PRE 2010 DOCSBase
w�rE� City of Fridley:
i f11 D. ffi j p cis nct `lie undersigned hereby makes application for a permit for the work herei.
Specified, agreeing to do all work in strict accordance with the e-; -W f)rdinance
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. Mina Aug � 1 A 7 2 1g._
Owner Dale Schmidt Sr.
PARTIAL RATE SCHEDULE
i Kind of Building f 12aMesower --
❑ Used gm residence
Cesspool
To be completed about A» m 21 1 Q 7 2
Estimated Cost. $—?n nn
®id -%New. Building Permit No. pemni Y
PLUMBING FIXTURZ RATES. NO. RATE TOTAL
Signed
Number Fixtures ...... • • • • • • • ... x $2.00 $
Future Fixture Opening .... ® ...... N$1-50 $ .. By MINNEGASCO
New fixture Old Opening .......... x $1.50 i Business Phune No
Catch Basin x $3.25 :
Water Beater (Up to 99.000 BTU) .... x $3.00 $
New Ground Nun Old Bldg. o ... a ... x $3.25 $ ROUGH
Electric Wetes Heater .............. s $8.00 $
GAS FITTING FEES. NO. IRATE TOTAL
lst 3 Fixtures ..... a ... • • • • _ 2 x $2A0 $ 2-00
Additional Fixtum............... x $ .75 $
Gas Rafte to 199,000 BTU ....... o .... x $5.00 $-- 6-e 98— lite & g r i 11
State Surcharge $ .50
REPAIRS
& ALTERATI® ter Is Cftk_
Dessription • o.o...... e® ao eo.a• •.e . e.•..aoe ..$
TOTAL IEE
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)
1 %-of Value of.Appiiance or Work
Commmrcial/1-ndi-trial
1.25%of Value of Appliance or Work
State Surcharge
TOTAL,FEE
d
MdNI_MUM FEE FOR ANY -HEATING COOLI ISIGNIENTILATION
REFRIGERATION/AIR CONDITIONI14G PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
wAir Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On March 1, 1996
JOB ADDRESS-l(q'to VA1J��a{Z�1•J S, /y
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.
^� 1 ,1997
OWNER SC AY00% ?
BUILDING; USED AS , �S _
ESTIMATED COST . ZZ.� PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heatin Uhits Circle One (Steam) (Hot Wate (Warm AI
Trade Name 1 , UU Size No. UG PILO gyFX�
BTU Lot 1430» HP ,!3 EDR
Fuel N3AT, Total Connected Load 16%i '501)
Burner Trade Name Size No.
BTU HP EDR
HEATING COMP
Signed
Approved By
Tel No. :15q-3351
FILL OUT BACK SIDE fOR STACK VERIFICATION ON
REPLACEMENT FURNACE
I
Remarks:
of
It
List ALTERATIONS Being Done:
2)JI QQ R_MA CA-,
HEATING CO:
Signed By:
Date:
CHMNEY AND STACK VERIFICATION
The
undel igned hereby verifies° that "the existing chimney or stack:
A "
1.
Hai been carefully ex"ed °
Yes (
No
2.
1 0
Is free .from rust or deterioration
Yes (l)
'
No
r P
3.
Has no foreign objects lodged within
Yes
No (�
4.
Is, securely supported Y;
Yes (`z)
No
5.
Meets. 41 current Code requirements for sing
add total BTU's connected
Yes �l
No {
)
.
#J µ
6
Has total heating BTU's of . �- 5Z) 4 '`
All other BTU's ,. 90060
TOTAL BTU's . ' '_:� C) CS 0 0
a
7.
Has a liner been provided for water heater
Yes ( .)
No (
)
8.
Has combustion air been provided for water heater
Yes(
No (
)
Remarks:
of
It
List ALTERATIONS Being Done:
2)JI QQ R_MA CA-,
HEATING CO:
Signed By:
Date:
IN
SUBJECT
INo.
City of Fridley
TRECEIP
AT THE TOP OF THE TWINS
BUIL ING
`458
PERMITi
�T
NO.
16COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r e �
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7 /6/98
JOB ADDRESS 7696 Van Buren Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Shaffer's Subdivision #1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dale Schmidt 7696 Van Buren Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE
LICENSE NO.
Reinke Construction 16405 Co Rd 47, Plymouth MN 55446 551-9244
20096054
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 C.k REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (18 Sq) Tear -off
9 CHANGEOFUSEFROM 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
1 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
$1,501
$.75
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-
$51.25
Fire
SC $1.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEEL
FEE
Licens C $5.
V/$58.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
E P 0
VALI THIS IS YOUR PERMIT
•.
afbG INSP
7 116
I C2 7 12
BATE
SIGNATURE OF OWNER OF OWNER BUILDERI tDATE
IN
NEW [ l
ADDN [ ]
ALTER
ConstructionAddress:
Legal Description: _
Owner Name & Addr
Contractor:
Address:.
LIVING AREA:
GARAGE AREA:
DECK AREA:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
76 79 IJ,, Aal //�e,
Effective 1 / 1 /98
Tel. #
MN LICENSE # ZeO,�'KC'
Tel. # 7/ 7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
OTHER: Y ! _/j �O
Construction Type: T Estimated Cost: $ (nn' 0 C2
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 7 `' APPLICANT: �1' Tel. #
TOTAL $ e
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ 6-0
.001 of Permit Valuation (1/10th%)
State Surcharge
.o
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$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 $ e
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 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.