PRE 2010 DOCSDate:
City of Fridley, Minm
BUIWING PERMIT
AUGUST 29, 1966
N° 8981
Owner: Builder HOMEDALE BUILDERS
Address Address 7000 HUMBOLDT AVENUE NORTH
MINNEAPOLIS, MINNESOTA
LOCATION OF BUILDING
No. 7534 Street TEMPO TERRACE N.E. Part of Lot
Lot 34 _ Block 3 Addition or Sub -Division BODY MANOR, 4TH ADDITION
Corner Lot Inside Lot X Setback 35' — sideyard , 32
Sewer Elevation ____..gg2 , Q tM Elevation 885.0
TOP OF FOOTING
DESCRIPTION OF BUILDING
To be Used as:
DWELLING Front 40 Depth 24/30 Height 20 Sq. FL 1032 Gt. Ft.20,66440�
Front Depth Freight Sq. Ft. Cu. Ft.
Type of Construction ERM Fit. Cost —n7
17 000 To be Completed
WATER - 136' East of Manhole
SEWER - 156' East of Manhole it 20' East of the West Manhole
In consideration of the issuance to me of a permit to c the building described above I agree to do
the proposed work in accordance with the description abov set o and Mance, with aJl provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of S 21.00 � permit is hereby granted to HOMEDALE
BUILDERS 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 is all respects to the ordinances of
Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE
Building Inspector
NOTICE:
'tide pend* lion not aowr the aondreadon, 6ftlldlon for airing, ph mbtng, gas boding, awoM or order. Be an to me
the Betiding Igor. for "Pardo Perrot" for tben ft"M
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER
D
OF BUILDING
at Part of Lot
LOT ADDiTION OR SUBDIVISION
I'k_'Z�Z&
Corner Lot Inside LOT Setback 0,5, Side -Yard 5 �
.SEWER ELEVATION FOUNDATION ELEVATIOIJ.
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
036
v - F 5-4, ✓ DESCRIPTION OF BUILDING
To be used as;
Front Dept 2 height
Sq. Ft. �sf%��' Cu. Ft. Ljt'
Front Depth _Height
Sq. Ft.
Cu. Ft.
Type of Construction���C
Estimated Cost�%�®�
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.
i w
I s �__1(Schedule of Fee Costs can be found 1.�
.. the Reverse/`
01
BuILDm PERT. m_tcammE
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 therefore, require the payment by the applicant for
such permit -of fees to the amount herein below set.forth and in the.manner hereirL, _
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-proofgrain elevator, or for the erection of any fire
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.
HOOSES
22.3. For any such permit for the erection of any non -fireproof building,
other than a garage, warehouse, factory or grain elevatoir, 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 cubicall 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 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.
22.5. 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.
City of Fridley -�
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
$/—'
% O
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
1st 3 Fixtures .......................... x $1.50 $
�S
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description...........$
.............................
TOTAL FEE $L
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this appcationare true and correct.
Fridley,_Mm ®6,/® o 19Z�
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Old New uild
ROUGH
FINAL
Z•
`
WATER HTR.
Base
IT,
lip,
1 -
1st
2nd
3rd
—
4th
• Future Connection Openings
� 1Sewer
.Fixture, Old Openings J
Connected with
E]New
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
$/—'
% O
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
1st 3 Fixtures .......................... x $1.50 $
�S
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description...........$
.............................
TOTAL FEE $L
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this appcationare true and correct.
Fridley,_Mm ®6,/® o 19Z�
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Old New uild
ROUGH
FINAL
HOUSE HEATING TEST RECORD
ADDRESS APT. FLOOR
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work' By Gas Line By _
TYPE OF HEAT GA FA HW STEAM SPACE HTR.
GAS DESIGN
MAKE MAKE OF BURNER _
Model a ' Model
Seriol Max. BTU Rating _
INPUT ^ ' MAKE OF FURNACE
CITY SUBURB
UNIT HTR. OTHER
CONVERSION
Model
CONTROLS
THERMOSTAT _
Heat Plug
Vent Size
Volvo "
KIND OF LINER
SIZE NONE
Limit
Draft Hood
Regulator
Limit Setting °
Filters Size
Number
Fan Setting
Chimney Location Inside
Outside
Pilot Type,
Chimney Construction -
Pilot Make
Pilot Model
Smoke Bomb
Wiring
Pilot Timing
Draft
Test Tao
L.W. Cut Off
Door Pressure
Lighting Inst.
