PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No(:5:7:33
Date:
Owner: _ Builder
Address _ _..__ _ _ ___ Address _ — _ ----- --
�. LOF;U L II�G
iA
_d'... Parf of
Lot _ .._ _ Block r,.___ Addition or Sub-Divis
Corner Lot Inside Lot _ _ Setback __ _ Sideyard
Sewer Elevation __ _ __ _ Foundation Elevation
t DESCRIPTION OF BUILDING
To Used
Front Depth Height Sq. Ft. Cu.
t Depth _ fight -� Sq. Ft. Cu. Ft.
Type 0 P. Est.. Cost 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 af1 provisions of
ordinances of .the city of Fridley.
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 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
yvithin the city limits and this permit may be revoked at any time upo violatiga of any of the provisions of said
prdinances. j " /
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wh%o, plumbing, gas heating, mower or water. Be sure to see
the Building Inspector for separate permits for theca Items.
4
Owner I s
Address
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
N4Name Builder.' .�
.......... Address m_.... _...._ Address ?l l 7 -
LOCATION OF BUILDING
No. Street 7Z,,, r- �e- Part of Lot
Lot Block 3 Addition or Subdivision WIeerla q ���
Corner Lot Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING12
��
A4- ��31
To be sed as:
Type of
To be Completed
Sq. Ft. /,2 % Cu. Ft.
Front epth 2-- Height
Sq. Ft. VP 4D Cu. Ft.
IMM
The undersigned hereby makes Wpplication for a permit
agreeing to do all work in strict accordance with the
the Department of Buildings, and hereby declares that
stated in th�applica.tion are true and correct.
DATE 4 IGNATURE
(A Schedul of Fee Costs can be found on the Reversei
ev
ted Cost
for the work herein specified,
City Ordinances and ruling of
41"he facts andre sentations
,� ,
BUILDING PERMIT FEE SCMMUIE
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./x.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
sLdaar 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
14inneapolis Building Code.
TTOUSFJS
2.3. For any such permit for the erection of any non -fireproof building other
t1han 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.
GATZAGT, S
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 for each one thousand cubic feet or fraction thereof, in the cubical
contents thereof with a minimum of $/..00.
For the purpose of computing fees for building permits the cubical contents of any
buiiding.or addition to a unl 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 feeshall 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 $1..00.
City of Fridley
Application for Plumbing and Gas fitting Permit
Dept. of Bldgs. Phone SU 4.1
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
y
G7
Base
W gQ
%
yy�,
Z
jy
i
F
Z Z
o�
y,
ha
O
G'�
t�
•�
a3
�°d
z
-�4a
00
Z
�0
N
N
WATER HTR.
GAS
ELE
ELEC.
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures x $1.50 $Z '�
Future Fixture Opening ................
-2 x 1.20 $T'z
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ......—Z x 2.00 $ _ O u
New Ground Run Old Bldg. x 3.25 $
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 $
REPAIRS & ALTERATIONS—Refer to Code
Description .............................
•..................
TOTAL FEE $ Z
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.
Estimated Cost,
Old—New. Building Permit No
ROUGHilk'
FINAL
Business Phone No. W h 9r —
N
Application for Power Plants and. Heating. Cooling. Ventilation, .�eF:7 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 $
,y
each add. 60,000 BTU .... . .................. 2.00 $
Replacement of Furnace .............................. .q.00 $
Repairs & Alterations—up to $500.00 ... ;a ............ 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 F7
ROUGH
FINAL
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.
Wey, A2ruL 19 6 �I
Owner
Kind o�juilding
P l .. A r
Used as
To be completed about s ��
Estimated Cost, $
01 —New. Building Permit Nol_'�_ Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS— Steam. Hot
Trade
Warm
Capacity Sq. Ft. E.D.R BTU—�J H.P.
Total Connected Load 441, Kind of Fuel —r `,"
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU ' H.P.
SignedRyi-- HEATING
By 4637 CHICAGO AVE. 1,
MINNEAP❑ IS 7, MINNESOTA
42 2M 7-59 Business Phone No -k :z
(REMARKS -OVER)
City of Fridley
SUBJECT
12330
AT THE TOP OF THE TWINS
BUILDING PERMIT'
r
I
RE
`L COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
`
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
9/24/73
JOB ADDRESS 7370 Tempo Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
6
3
Melody Manor SHEET
2 PROPERTY OWN R MAILADDRESS ZIP PHONE
Willard Nelson 7370 Tempo Terrace N.E.
