Building
Inspections
763-572-3604
763-502-4977 FAX
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 04/17/2018
Permit No.:______________
Received By:____________
Date Rec’d:_____________
DATE_____________________________________________ YOUR E-MAIL ADDRESS __________________________________________________________________
SITE ADDRESS ________________________________________________________________________________________________________________________________
THIS APPLICANT IS: OWNER CONTRACTOR
PROPERTY
OWNER/
TENANT
NAME:______________________________________________________ PHONE:_____________________________________________
ADDRESS:___________________________________________CITY____________________________STATE______ZIP_____________+
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
NAME:___________________________________________________________________________________________________________
STATE LICENSE #_______________________________________________ EXP DATE ________________________________________
ADDRESS:_______________________________________________________CITY____________________STATE_____ZIP__________
PHONE ________________________________________________ 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 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
NUMBER OF SQUARES __________ HOUSE & GARAGE
GARAGES ATTACHED GARAGE
PROPOSED SIZE:__________ DETACHED GARAGE
PROPOSED HEIGHT: __________
SIDING
Vinyl Soffit
Aluminum Trim
Other ____________ Fascia
WINDOWS
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__________
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS, & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
4. Letter of Structural Engineering for imposed loads
on existing foundations.
FOR WINDOWS PROVIDE U-VALUE AND
MANUFACTURE STICKER ON WINDOW.
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.C FEE SCHEDULE)
TOTAL JOB VALUATION $_____________________________________ OCCUPANCY__________ TYPE___________
$
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)
$
$2485 per SAC Unit (Plans to MWCC for determination)
$
______ft + 6 ft = ________ ft x $36 = $_______
$
$450 Conservation Plan Review
$
Fee Determined by Engineering
$
Agreement necessary ( ) Non Necessary ( )
$
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 case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT ______________________________________PRINT NAME________________________________DATE____________________________
APPROVAL INSPECTOR SIGNATURE_______________________________________ 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 1
st
$500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1
st
$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
st
$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 1
st
$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
st
$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
st
$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
st
$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