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PRE 2010 DOCSCity Of Fridley, Minn. BUILDING PERMIT Date: June 10, 1969 Owner: Smith & Anderson Builder Address 912 40th Avenue N E. Address Same Same LOCATION OF BUILDING No. 5760 Street Washington St. N. E. part of Lot Lot 7 & 1 Block 2 & 3 Addition or Sub -Division . Adams St. Addn . Corner Lot — Inside Lot —. x Setback 35' Sideyard 26' lot Sewer Elevation ___ 856.79 _ 859.79 ToA of Footing DESCRIPTION OF BUILDING 47sy�( N9 10273 To be Used as: Dwelling Front 44 Depth 26' Height 4 20' Sq. Ft 1144 Cu, Ft 22,880 Garage Front 22Depth 24' Height 10 1 Sq. Ft. Cu. Ft. Type of &o ction Frame Est. Cost r $17, 000.00 _ To be Completed Oct. 1, 1969 WATER LOCATION - WATER MAIN IS IN THE STREET BUT SERVICE IS NOT IN, SEWER LOCATION - 142.3 ' North of Manhole 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 f rth and in compliance with all provisions of ordinaacses of the city of Fridley. e $100.00 Sewer Connection Charge In consideration of the payment of a fee of $ 31.00 , permit is hereby granted to Smith & Anderson 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 dty limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. - s Inspector Knkeih- Muhich NOTICE: Sts permit does not cover the cons. cdon, Whlldioa for wWng, plumbing, gas heating, sewer or ureter. Be aro to we the Building hupector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT r. CITY OF FRIDLEY, MINNESOTA OWNER'S 0 ADDRESS -ADDRESS LOCATION OF BUILDING NO. -STREET Z44 17., LOT _Zk��-BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT Z-- SETBACK s3 SIDEYAIM SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn, on these Certificates. DESCRIPTION OF BUILDING To Be Vaed As.: FrontD epth Height e!) Square feet Cubic Feet �,2- Front Z Depth 02 Height, Square feet Z— Cubic Feet 4--.Z Type of Constructio t n Estimated Cos —74 To Be Completed - 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 SIGNATURE (Schedule of Fee C oste can be found on the Reverse Side.) IZI BUIILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure; or for any addition to any existing structure or building, or.for any alteration 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 -wits Uniform Building Codes Type 1, 2, & 4 - $1.75 for each o4e thousand cubic feet, or fraction thereof, in such cubical contents: Type 3 & 5 - $1.50 for each one thousand cubic feet. For the purpose of computing fees for building.permits, the cubical ` cohtents of uatf.orm he �thrnughput-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 height 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 as set forth in Section 2 be less than $5.00. NSSSD Connection Charges based on location - Area 1 or 2. Original PERMIT for Power lants and Heating, Cool. ing, Ventilation. Refrigeration and lair Conditioning Systems and Devices DESCRIPTION OF WORK No. o. Heating Plants to be installed--altered—repaired Make Oil fired—, Coal fired—,- Gas fired _ ; Gas Authorization No. Remarks Approved Final Inspection 19— Inspector e-1 0`� Permit No 4532 Fee $ ®% 00 Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. , 19L. Owner 'Q �l Location ' i Kind of Building How Occupied L1—""" Work to be Commenced—, 19 To be Completed4,19 ja 9 Estimated Cost, . crib Old- ew,, Building Permit No. Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all pec to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein namgd, and to the specificatao set forth in the approved application for this permit on file in the office of the Inspector of Buildings. ,Inspector of Buildings 42 2M t 1-U V Future Connection Openings I LMnnecYea wun e Mow Fixture, Old Openings PARTIAL RATE SCHEDULE 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that all the face and representations stated in this application are true and correct. Fridley, Minn 19Y Owner Kind of Building Sewer ❑ Used as Cesspool F1 PLUMBING FIBTU RATES: NO. RATE TOTAL Number Fixtures x $2.00 12V ®� Future Fixture Opening .. x $1.50 $ New Fixture Old Opening .... x $1.50 �Tw , Z 0O t i t N WATER HTR. GAS ELEC. Base— $® New Ground Run Old Bldg. x $3,26 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..... .... x $2.00 $ Additional Fixtures ..... .............. x $ .75 Ifft Gas Range to 199,000 BTU .............. % $ 2nd 3rd 4th _ Future Connection Openings I LMnnecYea wun e Mow Fixture, Old Openings PARTIAL RATE SCHEDULE 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that all the face and representations stated in this application are true and correct. Fridley, Minn 19Y Owner Kind of Building Sewer ❑ Used as Cesspool F1 PLUMBING FIBTU 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 $ Water Heater (Up to 99,000 BTU) .... �_ x $8.00 $® New Ground Run Old Bldg. x $3,26 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..... .... x $2.00 $ Additional Fixtures ..... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS 9: ALTERATIONS—Refer to Code Description .................................. ......... TOTAL FLE $ To be completed about Estimated Cost, $ �/- , /�} Old New. uilding Permit No.