PRE 2010 DOCSCity ®f Fridley, Minn.
BUILDING PERMIT
Owner: Roger Joliceour Builder
Address
,q,3:3 o
M 9825
Dalberg Blders, Inc.
1121 60 th Ave. N. E.
LOCATION OF BUILDING
No. 245 Street __ Stonybrook Lane - part of Lot
Lot 11 _ Block 7 Addition or Sub -Division _ Pearson's Craigway Estates 2nd
Corner Lot — Inside Lot _.._ Setback 35' _ Sideyard 5' 1 16'
Sewer Elevation — 836.3 _ 839.3
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 43 Depth 26' Height 291 Sq. Ft. 1118 Cu. Ft 27,928
Garage 6336
Front 22' Depth S24' Height 12' Sq. Ft. 528 Cu. Ft
Type of Construction Frame Est. Cost ^ $28,500 __ To be Completed
SEWER LOCATION - 40' South of Manhole
WATER LOCATION - 28' S. W. of Manhole
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 abovese in compliance provisions of
ordinances of the city of Fridley. �� i , /7 1; „ L
ewer Connection Char
In consideration of the payment of a fee of $ 52.00 _., permit is hereby granted
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, Mbinesota regarding location, construction, alteration, maintenance, repair and moving of buildinira
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Official
Building gKqXWW
Breher
NOTICE:
This permit dose not cover the construction, installation for wiring, ping, gas heating, sewer or water. Be aro to see
the Building hnpector for separate permits for these Items.
1 .
V
APPLICATION Rift HUILD�G• PERVaT
1�
CITY OF kftDLEY, MUMSOTA
OWNER'S NAME,:BUILDER
77
'ADDRESS "l �a P ADDRESS G���J+` �cyy✓�C�" C
^u
LOCATr.6x, *OF tUliDiNG
No.�;�EET
LOT ELO,CC�.`� ADDITION OR SUBDIVISION
G`ORT3ER LOTIN$E LOT--ETBACK '' STDEgARD 7
SEWER ELEVATION T611 OF FOOTING
Applicant attach :to this form. Two Certificates of Survey,. of ,Lot and proposed
building location. drawn on these Cer:titicages .
DESC$IIsTION OF B'!TlLDING
To Be Use , As 1d "
l
Front ,,.ADepth Heights q
7 � �Z F
Square feet % Cubic Feet `7
Front ,�L �� .,� Depth Height
Square feetCubic Feet
Type of Construction Estimated Cost���
To Be Completed_
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and represe "ions stated in thiss ap lication
are true and correct.
DATES �-�� �(O,SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
S'c c.
q
u
BUILDING PERMIT TEE SCHEDULE
SECTION 2. The Inspector of yi'1414 p ha11,"before issuing permits for
the erection of any buIjd-.ng:,ipT $firg; ure, or for any addition to any
existing structure or buil-din#,, 9T"f6iF.eny alteration or repairs to any
existing building or structure, F q ,jpplication therefore, require the
the payment by the applicant for b` h permit of fees to the amount herein
below set forth and in M—uWnn�r.thepta provided -to-wit:
Uniform Duilding Code:, Type 1, 2, b 4- $1.75 for each one thousand cubic
feet, or fraction thereof, ip staph' cubical contents. Type 3_& 5- $1:50 for
each one thousand cubic feet,.
S
Forr,=.the. "rpose of cum .;Ln� foo ,fffhuil�ctiag' permits;, the cubical
contents of any building or,'04# to a usniform height throughout by
multiplying the ground area,cq,yered from a point six (6).Xnches below the floor
line of 'tile' basement or. thj'0.c-11ar te the average .. height of the upper surface
everagp height of ..the,, roof., surface of the, mai ,gable of a
pitched roof. -
For repairs or aiter8tions,. ta; sn :.exist ng _ structure, the fee shall - be. at the
rate of $3.013 per eaci five heindred dollars ($5110.00) . or fraction thereof
in -'the cost of all proposed work.
-.xm po case shall the fee charged.for,any permit as set forth in -Section 2 be
Tess than ' $5. ®0;* `
NSSSD Cenneciietr Charges based on location- Area 1 or 2.
