PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: — MARCH 9, 1967
Owner: _ Builder
Address Address
LOCATION OF BUILDING
No 9156
CLEMRON, INCORPORATED
701 COLUMBIA BOULEVARD N. E.
MINNEAPOLIS, MINNESOTA
No. _ 7300 Street _.__ $XMF-J= STREET N. E. ____ Part of Lot
Lot _ 16 _ __ _ Block 5 -- Addition or Sub -Division ._MELODY MANOR
Corner Lot ...__X Inside Lot . _ Setback — 35' -- Sideyard -.R' & 6'
Sewer Elevation ____ 852.34 NN99WElevation 855.34
TOP OF FOOTING
To be Used as:
DWELLING
GARAGE - ATT.
Type of Construction
DESCRIPTION OF BUILDING
Front 40 Depth 25 Height 20 Scl. Ft. 1, 000 Cu. Ft. 20, 000
Front 20 Depth Z3 Height 10 sq.Ft. 460 Cu. Ft. 4,600
FRAME Est. Cost —$18, 000.00 __ To be Completed —
SEWER LOCATION - 84' NORTH OF MANHOLE
WATER LOCATION - 97' NORTH OF MANHOLE
In consideration of the issuance to me of a permit to c,, the buildin ve, I agree to do
the proposed work in accordance with the description above se rth and th all provisions of
ordinances of the city of Fridley.
$100.00 SEWER CONNECTION GE
In consideration of the payment of a fee of $ 25 .00 ., permit is hereby granted to_ _ CLEMRON,
INCORPORATED 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, Nnnesota 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 d
ordinances.
CLARENCE BELISLE Building MuPector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sower or water. Be arra to see
the Building Inspector for separate permits for theta hens.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIMEY, MINNESOTA
9
OWNER'S NAME ,� � r ,. ,� BUILDER
ADDRESS ADDRESS
LOCA ON OF PUILDING,
N0STREET PART OF LOT
LOT�_BLOCK S ADDITION OR SUBDIVISION
CORNER LOT_k::�IiSIDE LOT SETBACK SIDE YARD � �-0 9�-
SEWER ELEVATION FOUNDATION ELEVATION
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;
g Z
Front �� p Depth ,ZS�G Hei ht
Sq. Ft. `C�Oe5l Cu. Ft.
Front 1�04 -0 Depth s � Height—F :
Sq.. Ft. Cu. Ft.
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 representations stated in this application
are true and correct.
DATE_ `� % SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
- .,
BUILDING PERMIT FEE SCHEDULE
SECTION 2, The Inspector of Buildings shall, .before issuing any permit for
the erection of any building or structure, or for any addition to any existing
building or structure, or for any alterations'dr- 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 -wits
2.1. For any such permit for.the erection of any fire -proof building,
other than a garage, warehouse, factory or grain elevator, or for the erection
of any fire -proof addition, for similar occupancy, to any existing building,
shall be at..the rate of $1.40 for:each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2 For any such.permit for the erection of any fire -proof garage,
warehouse, factory or grain elevator, or for the erection of any fire -proof
addition, for similar occupancy, to any existing building shall be at the
rate of $1.25 for each one thousand cubic feet, classified as "fireproof"
by Section. 5.02 of the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof
building, other than a garage, warehouse, factory or grain elevator, or
any non -fireproof addition, for similar occupancy, to any existing building
permit $1.00 for each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non -fire -proof
addition, for similar -occupancy, to any existing building or for each such
building or addition -.ninety cents ($0,90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of -computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by.multiplying the
ground area covered from a point six (6),inches below the floor line of the
basement or cellar to the average height of the upper surface or to the average
height of the roof surface of the`main gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fee shall
be at the rate of $3.00 per each Five Hundred Dollars ($5004.00) or fraction
thereof in the cost of all proposed work. ' •
2.6. In no case shall the fee charged for any permit as set forth in
Section.2 be less than $4.00.
