PRE 2010 DOCS,I
Village of Fridle Minn.
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BUMI)ING PERMIT � 1258
Date:
Owner . �, Builder .................
i
Address .. Address .. ..
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LOCAIQN OF BUILDING ' "
No. treet'""� Parto%f Lot .
Lot ... B k Addition or Sib -Division ..a+� "�: ; ' ......
Corner 'Lot Inside Lot . Setback sp.. �.'^� .. .
DESCRIPTION OF BUILDING
To be Used : as: e
... _ Front .� Dept . : Height .+? Sq. � Cu. Ftc ..
.................. r Front Depth Height Sq, t , , . Cu. Ft. ........
Type of Construction Est. Cost d .;�r'i• To be Completed .
F
G.
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In consideratio of the issuance to ;me of a permit to construct the iuilding described, above, I agree to "do
the proposed work ' "accordance with the, description- above -set forth and ; in compliance with, all provisions ` of
ordinances of the age' of Fridley.
Y,
- _ _ • ..
In consideratio of the payment of a fee of $145? -Az- t is ereb anted t � � • .
•> perm lF Y b'�'
.. , .. . to construct the building or addition as described ab6ve. This permit is granted upon
the express conditi n : that the person to whom it is granted and his agents; employees and workmen, in all work
done in, around upon said ,building, or any part thereof, shall ,conform in a}l respects to the- ordinances of
Fridley,. Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village lim and this permit may be revoked at any time upon violation sof any of the provisions of said
ordinances.
. Buildin for
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a
NOTICE:
This pe sloes not cover the construction, in or alteration for�wirin , plumbing, gas heating,
sewer or water Be sure to see aiding Inspector for separate permits for items.
FJ
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A 1=101116100
Village ®f Fridley, Minn. N° 2340
Date:..�.........................
Owner .' ' .. . . , ....... .... ... ... Builder ' .............. .............
Address i. 1° � .... ............. Address .........................................
4®
LOCATION OF BUILDING
No. .. ... :.... } . Street .. Part, of Lot .......................
Lot . .. } . Block ..' :........... Addition or Sub -Division `s : ;. . r....:
Corner Lot ............. Inside Lot ... :`....... Setback ? r...e.. S eya d o .........
id r fr � "r"
DESCRIPTION OF BUILDING
To be Used as:
Front.... Depth <:.... Height,,:...... Sq. Ft.�`... Cu. Ft, ........
................. Front ........ Depth �.y....... Height ......... Sq. Ft......... Cu. Ft, ........
III. 'Y.A ....,T 0
ot
Type of Construction f'.. Est. Cost .� .............. To be Completed .........
1
In considerat *jof the issuance to me of a permit to construct the building 'described above, I agree to do
the proposed work ' accordance with the description above se. - orth and in compliance )with all proVislbin of�
ordinances of the village of Fridley. '
_ ` m: . r r• :. c..,. F.. w yy . . ky 4...............
In consideration of the payment of a fee of $.A -'j... /' ermit is hereby granted to,
... to construct the building or ad lition 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 �pon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota ri�garding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time, upon violation of any of the provisions of said
ordinances. f,f-
II
... Building Inspector
NOTICE:
This permit does not cover the Construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Bg sure to see the Building Inspector for sen r , + for these items.
City
1.Fridley,Minn.
1UEWING PERMIT
9' '
Owner: Builder
Address - ,: ,
LQ TION JILDING
No.�': Street
Lo _ 'Block Addition or Sub- on W.. " . - t-- - •--
Comer Lot Inside Lot .:aback ideyard
Sewer Elevation _ _ Fo dation Elevation
DESCRIPTION OF BUILDING
T ;M4
Front ,jr. Depth Height Sq. Fk Cu. F't.+t
I`r t Depth Height , _ Sq, Cu. Ft.
Type of Constructio Est. '"""_�' 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 city of Fridley.
In consideration of the payment of a fee of $ , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
win thhee city limits and this permit may be revoked at a � upon v�Qron of any of the provisions of said
odinan
Building Inspector
NOTICE:
'this permk does not cover the construction, hmealhulon for wMring, phmnhing, gas he@&#, sawar or water. Be rite to no
the Building Inspector for sopararo pormifs for these Items.
owner's
Address
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
No. Street Mift of Lot
Lot BlockAddition or Subdivision
Z��
Corner Lot Inside LotSetback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
q. Ft. Cu. Ft.�
Type of Construction Estimated Cost e
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 ruliugs of the Department of Buildings, and hereby
declares that all the facts and representations stated in this ppl ation
are true and correct:
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
c
BUILDING PERMIT FER SCHEDUL9
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 exist-
ing building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, require the payment by the
applicant for such permit of fees',;; the amount herein below set forth and
in the -manner herein provided to -wits
2.1. For any such permit for -the -erection of any fire -proof building, other
than a garage, warehouse, factory or grain elevator, or for the erection of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40'for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for.the.erection of any fire -proof garage, warehouse,
factory or grain elevator, or for the erection of any fire -proof addition,
for similar occupancy, to any existing building shall be at the -rate of $1.25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
;the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof building other
than a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non -fireproof
addition, for similar occupancy, to any existing building or for each..such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction, thereof, in the cubical contents thereof with a 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.rhe
basement or cellar to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all proposed.work.