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ..........................$10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
NECK. WARM AIR do
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam ... .................. 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal. per hour 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU)$®
...... 6.00
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE
1st 3 Fixtures ..... ................ x$ 2.00 $
Additional Fixtures ................. x .75 $
Gas Range to 199,000 ........... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
$
TOTAL FEE $ a G
Dept. of Bldgs. Phone 560-3450
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.
Fridley, Minn-
Owner
Kind of
Used a:
To be completed about
i
Estimated Cost,
Ol New Building Permit No. `7 Permit No.
DESCRIPTION OF WORK
HEATING or PO NTS -Steam, Hot Wa •, Warm Air--No�
Trade Name �v Size No - f r r -
Capacity Sq. Ft. E.D.R BTU o H.P.
Total Connected Load Kind of Fu1.
BURNER — Trade Name Size No
Capacity.
(REMARKS—OVER)
C111110.42
Sq. Ft. E.D.R BTU H.P.
Signed :URBAN AIR ONDITIamAS
9419 CENTER DRIVE
By
n
Business Phone No
1
City ®f Fridley
Application for PlumVing and Gas Fitting permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
€'�
Number Fixtures ...................... _
x
ZZ
rx�
OZ
OLL
x
O
n
a
Z
w
R
N
WATER HTR.
GAS
ELEG
x
3
$
a� �
Water Heater (Up to BTU)
tnn
�
o
u�
�
GF?
U �
<
C�9 °d
� nS
C�9 0
x
3.25
$
.��E.e.C,u- 70 4� IZ
4100
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$
$ �� ®mss
4-0,0
Additional Fixtures. ..................
x
$
%s
Base
Gas Range to BTU ..............
x
2Q#
$
1st
2nd
l
3rd
4th
• Future Connection Openings
Connected with
New Fixture, Old Openings
Sewer
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ...................... _
x
$
Future Fixture Opening ................
x
tA&
$
/•�Q
New Fixture Old Opening ..............
x
kM
Catch Basin .... .....................
x
3.25
$
Water Heater (Up to BTU)
v
3rao
......
x
s-3—®
New Ground Run Old Bldg . ............
x
3.25
$
.��E.e.C,u- 70 4� IZ
4100
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$
$ �� ®mss
4-0,0
Additional Fixtures. ..................
x
$
%s
19%aeo
Gas Range to BTU ..............
x
2Q#
$
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $�
City of Fridley:
700
�1
/I
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. P �y
Fridley, Minn- / � 19�f
Owner
Kind of
Used as
To be completed about
Estimated Cost, $ j
Old ew. uilding Permit No. vC Permit No. -4V7
Signed AR, - Ip F 14
By dam. mp
Business Phone No
ROUGH
FINAL
d2
3uilding
$ �7 g'
BUILDING
Plan Review
Permit No. •
65% of Building Permit Fee
Fire Surcharge
$
3.
nspections
Surcharge
RESIDENTIAL APPLICATION
!.7d
Received By.
r63-572-3604
$
CITY OF FRIDLEY
$5.00 (State Licensed Residential Contractors)
Date Rec'd:
$
YOUR E-MAIL ADDRESS
$1550 per SAC Unit (Plans to MWCC for determination)
ITE ADDRESS
$
ft + 6 ft = ft x $21= $
Erosion Control
$
HIS APPLICANT IS:
0 OWNER OCONTRACTOR
Park Fee
PROPERTY OWNER/
NAME;
Fee Determined by Engineering
TENANT
ADDRESS: " � � d� �% ITY / E10?6--Y STATE�✓J ZIP g6�;)—
PHONE:
Total Due
CONTRACTOR
NAME:
Make checks payable to: City of Fridley Attach Stipulations
STATE LICENSE 4 EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
X SINGLE FAMILY/NEW CONSTRUCTION SIZE
0 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
0 ADDITION O GARAGE/SHED 0 WINDOWS
0 BASEMENT FINISH � ROOF 0 DRAIN TILE
0 DECK Cl SIDING 0 OTHER
0 SWIMMING POOL
TYPE OF WORK:
0 NEW 0 ADDITION
0 MAINTENANCE/REPAIR 0 REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING 0 HOUSE ONLY
NUMBER OF SQUARES42z HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
0 ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
0 DETACHED GARAGE
3.