STORM REPAIR DAMAGE FEES:
Residential: Estimated Cost of work up to 5500.00 - $5.00
Estimated Cost of work c -,ex - ;;.., r.O
Commercial; Estimate 'lost of tr,...t L � r `O
4 Estimate, .;oat of a;oa:k over 4-11.0.00 - jO F'
City of Fridley
Application for Plumbing and Gas lifting Permit C
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
qUN'
N
3
Number Fixtures ...... ..............
���O
eJ
$
Future Fixture Opening ................
x $1.50
Y
New Fixture Old Opening ..............
C Z
H
Catch Basin ...... .....................
x $3.25
W
z
z
F
r
N
WATER HTR.
GAS
ELEC
Base
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $2.00
C"-6
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
1st
Q
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
I
Connected with
Sewer �
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
O. RATE TOTAL
Number Fixtures ...... ..............
x $2.00
eJ
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ...... .....................
x $3.25
$
Water Heater (Up to 99,000 BTU)
...... -— x $3.00
$
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $2.00
C"-6
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ........................................
TOTAL FEE ` P
0
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.
Owner
Kind of
Used as
To be compietiea aoouz
Estimated Cast, $ t
Old—ew uilding Permit No / Permit No. d
By a;=K='.k—
Business Phone
ROUGH &^ 7" L% � d `Y y e
FINAL
.QW42
r
7M
Application for Power Plants and Heating, Cooling, Ventilation, ReMpration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
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 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $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 $
ROUGH
FINAL
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.
Owner
Fridley,
..- :/// A % h Ar //
Kind of Building%
Used as
To be completed about
s
Estimated Cost, $ o
Old -Building Permit No. 1� `� Permit No. A 17
DESCRIPTION OF WORK
HEATING or PO PLANTS—Steam, Hot Water, arm ----Air--
4-No-
Trade
ir ' No -Trade Name � ��-��eed 4;� Size
Capacity Sq. Ft. E.D. �� 420& BTU H.P.
Total Connected Load Kind of Fuel'��
BURNER — Trade Name �� Size No
Capacity Sq. Ft. E.D R �� BTU H.P.
(REMARKS -OVER)
Si d N. WELTER HEATING CO.
4637 CHICAGO AVE.
By
4z Business Phone No-
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRI.GERATION AND
AIR
CONDITIONING
SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Job Address 7300 Symphony St. NE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
$ 20.00
$ 20.00
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping
$ 10.00
$
Tel. #571-3450
(piping needed with new furnace)
Gas Range
$_10.00
$
The undersigned hereby makes application for a permit for the work herein
Gas Dryer
$_10.00
$
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.
* Air Conditioning (all sizes)
$-10.00
$ 10.00
Fridley, Minn. September 71988
All Others/Repairs and Alterations
OWNER James Sandquist
1% of Value of Appliance or Work
$
KIND OF BUILDING Frame
COMMERCIAL/INDUSTRIAL
USED AS Residential
1% of Value of Appliance or Work
$
TO BE COMPLETED ABOUT
State Surcharge $ .50
TOTAL FEE $ 30.50
Reinspection Fee ($15.00) $
Rough Insp.
Date
**Also installing one (1)
Carrier 38ES024/24 2 ton
air conditioner
Final Insp.
Date **REPLACEMENT**
Approval for Permit j�
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00,
PLUS $.50 STATE SURCHARGE
Attach stack verification form with. replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
ESTIMATED COST $3600.00
OLD - NEW BUILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. one
Trade Name Carrier Size No. 58SX06OCC
Capacity Sq. Ft. EDR BTU 60 , 000 HP
Total Connected Load
BURNER - Trade Name
Capacity Sq. Ft. £•.DR
Kind of Fuel nat . gas
Size No.
