PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date:
Owner
Lof
AddrAQWQ
N° 5682
Builder
Address
LO .OF BUILDING
No. Part of Lot --
Lot Addition or Sub -Division •-OL
Corner Lot —_ _ _ _ Inside Lot ..._..._ _ Setback -a---- Sideyar _ t
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To e U
Front, Depth Height Sq. Ft. ^ Cu. Ft.
Fro t Depth . Height : _ Sq. Ft. Cu. FIL t1
Type o Construction Est. Co °,� 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
grdinances 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. , - �A
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 hems,
r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEYo MINNESOTA
owner's Name Builder J0 4, 91 I
Address Address 11"7„��"
LOCATION OF BUILDING
Nostreet 4-t�OcL Part of Lot
Leat 0 Wel Block _ ,rWo Addition or Subdivision
Corner Lot Inside Lot setback 3 1:� Side -Yard
SM1ER ELEVA'T'ION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
DESCRIPTION OF BUILDING
To be used as
I
�16 Front'Depth Leight .� ..
sq. Ft. ,�.° cu. Ft.
FronDepth ' Height
Sq. Ft. 11r_0 Cu. Ft 0— -
Type of construction �'' � eh am Estimated Cost-
To
os t -
[ T ��
To be Completed�i f 1,
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 ruling of the Department of Build-
ings, and hereby.declares that all the facts and representations
stated in this application are true and cor ect
DATE I I h i / 1/0 / SIGNATURE
(Schedule of Fee Costs can be found on the
BUILDING PENT iiE 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 existing building 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 $1.40 for each one thousand
cubic feet, or fraction thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof 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 $1.25 for each one thousand cubic feet, classified
as "fireproof" by Section 502 of the Minneapolis Building code.
HOUSES
2,2..3,. For any such permit for the erection of any non -fireproof build-
ing 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.
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 $4.00.
For the purpose of computing fees for building permits the cubical con-
tents of any building or addition to a uniform 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 per each Five Hundred Dollars ($500.00)
or fraction hereof in the cost of all proposed work.
2.6. in no case shall the fee charged for any permit as set forth in'
Seption 2 be less V _1 $4.00.
Application for Poorer Punts and. Hearing. Cooling, Ventilation, .Refrigerawion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
4
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 §.00 $
Repairs & Alterations --up to $500.00 ....a ............ 5.00 $
Repairs & Alterations each add. $500.00 ...... 1 :....... 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 8c REPAIRS TOTALFF,E $ N A
�r
ROUGH—
OUGH
FINAL—
FINAL
Dept.
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 spq true and correct.
Owner _
Kind of
Used as
To be cc
Fridley;--tMinn va-dA , , ;"L !2 19 4 Y
Estimated Cost, $
Ol( �ewding Permit No. )s 4 F rmit NO. C�
DESCRIPTION OF WORK
HEATING or PO R PLANTS—Ste of Wa , Warm Air—No J
Trade Name�'� r� ize No r
Capacity Sq. Ft. E.D.R.T BTU H.P.
Total Connected Load �4 o Kind of FuelG
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signed
RAY N
By 627 cwIr.AGO AVE.
42 2'M7 -S9 BusinessPA&g4 EAPOLIS 7. MINNESOTA
City of Fridley
AppCcation for Plumbing and Gas Fitting Permit
DepL of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location <
F
3i�
RATE
yxm
d�
Z
x
x}
3F
Zz
zip
ou
�a
pZ
��
a o
~�
gm3
$ %`
,
�a
G°d
z
�Z
Gc4
Z
as
U0
F
•
N
WATER HTR.
GAS
ELEG
Base
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
Z'
1st 3 Fixtures ..........................
x
$1.50
1st
�°
x
l
$
Gas Range to 200,000 BTU ..............
x
2.00
$
2nd
_
3rd
4th
Future Connection Openings
New .Fixture, Old Openings
Connected with Sewer
Cesspool E]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures ....... . ..............
x
$1.50
Future Fixture Opening ................
x
1.20
$ %`
New Fixture Old Opening ..............
x
1.00
$
Catch Basin .... .......................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......--/
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
Z'
1st 3 Fixtures ..........................
x
$1.50
$ ;_41
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ...................................
TOTAL FEE $ A2
City of Fridley:
The undersigned hereby .makes application for a permit for the work here4t
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.
_Pidley, 1Vl11nn- 19�'
Owner ( --
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old Ne ) Building Permit No ermit No.
By
Business Phone No
ROUGH 3 4 ` 41 Z
FINAL
Date: May 25, 1965
N° 7512
Builder Al. G. Anderson, Gonst. 00.
Address 7381 Temp Terraces Fridleg Address 998 Transit Ave. St. Paul, 13
No. 7381 street _Tempo Terrace Part of Lot
Lot 1 _ Block 2 Addition or Sub -Division Xelo& 9r
Corner Lot Inside Lot _ _ Setback Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation
Front - Depth Height
Front Depth Height
Sq. Ft. C:u. Ft
Sq. Ft. Cu. Ft.
Type of Construction _—__ __ Est. Cost . QQ __ 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 a'll provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of S 10-00 , permit is hereby granted to Al—Anderson
const. 00' 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, Minn location, construction, alteration, maintenance, repair and moving of buildings
within the city limit tm permit may be revoked at any time upon violation of any of the provisions of said
ordinances;.
