PRE 2010 DOCSCity of Fridley
SUBJECT
E ,
® 13981
AT THE TOP OF THE TWINS
BUILDING
P E R M iT
r �
TN
L ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
% 96 46
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
JOB ADDRESS 5209 Taylor Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
Marion Hills 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Frances Job 566 - 37th. Avenue N.E.
788-7267
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS VJPSNINCI
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Qa� jj
8,$IP PHONE LICENSE NO.
�+r...." - US
EIC.
6 USE OF BUILDING
Residential REQUIRED BY LAW
7 CLASS OF WORK
l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
DOES No' GVARAHM THE
construct a 30' x 48' Dwelling and a 26' ' r fRID«!
A6Ct�►
Un DATA IS FOIZ IMI.OItMmom PURPONS ONLY AN-j
9 CHANGE OF USE FROM nRsom
014M91%
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. Provide truss design before
capping.
SEWER LOCATION (Approx. 9' Deep) 1131 North of Manhole
(N. Inv. 843.6)
WYE ELEV: 848.12
TOP OF FOOTING: 851.12 Minimum
WATER LOCATION: 11.8' South of Sewer Service , 92.6' North
of Hydrant
D/W depression: N/A (Blacktop Curbing)
--IMPORTANT-
S'ERERAII'T PERMITS REQUIRED Fit .WIRING,
Att'yWY THE FRIDLEY ENGR.
PLUMBING AND SIGNS,
VVALREGARDING EREMOA
HEATING,
NT
AT DRIVEWAY OPENINGS,
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
T o
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
1580 + 728
37,960 �k
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.
$47,690
$23.84
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-
$151.54
$375.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$37.96
$588.64
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DA TE)
WHEN PR PERLY VALIDATED THIS"IS YOUR PERMIT
y 7
BLDG INSP
r5ATE
SfGMATURE OF OWNER V JILDER) (DA E)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: i K rdcv C/ I� �I^� /3 BUILDER: S xF L /-
Address: S205 % sr A,/ Address: -5-6 e ` 37 11-4
Tel. No.:- 7 fir"- 'Z 7—
No.:
No.: Street.
LOT: % BLOCK _�_ ADDITION :
CORNER LOT: INSIDE LOT: _�_ SETBACK: 36,G SIDEYARDS: /Q
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:
Front: 30
; Depth: I/r Height: 9-0 i
Square Feet: /S'oO Cubic Feet: �Y& eo So
is n- Front: �L 6 r Depth: )- rr Height: /V
Square Feet: 22S Cubic Feet: �02,9 d'
Type of Construction: Wvo e5 F�o-w R Estimated Cost: $ 37, Oo
To Be Completed: g -7 ? s alt. A Alt. B
Proposed Driveway Width If New g !/�'
p y Opening Is Desired - $ $
(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
Ire true and correct. See reverse side for additional information.
DATE:
2, i `-i SIGNATURE:
Stipulations: ,
—7,7L/
�J
a
'<tkktz-v SOY-
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 .gyp
6 inch depth; Driveway width plus 6 feet x $15.!�S
WA 0 6111100"1
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 $.50 state surcharge.
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
0
I—
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER: F K Yiyy G l S. E To DATE 3-29-77
SITE ADDRESS: s*'- o c1 T63roo ST 1912 PHONE: 7)-47
CONTRACTOR:
Determine working square footage of each
1. Total exposed wall area....... sq. ft. x .17 - 3
2. Toal roof/ceiling area ...... sq. ft. • x .05 = 76-00
Total exposed wall area above floor
a. Total wall window area ................................. Z.® Z S 1
0
b. Total door area ....................................:..
c. Total sliding glass door area .........................
d.Total fireplace wall area -
e. Total wall framing area (average 100) .................. I
f. Total rim joist area .................................. y®Af ®
g. wall area above floor ..........................
j
h. wall area above floor ..........................
2
i. wall area above floor ..........................
j. wall area above floor ..........................