�� / _Permit No. °7 7 616 Signed. By_. f Busi one No ROUGH FINAL - 0 " /?/ N? � 4986 origin Permit for 71UMBING AND GAS MUM 9V N.B. When work covered by this permit is ready, the Plumbing Ordinance r Permit y g equines that request for �,� inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., DESCE PnON Or WORT; II Number. Find and Location of Fixtures Stories K W 4 t z O Q J a 3 U �,.�,.v z m F Gt Q 7 m r- Z 01 ¢ m G Y Z to = G �, 4 Q K 3 r Y t z z O ❑ 11 W 3 O 2 N G: Z ❑ O ¢ J E 1, f3 i Z U F to Q Q U m 3 z s E Q❑ E J U G X 2 'a J N p, ¢ d n a W U N Z Q Q WATER HTR. GAS ELEC. Basement 1St 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings Permission is hereby granted to do the plumbing and gas fitting in the building described in the statement he o attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. .4Z IM -6-68-V City of Fridley t ,19-14 L 0 Owner - . (,,- 4 .i - Location J I —` Kind of Building�� Used as- To s To be Completed , 19� Estimated Cost Old -New. Building Permit No. Q, � 73 Inspector of Buildings. 69 NO. RATE TOTAL Number Fixtures ...... x $2.00 o va_i� Future Fixture Opening ......... ...... OST. $ i'i0 U f Catch Basin .. ... ........... (�9 �O ® F M WATER HTR. GAS ELEC. $ Electric Water heater a $200 $ GAB PITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures . .................. x $ .75 $ G►as Range to 199,000 BTU .............. —�_ x $5.00 $ 3.00 1� / -- 2nd 3rd -- 4th _ wohna Commoon Openinp Connected with Now Fixturs, Old Cesspool er ❑ I PARTIAL RATE SCHEDULE 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 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. x $3.25 $ Electric Water heater a $200 $ GAB PITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures . .................. x $ .75 $ G►as Range to 199,000 BTU .............. —�_ x $5.00 $ 3.00 ALTERi1TION$—Refer to Code cription...............................................$ TOTAL Fm $ .00 City of Fridley: The undersigned hereby snakes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fac9 and representations stated in this application are true and correct Fridley, Minn-- Dec. 129 1969 19, Owner Jams Hlavinka Kind of Building frame Used as residence To be completed about D®c • 179 1969 Estimated Cost, $ 10.00 O1dX-New. Building Permit No. Permit go.i Signed If Bus Phone No MINNEAPOLIS GAS CO, ROUGH FINAL APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER 'S NAME d A BUILDER4 ADDRESS �� e�'�" �i1 �% S I�%- .S �, �U�'ADDR�S. Q -740— LOCATION OF BUILDING NO. STREET LOT BLOCK :2 ADDITION OR SUBDIVISION S ?'o 4DO, CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. v DESCRIPTION OF BUILDING To Be Used As: /yvC S --c I N C 0 /` .sz Q j &r� FR o hl'-_ Front Depth 2 Height / G Square feet Cubic Feet Front cj Depth (� Height /0 Square feet Cubic Feet Type of Construction Estimated Cost 3 S �� To Be Completed 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 22--11— 7a SIGNATURE .(Schedule of Fee Costs can be found on the Reverse Side.) NOTE: A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing structure or building,.or for any alteration 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 -wits Uniform Building Codes Type 1, 2, & 4 - $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 $1.50 for each one thousand cubic feet. 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 the 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. 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 as set forth in Section 2 be less than $5.00. NSSSD Connection Charges based on location - Area 1 or 2. NMI SUBJECT PER IT N0. City of Fridley 1� �6 AT THE TOP OF THE TWINS BUILDING PERMIT ' RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. ti r 1 PROTECTIVE INSPECTION SEC -336' i NUMBER REV DATE POF AGE APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/31/94 JOB ADDRESS 5760 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 * 1 2 * 3 1 Adams Street Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lester Larson 5760 Washington St NE 571-9344 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Huepenbecker Construction 1008 Barberry Circle Waconia MN 55387 442-4614 2740 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 House (20 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,500 $.75 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- ST UCTION CPPTHE PERFOR . NCE OF CONSTRUCTION $35.00 Fire SC $1.50 PLAN CHECK FEE TOTALFEE License SC 42.25 SIGNAT REOFC(5NTR CT OR AUTHORIZED AGENT (DATE) N P OPE" VALIDATED THIS IS OUR PERMIT BLDG INSP DATE SIGNATURE OF OWNERI)F OWNER BUILDER) .IDATEI NMI NEW { ADDN { ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: _ Contractor: Address: 11 Effective 1/l/94 X36 1 Tel. #7,� MN LICENSE # ®OO �y Tei. # 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: Corner Lot [ ) Inside Lot { l Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Z06V-- A�() Approx. Completion Date: AQ6 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $ = $ DATE: ,3f APPLICANT: _ Tel. # Permit Fee $ 69 