PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° C5744�
Date:
Owner: Builder-- /
Address _ _ ._ _ Address
LOCAT1 OF BUILDING
No. �' Street L "� _._�.� Part of :t
Lot _ _..__ Block _ Addition or Sub -Division V
Corner Lot __ _w___ Inside Lot _ _ �_ _ Setback _.,5 ,' _ _ S eyard
Sewer Elevation _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To
ut; Front Depth Height AQ -L Sq. `t Cu. Ft.
_ y«w�7 Front _ Depth eight _ Sq. Ft. _ __ Cu. Ft.
____ _.-
Type of Construction Est. Cost f_.._.... To be Completed
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 compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of �"'., permit is hereby granted to..._..
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 city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits- for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY', MINNESOTA
7 /
Owner's Name Builder % y Q `� Aj
Address Address��ri0�'���`"``��
LOCATION OF BUILDING
No. S' I -)o Street Us Part of Lot
Lot J Block Addition or Subdivision s4d-1 ,
Corner Lot Inside Lot !� Setback -S9' Side -Yard � ®�
EWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
DESCRIPTION OF BUILDING
To be used as: &-_J�' #_-
Front Depth Height
Sq. Ft. CU. Ft •
Front Depth = eight
sq. Ft. CU. Ft.
Type of Construction Estimated Cost
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 ruling of the Department of Build-
ings, and hereby declares that all the facts and representations
stated in this application are true and correct.
DATE 2- ` 13 ` G SIGNATURE ✓ ° ��
(Schedule of Fee Costs can be found on the Reverse Side).
BUILDING PERMIT FEE SCHEDULE
Section 2. The inspector of Buildings shall, before issuing any
.permit for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alterations
or repairs to any existing building or structure, upon application
therefor, 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
2.1. For any such permit for the erection of any fire -proof building,
other than a garage, warehouse, factory or grain elevator, or for the
erection of any fire -proof addition, for similar occupancy, to. any
existing building shall be at the rate of $1.40 for each one thousand
cubic feet, or fraction thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof garage,
warehouse, factory or grain elevator, or for the erection of any fire-
proof addition, for similar occupancy, to any existing building shall
be at the rate of $1.25 -for each one thousand cubic feet, classified
as "fireproof" by Section 502 of the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof build-
ing other than a garage, warehouse, factory or grain elevator, or any
non -fireproof -addition, for similar occupancy, to any existing building.
Permit $1.00 for each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non -fireproof
garage, warehouse, factory or grain elevator, or for the erection of
any non -fireproof addition, for similar occupancy, to any existing,
building or for each such building or addition. Ninety Cents for each
one thousand cubic feet or fraction thereof, in the cubical contents
thereof with.a minimum of $4.00.
For the purpose of computing fees for building permits the cubical con-.
tents 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 -cellar to the aveage height of the
upper surface or to the average height of the -roof's . urface of.the main
gable of a pitched roof.
2.5. 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.
22.6. 3n no case shall the fee charged for any permit as set forth in
Section 2 be less t - , $4.00.
Application for Power Plants and Heating, Cooling, Ventilation, .Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL.
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace 5.00 $
Repairs &Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU .... . .................. 2.00 $ _
Replacement of Furnace 5.00 $
Repairs & Alterations -up to $500.00 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam- ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
b
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $_—
Additional Fixtures ................. x .50 $
Gas Range to.200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH
FINAL
Dept. of Bldgs. Phone SU. 4-7470
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 Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
A FridleeA Minn- 19 �-
Owner
Kind of Building
Used as
To be completed about '—�—
Estimated Cost, $
Old—New. Building Permit No.� O Permit No.
DESCRIPTION OF WORK
-`` -BEATING or POWER PLANTS—Steam, Hot W ar:Yl x
Trade Nam Size No 6'#/00
Capacity Sq. Ft. EM.ft AQ 0- Z2 BTU H.P.
Total Connected Load `�'• 7 Kind of Fuel 6
BURNER — Trade Name Size No
-
I Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
ByisT '(=N1-0-1'(=N1-0-1-11L-X-'1(✓f0�
42 2M 7-59 Business `Phone No �"2—/
Ds6 9
HEAT -LOSS CALCULATIONS ,/I DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E, Construction No.
Guide
n ws I �.o Out. Wall Int. Wall Ceiling Roof Floor
s No Yes No 19—
FIJZZA-,�44 Room I Leneth.—P/7 Width Height II ./ F1.1 01
Windows
nd Doors—Crackage and Area
Coef.
Btu
Width Height No. of Lineal ft, Area
No. of of p lights of crack sq. ft.
gpane
,�1a
49 jb :d
e 17',f 9,
Infiltration
Glass
Coef. Btu
+
' � "°
Glass
Int. wall
Glass
Ceiling
Floor
Exp. wall
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
Floor
Ceiling
`
Floor
Total Btu. I/V.,
Require orq. ins. W.A. Leader area
F11"hi#101 Room I Length ' "' Width " Height
Windows and Doors—Crackage and A
Width Height
No. of pa of panp
No. of Lineal ft. Area
lights of crack eq. ft.
ZAP
Coef. Btu
Infiltration
Glass
Coef. Btu
Infiltration
Net exp. wall
Int. wall
Glass
Ceiling
Floor
Exp. wall
Net exp. wall
Int. wall
Ceiling
`
Floor
Total Btu.
