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PRE 2010 DOCSCity of Fridley, Minn.. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BU"ING PE . T Date October 16, 1972 Owner: Rudy Mortenson Builder Tri -Co. Builders 7541 Van Buren Street N.E. Address __ _ _._ Address 7555. Van Buren Street 4!�3-3 C 1.7:5.1 LOCATION OF BUILDING No. 7541-- Street Van Buren Street NE. Part. of Lot 11 3 Shaffers Subdivision No. 1 Lot_ _: �._..._ dock Addition or Sub -Division Corner Lot Inside Lot X Setb 35' SiC��aTf�� 12 a0ater`looca .Ton 11 . LV . o ee`er�w Service Sewer _ Fb'iitiddfl6ff EldWall61i 43' N. r -Role Location -WN of Manhole Inv .881 Wye Elevation 881.47 Top of Footing 884,75(Rinimum) DESCRIPTION OF BUILDING To be Used as: Dwelling ___,___ Front 26' Depth 43 1 Height Sq. Ft. 1173 Cu. rL Garage Front 299' Depth 22' Height Sq. Ft. 590 Ca lit. Type of Construction `. Wood Frame Est. Cost — 28,431%._ To be Completed Feb. 73 Walkout to be 6' above 7555 Van Buren walk -out Provide a verification survey. Provide a hard surface drive. 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 se forth and in compliance with a'll provisions of ordinances of the city of Fridley. / ' In consideration of the payment of a fee of $ 53.00 permit is hereby granted to Tri -co. Builders to construct the building or addition as described above. Thispermit 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 ordin4um of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings vpithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinancm i dins Inspector CL NCE BELISLE NOTICE: This permit doss not cover the construction, installation for wiring, plumbing, gas heating, Sewer or water, lie sura to the Building inspector for separate permits for these items. F, APPLICATION FOR RESIDENTIAL, ALTERATION# OR ADDITION BUILDINQ PERMIT 2 40MM LOT: -XMIME LOT; ETBACKt SIDEYARD: Affi-j"" attach to tbAg foj=_Uo Certificates of SurvgX of Lot and proposed Wj,djug 1;mation Arwn on thmm Cartif icAtes, VESCRIPTION OF BUILDING 'ft Be us" As -. 4- )��4 6�ntl jV00t; C2 ff-7 Square reetz Cubic F"t-4. Front Depth; Height; square yeet, Cubic Feet: Tyfa of Constructions Cost: s TO 30 "144ted; fte Uad#,rVjSne4 hereby =mkas applicatim for, a pe=it for the, work herein ap"Ifted, agreeing to do all work in attict accordance with the lGity of SVI414W ord*X&nms 4R4 Tutftp pf Oe Departmen; of Bujdjngs., a* hereby &pjax" that all the facts and representations stated ta this app4cation axe true M4 clorrect" .V— DATS;13 SIGNATURE: (oft Ramue Me For AddWonal Info: i V, A- odoo' v 4 It I -BUILDING PERMIT FEE SCHEDULE SECTION 2, The Inspector of Buildings shall, before issuing permits for the ereetion of any building or structure, or for any addition to any existing buildixg or structure, or for any alteration or repairs to any existing bui.ldtug 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 spanner herein provided roowit : UNIFORM BUILDING GODEr Type 1, 2 & 4 - $2,15 for each one thousand cubic feet, pr fraction thereof. in such cubical contents. Type 3 & 5 a $1.85 for eAcb one thousand cubic feet. ADDITIONAL INFORMATION 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 stx (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the averages* heliftt of the roof surface of the main gable of a pitched roof, X= r"airs or alterations to an existing stzwture, the fee shall be at the zatie of $3,40 per each five hpndred dollars ($500,00) 4= f ,ctton, thereof in the drat of all proposed work, In ao came shall the fee charW for any permit as set forth in Section 2 be lose than $5.00, VIRTFICATION OF FOUNDATION W=s parfaits for eonstractlou will be issued a miuimum of 24 hours from the qe of application, to allow for proper review of the proposed stru&tore and of the construction site. A Certified Survey of the lots sbnving the location of the foundation, once it boa US= cppstruCte,41, will be required before R oceedW with the framing. CIMIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) ye prior to the use or occupancy of mW structure for which a building permit has been issued, and said structure shall not be used or occupied until a Certificate of 40cupancy has been issued. 