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PRE 2010 DOCSCity of Fridley SUBJECT PE 14002 AT THE TOP OF THE TWINS PERMIT4 r BUILDING RECEIPT N `L _ ____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. _r:)59_q_4 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 14/18/77 JOB ADDRESS 6200 Starlite Boulevard N.E. 1 LEGAL LOT NO. 16 BLOCK 4 TRACT OR ADDITION Sylvan Hills 3rd SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Wayne Pfuhl 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. S. J. Construction, Inc. 6305 East River Road N.E., Fridley 560-2970 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING �; %Ag' Residential 7 CLASS OF WORK -9, REMOVE ORKREMOVE ❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 8 DESCRIBE WORK 24' Garage `' V Construct a 40' x 24' Dwelling and a 24' x S%YEMIE PERMITS REQUMM Ftp WIRING4 9 CHANGE OF USE FFRE ATING, PLUMBING -AND SIG A 6 i7 6A WA STIPULATIONS Provide.a hard surface driveway. Provide sod in the front and side ,'i yards. Provide a verifying survey before capping. SMIER LOCATION: (Approx. 9' Deep in Street) 10' North of Manhd)le (N. Inv. 837.02 WYE ELEV: 837.11 TOP OF FOOTING: 840.11 Minimum WATER LOCATION: Service may have been put in by owner. We have no records of a water service. DRIVEWAY DEPRESSION: Alt. "A" 12' = 6' x $11.75 = $211.50 W� MI COY of FOW, DM NOt ®NAMM Thi Befog dittint 08 loci �tti ACcUMa OF LnM U.VA1Kft ' AM l ARON& TELEPOWE • &004 r'" "AA Ips POR *VOWAMN NVOW ©KY AND BY LAW �E+ UIRED P' -MONS USM rt Couto YM16Y T#W014 IFILD SITE �cawut+oN SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 960 + 576 24,960 Tot 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. $30,280, $15.14 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 OTHER STATE OR LOCAL LAW REGULATING CON- $99.84 $375.00 STRUCT ON OR THE PERFOR CE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE _>G4LP. $24.96 $514.94 IGNATURE OF'C(5NThACTOR OR AU VRIZEDAGENT (DATE) C/ W�H�EN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG. iNSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: IAl N e_ t7 M c — BUILDER: a e " n%57-10 067—/ 0 A, /AIC— Address: Address: 15.3675 X19,57- Ery A� Tel. No.: No. ®p Street: LOT: / BLOCK: _l� ADDITION: �/e_ I'An.i /V'/'. L- 5 �� CORNER LOT: INSIDE LOT: Y,_ SETBACK: -3 S SIDEYARDS: 10 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: �S Front: Depth: Height: / Square Feet: -- Cubic Feet: /9! (;4R- Front: -2-4 Depth: -2!_ q Height: / 0= Square Feet:%(Q Cubic Feet: 15(00 Type of Construction: Estimated Cost: $-j® !2t�— To Be Completed: y'07 _ / _ ? z Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired lam. $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additiona formation. 01) r ATE: _4 SIGNATURE: v Stipulations: 4y 608,1 Cf c7 om ' �( L D AAI . ILI BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $11.75 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x $15.40 W,1111 ! !' ! For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In -no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. W GERALD T. COYNE 300 BRUNSWICK AVE. S. GOLDEN VALLEY, MINN. MINN. REG. NO. 4741 INDUSTRIAL JUDICIAL COMMERCIAL - TOPOGRAPHICAL CITY LOTS - PLATTING LOT SURVEYS COMPANY LAND SURVEYMS REGISTERED UNDER LAWS OF STATE OF MNNESMA LICENSED $Y ORDINANCE OF QTY OF NMNNEAPOLM 5747 W. Broadway Minneapolis, I�Minnessootag,S5428 533-9922 oa¢murpra JOHN DOYLE 1401 ; 00stA,ov` co 01' ; s pµ1.Y 1W t 'cc o "S 41 p",USMG a �► � !� is �tCE t0 CITI C0'`, 0 u1R�D • OVA000 SIT p�ikt�' 'Ik ,i Vrw- t�E ` r Lot 16, Block 4, Sylvan Hills Plat 3, Anoka County, Minneso a G at :a i r-7 i � . � ".,' Fri' {��✓�. �,.. �� � �2 27-2- to C. �C I QN N , I We herebycertifythat this is a true and correct representation of a survey of the boundaries of the above described land and the locat;on of all builldings and visible encroachments, if any, from or on said land, Surveyed by us this 6th day of April 19 77 RAYMOND A. PRASCH 6917 IDAHO AVE. N. BROOKLYN PARK. MINN, MINN. REG. NO. 6743 INVOICE . NO. _ +� F. B. M0. 7- SCALE 11. 