PRE 2010 DOCSW_
BUILDING PERMIT
Village of Fridley, Minn. N? 2908
Date. ... ...v / �.......
Owner Builder .. ....................L.... . ......
Address 41.6. ... ...... ....... ... Address ......9A... ...
LOCATION QF BUILDING
No.Y �fe�/` .... Stree ? ..................... Part of Lot.. ... .......
Lot ,�/:: f ? Block ... f ......... lion or Sub -Division
Corner Lot ............ Inside Lot ............ Setback.... Sideyard ..� o.. ........!
DESCRIPTION OF BUILDING
To be Used as:
F .. Front .e7.�... Depth 2 ...... height ......... Sq. Ft. ..../. Cu. Ft. ........
Front ........ Depth ........Height Sq. Ft......... Cu. Ft.
Type of Construction.......... Est. Cost .....%.Ari. ®.5?..... 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 and in 'compliance with all provislons of
ordinances of the village of Fridley.
... . ..... .. ..... .r . .. ..... .........
....................... 4V 1.V11a LL U1:4 u1C UUUU1.119 Ur aU UMUi1 WS aescrlpea apove. tms permn is-gramea 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 with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ---I
- I . if•s..: ; x�uu jnspec
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring., Ing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these tems.
52-84-591 5.51
City of Fridley
Application for Plumbing and Cas Fitting Pennit
Dept. of Bldgs. Phone 560-3430
DESCRIPTION OF WORK 5916 2nd s t
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... ..............
x $2.00
$
Future Fixture Opening ................
x $1.50
N
3 1-
�e
O LL
_Z Z
g 6
u"S IL C U
w
o5
Q 3
Ci %
w
o
Ci
z
z
C� O
•
t
WATER HTR.
x $3.25
$
Base
a $2,00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
I
ns
G s I k-yE
r
$
Gas Range to 199,000 BTU ..............
x $5.00
$
Gas Dryer
1
5,00
1st
Description ................................................$
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings
Connected with
Sewer
Cesspool
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 BTL) ......
x $3.00
$
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water heater
a $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
$
Gas Dryer
1
5,00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ 5000
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 facl
and representations stated in this application are true and correct.
Fridley, Minn 9-20-68 19_
Owner C Garness
Kind of Building frame
Used as res
To be completed about 9-25-68
Estimated Cost, $ -.v®yy
Old—New. Building Permit N Celot No.
o
B WKEWIS GAS GOO
Business Phone No
ROUGH
FINAL 3 r ��
d2
SUBJECT
P MIT NOS%d
City of Fridley
� g
AT THE TOP OF THE TWINS
BUILDING PERMIT
t
RECEI
I?
�
• COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC._[
�� f
"1 CITY HALL FRIDLEY 55432
�►"'"
NUMBER
REY.
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
I®
JOB ADDRESS
5916 2nd Street N.E•, Fridley, MN 55432
1 LEGAL
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
ILOTNO.
11 & 1
9
1 Hyde Park Addition
SHEET
_T PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Robert A. Walrod 5916 2nd Street N.E., Fridley, MN 55432
574-9174
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION IX ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Windows Door Sidin
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
P
1_00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
�.
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
33.50
SIGs TU OF ON R OR AUTHORIZEDAGENT ATEI
LYT THIS IS YOUR PERMIT
WW=Z
4�
/b.�
INS
GATE
SIG ATURE OF OWNER OF OWNER ftILDERi (DATE)
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ) Building Permit Application
c�r
Construction Address: l l.e topp- 1,6 Lr -s4 ^ ltd
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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
Length Width
Length Width
h q�
LI%1JA®�� Ub&P—eSSAi4-•!
