PRE 2010 DOCSCity of Fridley, Minn. 0
BUILDING PERMIT N® 4085
Date: ..... /--_. . Q..._/. - 7 ._.............................
Owner:
Address
Builder -----------
Address-.............-..------....._........._.._...............__..._......._......._......_......_..._.._.__.
/ L CA 1 N OF UILDING
No. .... Street ..... -........... - _. .--------... Part of t .....-......._. _..
...................... • .. Addition or Sub -Division ..... ...... ............._....._....._.....
P
•�. r e � v
Corner Lot ......;C.... ................. Inside Lot ....................................... Setback—mi .............. deyard ...� Q ....................... _............. ............
% per/
Sewer Elevation ..... = .. ---......-----...---- ............................ Foundation Elevation ....t ....:1..... �._ _ J4
....................... ........ .... ........
DESCRIPTION OF BUILDING
To be Used as: p�
.................. Front ..:1� �f. Depth .:. Height .I –.110 Sq. Ft. A0..FCu. Ft. 0%7_$1r
..................... ...................................... Front ........................ Depth ...................._.. Height ....................... Sq. Ft......................... Cu. Ft. ......................
� ��}} e�
Type of Construction ....T!2 .� .... Est. Cost..�,J,......�9�.... '... 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 thea ll
p yment of a fee of permit is hereby granted
...... ............................. ..........-----------......_..--.--- 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. / l
Building Inspector
NOTICE:
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 items.
Via,.
City of Fridley, Minn.
BUILDING PERMIT N®
Date: ......__.___....._._.._...�_.� _ ___ _.__._....__—.
Owner: _ Builder_.i�"3`t .'e- 4e�
Address—
___.._..._____ �._.._...r.—__-.._.. ..._......_.. Address
-•: --,r.... s P r� LOCATION OF BUILDING
NO.L� t> a ... „ E .._..-` •�r--.... - ......_._........_ ....... Part of Lot
Lot ....._ ......................_........ Block ............. ............. ........................ . Addition or Sub -Division ... _.....................
Corner Lot ................. .......... ........ Inside Lot ..... _....... _....................... Setback .......................................... Sideyard
Sewer Elevation....._....._..............._.-..__....._.._............._..........._......._...._....._. Foundation Elevation ........ _........
DESCRIPTION OF BUILDING
To be Used as:
,..�s•� _ Front .. _.. Depth .,...e
....... _.. Height ...:........ Sq. Ft.? -w` Cu. Ft"1--�.,�._i
....
......................... _......... --.. Front ....._............... Depth .................... Height ...........P....... ... Sq. Ft. .................... Cu. Ft......_... .......... ...
Type of Construction :-n:"Est. Cosi.:...:.......... ..±-. ....................... .... To be Completed ............ _...___..........................
—AX ` 11®N
THIS PERMIT DOES NOT AUTHORIZE- Vj?Er, T.
)ON OF ANY I'RI«ATE LAND COVENANTS AND
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 $; _..:--- '---- __.y 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, olation of any of the provisions of said
OPdfnaIICe3.
w�4,WBuilding Inspector
NOTICE:
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 items.
I
G
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder<:at
Address �C> �l Address
LOCATION OF BUILDING
No.hO
of Lot
Lot
Block
Addition or
Sub.Div,
Corner Lot
Inside Lot_„^,r.Set
Back
Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as: /V-���
A Front Z Depth Height ��
Sq. Ft. Cu. Ft,
Front Depth Height
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
(A Schedule of Fee costs can be found on the Reverse Side.)
v
SUBJECT
P ��
City of Fridley
)
27091
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
v ______ COMMUNITY DEVELOPMENT DIV.
r I r PROTECTIVE INSPECTION SEC.
� r
1 r r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
8/10/98
JOB ADDRESS 6081 4 St NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
S # 29 � 30
3
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Allen Battle 6081 4 St NE
586-0323
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
❑ NEW ❑ ADDITION ❑ ALTERATION XX REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (26 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with State
Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2168
$1.08
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.