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 IX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBEWORK Replace window with sliding glass door
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRE® FOR WIRING?
HEATING,- PLUMBING AND 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
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 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.
$500.00
.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$5.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$5.50
OF CONTRACTOR OR AGENT
P�RO%PERLYgg��V%%ALIDyA�TED T IS IS YOUR PERMIT
/GNATURE /AUTHORIZED /(DATE)
J1�jWHEN�
SIGNATUR OF.OW ER 0F OWNER BUILDER) (DA EI-
- BLDG INSP DATE
APPLICATION FOR RESIDENTIAL, ALTERATI.DN,
OR ADDITION BUILDING PERMIT
CI'T'Y OF I-I:I ULLY, MINNESOTA
OWNER'S NAME: r� BUILDER : J,-��,--�
ADDRESS: ZY70 lie
G:e%ADDRES S
NO:. STREET:
STREET:
LOT: (9 -BLOCK: ADDITION:
CORNER. LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
buildiaig location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As: ✓UlE_uL-Ij C/K, &x�.k.J L -do a�-'' &C)�
Front: Depth: Height:
Square Feet:
Cubic Feet:
Front: Depth: Height:
Square Feet;
Cubic Feet:
Type of Construction: Estimated Cost: _$ a
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that -ill the facts and representations stated in this application
are true and co rrtct.
DATE: 2 SIGNATURE:
(See Reverse Side For Additional Information.)
* S. ou
P /=
sc>;z 1'
. 1 1
BUILDINC t EWMIT FEE: SCHEDULE
SECTION 2. The Inspector of Btti.ldings shall, before issuing permits for the
erection of any building or strUCLu r(�, or for any addition to any existing
building or structure., or for JT1y :41teration or repairs to any existing
building or structure, upon application therefore, rege,irk, 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 ons: thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL tNFOaMATI0N
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,
heisht 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.
VERIFICATION OF FOUNDATION
NOTRi 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 Certiiicate 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.
S
a
SUBJECT
PE
City of Fridley
2
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
y
r PROTECTIVE INSPECTION SEC.
�+y
`�
1 i
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
1 910-F15
9/27/82
JOB ADDRESS 7370 Tempo Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
3
Melody Manor SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Willard Nelson 7370 Tempo Terrace N.E. 784-8684
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548
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 Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd but not 3rd layer of roofing. Install ridged
galvanized valleys.
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
1
ISTALLS 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
$2.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,000
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-
TRUCTION OR THE PERF RMANCE OF CONSTRUCTION.
$44.50
NONE
PLAN CHECK FEE
TOTALFEE °
P
2 7-
4-
NONE
$46.50
IGNATUREOF CONTRA 0R 45R AUTHORIZED AGENT (DATE)
WHEN PROPE Y VALIDATED THIS IS YOUR PERMIT
�
V" oL
jXn )w BLDG IIOOTE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
a
CITY OF FRIDLEY
APPLICATION FOR RESIDINTIAL BUILDING PER4ITS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS: Z3 Z -%�9� A/3 � 11-C d'
TEL NO: '
STREET NO: :Z3:o
LOT: .
BUILDER:
ADDRESS: 2,f-ld
TEL 1.40:
Construction Location
STREET: �YB'J� d_ / C -
BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
• proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square.Feet: Cubic Feet:
Front: Depth: Height:
Square -Feet: •Cubic Feet:
Type of Construction c��R -® ¢� - Estimated Cost: $6�-8
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
'Me 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:A,v/ SIGNATURE:
Stipulations:
/-4
. AUILANG IIER141T FEE sCiir_1)uLE' �.•
I CTION 2. - ,'3 hi± ln�:pcctor. of Mlildin(J:; ::1.11.1, bCfUre i:;c:uirlcJ I nits for the erection
of ivay buildin(I or :A.ruct:ute, or fol: any addition to tiny existi jig Itlilcling or: :;tzucturr_,
cir for any alteration or repetirs to •any exi:.Ling buil.dini .j or structure, upon applicatS.on
therefore, require Oic paymcnt. by the applicant for :,uch permi.t of fees to, thb amount
herein below set forth tuld a.11 t Ile manner: hcrei.n provzdcd to -wit;
NBA -1 CONSTRUCTION.- Single Family Dome!; and Garages; `e4.0011,000 cubic feet:.
