part of Lot
Lot ,_,_,.4 __ Block 4 Addition or Sub -Division _ Bourdeaux Spring Brook Park
Corner Lot — X Inside Lot _ _ Setback 351 _ Sideyard 21' & 10'
ZHIR Elevation ____ 847.25' _ 851.25'
Wye Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 40' Depth 26' Height 20' Sq. Ft. 1040 ca. Ft 20.,800'
tt arage Front 20' Depth 26Height 10' Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _W,000-00 _ To be Completed MYs 1970
WATER LOCATION:
SEWER LOCATION: 58' East of Manhole
In consideration of the issuance to me of a permit to coIt-PCtell
building
the proposed work in accordance with the description above nd in
ordinances of the city of Fridley. M
In consideration of the payment of a fee of $9.00 , permit is hereby granted
sdo
of
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.
Building Inspector
HANK MUHICH
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas beating, stwer or water. Be sure to we
the Building Inspector for separate permits for there items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER 'S NAME
,
ADDRESS 7e G - 7
S
f .PC f�
m
f� � £ADDRESS
_°C' C
LOCATION OF BUILDING
NO. STREET 4--'
LOT BLOCK ADDITION OR SIIBDIVISION
CORNER LOT INSIDE LOT SETBACK 3r SIDEYARIc-;,2 // t1/6
SEWER ELEVATION TOP OF FOOTING
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:
Front = ® Depth Height'
L
Square feet Cubic Feet
��
°�� / F�'ront Depth Height
Square feet Cubic Feet
Type of Construct
To Be Completed
imated Cost c,24 f07
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 re -presentations stated in
this applicatiaxe t�rae and correct. /` -
.(Schedule of Fee Costs can be found on the Reverse Side.)
NOTE: A Certified Survey of the lot, showing the location of the foundation,
once it has been constructed, will be required before proceeding with the
framing.
f a'
MINDER ENINE-FRING >C0., INC
LAND SURVEYORS, AND CONSULTING ENGINEERS
6418 51, h AVENUE NORTH, MINNEAPOLIS 28, MINN. KE 7-3637
Cl WL AND MUNICIPAL ENGINEERING
LAND SURVEYING
L AND PLANNING
,soxs TESTING
60'
6
LO T F� LOC- K 4
cq cc-)
'j1vo1<A coclNr') IWIN'iles or
WE k7Tvt%'ANO Colk;tv-r-T QEppvsT%Th'T\t% OTA'SURVEY afTHE BOUNDARIES 14771AS LK%rj k%QVT VEStRISIEra
4qILD si- IT wy, 7iAn"EqN, N%b al. Ymtm Emooke"mms, IF ANY, F;krjm OR ON SAID ulgro.
mi"bip, ENGINEERING U., INC-
�: ul
40
I4a
99
8.
z
4L
0
F
N
WATER HTR.
GAS
ELEC.
Base
2nd
3rd
4th
PLUMBING FIXTURE RATES:
Number Fixtures
Future Fixture Opening
New Fixture Old Opening
Catch Basin
NO. RATE TOTAL
x $2.00 100
x $1.50 $--
X $1.50 $
x $3.25 $—
Water Heater (Up to 99,000 BTU) x $3.00 $- . .61. .6
New Ground Run Old Bldg. x $3.25 $
Electric Water Heater z $2.00 $—
GAS FITTING FEES: NO, RATE TOTAL
lot 3 Fixtures ......... ....I
.... .. x $2.00 Q C-2 J�—
Additional Fixtures ..... .............. x $ .75 $
Gas Range to 199,000 BTU .............. x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ............................. ........... $
TOTAL FEE
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.
— 1ridley, Minn— � —7 — 19 7-a)
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $— 40,00
Old -fe Vew. uilding Permit No.---- _Permit No. —
Signed.
