PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: February 16, 1971
Owner. Tom Swanson Builder Y:n, l to teak $u i 1 dQ..rs, Inc
Address _, 5114 Long Lake Road Address 3114 Long Lake Road
o.�_4iF76—
'1®931
LOCATION OF BUILDING
No. - 5550 Street ,_, 6th Street N.E_,.,,_ _ . — ._.._..,., part of Lot
Lot .2s Nz4 __ Block 7 Addition or Sub -Division . Hamilton's Addition to Mech'ville
Corner Lot , Inside Lot _ _ X Setback 35'___ Sideyard — 10'
slow Elevation 851.40 _ 854.40 (Approx..)
Wye Top of Footing
DESCRIPTION OF BUILDING
To be Used as: 10 14.5
Dwelling Front 26 Depth 30 Height 20 Sq. Ft. 920 CtL Ft, 21+200
Garage Front ___4 _ Depth 20 freight 10 Sq. Ft. 280 Cu. Ft. 21,800
Type of Construction _ Frame Est, Cost _ `a.__15, 000 __ To be Completed May 1, 1971,
Provide verification survey before proceeding with framing.
Provide hard surface driveway.
WATER LOCATION: 107' South of Manhole SEWER LOCATION: 94' South of Manhole
Garage w1m floor elevation 864.00 (Spike in tree at top of garage floor, 12 inches
above street.) Determined by Engineering.
In consideration of the issuance to me of a permit to constqct the building—described building—describedabover4vidy
I agree to do
the proposed work in accordance with the description above o and in plian with of
ordinances ofthe ty of Fridley.
In consideration of the payment of a fee of $ 40-00 ., permit is hereby granted to Th nma c Swar a^n
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 regardinglocation, 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 MMCR
NOTICE:
?his psenit does not cover the construction, Installation for wiring, Plumbing, gas heating, sewer or wafer. Bo wrs to iso
the Building Inspector for separate permits for these items.
oj!
ROY J.' 4WANSEN
Spring
13907 Lake Road
���
r.Su^'ey°r
AND
PLAT O F
SURVEY
� Hopkins, Minn. 85343
Civil Engineer * -
Telephone 99&5678
OF PROPERTYXXX_f nr
White Oak Builders
�, Z
LOCATION 5550 6th
St. N.E.' Fridley, Minnesota.
DESCRIBED AS FOLLOWS
Lot 3 and the North 1/2
of Lot 4, Block 7. Hamilton t s Addition
to Mechanicsville, Anoka County,q Minnesota.
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scd/e : / �ifcif 30 Av.,
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CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY
I hereby certify that on—. --19— I hereby certify that on�0-7 19?�—
I made a survey of the location of the building(s) on the above I surveyed the property described above and That the above plat
described property and that the location of said building(s) is is a correct representation of said survey.
correctly shown on the above plat.
ROY J. HANSEN, REGISTERED SURVEYOR NO. 6274 .
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:
ADDRESS :-3"W#� � �, ,,��ce /to� ADDRESS:, -3--//z/
1a�-fail `
NO:.�"L5'0 STREET:_
LOTJWZ BLOCK:_ ADDITION: ic di
CORNER LOT: INSIDE LOT:x X SETBACK: 3.5 SIDEYARD: /D
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: ' '"� Q/6-7,qa
/ `'' x /' ,-,4'
1aFront • �` & Depth: 3 0Height
Square Feet: 0 Cubic Feet:
Front
9
•�_ Depth : `� ,-�� Height: �
Square Feet; �, V 'r a Cubic Feet: -3. a r' 0 a
' Z3Pe of Construction: Estimated Coat: �e vU
To Be Completed:
The unders Zeby k s application or a permit for the work herein
specs ed, agreeito do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
-are true and correct.
DATE : • )—/7- 7/ SIGNATURE:
(See Reverse Side For Additional Information.)
} uP
spy
„ �, �J � d f�},,.., per" � �'"� Y� •� I
Apoicafto dor Power Pkuft ane! Heating, Coding,, VemAladon, R n and
Air C®n0loning S"em and Devic
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ..........................$10.00
$
Replacement of Furnace .............................
