PRE 2010 DOCSAPPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner°s.Name A Builder,�U/ L af 'AAL
Address Address
LOCATION OF BUILDING
No. V-4 f Street 10"a_ Part of Lot
Lot Block
Additian or Subdivision_�l�l�:�rK
Corner Lot Inside Lot Setback JJ —0 Side -Yard
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:
a
lfd �Ii� Front Depth Height -n—cp
Sq. Ft. Cu. Ft19 .
�JK- ^„ Front 20 Depth Height %
Sq. Ft. Cu. Ft.
Type of Construction
To be Completed
Estimated Cost
The undersigned hereby makes lication for a permit for the work herein
specified, agreeing to do al 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. A.
DATE VISIGNATURE
(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 exist-
ing; building or structure, or for any alterdtib as nr repairp, to .,any existing
building or structure, upon application therefor, t-equiro,``the payment by the
applicant for such permit.of fees to the amount herein below Aet forth and
in the manner herein provided to-wit.-
2.1.
o-wit;2.1. For any such permit for the erection of any fire -proof building, other
than a garages warehouse, factory�or grain elevator, or for the erection of
any fire -proof addition, for'siimilar occupancy, to any existing building
shall be at the rate of $1,40 for -each one thousand cubic feet, or lraction
thereof, in such cubical contents.
2.2: For any such permit for the erection of any fire -proof garage, wardhouse,
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 502 of
the Minneapolis Building (;ode,
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 -fireproof
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 a 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 poiat.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 su face.of the main gable of a pitched roof.
2.5. For repairs or alterhtions'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.
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00.
City of Fridley, Minn.
r
BUILDING PERMIT N° 5783
Date:
�iOF M� gyp# � ' �q' py✓'
Owner:Or er
Address `� _ _ Address --• ---- ---
u�� LOQ 5 ION OF UIL®ING
No. StreL►t" _ Part of Lo _
Lot _". _ .__ Block Addition or Sub -Di 101--,
Corner Lot Inside Lot Setback _ _ Sideyard
Sewer Elevation _ _ _ ____ Foundation Elevation
DESCRIPTION OF BUILDING
Toy Used : .�.._..
Front Depth Height Sq. Ft. Cu. Ft..,
xy
Front 1%
Depth eight Sq. Ft. Cu. Ft.
Type of ction Est. """'To be. Completed
In consideration of the issuance to me of a permit to construct the building described .above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. k
In consideration of the payment of a fee of $ , permit is hereby granted to—
to
oto 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, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time uponV� n of any of the provisions of said
ordinances. .,.+-^� .,,f"
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas, heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
City of Fridley
Application for Plumbing and Gas Fitting Perm
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORKd/� /�� �, �lc �� AZANumber. Kind and Location of Fixtures Locations A'
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
3O
RATE TOTAL
��/
12_}
N
3�
Z
cu
�a
Q� Z
�'o
Z
cpm
O=
<3
J
t�°d
WU'
Z
��
2
a
o
+
F
9
N
WATER HTR.
GAS
ELEC.
Base
3.25
$
Water Heater (Up to 200,000 BTT)
...... — x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
1st
2nd
3rd
4th
• Future Connection Openings I
New Fixture, Old Openings
Connected with
Sewer
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x
$1.50
$—z3,—<,o
Future Fixture Opening ................
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:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
Fk%a
City of Fridley:
The undersigned hereby makes application for a permit for the work herel
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.
Fridley, Minn MAY 1 1962 19_.
Owner < o / %)l G ��
Kind of Building
Used as 'D ev.
To be completed about Z'
Estimated Cost, $
Old a Building Permit No. �� Permit No.
ROUGH ' y e
FINAL
RATE TOTAL
x $1.50 $ �y
X .50 $
x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code.
Description ........... $ -W�
TOTAL FEE $ —
O
42 2M
Signed LONDON O L n i� T R G CC-.
By
Business Phone No
Applicaflon for' Power Plants and 'Healing, Coofing, Ventilation, AeMgeralion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470
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 ............
each add. 60,000 BTU .......................
Replacement of Furnace ..............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
8.00 $ z
2.00
$ _
5.00
$
5.00
$
2.50
$
STEAM or HOT WATER SYSTEM
5.00
$
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
$lz�
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
$ o
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
7
TOTAL FEE
$ > 610
ROUGH
\
FINAL
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 Ordinancesc
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, ;n MAY 15 1962
19
Owner
Kind of Building
Used as
To be completed about J uI–
Estimated Cost, $ ool Z-2 49 ' R
uilding Permit No.� Permit No. 6
DESCRIPTION OF WORK
HEATING Air—No 4'
Trade Name- Size No _47–
,B®
I
Capacity Sq. Ft. E.D.R 4I A� BTU H.P.
Total Connected Loa P Kind of Fuel
' lot
BURNER — Trade Nam. Size No���„_��
Capacity Sq. Ft. E.D.R,�A BTU H.P.
X17® GEO. SEDC CK HTG. & AIR-COND. CO
1001 Xenia env. S.
Minneapolis 16, Minn.