30, O - DENOTES IRON O- Den-otes Wood Hub Set For ExCavat '0 Only I -Jj Sign — - - - ' ,0-* g SLOT SURVEYS COMPANY w� ��7 CQ - FY21)lv-el 0 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Job Address 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 k Fridley, Mn. , 19 OWNER KIND OF BUILDING USED AS m TO BE COMPLETED ABOUT >, m ro ESTIMATED COST o PLUMBING FIXTURE RATES: 43 m TOTAL Water y m 49 to A x $3.00 m W H •.c+ •.Y�+i (6 m $4 M m m" W Ai W x $2.00 Heater s Signed By,� Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 o ROUGH INSP. Electric Water Heater rt v D ama Date y S a w t[n w U u`tl0 3 1st 3 fixtures chi $ 0.0 as lec Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ APPROVAL FOR PERMIT rte REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE State Surcharge $ .50 1st $ REINSPECTION FEE ($10.00) 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water Job Address 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 k Fridley, Mn. , 19 OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO. Number Fixtures 1 x $3.00 $ -2i0 0 Future Fixture Opening x $2.00 $ Company A„ New Fixture, Old Opening x $2.00 $ s Signed By,� Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ ROUGH INSP. Electric Water Heater x $5.00 $ Date GAS FITTING FEES: • FINAL INSP. 16 -2? 1st 3 fixtures x •$3.00 $ 0.0 ' Date Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ APPROVAL FOR PERMIT rte REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) SUBJECT M of Fridley 77 8City AT THE TOP OF THE TWINS BUILDING PERMIT r IPT • __ __ COMMUNITY DEVELOPMENT DIV. ;,:- - 1 PROTECTIVE INSPECTION SEC. � � I---1 CITY HALL FRIDLEY 55432 __t� NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/ 7/84 � � JOB ADDRESS 6200 Starlite Blvd. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 SHEET Sylvan Hills 3rd 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delores Hartos 6200 St 1' 571-5748 3 CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. Owner 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 7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 10' x 12' 3 -Season Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS T, le i ,._) H. g oU�N FA 1 "+CpLI,94 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 4UTHORIZED 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 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 $2 r 100 $1.05 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 OTHER STATE OR LOCAL LAW REGULATING CON- $38.50 NonE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $ 9.63 $49.18 SIGNTUREOF O PPACT ORA HORIZE AGENT (DATE) WHEN PROPERLY VAL TED THIS IS YOUR PE / /R /ITT /Me SIGNATURE O OWNER N� O NER BUILDER) I E) -' BLDG INSP D fE NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ R-1 AND R-2 ALTER. [ ] Building Permit Application a Construction Address: Legal Description: L-® < s M u Owner Name &Address: `� s Tel. �! Contractor:Tel. # Address:, f2cii yj LIVING AREA: GARAGE AREA: DECK AREA: OTHER• 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. 12011 11"N _ "L 111. Hca Corner Lot [ ] Inside Lot Ft. Yd. Setback _ Type of Construction: Approx. Completion Date: Side Yard Setback Estimated Cost: $ %r `_1100 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: kA $ $ See Back Page for Explanation Tel. DATE: APPLICANT• #� CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the, payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: Total Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. 3 GERALD T. COYNE 300 6RUNSWICK AVE. S. GOLDEN VALLEY, MINK, MINN. REG. NO. 4741 INDUSTRIAL — JUDICIAL COMMERCIAL — TOPOGRAPHICAL CITY LOTS — PLATTING JOHN DOYLE 6200 STf}pL IINT LOT SURVEYS COMPANY LAND SURVEYORS REGISTERED UNDER LAWS Or STATE Or MINNESOTA WCMMW RT ORDINANCE Or Cfi7T Or MINNEAPOLIS 5747 W. Broadway Minneapors. M;nnesota SS428 S33.9922 b P1JDr� QZPI'1fP C> I v; ® v c a V0--- Lot'16, Block 49 Sylvan Hills Plat 39 Anoka County, Mianeso a kevised to show ir outa 6L % t 4/27/77 ►Q1gnw _ _- .I___ LOT SL RVEYS COMPANY We hereby certify +het this is a true and correct representation Of a survey of the boundaries of the above describ-d lard end the lo.af;an of e!1 builldings and vm;ble encroachments, if any from or on said land. Surveyed by us this 6th . day of April Iq 77 RAYMOND A. PRASCN 6917 IDAHO AVE. N. BROOKLYN PARK. MINN. MINN. REG. NO. 6743 IN110iC1 N0.5732 F. B. NO. 167-46 SCALE 1" as 309 O — DENOTES IRON o -Denotes Wood Hub