Required *Lt. E.D.R. or sq. ins. W.A. Leader area
Fl.VrjO Qoom I Length' Widt HeightX/
Windows hd Doors—Crackage and Area
Width Height No. of L neai ft. Area
No. of Dane of pane 1lghte of crack so. ft.
Coef. I Btu
Infiltration
Glass
Exp. wall
Net exp. walf CZ d, 16P
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
MINNEAPOLIS, MINN.
Insulation
Kind How. Applied
Room I Length Width Height
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
Na. of pane of pane lights of crack eq. ft.
Btu
Infiltration 1
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling 1
Floor
Total Btu.
Required s&. E.D.R. or sq. ins. W.A. Leader area
FIT WITY 1% Room I Length . /" Width Heigh /
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. " Area
No. of pane of pane lights of crack eq. ft.
J
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width -10B
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. Of DBnB Of i)lights of crack eq. ft.
Coefil Btu
Infiltration
Glass F Aa r'
Exp. wall 7,1,
Net exp. wail.
Int. wall `
Ceiling ,
Floor
Total Btu.
Required sq. ft. E.D.R. or so. ins. W.A. Leader area
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470 r
DESCRIPTION OF WORK���1�
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
Q/ x $1.50
$
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
Z x 2.00
$ =2? , 0
New Ground Run Old Bldg . ............
QQ
$
�}'
GAS FITTING FEES:
NO. RATE T�OTAL.S_�
1st 3 Fixtures ........................../—
x $1.50
$�"
� y
pQ
;1S
x .50
6
Q
�U'
w
9U' 4a
z
99 O
s
F
•
N
WAIR HTR.
GAS
ELEG
Ad
�. fj
�
;
O LLG
ii
3
d
Base
1st
2nd
3rd
4th
• Future Connection Openings
Conn®cted with
Sewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
Q/ x $1.50
$
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
Z x 2.00
$ =2? , 0
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE T�OTAL.S_�
1st 3 Fixtures ........................../—
x $1.50
$�"
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $
City of Fridley:
The undersigned hereby makes application for a permit for the work herek
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 facl
and representations stated in this application are true and correct.
Fridley, iVlinn-
Owner��—
Kind of Building
Used as
To be completed about
Estimated Cast, $
o;"�e2e
New
Old uilding Permit No Permit No.
� = G
ROUGH
FINAL
d2 2M
r
Business Phone No
16 00
City ®f Fridley, Minn..
Corner Lot - Inside Lot _ _ Setback Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
In consideration of the issuance to me of a permit to c
the proposed work in accordance with the description above
ordinancxs of the city of Fridley.
In consideration of the payment of a fee of
permit 9, #breby granted to
to
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 anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any �tiolati
ordordinances.f1� oaf any of the provisions of said
.�
Building Inspector
NOTICE:
Ale porn* does not Cover the eonstrucooe, hwtallmon for Wig, phanhtug, on heating, surerr vrater. Be sere to we
the Building hupeetor for aparate permits for these *ens.
Class WAS' Surcharge .50f
eMM
Cd Fh41qS-.
6 fft�.
h � Soo o Q t� Nowt hand
sift ad to do 0 wwt gn Mkt wmdw= wM the Q1W 1.
®
a tMt a% va
In
t
ll
Gas
Glilldatedw%
6-8-73owuw
and
e ; is
®
Eugene Frank m
Kmd of BvMdbg Frame
®amw
®
vw Res.
®
To W evaWkied abMt 6-15-73
PARTIAL RATES E
EgimaWd Cook 10.00
/
Oft MATZ TOTAL.
w................
.
-42
NM Fbame ame e ..... e .
a
GASSr
...®,>...............
-nom
W89M Mwer up to "Am RM
Neu G ......... •
Umbft _^ .e............
a�/�
7�
GAB g
AL
q��
utg q�
3 Mxftm................. O
E, {p® ,------------
....... ► •
�1
Amy p� @�g� ,�.g�®m
e.® W iso ........... ♦
x so
-
State
Stabe
�{�
• $ .50
aSu
f .Y
-
Install Gas Grillvowlydon
5.00
see ►a .. a.. a sa• • . t..w•. ►.
••..e.ea... s•..:
TOTAL YM 6 5.50
Class WAS' Surcharge .50f
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
28716
72-V6®�
RECEi/�T N/O.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
I . ,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I "'1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
12/4/98
JOB ADDRESS
9812 TATa4hinorton gtret-t- NF
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
SHEET
2 PROPERTY OWNER MAIL AODRES$ ZIP
PHONE
3 CONTRACTOR MAIL ADDRESS ZIP
Walker Roofing 2701 lftb Ave 9 NpIs 99406 729-2129
PHONE LICENSE NO
4229
4 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
O NEW ❑ ADDITION ❑ ALTERATION 2�F REPAIR
❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage 23 S) 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
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
S1971
$ •98
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
862.25
Fire SI,.' $1.97
PLAN CHECK FEE
TOTAL FEE
T4--nje SC S5,00
70.20
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HEN PROPERLY LIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNERIIF OWNER&ALDERI IDATE,
BLDG -Ss
DATE
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
2
Effective 1/1/98
�v���
`\ K2-
Owner Name & Address: 1 S Tel. #
Contract
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
ENSE #
Tel. # qA -og 6 0�
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:
1j v C-1)�
Construction Type: re�� Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ = $
4
DATE: 12. - APPLICANT: 0 Tel. # 904
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 99
$ cgoo
$
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 [ ]
��.�► '.' +�
f
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.