PRE 2010 DOCSA
v- - Pwv .- m� a,; -,I . awe ja-g, �RQggg& a cad
Air -flIng 31%mms Q-
GRAVM WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ... ...
X10.00 �
Replacement of Furnace
6.00
Repairs & Alterations --up to $500.00
6.00 $
Repairs & Alterations each add. $500.00
3011 $
(�*;4"-' :ay+r ,tet A .: � A.1
Furnace S 1 & Duct Work to 120,000 BTU
..$1000
$-
/each add. 60,000 BTU
3.Uu
Replacement of Furnace
6.00
$
Repairs & Alterations—up to $500.0;
6.00
$
Repairs & Alterations each add. $300.00
3.00
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. FZR Steam
$10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
20.00
$.
Each add 200 sq. ft. EDR Steam
3.011
$
,Each add. 320 sq. ft. EDR Hot Water
3.00
$
OIL BURNER—to 3 gaL per hour 6.00 $_
over 3 gal. per hour—See Fee Schedule
OS`2 ✓�
GAS BURNER (up to W,000 Ii7'LT) V
over 1059,000 IBJ S" Fee Schoduls
GAS FITT2NC FEES: NO RATiE TOTAL
1st 3 fixtures x$ ZOO $
Additional Futures $ .75 $_
Gas Range to IW,0W X8 5.00, $
AIR COMMOMMO State Surcharge .50
rAN HMTMG STST= Fee schodab
G Z
ALTZRA IOND & REPAMS TOTAL FMQ
i
Dept. of M-lem. Ph* ars 310-M
, m--. tT A
City of I1idley:
The undersigned hereby makes application for a permit for the work herds.
specified. agreeing to do all work in strict accordance with the City Ordinancer
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, ?Mnn- — 197
,,caner - �X !� i`� o f Zg, J
Kind of Building
Used as %
To he completed about, /
Estimated Cast, $
Old ew. Building Permit No. _Formitno.
1,77m," 717,73=M71
H A77NG or POWER FLAN''iS---Stream, Not Water, Warm Air—No
Trade Name Sitz NO
Capacity—___-_ _ Sq. Ft. E..D.R BTU
Total Connected Lmd Kind of >l
BURNER — Trade Name Siam Nn
Capacity Sq. �. E.D- BTU
���
SUBJECT
PERMIT
City of Fridley
®3153
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION
�����
r PROTECTIVE SEC.
1 i
= CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
8-26-75
JOB ADDRESS
7
137 TALMADaR
1 LEGAL
LOT BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
RONALD ELLIS
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
WYMAN BUILDERS, INC. 15629 OAK RIDGE ROAD HOPKINS MINNESOTA
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 91 MOVE ❑ REMOVE
6 DESCRIBE WORK
MOVE GARAGE
9 CHANGE OF USE FROM TO
STIPULATIONS
SIEPERATE PERMITS REQUIRED FOR WIRMG,
HEATING. PLUM13ING Ali SIGNS.
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,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
XM .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 OR THE PER RMANCE OF CONSTRUCTION.
$10.00
PLAN CHECK FEE
TOTAL FEE
_
®2dZ�'%J
10.50
SIGNATURE OF CO 11F OR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLYOVALIDATED THIS IS YOUR PERMIT
8-26-75
BLDG INSP ZDATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
���
f a0 • jo ,
SUBJECT
ERMII b
City of Fridley
5
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
6
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
-AFP-ROVED B
612-560-3450
910-F15
JOB ADDRESS, 137 TA'LMADGE WAY N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
1
ELWELL'S RIVER HEIGHTS SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
RONALD ELLIS
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
WYMAN BUILDERS INC. 15629 OAK RTDGE
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW XXX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
ATTACH BREEZEWAY & GARAGE
9 CHANGE QF USE FROM TO
STIPULATIONS
PROVIDE HARD SURFACED DRIVEWAY
SEPERIATE'PERMITS -RE UIRED FOR WIRING,
HEATINC4 PLUMBING AND SIGNS.
WARMS
utilities
-
BetoT
TELEpH®NEELECT,,, - GAS Etc
W
TYPE MC15ftAJ 5
bMUPK-NdY 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,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,500
$1.00
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 PER RMANCE OF CONSTRUCTION.
$12.00
PLAN CHECK FEE
TOTALFEE
/
✓�'����°�
13...00
SIGNATURE OF CO R TOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATE THIS IS YOUR PERMIT
;1A A. -e 1'-/-%® 8-26-75
BLDG INSP '` ' • MATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
f a0 • jo ,
APPLICATION FOR RESI-DENTIAL:, ALTERATION,
• OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
• OWNER'S ME: i� A)ABUILDER:X�.
ADDRESS: /� % ��L/% ��r 0/fY ADDRESS : 014-e f%� � IM
NO • %? 7 STREET • TA L A Dd-E
LOT: BLOCK: ADDITION: ZE:;�
CORNER LOT: INSIDE LOT: SETBAGK:_��• SIDE -YARD:
Applicant .attach to this form Tcao Certificates -)f Survey.of Lot and.proposed
building location c:,:awn on -these Certificates.
