PRE 2010 DOCS•
City of Fridley, Minn. `�
BUILDING PEPMIT iv® 7377
Date:�' �-- -�
Owner: Builder OZ r-7 P,
Address Address
LO TI OFWIDG
No. Street ____ 5 P f Lot
Lot __ Block Addition or Sub -Division
Corner Lot _ �� Inside Lot _ _ Setback -vim—_ Sideyard
Sewer Elevation 10 1 1 2- --Faundation Elevation
„Y„
DESCRIPTION OF BUILDING
T Used _
Front ZltDepth Height Sq. Ft. Cu. Ft
n Depth eight -ZV Sq. F't. Cu. Ft 141(60
Type of coon Adu_. Est. Cost 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 f9M and in mpliance with ah 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 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
Ridley, 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 violatio of any of the provisions of said
ordinances. lR, e rt
• NOTICE
This peemh doss not sorer the construction, hntaliatien for wiring, phunhing, gas hsatht& ewer or water. Be sura to see
the Building hopwor for separate pwmhs for than items.
APPLICATION FOR.BUILDING PERMIT
CITY OF FRIDLEY,.MINNESOTA
OWNER'S NAME���j �� BUILDER ? �'
ADDRESS ADDRESS 7 0
LOCATION OFr� BUILDING
No. ,/� ,� Street Part<,of Lot
Lot" Block _ Addition or. Subdivision . a61
zo
Corner Lot_L_Inside tot Setback Side Yard.
SEWER ELEVATION FOUNDATION ELEVATION
Applicant.attach to thi6 form Two Certificates of Survey of Lot and proposed build-
ing.locaiion drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
Front. 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 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.
.,( Schedule of Fee Costs can be found on the Reverse Side).
. MONTH -
DATE
DAY
CONTRACTOR CALL -TIME SPECTION & ADDRESS TIAL
is
40
Q10-
Co,
C /5
ol
o
it -e tv,
fz 6-e
C: he id S
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C /5
MaMil
SUBJECT
PERMIT NO.
City of Fridley
133
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
16-0
RECEIPT NO
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
GW
r
�l i /••'1 CITY HALL FRIDLEY 55432
NUMBER
REV. .
DATE
PAGE OF
APPROVED BY
i-•••'�'� ,'� 612-560-3450
910-F15
2-20-76
JOB ADDRESS James P. Wilson 131' 75th Avenue N.E.
1 LEGAL
LOT NO.
13
BLOCK
T3
TRACT OR ADDITION SEE ATTACHED
Don's 5th
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James P. Wilson 1319 75th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
SAFE
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW 0 ADDITION ❑ ALTERATION X,, REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
waterproofing
9 CHANGE OF USE FROM 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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATtA
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
0
.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-
5.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
5.50
SIGNATURE DONTRACTOR OR AUTH RIZE AGENT (DATE)EN
PROPERLY VA IDATED THIS IS YOUR PERMIT
BLDG 'NS, DATE
NATURE OWNER IIF OWNER BUILDERI (DATE)
MaMil
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME • s� r�C .�-L BUILDER
ADDRESS:—/319-75-
DDRESS : / / 9 —5- - PE ADDRESS:
NO:. STREET:
LOT: I-3 BLOCK: 3 ADDITION:
CORNER LOT: INSIDE LOT: SETBACK:
Im
SIDEYARD•
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
i
To Be Used As:
Front: Depth • Height
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction:
To Be Completed:
Estimated Cost_: �
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in st?ict 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: 4-1-170-16 SIGNATURE:
(See Reverse Side For Additional loformation.)
v
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
f)
j3l
GRAVITY WARM AIR:
RATE
TOTAL
Job Address
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
Minn.
Repairs & Alterations each add. $500.00
4.00
$
Fridley,
--Z-30
�✓
STEAM OR HOT WATER SYSTEM:
OWNER'
r
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each addn. 50,000 BTU
4.00
7.00
$
USED AS
Boiler only up to 100,000 BTU
$
each addn. 50,000 BTU
6.00
$
,p
7 2
TO BE COMPLETED ABOUT �,p _
I
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$
DESCRIPTION OF FURNACE/BURNER
°
Additional Fixtures x
$ 1.00
$
��
��"'
Gas Range to 199,000 BTU x
$10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. VNOad
AIR CONDITIONING
$.��
K,. R A FA ®1 `(
Trade Name ®�.+� Size No.