Pressure
Percent CO
Date Tested
Input CFH `"
2
Percent 0 2
Company Testing
Stock Temp
Percent CO _
Name of Tester
Form 235
Application for Power Plants and Heating. Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ............... _ .......... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ........................ 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) .......................
5.00
$ -1
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 FEE
ROUGH
FINAL
Dept. of Bldga. Phone 560-3450
3
City of Fridley:
Pip �V
61- oc�T
1966
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�(]e and correct.
Fridley, gyp , l 19
Owner
Kind of Buildingi! J —
/] A
Used as
To be completed about et�_'ee { z = 6 e,
J /�
Estimated Cost, $ n
Old New. Building Permit No. Permit No. ! Z K
DESCRIPTION OF WORK
HEATING orWER PLANTS—Steam, Hot Water, Warm Air.—No 0
Trade Name 7f2C `t-ek -e (f -e c4 61 t �� Size No y / 4L
Capacity Sq. Ft. EMM ) BTU ' � H.P.
Total Connected Load CE ��' .' Kind of FuelAt
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
STRAY N. WELTER HEATING CO.
4637 CHICAGO AVE.
By
40 Business Phone No
h
(REMARKS—OVER)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
r
OWNER'S NAME : BUILDER:
e
ADDRESS • %iia a.4e ADDRESS
NO :. % O f STREET:
LOT: BLOCK: ADDITION :3{
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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: d?�� Height: 2500
®�
Square Feet:Cubic Feet:�C� a
Front: Depth: Height:
Square Feet;
�/ Cubic Feet:
Type of Construction: J'C]69-, (� Estimated Cost: $
To Be Completed: I i7�
,; �/' 17
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 all the facts and representations stated in this application
are true and correct.
DATE: �. , 1 f l V SIGNATURE:
(See Reverse Side For Additional Information.)
BUILDING PERMIT FEI 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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.55 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
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 $5.00.
VERIFICATION 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 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 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.
City of ]Fridley, Mann.. ` 15
6431 University Ave. N.E., Minneapolis, Minn. 55432 —
Date July 7, 1272
Owners Harold Johnson Builder
Western Construction
Address _6950_W zata Boulevard Address 6Q 50gyzata Boulev� �
No. _.._.7534...._...... Street Tempo TS Trace N F,y Part of Lot
Lot _ 34 _ _ _ Block__...__.._3....._._....._------ ..__ Addition or Sub -Division Melody ody M nor 4th Addi ti on
Corner Lot __..___.... Inside Lot ._ _ Setback _ _ ___ Side -yard
Sewer Elevation Foundation Elevation _..._
To be Used as:
Garage Front _ 24' Depth 24, Height 10' _ Sq. Ft. 5761 Cu. F't. 5760:
Front . _ Depth Height Sq. Ft. Cu. Ft.
Type of Construction Wood Frame Est. Cost __2200 _ To be Completed 90 days
Stipulation: Provide a hard surface driveway and a 1 hour fire door and 5/8 inch
type X gypsum firewall from masonry to roof boards.
In consideration of the issuance to me of a permit to construct the building described above, Y agree to do
the proposed work in accordance with the description above set forth and in Lghant with all prgvisions of
ordinances of the city of Fridley.
IMM 1.30 State Surcharge
In consideration of the payment of a fee of $ 11.00 - , permit is hereby granted to WARtP.rn rnngtruction
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 ordinkmaes of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildblo
Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of add
ordinances. _
CLARENCE BELZSLE " t,
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sur® to see
th,$ Building Inspector for separate permits for these Items.
It
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
',' a,
OWNER 18 NAM: 7�7741,� iA�.l BUILDER : W
ADDRESS: 9 --f_0 Z A 3tV-D ADDRESS:
N S3
0:, ISI-3, STREET
LOT; -BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn an these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: a�A Height:
Square Feet: Cubic Feet:
. Front: —Depth: Height;
Square Feet; Cubic Feet:
Type of Construction: 212-441 Estimated Cost:
To Be Completed:, ® ZA-r�n 17
The undersigned hereby makes application for a permit for the.w9rk herein
specified, agreeing to do all work in ottict accordance with the City 9f
Fridley Ordinances and rulings of the Department of Buildings$ and herobj
declares that all the facts and representations stated in this applicatim
are true and correct.