0 "Application for Power Phuft and Heaft. C0011mg. Ventilation. Refthgeration and Air Comiltioning SyNems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ... .... ....... .. $10.00 $ Replacement of Furnace ... ..... 6.00 9 Repairs & Alterations—up to $500.00 6.00 $— __— Repairs & Alterations each add. $500.00 3.00 MECIL WARM AIR VD Furnace Shell & Duct Work to 120,000 BTU ...... . _$10.00 1e each add. 60,000 BTU .................... 3.00 S Replacement of Furnace . .. .... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .... .. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. FZR Steam $10.00 $.---- . —__Furnace FurnaceShe]] & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3,00 $ _ Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6,00 $ over 3 gal, per hour -fie Fee Schedule GAS BURVER (up to M,000 BTU) 5.00 $ over 199,000 B'E'iT See Fera Schedule CCAS FITTING NO RATE TO T AJ. 1st 3 Fixtures x$ Zed $,r Additional Fixtures x .95 $ Gas Range to 199,000 x$ 5.08 $ JIR CONDITIONING ACR 500 3 63 tons A, b 6 FAN DATING SYSTEM Seo F" VENTILATING SYS 6_ ALTERATIONS & REPAIRS TOTAL FEE Dept. of Bldgs. Phon* 9804M Loam 7541 Vanf.Buren St. N.E. City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department of Buildings, and hereby declares that an the facts and representations stated in this application are true and correct. Fridley, Minn Owner Tri -Co. Builders Kind of Building .__ Frame Used as ...___ ._._. _ Dwg. To be completed about Estimated Cost, Old—New.-%uilding Permit No. Permit No. S 1244 DESCRIPTION OF WORK IMA77NG or PO team, Hot Water, wam Air—No Trade Name Singer she N® GB 1105-12B Capacity—_ Sq, Ft. E,D.R 12 5 , 0 0 0 BTUHy Total Connected Load 64,683 of Fuel Nat. Gas BURNER — Trade Name Size Nat Capacity Sal. Ft. ED BTU . Rouen (SURCHARGE $ _.50) FINd61. (REMARKS -OYER) Sial Mill City Heatng Co. Business No 544-1501. Infiltration Glass Esp. wall Net exp. wall Y. a- b4oraLCr—ackage and Area -;[ USALM Infiltration Glass Exp. wall Net exp. waU Int. wall Ceiling Floor , Total BuL Infiltration Glass Exp, wall Ceiling .Floor -- Floor Total Btu. Net exp. wan Total Btu. Infiltration Glass Exp. wall Net exp. waU Int. wall Ceiling Floor , Total BuL Infiltration Glass Exp, wall Ceiling .Floor -- Floor Total Btu. L.I Oonl 1 g.engttl w Butn �;,3 a ®cabs.. Windowsnndoors—Crackage an Area 6Wid Ilei t Pio. of Lineal it. Area of e e sigh a of c ack sq. Infiltration Glass Exp. wall Net exp. wall Required sq. ft. ED R. or sq. ins. W.A. Leader area F1.1 Room Width QVrrldom and labors—Crackage and Area iWl®tb Helgbt loo. of Llnmal Pt. Ares leo. oP pane of pane lights of crack 04. 4t. Infiltration Mass aU Net eap. wall Int. wall Ceiling Floor Total Btu. Rapired sq. ft. E.D.R. or sq. ins. W.A. leader area Idose notes: Windows and Door*--Crackage and Area ---Btu No. Width of Dana rleight Afo. oa Lineal ft. Arora of pane lights of crack aq. tt. Coef. Star Infiltration Glass Exp. wall Net exp. wall Int. wall Glass Ceiling .� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. Wil.A. I.aader area Fl I Room I length Width Height Windows and Doors—Crackage and Area ---Btu No. Width Height No. of Lineal 4t. oP paneo4 Ban® lights of crack Area sq• ft. Infiltration Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Rpnuired so. ft. E.D.R. or sq. itis. W.A. leader area COOLING' LOAD Job Da:� me Room: Width ,n—i n r'nnAitinns: Outside: ®EPARTMEN , , .SPEC . 