PRE 2010 DOCSAPPLICATION FOR BUILDING PERMIT
CITY OF FRIMEY, MINNESOTA
OWNER'S NAME BUILDER
ADDRESS d- 3 7-0 � , � 7-;7 ADDRESS
LOCATION OF BUILDING
1
N0, STREET PART OF LOT
LOT,4 / LOCK �� ADDITION OR SUBDIVISION -
CORNER LOT(/ INSIDE LOT SETBACK SIDE YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
Front Depth--fz' Height
Sq. Ft. 16 zr Cu. Ft.
Front
Dept _ Height
�Sq. Ft. Cu. Ft.
Type of Construction. ��-�- 7 Estimated Cost
To be completed_
V -=-AL-/- /, 1,9 Z�l 4(1
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in -strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE ,,z / 716 6 SIGNATURE �� d
(Schedule of Fee Costs can be found on the Reverse Si ).
SU LDING PERMIT FEE SCHEDULE
SECTION 2, The Inspector of.i$uildings shall, before issuing any permit for
the erection of any -building or structure, `or for any.addition to any existing
building or structure, or for any;alterations,or.repairs to any existing
building or structure, upon application 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-vtt:
2.1. For any such permit for the erection of*any fire -proof building,
other than a garage, warehouse, factory or guain elevator, or for the erection
of any fire -proof addition, for similar occupancy, to'any existing building,
shall be at the rate of $X.40 .far 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
2i3. For any such permit for theerection 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 -fire -proof
addition, for similar occupancy, to any existing building -or for each such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of computing fees for -building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six :.(6) inches -below the floor line of the
basement or cellar to the average height of the upper surface -or to the average
height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing'structure,.the fee shall
be at the rate of $3•.00 per each Five Hundred Dollars ($500.00) or fraction
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.
STORM REPAIR DAMAGE FEES:
Residential: Estimated Cost of work up to e5M OO - $5.00
Estimated Cost of work over Y:G,00
Commercial; Estima.tost of c ort u" �o `a x_ 00 - s. ^0
Estimate ost of work over $500.00 - $� 00
� X4.43
City o -Fridley, Blinn. N° 8833
BUMDEI G PERMIT
Date: MAY 17, 1966
Owner: JOHN KRZYSK& Builder SAME
Address 637.0 VAN BUREN N. E. Address
FRIDLEY, MINNESOTA 55421
LOCATION OF BUILDING
No. 6370 Street VAN BUREN N.E. — Part of Lot
Lots 1 & 2 _ Block Addition or Sub -Division FLORENCE PARK
Corner Lot _ X Inside Lot — Setback _ Sideyard
Sewer Elevation __ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
UTILITY BLDG. Front 8 Depth 21 Height 10 Sq. Ft 168 Cu. Ft 1, 680
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Frame —Est. Cost $250.00 _ 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 fort�a and in compliance with a'll provisions of
ordinances of the city of Fridley. / / A i
In consideration of the payment of a fee of $ 4.00 , permit is hereby granted to JOHN KRZYSRA
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within- the city limits andel this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
WILLIAM H. SANDIN
NOTICE,
Tido permit dot not cover the construction, hostaihition for wirlog, plumbing, gas heating, course or wafer. Be sure to as
fbe MlMh* Inspector for soperaH permit for these items.
SUBJECT PE NO.-�
City of Fridley
2014
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�
RE
i rry__ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
7d��
1 . .
I "1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
/10/3/89
JOB ADDRESS 6370 Van Buren Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1,2
Florence Park Addition to Fridley SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vera Phillips 6370 Van Buren Street N.E. 571-3820
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Thyen Construction Inc. 1872 - 29th Avenue N.W., New Brighton 636-8357
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 J ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 141 x 1W Addition to Rear of Dwelling
SEPARATE PERMITS REQUIRED roR
9 CHANGE OF USE FROM WIRINGTNHEATING, PLUMBING•
STIPULATIONS
Variance approved for a street side setback on October 2, 1989 to 11.1 feet.
See notations on plan
On all new roofs or tear-offs and replacement roofs, Wore ci:^ir,y call for
State Code requires that 2 layers of 15 Ib. felt, all utility locations
mopped together, be installed to a point 24 inches 454-010012
up from exterior wall line, or the use of other PEQUIRED Y L3` VV
approved underlayment membrane.
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
1 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
$2.70
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,400
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-
$81.00
STRUCTION OR HE PERFORMANCE OF CONSTRUCTION.
d
FkLANCHECKFEE
TOTAL FEE
$83.70
SIGNATU OF -RACTORtRA HO i DA ENT (DATE)
WHEN PROPERLYV 1 ATED THIS IS YOUR PERMIT
BLDG )NSP AT
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
NLW [ ]
ADCN [ ]
ALTER [ ]
Construction Address:
Legal Description:
Owner Name & Addrese
Effective 5/1/88
R-1 AND R-2
Building Permit Application
set 444 0
..�.
Attach to this application, a Certificate of Survey of the
lot, with the pruPosed construction drawn on it to scale.
EESMMICT OF II_'RDVH =
1to
.LlvnaG AREA:Length lA —0 -Width 1-0 Height t-�D0 Sq. Ft.
GARAM AREA: Iexqth _ Width Height Sq. Ft.
DECK AREA: Length _ Width Hqt/Grourxi Sq. Ft.
onm:
Corner Lot U*Y/ Inside Lot [ ] Ft. Yd Setback 3 Side Yard Setbacks ,
Type of Construction: a 6 S + Estimated Cost: $
Approx. Cmpletion Date: c'r.
