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PRE 2010 DOCSSUBJECT®(18 PER City of Fridley 18 AT THE TOP OF THE TWINS BUILDING PERMIT ' ' RECEI 0. • COMMUNITY DEVELOPMENT DIV. v ------'I r PROTECTIVE INSPECTION SEC. 107 , 1 ; , 1 , ----1 � CITY HALL FRIDLEY 55432 � ,.J NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/30/85 JOB ADDRESS 6170 Trinity Drive 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. pt. 4 2 Sylvan Hills Plat 2 SHEET —T PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ruby Sholander 6170 Trinity Drive 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Ray Rta Palmer 3482 Auger White Bear Lake 55110 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. R & M Associates Same 770--8322 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING R-1 7 CLASS OF WORK ❑ NEW ❑ ADDITION Cid ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Structure 9 CHANGE OF USE FROM TO STIPULATIONS Can be two layers but not three. 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 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 $1,300 $.65 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. 22.00 PLAN CHECK FEE TOTAL FEE I $22.65 IGNATU OF ebNTRATCTORORAUTHORIZED AGENTIDATEI WHEV PROP G INSP RLY V I THIS IS �PERMIT NATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: f Legal Description: 0 Owner Name & Address: TL E Tel. # S7j` A9131 Contractor: ck-y fa, I Tel. # 776-.7322- Address: 3' �� da�� P �o 5 LIVING AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ er> Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge STIPULATIONS: APPLICANT: CITY USE ONLY Tel. #. Fee Schedule -on Reverse Side 25$ of Building Permit Fee $•50/$1,000 Valuation $425 per SAC Unit 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 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,eaeh 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 m nimum of 24 hours from the time of application to allow for proper review o 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. CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE �` !� � J RESIDEKTIAL RATE TOTAL Job Address ( ® / �� /� /{" ' " Furnace Shell and..Duct Work, Building Inspection Div. 6431 University Ave NE Friedl MN 55432 Burner (Also replacbsont furnace) $ 20.00 $ p y Fridley Tel. No. 572-3604 Gas Piping $ 10.00 $ (piping needed with new furnace) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ �A'r C ndi.tionog (al Si gs)S 10.00 11 ems/Repai> and Altfterations ®U It of Value of Appliance or Work S COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work State Surcharge iW� REINSPECTION FEE $30.00. Rough Insp. Date Final Insp. . /" Date Approval for Permit 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct.�� A 1.11-6 r 19 OWNER KIND C USED A $ TO BE COMPLETED ABOUT ESTIMATED COST $ .50 1� a OLD - NEW BUILDING PERMIT NO. PEAMIT NO. $ $�� c DESCitIPTION OF FURNACE/BURDIER EATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU or Total Connected Load Kind of Fuel BURNER - Trade Name Size No. MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Capacity Sq. Ft. EDR BTU HP Company • Signed By 04 Tel. No. Fill out back side for stack verification on replacement furnaces 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 connected Yes ( ) No 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Da to I SUBJECT P Cityof Fridley `? 3 8 6 2 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir � ` _______ COMMUNITY DEVELOPMENT DIV. L 1 PROTECTIVE INSPECTION SEC NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/2/95 JOB ADDRESS 6170 Trinity Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I Pt 4 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lyle Johnson 6170 Trinity Drive NE 571-5694 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION IX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install egress window 9 CHANGE OF USE FROM TO STIPULATIONS Egress window must comply with the State Egress Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 @ $•50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $500.00 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- $21.00 Fire SC $.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE $22.00 SIGNATURE OF CO NTR CTO OR AUTHO RIZED AGENT (DATE) HEN PROPERLY YALMDATED THIS IS YOUR PERMIT SiGNATU RE OF OW NER qF OWNER BU4 DE Ri IDATE� BLDG iN 'P PATE I NEW [J ADDN [ J CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: - 1'7 0 -f i v11 414 b I Effective 8/1/95 Legal Description: Owner Name &Address: Lu I Q i 4q L n Tel. # Contractor: Address: MN LICENSE # Attach to this application, a Certificate of Survey of the lot, • with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel_ # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgdGround Sq. Ft. OTHER: 1:: a- W Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks T Type of Construction: Estimated Cost: $ 50 0 , 0 0 A0prox. Completion Date: Driveway Curb Cut Width Needed: DATE: APPLICANT: (Cost on Back) Ft. + 6 Ft = Ft x $ _ $ Tel. # STIPULATIONS: CITY USE ONLY (9'J ,Permit Fee $ �. Fee. Schedule on Reverse Side Fire Surcharge $ �'Z,l .