Total exposed foundation area = / e.
k. Total foundation window area ..................... a
1. Total net foundation area above grade .................
Determine "U" value of each wall'segment
(e.g. window, door, each separate wall section)
i
X slugs
C.ev X Itull'
d. U0 X foul$
e.
f X °1U"
°
diftme
9°
X "u" —
iX 9OU"
°
j X "U"= Tf it #3 is the same as,
es than item #1, you
X °'U" - have met the intent of
SBC 6006 (c) 2.
1 X "U"
30 ..00.......0...0...°...... Total =
` Exterior Envelope Average "u" Computation
Total exposed roof/ceiling area
Page 2 of 4
m. Total skylight area ............................ -�-
n. Total roof/ceiling framing area (average 10%)...
o..Total net insulated roof/ceiling area...........
Determine "u" value for each roof/ceiling segment
M. X nun =
.
n. X nun
o. X nu„ _
4 ........................... Total =
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 (c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2. =a
1. + 2. _
3, + 4. -
10
• WALL SECTIONS
NO�rE: Use 10% of opaque wall area for
s frame construction
FRAISE WALL
�, ! (P
I•3G. #3
en
Construction R -Value
1. Interior air film 0.68
2.
3.. E o O: S TIAO
5. _ Road �� �m &TOCIt'a OM AD G aMfi sly
6. Exterior air film 0.17
Total
1. Interior air film 0.68
3.
4.
e
6.' Exteri r air film 0.17
Total
1, Interior air film 0.68
®o
2. S �•� m l�®�u�
3.
5. TINT. tea 14nekjo
6. Exterior air film -0.17
Total
1. Interior air film 0.68
2. 11 S w,� �
3. LA'
5. L 4 Mftflk L - ®7�s
6. Exterior air film 0.17
Total .2,
s t!1 _
.—i��
- - C ,J
FIGO 114 o
X.~
Z.
NOTE,: Indicate type, "?'." value, dept); and
placement of insulation.
,
ROOF/CEILING
Vented
Heat flow
up
FIG. n5
.. us�j..t.�lu�-%'•C1_'�i1.,'��'.. :%tp,/.4�_T�•Li �'J'^.�-l•.x tnl
Heat flow up ' a ..vented
a � .
.. - ,FIG. �6 `..... � •
E.i• :ice-+);
Page •4 01 4
Construction —R -Value
1. Interior air film 0.61
2.
4. Exterior air film (still) 0.61
Total
1. Interior air film 0.61
2. A�, 1' 5 A &o,T
3. 101, AL&P-qj4%Qa P.- 3
4. Exterior air film (still) 0.61
Total
1. Inside air film 0.61
2.
u 3.
• � �� ` .' Hent • �• �,if
e
t
0 a flaw up
1 „ ' , • `
4.
5. Outside air film
0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
—�
$3.00
$-96-00
Future Fixture Opening
x
4-1
0Water
New Fixture, Old Opening
x
al
w
+
m
x
$5.00
$
w
a •oi
$5.00.
$ x•00
100,000 BTU to 199,000 BTU
x
a
w
tr
x
Heater
+i
H 0
W
W
ro
$5.00
$
N
x
ai14
5:
Gl
H
Z
.0 q
6 N 4)
�
1st 3 fixtures
x
H
$ �•0d '
Additional Fixtures
x
$1.00
$
Gas Range t0 199,000 BTU
x
$10.00
$ � dp
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
ui
ro U
P
$ .50
TOTAL FEE
3.
o w°
REINSPECTION FEE
me
3
($10.00)
`u�
o
as
lec
lst
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
—�
$3.00
$-96-00
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
_� x
$5.00.
$ x•00
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
• $3.00
$ �•0d '
Additional Fixtures
x
$1.00
$
Gas Range t0 199,000 BTU
x
$10.00
$ � dp
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTION FEE
($10.00)
Job Address ® / 0 A "
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
Fridley, Mn.- /3 , 19
OWNER F &wuc(L / Jo 6
KIND OF BUILDING /'-t O M R
USED AS
TO BE COMPLETED ABOUT _jy W L I S
ESTIMATED COSTr-
OLD-6�BUILDING PERMIT NO. PERMIT NO.
ROUGH INSP.