Proposed Driveway Width If New opening Is Desired: Ft. $ $
`1m 11 comr, , idth + 6' See Back Page
DATE: APPLICANT: Teel. #;a
Permit Fee
State Surdkarge
SAC Charge
Driveway Escrow
Park Fee
Sewer Main Okuge
TOTAL
�Q5
S�TIPUTATICNS:
CITY am QrII,Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Eml;rmx n
Agreement Necessary [ 7 Not Necessary [ 7
r
Woo
3-C.
3 /,®j
_�Ip at■ ■ ,•.V a 4 .: _ .:,sem
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:
$1 to $500 $15 (Minima 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
BPJNDW SSICK 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.
Permits for construction will be issued a mini== 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 onoe it has
it has been oonstructed will be required before proceeding with the framing.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On March 1, 1996
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES To BE INS TALLED ON EACH FLOOR
ath
!Vfate, T67as Misc. Water Heater
Cntch 'Auto. Gas
fit; p 'Range I Fixt ,as Elec:
Rf,p) A c-%,
a
TOTAL FEE
rk her em
cczjes
?//a -- 199F
P. 4 a-
a LC Fina! Date
MINIMUM -FEE F R ANY PLUMBING/GAS _PERMIT 15 $20.00
$-.24 Xa PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
SUBJECT
NO•
City of Fridley
2 6 4 3 6
AT THE TOP OF THE TWINS
BUILDING
PERM
RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
______
L PROTECTIVE INSPECTION SEC.
r
I ,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L CITY HALL FRIDLEY 55432
--•- �/"'1�•�
L J` 612-571-3450
910415
/2/98
JOB ADDRESS 6370 Van Buren Street NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1 & Pt2
5
I Florence Park Addn
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Phillips 6370 Van Buren St
571-3820
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
PhAlen Siding & Trim 1528 Lincoln St Paul MN
731-2092 6216
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
e
If
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK v
❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ ff MOVE ❑ REMOVE
8 DESCRIBE WORK
Repair vinyl siding
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and call for inspection b efore
covering
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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
DOES NOT PRESUME TO GIVE AUTHO TO VIOLATE OR CANCEL THE
PERM) FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STA OR LOCAL LAW REGULATING CON-
STRUCTIO ERFORM E OF CONSTRUCTION.
$162.25
Fire SIC 9.50
PLAN CHECK FEE
TOTAL F E
License.8f
$5.0
$18 .50
SIGNATUREOF BRACT ROR AUTHORIZED ENT (DATEI
P PER
IOATED T IS YOUR P RMI
120
DATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: .S
Legal Description:
Owner Name & Address: /
Contractor•
Address:.
Effective 1/1/98
Tel. #
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: w
Length
Width
Height Sq. Ft.
DECK AREA:
OTHER:
Length
Wid
Hz/Ground Sq. Ft.
Construction Type:
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft =
Ft $ _ $
DATE:
APPLICANT:
—:
Tel. #
CITY USE ONLY
Permit Fee $ �' /� ' 4Fee Schedule on Reverse Side
Fire Surcharge $ • 5'0 .001 of Permit Valuation (1/10th%)
State Surcharge $ L j .77 5� $.501$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ Ste• 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 $ 9 ' S
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
$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 -
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for "first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$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.
Building
/
BUILDING
Permit NO.• � b
Inspections
See Back Page for Fee Schedule
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Fire Surcharge
CITY OF FRIDLEY
'Ml
DaIMAgY ZQQ�
763-502-4977 FAX
EFFECTIVE 1-1-08
.0005 x Permit Valuation Minimum $.50
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
THIS APPLICANT IS: ❑ OWNER ❑CONTR`ACTOR
PROPERTY OWNER/
NAME: \
TENANT
2 y
ADDRESS: li7'3 (� rA t td'�tf� CITY t� %� I hey STATE/"/') ZIP
$450 Conservation Plan Review
PHONE:
CONTRACTOR
NAME:
ADDRESS:13' 1 1 Jar, sTATi c�'I zrn
SUBMIT A COPY OF
PHONE aPP "7 A� �`F� F
YOUR STATE LICENSE
# "'T $?5 EXP DATE
Make checks payable to: Ciq of Fridley Attach Stipulations
STATE LICENSE 49b
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
• TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
ation above is complete and accurate; that the work will be in conformance with the ordinances and codes
❑ BASEMENT FINISH ❑ j2OOF ❑ DRAIN TILE
at I understand this is not a permit but only an application for a permit and work is not to start without a
❑ DECK SIDING ❑ OTHER
lan in the case of all work which requl review and a oval of plans.
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
SIGNATURE OF APP NT
❑ MAINTENANCE/REPAIR XREMODELING
DESCRIBE WORK BEING DONE: r �� I Lo N 31
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIG SQ FT �0_
a DAA
APPROVED BY
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
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:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
•6Soffit
ADDITIONS & PORCHES SUBMIT:
Vinyl
1. Site Plan/Survey showing the existing structures
❑ Aluminum
'0 Trim
°
and proposed project.
❑ Other
Fascia
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, IINCLUDI NG THE COST OF LAISUM APU1 IYlA 1 ZAIALw:
A (USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $
/
vllq-UrAlla, 1 1 11 L
Permit Fee
$ '16 1�0
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ d
.001 times the total job valuation
Surcharge
$ ,UQ
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ W
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ 1 •
Make checks payable to: Ciq of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I
acknowledge e m
ation 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 ns tion Code
at 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 accord cc w' th�appo d
lan in the case of all work which requl review and a oval of plans.
�`� � DATE:5'
SIGNATURE OF APP NT
PRINT NAME r
a DAA
APPROVED BY
4
a �
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 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 I" $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 1s1$50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for I" $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 V $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