VIAN CHECK: 25 percent: of building }permit fee.
L)IIIVBWAY DL•'i'P.L•'SSION: (Concrete. Curb Streets Only) '
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $13.50
Alternate B: Removal and replacement of concrete curb and
gutter and install •a 3 foot- wide approach with -
6 inch depth; Driveway width plus 6 feet. x .$15.75
ITIONAL It' FOR��f/1TI0. N
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 ;gain 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.
Xn -no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATIOWN 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 Certificatelof 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 hall not be used or occupied Until a. Certificate of Occupancy has
been issued.
I
SUBJECT
P15AMIT NO.
City of Fridley
26320
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
Com( (aO
e � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/23/98
JOB ADDRESS 7370 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
3
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Darlys Nelson 7370 Tempo Terrace NE
784-8684
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
Reroof house & Garage (25 Sq) 2nd Layer
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
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 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
OMPLIED
$1,566
$.78
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF
A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CA
4CEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAT
NG CON-
$51.25
Fire SC $1.57
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
FEE
T;51.
I
60
SIGN RE OF CONTRACTOR OR AUI.L40RIZED AGENT (DAT
ENP OP�,VAL14DATEHIS
IS YOUR PERMIT
BLO NSP
TE
SIGNATURE OF OW R IIF OWNER BUILDERI I T
I
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY U
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION (�
ConstructionAddress: %`� 7 0 0 Af 4J
Legal Description:
Owner Name & Address: Tel. #
Contractor: MN LICENSE #
Address:,
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EUPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:�, 4`- >�
Construction Type:
Estimated Cost: $ /
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: d APPLICANT: Tel. #
TOTAL $ ' t
STIPULATIONS:
CITY USE ONLY
Permit Fee
$�• ��f
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$_ ° �7
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$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 $ ' t
STIPULATIONS:
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 I he foundation once it has it has been constructed
will be required before proceeding with the framing.
f � R
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURFR TO RF INRTAI I Fn ()NI FAr'H FI rx)R
Effective On Jan 1, 2000
.. „� c B
� • �
.its • � �
k'a - - -
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Figure .
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water. neater -Electric
Water Heater - Gas"
Gas Range"
NO. RATE TOTAL
ME
Gas Dryer**
Back Flcw P; venter Required ( )Yes (j No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
JOB ADDRESS_ ` NIF - dWOIE3 IZ.
The undersigned hereby makes applicatior, ror a permit for the.work herein
specified agreeing to do all worf: in strict accordance with the city codes
and rulings of the J3.ililding Divis on, and hereby declares that all the facts
.and rel NELSON, DARLYS
7370 TEMPO TERRACE NORTHEAST
FRIDLEY, MN 55432
(763) 784-8684
Owner
Building Used As `6ZI -14 CZ
rue and correct.
&d" j 61
Cost st � � PERMIT 110. ) y
A
PLUMBING COMPANY a OLOiA / A,�
Reinspection Fee $47.00/Hr SIGNED BY �� TEL N0. IZ-60V-�dO
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved By Rough -In Date Final Date i e2 j
State Surcharge $ .50
'-7A MINIMUM UMBING/GAS PERMIT IS $20.00
TOTAL FEE $ 1.50 PLUS THE &SO STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting;.system is, plastic/PVC and meets all current codes and manufacturer
specifications .including sizing, length, number of elbows and termination. Yes( ).No(:
)
The undersigned also verities that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to Install a new co y<,bustlon air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance:has been -removed from the common vent and vented
separately riper current codes. Yes( )No.(
)
Appliance Type and Size/Common Vent and Vent Conanector Information
Appliance #1 Type
BTU Input Fan Assisted or Nat -
Appliance -#2 Type
BTU Input Fan Assisted or Nat
Appliance #3 Type
BTU Input Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diamie�er in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date