6.00 $
Repairs & Alterations—up to $500.00 .............
.. 6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
MECIL WARM AIR 6 C)
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 '
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .$10.00 $
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $
Each add. 200 sq. ft. EDR Steam ...................... 3.00 ' $
Each add. 320 sq. ft. EDR Hot Water ... ........ .. 3.00 $
OIL BURNER—to 3 gal. per hour ..... 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTL) ........................ 8.00 $ !
over 199,000 BW SeeFee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ..... ..... x$ 100 $ �` , ® 0
Additional Fixtures ................ x .78 $
Gas Range to 199,000 .. — ...... it 5.00 $
AIR CONDT1iONING
FAR BEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS do REPAIRS
ROUGH
FINAL 5-13 %
s
See Fee Schedule
TOTAL FEE $
Dept. of Bides. Phone 980 -MM
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 Ordinance;
and ruling of the Department of Buildings, and hereby declares that an the facts
and representations stated in this application are true and correct.
owner sffl�j
Kind of Building
Used as
To be completed
:ed Cost, $-
ew Building Permit No. Permit No. 'Y 7
HEATING or POWER P'LAN7 --Steam, Hot Water, Warm Air—No
Trade Name- Size No- CILl®
Capacity Sq. Ft. E.D.R BTU d H.P.
Total Connected Loa02) — Kind of Fuc
BURNER — Trade Nems Size No
Capacity Sq. FL E.D.R BTU H.P.
(Ru"AKs–OVER)
SL'.'RWlUM MIN WN!M1"' 141 0.
Signed 8419 CHM MhE
By
Business Phone N�
City of Fridley
AppificcNogn fec- pjumping cilld Gas pjj-,
kitsg pc,_
nE3C111PT10jj Or WORIC Dept. of Bldga. JPhor%G 560-3450
Numb--, Kind and Locallon of riturem Locatio 5 c5u r, T?4 4
P A A L RATE S C 'rED U L E
PMJ)
C -M: -� *-!----S:
Fixtur,
1'-1:--1e to lc1.) 11TIJ
RZPAMI '- M. TrnATIC!; �--Tlc for to Codo
T'-*-,
Sewer
ce.-spo'01 rl
RATE TOTAL
14 ou
x T2.00
-
x $I.So
03.25
S ----
v oo
x t-3.25
52.00
<
F�l
RATE TOTAL
R $2.00
•
-T, I- Ti`
X $1.00
P A A L RATE S C 'rED U L E
PMJ)
C -M: -� *-!----S:
Fixtur,
1'-1:--1e to lc1.) 11TIJ
RZPAMI '- M. TrnATIC!; �--Tlc for to Codo
T'-*-,
Sewer
ce.-spo'01 rl
RATE TOTAL
14 ou
x T2.00
X1.50
x $I.So
03.25
S ----
v oo
x t-3.25
52.00
RATE TOTAL
R $2.00
.75
X $1.00
TOTAL nX
ItY of Fridley:
The undt-i-jrr,,t:(j IW -b; rmk("S;jPP11C,'I1jun !(r j,:Tnjt f,,r I;,
to (11? -Il %-.()rk m strict "Ith
aiid rule,,,, ()r jil, 111k.11t ()f iri,, 01c NJ -
'Ind (.11 Irl
-Iry tlul-
Ownvr
K;ncl of 13W1,jirl4
U, -( .(l a--, 0
F:.*;-, zit, --d CL,.t.
ROUGH______
<!tb A a
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERMIT
P
15549
rp
�
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
`.J 612-571-3450
RE
9 7
NUMBERREV.
910-F15
DATE
1/5/79
PAGE OF
APPROVED BY
JOB ADDRESS 5550 - 6th Street N.E.
1 LEGAL
DESCR.
LOT NO.
3, Pt. 4
BLOCK
7
TRACT OR ADDITION SEE ATTACHED
1 Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dennis Sando 5550 - 6th Street N.E. 571-2832
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Hogar Construction 1061 - 109th Avenue N.E. 755-6600
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X X
8 DESCRIBE WORK
Construct a 24' x 24' Detached Garacre and r-onvert Existing Attached Garage to
Living Area.
