AF - 35535City of Fridley, Mi.nn..
BUILDING PERMIT
N° � 2.� �
Date: ..�ar'._'.'.�.�.`_" �� .....____..._...._.__
.. ._ .
Owner: _: _ / Buiider J
Address.....---•••----•--_...----_....__..__.._.._.__.._.._......._.._....._..._ ..........._.:.---••---_..._ Address ..---_...._..___._......__.......-----�-•-----......_...._......_.. --
OC N OF BUILDING
No.�.Q'�-•-----... Street ....___-- �--- *�fi��,�•,-�----......_..._.-. --........._.......... P of Lot ..........I.._ _.- --•-•--- ......�_..
. ._.:.: ... •--
�...----- •
Lot •_-...... ..:�._._.. Block .................�-------.....------•----. Additfon or Sub-Divis� .. . .: ... •_ ----- .. . .
� -.. ,/�
Corner Lot ----.: ............._........ Inside Lot -----..�*�."..�---._....----�-- Setback ..,�.%�..._......._......----. Sideyard •----�./�+a=..._..-•---._.... ..�_.........---....._....
Sewer Elevatian .._.._........._.._......W._._.._..__._____._. ..__...._....._. Foundation Elevatian
� DESCRIPTION OF BUILDING
To U : y �
._ ........ Front ..1.�!........�.�.._.. Depth q��.. Sf?_...._.. Height ....d.:..T....__ Sq. Ft. ��� Cu. F�1�...�..�...�„�.•�
... . _ . .;_....._.._ Fr t .. �._.. Depth ..�.:.._. Height� �L.r .� q. Ft. ....c.•�+4! Cu. Ft. ,����!�
Type o onstructio .........._ _ -.---.. Est. Co�l� .. ...��✓.......�--•----. To 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 tlxe description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
_.�!i_._....___.._....�._...._..._..�..._....._..___......._.
In consideration of the payment of a fee of $..j,,,1��..�-..:..._.., permit is hereby granted to....._.....__.____�...._....�...._.
....._..._......._.._...._..�__..._....__..._..._._.. to construct the building or addition as described above. This permit is granted upoa
the express condition that the person to whom it is granted and his agents, employees and workmen, m all work
done in, sround and upon said building, or any part thereof, shall conform in all respects to the ordinances of
k'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city ]imits and this permit may be revoked at any ti�upon violation �f any of the provisions of said
ordinances, l 1 .� , f
Inspector
NOTICE:
This psrmh does not eov�r �h� eonMrue�ion, installation for wi�ing, plumbinp, gas hsating, awer or water. 6� wn to �
fh� Buildfng In:pector for ssparafa pe�miq foe thas� itamt.
_ . .. � �� � . ; _
APPI,ICATION F�R BIIII�ING PER�IIT
CITY OF FRIDLEY, MINNESOTA
Owner'g Name Builder
�ddress Addreas
LOCATION OF BIIILDINa
No. ���/ Street Li?'�:s--�'.e ���� �� Psrt of Lot
_ ,
Lot „ � � „Block � Addition or Subdivision G�� �o ��,�
`�`.�e' .
Corner Lot �Inside Lot � 3etbsck -� �� Side-Yard !o � �
S�. ELEVATION FOUND�TION EL�EVATION
Applicant attach to this Yarm Certificate of Survey oP Lot and propo�ed building
locetion.
To be used as:
DFSCRIPTIQN pF BIIILDING
� i /�� /
O De�th �(o Hsiaht __/ g,
Sq. Ft. ��C� „ Cu. Ft. ��,! 7L�Y�
�ont_ - � � Dep't2� �°2- � �eight � �
Sq. Ft. Cu. �'t. �, ,_
0
Type of Construetion iS,n �� Est3mated Cost ��o � l� _
To be Completed ,_______
The uridersigned hereby makes applica.tion for a permit for the work herein specifisd,
agreeing to do all work in atrict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby dec].ares that aZl the facts and representations
stated in th3.s appliaation are true and correct. O�� q�� �
/
DA� / �- L.,� � � SIGNATiki� ✓� � _ Zr - .�'�,
(A Schedule of Fee Costs can be fow�d on the Reverse 3ide.)
d.�'" � ��-� % / C���
�'�� �..----- , _
. . � � _. �
BIIILD ING P'ERMIT FEE SCF�DIIIE
5e�t__i_ion 2_ The Inspector of Buildinga shall, before issuing ar�y permit for the
erection of any building or atructure, or for ar�y addition to any existing buil.d-
3ng or struct�e, or for any alterations or repairs to any exi�ting bui.lding or
st,ructure, upon application iherefor, 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:
2.1. For any suah permit for the erection of any fire-proof building, other th8tt
a garage, �rarehouse, factory or grain elevator, or for the erection oP any fire-
praoP addition, for �imilar occupaney, to a�r exi.sting bui2ciing shall be 8t the
rate of �1..L,A for each one thousand cubic feet, or f`raction thereof, in such
cubiQe,7. contents.
2.2. For any such permit for the erection of any fireproof garsge, wasehouse,
factory or grain elevator, or for the erection of any fireproof addition, for
�similar occupancy, to any existing building shall be at the rate of �L.25 for
each one thousand cubic feet, classified as "fireproof" by Section 502 of the
M3nneapolia Building Code.
