PRE 2010 DOCSCity of Fridley, Mim.
Date:BUILDING PERMIT (@6�)
4,,q e,7
:tZ 'Builder
Address Address ....c''/
LOCATION OF BUILDING
No. Street _ .G.._. Part 9 91jet
Lot __ Block _ A tion or Sub --Dr ivisioV . 4''`.. ef-
Corner Lot Inside Lot — " Setback _.l ` 0 - Sideyard 42
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To Ae Used
Front Depth Height Sq. Ft �+� Cu. Ft,
Front Depth eight Sq. F't. Cu. Ft.
Type of retraction Est. Co o be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.,_ permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that theperson 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 tins permit may be revoked at any time upon violgtiea any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does net cover the Construction, installation for wiring, plumbing, gas heating, sower or water. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No. ,r �/ .Street Z o! � Part of Lot
Lot % Block Addition or Subdivisiodxc�
/ r
Corner Lot Inside Lot ✓ Setback .3 Side -Yard 40
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
Depth �Height �9
Sq. Ft. Cu. Ft.
i
Front 'n Depth Z z-/ Height /y
! Sq. Ft. Cu. Ft.
1
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 representations
stated in this application are true and correct.
DATE % / SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
Application for Power Plants and: Heeling. Coding, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR.: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 8.00
each add. 60,000 BTU 2.00
Replacement of 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
5.00
GAS BURNER (up to 400,000 BTU) 5.00 $
GAS FITTING FEES: NO RATE 2131AL
1st 3 Fixtures ...................... x $1.50 $ TUU
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN DATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE s --L4 - 50
ROUGH
•
, FINAL
Dept. of Bldgs. Phone
171 - 6339, Way N. E.
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.
Fridley, Minn 6-29-61 19
• .., = ..M --40n. ..
Kind of Building Fr.
Used as Res.
To be completed about 7-9-9-61
Estimated Cost, $ 450.00
i
Old—New. Building Permit No. Permit No.
DESCRIPTION OF WORN
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Westinghouse Size No GUE-100
Capacity.
Sq. Ft. E.D.R 100M BTU H.P.
Total Connected Load 45:631 Kind of Fuer Gaa
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Plan R-1
(REMARKS -OVER)
Sign
FRED VOGT & CO.
ByNUM 9 IR- CONDITIONING
42 22M 7-39 Business PhOMMOwesf Lake of %'E -- -
St. Louis Park, AAlnnesotd
City of Fridley
Application for Plumbing and Gas Fitting Porn*
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK 171 – 63rd Via
Number, Kind and Location of Fixtures I'SOa
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
7 x $1.50
$ 10.50
Future Fixture Opening ................
y
••
Qy Z
Z�j
$
Catch Basin
w
�U'
?
01
�G
•
F
•
N
WATER HTR.
GAS
C.
$
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
o
v'f
<
t)
<
$_1.50
4n
O
$
Gas Range to 200,000 BTU ..............
x 2.00
$
uZ-i
Base
1st
1
1
1
1
1
Di
po
al
2nd
_
3rd
4th
• Future Connection Openings
I
Connected with
Sewer
New .Fixture, Old Openings
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
7 x $1.50
$ 10.50
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin
x 3.25
$
............................
2.00
Water Heater (Up to 200,000 BTU) ......
x 2.00
$
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures ..........................
x $1.50
$_1.50
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ x-4.00
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.
Fridley, Minn July 10 19 61
Owner Paul Schwartz Const Co
Kind of Building Frame
Used as Dwe l l
To be completed about Oct. 10 r 61
Estimated Cost, $ 800.00
Old—New. Building Permit No ® Permit No.
Signe
STDARD PLURIBING
By
Business Phone No We 3 3589
ROUGH
FINAL
42 2M 7-59
U ,
City of Fridley
Application for Plumbing and Gas Rtting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures Location—
q
G7
K
�u
Sit
v�
y
y�
��F
I{ 4
a
s��"
3F
Y 1-
zZ
cu
un
Z_
Q
ac
Z
�_
U
O J
� 6
<3 c�1
NU'
w Z
(� z
7 Z 7 d
U' 9 (90
• •
F N
WATER HTR.
GAS
ELEC
Base
Electric Water Heater
a $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ....................
x $ .76
$
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
I
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 BTU) ......
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 $ .76
$
Gas Range to 199,000 BTU .............. x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
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 fact
and representations stated in this application are true and correct. /
,–� Fridley, Mm � -2-4!2
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $ 30 `/
Old—New. Building Permit No Permit No. "7 6 -
Signe
By
Business Phone No—
ROUGH
FINAL
Description ................................................$
TOTAL FKE $ a z
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date A 0
763-502-4977 FAX
EFFECTIVE 1-1-08
DATEDI�
YOUR E-MAIL ADDRESSSITEA
THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
ye
ADDRESS: C CITY
STA ZIP
TENANT
PHONE: 3 -- 6
NAME:
ADDRESS: (0-1 � CITY
STATOY) ZI
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPEINGLE
FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: T V
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING 1 ❑ HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER OF SQUARES
❑ 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,
SIDING
ADDITIONS
& PORCHES SUBMIT:
❑ Vinyl
❑Soffit
I. Site Plan/Survey showing the existing structures
❑ Aluminum
❑Trim
and
t.
proposed project
❑ Other
❑ Fascia
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:
LASING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ ,`� 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)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable 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 requires review and approval of plans. $
SIGNATURE OF APPLICANT v PRINT NAME [.. ' 1L DATE 0 Za Ali
APPROVED BY DATE