PRE 2010 DOCSAp-� _ _
BUILDING PERMIT
Village of Fridley, Minn. N° 27.44
Date�I�.-1.a —.C7 .........................
Owner .........
........ ....... Builder `......................
Address ... .. Address .........................................
LOCATION OF BUILDING
No. �0�....... Stree ...... ......... Part of Lot .......................
Lot J.4—A7... Block .. ........... Addition or Sub -Division -9 ...........
a
Corner Lot ............ Inside Lot ............ Setback ?W-1 ... Sideyard �.` . ..........
DESCRIPTION OF BUILDING
To be Used as:
a
.... Front .. Depth ..... Height / 4 &.... Sq. Ft. .1/ Mf Cu. Ft. ........
__AV44� .... Front .... Depth , -t... Height Sq. Ft. Cu. Ft.........
aw
Type of Constructio , . Est. Cos 1*.Kt�................ To be Completed 14.-W
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 com P10vtSiulls of
ordinances of the village of Fridley.
co si f the payment of a fee of $..�' ... permit is hereby granted to �J . ..... o.... . .
.. to construct the building or addition as described above. This permit is granted upon
?eexpress 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 with-
in the village limits and this permit may be revoked at any timeu on violatjoZ 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.
Oct. 28, 1957
To Whom It May Concern:
Ree sots 141 and 159 Block 47 Florence Park Addn.
It is agreeable with us if Mr. Folstad wishes to build within
two and one-half (2*) feet of our lot line and at such time
as we wish to build a garage, we will have it constructed
seven and one -hall (7--) feet from the lot line.
G(/• �iZQ
P!_N, CGASC
53-84-5-915.51 .
Citi of Frialloy
Ap
Dopgt. of Bldrs. Phone M-3450
DESCRIPTIO:S laO:' V1011 6}x00 N. E® Vasa Buren'Street
Numb -or, land and LocrIfon of Fixtures Locati�� -
• Futura Coa:oct.:n Oponi:,a
K iev Fi-_turo. Old Op e5.inrs
PARTIAL. RATE SCHEDULE
$3Lr�1!
Cc: spool
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................ ______.
x $2.00
S
2
.
a
',%'ew Fixture Old Opening..........
U X
et I' I
V
$ O
1
U a
N
t�
O V
$
N
wATt4 MTA.
GAS
ELM
Base
$
i10ctric Water Hmatar...... ........
z $2.00
$
ZAB FITTING FEES:
NO. RETE TOTAL
Ist 3 Fixtures ...............
x $2.00
$ .
Additional Fixtures ..........
x $ .75
$
Gas Raaae to 199.000 BTU ...........
x $5.00
$
Ist
In 3tall
GasGr
1
2rd
_
3:d
Oils
• Futura Coa:oct.:n Oponi:,a
K iev Fi-_turo. Old Op e5.inrs
PARTIAL. RATE SCHEDULE
$3Lr�1!
Cc: spool
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................ ______.
x $2.00
S
Future Fixture Opening ..........
x $1.50
$ _.
',%'ew Fixture Old Opening..........
x $1.50
Catch Basin ....................
x $3.25
$
Water lfeater 'Up to 99.000 BTU) • • •
x $3.00
$
New Ground Run Old Bldg....:.... ,---
x $3.2.5
$
i10ctric Water Hmatar...... ........
z $2.00
$
ZAB FITTING FEES:
NO. RETE TOTAL
Ist 3 Fixtures ...............
x $2.00
$ .
Additional Fixtures ..........
x $ .75
$
Gas Raaae to 199.000 BTU ...........
x $5.00
$
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, arreesg to, do all work in strict accordance with the C:ty C`.d1n2nct
and ruling of the Department of Buildings. and hereby declares that all the fact
and representations stated in this apFLcatica are true snd correct
Fridley, YJnn 8-6-75
Owner Richard L. Carlson
Kind of Building Frame
Used as Res.
To be completed about 8-13-75
Estimated Cast, $ 10.00
Old Building Permit No. Pemit N
• Si
By MINNEGASCQ _.