%Tl;
SIGNATURE
(See Reverse Side For Additional Information.)
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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cublc
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.$5 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
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 averaged
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 $5.00.
VERIFICATION 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 Certified Survey of the lot, showing the location of the foundatj9% 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 priors
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.
01
SUBJECT
PE NO.
City of Fridley
18 5 46
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r L PROTECTIVE INSPECTION SEC.
®`Ir
�
1 0 �
CITY HALL FRIDLEY 55432
L J`
1
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/16/86
JOB ADDRESS 7534 Tempo Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
34
3
1 Melody Manor 4th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mark and Coreen Kennedy same
786-3032
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Ron Skibsted
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install Patio door and deck
9 CHANGE OF USE FROM TO
STIPULATIONS
Carpenter to call for pre -construction on-site meeting
prior to commencing
project.
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,000
$1.00
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-
$32.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
.13
$41.63
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
. VVHEN P I R01 L
TED THIS IS YOUR PERMIT
P.
BLDG INSP
0-��
BATE
IG OF OWNE OWNER BUILDER) (DATE)
01
NEW [ J
ADDN.
ALTER. [ J
Construction Address:
City of Fridley Effective 4/1/86
�R-1 AND R-2
Building Permit Application
Legal Description:
1,
Own ez Name &Address:
�-C� RCS C`�� ►'V (> Tel. # r a
Contractor: S-�e-c� Tel. #
C�-4
Address:
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. 10
DECK AREA: Length % Width Hgt/Ground Sq. Ft. OTHER: ��� e -� 0 P !�:) r'�' 0
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback __ Side Yard Setback
Type of Construction:
L-C�/Y1f�« E timated Cost:
-1-2),3 `�c�a-a- L"' --Approx.
"'- w
Approx. Completion De: 1
I 0 d?0 •��Zvi Alt.
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE:I APPLICANT: � 2�� i Tel.
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$40 Fee Schedule on Reverse Side
$ . 63 25% of Building Permit Fee
$ V(00 $.50/$1,000 Valuation
$ - $475 per SAC Unit
$ Fee Determined by Engineering
$ h'n Agreement Necessary [ J 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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
including $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including $100,000.
$100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 been constructed will be required before proceeding with the framing.
Land PlanningiU�'�1f 6'�%Z 6875 Highway No.65 N.E.
land Surveying nnh •�1�1�JMinneapolis,
Soils Testing &Wh
CG'l�/?Ji4C•Minn. 55432
Civil Engineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Area Code 614
Certificate of Survey for WESTE{2N GAPAGE
-
N
F
P �J
Ck
A
ass' ,�'' X39 �',� ► �
3�•
c�
StoYy�,ouse , o n
D
0 ?1.95 0 • X115
w
,t
M�
SOT 34119LOCK 3,
Scale -I inch= 30 Feet
0 Denotes iron monurnent
c®unty off' Anoka.
1 hereby certify that this is a true and correct representatt'on of a survey of the boundaries of the above
described land, and of the location of all buildings, thereon, and all visible encroachments, if any, from or on
said land. As surveyed by me this _'Ll '�Tday of June A. D. 1964.
SUBURBAN ENGINEERING, INC.
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CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
May 8, 1989
Mark and Coreen Kennedy
7534 Tempo Terrace N.E.
Fridley, MN 55432
RE: First Notice of.Noncompliance at 7534 Tempo Terrace N.E.
Dear Mr. and Mrs. Kennedy:
The City of Fridley,has established a City Code for the purpose of
promoting a pleasant and attractive suburban environment. A recent
inspection of the property at 7534 Tempo Terrace N.E. revealed that
not all Code requirements are presently being met. Listed below
is an item which does not comply with the City Code:
1. Observed vehicle (CLV-680) parked on grass beside driveway.
Fridley City Code requires that all vehicles must be currently
licensed/street operable and parked on a hard surface parking
area, or stored in an enclosed structure, or removed from the
property.