C� CIS, USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ -.001 of Permit Valuation (1/10th%) State Surcharge $ S $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ C 61 $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 $� 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 hercin below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $15 (Minimum 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 fust $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 $6.50for 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 $1001000 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 fust $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 fust $1,000,000 plus $2 for each additional $1,000 or fractioa -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. Effective January 1, 2003 CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 JOB ADDRESS CO tl"'G7V > / .�C7- RATE SCHEDULE Residential Furnace Shell and-Duct:Work, Burner - Also Replacement_ Furnace (Side Vent - Fill -Out Back) Gas Piping (Needed .with new furnace, but not replacement) Gas Range Gas Dryer - Rate $ 30.00 $ 10.00 $'10.00 $ 10.00 *Air Conditioning All Sizes $ 25.00 All Others/Repairs &Alterations (LIST ON BACK) . 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of.Appliance or. Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. TOTAL $ .50 .S x,60 OWNER 0 A-) BUILDING USED AS ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER .No. of Heating Units_ Circle One (Steam) (Hot Water(Warm Trade Name C ",Ot c� Size No BTUA,,02DO HP EDR Fuel /JAS G A -S Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 an ._rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 1/- 2-0 HEATING CO Rr--R to CC) oJi—kA e -,M2 s i tic - Signed TEL # 96:5-_53?—Y FAX # Approved By Rough -In Date Final Date /.3 C FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED CnMM012 VFNT. VENT nQNNFnTQR AND r.QMR1ISTION AIR V RIFT .ATIr)N When re In acing an existina furance, the undersigned hereby verities that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes�6 No( ) The E±xistin® comhusfinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new cemhustien airrit will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When jp�lljpg a new venting nys Am, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes M No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes (,VNo ( ) Applianm Topa and Si7P1Common Vent and Vent CnnnP&nr Information Appliance #1 Type"NA-45- BTU Input Assist r Nat Appliance #2 Type ll.¢ BTU Input 3Z ooJ Fan Assisted a Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input I® ob Common Vent Type' Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type __ HEATING CO: �(je Cp�'�k-'O 2S Signed By: Date It Building BUILDING• $ Permit No.: — l��p Inspections $ RESIDE+ NT'IAL APPLICATION .001 times the total job valuation Received By: /)W 763-572-3604CIT'Y .0005 x Permit Valuation Minimum $.50 OF �'RII�I�I+ �r r� , C)o Date Recd: `�'�`�� 763-502-4977 FAX $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ EFFECTIVE 1-1-08 $450 Conservation Plan Review $ �l� Fee Determined by Engineering $ DATE �8 YOUR E-MAIL ADDRESS $ SITE ADDRESS 7100 Q$ / 56»% Make checks payable to: City of Fridley Attach THIS APPLICANT IS: ❑ OWNER WONTOORACTOR PROPERTY OWNER/ NAME: e_ -We ®/f ' G Q ADDRESS: 5_2160 W041 CITY STATE////CUs ZIP 6Ue1A2 TENANT PHONE: 2�� ✓�7� ^ �� NAME: ADDRESS: ® ®0� ®®'- CITY STATEZ CONTRACTOR SUBMIT A COPY OF PHONE FAX _ YOUR STATE LICENSE EXP DATE 1. STATE LICENSE # PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH WOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ,!?,er qP q* Ifeld f SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES 11HOUSE & GARAGE I. 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 ❑ Vinyl ❑mgt ADDITIONS. & PORCHES SUBMIT: -per 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ and proposed project. ❑ Other 11 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, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ � 6,00rI 341q® 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 $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ 3 .t{ .001 times the total job valuation $ f. � .0005 x Permit Valuation Minimum $.50 $ r� , C)o $5.00 (State Licensed Residential Contractors) $ $1825 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 Fridley Attach 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 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 the work will be in accordance th th ved plan in the case of all work which requires review and approval of plans. SIGNATURES PLIC 1` PRINT NAME I -Ale Iliy�GAe DATE 6 APPROVED BY i� DATE_ 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 I' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1- $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 1" $50,000 plus $7 for each additional$ 1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1" $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 1" $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 1' $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: 763-5024977