PRE 2010 DOCSowner
Architect
Permit is hereby gi anted to
the bundin 0described in the above statement. This permit is granted
upon the express co dition `t the .' son to whom it is granted; .and his agents, employees and workmen, in all
the work done in, i round and n Wd building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, dInn,., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limil and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
LID_inspector of Buildings.
WV
AGREIEMFM AND SWORN STATtVEN'
in considera ion of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above perms , i hereby agree to do the proposed work in accordance with the description
above set forth d according to the provisions of the, ordinances of Fridley, and, being est duly
sworn, I hereby tate and say that the facts stated by me and contained in the above I permit are
true as therein s ated.,
N
Subscribed' and., sworn to before nye at Fridley, Minnesota, th'
dayl o A.D.` 1
NOTIM ,
This permit d es not cover the construction, installation or alteration for:wiring, plumbing, gas heating,
sewer or water. sure to see a Building Inspector for separate permits for hese Items.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate
Furnace Shell and Duct Work, Burner –
Also Replacement Furnace $ 30.00
(Side Vent – Fill Out Back)
Gas Piping (Needed with new furnace) $10.00
Gas Range $10.00
Gas Dryer $10,00
*Air Conditioning – All Sizes $ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
TOTAL
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On March 1, 1996
JOB ADDRESS '-",,4 l I NGna-\bLA_g Q t5i n E
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
OWNER_ _ /71"— 66-1"1
BUILDING USED AS
ESTIMATED COST �c'��I—`� PERMIT N0. �4
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_ I - Circle One (Steam) (Hot Water Air)
Trade Namo &'Z� Size No.
BTU 0, &e f) HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY19r, 6 �7 4 t! C
Signed By-1No. %
Approved ByRough–in Date Final Date
FILL OUT BACK SIDE OR STACK VERIFICATION ON YX
REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
0
CHIIVINEY 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's connected
Yes ()
No
( )
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes ()
No
( )
8.
Has combustion air been provided for water heater
Yes ()
No
( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
0
01
SUBJECT
PEfiROff NO.
City of Fridley
r-1133 13 3
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
�
RECEIPT NO.
� ` COMMUNITY DEVELOPMENT DIV.
v
r PROTECTIVE INSPECTION SEC.
DATE
PAGE OF
APPROVED Br
CITY HALL FRIDLEY 55132
763-571-3450
=UMBERpEv
10/2/02
JOB ADDRESS 7411 Van Buren Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1 24
4
I Shaffer's
Subdivision #1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Wendy Menken 7411 Van Buren Street NE
763-717-1375
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
American Building Contractors Inc 12247 Nicollet Ave S, Burnsville, MN 55337
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
952-707-6959 20169383
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION Ck REPAIR
O MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House (16 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the 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 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
$1,715
$.86
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 LOCAL LAW REGULATING CON-
$63.15
Fire SC $1.72
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
Licen a SC $ .00
$70.73
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT iDATE.
WH N P RLY VA DATED THIS ISYOURPERMIT
B OG -NSP
pAtE
S-GNATURE OF OVVNERoF OWNER BUILDER, iOATE,
01
NEW[ ] Effective 5/10/99
- ADD.N [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: VAN � tel R E N STL ET N �^
Legal Description:
Owner Name & Address: W E N) V M 1= N k E Pq Tel. # %/0 3 - ?J'7 `13 ??-
Contractor: e r,'cAv% Bt,.,Idj MN LICENSE # ;2616 9 3,?3
Address: i Ar 16 o I I e. live Sd . LA f � sy % 11 e- !tel Tel. # 95,1 - 767 -(b9 5' i
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.
Construction Type: �E- a e 1' Estimated Doe
II��
1 �c�
Driveway Curb Cut Width Needed:
DATE: (0`1-6-1,
Ft. + 6 Ft =
APPLICANT: DAhTel. # ( V�-Z'761 "fit 51
TOTAL -73
STIPULATIONS:
V
CITY USE ONLY
Permit Fee
$ 3,
Fee Schedule on Reverse Side
Fire Surcharge
$ I =-
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , �b&
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ Q
$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 [ J
TOTAL -73
STIPULATIONS:
V
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
$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
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof; to: and including $2,000 _. .
$69.25 for first $2,000 plus $14:00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 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 $15.50.
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 $23.25.
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.