Your prompt attention in correcting this situation would greatly
assist us in helping make Fridley a better place to live. An
inspection will be conducted on or about May 22, 1989, to determine
compliance.
If you have questions or would like to discuss this, please contact
me at 572-3595. Thank you for your cooperation!
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
C-89-236
SUBJECT
P
City of Fridley
22105
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 I
NUMBER
REV
DATE
9/13/93
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 7534 Tempo Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
34
3
Melody Manor 4th. Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mark Kennedy 7534 Tempo Terrace NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Westphal Roofing 8232 Greewood Dr, Mounds View MN 786^7000 3937
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Squares) Second Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd. Install adequate attic
ventilation, Install smoke detectors as per UBC 1210 adjacent to all sleeping areas
and in basement.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
MOT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2. 100
$1.05
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$•54.00
Fire SC $2.10
STRUCTIO THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
Z
License SC .00
$62.15
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHE P PE L ALIDATED THIS IS YOUR PERMIT
. - r�� ��_ �- /'? -9
BLDG )NSP DATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
1. .n`u1a. aL•. .M. ....♦
NEW [ ] Effective 5/26/93
ADDN j ] CITY OF FRIDLEY 3 t 'K J
ALTER j ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: '� 5-3 L{ `r G -z-7 P o T—c�- t- /-- 6 c - C -
Legal Description:
Owner Name & Address: U- t-` Ct /Y c � <a 167 Tel. # 79 .3o 3 a.
Contractor: Pj1— �, CA --U. A a _,I 17- f "L/ MN LICENSE # 3 7
Address: 9: - 3 /L Y c� ti Civ 4��—� �� � d t a.- r v r Tel. # 1�. 4 C� 4
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF H"ROVEMENT
LIVING AREA: Length, Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ J Inside Lot j J FL Yd Setback
Type of Construction: c- r— o o
Approx. Completion Date:
N
r
Side Yard Setbacks.
Estimated Cost: $ o� ( B ® v
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + b Ft = Ft x $ _ $
DATE: t APPLICANT:,/ Tel. # l ��
Permit Fee
$ J `1. 0
CITY USE ONLY
Fee Schedule on Reverse Side
Fire Surcharge
$ /0
.001 of Permit Vduation (1/10th%)
State Surcharge
$ / C
$.50/$1,000 Valuation
SAC Charge
$
$750 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
Conservation Plan Review $450.00
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$ �,,
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 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additionall$100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$25;001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
$252 for first $25,000 plus $6.50 for each additional $19000
or fraction thereof, to and including $50,000 -
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to . and - including $100,000
$639.50 for first $100,000 plus $3.50 .for each additional
$1,000 or fraction thereof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$3539.50 for the first $1,000,000 plus $2 for 'each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
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 SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner - ®� city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace $ 20.00 $_ 10 that all the facts and representations stated in this a plica ion are
true and correct. 1/1319 ,19941
Gas Piping (Needed with new furnace) $ 10.00 $
OWNER V, Y_ V,e-
Gas Range $10.00 $
BUILDING USED AS
Gas Dryer $10.00 $
ESTIMATED COST 3 Z®G PERMIT NO. ll3Vd--
Air Conditioning - All Sizes $ 10.00
DESCRIPTION OF FURNACE 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) Varm Air)
Trade Name Size No. '7 000
Commercial/Industrial BTU -L4 ® HP EDR
1 % of Value of Appliance or Work $ Fuel W-6W-61F Total Connectedload 3 9
State Surcharge $ .50_ Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE $ ���
ROYALTON HEATING & COOLING
HEATING COMPANY A I &M AVENUE N.
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION BROOKLYN PARK, MN 55443 ,,VL
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed B 0 W 0 T, I
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00 Approved By -OPIRough-In Date Final Date G
"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(�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 1 1-0 0 0
All other BTU's Ll a eve
TOTAL BTU's Y-00 0
Remarks vt
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
ROYALTON HEATING
a»o - 85TH AVENUE N.
wrnnn111 VK1 OACV AAAI R5dd9
tsst
HEAT LOSS CALCtJt.A'[i0N3 _ _. ii i
Weatherstrips
Guide
Wdndowt Doon Reference Odti Mall Int. W
0 19_. — -
r
Windowt and Doorf--Ctaekage MW Atop -
xx
H6
IdUt Haight a at tl
of Daae of Dant• Ileets st a "k :,
AV"
Ac tt.