Signe
By
.4z 2M 7.59 Business Phane µvo-
(REMARKS—OVER)
t'^ 4
oo
D•56 s
HEAT LOSS CALCULATIONS DEPARTMENT OF '°BUILDINGS MINNEAPOLIS. MINN.
Weatherstrips A.S.H..E, ` Construction No. Insulation
Guide
ndows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How.'Applied
es No I tY =No 19J
FIJ A Room I Length If Width f Height V II F1.10 ,,- `Room I Length Width ','Y Height '
`Windows and Doors—Crackage and Area
-'
Width height No. of Lineal'f . Area
No. of p&. a of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights' of crack sq. ft.
Vr p
r
Coef. ;
Coe€., Btu
Infiltratiott
Btu
Infiltration' ,
Infiltration
70
Glass
I '`r
..
Glass 0;
vtlNet
Exp. wall 110 f ,
''°
x:
Net exp. wall
,s '" "�
3 3
4,
'
Int. wall ,
`'Net exp. wall
IW, wall
Ceiling
1 ".6,
Int. wallAw
a
i:..°
.;
Int. wall
Ceiling
N .: q-
�Aotal Btu. fW 40V.
' ,°Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I' Fl.l ,,: `. s Room] I enath " Z"Width .I Heisrht
Windows. and' Doors—Cra % ge" and Area
-'
Width Height I No. of Lineal ft. Area
No. ;% of pane of pane light's of crack" sq._ ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights' of crack sq. ft.
Vr p
r
Coef. ;
Btu
Coef.
Btu
Infiltration' ,
Infiltration
Glass
Glassor
I '`r
..
Glass 0;
vtlNet
Glass
;. Exp. wall I x
x:
r. Exp. wall';
,s '" "�
3 3
4,
`'Net exp. wall
IW, wall
t.,,
1 ".6,
Int. wallAw
a
i:..°
.;
Int. wall
Ceiling
N .: q-
.{
{
Ceiling
Total Btu'."- 1
` Required sq. ft. E.D.R., or sq. ins. W.A. Leader area
FIA .�d� 1m. x7d ++. . Room I Lensrth " Width 7 Height
Windows and Doors—Crackage and Area
-'
Width Height I No. of Lineal ft. Area
No. ;% of pane of pane light's of crack" sq._ ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights' of crack eq. ft. '
we
r
Coef. ;
Btu
Infiltration
Coef.
Btu,
Infiltration
Glass
Glassor
I '`r
.
4.
vtlNet
Glass
;. Exp. wall I x
Int. wall
Net exp. wall
3 3
Exp. wall
Int. wall
IW, wall
Net exp. wall
Ceiling
r?
a
i:..°
.;
Int. wall
. ;_�
•.:
.{
{
Ceiling
d
F%
Total Btu."
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows attd Doors—Crackage and Area
-'
Width Height I No. of Lineal ft. Area
No. ;% of pane of pane light's of crack" sq._ ft.
Width Height No. of Lineal ft. Area
No. - of panv, of pane ,►fights ` of crack sq. ft.
we
Coef. ;
Btu
Infiltration
Infiltration
Glass
Glassor
$na
.
Exp. wall
exp. - Wall
vtlNet
Exp. wall
;. Exp. wall I x
Int. wall
Net exp. wall
Ceiling
Int. wall
IW, wall
Total Bt' i.:
Required sq. ft. E.D.R. or sq. i3ls. W Leader area
I FI_I / .. Room I Length Width,; a Height
Windows and Doors---Crackage and Area
-'
Width Height I No. of Lineal ft. Area
No. ;% of pane of pane light's of crack" sq._ ft.
I` v ywv 7
we
Coef. P to
In£iltration:
Infiltration
.r'
Glassor
Glass
`'
Exp. wall
;. Exp. wall I x
7"
Net exp. wall
Net exp. wall
Int. wall
IW, wall
Ceiling
r?
.
h
. ;_�
•.:
.{
Total Btu.'`'`"
Required sq. ft. E.D.R, or sq. iris. W.A. Leader area
`F7IRm.I.i':m.th / Width ' � Height
Windows and Doors—Crackage and Area
Width Height No. of ,Lineal ft. Area
No. of pane, of -pane lights of crack sq. ft.
L
Coe,..
Btu
Infiltration
Glass
`'
F
;. Exp. wall I x
7"
Net exp. wall
IW, wall
i
n
Floor, r .,f,x
. ;_�
•.:
Total Btu.
�� mequlrea sq. Ft. c.v.m. or sq. ins. w.e>,, r.eaaer area
f
D•56 0 9,
HEAT LOSS CAI:CULATIONS DEPARTMENT OF BUILDINGS NIINNEAPOLIS, MINN.
E
V
H
S. . ..
Weatherstrips A.Construction No. <. Insulation
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied
Yes—No Yes—No 19_.
4 F1.1 } -z. , Av Room I Leneth °` Width I II = Fl.l Room I Lenitth Width 'Height
Windows and Doors—Crackage and A
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height; No. of Lineal ft. Area -
No. of pane of pane lights of crack sq.ft.
C¢ef. Bin.