By -
Business Phone No- %,d e0
ROUGK_
FINAL —jLjjL- ? 0
N® 5110
Original Permit forPLUMBING ANDGS FITTING AL-
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit
permit.,
inspection shall be phoned in to the plumbing Inspector, 860-3450 giving number of this Fee $ /Y
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures . 7 D l f�Jg
T W Q Z m T m Y' F W K m T m 3 W WATER HTR. City of Fridley
Stories
m m z m _ x y z z ; O z V Z ai e
Permission is hereby granted � do the plumbing and
gas fitting in the building described i the statement hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
4z JM—"9-v
Location -24— e 4c �
Kind of Building
Used as Lj
To be Completed ,19_
Estimated Cost $- X. 0 Oe) - 0 0
Old F Building Permit No.
Inspector of Buildings.
Q o
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Basement
ist
2nd
3rd
4th
Connected wi Sewer'Cesspool Gas Piping for Openings
Permission is hereby granted � do the plumbing and
gas fitting in the building described i the statement hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
4z JM—"9-v
Location -24— e 4c �
Kind of Building
Used as Lj
To be Completed ,19_
Estimated Cost $- X. 0 Oe) - 0 0
Old F Building Permit No.
Inspector of Buildings.
PERMIT for Power Plants and Heating Cool=
ing, ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be installed—altered—repaired
Make 4A , Size Ce P ® r2—
Oil
2Oil fired ; Coal fired—, Gas Gas Authorization No.
Remarks
Approved
Final Inspection
19_
Inspector
Permit N° 4701
Fee $ ,% ®U
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. , 1920
Owner "INTI ,Location
1
I
Kind of Building
How
t ,
'• i� R
Occupied, I /l,
S
Work to be Commenced-,
To be Completed ,19_
Estimated Cost, $ 6,5-6-6 0
Building Permit
Permission is hereby granted to - ,t U1 O �Q to instalt--erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifica . ns 2setforth in the approved application for this
permit on file in the office of the Inspector of Buildings. ,
42 2MIlw v , Inspector of Buildings
SUBJECT
City ®i Fridley
2 6 0 2 6-
AT THE TOP OF THE TWINS
BUILDING
r
Reeewrwo-
COMMUNITY DEVELOPMENT DIV.
i _
L PROTECTIVE INSPECTION SEC.
01 ���
NUMBER
REV
DATE
5/7/98
PAGE OF
APPROVED BY
/---� CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 8125 RUTH STREET NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
4
BOURDEAUX' S
SPRING BROOK PARK SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Stock Roofing Inc 289 Liberty St NE, Fridley, MN 55432 780-3561 3112
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 IRC REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the 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 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
1STALLS 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
$1,751
$.88
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 OTH OR LOCAL LAW REGULATING CON-
$56.75
Fire SC $1.75
STRUCTIQN OR THE PI\ FOR�F CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$64.38
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HEN PROPERL ALI DATED THIS IS YOUR PERMIT
OG INSO DATE
SIGNATURE OF OWNER I IF OWNER BUILDERI IDATEi
i
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress
loe:� //
Legal Description:
Effective 1/1/98
Owner Name & Address: 9,/ a S Ifu Ic <4 (-S,t. Tel. #
Contractor: S-7"oo%C" �4o 14� � d� � � MN LICENSE #
Address: 2 9'7 zf � e"2Ay �� �(��Z- Tel. # 7�� -
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.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
a/4'
Construction Type: -le lix o ��J XPt=W/�" Estimated Cost: $ %M
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE. ��� ��� APPLICANT: Tel. # -Zyo °-3 5-o
Permit Fee
$ S(- 7r
Fire Surcharge
$ i.
State Surcharge
$ , �g
SAC Charge
$
License Surcharge
$ S-100
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ '7. 38
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.50/$1,000 Valuation
$1000 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 [ J.
1
SUBJECT
City of Fraley
30534
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
16ma
RECEIPT NO.
y_-_____ COMMUNITY DEVELOPMENT DIV.
-
INSPECTION SEC.
725
f � � PROTECTIVE
1 �
= I CITY HALL FRIDLEY 55432
I''
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
11/22/99
f'
JOB ADDRESS 8125 Ruth Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
4
lBourdeaux's Spring Brook Park SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Walter Streich
780-2785
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ffix REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house and garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap inspection before covering.
SEPARATE PERMITS ARE REOUIREO 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3450
$1.72
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS-$F'nSNY OTHER STATE OR LOCAL LAW REGULATING CON.