Business Ph.,ne No
ROUGH
FINAL °L`/ 7' _?6
PXPAIRS & ALTERATIONS—Rafer to Cod* .50 State Surcharge
Install Gas Grill 5.00
. Description ........................................$
TMAL F= 3 5050
` c;t r.4'' Ziur.c Bargee: x:500
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
g U I L D I N G P E R M I T
PE R,-
_ 15642.
r
�
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
1.' 612-571-3450
CEIPT �
NUMBER
910-F15
REV.
DATE
4/4/80
PAGE OF
APPROVED BY
JOB ADDRESS 6400 Van Buren Street N.E.
1 LEGAL
DESCR.
LOT NO.
14
BLOCK
4
TRACTOR ADDITION SEE ATTACHED
Florence Park Addition SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Richard Carlson 6400 Van Buren Street N.E. 571-6862
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Professional Roofing Services. 7257 Yucca Lane 425-8233
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof Structure
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be second but not third roof.
SEPERATE PERMITS REQUIRED F
4EATING, PLU'"ING AND SIGNS. ®R WIRING,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE OF CONST.
Asphalt
OCCUPANCY GROUP
OCCUPANCY LOAD
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SQ. 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
1
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
$1,40G
SURTAX
$� ��
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 ERFORMAWfIE OF CONSTRUC ION.
$9.00
PLAN CHECK FEE
TOTAL FEE
a /
�
$ 9.70
SIGN*U EO TRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY V DATED THIS IS YOU/Rj PERMIT
BLDG INSP DATE
SIGNATURE OF OWNERIIF OWNER BUILDERI o-.1 4aTEl
011
CITY OF FRIDLEY
APPLICATION I -OR RESIDhTIAL BUILDING PERMITS
(Neer, Alterations, Additions, or Repairs)
OWNER: i -4 -
ADDRESS :
TEL NO:
Mi I i z' wKWIF MA �'z"
0441'.j nwo
ADDRESS:
TEL NO:
Construction Location
STIMT NO: L STREET:
LOT: %1/ BLOCK: ADDITION: Da
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front:
q Ck Square Feet_
Front:
Depth: Height:
Cubic Feet:
Depth:
Height:
Square - Peet: Cubic Feet:
Type of Construction: Estimated Cost: $1�f��,
To Be Obmpleted-
Alt. A Alt. B
Proposed. Driveway Width if New Opening Is Desired: _ $ $
SEE REVERSE SIDE OF SHEET .
The undersigned hereby makes application for a permit for the vork 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 corrKt.
DATE: G�— SIGNATURE:
Stipulations:
9. y. '�'C)
bUII_UiINU I't:.I{1II I 1'I,IZ .:UHLIJULh
SUC'.CI011 2. `i'lie liu;pector. ofBuil.din,1; shall, befo):c i:, suing perinits for the erection
of any bui.ldi.ng or. ::truc:Lurc, or for any addition to any exi!Aing building or structure,
cir for any alteration or- ).epairs to -any exi.:'t 117) building or structure, upon application
t:hrrefore, regnire Uic payment by the applicant for :,uc:li permit: of fees to the amount
herein below scat forth and in the, mannor herein provided to -wit:
141'31-1 COUSTRLJC'1101'1: Single l'amil.y Homes and Garages: $4.00/1,000 cubic feet. e
Cia'CK: 25 p(.-rcent- of building permit fee.
DJUVEWAY DEPRESS101i: (Concrete. Cur)-) Streets Only)
Alternate A: Removal and replacement- of concrete curb and
gutter only; Driveway width plus 6 feet 5c $15,75
Alteynat-e B: Removal and replacement of concrete curb and
gutter arid install a 3 foot- wide approach with '
6 inch depth; Driveway width plus 6 feet- r $17.85
ADDIDON L INFORM TION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below_ the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars -($500.00) or fraction thereof in the cost
of all proposed work.
in -no case shall_ the fee charged for any permit asset forth in Section 2 be less
than $7.50 plus $.50 state.surcharge.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A 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.
ERT I F I CATF OF OCU IC
Application for a Certificate of occupancy shall be made ten (10) days prior -to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
SUBJECT
PERMIT NO.
City ®f Fridley�§,
AT THE TOP OF THE TWINS
BUILDING
I T
P
RECEI-P-rffu-
1 06______ COMMUNITY DEVELOPMENT DIV.