Infiltration
Coef. Btu
Infiltration
Coef.
Btu -
Infiltration
Glass a ;<
Exp. wall
,
'
Net exp. wall
Int. wall
f
..
Int. wall
Floor: r�
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area,,
Net exp. wall
01'
Windows and Doors—Crackage and. Area ;
Width Height No. of Lineal,ft. Area
No. of pane of.pane lights of crack., sq. ft.
,.Floor it ,- t It.
Coef. Btu
Total Btu.
"'`"Required sq., ft E.D.R. or sq. ins. W.A. Leader area
X,, FI.Id J� _1 RoomI Length o. ov�e Width 4 Heilxht
Windows and Doors-Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
C¢ef. Bin.
Infiltration
Coef. Btu
Infiltration
Coef.
Btu
Infiltration"'
Exp. wall
'
Glass
Int. wall
f
..
Exp. wall, .;
Floor: r�
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area,,
Net exp. wall
01'
Windows and Doors—Crackage and. Area ;
Width Height No. of Lineal,ft. Area
No. of pane of.pane lights of crack., sq. ft.
Int. wall
Coef. Btu
Infiltration
Floor
lop: 40t
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.I ih , , i i— Room I Length ':.' Width Heiitht --.
Wirldows .and.:Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
r Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
C¢ef. Bin.
Infiltration
Coef. Btu
Infiltration
Coef.
Btu
Infiltration
Exp. wall
Net exp. wall
Glass
Int. wall
f
..
Exp. wall a j,
Floor: r�
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area,,
Net exp. wall
- Height
Windows and Doors—Crackage and. Area ;
Width Height No. of Lineal,ft. Area
No. of pane of.pane lights of crack., sq. ft.
Int. wall
Coef. Btu
Infiltration
Floor
lop: 40t
Total Btu.`
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
C¢ef. Bin.
Infiltration
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
-
Floor: r�
Total Btu. Ii
Required sq. ft. E.D.R. or sq. ins. W.A. Leader ,area
F1.I Room I Length Width
Windows and Doors—Crackage and Area
Width I Height No. of Lineal ft. Area
an
N of a of -Nle lights of crack sq. ft. AA
o. PPa
C¢ef. Bin.
Infiltration
Glass
Exp. wall
Net exp. wall =
Int. wall
Coiling
Floor
-
Total 'Btu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area,,
Fl.) Room I Length Width '
- Height
Windows and Doors—Crackage and. Area ;
Width Height No. of Lineal,ft. Area
No. of pane of.pane lights of crack., sq. ft.
Coef. Btu
Infiltration
Glass
Exp.-vall
Net exp. wall,:;. µ
Int. wall
Ceiling `
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
CITY OF FRIDLEY INSPECTION DIV,
Effective On January 1,1993
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
RATE SCHEDUILE
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 $ 20.00
®
representations stated in this application are true and correct.
,1993
Gas Piping (Needed with new furnace) $ 10.00
$
��
OWNER -®% � �'9 �. ��,� M7�
Gas Range $ 10.OQ
$
BUILDING USED AS
Gas Dryer $10,00
$
ESTIMATED COST� '5'09�-5 �v PERMIT NO.
*Air Conditioning — All Sizes $10,00
$
•
DESCRIPTION OF FURNAgE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water)amtir)
Commercial/industrial
BTU P ® ® HP EDR
I% of Value of Appliance or Work
$
Fuel 7—° Total Connected Load
�
State Surcharge
$ .50
Bu n�Trade Si�i�No.
TOTAL
BTU HP EDR
FEE
HEATING COMPANY ��i�/� A ' { /�
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
Signed By e o.
PLUS THE $.50 STATE SURCHARGE
/►�
W,,
REINSPECTION FEE $30.00
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes f No ( )
2. Is free from rust or deterioration Yes No ( j
3. Has no foreign objects lodged within Yes (fit)" No { )
4. Is securely supported Yes No ( i
S. 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
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date���
s
SUBJECT
O.
City ®f Fridley
2 7�3�06
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
✓""{CITY HALL FRIDLEY 55432
�j 612-571-3450
910-F15
18/19/98
JOB ADDRESS
7341 Tem o Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
IMelodyManor
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Jim Woltering
784-0093
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Owner
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
Reroof house and izarage 24 S Tear-off;
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Call for building wrap inspection before covering.
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. OWLG. UNITS
OFFSTREET PARKING
1 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
$10,500
$4.00
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 PERFORMANCE OF CONSTRUCTION.
$149.75
Fire SC $8.00
�.. '✓v +�
PLAN CHECK FEE
TOTAL EE
.75
Si ATURE OF CONTRACTOR OR AUTHORIZ DAG NT (DATEI
e
NleeOP
LDA INSP
Y ALIDAT D IS IS UMI
Cy �'rjjij-C e
GATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
s
NEW- e [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: i
g P
f
Mm
62
Owner Name & Address: 14 &)OIL�rtnT Tel. # 7e-jill-005-3
Contractor:
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 L%IPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
R
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Construction Type: �e�rn S - t-- �i�t Estimated Cost: $ jam, u�'OI)
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
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 $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.