PRE 2010 DOCSApplication for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAINY 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 $
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 BTL) ....................... 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 1 $
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH
FINAL
Dept. of Bldgs. PhoneSU4-77�470 �(
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,.
C Fridley, Minn �- / / 1.4/-
Owner
94
Owner v ! /([yit
Kind of Building _
Used as
To be completed about
Estimated Cost, $
Permit No. \5-6 776 Permit No. I
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name C-�i�l 'Size No
Capacity Sq. Ft. E.D.R I BTU H.P.
(REMARKS -OVER)
Signe
By
c4W42 2M Business Phone No
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
--a
Owner's Name, Builder
Address Q`� � Address
No. e �_ 3--�
Lot Block
LOCATION OF BUILDING
tion or
Part of Lot
Subdivision
Corner Lot __-._Inside Lot Setback Side -Yard
SEWER. ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
Type of Cons
To be Completed
DESCRIPTION OF BUILDING
j®'
Sq. Ft. .91
J/ /0,;2- Cu. Ft. l J�J O
Front Depth Height
Sq. Ft. Cu. Ft.
timated Cost Lv� 6 CT a
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 his application are true and correct.
DATE/ SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley, Win.
BUILDING PERMIT
Date:
Owner: s ,�:°S
Address
-I 2e
Builder —_--
Address
OCTI,ON OF BUILDINt�
fit
✓_w__ _
Lot s" _ Block .—.. Addition or Sub-Divisio
Corner Lot ---- Inside Lot _.—_. ` — Setback Sideyard.._,—>-----
Sewer Elevation _ — —. Foundation Elevation
DESCRIPTION OF BUILDING
To Used
_ -
Front,1;2--- ; Depth 4 Pe Height q.,
S Cu. Ft. r
Front Depth Height _ Sq. Ft. _ Cu. Ft.
Type of Construction `� °' ' �' `" 'Est. Coat A �i° --moo 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 sex forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $-I,,_. - 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 violaf any of the provisions of said
ordinances.
Building Inspector
NOTICE.-
this
OTICE:This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these home.
4
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures I'ocahon
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
Is
Ln
Future Fixture Opening ................
S}
ZZ
�a
QZfZ
��-��
$
s=
Q3
t�J°�
wU
�G4aU'
0
Z
O
•
R
6
N
WATER HTR.
GAS
ELEG
Base
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
$
I
1st
4
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer �
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
$ 0
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
$
New Ground Run Old Bldg . ............
x 3.25
$
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
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ o�- • 'S— v
City of Fridley:
�slffa
The undersigned hereby .makes application for a permit for the work here!
specified, agreeing to do al1 work in strict accordance with the City 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
Kind of
Used as
To be completed about Ar-�' -� s
Estimated Cost, $ ` C)
\s— ---
Permit N
Old New. uilding Permit No �G
'n A -L' nofl �
ROUGH Jen `// _ J® /
FINAL
Chu
Business Phone
Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work ............... I ..........
8.00
�+
Replacement of Furnace .............................
5.00
$
Repairs & Alterations—up to $500.00 .................
5.00
$
Repairs & Alterations each add. $500.00 ...............
2.50
$
NECK WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
8.00
d
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
$
SMEAM 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
$
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
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH E�s
Z4^-
FINAL
4^t
FINAL
See Fee Schedule
$
Dept. of Bldgs. Phone SU 4-7470 q
Location ` -1 (Vm vim,
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.
Owner
Kind of Building
Used as
19 L2 -
To be completed about ''V
Estimated Cost, $ A5 6, 0 _
Old Building Permit No. i� Permit No.
New
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No IL/, 67,
Trade Name Ll--ol//�/V -5 y 1v Size No Zoo, o G
Capacity
Total Connected
Sq. Ft. E.D.R BTU H.P.
off;". -7-Kind of Fuel -!
BURNER — Trade Name Size No
Capacity.
TOTAL FEE
m 4Z 2M
(REMARKS -OVER)
Sq. Ft. E.D.R BTU H.P.