9 CHANGE OF USE FROM TO
STIPULATIONS Existing attached garage door must be removed before final inspection
on detached garage. Side yards to be maintained at 3 feet with survey to be
submitted. provide hard surface driveway.
WARNING
Before digging call utilitiesSEPERATE PERMITS REQUIRED FOR WIRIN. �TELEPHONE - ELECTRIC -
SAS Etc,
HEATING, PLUMBING AND SIGNS. REQUIRED BY 14
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE OF CONST.
Wood Frame
OCCUPANCY GROUP
OCCUPANCY LOAD
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ZONING
SQ. FT.
576
CU. FT.
5760
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$4,821 + 2,000
SURTAX
$1. 00 + Wl
DOES NOT PRESUM TO GIVE UTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OFOY� OTHER T TE OR LOCAL LAW REGULATING CON-
STRUCTION OR TERFOR A CE F ONSTRUCTION.
$23111104 + 12.00
PLAN CHECK FEE
TOTAL FEE
x
$38.45
SIGNAWJRE OFCONTRACTO -RAJTHO IZEDAGENT (DATE)
IT
WHEN PROPERLY V IDATED THIS IS YOUR ER7EF
ZILJL
BLDG INSP 0
SIGNATURE OF OWNER I IF OWNER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDLNTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: fv" -S S /t/ve 0
ADDRESS: _SSS® tff54
TEL NO: �
BUILDER:
ADDRESS: ZQ61 Axf-el-Ale-11116
TEL NO:
Construction Location
STR12T NO: �(J STREET: 4 t 1 5'�c IV
LOT: /'� �- BLOCK: -7 ADDITION:
Corner Lot: Inside Lot: "✓ Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
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 her decla es that all the facts and
representations stated in this application are ru and oZ�
rr ct
C
DATE: U ✓ SIGNATURE:
Stipulations:Y4, bL Fi � Y4,
lA1J �r W 1 r�zf 'Sc _e_'Lj
2
�a Qa a-�� I x��►,��► 0,CN�6 � _X002 us— �
J7,NAL r,uSP����v►J 6.0 1► Acr1L02A�L
- 38 qs-
Front:-(
Depth:
Height:
`V
Square. Feet:
51-7
Cubic Feet:
0
G�} t d Lm
Front:
Depth:
Height:
Square - Feet:
Cubic Feet:
1
Type of Construction:
Estimated
Cost: $
�GTo
Be Cbmplete6:
'
v
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 her decla es that all the facts and
representations stated in this application are ru and oZ�
rr ct
C
DATE: U ✓ SIGNATURE:
Stipulations:Y4, bL Fi � Y4,
lA1J �r W 1 r�zf 'Sc _e_'Lj
2
�a Qa a-�� I x��►,��► 0,CN�6 � _X002 us— �
J7,NAL r,uSP����v►J 6.0 1► Acr1L02A�L
- 38 qs-
ROY J. I- ANSEN 13907 Spring Lake Road
Lend Surveyor PLAT O F SURVEY Hopkins, Minn. 35343
AND Telephone 938.5678
Civil Engineer
OF PROPERTY= fnr White Oak Builders
LOCATION 5550 6th St. PI.v., Fridley, Minnesota.
DESCRIBED AS FOLLOWS Lot 3 and the North .Z2 of Lot 4, Block 7, Hamilton's.Addition
to Mechanicsville, Anoka County, Mintesota.
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ods
sMeasurF� /30,.2'�P/af iso' - \
6
1,41
o,— ho O �Ci
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WW2 41 cornFit i. M
h
_=4o (�
I V
*'4
30' f
.Se..71e , / A'e-4 e .?0 /rNe,'
0 Vei701"es icon xlfallc a
CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY
�PrgoOsed
1 hereby certify that on—. _1?_ F 19,— I hereby certify that on_�' 191�—
I made a survey of the location of the building(tT on the above I surveyed the property described above and at the above plat
described property and that the location of said building(*) is is a correct representation of said survey.
correctly shown on the above plat.
n
R J. HANSEN, REGISTERED SURVEYOR NO. 62
�i ,.,v n F�--"+cr* T; w!s, vv • := g :r' _ "� "^*n'.' t >r� n +ap,r � � "w ` t, . 7 r.� r.
r
000
OGAR
CONSTRUCTION, INC.