FAN HEATING SYSTEMS See Fee Schedule
$-��
r5
Lfq.
VENTILATING SYSTEMS
$ -
Capacity Q Ft. EDR BTU HP
ALTERATIONS $ REPAIRS_
$
State Surcharge
$ .50
Total Connected Load Kind of Fuel
TOTAL FEE
M'9-0
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Date ($10.00)
s Air, Cond. Mg. & Reed& IPS..
Company
FINAL INSP.
Date
Signed By
/�,,�Q
APPROVAL FOR PERMIT -�r�
Tel. No.
MINIMUM FEL'' FOR ANY 11KATING PERMIT IS
Ifta From e desk of
NASIM QURESffi MEMORANDUM JF-315
W th
CITY MANAGER'S OFFICE
DATE: July 3, 1986 TO ACT;
SUBJECT: John Flora, PWD _
Request for Street Light at 1319 75th
�.Elvenue NE --
Please see the attached petition requesting for a street light at 1319 75th Avenue NE.
Review and take appropriate action.
Please answer verbally or in writing by Monday, July 7, 1986.
NMQ/la
cc: Councilman Schneider
TO: Nasim Qureshi
FROM: John G. Flora �� DA -TM: July 7, 1986
We have received a petition from the cul-de-sac neighborhood off of 75th Avenue
between Old Central and Hayes Street regarding a street light.
In reviewing the request and the NSP power lines, it would appear the most
prudent location which would be campatible with our street lighting system
would be at the end of the cul-de-sac between properties 1343 and 1351 75th.
I have contacted Mrs. Kathy Bernard, the originator of the petition, and requested
her assistance in obtaining the two property owners' concurrence to grant NSP
an easement and install a street light at that location (she indicates this
will be forthcoming).
The Council could approve the petition and order the staff to take action or we
could wait for receipt of an agreement fram the property owners for a street light
at the cul-de-sac on 75th Avenue and then process the recruPst to Council.
Request action how we should proceed.
JGF/ts
[are]
CITY OF FRIDLEY
PETITION COVER SHEET
Petition No. 5-1986
Date Received July 71, 1986
Object Street light installed on the -property of Ronald C. 8 Kathleen K.
bernard, locatedat 131 _-75th Avenue N.E. If the power lines prevent
this action, the street light could be installed on nearest convenient
property in the cul-de-sac area.
Petition Checked By Date
Percent Signing
Referred to City Council
Disposition
010
61 JuL oIZ ryas
aid Y-
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0
.iune'�d, 1986
• • ►JUL 0' 1a��
Attention: Fridley City Council Members
We the undersigned are hereby petitioning the right to have a street light installed on the
property of Ronald Charles and Kathleen Kay Bernard, located at 1319 75th"Ave. N.E., Fridley,
Mn. 55432. Should power lines prevent this action we request the street light be installed
on nearest convenient property in the cul-de-sac area. We request this action be taken as
soon as possible, as we are experiencing vandalism and many noise disturbances during late
night hours. There are many small children in the area and this would be a safety feature
for them. .
a
NAME ,Q ADDRESS TELEPHONE
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MDTMN by Councilman Schneider to receive Petition 5-1986. Seconded by
Councilman Barnette. Upon a voice vote, all voting aye, Mayor Nee declared
the motion carried unanimously.
NDTMN by Councilman Schneider to direct staff to work with the neighborhood
and Northern States Power for the installation of a street light on 75th
Avenue. Seconded by Councilman Barnette. Upon a voice vote, all voting
aye, Mayor Nee declared the motion carried unanimously.