Signed
By Y Business Phone No—, -L/
D-36 r.,nz s
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E, Construction No. Insulation
Guide
Windows I ors Reference Out. Wall Int. Wall Ceiling I Roof I Floor Kind How Applied
Y4 ' No es No 1 19—
FV ;its -2.e -Room I Length f' % Width 1 ? Heisrht II / Fl.l /;�-fi Room I Length % Width 37i;�`eighth 7
Windows a
oors—Crackage and Area
'
�1
Width Height of Lineal Area
No. of pane of pane lights of crackk s4. ft.
0 C.s S, 72
o ® . 4i!i
t,
6®
e--79
Coef.
6o
Coef. Btu!
Infiltratlon5
Glass
Exp. wall
7
tf
Glass
a
.0
(j Ci
Net exp. wall
Exp. wall
722
tQjZ20.,
Exp. wall
Int. wall
(5
F 00
10
® C
Int. wall
Ceiling
�/
C(26
Floor1.5i17
It Z
Floor
/1,2-,2
Ceiling
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F1.I ,lR®, a Room l Length /A � n idth �1 Hei
1,
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack 54. ft.
®
Coef.
Btu
Infiltration
,
7
tf
Glass
o
D...q
t 0
Y3.�
Exp. wall
722
tQjZ20.,
Exp. wall
Net exp. wall
(5
F 00
10
® C
Int. wall
Ceiling
Y125
/0
It Z
Floor
/1,2-,2
Ceiling
e 7,'3'
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
R-1 & 4 T c# Room I Length ?— Width
Windows and Doors—Crackage and Area
Wldth Height No. of Lineal ft. Area
No. of pane of pane lights of crack
00,9 '1f'O 3
3. JCoef.
Infiltration
Glass
Exp. wall Jim
/ D
Net exp. wall
Int. wall
Ceiling
Floor Z
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of Dane lights of crack s4. ft.
®
Coef.
to
Infiltration
s
7
Glass
Exp. wall
Net exp. wall
o
D...q
t 0
Y3.�
Int. wall
c
Exp. wall
Ceiling
Floor
(5
F 00
10
® C
Total Btu. ' s
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FV AD - . Room I Length I Width 4- Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack e4• ft.
a. 3
Coef.
Btu
Infiltration
{;
.7 2
,, l
Glass
.>
c
Exp. wall
¢
1 v
G ®®
Net exp. wall
Int. wall
Ceiling
b
Floor
q C>
7
2 9'
Total Btu. I
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
"? Fl.1 M, IV, Room I Leni:th 17 Width Height -7 `
Win ows and Doors-Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack s4. ft.
G. Y
Coef.
-Btu
Infiltration
Glass
Exp. wall
��. C
Net exp. wall
Int. wall
Ceiling
b
Floor
G
7 L
P. �
1 otal Btu.
Required sq. ft. E.D.R. or so. ins. W.A. Leader area
Windows and Doors—Crackage
and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights ofyyc)�rack sq. ft.
;7 yVf
22-
Coef.1 Btu
Infiltration
Coef.
HEAT
LOSS
CALCULATIONS
DEPARTMENT OF BUILDINGS
FRIDLEY, MINN.
Weatherstrips
Glass
A.S.H.V.E,
p
Construction No.
Insulation
�,
V
l B ® f
Guide
Int, wall
Windows
( Doors
Reference
Out. Wall
eiling Roof Floor
Kind How Applied
e No
—No
Floor
19—
0o
m,4.,.U'1-7ii
FI.I
,, �
Room I Length f i Width
FLI 14A I I-
Room I Length I ? Width A4F Height -7
Windows and Doors—Crackage
and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights ofyyc)�rack sq. ft.
;7 yVf
22-
Coef.1 Btu
Infiltration
Coef.
Coef.
Btu
Infiltration
o
Net exp. wall
.
Glass
0
p
C .o
Exp. wall
�,
V
l B ® f
Net exp. wall
Int, wall
Int. wall
Ceiling
Ceiling
U
/6
w�Qo 0
Floor
0o
m Q
Total Btu. 673- (p
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
O,
Coef.1 Btu
Infiltration
Coef.
Glass
Infiltration
Exp. wall
-7
Net exp. wall
Glass
Int. wall
0
Ceiling
Exp. wall
Floor
1 U
Total Btu.
Required sq..ft. E.D.R. or sq. ins. WA. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
O,
Coef.1 Btu
Infiltration
Coef.