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 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 fust $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 $500,00 $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 fiaming. r � 1 PERMIT NO. City ®f FridleySUBJECT 2622 9R AT THE TOP OF THE TWINS BUILDING E I P 16 COMMUNITY DEVELOPMENT DIV. rr - PROTECTIVE INSPECTION SEC. I , I NUMBER REV DATE PAGE OF APPROVED BY `----/--',,� CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/12/98 JOB ADDRESS 6170 Trinity Drive NE 1 LEGAL LOT NO. ' BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 4 2 1 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lyle/Vicki Johnson 6170 Trinity Drive NE 571-5694 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 22' x 18' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. n WARNING Before digging call for all utility locations 454.00DZ REQUIRED BY LAW 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 MOT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO 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 $1.78 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,552 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- $87.25 Fire SC $3.55 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL EE $9 .58 . I'SIGNA URE OF CONT�RRRIZEDAGENT IDATEI jV' P p BLDG j2SP ALIDATE �S IS Y U��T 4110 FJATE SIGNATURE OF OWNEFIAfF OWNER BUILDER) I IDAT t r � 1 NEW [ ] Effective ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 I BUILDING PERMIT APPLICATION ConstructionAddress: n Legal Description: , r Owner Name & Address: L y 1,e U —n—ob ne o nI Tel. # ✓-7 1 v Contractor: 0 w rr f - 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 9a '' Width Hgt/Ground 4W Sq. Ft. OTHER: 3r4 1,i. Z, /Z Construction Type:!'lfe-ems �/'eo-4C Estimated Cost: $ (Fee Schedule on Back) Ft x $ _ $ Driveway Curb Cut Width Needed: DATE: 6 -1 t—q 8" Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Ft. + 6 Ft = APPLICANT: u i-'"�cz'U'� Tel. # 7 q2. - s8 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Oficial 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. I � , I l, f l i l l i.. -! 4 1! j . _ I � � i i i _. I __ i_ _, ._ I .. I_ � I _I�.i _ t ' I � t j_ � _'r_ I ; I I 7� ..... ..... . .. ..... .............. .... 1 F%v A'A 0; 1 Iry r- 7 tt 71 A =M -w lc4, Cl, ICA IIIA I i l'Y ILA N -4t i-4 76 N A Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: . 763-572-3604CITY OF FRIDLEY Date Rec'd:®° '® DATE UR -MAIL SITE ADDRESS f� //I,g� V THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: ADDRESS: ITY STATE IP OWNER/ N "' PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDS: CITY STATE—zip— TATEZIPAPPLICATION APPLICATION PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW/PLACEMENT 11ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK -4A 6 l f e—ki PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x,01 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 TFURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 - Number of fixtures @ $10.00 x $10.00 = $ Permit Fee $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 1 x $35.00 = $ State Surcharge = $ 50 Total = $ 3S 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 w k which re es view and approval of plans. f� SIGNATURE OF APPLICANT NAME 114) 10 -'�SZ C /t 3 ' '..? �i�<,.AIN Y C .' �f..s.x _010 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: +� 763-572-3604 CITY OF FRIDLEY Date Rec'd: ®i`�'� DATE 96 a ® ADDRESS SITE ADDRESS 6 17 fbw THIS APPLICANT IS: ❑ OWNER ,CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: CITY STATE IP .3 Z - TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # 134= EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS -S-5- / :k i.1 CITY STATE IP ,2c? WITH APPLICATION PHONE '76 3 `-5 B-2 ' % q 5 FAX 76-3` F ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED JCWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ` ANCE/REPAIR ❑ REMODELING o DESCRIBE WORK BEING DONE:4-1. 3 ` d ° SIZE OF IMPROVEMENT L TH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. ming 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 IN EXISTING OPENINGS )gYes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & qn TYPE OF WINDOW TO BE INSTALLED ER OF WINDOW ALL FEES ARE BASED O VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 14 n ®"' OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire 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 (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 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 uavable to: City 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 applicatio a ermitd ork is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wort hich uir A d approval of plans. C SIGNATURE OF APPLIC PRINT NAME ®� L �� DATE 97' Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Oficial 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 1' $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 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