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be less than $.4.00,
53-84-s-915.51
Base
lk
PARTIAL RATE SCHEDULE
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W& H&TE TOYAL
................
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w8wr waswr ",up to MAW Erm....
mew Gnmd mm ou ® ........ •
$a-=
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Ls3 rmftm...............
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...............
z 75
to . mu ...........-
$s
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State Surahasge
$ .SQ
20ML$5.50
OW ace S rGharge ZO5t
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
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Water
Heater
aS
1@C
Catch Basin
x $5'.00
$
Water Heater - to 99,000 BTU
x $5.00
$
9a s 71
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
1st
$
Electric Water Heater
x $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x '$3.00
$
Additional Fixtures
x $1.00
$
2nd
Gas Range to 199,000 BTU
x $10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
3rd
$
.50
TOTAL FEE
$'
$
REINSPECTION FEE
($10.00)
4th
(R) = Future Connection Opening
(*} = New Fixture, Old Opening
Connected with Sewer
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5'.00
$
Water Heater - to 99,000 BTU
x $5.00
$
9a s 71
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
Electric Water Heater
x $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x '$3.00
$
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTU
x $10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$
.50
TOTAL FEE
$'
$
REINSPECTION FEE
($10.00)
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
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
Fridley, Mn. 0 , 19 '' Q
OWNERF-
KIND OF BUILDING`
USED AS
TO BE COMPLETED ABOUT e
ESTIMATED COST
OLD-'- NEW BUILDING PERMIT NO. PERMIT NO.
60�
Company
Signed By �� y
Tel. No.
ROUGH INSP.
Date
i
FINAL INSP. 3
Date
APPROVAL FOR PERMIT dJX/
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
SUB EC
MI
City of Fridley
o 18-382
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE T NO.
• r COMMUNITY DEVELOPMENT DIV. �.-------,
PROTECTIVE INSPECTION SEC.
®3 9S
----n CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/17/86
JOB ADDRESS 6339 Van Buren Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
23,24
6
Florence Park
Addn. to Fridley SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dave Depoint 6339 Van Buren Street N.E. 574-0077
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Schmidgall Construction Co., Inc. 13605
Vincent Avenue So., Burnsville 55337
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
890-6270
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 141 x 16' Addition to Dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
See plans for notations.
SEPAR
�����ATE BERM/ TS
� R�
ATf1vG, pL��RE
Ab
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
9,950.00
$4.98
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 CONSTRU TION.
80.50
None
1de
gd-J�" l '
PLAN CHECK FEE
20.13
TOTAL FEE
$105.61
1 SI NATURE OF CONTRACTOR ORAUTHORIZ AGENT (DATE)
WHEN PROPE VALIDATED THIS IS YOUR PERMIT
JQ
BLDG WSP GATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW[1C] City of Fridley Effective 4/1/84
ADDN. L R-1 AND R-2
ALTER. Building Permit Application
Construction Address:
Legal Description:
r9
Owner Name & Address: 22 &Ao&�� Tel. # 5-7 . P®77
Contractor: Af Af 17P 42744 L.. 470,0. 1— (CO- Tel. # tM-- 62,7,v
Address: 6 &,r x1j s, e vr— ify,&- s&, Aaww--c
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 -Z6- Height �� Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
ez2y)6
Corner Lot [ ] Inside Lot [Vf Ft. Yd. Setback Side Yard Setback
Type of Construction: U/,90 P- 4�5"444 Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: �N°� $ $
See Back Page for Explanation
DATE: ?�/-I!K _ APPLICANT: �4;4j®- Tel. # f ?0-W/P?a
CITY USE ONLY
Permit Fee $ VA & Fee Schedule on Reverse Side
Plan Check $�ri•13
e� 25% of Building Permit Fee
State Surcharge $ 4A $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ `11'
TOTAL $ �f •/ ' Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
.
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.
0 v G---
SW6
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.
0 v G---
SW6
SUBJECT
City of Fridley
2 b 12
AT THE TOP OF THE TWINS
BUILDING PERMIT
NO
t • _ PROTECTIVE INSPECTION SEC.COMMUNITY DEVELOPMENT DIV.
-
4� i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
----/---,.,
J` 612-571-3450
910415
7/24/98
10B ADDRESS
6339 Van Buren
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
23.:
6
Florence Park Addn. to Fridley
SHEET
2 PROPERTY OWNER MAIL ADORES* ZIP
PHONE
David De oint
574-0077
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Anderson Construction
- 6431
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20098630
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION N REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (33 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building 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
SO. FT.