Set For Excavat o Only CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 4�e; vO t'E-0 C5�Ael' l %`� � '� RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - p city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $� that all the facts and representations stated in this application are 0o true and correct. ,1991 Gas Piping (Needed with new furnace) $10.00 $ % OWNER Gas Range $10.00 $ Gas Dryer $ 10.00 $ l *Air Conditioning - All Sizes $10.00 $� All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE $ MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. BUILDING USED AS l � ESTIMATED COST��� PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating j.Jnits Circle One (Steam) (Hot Wate Warm Ai Trade Name Size No.��� 114 �> A= z; BTU G QC?® HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Signed By - Approved By Rough -In Date Final Date 7-/Z FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY 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 04e No ( ) 3. Has no foreign objects lodged within Yes ( No ( ) 4. Is securely supported Yes ( No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes •� No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's a S r 1k List Alterations Being 41=, Done: ]�/,/, V D HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace t ing {AdZY)'Aedit ew�ace) Gas Range Gas Dryer "Air Conditioning - All Sizes Rate TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK 1 % of Value of Appliance or Work Commercial/Industrial 1 % of Value of Appliance or Work State Surcharge TOTAL FEE JOB ADDR 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. A BUILDING USED AS ESTIMATED COST PERMIT NO. 1113c DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load .50_ MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR HEATING COMPANY U4, k ) jo � le Signed By Tel No. i5_7/ _ 7 N,� Approved By Cmc Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY 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 ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date sue�Ecr IT N0. City of Fridley 4� AT THE TOP OF THE TWINS BUILDING PERMIT r RE ` COMMUNITY DEVELOPMENT DIV. ______ y t r PROTECTIVE INSPECTION SEC 1 � � 1 CITY HALL FRIDLEY 55432 �..... ".' NUMBERDATE REV PAGE OF APPROVED BY 612-571-3450 910-F15 10/8/96 JOB ADDRESS 6200 Starlite Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 Sylvan Hills 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE DEloris Hartos, 6200 Starlite Blvd., Fridley, MN 55432 571-5748 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Golden Hatchet Roofing, 31833 Roanoke St. NGT, Cambridge, MN 689-0400 20003158 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 X] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOR ear -off and re -roof. 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must meet 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 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 $13-320.00 License SC $ .66 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A'PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO OLATE OR C NCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCA LAW REG ATING CON - $4,r 7)r Fire SC $1.32 ST CTIO OR THE PERF ANCE F CON RUCTION 0 T PLAN CHECK FEE TOTALFEE License FEe $5.00 $52.73 SIGNATURE OF CON CTOR OR AJT46RIF2A (DATE) WHEN PROPERLY WPATED THIS IS YOUR PERMIT SIGNATURE OF OWNER SIF OWNER BUILDERI IDATEI BLDGF-0SP DATE NEW [ ] Effective 3/1/96 ADDN - [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application��7 ConstructionAddress: 6 -'-0 Q �1 � 13h4 Legal Description: Owner Name &Address:��Q�/l ` 5g�% �� S � e- Tel. # S'� ;71 --7 Contractor: 6,--o l!� eo-? MN LICENSE # pfd�5� Address: 31$ 5 3 Roctyt O Tel. #1 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-9 0�f �J l� %C ul if o /'� a "&1 Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: A 0 0teAI C4 Estimated Cost: $ Approx. Completion Date: 10171"'94 (Cost on Back) Driveway CurbCut Width Needed: Ft.+ 6 = Ft x $ _. $ DATE: Q APPLICANT: Tel. # CITY USE ONLY Permit Fee $ � o Fee Schedule on Reverse Side Fire Surcharge $ - .