Cowf.
Btu
.
I/
L�
`
z
</i. a
O.G
Loaf. Btu
Infiltration
Exp. wall
Glass
-
r
����✓�
Int. wall
Exp. wag
Ceiling
,
Net e --p. wall
t y'
i✓ .
Floor
Int. wall
!_
Ceding
--
Floor
�' it`151��C'iION 1NmVIVEAPOLI3. II+@!N.
ululation
Roof, . Floor Kind How Applied
F.M Width Height
Windows &W Dft*",t a and Area
Total Btu.
Required sq. ft. E.D.R. or tq. 6&WA. Ltd cW qft
Ft_I Ratim I lweadh Wldeh - l laid t I•"•`
V"m&ws and sem! Area
Width Height No. at At"
Na of Dan* of Duca HOW of Whop _ m tt
Cowf.
Btu
Infiltration
4D .,.
Glace
Exp. wall
Net ev. wag
-
r
����✓�
Int. wall
Ceiling
t y'
i✓ .
Floor
Total Btu.
Required sq. ft. ED.R. at sq. -int. W.A. LieIyraa
RT P-bdui:ILAfis* 7-1
w...A.t... atut a*A drni`
Infiltration I
Glace
Exp. wall
Net mp. wall
tot. wall
Ceiling
HOW
Total Btu.
Requited sq. it. IMA or at. ins. W.A. Cadet wren
K
71-777-71
I =.' --- �M=
M Leader
and Area
Btu
SuBjECT
ERMIT NO.
City of Fridley
29661
AT THE TOP OF THE TWINS
BUILDING PERliltIT
�
RECEIPT NO.
•
L.W_ COMMUNITY DEVELOPMENT DIV.
SEC.
�j
f � � PROTECTIVE INSPECTION
CITY HALL FRIDLEY 55432
NUMBERREV
DATE
PAGE OF
APPROVED BY
�.___1l.' �•� 612-571-3450
910-F15
16/10/99
10B ADDRESS
7534 TeMDo Terrace NF
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR.
34 3
1 Melody
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mark Kennedy
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
American Bldg. CW17-69-99
2()1fiQ*1R-1
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 ®X REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house (24 S) 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
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2098
$1.05
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
$83.25
Fire SC 2.10
_
PLAN CHECK FEE
TOTAL FEE
'�'
License SC $5.00
$91.40
S-GNATURE OF CONTRACTOR OR AUTHORIZED AGENT -DATE-
HEN PROPERLY VA
ATED THIS IS YO,4R MIT
/P/Cr
SIGNATURE OF OWNEROV OWNER BUILDER, -DATE'
BLDG &P
PATE
NEW [ ] 4 Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 75-31 'Fe r o /l-oL (,
Legal Description:
Owner Name & Address: mat L (-unJ, 73-3q -ettace Tel. # 7F,6-30'3-2-
Contractor:
F,6-3a'3"LContractor: ,AA®►"LILA X'U'A4 (C J;e 4 -5 MN LICENSE # -z0/95-39'3
Address: /--'1-q-�?&./�Ip� 5T33-2 Tel. # 70'7-695'%
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:
Sq,
Construction Type:
1'el-rloy
Estimated Cost:
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: 6-/0-91 APPLICANT:
Tel. # 707 -60S I
CITY USE ONLY
063'T-
Permit Fee
$ -t-tt;�
Fee Schedule on Reverse Side
Fire Surcharge
$s
!Q
.001 of Permit Valuation (1/10th%)
State Surcharge
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
.5- 00
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
�l VO
STIPULATIONS:
v
Vv�.
-A 1 . e
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
$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.
PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
I NOTE: IF PROPERTY IS NOT OWNERIOCCUPIM A LICENSED CONTRACTOR MUST 013TAIN THE PERMrr.