1 . _. jil ;0 Address h ; Height Time: A. M. P. M. Bulb ; Wet Bulb Inside: Dry Bulb ; Wet Bulb Wall Color: Dark O; Light ❑; edium %-J r-, Roof: Dark 0; N W111UUW0- A. .r•-..... •• .--.. --- ---- AREA SENSIBLE LATI:Id4 — NO. Imm DIMENSIONS So. FT. K ® HEAT HEAT CONDUCTION HEAT GAINS 0 •o as •ea• •aeo 1. Exterior wall, gross 2. Exterior glass r � •saa 3 Exterior wall, net s••a 4. Partitions, net oa0s 5. Floor 6. Ceiling or roof EXCESS SOLAR GAINS WALLS (direction faced)/ � a•s• 7' .S.S"i �C�'o "/fid 'r" 1' CJ✓ l9 S, sees 10. Roof GLASS (direction faced) •ase 11. 1e0 / / 9 ease 12. !�y 0••0 13. •eaa 14. Skylights BODY HEAT GAINS / � Dees 15. Sensible /® No. of people x 225 16 Latent (quiet) 196 No. of people x 175 Dass 17. Latent (active) No. of people x 450 oa•• EQUIPMENT HEAT GAINS 0000 18. Electric lights tts x 3.4 19. Electric motors (total H.P.) o x 2545 x Power Factor a••o 20. Other electrical equipment 21. Gas burning equipment C. F. H x 1000 Miscellaneous heat 22. gains 23. Miscellaneous heat gains a•am 24. TOTAL HEAT GAIN (SENSIBLE) vwT r r a FV-WA4Rat 00.0 _ ,Item 24 x 100 _ -_ x 100 26. Sensible heat ratio=Item 24 + Item 25 27. Temperature of air supply Dry bulb. Wet bulb Item 24 C.F.M. 26. Total air supply= = = 1.1. [room d.b. — Item 27 d.b.] HEAT LOA® OF VENTILATING Alla C.F.M. Outside Air. 29. No. of people x C.F.M. per person= 30. Item 29 x B.T.U. per C.F.M.= B.T.U. per hour 31. Total cooling load = Item 24 + Item 25 + Item 30 = B.T.U. per hour 32. Tonnage equivalent of cooling load= Item 31 = = Tons 12000 12000 ; r r ..��yy�yy�� ya 88 << �$I (9 • ® WATER MTR. GASF—C Base[—/ e e PARTIAL RATE SCHEDULE Sever Csspool n PLUMBING FIXTURE RATES: NO. RATE .,TOTAL ) Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $ New Fixture Old Opening .......... . x $1.50 $ — Catch Basin .................... x $3.25 $ / d' e_j Water Heater (Up to 99,000 BTU) .... / x $3.00 $ New Ground Run Old Bldg...... ......... x $3.25 $ Electric Water Heater . . ............ z $2.00 $ :;AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • • • • x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Flange to 199,000 BTU ...... , . , ..... x $5.00 $ REPAIRS & ALTERATIONS• --Refer to Code Description ........................ , .................. . A TOTAL FEE gF City of Fridley: The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do all work in strict accordance with the Citi Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn - Owner Ai nnG go "400 Kind of Building Used as To be completed about Estimated Cost, $ / Vim' Qk*v New. Building Permit No. Permit No.�/ Signed W COO By s1► Ta/ Business Phone No -0 6 C ROUGH$ F'INAI, ' 53-84—s-915.51 -1 R_,MnMMMMMMMI Base Cit` of Friidler. OR ra cAs «a The undersigned hereby crakes application for a permit for the work hereto specified, agreeing to do 811 work in strict accordance with the City Ordinance and railing of the Department of Buildings, and hereby declares that all the fact' and representations stated in this application are true and correct 1Mdley, t fine JUN 5 1973 18_ Owner Rudolph H. Mortenson Kind of Building Frame PARTIAL RATE SCHEDULE PLUMING nXTUM MUM NO. PATE TOTAL Number Fixtures ................ x WO Future Fixture Opening . ©......... it $1.50 i—.. New Fixture Old GWWng .......... x $1.50 ti Catch Basin .............. ®.. ®.. x $3.25 tf Water Heater Mp to 99,000 EMP. • • • x $3.00 tf New Ground Run Old Bldg......... x $3.25 $ Wetw Hmtw .............. s $2.00 $ GAS FTrT G FEEM NO. BATE TOTAL 1st 3 Fixtures.......... ®®... • • x $100` :2.00 ............... x$.76 i Gas Rama to 1980,000 BTU ..........._ x $5.00 $ Stere Surcharge $_ .50 BEPAMS b AL T1O er to Codo _ Install (1) Gas Lite and Grill �.$$ww Description o .. . . a o G . , t . s .. a ... s A.... ........ .. f ....... • 6.00 TOTAL FM 8 8.50 Used as Res. To be completed about 6/10/71 Estimated Cost., $ 1.0.00 209&New. Building Permit No. Permit No. 498 Sign� BY QIA 6A=0 Business Phone No ROUGH , FMAL Surma.-�, 01 SUBJECT ,� City ®f Fridley 2 3 3 AT THE TOP OF THE TWINS BUILDING PERMIT ' NO. 1 v ------COMMUNITY DEVELOPMENT DIV. SEC %® q r e PROTECTIVE INSPECTION e f ` A '��f;•� CITY HALL FRIDLEY 55432 NUMBER GATE PAGE OF APPROVED BY .--- L J` 612-571-3450 9t0-F1A]REV 10/21/98 JOB ADDRESS 7541 Van Buren Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 3 1 Shaffers Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Liz A erbeck 783-9178 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ea leview Const. Inc. 2753-5469 20076041 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 Qx REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 22,S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1885 $.94 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 $59.50 Fire SC $1.88 PLAN CHECK FEE OTAL FEE `� I � Licens 5.00/$67. GNATU E OF CONTRACTOR OR AUTHORIZED AGENT f IDA EI PRO RLY AT 0 T S YOUR PERM17 _ BLDG I A a MATE SGN4 TURE OF OW NER iIF OWNER BWLDERI IDATEI 01 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION "l ConstructionAddress: 75 �2 IL Legal Description: Owner Name & Address: Z1 --z- Tel. # `7� 3 _ %%P Contractor: P'C/vis MN LICENSE # �;Lab7 6, ©`f� Address: "! 3 % % % - L Tel. # 2 5-3 °- YY6 2 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: g�` Construction Type: EstimatedCost: $ 16& UV � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # L{3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $ 00 $5.00 (State Licensed Residential Contractors) Y $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] S 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 additibnal $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. Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 67- 763-502-4977 FAX $ EFFEcnvE I -I -N Plan Review DATE YOUR E-MAIL ADDRESS 65% of Building Permit Fee SITE ADDRESS '7 �TL46 Ila f) L� iii 4 THIS APPLICANT IS: ❑ OWNER ONTRACTOR Surcharge PROPERTY OWNER! Nom: ® G ADDRESS: TENANT PHONE: 3(e 3 % 0 I Q✓ SAC Charge $ - NAME: I CONTRACTOR ADDRESS: C Crl'Y /l STATE P IP % SUBMIT A COPY OF PHONE - d 123 Ae!!�2 agoo FAX $ YOUR STATE LICENSE 0 EXP —c $ STATE LICENSE #: DATE / PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE Agreement necessary ( ) Non Necessary ( ) ❑ TWO FAMILY/NEW CONSTRUCTION STORIES $ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISHPROOF ❑ DRAIN TILE 13 DECK tSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING �❑ DESCRIBE WORK BEING DONE:C''.,e a i —f -Aoct j t Oki,, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFIl1TG ❑ HOUSE ONLY NUMBER OF SQUARES f �y OUSE & GARAGE BASEMENT REMODELING SUBMIT: -+�-- / 1. Existing Floor Plan GARAGES °�NIAV ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE j 3. List of structural members to be used PROPOSED HEIGHT: —� FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ INmyl Moniit ! ADDITIONS_ & PORCHES SUBMIT: 1. Site Plan/Survey slowing the existing structures uminum ❑ Trim El Other and Propos prof 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 8-1/ NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 3 --, OCCUPANCY TYPE Permit Fee $ ree Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 41_ 1?0 0005 x Permit Valuation Minimum $.50 License Surcharge $ $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 $ /9,3. to b Make checks payable to: City of Fridley Attach W ulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge hurt 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 on site; that�AP co with the appro plan in the of all work which requires review and approval of plans. SIGNATURE ONAME �� ���/� DATE APPROVED BY NOTE: SEPARATE PERMITS ARE REOUIRED FOR DA AND MECHANICAL