PRE 2010 DOCSCity of Fridley.) Minn.
BUILDING PERMIT N? ( -P 0=5 4
U O ILDINIG,
.AAA 10
Lot -Division
Comer Lot, Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
In consideration Of the issuance to me of a permit to. construct the building described above, I agree. to do
the work In accordance with the description atlove-set forth and in compliance with all provisions of
ordinancsei of the city of Fridley.
Jr
In consideration of the payment of a fee of permit Is hereby granted to,
to construct the building or addition as .described above. This permit Is granted upon
the express condition that the person to whom it Is g1ranted and his agents, employees and workmen, In all work
done in, around and upon said building, or anythereof, -'shall conform in. all respects to the ordinances of
Fridley, Minnesota regarding location, construction, 'alteration, maintenance, repair 4fid,moving of buildings
within the city limits and this permit may be revoked at anytime any of the provisions of said
ordinances. Opmetr^
Building Inspector
NOTICE:
Tk% permit don not cover the construction, IneftDodon for "ins, phm"11, *n heath* sower or water. Be so.a to see
the Building Inspector for oqsaraft ponnift for these ham
4.0
f
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIZY, MINNESOTA
Owner's Name Builder
Address
LOCATION OF BUILDING
No. Street 4-:I y) ij�g,- Part of Lot
Block Addition oSubdivisionL/
��
r
" Lot _ � � � .�
Corner Lot Inside Lot Setbac3s Side -Yard Y S
SEWER ELEVATION, FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be d as:
9
DESCRIPTION OF BUILDING
i
Depth3-e)
Sq. Ft. �'� d Cu.. Ft.
Front 2 - Depth 2 � Height L
Sq. Ft.Cu. Ft.
Type of Construction d- � Estimated Cost X , j
To be Completedi^6
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 1 the facts and representations
stated in this application are true and correct.
F
(A Schedule of
can be found on the Reverse lade.)
BUIiDING PERMIT FEE SCHEDUIZ
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 build-
ing or structure, or for any alterations or repairs to any existing building or
structure, upon application therefor, 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:
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 $1.1+0 for each one thousand cubic feet, or fraction thereof, in such
cubical contents.
2.2. For any such permit for the erection of any fireproof garage, warehouse,
factory or grain elevator, or for the erection of any fireproof 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 502 of the
Yinneapolis Building Code.
HOU��S
2,3. For any such permit for the erection of any nor -fireproof building other
Va-an a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any existing building. Permit $1.00 for
Bch one thousand cubic feet.
On i.RAG ,S
24. For any such permit for the erection of any non -fireproof garage, warehouse,
factory or grain elevator, or for Ahe erection of any non -fireproof addition, for
similar occupancy, to any existing building or for each such building or addition.
Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical
contents thereof with a minimum of $1+.00.
For the purpo7e of computing fees for building permits the cubical contents of any
building or addition to a unj.-orm 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 for each Five Hundred Dollars ($500.00), 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 $/..00.
-
City of Fridley
Application for Plambing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470°
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Loo ahon
G7
,�,�
►:
'�
{xu
w
0
Z
•
F
•
N
WATER HTR.
GAS
ELEC.
O
Base
1st
f'
2nd
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 $1.50 $ /6 --sq,
Future Fixture Ope.. ................ x 1.20
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTT) ...... x 2.00 $
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOT
1st 3 Fixtures .......................... x $1.50 $ -6
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description...................$
.............................
TOTAL FEE $ , 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 Building's, and hereby declares that all the fact
and representations stated in this application are true and correct.
Owner
Kind of _
Used as
To be completed about
Estimated Cost, $
Ol t9
Building Permit No
ROUGH 9 - a % s 6 �
FINAL
By
Business Phone No
Fd
4
!
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration 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 $ s�
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
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
$
See Fee Schedule
$ �
TOTAL FEE $�
Dept. of Bldgs. Phone SU 4-7470
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.
%1 Fri4iey�Viinn_ 4'� °� 7 . 196—?,
Kind of BU64
Used as
To be completed about �� b
Estimated Cost, $
Old New Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or CPLANTS—Ste , Hot Water, 1 arm Air o
Trade Name Size Nn -
Capacity Sq.
n-
CapacitySq. Ft. E.D.R COLI A -OL -d BTU H.P.