Height
Height
Hgt/Ground
Tel. #
el. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot [ ) Ft. Yd. Setback Side Yard Setback
Type of Construction:
Approx. Completion Date: 1jj2 f1f&s
Proposed Driveway Width If New Opening Is Desired:
Estimated Cost: $ oOOO 1 ® a
Alt. A Alt B
See Back Page for Explanation
QDATE: lb 4$ it 55 APPLICANT:Q,�,`� Tel . #63
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
,s
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RAIE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (LIST ON BACK
1% of Value of Appliance or Work
Com mercialli ndustrial
I% of Value of Appliance or Work
Effective On January 1, 1993
JOB ADDRESS 591 (e 2Ai'� , i_C .
State Surcharge .50 Burner Trade Name Size No.
r 6 BTU HP EDR
TOTAL FEE
MINIMUM FEE FOR ANY HEATINGICOOLINGIVENTILATiON
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING COMPANY �@tl14% &4Y,
Signed By Tel No.,�(�
Approved y Rough—in Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
The undersigned hereby makes application for a permit for the work herein
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
A
00
rulings of the Building Division, and hereby declares that all the facts and
$ 20.00
$
&1�10
representations stated in this application are true and correct.
$10.00
$
t�'.G�
OWNER M14 1!4 YL -_ (Ae V 1210
$ 10.00
$
_99
BUILDING USED AS ®lA-iC
$ 10.00
1119. ���
ESTIMATED COST PERMIT NO.
$10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$
No. of Heating Units Circle One (Steam) (Hot Water (Warn Air)
Trade Name Bv�a �20�(�-+� 1 Size No.
BTU R Q, ao ® HP EDR
$
Fuel LI'a`r Total Connected Load
State Surcharge .50 Burner Trade Name Size No.
r 6 BTU HP EDR
TOTAL FEE
MINIMUM FEE FOR ANY HEATINGICOOLINGIVENTILATiON
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING COMPANY �@tl14% &4Y,
Signed By Tel No.,�(�
Approved y Rough—in Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: NF1 through #8 required when using a side vent furnace.
CHIMNEY AND STACK VEIRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
I . Has been carefully examined Yes (#� No { )
2. is free from rust or deterioration Yes(,/) No ( }
3. Has no foreign objects lodged within Yes (-J No { }
4. is securely supported Yes (d ) No { )
5. Meets all current Code requirements for size
and total BTU's connected Yes (j/) No ( }
6 Has total heating BTU's of
All other BTU's
560
TOTAL BTU's 6-0
7. Has a liner been provided for water heater Yes (+tNo (� �trr ►dr �-
60!(V Z� ti be-u,&-.�,6----cS je try
8. Has combustion air been provided for water heater Yes (P) No ( )
Remarks:
� ei'�.,� L �.� .A a ►'�t i r.�.t � �� rr �✓ +�--5 °� � a �4�.�+ car e
ei
Lit ALTERATIONS BeingDoe-
HEATING CO:
Signed By:
Date:
U-& 1,.
V ei. - t--7 ` q y
0610m-
\'
u1.PAtt7�tF.
��i—"` = --- NZ• OF 1NSrEC7'ION
coastructl0n No.
J� ( 7r, } �� �I R1cQcrcnce li tel. \Nall Int. Wall Ceilin
Roo/ Floor Kit
Dorn , Le ll to 7 Z. ' ._._.
1•'i:nciow, .ln �� ZSIViclth t$.✓� Height
- _ f" --Cracks e A.ca •�a..... Fi.� 1 Nicj rioone
9 and
n)�hWindows and D4,614.4
3� .(j "Z8 � k•. •/ oar e% t:�i
r•nc^ ral:on I Coe(. Btu
Ca11
_:,•:. L ^a': 5 I�Z.S �� 1~ap. wall t -z t \ -1S s
Nct ttp. wall o _
Z Int. wall
•. r.l.l _ (_
12.Z°7 K l't;',�a..� Ctllltl
:��,:.�: •, •Z2,4.t,
_- =----- -••-.. Floor
.--- _�±�. ar ,y. ins. 1V.A. Leader'... •=r.Fl. Total Btu.
area 2.6
_ u �, nom -=n�=h \V dlh e' hle;�ht Rrquired sq. !<i. L.D.R. or sq. ins.