MDTION by Councilman Barnette to adjourn the meeting. Seconded by
Councilman Schneider. Upon a voice vote, all voting aye, Mayor Nee declared
the motion carried unanimously and the Regular Meeting of the Fridley City
Council of July 7, 1986 adjourned at 10:15 p-96
Respectfully submitted,
Carole M. Haddad, William J. Nee,
Secretary to the City Council Mayor
Approved:
-18-
1ts
DIRECTORATE o;,
cytv�
PUBLIC WORKS
C17yor MEMORANDUM - LfMDLW
TD: Nasim Qureshi, r1ityManager PW86-190
FROM: John G. Flora, Public Works Director
DATE: July 10, 1986
SUBJECr: Petition for a Street Light on 75th
Update on JF -316
I have been contacted by Mrs. Bernard, originator of the petition
for the street light on 75th Avenue. It appears that the desired
location for a street light at the end of the cul-de-sac is not
possible since the adjoining property owners will not provide an
NSP easement. Mrs. Bernard is currently working on obtaining an
easement frau the property owners at 1319 and.1327 75th Avenue
for a light location at the intersection of 75th and 75th. If the
NSP agreement is received, we will process the request to NSP for
installation.
JCS'/ts
Allan Schmidt
1335 - 75th Avenue N.E.
Fridley, MN 55432
Gillman Ulstad
1343 - 75th Avenue N.E.
Fridley, MN 55432
July 16, 1986
Mr. John Flora
City of Fridley
6431 University Avenue N.E.
Fridley, MN 55432
Dear Mr. Floras
We, the undersigned, agree,toprovide the City of Fridley
and Northern States Power Com' any the easement required
p
along our property lines for the purpose of installing power
poles necessary to provide a street light at the location of
these properties on 75th Avenue N.E.
Thank you for your consideration.
Yours truly,;'
AVow, OLf
Allan Sch�idt
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From the desk of
NASIM QURESIU
CITY MANAGER'S OFFICE
� ` _
MEMORANDUM JF -315
ATE: July 3, 1986 TO ACTION NFO
iBJECT: John Flora, PW
Request for Street Light at 1319 75th
Avenue NE
Please see the attached petition requesting for a street light at 1319 75th Avenue NE.
Review and take appropriate action.
Please answer verbally or in writing by Monday, July 7, 1986.
NMQ/la
cc: Councilman Schneider
L
TO: Nasim Qureshi FROM: John G. Flora MIND: July 7, 1986
We have received a petition from the cul-de-sac neighborhood off of 75th Avenue
between Old Central and Hayes Street regarding a street light.
In reviewing the request and the NSP power lines, it would appear the most
prudent location which would be compatible with our street lighting system
would be at the end of the cul-de-sac between properties 1343 and 1351 75th.
I have contacted Mrs. Kathy Bernard, the Originator of the petition, and requested
her assistance in obtaining the two prey hers' c'L to grant NSP
an easement and install a street light at that location (she indicates this
will be forthcoming) .
The Council could approve the petition and order the staff to take action or we
could wait for receipt of an agreement frac the property owners for a street light
at the cul-de-sac on 75th Avenue and then process the reauest to Council.
Request action how we should proceed.
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CITY OF FRIDLEY
PETITION COWER SHEET
Petition No. 5-1986
Date Received July 7, 1986
Object Street light installed on the property of Ronald C. & Kathleen K.
..Bernard, located at 19 - 75th -Avenue If the power lines prevent
this action, the street light could be installed on nearest convenient
property in the cul-de-sac area.
Petition Checked By
Percent Signing
Referred to City Council
Disposition
Date
Jurw 39, 1986
• - ' ,JUI.O
vl
Attention: Fridley City Council Members
We the undersigned are hereby petitioning the right to have a street light installed on the
property of Ronald Charles and Kathleen Kay Bernard, located at 1319 75th'Ave. N.E., Fridley,
Mn. 55432. Should power lines prevent this action we request the street light be installed
on nearest convenient property in the cul-de-sac area. We request this action be taken as
soon as possible, as we are experiencing vandalism and many noise disturbances during late
night hours. There are many small children in the area and this would be a safety feature
for them.
NAME AVVKk;bb ar.i.r.�wvar+
,44
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Pt
WO
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I
716 3� ��•
CITY OF
FWDLEY
DIRECTORATE
OF
PUBLIC WORKS
MEMORANDUM
T0: Nasim Qureshi, City Manager PW86-224
FROM: John G. Flora, Public Works Director
DAZE: August 7, 1986
SU JDCT: Petition for Street bight on 75th Avenue -
Update to Speed Memo dated August 6, 1986
iIEIGO
ro-
We have been working with Mrs. Bernard on obtaining agreements for
placement of poles and utility easements for street lights at
75th Avenue. We currently have the neighbors at 1335 and 1347
75th Avenue to agree on an easement between them. A street light
through this agreement will necessitate the installation of two
poles and light the end of the cul-de-sac.