Glass
Infiltration
Exp. wall
-7
Net exp. wall
Glass
Int. wall
0
Ceiling
Exp. wall
Floor
1 U
1 btal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
O,
Coef. Btu
Infiltration
Coef.
Btu
Infiltration
t�,
-7
C
Glass
Int. wall
0
7 G T C
Exp. wall
70-1
1 U
% e5 ® ,
Net exp. wall
Int, wall
Ceiling
U
U
b
Floor
U
0o
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Height
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
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
Fl.l Room I Length Width .Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or so. ins. W.A. Leader area
City of Fridley, Minn. N 10702
BUILDING PERMIT -
Date: - June 17,E 1970
owner: _ RQdngy Troki Builder Roger E. Brenny
Address --. b05 -grad Street N E Address 6011-Ird„ Strdat N E -
LOCATION OF BUILDING
No. 6035 Street 2nd Street N.E. — Part of Lot
Lot ?405 -_ Block 7 Addition or Sub -Division .ode Park Addition
Corner Lot Inside Lot ____ X Setback —_ Sideyard 21
Sewer Elevation ^ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 15'10" Depth 25.5' Height 10' Sq. Ft. Cu. Ft. 4080'
Front Depth . _ Height -- Sq. Ft. Cu. Ft.
Type of Construction Frame_ Est. Cost To be Completed August 15, 1970
Provide Hardsurfaced Driveway
Complete garage to be sheetrocked with 5/8 inch sheetrock per the Board of
Appeals.
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 $ 81 D0_ ., permit iAereby 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, Minn ota 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.
Building Inspector
HANK MUHICH
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to as
the Building Inspector for separate permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME; e BUILDER:
ADDRESS: ' ADDRES S :
NO:. 0 3 5' STREET:_
LOT •0
i
BLOCK • 7 ADDITION •
CORNER LOT: INSIDE LOT: SETBACK:Zzzle�SIDEYARD:`_
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To B Used As
Front • Depth • HeightF
Square Feet; Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:_
Type of Construction:. Estimated
To Be Completed: e A "
Cost:_ $ a e -a
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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.
5)
DATE: � -1' 7 SIGNATURE:
(See 4everse Side For Additional I ormation.)
LV-
• LandPlanning.
� 6875 Highway No. 65 N. E.
Land Surveying' • Minneapolis
Sails Testi n Qi!%�/G %�Li•
9 Mi nn. ` 55432 `
Civil Engineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Area Code 612
Certificate of Survey for
c; r i 90 .e
017 lne 30 �
!es
72
�d 152,T
t
C 01
M`�! 2 Sorg
,
t
IN ropcvi
J
ar
i 1
- I
o
/ r
71
I hereby ter,tify that -this is a true' and, correct':representation of a survey of the boundaries of the, above
dek116ed land and of the location of ati�l� buildings, thereon, and all visible encroachments -,if any, from or on
sacci and. Ar, surveyed -by me this �%"day of AAoc A.D. 19 O
SUBURBAN ENGINEERING, INC. .
Engineers ' urveyoIrs
-40
! V
City of Fridley
SUBJECT
E �� O
AT THE TOP OF THE TWINS
PERMIY
BUILDING
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL FRIDLEY 55432
�.--- • •-�
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612 -NO -345o
910-F15
4/27/77
JOB ADDRESS 6035 2nd Street N.E.
1 LEGAL
DESCR.
LOT NO.
24 & S 1/2
BLOCK
of 25 (7)
TRACTOR ADDITION
Hyde Park Addition
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Rodney Trocke 60352nd Street N.E.
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
SAME
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential garage
7 CLASS OF WORK
E� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
15 1/2 feet x 20' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Variance approved by Council 6-15-1970.
1. South wall must be one hour rated (5/8 Type X Sheet Rock -NO OPENINGS
2, Provide a Hard Surface Drive
.4,
SPERM FS9MITS REQUIRED FOR WIRG
HEATING, PLUMBING AND SIGNS,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
frame
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
310
8370
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 SAMETO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED,300
1.15
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
34.63
SIGNATURE OF CONTRACTOR OR AUTHHORIRIZ_EDARGENT ((DATE) ,.