CU. FT.
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
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
$2752
$1.37
DOES NO ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI S F ANY OTHER STA OR LOCAL LAW REGULATING CON-
Fire SC $2.75
STRUCT ON R E PERFORM C OF CONSTRUCTION.
$74.75
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$83.87
SIGNATURE OF CON' ACTOR OR AUTHORIZED AGENT tDATEI
HEN PROPERLY V
DATED THIS IS YOUR PERMIT
y - r OG SP
//mag
.!' a...i-
OATS
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 67s sq lwkv 13z,,{,\
Legal Description:
Owner Name & Address: at, ZI H lgizve4. Tel. # 'S 74 -Co7 7
Contractor:C_ d IN S y G. MN LICENSE #_ .ZO®2� 3
Address: 12>916 (/VI &W /' 136, />`"�� �l yh Gv �, IW TS-143Tel. # -12-'2 - 44- �
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.
GARAGEAREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: 3 3 5� � r�rS �- G���.1 e
Construction Type: ) &A v -
Estimated Cost: $ �'SJ,2-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 74 U APPLICANT: Tel. 6431
STIPULATIONS:
7
CITY USE ONLY
Permit Fee
p�
$ / Sr
Fee Schedule on Reverse Side
Fire Surcharge
$ �
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 6.06
$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
$ 8
STIPULATIONS:
7
It
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.
From: City of Fridley To: 7637542908 Page: 2/4 Date: 41:161200P 11:00:09 AM
3uildinaMECHANICAL
Equipment Installed
Fermiz Ncl.` -cam a�
SIZE/BTU *! 0. 0_ UIQ
inspections
RESIDENTTLkL APPLICATION
� Received Fid
604
7/603+ -5++7�,''2 -,22
�[T
I jkC% J N ON
_FIREPLACE (GAS) $15.00
_GAS RANGE/OV EN $10.00
[%� t{��}
( WOOD) $35.00
NEW GAS GRILL $10.00
-[3Ay
FAX
_FIREPLACE
FURNACE $35.00
_GAS UNIT HTR $10.00
_BOILER
LINER $10.00
DRYER $10.00
>:FFEC-rI VL =-19-00
_CHIMNEY
DUCT WORKS I0.00
_GAS
GAS PIPING $10.00
DATE
YOUR E-MAIL ADDRESS
_
AA
SITEADDRESS x®139 � ,, A,d
8L&C,d0 Zt 1136 35:A.Ibo(,I,
THIS APPLICANT IS:
❑ OWNER XCONTRACTOR
PROPER'T'Y
NAME:
ZIA g-3 ty I 01, PC".✓1�
OWNER/
ADDRESS: JAW i%k =rL^ hIC CITY F&O1p(d.,
STAT LI
� b
TENANT
PHONE:
s/ t 3- !T-74 b 60 17 6
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
COMPANY NAME: (2tV 6.® C11,
CONTACT PERSON: a
T
STATE LICENSE it EXP DATE
ADDRESS:6.)i6 t–lAt^ tJE CITY i=OLAOe—:6 STATE 040Zlpz _-�_
PHONE -1 6 'b 7 E'Y 4% R FAX
'SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
❑ NEW P6 REPLACEMENT ❑ ALTERATION/REMODEL
IDETAILED DESCRIPTION OF WORK oJ- G
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NU--MBER OF EACH BELOW)
Equipment Installed
MFG: ro,.&_0A &- MODEL:
SIZE/BTU *! 0. 0_ UIQ
MFG: Cf e,@]s G1 MODEL: .2)4A10A33b
SI7.laFHTU 0d/, 14
MFG: MODEL:
SIZE/BTU
�A/C $25.00
_FIREPLACE (GAS) $15.00
_GAS RANGE/OV EN $10.00
TO Alit EXCHANGEER $15
( WOOD) $35.00
NEW GAS GRILL $10.00
_AIR
$35.00
_FIREPLACE
FURNACE $35.00
_GAS UNIT HTR $10.00
_BOILER
LINER $10.00
DRYER $10.00
HEATER $35.00
_CHIMNEY
DUCT WORKS I0.00
_GAS
GAS PIPING $10.00
_POOL
VENTILATOR $15.00
THIS IS AN APPLICATION FORA 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 Coda; that 1 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 alll_ work which requires review and approval of plans.
SIGNATURE OF APPLICANT •�~ t 4 �� ��
PRINTNAME C i, d dS DATE �� a_�
RT,.F.,dri.F+::1�il1TT iRA:A.rF;.AF,R1SrIITG.A'i2H:12FX111t1Z:#7L5;FC'tR;:iT:Tti•T7titiifT #�T F('TRTf1k:.AN:I�:149E{CHANIC:AL WOIZI:
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 554321
763-572-3604 FAX: 763-502-4977