NOTICE:
Ub permit does not ewer the construedon, kohdlzftn for wine®, phunbing, gas heating, sewer or water. Be sure to we
the Building hapsetor for separate pwn&s for these Nene.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME ?'pert Larson BUILDER Al* G. An.iereon 01met, Co.
TE R Cc' c- E�t 1, 13
ADDRESS 7 �1 Temw Zoom, Fridley ADDRESS 999 Transit Ale.
LOCATION OF BUILDING
No. Street Part of Lot
LOT / BLOCK ADDITION 'OR SUBDIVISION
Corner Lot Inside LOT Setback 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;
Front`.. Depth ^_ Height
Sq. Ft. Cu. Ft.
1 ...
Fr6nt Depth Height
Cu. Ft. _
49
Type of Construction Estimated Cost ' C, -,o
To be completed
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 are true and correct.
DATE `° SIGNATURE`S
(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 existing build-
ing or structure, or for any alterations or repairs to any existing building or
structure, upon 4pplication 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 -rift:
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 $1.4.0 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof 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 $1.25 for each one thousand cubic feet, classified as "fireproof" by
Section 502 of the Minneapolis Building Code.
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 the 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 Ithroughout 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 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.
al . anderson
commercial and residential building and remodeling
998 transit • st. paul 13, minnesota
Reply entire Roof
InstaU now titters
Refinis St cce
Replace Pence
Reeinsulate Attie
Replace Broken Windows
Install now Garage lie®r
Faint rIxtorier
IV 4-1433
�;3
V 3:. 3
M
A� .h_
!'E R - +
i
4
Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ...........................$10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ....... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam ... .................. 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal. per hour ........................ 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x$ 2.00
$
Additional Fixtures .................
x .75
$
Gas Range to 199,000 ...........
x$ 5.00
$
AIR CONDITIONING
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$
ROUGH
FINAL �' .2 �
Dept. of Bldgs. Phone 560-3450
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.
Owner
Kind of Building
Used as��!���a
To be completed about
Estimated Cost, $
9eje "T
Old New. Building Permit No. Permit No. 190
r� _ DES RIPTION OF WORK
AX 604 - AA6C — A00 6!'&WZIO
HEATING or PO77fRPLANTS-Steam, Hot Water, Warm Air—No_
Trade Name .e�f Size No.
Capacity BTU
l
Total Connected Load A 11fe
BURNER —Trade Name Size No
Capacity -) Sq. Ft. E.D.R BTU H.P.
(REMARKS-OVER)
S RAI( N. WELTER HEATING CC
4637 CHICAGO AVE.
By Ll"UNVAP131 an !7 MINNtrm
az Business Phone No—
CITY OF FRIDLEY INSPECTION DIV.
Effective On August 1, 1995
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 ADDRESSI
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 — cZ)
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $
representations stated in this applicatio &retrue and correct.
Llr l 199 9
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace) $ 10.00 $
a 137
OWNER
Gas Range $ 10.00 $
VV
d
BUILDING USED A.��L
Gas Dryer $ 10.00 $
ESTIMATED COST 191100 PERMIT NO.
*Air Conditioning —All Sizes $ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
$
No. of Heating Units_ Circle One {Steam} (Hot Water arm Air)
I% of Value of Appliance or Work
Trade Namei).rv► fl ri�l`t1Y1 gCc.v d a rrd Size No.
Commercial/Industrial
BTU 'i_ZbOC(Q 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
HEATING COMPANY,
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
JJ
Tel No.
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signed.By . ZA aL
PLUS THE $ 50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without
FILL OUT BACK SIDE F R STACK VERIFICATION ON
written permission from adjoining property owner.
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
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 ( ) 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
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 Dona:
HEATING CO:
Signed By:
Date:
SUBJECT
City of Fridley
'r61 15
AT THE, TOP OF THE TWINS
I
I I
BUILDING
PERMIT
`
�J
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r tr _em__.� PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
6/1/98
JOB ADDRESS 7381 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeffrey/Theresa Lee 7381 Tempo Terrace NE
785-1389
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 L� REPAIR ❑ MOVE ❑ REMOVE
S DESCRIBE WORK
Reroof House & Garage (19 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 REOUIREO 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
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
$.79
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,584
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-
Fire SC $1.58
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$51.25
PLAN CHECK FEE
TO FEE
53.62
SIGNAT OF CONTRACTMORAUTIZED ENT �DATEi
`�DATEI
HEN R P
BL G NSP
VALIDAT THIS IS YOUR PERMIT
�/ F1ATE
GNATUREOFOWNEROFQ
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY /
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 j 7
BUILDING PERMIT APPLICATION
ConstructionAddress: %_3 I l — 1 e- fn D O e-1' f- G C &-
Legal Description:
Owner Name & Address: '�Y'Fr-eel �-� he,�2 I� L e.�- Tel. # 7 5 13
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 IMPROVEMENT
LIVING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
Height.
Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
n
Z 2 S %�
Construction Type: - Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = —Ftx, $ _ $
DATE: APPLICANT: Tel. # 7 5-- 13'9'�
rug USE ONLY
Permit Fee
"ire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
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.