EN PROP RL AIjr1D4TEEfjTHIS IS YO4R PERMIT
SIGNATURE OF OWNEROF OWNER BUILDER) (DATE)
OG INSP
DATE
1
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: BUILDER:
Address: a Address:
Tel. No. 71 L lv 41
No.: 1 Street: 2 seers
LOT: Q44V% r BLOCK: / ADDITION:
CORNER LOT: INSIDE LOT: X0,_ SETBACK: -0 SIDEYARDS: f
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: /l� Depth: Height: 70 lop e'o'
Square Feet: ;51'/ 0 Cubic Feet: g -iu
Front:
Depth:
Square Feet: Cubic Feet:
Height:
Type of Construction: Estimated Cost: $
To Be Completed: �z �! /, /�f7z Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: rim r.� . , �_!
Stipulations:
T
S6jraA wVtL%,- My%r
R o Pry IAd t�
a
WILLIAM D. SCHOELL
REGISTERED CIVIL ENGINEER
MINN. NO. 2288
SO. OAK 798
WIS. NO. E-6176
FLORIDA NO. 6271
NO, DAK. 623
MONT. NO. 1816-E
SCHOELL and MADSON
ENGINEERS AND SURVEYORS
2829 LOUISIANA AVENUE
MINNEAPOLIS 28, MINN.
WEST 9-0444
CERTIFICATE OF SURVEY
FOR: MR. ROGER E. BRENNY
o --Denotes Iron Monument
o: Denotes Stakes Set
41101 27.31
CARLISLE MADSON
REGISTERED LAND SURVEYOR
MINN. NO. 4374
SO. DAK. 791
WIS. NO. S-674
IOWA NO. 3708
NO. DAK. 1108
M ONT. NO. 1742-S
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF:
Lot 24 and S'h lot ZS) Block 71 Hyde Park, Anoka Co,
AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF
�r
ANY, FROM OR ON SAID LAND. /i�0!/�/116�r
AS SURVEYED BY US THIS DAY OF 19
It also Shows the location of stake as set
for a proposed 6uildin . • - '
Z."z
LANG 'RVEYOR, MINN. REG. NO. 4874
HARCO 977 2-80
(130.9 Plan
f--
,--- - - 131.00' Meas...
:. = •.
LAA
.North line of S'lz lot ZS
o----- -- 4�3--------- '
lot ling PS D �,,• ''
_ o m
� r�
HOUSE
'•,. iii
�•'
_ . r1i f
Q f
o R' .I 4
2_v- J Clothes
tine s
:r
1 �
0.111, Vol
1 .
Ho. 60 3 I
'
- --131.00' Meas.••
-
(13o.�i�' Plat)
o --Denotes Iron Monument
o: Denotes Stakes Set
41101 27.31
CARLISLE MADSON
REGISTERED LAND SURVEYOR
MINN. NO. 4374
SO. DAK. 791
WIS. NO. S-674
IOWA NO. 3708
NO. DAK. 1108
M ONT. NO. 1742-S
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF:
Lot 24 and S'h lot ZS) Block 71 Hyde Park, Anoka Co,
AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF
�r
ANY, FROM OR ON SAID LAND. /i�0!/�/116�r
AS SURVEYED BY US THIS DAY OF 19
It also Shows the location of stake as set
for a proposed 6uildin . • - '
Z."z
LANG 'RVEYOR, MINN. REG. NO. 4874
HARCO 977 2-80
01
sueJEcr
PER
City of Fridley
.14926
AT THE TOP OF THE TWINS
BUILDING PERMIT
RtSQELNO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBERREV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
]9/19/781
JOB ADDRESS 6035 - 2nd Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
24, Sl� 25
7
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rod Tracke 6035 - 2nd STreet N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Robert W. Anderson 3219 Lyndale Avenue North., 529-3605
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
p�
❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
I.nstall masonry fixeplace
9 CHANGEOFUSEFROM 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
SQ. 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
ING ITYPE OF
AND ORDINANCES MPLIED
$1,500
$.75
WITH WHETHER SPECIFIED HEREINOR NOTS . THE OF AO PERMIT
DOES NOT PR UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS F ANY OTHER STATE OR OCAL LAW REGULATING CON-
�
$�-2.00
STRUCTIO O THE PE F�R/MANCE NST CTION.