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ e9-6 $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 f ] Not Necessary [ ] TOTAL $ q STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1;000 or fraction thereof, .to and. including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. SUBJECT PF. - —NO'. - Clty Of Fridley WRECKING 15533 AT THE TOP OF THE TWINS PERMIT _-- REC/E�IP�TJN®O. COMMUNITY DEVELOPMENT DIV. __ e v e___ -- PROTECTIVE INSPECTION SEC. 4VVNO. Y "T r e � e iCITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 9/23/97 JOB ADDRESS 6200 Starlite Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 Sylvan Hills 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delores Hartos 6200 Starlite Blvd NE 571-5748 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE jJ REMOVE 8 DESCRIBE WORK Wreck a 22' x 30' Shed 9 CHANGE OF USE FROM TO STIPULATIONS Remove all demolition debris from property. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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. PLAN CHECK FEE FEE 7TAL $15.00 SA NATURE OF CONTT14ACCTOR ORA TO�RiZED�AyGEENN�T ._ IDATEi E P Y VALI D THIS IS UR PERMIT "I 'CIE G iN ' .r CRATE �G ATUREOFOWNERoFOWNE BUiLDERi iOATEj CITY OF FRWLEY 6431 University Ave NE Fridley MN 55432 572-3604 Job Address: Legal Descri Owner & Addre Effective l/ 1/97 MOVING [ ] WRECKING [ PERMIT APPLICATION Contractor:_��� Tel. # Address: 9 State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. GARAGE: Length Width Height Sq. Ft. '5i&��t Lengthy Width Heightzz! Sq. Ft. Estimated Cost $ A C , Approx. Completion Date UTILITIES City Water/Sewer Minnegasco NOTIFIED: 572-3529 [ ] 372-4720 [ ] Water Bill Paid: Yes [ ] or Collect [$ Moving Route: N S P 330-5500[ ] Cu. Ft. Cu. Ft. Cu. Ft. U S West 663-6000 [ ] ] Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. Date Signature Moving: Principle Building into Fridley .... $300.00 Accessory Building into Fridley .... $ 42.00 Minimum Fee: $20.00 Through or within the City ...... $ 20.00 Move a building out of City ...... $ 80.00 Wrecking: For each 1,000 cubic feet or fraction .. $ 1.25 For structures which would be impractical to cube the fee shall be based on the Minimum Fee: $15.00 total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. 66 PERMIT FEE. J STIPULATIONS: Ina SUBJECT City of Fridley 2556 AT THE TOP OF THE TWINS BUILDING PERM I' r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � J Z� 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 , 612-571-3450 910415 10/1/97 JOB ADDRESS 6200 Starlite Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 Sylvan Hills Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Craig Hartos 6200 Starlite Blvd NE 571-5748 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO First Landmark Builders 611 S Snelling Ave, St Paul, MN 55116 699-3135 1992 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct slab for 22' x 24' Garage to be moved; Construct a 38' x 24' New arage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. See notations on plan. Special Use Permit 497-06 with the following stipulations; The structures shall be architecturally compatible with the existing dwelling; Neither accessory structure may be used for a home occupation; The 10 foot by 28 foot accessory structure shall be remoed within 3 months of completion of the garages; A demolition permit shall be obtained; Proper moving and building permits shall be obtained prior to construction being started; the 2nd garage (22' x 22') shall not be located in the utility easement. 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 ISTALLS 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 $169862 $8.43 WIT HETHER SPECIFIED HEREIN OR NOT. THE TING OF A PERMIT D S N T PRESUME TO GIVE AUTHO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE P OVISIO S OF ANY OTHER OR LOCAL LAW REGULATING CON- $249.75 Fire SC 16.86 S RUCTI OR THE PE ANCE OF CONSTRUCTION. 