We are working with the two property owners to obtain concurrences
to install the two poles along the mutual line. once this has
been achieved, we will contact NSP to initiate action to install
a street light at this location.
Should this agreement not be reached, we will again contact Mrs.
Bernard and detennine what other courses of action would be desirable.
"As
Attachment
I
John Flora August 6, 1986 Speed Message
To_
9----- ----- - e9
® - ---------------------------- From NASIM QURESHI, CITY MANAGER'S OFFICE
subject Petition for a Street Light on 75th
Please provide an update on the subject listed above.
._ Thank -you.--- — --- - ---- -- ---- -- -- - -
NMQ/la
Wilson Jones Company 17D Signed __ -
DIRECTORATE
oc
°Im OF -o
PUBLIC WORKS
�ITYor MEMOR �—
EY ANDUM
fNDL
m: Nasim Qureshi, pity Manager PW86-190
FROM: John G. Flora, Public Works Director
DATE: July 10, 1986
SUBJEX.T: Petition for a Street Light on 75th
Update on JF -316
I have been contacted by Mrs. Bernard, Originator of the petition
for the street light on 75th Avenue. It appears that the desired
location for a street light at the end of the cul-de-sac is not
possible since the adjoining property owners will not provide an
NSP easement. Mrs. Bernard is currently working on obtaining an
easement frau the property owners at 1319 and 1327 - 75th Avenue
for a light location at the intersection of 75th and 75th. If the
NSP agreement is received, we will prooess the request to NSP for
installation.
JGF/ts
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SUBJECT
PERMIT NO.
City of Fridley
® Q
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir
O
COMMUNITY DEVELOPMENT DIV.
Qa``
r � � PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/19/94
JOB ADDRESS 1319 75 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
3
Don's 5th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Ronald Bernard 1319 75 Avenue NE
784-4971
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Same
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❑
8 DESCRIBE WORK
Reroof House & Garage (20 Squares) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
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
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
I GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,100
@
$.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$27.00
Fire SC $1.10
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$28.65
SIGNAT OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
W►{ P PERL VAL
TED TH S YOUR PERMIT
I-7
�-zcLL
BLDG INSP
�
DATE
S NATURE OF OWNER OWNER BUILDERI IDATEI
V
NEW ( ] Effective 1/1/94
ADDN (] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-23 2J S
Building Permit Application
Construction Address: f 3 9- J- K,Q� -L--
Legal Description:
Owner Name & Address: / -7s- T '4 ,v Tel. # '
Contractor:
Address:
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground
Sq. Ft.
OTHER:
o o g
1 C/ a d Cn,�,� ,r a
SAC Charge
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: -T, /�< a Estimated Cost: $
Approx. Completion Date: e/� .f137, y ^ Moo
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $ = $
DATE: F APPLICANT: c Tel. # 7Vz/-
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
60
Fee Schedule on Reverse Side
Fire Surcharge
$
4/0
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$
SS $.50/$1,000 Valuation
SAC Charge
$
$800 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:
SUBJECT
City of Fridley
25
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
-7
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/29/97
JOB ADDRESS 1319 75 Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
13
3
Don's 5th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Greg McLaughlin 1319 75 Avenue NE
785-4155
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Same
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 Ik REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Replace windows
9 CHANGE OF USE FROM 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
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
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
$6r,0
Y$.)ro
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-
$.65
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TI AL FEE
$27.65
ORAUTHO I DAGEN7 IDATEI
HEN R P
VALID
THIS I UR PERMIT
r11ATUREOFCONTRACT
nor
•BL INSP Y,�l
,TE
NAT OF WNE F bWNER ILDERI IDA EI
NEW
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: �% 1 QJ' )S7r 1 Avc- )U --- 1,2 ("D [,CL
Legal Description: p�
Effective 1/l/97
4P 4,QG- 3 a-7
0/u S�5-454� .2-,
Owner Name & Address: �� /4 � fiv �i (,�y J Tel. # INS SSS
Contractor: MN LICENSE #
Address:
V
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/ r and Sq. Ft.