't :---�c+4rr-('rntkage and Arta
4-7,71; . ••-,:�.4. �:1
.._+. p _
"_^•�---j�°•_...?..°„•!..,..i
t � -- •_ or tt.�. ., Ji Windom sad Doom-.t'...L--
W1 gra N.lel►/
•f Pear
,
AMNNEajV .S. MINIV.
lasulatioa
How ADnl;..t
t+-enela iz. z� Width
:rackalt sad Alta
IL
P7 -
°v S st ~r
lntltratioa
call
FF.xp. wall X Q.
Net txp, wall 35 .
Ccilinj !; r •�
_Floor S X 7
1-01al Btu.
R,9.4,.d sq. It. E.D
f
Windows and
lao
a. t • /
1 ZZ
-./.....� . 2 • S
lnfilttation
CJall
Exp. wall
Net exp. wall -2-L(53
Int• wall
Ceiling
Floor tz. s k t�,
Totsl Btu..
.ott. Diu
Y0
cv,s<y 7 l { Zt
Ludo area
l 14 6
i"
Hsiallt '
Area
ra tl alr •f st •tY� Af 4
tl. wfN
Y N• 11.
.._ .cl will _ t `�
•"""'.....
1 ..t .'•
7gi.. �. I i
_
�lY
Clot( Btu
` o
ye
orin,
W.A. L,.der arca
dth 1 d. 4 Widti• `�'•> Hc.
= _ _ L—CratVcae� and Arca
L', Iii., Jr.��l�--•���r ,
7-7
IL 25,0
d D
D
c
`
..... r;. f• �J ;t.
A`
/\.
.trn
r
lntltratioa
call
FF.xp. wall X Q.
Net txp, wall 35 .
Ccilinj !; r •�
_Floor S X 7
1-01al Btu.
R,9.4,.d sq. It. E.D
f
Windows and
lao
a. t • /
1 ZZ
-./.....� . 2 • S
lnfilttation
CJall
Exp. wall
Net exp. wall -2-L(53
Int• wall
Ceiling
Floor tz. s k t�,
Totsl Btu..
.ott. Diu
Y0
cv,s<y 7 l { Zt
Ludo area
l 14 6
i"
Hsiallt '
Area
ra tl alr •f st •tY� Af 4
tl. wfN
Y N• 11.
i�1.S 1Y_�
ct 3.5r
_
�lY
� 10 3S0
7 2ys
.R. or i .i r+�•
liq. las. �/.A. Lich,
7
arta
Room I Le h Z_5 'Q/idtb r .. Hs• h1 r'
or—Ctaeka t and Ana
ra tl alr •f st •tY� Af 4
t�
�t4�j ty ZZ1
'�'� `sro.are.1••�'�
i�1.S 1Y_�
01a f �,
Clot( Btu
` o
ye
ltt�ultetl 64. lt. EO.Ix. Oe
0
51•ts o z3 14
Vi 1. Zs 71 i b 1
l3 a
W ,k 1 a••tl.s rite
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
March 31, 1995
Janet Taylor
5916 - 2nd Street N.E.
Fridley, MN 55432
RE: Written Notice of a Hazardous Tree Located at 5916 - 2nd Street N.E.
Dear Ms. Taylor:
A recent inspection by the City Forester has revealed an extremely hazardous tree located at your
address. For your safety and the safety of others, you must make arrangements to remove the
dead elm tree on the north side of your property immediately.
Please be advised that Fridley City Code requires any tree that endangers the safety or health of
the public, to be removed within thirty days of receiving written notice. this letter will serve as
written notice. The City Code also provides three options for private property tree removal.
They are:
1. Property owner can remove the tree within thirty days from the date of notice, and
be entirely responsible for the cost.