I v SEC.
r PROTECTIVE INSPECTION
1 . I
J/
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
10/15/97
JOB ADDRESS 6400 Van Buren St NE
1 LEGAL
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.1415
ILOTNO,,
4
Florence Park Addu to Fr dle
SHEET
2 PROPERTY OWNER MAIL ADDRESS IP
PHONE
Carlson 6400 Van Buren Street NE
784-6565
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Phalen Siding & Trim 1528 Lincoln Ave, St Paul, MN 55105 731-2092 6216
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 CA REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage; Trim
9 CHANGE OF USE FROM TO
STIPULATIONS Install building wrap and have inspection of same unless
manufacturer's specifications state it is not required.
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
$6,500
$3.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOC L LAW REGULATING CON-
$124.75
Fir SC $6.50
STRUCTION 0 THE R RFORMA E OF UCTION.
PLAN CHECK FEE
TOT FEE
6 - �~ -
L C $ 0
$139.50
SIG TU OF 0 TRACTOR RIZEO GENT DATE)
EN R P VALID THIS IS YOUR PERMIT
MAG INSP
97 /D _(
MATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
NEW [ j Effective 1 / 1 /97
ADDN [ j CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION fl
ConstructionAddress: Y� ig &, eal 2
Legal Description:
Owner Name & Address:�2�.�e�s) Tel. #�'-
Contractor: tp",, S A t� $ , g;, MN LICENSE#.
Address: C 7 3
�t
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:%'�' S'.�ij
�� G1®
V I , j9,�
Construction Type.: ?a Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: D APPLICANT: 1 'l n�/ Tel. # % 3 t-9,�p
CITY USE ONLY
Permit Fee $ I ' ,
� Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ .3. d�7 $.50/$1,000 Valuation
SAC Charge $ $950 per SAC Unit
License Surcharge $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
—�'rosion Control. $ •$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [) Not Necessary j ]
TOTAL $ /,3n S-
3'ru)(JLATIONS:
BUILDING [PERMIT FEE SCHEll LE,
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 S62.25 for first S2,000 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 $5:0.0. for each additional
$1,000*or fraction thereof,.to .and including $500,000
$500,001 to $1,000,000 $2887.25 for the fust $500,000 plus, $4:25- for each -additional
$1,000 or. -fraction thereof, to and including $1,000,000 '
S 1,000,001 and -up $5012.25 for the fust $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 tinges $15.75.
VERIFICATION, OF FOUNDATION
'omits for construction will be issued a minimum of 24 hours from the time of application to allow for proper.
.vie�ar of the proposed structure and of the construction site.
— utiticate of Survey of the lot, showinn the location of'the foundation once it has it has been construcii:d
'�. reijuircd bet -Ore with the framing-
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i �
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
Lu
f♦ a_____ PROTECTIVE INSPECTION SEC.
/
CITY HALL FRIDLEV 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
17/2/28
JOB ADDRESS
6400 Van Buren St NE
1 LEGAL
LOT NO.
BLOCK TRACTOR ADDITION
SEE ATTACHED
DESCR.
14 15
4 Florence Park Addn
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Carlson 6400 Van Buren
71-6862
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
p 55105
731 -2092 6216
ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and call for inspection kwfiffam before 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
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
0.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TH PER=CONSTRUCTION. OF CONSTRUCTION.
21 . QQ
FirejSC $0.50
PLAN CHECK FEE
TOT FEE
Licens
$
$)7.00
NATURE OF CO RAC R OR AUTHORIZED AGE IDATEIOW
'EN ROP
VALIDA IS ISOF FERMI
SIGNATURE OF OWNER I IF OWNER BUILDER? IDATEI
BL G INSP
MATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: `
Owner Name & Address: '",s ° rTel. #
Contractor: _ 10�51 4--- �- �f%'""' MN LICENSE #
Address:. IF— Z • r,�. c lti �S9~- /'Z .-% Tel. # !? -2, G1
Attach to this application, a Certificate of Survey of the
Plot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E%IPROVEMEN T'
LIVING AREA: Length Width Height
GARAGE AREA: Length
DECK, AREA:
OTHER:
Construction Type:
Width Height
_ Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Fit.