OTHER:"
f A( iAl — / rcl-b-,j
k."-)C'6Y)
Construction Type: �Lf34-4g i Estimated Cost: $ so , oc car aOd7 l�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft !x $ _ $
DATE:
APPLICANT:
Tel. # ZF-5-
CITY USE ONLY
Permit Fee
$
�0 Fee Schedule on Reverse Side
Fire Surcharge
$
(oS .001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge g
$
$950 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:
MIT NO.
8170
SUBJECT
City of Fridley
2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
v __���_ COMMUNITY DEVELOPMENT DIV.
r , PROTECTIVE INSPECTION SEC.P
1 = �
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
ti.__- 2®3 #12-571-3450
910-FIs
10/9/98
JOB ADDRESS
1319 75th Avenue NE
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
3 Don's 5th Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gregory J McLaughlin
785-4155
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW D ADDITION O ALTERATION jk REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and arae 20 S Tear-off Hail damage)
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
1714
.86
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
Tj 5
Are S 1.71
PLAN CHECK FEE
OTAL FE
5
SIGNATURE OF CON'R CTOR OR T ORIZED AGENT ID
le
PR
ER Y A EDT $ YQ R PER
00, /4D- 4
PATE
SIGro
N RE OF OwN R,60N ER BUILDER. IO TEI
MIT NO.
8170
NEW [ ]
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: / J
Effective 1/1/98
Legal Description:
yOwner Name & Address: ,::�aS% s
�—
x Contractor: MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width —� Hgt/Ground Sq. Ft. ��
OTHER: Tei � ,�� 1�t: `� '' l o•o
g
Construction Type: Estimated Cost:
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: P —`� - �� APPLICANT: ,�2�� L , _: 11- /14) Tel. �/z 17J-5-����
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.501$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 [ ]
9
SUBJE&
City of Fridley
1 7
AT THE TOP OF THE TWINS
BUILDING
PERMI
L297
�
COMMUNITY DEVELOPMENT DIV.
-
♦� V ����� _
SEC.
3
r�i
INSPECTION
�
3J6PROTECTIVE
----1 8- CITY HALL FRIDLEY 35432
NUMBER
REV
DATE
PAGE O:
APPROVED By
L 612-571-3450
910415
6/18/99
JOB ADDRESS
1319 75th Avenup- NF
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
OESCR.
13
1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Greg McLaughlin
785-4155
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 %E REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside house and garage
9 CHANGE OF USE FROM
TO
STIPULATIONS
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
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
$1000
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$38.75 XFire
S(;1$1.00
PLAN CHECK FEE
TOTAL F
0.
S1.('j NATURE Of CONTRACT OR AUTHO 1 DAGENT i A I!,
EN ROP AWLS T S IS YR PERMIT
i
BLD �NSo DATE
S,GNATfijrE OF OWNE IF OWNE UILDERi �DAiE�
9
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMELY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
y l_ J
Construction Address:—1 3 �/ Q 2:5 �yt 4U6Ai
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
C- L4y k (' ( ^—)
Tel. (o 14 ��S— ef/-SS
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height' Sq. Ft.
Length Width Height Sq. Ft.
Length Width �— Hgt/Ground Sq. Ft.
TZC- 5 i DC-- ����' .P -
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel.
CITY USE ONLY
Permit Fee $ J
Fire Surcharge
$
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ "7 6 -o2s
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
Building
$ '73 3./E
BUILDING
Plan Review
Permit No. 2110- D
Inspections
Fire Surcharge
RESIDENTIAL APPLICATION
Received By:q'
763-572-3604
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
CITY OF FRIDLEY
D
763-502-4977 FAX
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
EFFECTIVE 1-I-2010
$
Fee Determined by Engineering
DATE (� YOUR E-MAIL ADDRESSC7 /�r'rl✓ id • ? X �i S x"r), c-C�
SITE ADDRESS /�/
++
% 7,57"
Total Due
THIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: CITY
f'/�G� �E�7 STATE �/ILIP
PHON .