STTRUCTION OR TW -;O�FXANCE OF CONSTRUCTION
$97,25
Fir SC $3.45
PLAN CHECK FE
TOT EE
$ 2.4z
S NAT ON'AACTORORAUTHORIZEDAGENT (DATE'
HEN RVALID
IS RMIT
9l 'NSP
XISYZUP
pArE
S.GNATURE OF OWNER'IF OWNER BUILDER' (DATE'
1
r �
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY ^
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1
BUILDING PERMIT APPLICATION h
Construction Address:
Legal Description: J� o t( J(( c®({ r7
Owner Name & Address: Tel. # -79 V j -7 :K S
Contractor: 0 W LA -.f- MN LICENSE #
Address: Tel. # 780- Q D i
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. R.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: ,-, A Si e4 'I ✓l u
i
Construction Type: Z c t Estimated Cost: $
Driveway Curb Cut Width Needed:.
DATE: C1 APPLICANT:
Ft x $
CITY USE ONLY
Tel. #? W 0-7
Permit Fee
$ 9 % P S
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
/. ?�
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
$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
$
1®
STIPULATIONS:
Building
PLUMBING
PermitNo.*
Inspections
RESIDENTIAL APPLICATION
Received By:4-;
763-572-3604
CITY OF FRIIDLEY
Date Re('cfi l3
DATE . & SCJ! ® YOUR E-MAIL ADDRESS
5-1-, W F
SITE ADDRESS _ lb 7'Vi
THIS APPLICANT IS: 0 OWNER @CONTRACTOR
PROPERTY
NAME: it
ADDRESS: val3')xp_ CITY STATE4ZIP SScI 3a
OWNER/
TENANT
Sas— T 0- 03T
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE e#--� EXP DATE 09
ADDRESS: 0 CITY n sTATF tLZII 55
LICENSE WITH
PHONE ® FAX
APPLICATION
PERMIT TYPE
VI -SINGLE FAMILY Q TWO FAMILY O TOWNHOUSE
TYPE OF WORK:
IJ NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK���r
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.057
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV FLOOR DRAINS _ SHOWER _ WATER PIPING
_
BATHTUB GAS PIPING � crrrucEw4 _ SWIMMING POOL _ WATER SOFTNER ($35)
_ _
CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. ($15)
_ _
DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_
WATER METER —OTHER
Permit Fee
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
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 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.
�� PRINT NAME
SIGNATURE OF APPLICANT`
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
a
Building
$
BUILDING
$
Permit No.: -601011 tax
Inspections
Surcharge
RESIDENTIAL APPLICATION
Received By:
763-572-3604
SAC Charge
$ -'
Curb Cut Escrow
$
763-502-4977 FAX
CITY OF FRIDLEY
Park Fee
$
Sewer Main Charge
$
EFFECTIVE 1-1-2010
S ,
DATE !
YOUR E-MAIL ADDRESS
SITE ADDRESS
' —
THIS APPLICANT IS:
❑ OWNER NTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: CITY
STATEZIP
PHONE: . —
CONTRACTOR
NAME: Mr p I—
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: zJ qd-7--
CITY ZL IRt Ut0tWtR-- STATE IP�
INSURANCE
PHONE FAX
PROPERTY TYPETGLE
FAMILY/NEW CONSTRUCTION SIZE
WO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH AROOF ❑ DRAIN
TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING O HOUSE ONLY
NUMBER OF SQUARES OUSE & GARAGE
BASEMENT REMODELING SUBMIT:
-;gq
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,
❑ Virryl
❑Soffit
ADDITIONS_ & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
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
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 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
$
Plan Review
$
Fire Surcharge
$ 3a
Surcharge
$ I I, -b
License Surcharge
$ [)
SAC Charge
$ -'
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
S ,
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)
$2100 per SAC Unit (Plans to MWCC for determination)
-ft +6ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks Davable to: Citv of Fridlev 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 codes of a ity of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applicatio or 71c it d or k is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of 1 w h ires review and approval of plans. P
SIGNATURE OF APPLICANT11r,P AME 4 beff USSODATE ��� !