Total Connected Load 7 11,6 z) Rind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS-OVER)
sigRAY N. WELTER HEATING C®.
ned
4637 CHICAGO AVE.
ByMINNEAPOLIS 17, M1NN6rpC;T-A
4 Z 2M Business Phone No P " d10
SUBJECT
PERMd--,
City ®f Fridley
n 4 � 2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
CEI
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 �
1 1
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
=
1 /'-'1 � CITY HALL FRIOLEY 55432
IL"""11•"
�.j 612-571-3450
910415
6/8/92
JOB ADDRESS 144 Talmadge Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
Elwell' s. Riverside Heights
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Ethel Ratfield 144 Talmadge Way NE
571-5664
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
D & D Home Improvement 7401 Central Avenue
NE, Fridley 55432
784-7543 4840
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
Reroo;� House (19 Squares)
9 CHANGEOFUSEFROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1x007
$..50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$27.00
Fire SC $1.01
STRUC OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5,00
$33,51
IGNATURE OF CONTRACTOROR AUTHORIZED AGENT IDATEI
HE7ROMPLY AL
ATEID THIS IS YOUR PERMIT
FLOG INS P
f1ATE
SiGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW { ]
ADDN ( ]
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/1/92
Legal Description:
Owner Name & Address: / Tel. #��
Contract
Address:
ICENSE #�
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IWROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: A C 7 '' &, 0 /-S& Estimated Cost: $ %00-q
Approx. Completion Date: �i�ise -! -;-V ! / Q%%T_ -/
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $
DATE: /Vs APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park Fee
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ �L,3 , 51
zL
Tel. #
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
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 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fiaction 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
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.
qG
SUBJECT
PER
City ®f Fridley
22269
AT THE TOP OF THE TWINS
BUILDING PERMIT(
r
s
�•
COMMUNITY DEVELOPMENT DIV.
j
__
L PROTECTIVE INSPECTION SEC.
/fir 33
i CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
12/21/93
JOB ADDRESS 144 Talmadge Way NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
5
2
Elwell's Riverside Heights SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Ethel Ratfield 144 Talmadge Way NE 571-5664
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Home Improvement Inc. 7401 Central Avenue NE, Fridley 55432. 784-7543 4840
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
Install aluminum fascia & soffit
9 CHANGE OF USE FROM TO
STIPULATIONS provide adequate attic ventilation.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS I GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,495
$. 75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVIS S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$ 350 00
Fire SC $1.50,
STRU ION R THE PERFORMANCE OF CO STAUCTION.
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$42.25
Si"-ATb<EO NT aCTORORa RizEDAGE iDATEi
WHEN PR Y AL DATED THIS IS YOUR PERMIT
BLD iNSP MATE
SiGNATURE OF OWNER 0E -OWNER BUiLDERi iDATEi "c—
NEW [ l Effective 5/26/93
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND .DUPLEXES R-1 AND R-2
Building Permit Application
P.M. 71F.M. PIM, IR
Legal Description:
Owner Name & Address:
Tel. #�
Contractor: D & D Home Improvement, Inc. MN LICENSE # 4840
Address: 7401 Central Avenue N.E., Fridley, MN 55432 Tel. # 784-7543
Attach to this application, a Certificate of Survey of the
lot, with the propos construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
OTHER:
DESCRIPTION OF 1WROVEMENT
Width Height Sq. Ft.
Width height Sq. Ft.
Width Hgt/Gimmd Sq. Ft.
Corner Lot [ j Inside Lot [ ] Ft. Yd Setback Side Yard Sks
Type of Construction: ,S7W f Jk Estimated Cost: $ !!Z V
Approx. Completion Date: f ��
Driveway Curb Cut Width Needed:
(Cost on Back)
Ft. + 6 Ft = Ft x $
M
DATE: APPLICANT: Tel. #.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$j.r�—o
$ , 7 sr
$
00
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ l Not Necessary [
TOTAL $� �2 • ` S S'T'IPULATIONS:
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 $15 (Minimum Fee is $15 plus surcharge)
$501 to 32,000 $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
$50,001 to $100,000
$100,001 to $500,000
$5007001 to $1,000,000
$1,000,001 and up
$252 .for first,- $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to. and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to .and including $100,000
$639.50 for first $100,000 plus $3.50 .for each additional
$1,000 or fraction thereof, to and including $500,000
$2039.50 for the fust $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof z
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 INSPECTION DIV. Effective On August 1, 1395
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 a
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $ representations sated• in this application are true and correct.