$74.75
Fire SC $2.17
PLAN CHECK FEE
TOTAL E
.00
SIGH E CONTRACTOR THORIZ 4T iDATEi
EN P OP
ALIDATE IS PERMIT
LI -t- /A.,;.
ldo wc 0-!o
If -C
BLD INSP
21SY5UR
V'9-f7_L _//
GATE
SitAATURE OF OWNER OF O N R BOTiOERI IDA'EI
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
Owner Name & A(�__-
Contractor: MN LICENSE #
Effective 1/1/9$
CITY OF FRIDLEY nO
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �'�
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF UAPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Width Hgt/Grou�nd Sq. Ft.
OTHER: % /(O�% .�%Z�� S -P -'UL� rc� �I� / ® X (�qq C;' % a S
L9 6 'Sq-ua,'-e (sacra I i
Construction Type: Estimated Cost: $ 1 ('0 0 . V0
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ -
1a)
b
DATE: /�� (� APPLICANT:Rel. #j
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ y %s�Fee
Schedule on Reverse Side
$ ?
.001 of Permit Valuation (1/10th%)
$ • O'f
$.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 [ ]
00
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE (;AS
Residential Q" Rate TOTAL
OWNER /fie Al 1�4 /c._
Effective On January 1, 2000
A 5 �/Jt�7
Furnace Shell and Duct Work, burner - BUILDING USED AS
Also Replacement Furnace $ 30.00 $
(Side Vent - Fill Out Back) ESTIMATED COST O2 T PERMIT NO.
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement) DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) (Warm#ir)
Gas Dryer $ 10.00 $ Trade Name K&Q_c�' Size No. DQV 33 VZtl�/
BTU HP EDR
*Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
1% of Value of Appliance or Work $ BTU HP EDR
Commercial/Industrial
1.25/0 of Value of Appliance or Work $ 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
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and corr ct.
TOTAL FEE $
DATE l / D o
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING—Co A!,SIAF -
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 /b
PLUS THE $.50 STATE SURCHARGE Signek-- TEL # y -7
REINSPECTION FEE $47.00/Hr
*tp—<
*Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Dawritten permission from adjoining property owner.
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies 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 () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, 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 () 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( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted
or Nat
Appliance #2 Type
BTU Input
Fan Assisted
or Nat
Appliance #3 Type
BTU Input
Fan Assisted
or Nat
Total Appliances
Total Btu Input
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
aim
GiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
February 11, 2002
Mr. Allen Battle
60814 Street NE
Fridley, MN 55432
Re: Final Inspection at 60814 Street NE
Contractor: ARE Plumbing
Dear Mr. Battle:
A mechanical permit was issued on November 20, 2000 to install a gas fireplace at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. On November 22, 2000 we inspected the
work and noted that caulking needed to be completed around the pipe on the outside wall.
We have not been notified that this work has been completed and ready for reinspection.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
SEPARATE PERMITS4REQ61RED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY
OF FRIDLEY PERMTT O=2004-01585.
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 09/13/2004 t
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 60814 ST NE
PIN : 233024210098
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 400.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER
HEATER.
# ELEC WATER HEATERS 0
VALUE OF FIXTURE/APPLIANCE
0
# NEW FIXTURES (EXIST OPENINGS) 0
# GAS WATER HEATERS
1
# GAS DRYERS 0
# GAS RANGES
0
# OF NEW FIXTURES 0
VALUE (FOR MINIMUM CALL)
400
# WATER TRMT APPLIANCES 0
APPLICANT
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
0.00
0.00
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
PLBG FIXTURES (EXIST OPENINGS)
0.00
MINNEAPOLIS, MN 55408-2173
WATER TREATMENT APPLIANCE
0.00
(612) 8274033
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
35.00
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
0.00
0.00
0.00
OWNER
BATTLE ALLEN G & PHYLLIS D
6081 4TH ST NE
STATE SURCHARGE, PLBG FLAT
0.50
FRIDLEY, MN 55432
TOTAL
35.50
PAID WITH CHECK # 29032
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the pe rmanc of construction.