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
_ 253i
THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR
NAME Qrr 1!C. IL n neJ l
PROPERTY OWNER/
TENANT ADDRESS
CIN �j STATE ZIP
PHONE
r nla ks AN APPLICATION FOR A PERMIT —NOT VALID UNTIL PROCESSED
I hereby apply for a plumb)ng permit and I acknowledge that the intormaticn above is complete and accurate: that the work will be In conformance with
the ordinances and codes of the Gltyr of Fridley and with the Wnnesota Construction Codes: that I understand safe is not a permit but only an
application for a permit and work is not to start without aermit that the work will be in accordance with the
P approved plan in the case of all work which
requires review and approval of plana.
Lf"NAMEOFAPPUCANT DATE �� ®
Please type or pr
SIGNATURE OF APPLICANT
TOTAL P.01
NAME 1214UCENSE
#
" CONTRACTOR
ADDRESS
CITY
. STATE
ZIP
PHONE
rMN FAX#•
a S
PERMIT TYPE
SINGLE FAMILY TWO FAMILY
TOWNHOUSE
TYPE OF WORT(
❑ NEW
REPLACEMENT'
DEfAU.ED DESCRIPTION OF WORK
I a�a ►/)� Q,�_
r
FEES ARE BASED ON 310.00 PER FmTURE, EXCEPT WHERE NOTED
FIXTURES; (INDICATE TOTAL NUMBER OF Ems)
BATH SBIK4AY FLOOR DRAINS
SHOWER
WATER PIPING
13ATIMS GAS PIPING (Need CW License) SWM>rlMMG POOL
WATER SOF. rENER ($35)
CLOTHES WASHER KITCHEN SINK
WATER CLOSET
BACKFLOW PREY. ($95)
DISHWASHER LAUNDRY TRAY
NATER HTR ($M
FOR IRRIGATION
WATER METER
OTHER
Permit Fee, $ d - ®®
MINIMUM: $95.00 or 5% of cost of the improvement
-whichever is
Plan Review $
greater on work less than $30O
Surcharge $ ,50
TOTAL. DUE $ 6 S . S&
Make checks payable to: City of Frldley
r nla ks AN APPLICATION FOR A PERMIT —NOT VALID UNTIL PROCESSED
I hereby apply for a plumb)ng permit and I acknowledge that the intormaticn above is complete and accurate: that the work will be In conformance with
the ordinances and codes of the Gltyr of Fridley and with the Wnnesota Construction Codes: that I understand safe is not a permit but only an
application for a permit and work is not to start without aermit that the work will be in accordance with the
P approved plan in the case of all work which
requires review and approval of plana.
Lf"NAMEOFAPPUCANT DATE �� ®
Please type or pr
SIGNATURE OF APPLICANT
TOTAL P.01
Building
BUILDING
Permit No.•
Insp'ections
RESIDENTIAL APPLICATION
Received BS-
763-572-3604
CITY OF FRIDLEY
nate
763-502-4977 FAX
EFFECTIVE 1-1-09
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
4 " /
THIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: r t~
TENANT
ADDRESS:'?Sfey-v.-Pn ier1
G1 gCq�32_
CITY
STATE ZIP
PHONE: i (x -!77 A3 -LE R (7
CONTRACTOR
NAME: g��
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE #Vb EXP DATE -� -:3
AND CERTIFICATE OF
ADDRESS:�)p (,—
CITY 9 STATEMA ZIPc�,3?
I
INSURANCE
PHONE FAX
7 IS
PROPERTY TYPE
),SINGLE FAMILYINEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN
TILE
❑ DECK ❑ SIDING Z OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR JRREMODELING
DESCRIBE WORK BEING DONE:G`I �^��•-o���`
SIZE OF IMPROVEMENT
LENGTH 1 WIDTH '
HEIGHT SQ FT
ROOFING
,B HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�S�NGE1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALVA N i,- - OCCUPANCY TYPE
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due .
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks Davable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of:Z2
ich requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME ft✓; Xrn4W'1 t„ DATE -2
Page 2 - Building Residential Application
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
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1" $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for I' $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25;001 to $50,000
$391.25 for 1" $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for 1" $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the Is' $500,000 plus $4.75 for each additional $1,000 or
-fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the I' $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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