Date
Company
Signed Byi��iivr�s,` g7
Tel. No. 2 k L-2 1 6Z
S-66- e37 t1j 41-1k /U"o—,
FINAL INSP. / - 3
Date
APPROVAL FOR PERMIT (t
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
0
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
97-84 416051 .
•
x
$3.00
a
$2.00
N
a
$2.00
I
X
u
k Nater Heater - to 990000 BTU,
43
a
100;000 1BTU to 199,000 BTU
Wator
of
Water Softener
x
A
New Ground Run Old Building
.� x
w
a .�
a
$5.00
0
i
FO 14
w
liaater
�G
8.C��
a
W
o
_~
A
�
��
�
o
ns
lec
U'
win
w
c����
1s t
n
c;t•
ra•
e
2nd
3rd
4th
_
(R) •• Future Connection Opening
Connected with Sewer
{•) - 11av Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUNLBING FIXTURE RATES: NO. RATE
h%" -Cr Fixtures
x
$3.00
Future Fixture Opening •
$2.00
Now Fixture, Old Opening
x
$2.00
Catch Basin•
X
$5.00
k Nater Heater - to 990000 BTU,
x
$5.00
100;000 1BTU to 199,000 BTU
X
$10.00
Water Softener
x
$7.Q0
New Ground Run Old Building
.� x
$5.00
Electric Water Heater "
-X
$5.00
GAS FITTING FEES;
1st 3 fixtures
Additional Fixtures
.Can Range to 1990000 BTU
REPAIRS & ALTERATIONS
First $100.00
each add. $100.00 or fraction
x $3.00
x $1.00
x $10.00
State Surcharge
TOTAL FEE
INSPE'CTION rEE
$5.00
$2.00
TOTAL
Job Address 2LUY JNS TAXWK 5i=k1'
Department of Buildings
City of Fridley l
Tel. #571-3450
The undersigned hereby makes application for permit for the work h
specified agreeing -to do all work in strict accordance with the City C
and rulings of the Departmont of Buildings, and hereby declares that a
the facts and representations stated in this application are true and
Fridley, Mn. 8-9-7'7 19
OWNER FRANK JOB
KIND OF BUILDING frame
USED ASE'er•
TO BE COMPLETED ABOUT l_F6-7.7
ESTIMATED COST I nn
OLD - NEW BUILDING PERMIT NO. PEWT NO. 1-28.2
Company'✓ c��y�`s�"
M11M c CO
Signed By'
1 Tel. No.
ROUGH INSP.
Date
FINIAL INSP. e /
Dato
APPROVAL FOR PERMIT t ,
MINIMUM FEE FOR ANY PLUMBING PERMIT 29 $7.50
August 16, 1977
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRID LEY, MINNESOTA 66432
TELEPHONE ( 612)571.3450
Mr. Francis. Job
5209 Taylor Street N.E.
Fridley, Mn. 55421
Re: Final Inspection at 5209 Taylor Street N.E. Before Occupancy
Dear Mr. Job:
A final inspection was made on August 15, 1977 of 5209 Taylor Street N.E.
and the following items were noted which must be completed before the
structure can be finaled out;
1. Provide sod in the front and•side yards by October 23, 1977.
2.. Complete all outside painting by October 23, 1977.
3. Insulate under tub by October 23, 1977.
We will expect the above items to be completed by the scheduled date
when a reinspection will be conducted to determine compliance. If you
have any questions on these items, please feel free to contact me at
571-3450.
Sincerely,
RON HOLDEN
Building Inspector
RH/mh
Permit #7141 HOUSE HEATING TEST RECORD 571-9392
ADDRESS 5209 NE Taylor St 55421 APT. FLOOR CITY SUBURB Pridleg
OCCUPANT Frank Job OWNER— Same
HEAT LOSS DATE HTG. INST. Su t 15 , '77
SOLD BY INSTALLED BY owner
Electrical Work By Owner Gas Line By nay
TYPE OF HEAT GA FA HW _X_STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
MAKE M Weil -McLain MAKE OF BURNER _
Model�' �j( Model
Serial Max. BTU Rating—
INPUT
ating—INPUT MAKE OF FURNACE
Model
CONVERSION
. CONTROLS `e
THERMOSTAT�� �y
Vent Size
Valve 'W elye^ 1f we -f0
Heat Plug
f ���
KIND OF LINER A 1y N1
SIZE �' NONE
Limit WA;re ede,.jX f ( d `)°4.-3
Draft Hood
Regularor
Limit Settings
Fi Iters Size
Number
Fan Setting '
Chimney Location Inside
P-11 Outside
Pilot Type r
Chimney Construction
Pilot Make
Pilot Model
Smoke Bomb
Wiring
Pilot Timing -�'
t��0 ;
Draft
Test Tag &VAQ
L.W. Cut Off
Door Pressure
Lighting. Inst.