1 PLAN CHECK FEE TOTAL FE Li e 0//1 280.04 Si N TURE OF CONTRACTOR OR AUTHO t E GENT tOATE) WH PR PERLY DATED IS YOUR PERMIT 1.40- s BEDG 6P GATE !V SIGNATURE OF OWNEROF OWNER BU(LDER) tDATEi NEW [ ] Effective 1 / 1 /97 ADDN [ J CITY OF FRIDLEY 6 ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ��� Legal Description: Owner Name & Address: ^ i Tel. #��1- Contractor: MN LICENSE # 00n r 2 q � Address: _ C;' Tel. # Attach to this app ication, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length r Width P Height Sq. Ft. GARAGE AREA: Length Width Height 4- Sq. Ft. 4- DECK AREA: Leng}t�h WidthHgt/Ground Sq. F . OTHER: SL` -6-7 S' .146 ,I -q v- Construction Type: Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ APVLICANT: Tel. # /V ITY USE ONLY Permit Fee $ 7� Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ �oa 4 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 j) Not Necessary j ] �, -99 STIPULATIONS: a. ,� f 7 1. �j�` _ r y y —t g r. :.� ;.f qty �- R � ,��- � _,a�f�%A�°v �=-',z` ��'p �.� .�f��� •r r ;� BUILDING PERMIT FEE SCHEDULE The Chief Building Official sliall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to. $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, .to .and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1, 000,000 $1,000,001 and rip $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A". Removal.and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it leas been constructed rri;! be required before M-OC'eediM4 with the framin�o. SUBJECT P City ®f Fridley(�i27"07 AT THE TOP OF THE TWINS BUILDING PE MIT r E O. • _____ COMMUNITY DEVELOPMENT DIV. I VV e PROTECTIVE INSPECTION SEC. r e NUMBER REV DATE PAGE OF APPROVED BY � CITY HALL FRIDLEY 55432 612-571-3450 910415 8/10/98 JOB ADDRESS Starl to 6200 Sir art Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 4 1 Sylvan Hills 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Delores Hartose 571-5748 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Golden Hatchet Roofing P.O.427-4006 20003158 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 XX REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof garage (8 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 $667 $.50 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 O"HE PERF MANCE OF CONSTRUCTION. $26.50 Fire SC $.66 PLAN CHECK FEE TOTA EE �"'(�� Lice $5.0 2.66 - SIGNATURE OF CONTRACTOR OR AUTMORI G IDATEI EN P OP ALIDAT THIS 1$ Y1;11{(i PEpMT SS 1 4ria T E 405 SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ J Effective 1/1/98 . A VN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (j Legal Description: Cr-u,(,a a Owner Name & Address:®U C 5' (CJS' Tel. # Contractor: i!�O 1401 17�??-e-, G( f 710VO (9 )- MN LICENSE #; e73157 Address: Ce &42 3 / S SG Tel. # �� Y29a6 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/ round 5q. Ft. OTHER:J Construction Type: �� d®®�°� Estimated Cost: $, aX d�� �� (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ A DATE:is/C®� APPLICANT: i Tel. #�2 7 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ . ��b Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) . $ d $.50/$1,000 Valuation $ $1000 per SAC Unit $ UCS $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 [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee, is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. City of Fridley Building Inspections Dept. 6431 University Ave NE Fridley MN 55432 Mechanical Ph: 763-572-3604 FAX: 763-571-1287 Residential Application City of Fridley See Back Side For Required Information �_ 0313 L Permit #Dv Date Site Address: ��� $ ?' ui a diyo 17 The applicant is: (cirice one) Owner ontra Property Owner o t Address: City:State: M%1 Zip: 3 Phone: - Cell: Fax: Contractor Information Company Name:Inn Contact Person: River ° 6 ' rJ Address: 89go Maid St. ., City: e tri :�V N Zip: Phone: 99—pu gm) 754-290 Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New Alteration/Remodel Detailed Dpspription of work: Equipment Installed: MFG: MFG: Model: '2Lrftt v:�L v:.Size/BTU: Model: 07y Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 _A/C $25.00 Fes' eplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 usFumace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ 39.190 (Total from above -Minimum fee $35.00) Surcharge $ 0.50 Total Due $ o Make check payable to City of Fridley phis is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. Signature of Applicant: (� Date: Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ 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 Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC 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 IMC 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