�v
PLAN CHECK FEE
TOTAL FEE
$12.75
SI NATURE OF CONTRACTOR OR UTHORI2ED AGENT (DATE)
WHEN PROPERLY ALIDATED THIS IS YODURRy PERCM%IT/j
BLDG WSP.) DATE
SIGNATURE OF OWN ER (IF OWN ER BUILDER) (DATE)
01
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
BUILDER:
' OWNER-
�j
Andress • D �J.j. � • Address : raj G' L
• Tel. No.:
No.:
LOT: Q/ a
Street:
BLocY.:
l0 G J� •'r/
aL// G� C_ r
ADDITION:
CORNER LOT:
INSIDE LOT:
S13TBACK: SIDEXARDS:
Applicant attach to
this form Two
Certificates
of.Survey of Lot and proposed
building location drawn on these
Certificates.
0
3
DESCRIPTION OF BUILDING ,
To Be sed As:
C
Front: Depth: Height:
Square Feet: Cubic Feet:
'Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:
Estimated Cost:
To Be Completed: Alt. A Alt. B
Proposed Driveway Wide% If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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 -tated in this application
are trIW
. See reverse side for ' tionaal info ion
DATE: SIGNATURE:
Stipulations:
ac"
/Cl , 00
/a<7�
' •;' �'� �1 T•
y i
all
�r
• I Iii' •1 Y' ' M:I• `{�'
M�'� • " • MM �1 til :rti •
• i •' • 'J1 1 ►• 'M •
B. SPECIAL USE PERMIT (S): #
C. IDT SPLIT(S): #
D. VACATIONS) : # ' fy X0 -d j ORDINANCE W: y�
E. VARIANCES
APPEALS COMMISSION: APPROVED DISAPPROVED DATE N0.
CITY COUNCIL: APPROVED DISAPPROVED DATE NO.
F. EASEMENTS: REQI D DEPT REM
Bikeway/walkway
Street right-of-way
Utility
Drainage
Alley
Other (Specify)
G. LICENSE(S) (List): Date of Renewal:
H. STIPULATIONS (List): DATE SIRED DATE COMPLETED
I. MISCELLANEOUS:
c
SUBJECT
City of Fridley
4 5
AT THE TOP OF THE TWINS
BUILDING
PERMIT (L3111
i •
• ____ COMMUNITY DEVELOPMENT DIV.
� LV
PROTECTIVE INSPECTION SEC.
61jq
1 � �
i A ��'���,.; CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
-•__
L �\ 612-571-3450
910-F15
10/16/00
JOB ADDRESS 6035 2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1 24, Pt 25
7
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kevin Ahlers 6035 2 Street NE
571-2729
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Abbacare LLC 7091 Carey Lane, Maple Grove, MN 55369
476-8372 20122698
4 ARCHITECT OR DESIGN�R 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
8 DESCRIBE WORK House
Reroof XXXX & Garage (26 Sq) Tear -off
9 CHANGE OF USE FROM 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 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. DVVLG. UNITS
OFFSTREET PARKING
I 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,659
$1.33
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
STRUCTION OR THE PERFORMANCE
$83.25
Fire SC $2.66
OF CONSTRUCTION
6 s.I L
PLAN CHECK FEE
TOTA FEE
1L
Lice e SC
$5.
$92.24
51GNar CON'RAC ORQRAUTHORIZED AGENT TE,
HE PRO
VALID TE T+IS IS YOUR PERMIT
_
B G !NSP
,% -^A
gArE
S-GNATURE OF OWNER!!F OWNER BUILDER! !DATE!
c
NEW [ l Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Construction Address: (®03r 2-y ! D (V , (-:E� .
Legal Description:
Owner Name & Address: Tel. # 21 — S7 - 2 -7Z -1T
Contractor: _� b' 1.t-�- MN LICENSE # 22) 12-2 b 7,P
Address:_ %i) CX)4�W t r,� PnW w 6- o JL, M J .5-�-31 4 Tel. # ?`ry - 47 4- P3 7.e-
1
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. 7—
GARAGE
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type o � kgo O lr- Estimated Cost: $—O 44
0Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
I L. Tel. #
1
DATE: I'D t ®® APPLICANT:
��N
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ J,--33 $.50/$1,000 Valuation
SAC Charge $ $1100 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 $ -40Y
STIPULATIONS:
.
