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PRE 2010 DOCSa Village of Fridley, Minn. BUILDING PERMIT � r� Date:......................... Owner....................................... Builder..,.. r u Address...................................... Address ..�.. !....�......m!.!�i 1802 SOC TION OF BUILDING No . ............. Street : �" .. ....... Part of of .. ..... Lot ..... p....... Block ...... /.......... Addition or Sub -Division . .... .... ..000. Corner Lot ........... Inside Lot ... .. Setback ... .. Sideyard .. �.�. � .:� ............ DESCRIPTION OF BUILDING To be Used as: ..... Front .. Depth 'Z . ... Height ........ Sq. Ft. ........ Cu. Ft. ........ Front . /.. .. Depth Height ..... Sq. Ft. ........ Cu. Ft. ........ Type of Construction ��• ...... Est. Cost . f. ............ To be Completed .................. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ,ordinances of the village of Fridley. .............................. ........... In consideration of the payment of a fee of $..f....., permit is hereby granted to ... ... ......................... to construct the building or addition as described above. This permit is granted upon the exprQss 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, Xna3ntenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any.>.me upon violation of any of the provisions of said ordinances. . ....•................. Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. COMMUNITY DEVELOPMENT DIVISION o CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NORT"dEAST FRIDLEY, MINNESOTA 55432 NOTICE OF NON—COMPLIANCE Name/{+.� Jl�'c i?ai� Date--/- . ------ Address e%f / re, iJ. , T, -I -D(;-;, /V:E. Date & Time of Inspection 45- -rte^ An inspection by this Department has indicated that you are in non-compliance with the following checked (x) sections of Chapter 113, Refuse Disposal, of the City Code. You are hereby notified to take whatever action. is necessary to correct any violations on or before 2S` --St. Failure to comply with this notice may result in legal action by the City Prosecutor. 113.02 Provide sufficient containers for the storage of au refuse (including garbage accumulated on the premises between collections. -3 0 .4`IW I -TI -4 2ontainers ( ) 113.02 All refuse shall be water tight, have a tight fitting lid, be impervious to insects, rodents, vermin, and absorption of moisture, be fireproof, and not exceed 3Q gallons in size (unless otherwise specifically authorized). ( ) 113.02 All refuse shall be stored in approved containers, with the cover in.place. ( ) 113.08 Containers shall not be placed or maintained as to interfere with the use of adjoining property. For the purposes of collection . ! only, the containers may be placed a maximum of 3 feet in front of the dwelling unit. (�) 113.07 The contents of storage containers- ontainersor ormore frequently if necessary. ( ) 113.09 Containers without covers, in poor repair, corroded, or otherwise defective shall be repaired or replaced. ( bf) Other 7 G ✓s PF N S t4 Ec- (C 1 EM- eq 4- • /ani tTP4 c. -&Wr4/AI LP -J ' y,s 1T�--F' (�V�3' 7�� •E /�G� 6'A�d3e�c /�N,� �'�r.�1•E iiW° r�E .��`7�l�t€�N If you have any questioris concerning this matter, please feel free to call on -..us at 571-3450, extension 164. By: Inspection De a tment Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas. Dryer i Back Flow Preventer Required ( )Yes ( ) 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 n, c $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance 15 y C� State Surcharge TOTAL FEE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. k"n — '1991 s Owner \-k e 1 !% IRL� z) Building Used As I\,t Q Estimated Cost I -On, 0 6 PEFMIT NO. `/ PLUM ING COMPANY tn 0 TEL N0. MINNEGASCO Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 SUBJECT P J. City of Fridley 2 0 9 2 4 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 , -RECEIPT-NG---- _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REY. GATE PAGE OF APPROVED BY "'j 612-571-3450 910-F15 7/9/91 JOB ADDRESS 6141 Trinity Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carl Hedlund 4129 Jefferson St NE 788-01.57 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyd's Home Improvement Inc. 1012 � 4 ColumbiaHeights5542,788-5602 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 Dwelling 6 S' ares} 2nd Layer. 9 CHANGEOFUSEFROM TO STIPULATIONS Roofing can be.the.2nd. layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. 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 $� $.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r��2 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- $27.00 $1.09 Fire SC T UCTION OR THE PERFOR CE F CONSTRUCTION. 11 PLAN CHECK FEE TOTAL FEE s $28.64 IG ATURE OF CONTRACT R OR AUTHORIZED AGE IDATEI WHE14 LY 1C D THIS IS YOUR PERMIT AA SiGNATUREOFOWN ER0F OWNER BUILDERi IDATEI G fit FIAT NEW [ ] ADLN [ ] AMER [ ] Construction Address: Iegal on: _ Amer Name & Add Oontractor• Address: LIMIG AREA: GARAGE AREA: Det AREA: Off: Effective 1/1/91 R-1 AMID R-2 Building Permit Application Attach to this application, a Certificate of Survey of the lot, with the proposed omwtruction drawn on it to scale. Length Width Height Length Width Height 6 AIS Sq. Ft. Sq. Ft. Sq. Ft. Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: Gf J - /69 9d Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: �' — G APPLSC U QTY USEY Permit Fee $ 17, 60 Fire Surcharge $ State Surcharge $ �✓ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Marge $ $ C' - SI'IRJ=C<JS: Fee Schedule on Reverse Side .001 x Pdrmit Valuation (1/10th $) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to arty existing building or structure, or for any alteration or repair to any existing building or shore, 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: $1 to $500 $15 (Minin mm Fee is $15 plus surcharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $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 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof ERIVENU SSICK ESCWW (Concrete Curb Streets Only) Alternate "A11: Removal and replaoecnent of curb and gutter only - Driveway width plus 6 feet tildes $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. `• ✓1' 1' �+� •' •)" "x`11 11 � •� Permits for construction will be issued a minimum of 24 hairs from the time of application to allow for proper review of the proposed structure and of the consteucticn site. A Certificate of Survey of the lot, showing the location of the foundation cnoe it has it has been 000ristrvcted will be required before prooeedirg with the fraanirg. CITY OF FRIDLEY INSPECTION DIV, 6431 University Ave NE Fridley, MN 55432 572-5604 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 20.00 $ Gas Piping (Needed with new furnace) $10.00 $ Gas Range $ 10.00 $ Gas Dryer $10.00 $ (*:AJr:C*nd:1tIonlng — Ali Sizes $10.00 $62 e O Ali Others/Repalm & Alterations (LIST ON BACK I% of Value of Appliance or Work (2k" $ . Commercial/industrial 1% of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERAT16NIAIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Alr Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 1993 JOB ADDRESS >-2, , The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations -stated in this application are true and correct. ,191212 BUILDING USED AS ESTIMATED COST PERMIT NO.____, its s(ta} Trade Name c � %a Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Signed By Tel No S3 7 Approved BJ__ Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VE1JAaT*N@ TAACTORS INC. REPLACEMENT FURNACE 6121 42no avenue No. Crystat, ISN 65421 CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 2 1. Has been carefully examined Yes ( ) No ( ) 12. Is free from rust or deterioration Yes ( ) No j ) 3. Has no foreign objects lodged within Yes ( i No ( ) 4. Is securely supported Yes ( ) No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY signed By Date 0 SUBJECT - P City of Fridley 17817' AT THE TOP OF THE TWINS BUILDING P E D M I T f '\ O. RECEIPT NO. � `v COMMUNITY DEVELOPMENT DIV. , ----- _ f PROTECTIVE INSPECTION SEC. f/N NUMBER REV DATE PAGE OF APPROVED BY ---,•jam 55432 ----� 1 612-571-3450 g�p.F1g 9/16/98 JOB ADDRESS 6141 TRinity Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elaine Fitzgerald 571-5448 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ace Construction 6230 218th Ave NW Elk River 55303 323-3019 20001884 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 O ADDITION 0 ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reroof house & garage (25SQ) 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. OWLG. 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 $2,142.00 $1.07 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE 0 C LAW REG CON- $74.75 Fire SC $2.14 STRUCTION OR THE P RFORMANC RUCTIO PLAN CHECK FEE TOTAL EE Licens C $5.0 $82.96 SIGNATURE OF COFN72T 0 AUTHORIZED AGENT iOATEI N P OP ALIDATE HIS 1$ PE MI .r. IDAT SIGNATURE OF OWNER OF OWNER BUILDERI EI BL I N S P OAT NEW Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION [ ] ADDN[ ALTER ] ConstructionAddress: Legal Description: Owner Name & Address: ��i,�,e ��z g��i� Tel. # Contractor: @ QMN LICENSE # r / Address: d/� �= �✓ //� /ice ryy7�,Tel. # 3�_�--,3®/2 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: A &-'C� �� ®c�CeAC-1 Construction Type: u ' ®k - Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT:Tel. # 3.>-3- 3vl 9 TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ 5 Fee Schedule on Reverse Side Fire Surcharge $ c2, l .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S7,60 $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 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 the foundation once it has it has been constructed will be required before proceeding with the framing. City of Fridley 5�'� HE TWINS SUBJECT BUILDING PERMIT P 28229 � • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEV 55432 612-571-3450 ECEIPT 1 NUMBER 910415 REV DATE 10/13J98 PAGE OF APPROVED By JOB ADDRESS 6141 Trinitv Drive NE 1 LEGAL DESCR. LOT NO. 9 BLOCK 1 1 TRACT OR ADDITION 1 Sylvan Hills SEE ATTACHED Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elaine Fitzgerald 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Best Siding Co. Inc. 1310 154th e -413-050n 2A46 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 O NEW 0 ADDITION O ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reside house 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT CU FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $6000 SURTAX $3.