Applicant Date
Bldg Insp D
SEPARATE PERMITS4REQ61RED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
;431 University Ave NE
=ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT �4yq<
763)f 572-3604, FAX (763) 571-1287
MARK NLIMBFR OF FDM JRFS Tn RF INi4TAI I Fn ntj s=er_u FI nnR
IN
(Po31 )/ "�r /U �-
3LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESSa.S OW &Ad -
Jew Fixtures
$10.00
)Id Opening, New Fixture
$10.00
3eer Dispenser
$10.00
Now Off Basin
$10.00
;atch Basin
$10.00
lain Water Leader
$10.00
3ump/Receiving Tank
$10.00
Nater Treating Appliance
$35.00
Nater Heater -Electric
$35.00
Nater Heater - Gas"
_J_ $35.00
Sas Range"
$10.00
Sas Dryer"
$10.00
(Po31 )/ "�r /U �-
3LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESSa.S OW &Ad -
Jew Fixtures
$10.00
)Id Opening, New Fixture
$10.00
3eer Dispenser
$10.00
Now Off Basin
$10.00
;atch Basin
$10.00
lain Water Leader
$10.00
3ump/Receiving Tank
$10.00
Nater Treating Appliance
$35.00
Nater Heater -Electric
$35.00
Nater Heater - Gas"
_J_ $35.00
Sas Range"
$10.00
Sas Dryer"
$10.00
3ack Flow Preventer Required ( )Yes ( ) No
Type $15.00
leinspection Fee $50.00/Hr
4LL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
df 35. o®
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that*all the fads
and representntinnc ct2tM in this tanniin2tinn ern fn um and correct.
IACONO, BRIAN
6081 4TH STREET NORTHEAST
FRIDLEY, MN 55432
(763)571-6646
OWNER _
'6151 .20�
BUILDING USED AS k4_,51 J e nc.C_
ESTIMATED COST q61, 00 PERMIT NO. ooL-o/yc"'l
PLUMBING COMPANY O C \0 ` OVA wvv►. bQ
SIGNED BY //(✓ TEL NO Ag 827-cl033
Approved By
State Surcharge
MINIMUM I
TOTAL FEE OF THE IMI
Rough -In Date
Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies 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 ( ) No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () No ( )
When required to install a new combustionair. it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes () No( )
When Installing a new venting system, the undersigned hereby verges 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 ( ) 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 ( ) No
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
Building
BUILDING
Permit No.:-r�
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
l
THIS APPLICANT IS:
❑ OWNER ,QNTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: l / �� CITY,_��'l�
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # 2M ?--3 EXP DATE i73/ a
/a CITY /9J S STATL IP 5� f�/�
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: -157-.2,5 c- 5e'
WITH APPLICATION
PHONE 6 ,---,? - 7 e/ ` % -5 FAX -2 e
PROPERTY TYPE
-Iff-SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH W -ROOF ❑ DR AIN TILE
❑.DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELING
DESCRIBE WORK BEING DONE:oa� u s
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFINGOUSE ONLY
NUMBER OF SQUARES �� ❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
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:
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 ❑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:
(USING THE 1997 U.B.0 FEE SCHEDULE)
)TAL JOB VALUATIO.
Permit Fee
Plan Review
Surcharge
Fire 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
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary
$ yj; 57 Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
Attach
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; that the work will be in accordance with the approved
plan in the case of all work which requires
revi v and apftroval of plans.
�
SIGNATURE OF APPLICANT �LGr��l9�(� �e�ii PRINT NAME --UD f fj� P f 6e/el6' r-�iTE