.DESCRIPTION OF BUILDING
To BeUsed As-.*
�2. Front : Z 2— r Depth : e� Height
• Square Feet: Cubic.Feet: 57. 1,-5—
Front: Depth• Height:
Square Feet; Cubic Feet:
�®
Type of :Construction: Estimated Cost: $ ,
_ -wrt lgx
To Be Completed: ®d;7 Z.!6
The undersigned hereby makes application fora permit for the work herein
specified, agreeing to do all work in, stiict 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
f are true and correct.
DATE: SIGNATURE:0 cam%
See Reverse Side For Additional Informat on.)'too
'
'��� � d� ted � . 0�• �� : .
p s °
' BUILDINC L'LsRMI'L' I^EL SUII.LVULD .
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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet- or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
'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 $5.00.
1lERIFICATION 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 Certified 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 aiiy 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..
AGREEMENT
owner of the property located
at / !Lz m1drT,9 have no objection to the Cit allowing
the constructio�f a• to be located at f
UL' L without the required certificate of survey that the
City ordinarily requires for all new constructi
ign ure
Addrr6sss
Date
Witness
CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
The undersigned hereby makes application for a permit for the work herein
.AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
GRAVITY WARM AIR:
RATE
TOTAL
Job Address 1�'7 i toHAL E WA -e '
Furnace Shell & Duct Work
$12.00
$
7.00
4.00
Replacement of Furnace
7.00
$
FAN HEATING SYSTEMS
Repairs & Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
$
KIND OF BUILDING fpm a
each addn. 50,000 BTU
Tel. #571-3450
MECHANICAL WARM AIR:
GAS FITTING FEES:
lst 3 Fixtures
x $ 3.00
$
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
4.00
$
�` J
Repairs & Alterations each add. $500.00
FAN HEATING SYSTEMS
$
Fridley, Minn. c7 , 19
STEAM OR HOT WATER SYSTEM:
Size No.
OWNER R& ?-3 A L. ® L. L'5
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING fpm a
each addn. 50,000 BTU
4.00
$
$
Boiler only up to 100,000 BTU
7.00
$
USED AS �C-5 f ®a &a c iL
each addn. 50,000 BTU
6.00
$
i /)�``T-
Kind of Fuel
TOTAL FEE
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
Size No.
ROUGH INSP. REINSPECTION FEE
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$
OLD - NEW BUILDING PERMIT NO. PERMIT N0.
(over 199,999 BTU see Fee Schedule)
$
Company
GAS FITTING FEES:
lst 3 Fixtures
x $ 3.00
$
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures
x $ 1.00
$
Gas Range to 199,000 BTU
x $10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, Warm Aik- No.
AIR CONDITIONING
$ ®•E3f
FAN HEATING SYSTEMS
$
Trade Name
Size No.
See
VENTILATING SYSTEMS
Fee Schedule
$
ALTERATIONS & REPAIRS
$
Capacity
Sq. Ft. EDR
BTU HP
State Surcharge
$ .50
Total Connected Load
Kind of Fuel
TOTAL FEE
BURNER - Trade Name
Size No.
ROUGH INSP. REINSPECTION FEE
Capacity
Sq. Ft. EDR
BTU HP
Date
($10.00)
Company
/
l
FINAL INSP.
Date
Signed By
JJyyqq
APPROVAL FOR PERMIT G l �'
Tel. No.�
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
16
Building
$ �, A
BUILDING
Permit No.:TC��z
Inspections
$ l k 4
RESIDENTIAL APPLICATION
Received B763-572-3604763-502-3604
License Surcharge
$
CITY OF FRIDLEY
Date Rec'd:
FAX
$
Erosion Control
$
Park Fee
EFFECTIVE 1-I-09
Sewer Main Charge
DATE
YOUR E-MAIL ADDRESS .4 r a G 1®
cl CPL. C 4, NM
SITE ADDRESS
(iL.1 a t9'
THIS APPLICANT IS:
OWNER ❑CONTRACTO
PROPERTY OWNER/
NAME: AguoLb '
TENANT
ADDRESS:7 �� L.� C` CITY ��(f
STA ZIP
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
0 SINGLE FAMILY/NEW CONSTRUCTION SIZE 1.'L®®
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH *ROOF ❑ 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 &HOUSE ONLY
NUMBER OF SQUARES r� 40 HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
FO_R_NEW CONSTRUCTION INCLUDING DECKS,
SIDING-- - - — - -
— - -- _ __ __ ___ __ _ _
_
ADDITIONS.
& PORCHES SUBMIT:
❑ Vinyl
❑Soffit
l . Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and
proposed project.
❑ Other
❑ Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No 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 $ 2 4l S OCCUPANCY TYPE
Permit Fee
$ �, A
Plan Review
$ _ �1 0
Fire Surcharge
$ l k 4
Surcharge
$
License Surcharge
$
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$ F
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)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: Citv of Fridley Attach
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 on site; that the work will be in accordance with the
approved plan in the case of all work which re 'res review and approval• of plans.
SIGNATURE OF APPLICANT ��� RINT NAME 01 A I 4t hATE
Page 2 - Building Residential Application
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
$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 g $2,000 plus $14 for each additional $1,000 or fraction, to and
4ricluding $$25,000
$25,001 to $50,000
$391.25 for 1' $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