HomeMy WebLinkAbout3942_001 Building BUILDING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604
763-572-3604 FAX CITY OF FRIDLEY Date Rec'd:
EFFECTIVE 04/17/2018
DATE - L c. j YOUR E-MAIL ADDRESS r �V++ltat-d LC7l3+-Y +C+1���1._� ►l
SITE ADDRESS (31LL AJ
THIS APPLICANT IS: ❑OWNER�� CONTRACTOR 1
PROPERTY NAME: 4k L PHONE:
OWNER/ ADDRESS: rs _CITY STATE ZIP 5'5Y3c
TENANT a
CONTRACTOR NAME: -AA%poeed C ' 15tr i �+'.
SUBMIT A COPY OF STATE LICENSE# C.. 76 'q0 EXP DATE *3--
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YOUR STATE LICENSE _
AND CERTIFICATE OF ADDRESS: 1 CITY �bSkl f STATEi�V! IP S s-o 11
INSURANCE PHONE Z- — z.'� FAX
PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE ❑ADDITION ❑GARAGE/SHED ❑WINDOWS
❑BASEMENT FINISH ❑ROOF ❑DRAIN TILE
❑DECK ❑SIDING 1OTHER
❑SWIMMING POOL
TYPE OF WORK: ❑NEW HOME CONSTRUCTION ❑ADDITION
9AINTENANCE/REPAIR ElREMODELING
DESCRIBE WORK BEING DONE: tt ' Y i
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT
ROOFING ❑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:
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑Vinyl ❑Soffit ADDITIONS.&PORCHES SUBMIT:
❑Aluminum ❑Trim I Site Plan/Survey showing the existing structures
and proposed project.
❑Other ❑Fascia 2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 4. Letter of Structural Engineering for imposed loads
OR FOR NEW OPENINGS-DESCRIBE SIZE OF on existing foundations.
OPENING CHANGES& FOR WINDOWS—PROVIDE U-VALUE AND
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I MANUFACTURE STICKER ON WINDOW.
ALL FEES ARE BASED ON VALUATION,INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION$ SL). 00C OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65%of Building Permit Fee
.a Fire Surcharge $ .001 times the total job valuation
z Surcharge $ .0005 x Permit Valuation Minimum$.50
O
W License Surcharge $ $5.00(State Licensed Residential Contractors)
] SAC Charge $ $2485 per SAC Unit(Plans to MWCC for determination)
w Curb Cut Escrow $ ft+6 ft= ft x$36=$
U Erosion Control
� $ $450 Conservation Plan Review
rs Park Fee $ Fee Determined by Engineering
Sewer Main Charge S $ 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 forVpermit 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 a 1 which requires review and approval of plans. �� S 7
SIGNATURE OF APPLICANT — PRINT NAME :YQC k L fI lit is n. DATE I LZ—&)Z.;
APPROVAL INSPECTOR SIGN TUBE DATE:
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING.ELECTRICAL AND MECHANICAL WORK
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 15'$500 plus$3.05 for each additional$100 or fraction,to and
including$2,000
$2,001 to$25,000 $69.25 for Is'$2,000 plus$14 for each additional$1,000 or fraction,to and
including$$25,000
$25,001 to$50,000 $391.25 for 15t$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 15t$50,000 plus$7 for each additional$1,000 or fraction to and
including$100,000
$100,001 to$500,000 $993.75 for 15t$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 15t$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
7071 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977