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFO MANQE OF CONSTRUCTION PERMIT FEE $112,25 SAC CHARGE Fire SC $6.00 PLAN CHECK FEE TOT EE X6.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDA EI E PR P VALID THIS IS�IQUR PERMI�e T l/vJ/Ji011 B -NSP Z Fl 1E S-GNATURE OF OWNER,IF OWNER BUILDER, IDATEI NEW [ ] ADDN [ J CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: _ Contractor: s `- Address: 13 k '�:_ICk e- -F;+z 07elC' Effective 1/1/98 Tel. # MN LICENSE #� t_,A 5.5 36 Tel. # c/l3y 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: G� Construction Type: �F S � S� Estimated Cost: $ 4�600 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: -?(APPLICANT: Tel. # Z i 3 o ` o Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge C20 .001 of Permit Valuation (1/10th%) State Surcharge $ b . QO $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ vc� O $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 $ 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 ,$5.0,000 $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. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Effective On January 1, 2002 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS- lol Lk RATE SCHEDULE �. \ OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS W-Q. Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) / ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning - All Sizes $ 25.00 $ BTU HP EDR Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work 9wr, Gove, BTU HP EDR a0"'Z-tUU th aeA-� -�4ep Slc Commercial/Industrial 'nS.p� bZ�Et. 7V3i � 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE $ .SO DATE 's— as -03 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO S REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # REINSPECTION FEE $47.00/Hr FAX # *Air Conditioners can not be placed in a side yard without Approved By Rough-In Date Final Date written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT, V NT cnNNFcTnR AND COMR1ISTION AIR V RIFT ATION When _rela _ing 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 verifies 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 existingg{-nmb ,ction air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new nnmht ictien air �itwill be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new venting cvct _m, 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 as per current codes. Tynga and Si7p/ Vent and Vant VanConnecter Yes( )No( ) Information pplianre .ommen 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 ft Length ft Diameter Appliance #2 Vent Connector Height ft Length ft Diameter Appliance #3 Vent Connector Height ft Length ft Diameter ALTERATIONS- (Dprndbel in Type in Type in Type HEATING CO: Signed By: Date Building BUILDING Permit No-- `6 M313 Inspections RESIDENTIAL APPLICATION Received By. ti 763-572-3604 CITY OF FRIDLEY Date RecW, 19 to DATE — -2 — 06 SITE ADDRESS 6 , THIS APPLICANT IS: YOUR E-MAIL ADDRESS rf"fa, ❑ OWNER JrCONTRACTOR PROPERTY OWNER/ NAME: CA /-15 Lei (1 e I° TENANT ADDRESS: 61 *I CITY 1�� STATE U GIP PHONE: 763 t5 -f— 11616 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE NAME -/14 ° f STATE LICENSE # ° 10 )-i 1 3 EXP DATE ADDRESS: 3 1 3 4-%y CITY Pwovp. 7 C. 3 - � 7 — l �°t FAX '% 63— 4-.)--7y '1 ao L ®. SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ BASEMENT FINISH ❑ DECK XROOF ❑ SIDING ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:: %fit' JP— 4 PTO P SIZE OF IMPROVEMENT LENGTH ROOFING NUMBER OF SQUARES '� S� ❑ HOUSE ONLY Off HOUSE & GARAGE GARAGES ❑ ATTACHED GARAGE PROPOSED SIZE: ❑ DETACHED GARAGE PROPOSED HEIGHT: SAC Charge SIZE ❑ DRAIN TILE ❑ OTHER HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. 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: (USING T 97 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ` 20,9,— OCCUPANCY TYPE Permit Fee $ e' 321' Z Plan Review $ "-61;1 Fire Surcharge cA e t7 6 $ Surcharge- $ License Surcharge $ 5�— 0 b SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Char $ Total Due e�� •-5 $ 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Ci!y of Fridley 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; that the work will be in accordance with the approved plan in the case of all work whit requ' review and approval of plans. \ _ - ` �r SIGNATURE OF APPLICANT r�� PRINT NAME �'7 y O '° 2�a"e DATE '� �G 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 1s` $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 15` $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 lsc $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 15` $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 1" $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 1" $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