List of struchual members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
0 Vinyl
OSoffit
ADDTfIONS
& PORCHES SUBMIT:
O Aluminum
0 Trim
1.
Site Plan/Sumey showing the existing structures
0 Other
0 Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS OYes ONo 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 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 5 q 3 c — OCCUPANCY TYPE
Permit Fee
$ �7 g'
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
3.
.001 times the total job valuation
Surcharge
$
!.7d
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
,j 00
$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
$
/ d
Make checks payable to: City of Fridley Attach Stipulations
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 w rich req ires review d aproval of plans.
Page 2 - Building Residential Application
BUILDING PERAUT 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
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 #
$23,50 for 1"$500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$391.25 for I" $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for I" $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the 1- $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the 1 $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
_Duilding I(:
Permit No.:161(3T ,� rl
Inspections ENTAPPLICATION ION
Received By: fnij,
763-572-3604 CITY OF F LEY
D to c'(�
763-502-4977 FAX
E
EFFECTIVE 7-I-2010
DATE 1(- ID YOUR E-MAIL ADDRESS
.10-
SITE ADDRESS D q T a p v, * j3y
THIS APPLICANT IS: I7 OWNER 113CONTRACTOR
PROPERTY
NAME: LAJA`.rvi,,_ 0 -
-OWNER/
OWNER/
ADDRESS a S S� 6 )V- 0 6 k . tjA y N r CITY F►e.1 to STATEH 1-) ZIP S r q3�t_
�,1a
TENANT
a O
CONTRACTOR
COMPANY NAME: 12;,, C� S►� L I �i �- t
SUBMIT A COPY OF
CONTACT PERSON:
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 0 r'i CITY r121'0(c4 STATE (OZIP 9 3)_
APPLICATION
PHONE '7161 -7S1,4 .2 99 FAX
PERMIT TYPE
SINGLE FAMILY D TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
❑ NEW "REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK s l A t t
�Y
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALCIS PER MANUAL J 2006 ASHRAE HANDBOOK
Equipment Installed MFG:yu p n b- MODEL: 3 S S &Ay OId a D yb SIZE/ `r I ll o o
MFG:I� YT- MODEL: I D4 i3 NJA 0 3 D SIZE/BTU ;L14 T o VI
MFG: MODEL: SIZE/BTU
_L_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 _GAS UNIT HTR $10.00
CIIIMNEY LINER $10.00 DRYER $10.00 _POOL HEATER $35.00
_GAS
DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00
' 9 x �� . � •`�i� S � , &=rim° 3 .'' , y t>�p�� T �w4��.��y�1tt ? � b � �ry'� 4S
t`'
,. (`fit. _ SET✓ �`'" �i s4`,. _ � � �3� She^ �a 6,. _ � i � 3,: �, h fu'k IX b � � eeh� S x �A�iT?'�� � � }� k`.:i. +it �'��C � ��r�"."�
}�"•� � �`. ?L -t�� �'�^�' „�h�fa:.f?�{�,.,.di;� fa � wt, `,�"x� @.ees},��� ��� ��x��::� �,� ''2�'FkL�: ����',7 Hie �, "t � -��"� ��ir'�s a�:
��*,
' +. -fir ,- P'' Y> u„ s=`�''Yv �'' p'�� ?�.;� � 3 '� $� r��f h�„����rr �s wr.`�' � t�..h•'�.T.'� �' �ai5'1� � �;iY- v .zb� s� � 'L N
r? i�
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. 9- 3 a„ 1 p
SIGNATURE OF APPLICANT PRINTNAME l�� i' 1, DATE F 1
-
APPROVAL INSPECTORS SIGNATURE DATE -
IIAS, S1TNOSATEiE S t .... ;
City of Fridley — XF
Building Inspections Department
6431 University t_ venue NEE, Fridley, NIN 55432
763-572-3604 FAX: 763-502-4977