PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560- 1570 69th Avenue N.E.
City of Fridley, Minn. 11324-
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
-nates February 22, 1972
per: _Rice Creek Development Company Builder ,_ Approved Contractors, Inc._
Address R5 West Rondei( it le Pjnnea, Minn. AddTe3s _ 1052 Osborne Road_ N_E__ Fridley
- 786 - 3680 ...
161921617, LOCATION OF BUILDING
Na 1615, 1611treet 68th -Avenue i1. E _ Part of Lot
Let Block
Addition or Sub -Division
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation _
DESCRIPTION OF BUILDING
To be Used as: Each Unit
4 '.townhouse Units Front 20' Depth 32' Height 211 Sq. Ft. 1213' Cu. pt.
Front Depth Height .— Sq. Ft. _ Cu. Ft.
Type of Construction _ Wood Frame Est, cost -.,See #11.315 To be Completed - I year
In consideration of the issuance to me of a permit to constru the building described above, I agree to do
the proposed work in accordance with the description above set and in compliance wyCh/ all provisions of
Ordinances of the city of Fridley. — o / [ 1/
In consideration of the payment of a fee of - See #11.31,5permit is hereby granted Rice Creek Dev. Co.
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 buildbM
n� city limits and this permit may be revoked at any time upon violation of any of the provisions of add
ordint
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating,• sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
Application for Power Plants and Heating Cooling, Ventilation. Re/Eigeralioa and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .. $10.00 $
Replacement of Furnace ..... ..... .. 6.00 $
Repairs & Alterations—up to $500.00 600 $
Repairs & Alterations each add. $500.00 3.00
MECiL WARM AIR
Furnace Shell & Duct Work to 130,000 BTU .....�. $10.00 �® •
each add. 60,000 BTU .................... .. 3.00 i
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. EDR 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 BTU) Z� _ 8.00 i,
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 200 $�
Additional Fixtures x .75 $
Gas Range to 199,000• x$ 6.00 $
AIR COifDPPIONIIIG � ' C
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM 2 Ll L
ALTERATIONS & REPAIRS TOTAL FEE $ ®
ROUGH (SURCHARGE $_.50)
Dept. of Bldgs. Phone 560.3480 ,r
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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 aXe true�and correct.
Owner, -
Kind of Building
Used as . z _ \�l•�`i.���
To be completed about
Estimated Cost,
Old ew.l'Building Permit No. Permit No. Ie12 9
DESCRIPTION OF WORK
HEATING or PO PLANTS—Steam, Biot Water, arm —No
Trade Nam e`s 7�/^ NL Size
Capacity Sq. Ft. E.D.R BTU Hp
Total Connected Lead Bind of Fuel
BURNER — Trade Na.ne Size No
Capaci Sq. Ft. EDR BTI)
BSP.
(REMARKS—OYERI
l
NEV-17 rMN
City of Fridley
and GasMag '
Dept. of Bldge. Phone 500 -SM
0
DESCRIPTION OF WORESri-
Xumbsr, Iliad and Loca0ou of 71xtus®e
4th
' Fulu m ConnecSm Openings with
8av►as
• Noir F lam. OW Openiaga CMNPDW❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTVRE R&TES: NO. RATE TOTAL
Number Fixtures ............. x $2.00 $
Future Fixture Opening ........... x $1.60
New Fixture Old Opening .......... x $1.50 t
Catch Basin ...... x $3.26 $
er-v
Water Heater 'Up to 99.000 BTU) .... x $3.00 $ QO2
New Ground Run Old Bldg. ........ x $3.25 $
Electric Water Heater .............. a $2.00 $
GAS FITTING FEES-. NO. RATE TOTAL
lot 3 Fixtures x $200 $
Additional Fixtures ............... : $ .76 $
ere
Gas Range to 199.000 BTU ............ x $5.00 $ °
State Surcharge $ .50
REPAIRS ! ALTERATIONS Asfos to Cod® _
Description . . . . . . . . .. .... ... ... ...... . ...... . A. ._.. .... •I
TOTAL iM .
Cita of Fridley:
The undersigned hereby makes application for a permit for the vrork herei,
specified, agreeing to do all work in strict accordance with the City Ordinance
and coling of the Department of Buildings. and hereby declares that all the fact
and representations stated to this application are true and correct
Fridley. Mina , I9_
Find of Building % Ok4 /Yckrtsep 'Y Com( et-, r
Used as �6 9 IL -A+ i- W, t T
To be completed about _ ty+
Estimated Cost. $
Old—New. Building Permit No. Permit No.
Signed v
Business Phone No
ROUGH
SUBJECT
City of Fridley
25562
AT THE TOP OF THE TWINS
?