1061 109th Ave., N. E.
CEMENT WORK ORDER MINNEAPOLIS MN 55434 755.6600'
Permit Number
Date Promised
Salesman
61
Cement Man
Cement Supplier
Fill Supplier
Date 1
A
Garage Side /-7 X 2"� Apron,
Detached ❑ Attached
0141remesh ❑ 112" Rods EjyCondult Pipe
Ix 7'5
Overhead Door Si zq Offset 6 � , Lo r"plc
Service Door Location 6A1
Old .Garage Removal By
Old Cement Removal By�
D�Ivevray Size i
Blox Size and Location
Waterproof Backfill
Excavation By - _-
Gradual Steep
Grade Flat Slope Slope__
f
SUBJECT
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
27915
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i = ,
1 1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE O:
APPROVED BY
"'j 612-571-3450
9t0-Ft5
9/22/98
JOB ADDRESS 5550 6th St NE
1 LEGAL
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
ILOTNO.
3, N$4
7
1 Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Elaine Sando
571-2832
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Solomon & Sons 12211 Olive St NW Coon Rapids 55448
754-5875 20055664
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION :0 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house, garage & shed (23S Tear -off
8 CHANGEOFUSEFROM 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 80 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
$1,971.00
$.98
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 -
Fre SC $1.97
ST OR THE PERFORMANCE OF CONSTRUCTION
OR
PLAN CHECK FEE
TOT EE
License $5.00
$70.20
SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IOATEI
EN ROP VALID
THIS I�OUR PERMI
IN P
ryA TE
SIGNATURE OF OWNER,IF OWNER BUILDERI IDA TE -1'
f
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �-iel te
ConstructionAddress: 55-5-0 61" Ste- kL
Legal Description:
Owner Name & Address: �.rr, o� s Tel. #
Contractor: ,91) 0 ✓ ? So y- MN LICENSE #
Address: // O ice If-- e&W Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground
OTHER:
V- �
Wt.
'
Construction Type:
Estimated Cost: $
I97 )
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:–� `'� –"—� Tel. #
CITY USE ONLY
Permit Fee
$ o2S
Fee Schedule on Reverse Side
Fire Surcharge
$ 1, G%
.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:
g D•�?0
Building
$
BUILDING
Permit No.:' [1 — -3;f6
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Surcharge
$ �, 7S
.0005 x Permit Valuation Minimum $.50
License Surcharge
CITY OF FRIDLEY 2)4
Date Rec'd: g mss -
763 -502-4977 FAX
$
EFFECTIVE 1-1-2010 ��
Curb Cut Escrow
DATE �3�/�r%
YOUR E-MAIL ADDRESS PIW,,
SITE ADDRESS _ _
S� �_ -, Arg
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS:_7 CITYSTATE &P
Agreement necessary ( ) Non Necessary ( )
PHONE:
CONTRACTOR
NAME:��
SUBMIT A COPY OF
YOUR STATE LICENSE
_I -D �'] J J %( EXP DATE '3 /
STATE LICENSE #/zO
�%
AND CERTIFICATE OF
ADDRESS&D3CITY 'SP !lam F,V. STA IP
INSURANCE
PHONE B Z 6/ OO FAX i 17--2—Zft OZ/1
PROPERTY TYPE
OLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEJSHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK 9SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
R MAIAITENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:_ IZ 21- J'1 12
SIZE OF IMPROVEMENT Z Z S LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ 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
FOR WINDOWS – PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPINING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING/ 1997 U.B.0 FEE SCHEDULE)
COTAL JOB VALUATION $ 9P ® OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ ,
.001 times the total job valuation
Surcharge
$ �, 7S
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ :;;etPV—
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ftx $24 = $
Erosion Control
$
$450 Conservation Plan Uview
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$— P;so
Make checks payable to: City of Fridley Attach Stipulations
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 c=0f,,ork�yv ' h uires review and approval of plans.
SIGNATURE OF APPLIC�/ PRINT NAME_ �i0264C,' C� ,�tr Z ATE J 2