BTU HP
Company , Dependable
nnHeating
and AA/�C/
Signed By'Z \ iLld�(i—vim'
Tel. No. 757-5040
HOUSE HEATING TEST RECORD
ADDRESS APT. F OR ITY UBURB;Z9:d:2w,
OCCUPANT -OWNER-
HEAT
OWNER HEAT LOSS DATE HTG.INST. GAS CO. METER BAD
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA _HW STEAM SPACE HTR. UNIT HTR; OTHER
GA ES1Go CONVERSION
MAKE MAKE OF BURNER
Model 4) 6 VAAL Model
Serial Max. BTU Rating
INPUTMAKE OF FURNACE
Model
THERMOSTAT
Volvo
Limit
Limit Setting _
Fan Setting —
Plug —
Form 235
Vent Size el
KIND OF LINER
„�” �Z NONE
Draft Hood 6�Regulator
Filters Size Number
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring 111114 -
Draft
door
Test Tag
Pressure Li htin Inst. C�
T�..asJ
Company
Name of
f�
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes J---r�No
2. Is free from rust or deterioration Yes Jrj No ( )
v
3. Has no foreign objects lodged within Yes .(�� No ( )
4. Is securely supported Yes,( No ( )
5. Meets all current Code requirements for size and
total BTU connected Yes � No ( )
6. Has Total heating BTU's of D
All other BTU's 410, I)OD
TOTAL i.'�e 00()
Remarks 05i0I�® T G7��cJ
yE
Company
Signed
Date
SUBJECT
P
City of Fridley
20011
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• ___ __ COMMUNITY DEVELOPMENT DIV.
L •�
r PROTECTIVE INSPECTION SEC.
C)
'
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/20/89
10B ADDRESS 7300 Symphony Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
5
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Sandquist 7300 Symphony Street N.E.
786-5711
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 101 x•201 Shed in Rear Yard
9 CHANGE OF USE FROM TO
STIPULATIONS
Shed must be securely anchored to ground
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 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
$1,000
$,50
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-
$25.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$25.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIWHEN
PROPERLY ALIDATED THIS IS YOUR PERMIT
BLDG )NSP
GATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ] Effective 5/1/88
ADEN [ ] P-1 AND R-2
AMER [ ] Building Permit Application
Construction Address: 73 ®0 S �/��
Legal Description: e / .3" —u
Owner Name & Address: Tel. #
CMItractor• d
Address• ..,..P
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
n
07rlaN CF nlP ROVEM r
iavnr. AMM: length Width Height sq. Ft.
� ARS: length Width Height Sq. Ft.
EM Aim: Length Width Hgt/CmundSq. Ft.
oTm: "a- . J -"A A , � � V-1^/
s
Corner Lot ['Inside Int j ] Ft. Yd setback Side Yazd Setbacks ' ;7 / ®0
Type of Construction: -- m Estimated Cost: $v
Approx. O m pletion Date:
FrCPOsed Driveway Width If New opening Is Desired: Ft. $ $
Width + 6' See Hack Page
DATE: - - APPlMM: Tel. 7
Permit Fee $
State Surcharge $
SAC Qhazge $
Driveway Escrow $
Park Fee $
Sewer Plain Charge $
6�
s ULMCKS:
Y
MY Un �Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by
Necessary [ ] Not Necessary [ ]
l®a d
loop
SIC
The Chief Building Official shall, before issuing permits for the erection of any
building or structure, -or for any addition to any existing ng building or structure, or
for any alteration or repair to any existing building or structure, upon application
therefore, requi re 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 VA= )FEES
$1 to $500 $15 (Minimum Fee is $15 plus suraharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50, 000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
EMEMY I I I I EMICK ESCWW
(Concrete Curb Streets Choly)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": Ren val and replacement of curb and gutter and install a 3 foot wide
approach with 6 indi depth - Driveway width plus 6 feet times $15.75.
Permits for construction will be issued a minim= 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 rm iired before proceeding with the framing.
6875-Hiyhivay AC'S AT
Lone Plonnin�(4a&"6r"L
Minneapal s 21,
Land Surveying
® I /lflinncsof4
Soils lesfrir9
0
SUnsef 4-6066
Civil b Alunicipal i „ _
UT
O DENOTBs 'IRON _ --- p�N®TES UT11_t'6Y 6 oRA1MAGF EASEMENYS
I. ELEVATIOMS ARE. PROPOSED
2. FIRST FLOOR EL.Ea/A'7tOt4 -To es-- 2.5 FEF --f ASOVS GP-OUt4T3 F-F-V.SbA0Wh1
LOT 4( E)LOCK 5 MES ---OILY
l hereby cern y Thai Hns is a true and carred represedation 00 survey effie bwndories of 4e abore aFe;cr kd /acrd, and
oF"ffie /ocvtinn ol'all bu;ldm9s , fhereon , and ell risible mavachmen`s , �,rany. Fran or ov said lend. As surveyed by me this _dolt'
SUB UI28AN ENGINEERING, INC.