BUILDING
PERMKII�(
r
:
O.
rr ___ __ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
r
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/2/97
JOB ADDRESS 1613,1615,1617,1619 68 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Parcel 10
& 200
Section 13
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jim Bern. Management
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Horizon Roofing 1333 Larc Ind. Blvd, Burnsville MN
55337 890-3900 2001279
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
WJ�M 4 Unit Townhouse
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Structure (37 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 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
4
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
$310085
$1.50
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-
$87.25
Fire SC. $3.09
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC
$5.00
$96.84
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT MATEI
WHEN PPROPERL ALIDATED THIS IS YOUR PERMIT
&Y� e0
BL INSP
�/J
OA TE
SIGNATURE OF OWNER oF OWNER BUILDERi IDATEI
------------
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 2a,
Building Permit Application r�
h
ConstructionAddress: /�3 / �� `� ����� C�e-�eA
Legal Description:
Owner Name & Address: J/rC l3eer7 Vic, K� Tel. # X7$8
Contractor: /Z%6 Zer7 MN LICENSE # �2;%o/13: W -
Address: 1. 6960 veJ) e,? -->s LLL, P , 337 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlAPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: ee-� C -7e-,,9,c-gn
Estimated Cost: $ 6) 6 Zf�,
Approx. Completion Date:
3i_j7V =
(Cost on Back)
Driveway Curb Cut
Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE:
APPLICANT:
Tel. #
CITY USE ONLY
Permit Fee
$ /
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /. j�
$.50/$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$ 5 -coo
$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 j ] Not Necessary [ ]
TOTAL
$ %
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
57 —3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Alr Conditioning — All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $
$ 10.00 $
$10.00 $
$ 10.00 $ i
2Y
$ 25.00 $
State Surcharge
TOTAL FEE
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On August 1. 1995
JOB ADDRESS
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 facts and
representations stated in this application are true and correct.
1995
BUILDING USED AS
ESTIMATED COST PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU: -HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING CO Y I M FGAM
now
Signed By Tel No. W= vim Sun
'�
Approved By Rough—In Date_ Final Date
FILL OUT BACK SIDE ICOR STACK VERIFICATION ON
REPLACEMENT FURNACE
`i
CHIMNEY AND STACK VERIFICATION
The under^'eby verifies that the existing chimney or stack:
1. Hash } lly examined Yes ( ) No ( )
2. Is free from rust or deterioration Yes () No ( )
3. Has no ign. objects lodged within Yes O No .( )
4. Is secur upported Yes ( ) No ( )
5. Meets A..-, urrent Code requirements for size
and to, B. 's connected Yes O No { )
6 Has t eating BTU's of
All other�'f`U's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ( )
8. Has combustion air been provided for water heater Yes () No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
City of Fridley Building Inspections Dept.
6431 University Ave NE
Fridley MN 55432
Mechanical
Ph: 763-572-3604 FAX: 763-571-1287
Residential Application
City of Fridley
i / See Back Side For Required Information
Permit # d oo s- -01 �L, %
Date Site Address:
The applicant is: (cirl a one)
Owner Contractor
Property Owner:
s
Add ress:AS-7
aro
City:
State: Wk/ Zip: -
Phone:
Cell: Fax:
Contractor Informati n
'
Company Name.
CL�
Contact Person:
-�
Address:
City: k0nt' /
State: d&LV Zip:52Z4C
,Fax:57
Phone: AV x164,-'/� MeT
Cell:609t7 6( 51��
Email: a
Q. MN Bond# & Exp Date S/ O
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work: 6W 09%j 2,9e &r46&=&49 Cek,
Equipment Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
Please check all that apply:
_Fireplace (gas) $15.00 New Gas Grill $10.00
A/C $25.00
_Fireplace (wood) $35.00 _Gas Unit HTR $10.00
to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00
_Air
$35.00
_Gas Dryer $10.00 Ventilator $15.00
_Boiler
_Chimney Liner $10.00
_Gas Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00. `'�' �;%<<• °; �}
Permit Fee $
(Total from above -Minimum fee $35.0
Surcharge
0.50
Total Due $
Make check payable to City of Fridley
This is an application for a permit- not valid until processed if
I hereby apply for a mechanical 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 case of all work which requires review and approval of plans.
le Signature of Applicant, Date:
Approval Inspector Signat Date
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a.. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
RUG -09-2005 13:34 CITY OF FRIDLEY
P. 02Z04
loo,
Permit Number
Received By
Date Received
NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED. A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
DATE e % 2 YOUR AIL ADDRESS_
SITE ADDRESS
THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR
NAME
PROPERTY OWNER/ ADDRESS
TENANT
CITY STATE ZIP
PHONE 0.
NAME ® ' LICENSE # ,�
CONTRACTOR
ADDRESS Ivo
CITY ct.�� S7ATE /Li ZIP
PHONE # FAX#.
PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORK p NEW lie REPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FDCTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINKILAV FLOOR DRAINS
BATHTUB GAS PIPINGS (Need Citi License)
CLOTHES WASHER KITCHEN SINK
DISHWASHER LAUNDRY TRAY
Permit Fee $ 00
Plan Review $
Surcharge $ .50
TOTAL DUE $
SHOWER
WATER PIPING
SWIMMING POOL
WATER SOFTENER ($33)
_,PATER CLOSET
BACKFLOW PREV. ($1s)
WATER HTR ($35)
FOR IRRIGATION
WATER METER
OTHER
MINIMUM: $15.00 or 50/6 -of -cost of the improvement whichever is -
greater on work less than $300
Make checks payable to: City of Fridley
r nrz r, AN AVFLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and 1 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 review and approval
NAME OF APPLICANTDATE �J
Phase type or print
SIGNATURE OF APPLICANT
0431 UNIVESITY AVENUE NE, FRIDLEY. REIN 56432
RUG -09-2005 13:34 CITY OF FRIDLEY P.03iO4
City of Fridley Building Inspections Dept, Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NF
Fridley MN 55432
Mechanical Permit#
Residential Application
City of Fridley
See Rack Sitia Fnr RAmmidrari Infnrn��b:n.,
Date Z1 I Z— Site Address:
The applicant is: (cirice one)
Owner Contractor
Property Owner.
Address:
City:
State: Zip:
Phone:
Cell: Fax:
,
Contractor Informat�r�m���
Company Name:
�
Contact Person:
Address: YAW
City:
State:
Phone:_Ped l S/ ��
Cell: bid ?® Fax:
Email: ArtBh. MN Bond# &Exp pate .T6 6/�eG
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work
dI12& 11r1.
U toeEquipment
ilv t- a,& dm ,�4 � i Zu/z tl2C
Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
MFG:
Model: SizeBTU:
Please check all that apply:
_Fireplace (gas) $15.00 New Gas. Grill $10.00
AIC $25.00
Fireplace (wood) $35.00 _Gas Unit HTR $10.00
Air to Air exchanger $15.00
_Furnace $35.00 _Pool Heater $35.00
_Boiler $35.00
_Gas Dryer $10.00 $15.00
_Chimney Liner $10.00
_Ventilator
_✓Gas Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00
Permit Fee
bu
(Total from above -Minimum fee $35.00)
Surcharge
Total Due
Make check a able to City of Fridley
U ...a .-P an wr a Prsuun.- nuri vduu uniu prvicessea
1 hereby apply for a mechanical 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 apprication
for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in case of all work which requires review and approval of plans.
Signature of
Approval Inst
Building
BUILDING
Permit No.: POA-6c6t5
Inspections
COMMERCIAL/INDUSTRIAL
Received By:
763-572-3604
CITY OF FRIDLEY
DatdMAY 0 7 2008
763-502-4977 FAX
EFFECTIVE 14-08
DATE S - —7,6 0
//11
YOUR E-M/A,IL ADDRESS SC ®��
SITE ADDRESS 161
TENANT NAME:
SUITE NUMBER
PROPERTY OWNER
NAME:
–94
ADDRESS: ff7%
CITY
STAT IP�iss�i�
PHONE:yo
ARCHITECT
NAME:
ADDRESS:
CITY
STATE ZIP
CONTRACTOR
NAME:
ADDRESS:
CITY
STATE ZIP
* NOTE: CITY
LICENSE REQUIRED
FOR COMMERCIAL,
PHONE:
CELL:
FAX:
INDUSTRIAL AND
CITY LICENSE #:
EXP:
MULTI FAMILY
PROPERTY TYPE
OWNHOUSE
❑ COMMERCIAL/INDUSTRIAL
❑ INSTITUTIONAL
❑ MULTI -FAMILY
PERMIT TYPE
❑ ADDITION
❑ NEW CONSTRUCTION
❑ OTHER
REMODEL
❑ ROOF
❑ SWIMMING POOL
PLEASE SUBMIT:
1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR
6. SPECIAL INSPECTION
2. SURVEY/SITE PLAN
LICENSE APPLICATION
SCHEDULE
3. LANDSCAPE PLANS
7. PERFORMANCE BOND
4. ENERGY CALCS
AMOUNT $
BUILDING TO BE USED AS:
OFFICE sF WHS
SF OTHER SF
TOTAL SIZE:
STORIES FIRE PROTECTION (Y/N) &C(YIN)
DETAILED DESCRIPTION OF WORK G
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHEDULE)
Sq. ft. x $ Cost/sq. ft. = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
TOTAL JOB VALUATION: $ '-:::>- DO - 0 D USE OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
SAC Charge
Erosion Control
Park Fee
Special Assessments
Curb Cut Escrow
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
$1825 per SAC Unit (Plans to MWCC for determination)
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
ft+6ft= ftx$21=$
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 JJ'accord ithe r ed plan in the case of all work which requi review and approval of plans.
SIGNATURE O�ICA191T PRINT NAME �✓7 DATE� 6'
VV
APPROVED BY tA DA