2. The property owner can request the City to remove the tree. The property owner
is then billed, and required to pay the full amount within thirty days of receipt of
the billing.
3. The property owner can request the City to remove the tree, and assess the cost
plus interest, and a $25 administrative charge to the property. This special
assessment will be spread over a five year period.
Included with this letter is a copy of the City of Fridley tree ordinance and a reply form. Please
respond as soon as possible using the diseased tree reply form. If you have any questions, or need
further clarification on this issue, please call me at 572-3595.
Sincerely,
Kurt Schneider
Code Enforcement Officer
Enc.
KS:da CE -95-56
1
SUBJECT -
-
City of Fridley
=82�8!
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
~
r PROTECTIVE INSPECTION SEC.
0
u +
NUMBER
REV
DATE
PAGE OF
APPROVED Br
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/16/98
JOB ADDRESS 5916 2nd Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCA.
11, 12
9
1Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Janet Taylor
5 432 572-9366
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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
0 NEW O ADDITION 0 ALTERATION is REPAIR O MOVE 0 REMOVE
B DESCRIBE WORK
Reroof house and garage (15 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Buildng 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 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
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
1285
.64
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
$43.00
Fire SC $1.28
PLAN CHECK FEE
TOTAL FEE
Z
SIGNATURE OFCON'RCTORD AUTHORiIEDAGENT (DATEr
WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
Si N TURF OF OWN R.6 NER BUILDER. IOATEi
BLO IN SP
Oa E
1
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
8�
ConstructionAddress:�-
Legal Description:
Owner Name & Address: " 1,!, SS Tel. # 5.�
J( Contractor: F -� (7 MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
XOTHER:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Estimated Cost: $
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
�DATE:Z-41�Ls
/ 9
APPLICANT: U � / y/', 'r Tel. #
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ � 00
Fee Schedule on Reverse Side
Fire Surcharge
$ /,.28
.001 of Permit Valuation (1/10th%)
State Surcharge
$_
$.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
STIPULATIONS:
Building
BUILDING
Permit No.: Z 6 C0 "7 1
Inspections
RESIDENTIAL APPLICATION
Received By: n
763-572-3604
CITY OF FRIDLEY
Da ' r P 2 0 MG
763-502-4977 FAX
$
156
.001 times the total job valuation
EFFECTIVE 1-1-2010
$
DATE O 100x_0®® YOUR E-MAIL ADDRESS ®°j�C �® "X� ^ �''17
SITE ADDRESS le — 'z --r-:
License Surcharge
$
THIS APPLICANT IS: ,OWNER ❑CONTRACTOR
SAC Charge
PROPERTY OWNER/
NAME: ApAle"_'
$2100 per SAC Unit (Plans to MWCC for determination)
ADDRESS: 5�'A� X"-% '5� �' °�• CITY � 'sT j�
STATfi�9�ZIP �
TENANT
ft + 6 ft = ft x $24 = $
PHONE:
$
CONTRACTOR
NAME:
Park Fee
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
$
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE ?J1__--'°
❑ TWO FAMILY/NEW CONSTRUCTION STORIES I
PERMIT TYPE
❑ ADDITION fil-GARAGIVSHEW ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
$-NEW RIvl£ CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: �u'®� ��"Olf
,r
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT / SQ FT S
ROOFING Q HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES 13 ❑ HOUSE & GARAGE
1. 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,
SWING
[3 Vinyl ❑Soffit
ADDITIONS & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
❑ Aluminum [3 Trim
Other �— d� �����A�` [3 Fascia
and proposed project.
2. Two
sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yesfi[No LOCATION OF WINDOWS
FOR WINDOWS
— PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON"VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ /X OCCUPANCY TYPE if,
Pennit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
156
.001 times the total job valuation
Surcharge
$
-7 G
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
j Ic c
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 with the
approved plan in the case of all work which p6hires review and approval of plans. �.
SIGNATURE OF APPLICANTC!���`s - PRINT NAME /�G �/������ DATE
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