Engineers E Surveyors
SCALE t 30'
-. .: A& iii '.,!'F�7y07 -580:��1183VMT:lsa
0,3.:.,.� %aoM ;o :1900 pa:;tnu' :l G3
0000 S;� 03 do %aoM ;o asoo pg4vmTgsg :19 Lap-fsag
— 14 2. ,30 _
1
�
F-
�
�
w
!
c�
!m
—
T
IPC
+ �
��
T-2010
EL. 8 rj9.4
S6O.2
859.ti
73 IP AVE N UE N.E.
O DENOTBs 'IRON _ --- p�N®TES UT11_t'6Y 6 oRA1MAGF EASEMENYS
I. ELEVATIOMS ARE. PROPOSED
2. FIRST FLOOR EL.Ea/A'7tOt4 -To es-- 2.5 FEF --f ASOVS GP-OUt4T3 F-F-V.SbA0Wh1
LOT 4( E)LOCK 5 MES ---OILY
l hereby cern y Thai Hns is a true and carred represedation 00 survey effie bwndories of 4e abore aFe;cr kd /acrd, and
oF"ffie /ocvtinn ol'all bu;ldm9s , fhereon , and ell risible mavachmen`s , �,rany. Fran or ov said lend. As surveyed by me this _dolt'
SUB UI28AN ENGINEERING, INC.
Engineers E Surveyors
SCALE t 30'
-. .: A& iii '.,!'F�7y07 -580:��1183VMT:lsa
0,3.:.,.� %aoM ;o :1900 pa:;tnu' :l G3
0000 S;� 03 do %aoM ;o asoo pg4vmTgsg :19 Lap-fsag
SUBJECT
PE
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
-� 2
'r 'ECH
COMMUNITY DEVELOPMENT DIV
v PROTECTIVE INSPECTION SEC
4
r 1 i
CITY HALL FRIOLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
9/8/94
JOB ADDRESS
7300 Symphony Street NE
1 LEGAL
LOT NO-
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
5
1 Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
James Sand uist 7300 Snphony Street NE
786-5711
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION XJ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (20 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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS
I 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
$1,500
$.75
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
Fire SC $1.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$35.00
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$42.25
OF CONTR TOR ORA ORIZE AGENT s (DATEI
WHEN PROPE Y�,VALIDATED THIS IS YOUR PERMIT
;NATURE
T".- B G INSP
'
TiATE
A RE OF OWNER IIF WNERBUILDERI iDATE)
NEW [ ] Effective 1/ 1 /94
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: �.5t) L
Legal Description:
Owner Name & Address: Tel.
Contractor: MN LICENSE # -------
Address: Tel. # G -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
Hei
- Sq. t.
GARAGE AREA. Length
V4 idtl� '
Neigh
Sq.
DECK AREA: Length
Width
HgdGround
Sq. Ft.
OTHER:
2-C
Corner Lot [Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: i Estimated Cost: $
Approx. Completion Date: g • 3_�4 %5 . (10
(Cost on Back)
Driveway Curb Cat Width Needed: Fit. + 6 Ft = Ft x $ = $
DATE:APPLICANT: � Tel. # �
CIf USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%a)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary C ] Not Necessary [ ]
01
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure,
or fir 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:
I'OTAL VALUE FEES
$1 to $500 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50for each additioctal $1;000
or fraction thereof, to. and including $50,000
$50,001 to $100,000 $414.50 for fust $50,000 plus $450 for each additional
.$1,000 or fraction thereof, to .and including $100,000
$100,001 to $500,000 $63950 for first -$100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including -$500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 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 "13": 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 stricture 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.