Estimated Cost: $® C-7�0
(Fee Schedule, on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ = $
DATE:
APPLICANT: Tel. # 3 / - C
Permit Fee
$
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ /® OD
STIPULATIONS:
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 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.T_,;4�_CXI�4dIf
See Back Page for Fee Schedule
Plan Review
$
Inspections
P
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Da d „ 4 % 9
DATE (�®1 cl1
Y UR E-MAIL ADDRESS �SC�t�AO�C � eD�D
1'C pC-�--�—
SITE ADDRESS (0L i v� /
VI+ -yl _ulc`e'r 5 .
$
THIS APPLICANT IS:
❑ OWNER A3CONTRACTOR
SAC Charge
PROPERTY OWNER/
NAME: C
$1550 per SAC Unit (Plans to MWCC for determination)
ADDRESS: CITY
STATE ZIP
TENANT
ft + 6 ft = ft x $21 = $
PHONE:
NAME: Renewal By Andersen
$
CONTRACTOR
SUBMIT A COPY OF
#_
STATE LICENSE 1920 County Road "C" est
$
YOUR STATE LICENSE
ADDRESS: Roseville, MN 55113
STATE ZIP
WITH APPLICATION
PHONE License #20130983
❑ SINGLE FAMILY/NEI 651-264-4777
Agreement necessary ( ) Non Necessary ( )
PROPERTY TYPE
$
13 TWO FAMILY/NEW G -
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
Make checks payable to: City of Fridley Attach Stipulations
PERMIT TYPE
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK D SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:13NEW
❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: J C�_ C¢ (A1S�
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT So. Ft.
ROOFING
❑ HOUSE ONLY
REMODELIN SUBMIT'
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
I.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
13
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
❑ Vinyl
❑ Aluminum
❑Soffit
❑ Trim
ADDITION&
I.
& PORCHES SUBMIT-
Site Plan/Survey showing the existing structure
❑ Other
❑ Fascia
2.
and proposed project.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ERIALS•
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MAT
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 10 1 975 OCCUPANCY TYPE
Permit Fee
$
13
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
3.15'
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
5-,C�o
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 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
$
15 3 . (.Cq
Make checks payable to: City 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 that the information above is complete and accurate; that the work will be
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not
permit but only an application fa permit and k is not to start without a permit; that the work will be in accordance with the approve
plan in the case of all work which qu' es revie d approval of plans.
SIGNATURE OFNT TV
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
DaQ0
DATEda3w®9
YOUR E-MAIL ADDRESS���('
C.�C • C,CiYlr1
SITE ADDRESS (0 00 �V� 57-.
THIS APPLICANT IS:
❑ OWNER XCONTRACTOR
PROPERTY OWNER/
NAME: �•C�'VA `(� �y I�OY�
TENANT
ADDRESS: CITY
CITY
STATE_ZIP
PHONE:E1J- - 177U D
NAME:
Renewal By Andersen
CONTRACTOR
SUBMIT A COPY OF
STATE LICENSE # 1920 County Road "C" West
YOUR STATE LICENSE
ADDRESS: Roseville, MN 55113 e
STATE ZIP
WITH APPLICATION
PHONE
❑ SINGLE FAMILY/NEI License #20130983
PROPERTY TYPE
❑ TWO FAMILY/NEW G 651-264-4777
❑ ADDITION ❑ GARAGE/SHED IPWINDOWS
PERMIT TYPE
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENTLENGTH WIDTH
HEIGHT S a.Ft
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
❑SIDIN nyl
❑Soffit
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Aluminum
❑ Trim
ADDITIONS.
1.
& PORCHES SUBMIT:
Site Plan/Survey showing the existing structure
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
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 THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ , ) g c�3 — OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ P" .0
$ .16 0
$ E°% 00
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$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridlev Attac
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 iI
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not,
permit but only an application or a permit and work is not to start without a permit; that the work will be in accordance with the approve(
plan in the case of all work w 'ch requires • ,view and approval of plans. �r
SIGNATURE OF APPLICANT V� -) PRINT NAME/t 1 ( ay�Gt� If�7 DATE_ Ql � CI V 7