SUBJEL'T -.
P
City of Fridley
3271 o
AT THE TOP OF THE TWINS
BUILDING
PERMIT
-ft-CV-PT NO.
� • COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
����PROTECTIVE
E ,
NUMBER
REV
DATE
P AGE OF
APPROVED By
l CITY HALL FRIDLEY 55432
; /'��,•�
-_--
l J\ 612-571-3450
9�aF�s
6/19/02
JOB ADDRESS 6035 2 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
24$ S j 25
7
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kevin Ahlers 6035 2 Street NE
763-571-2729
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Renewal By Andersen 1920 Co Rd C W, Roseville, MN 55113 651-264-4777 20130983
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 Cj REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Replace 8 windows within existing openings
9 CHANGE OF USE FROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit inspection Cards
111 B& M8110d '
To Homeowner To Post
SEPARATE PERMITS ARE REOUIRED 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
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
$3.28
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,566
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-
Fire SC $6.57
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$139.25
PLAN CHECK FEE
TOTAL FEE
Licens C $5.0
$154.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDAM
R 'VALIDA D THIS IS OUR PERMIT
'000HE "4;RO
V
S-GNATURE OF OWNERoF OWNER SU4DER1 iOATE
I "--W[4G -NSF' - rrj&TE
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAAMY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: - (9 0 3 c:h a a r1d 15� .
Legal Description:
Owner Name & Address: ,�A v {din � cj . !'T' Tel. # _ Lo B -:S+ I - Pt 3L
Contractor:; Cyt ,w� MN LICENSE # Zib 1309 B 3
Address: 19 al C.oLkn� _?\Oo d C, Wten3r: We the I MA,) SSS l l-_::� Tel. # (x51.2(04.4
Attach. to this application, a'Ceriif eam of Survey. of -the
lot, with the:progosednstructioa drawri on it to scale.
TOTAL $
STIPULATIONS:
4
DESCRII ION' 4F MOR. VEMENT... '
LIVING AREA:
Length
Width Height Sq. Ft.
GARAGE AREA:
Length
Width Height Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground Sq. Ft.
OTHER:
ice, -
Construction Type:
Estimated Cost: $ C' ID LO
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: `L.- ILM,0 •®"a APPLICANT:
n Tel. #_ 9ej a --64,S • Wq 4 -
CITY USE ONLY
Permit Fee
$ 3�
Fee Schedule on Reverse Side
Fire Surcharge
$ �0'6*
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 3
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ .5.0 ®
$5.00 (State Licensed. Residential Contractor, -q)
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:
4
Building
BUILDING
Permit No.010
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
763-502-4977 FAX
CITY OF FRIDLEYDate
Recd:
EFFECTIVE 1-1-2010
DATE 3&fZ1J
YOUR E-MAIL ADDRESS
SrM ADDRESS p 6 ?j Gj
' S
THIS APPLICANT IS:
❑ OWNER P=NTRACTOR
PROPERTY OWNER/
NAME: fm coo 7-A
TENANT
ADDRESS: CITY
c -e l STATE IP6 51132
PHONE:.
CONTRACTOR
NAME: < U'5 ('ayn 2eme) L I e f s
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
STATE LICENSE #
ADDRESS: �Dl CI �-� ;r ¢
EXP DA/TE
CITY//i�STATE /Wip
INSURANCE
PHONE 651- 7V-260 FAX
PROPERTY TYPE
0 SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑`'TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
OWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR 'MEMODELING
DESCRIBE WORK BEING DONE:_ 1 Inhaintt9 L')
SIZE OF IMPROVEMENT
LENGTH 6D WIDTH
0 HEIGHT D SQ FT Z5
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
13 HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
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:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS Wes ❑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 I e,�Vr-'e— NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
n ¢jSING THE 1997 U.B.0 FEE SCHEDULE)
COTAL JOB VALUATION $ _/� V 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
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2100 per SAC Unit (Plans to MWCC for determination)
-ft +6 ft= ftx$24=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridlev 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 re res review and approval of plans.
SIGNATURE OF APPLICANT /Ul PRINT NAME