(Side Vent - Fill Out Back)d L 11995
Gas Piping (Needed with new furnace) $ 10.00 $ %Q,� �/� _
OWNER �7�� ,, / °moi' i �,W 5' 7/ - (, 4 -4
Gas Range $ 10.00 $ �f
BUILDING USED AS ' /A�
Gas Dryer $10.00 $
ESTIMATED COST PERMIT NO.
*Air Conditioning - All Sizes $ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/Industrial BTU _ ®f�L� HP EDR
1.25% of Value of Appliance or Work $ Fuel Total Connected Load
State Surcharge $ .50 Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE C, �
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING COMPANY
Signed B
Approved By
FILL OUT BACK SIDE OR
REPLACEMENT FURNACE
6A /v/
Tel No. '�2j ! So
Rough -In Date
STACK VERIFICATION ON
Final Date
HIMNEY AND STACK VERIFICATI
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 AA
No ( )
5.
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 CV.
7.
Has a liner been provided for water heater
Yes ()
No ( )
8.
Has combustion air been provided for water heater
Yes ()
No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SUBJECT
PERMIT NO.
City of Fridley
2 3 21
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
' ,
O
w____ COMMUNITY DEVELOPMENT DIV.
-_
PROTECTIVE INSPECTION SEC.
O
�P
�A6
j
1
NUMBER
REv
DATE
PAGE OF
APPROVED BY
1 " I CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/20/98
JOB ADDRESS 144 Talmadge Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1 5
2
lElWell's Riverside Heights
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ethel Ratfield
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
D & B Home Improv. 4901 105th Ln Circle Pines MN 55014
784-0922 7773
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
0 NEW 0 ADDITION 0 ALTERATION 9 REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof house and garage (23 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. '
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
1971
.98
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER AT LOCAL LAW REGULATING CON-
STRUCTIOObi E'ERF O N F CONSTRUCTION
62.25
j Fire 1.97
PLAN CHECK FEE
TOTAL F
-EN
Lice nPWI@
5. .20
SIGNATURE OFCOilCtb kuTMOR,ZED AG T IDATEt
N P P
LI A I$ I$ YQ�1�1 PE IT
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S-GNATURE Of OWNER,if OWNER BU4DER� 90ATE�
BLDG NSP
gAtE
4 w
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION q �- 1
ConstructionAddress:
Legal Description:
Owner Name & Address: Tel. #
Contractor: jt �(? '�/ LICENSE# 1 Elf
Address: ® f`(G �'� Tel. # :7Z
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: fl f 12 `- e7 a lI &® O
Construction Type: ®� �-!s Estimated Cost: $ C)
(Fee Schedule on Bac )
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: `C% APPLICANT: r Tel. # �U`�C-�
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ �� 9�J
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 00
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Oficial 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.
�j
Building PLUMBING Permit No.: '
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604CITY OF FRIDLEY Date Recd:
DATE E�-�MAIL ADDRESS
–� J/YOUR
SITE ADD SS MY i 0j d1G�4L rir�Q /r/O/�R3
THIS APPLICANT IS: 0 OWNER AONTRACTOR
PROPERTY
Nom:
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
NAME: NORBLOM PLUMBING CO.
SUBMIT A COPY OF
STATE LICENSE # `619T897003ATE
YOUR STATE
ADDRESS: 19 1904 G G A RC l E STATE ZIP
LICENSE WITH
�� n •
PHONE
APPLICATION
PERMIT TYPE
*SINGLE FAMILY O TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
0 NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK laxt- Wa�tY ✓
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500:00,: whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. .(This.shovld reflect only.the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJEm WHERE LABOR EXCEEDS—U00,EEs ARE BASED ON $10.00 PER FIXTURE *EXCEPT WHEItUNQTEE), R[TC'I :>�MIC-iTE TOTAL
NUMBER OF EACH BELOW) .
BATH SINK/LAV FLOOR DRAINS —SHOWER _ WATER PIPING
_
. GAS PIPING {nim crrrrrmm) _ SWIMMING POOL _ WATER SOFTNER ($35)
—BATHTUB
CLOTHES WASHER SINK _ WATER CLOSET _ BACKFLOW PREV. ($15)
_ --KITCHEN
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_ WATER METER —OTHER
e .
Permit Fee $ 3 00 Number of fixtures @ $1.0.00 x $10.00 = $
Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ 3 .TO Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an app 'cation 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 IAI work ch requires review and approval of plans.
J ` 1
SIGNATURE OF APPLICANT PRINT NAME 39 /VOV' D l 0 IM DATE l
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
; r