Pressure m
Percent CO2 7 r61
€�
Date Tested d /
7
Input CFH 1M® EM —Percent
02 7`
Company Testing —� ��
Stack Teml —Percent
CO AW A(1-
Name of Tester
Form 235
December 27, 1977
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571.3450
Mr. Francis Job
5209 Taylor Street N.E.
Fridley, Mn. 55421
Re: Final Inspections at 5209 Taylor Street N.E.
Dear Mr. Job:
Our inspections for your house at 5209 Taylor Street N.E. are incomplete
with regard to final plumbing and building inspections. Please contact
this office to schedule both of these before January 12, 1978.
if you have any questions, please contact our office at 571-3450.
Sincerely,
RON HOLDEN
Building Inspector
RH/mh
yyyJ
r r,
r
July 5, 1978
Y aA
100 1
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNdESOTA 55432
y Mr. Francis Job
5209_ Taylor Street N.E.
Fridley, MN 55421
Re: Final Inspection of 520.9 Taylor Street N.E.
Dear Mr. Job:
TELEPHONE ( 612)571-3450
On June 26, 1978 a final inspection was made*on your house to check
for completion of sodding and insulating. Most of the sod has been
placed, with the exception of the north side of the garage, which
may be disturbed before sod is completed. The other item of insulation
has not been'completed. In order to meet State Energy conservation
requirements when your plan was submitted for approval, it became
necessary to insulate the lower level block wall as you indicated on
your energy calculation sheet.
Please install this insulation before the heating season begins and
we will reinspect on October 10, 1978 to check for compliance.
If you have any questions on these -items, please contact me at
571-3450.
Sincerely,
2 /-
2�a_
RON HOLDEN
Building Inspector
RH/mh
SUBJECT
City of Fridley
(�_
31896
AT THE TOP OF THE TWINS
BUILDING
PERMIT
� • _ COMMUNITY DEVELOPMENT DIV.
�
V -
®
7 3604
-_
REC IPT NO.
/ /��
"]►
r PROTECTIVE INSPECTION SEC
E �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
v"9 CITY HALL FRIDLEY 55432
IL"---j%1
612-571-3450
910415
6/12/01
JOB ADDRESS 5209 Taylor Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
Marion Hills 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
IIP PHONE
Abdov Hitti 5209 Taylor Street NE
763-586-8053
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
d 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 O ADDITION 0 ALTERATION E REPAIR O MOVE 0 REMOVE
B DESCRIBE WORK
Reroof House & Garage (32 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the State Building Code.
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
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
L
1STALLS 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
$3,272
$1 .64
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-
$97.25,
Fire$3.27
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PC
PLAN CHECK F
TOTAL yF,4
$1X2.16
SIGNATURE OF CONTRA "' ORD AUTHORIZED AGENT IDATEI
ENROPERV IDAT D IS IS UR PERMIT
� O
iGNAT qE OF O R OF eWNE5 BUILDER. IDATEIBL
9OATE
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: -,04
Owner Name & Address:
Contractor:
M
�s Val
MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hg�t/Grounnd Sq. Ft.
OTHER:
Construction Type: z4r–.$lr Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 6— , ,&QJAPPLICA Tel. #
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ Fee Schedule on Reverse Side
$ b-°�— .001 of Permit Valuation (1/10th%
60!! $.50/$1,000 Valuation
$ $1150 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 [ ] Not Necessary [ ]
BUII.DING 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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 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 $15.50.
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 $23.25.
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. New Houses Only