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE #
EXP DATE 3 /
AND CERTIFICATE OF
ADDRESS:"'O /�/l>
CITYr%✓€ STATEZ�/IP ,SSS•
INSURANCE
PHONE / FAX
PROPERTY TYPE
'SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK WSIDING
❑ OTHER.
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
13 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:
vG
FOR NEW CONSTRUCTION INCLUDING DECKS,
j❑SofNitryl
fit
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.
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)
TOTAL JOB VALUATION $ ':�2' �;' ® O. 0 n OCCUPANCY TYPE
Permit Fee
$ '73 3./E
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$/;
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 ' -not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all worktt re '"re d approval of plans. /
SIGNATURE OF APPLICA �;f PRINT
Building
$
BUILDING
See Back Page for Fee Schedule
Permit No.: & 10
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
30
CITY OF FRIDLEY
Surcharge
Date Rec'd: �/0
763-502-4977 FAX
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
EFFECTIVE I-1-2010
$
DATE
l
YOUR E-MAIL ADDRESS
SITE ADDRESS
7S vE' -.,5- P
ft + 6 ft = ft x $24 = $
Erosion Control
$
THIS APPLICANT IS:
❑ OWNER 000NTRACTOR
$
PROPERTY OWNER/
NAME: Z,-
Sewer Main Charge
TENANT
v
Agreement necessary ( ) Non Necessary ( )
Total Due
ADDRESS: CITY
STATE ZIP
Make checks payable to: City of Fridley Attach Stipulations
PHONE: 66---
SiCONTRACTOR
CONTRACTOR
NAME: ,
SUBMIT A COPY
YOUR STATE LICENSE N
STATE LICENSE # _ �d S' ��/ O EXP DATE 4eJJ -
AND CERTIFICATE OF
�7
ADDRESS: %/�/� �"y<t, �E� /`�'yE.
CITY N STATF,/%�IZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
X SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES_
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED M'WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN
TILE / S��E
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: G' % �G-j" Sr "Ve' J uJ
SIZE OF IMPROVEMENT
I LENGTH WIDTH
HEIGHT SQ FT
p
ROOFING e&,Xle -2X&' HOUSE HOUSE ONLY
NUMBER OF SQUARES
w� %Uwe ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT
GARAGES
��`� e 6 //❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
/�/f�Bd+�� ` 7 7 ,,'
SIDING
lFOR
Q� ��o,,,,t
NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
❑ Vinyl
r,
❑ 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 WINDO_S
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 NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ / -?0 OCCUPANCY TYPE
Permit Fee
$
1 RD D
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
30
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
ro`A V3
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 start without a permit on site; that the work will be in accordance with the
approved plan in the case of all work ich r es d approval of plans.
SIGNATURE OF APPLICANT PRINTNAME
Page 2 - Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to -wit:
TOTAL VALUE
FEES
$1 to $500
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1" $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$391.25 for 1" $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for 1s` $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for 1 s' $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the 1' $1,000,000 plus $3.15 for each additional $1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:,5
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE O YOUR E-MAIL ADDRESS , s1 c�����
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER (CONTRACTOR
PROPERTY
NAME:
ADDRESS: CITY STATPYp� ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE #q`// 2f-,r,-:M EXP DATE/L j
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
STATE BOND # EXP DATE
, G
CERTIFICATE OF
ADDRESS: - , i % CITY �lycwl rL5 STATE ZIP
INSURANCE
pHONE_6I Z u \� �T — 103 FAX
PERMIT TYPE,SINGLE
FAMILY . ❑ TWO FAMILY ❑ TOWNHOUSE
❑ NEW dREPLACEMENT
TYPE OF WORK:
DETAILED DESCRIPTION OF WORKJ�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAV FLOOR DRAINS SHOWER _WATER PIPING
I BATHTUB ( GAS PIPING (NEED CITY LIC)_ SWIMMING POOL _ WATER SOFTNER ($35)
WASHER )KITCHEN SINK -ZWATERCLOSET _BACKFLOW PREV.($15)
_CLOTHES
1 DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER —OTHER
H a r r
-
��
:
p
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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=all all work whi requires review and approval of plans.
1-
SIGNATURE OF APPLICANT PRINT NAME ��'�/ �✓��� DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977