OH USES
2.3. For any such permit for the erect3.on of any non-fireproof buflding other
than a garage, warehouse, factory or gra3n elevator, or any non-fireproof
addit3on, for similar occupancy, to any existing building. Permit �]..00 for
each one thousand cubic feet.
G GES
2�4. For any such permit for the erection of any non-fireproof garege, warehouse,
factory or grain elevator, or for the erection of any nor� fireproof.addition, for
s3,mila� occupatzcy, to any existing building or for each such building or addition.
Ninety Centa for each one thousand cubic feet or fraction thereof, in the cubical
con�ents thereof with a minimum of �/�.00.
For the purpoee of computing fees for building permits the cubical contenta oP any
building or addition to a un3form height throughout by multiplging the �round srea
covered from a point six (6) inches below the floor line of the basement or cellar
to the average height of the upper surface or to the average height of the roof
surface of the main gable of a pitched roof.
2.5. For repairs ar alterations to an exiating structure, the fee shall be at the�
rate of �3.00 for each Five Hundrsd Dollara (�500.00}, or Fraction thereo� i.n the
cost of all proposed work.
2.6. In no case shall the fee charged for any permit as set fort�i in "aection 2 ba
Iess than �4.00.
., , _ ` � � . .
�►PPiication �or Po�wer Ptants c�nd He�ing, Coding. Yer�tilation, .Refrigerce�ion nnd
Air Conditioning Systems and Device�s
PARTIAL RATE S�HEDULE Dep:. of Bidgs. Phoae SU 4-7470
GRAVITY WARM AIR: RATE TOTAL .
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 �
Replacement of Furnace ........................:.... 5.00 �
Repairs & Alterations—up to $50Q.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . , . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 1?A,OOQ BTIJ . . . . . . . . . . . .
� � �each add. 6U,000 BTU . . . .... . . . . . . . . .. . . . . . . .
Replacement of Furn.ace .............................
Repairs & Alterations—up to $506.00 . . . . .. . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 .......:......
a.oa � 8.00
2.00 $ __
5.00 �,
5.00 $
2.50 $
3TEAM or HOT WATER SYSTEM
,� Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $
i F'urnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
.
, Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . : . 2.50 $
y
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURI�iER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up ta 400,000 BTLT> . . . . . . . . . . . .. . ... . . . . . . 5.00 $����
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ..... x $1.50 $ �'•�0
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR COPiDITIONING $
FAN HEATING SYSTEM See Fee Sched.ule
VENTILATING SYSTEM �
.�iLTERATIONS ffi REPAIRS TOTAL FEE $ 1� •5�
' ROUGH
FINAL
Location ���_ �b�e� ��-. �I• �s
U -
�'
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 Ordinance:
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. 1'll , 19 n 2
�wner ` Pa�- Schwartz Construction Co. _
Kind of Building - F� *+��
Used as Re�idence
To be completed about 2�11�62
Estimated Cost, $ �y�O.Qn
r
Old—New. Building Permit No. �� 7a �'--PB=mit No. �
DESCRIPTION OF WORK
fi�ATING or POWER P"LP,NTS--Steam, Hot Water, Warm Air—No. �_
Trade Name Westin�house Size No. GUE-100
Capacity Sq. Ft. E.D.R. BTCT ������ H.P.
Total Connected Load �7 � 965 Kind of Fue�
BURNEft — Trade Name Size No.
Capacity Sq. Ft. E.D.R. BTLJ H.P.
(REMARKS-OVER)
Signeci FRED VOGT & CO.
HEATING & AIR CONDITIONING
B3° ��3a Wes�t 6ek��.--W6. �-67�7
St. Louis Park, Minrtesota
�;;�<Z zM i-s9 Business Phone No.
r,as .s��..,> • 'a^��r � , _ �4 n �� x
HEA7 1„0.5S CALCUI..�7IC�NS [�EPA�'IMi�:PvT� t�F BUILDINGS ��' ' �'� � %� �j ' � ' M1NNH.AE'C)E.I;�, P��'�;��
- --�.__ > _ � �___�_ �._____ -_ ---_ �_--- - =� ... _
T� __�_ _ _ -�— ...--_ �- _ �. � ------- ----- _
A.S.H.V�, i • i
Weatherstrips Construction Na. Insulatiars
_ Guide _ _ _�—. —.
- - ---- --- ____ r Y _. ____
Windows Doors Reference Oait. Wall Ini. Wall Ceiling RooE Flnar Kind Flow Applied
-- — ---- _ _-- — ---- — __ _— _._
Ycs�-�Vo-- Yea—No (9_� !
�' Fl.� � �/ Room � Length I Width /" He�ght v II / Fl.� Room Length Width ,S" �Height
---- -- --�--- — -----�-
Windows and Doors—Crackage and Area Windowa and Doora—Crackage and Area
1�'Itlth Hei�ht Nc. o! Llneni fL Area � WIdtA Hei��t No. ot Lln�al ft. Aro•
To. of Dar.e of pane lighte ot c ack �Q. ft. /� � No, et pane ot Dane Il�ht� ot ciacic �Q. (t.
(` �
�' p � � �� `
a
Coef. Bcu Coef. Btu
Infiltration In6ltration
Glasa � �U C Glas� �'1
�cp. wsll ' � Exp. wall �
Net tap, wall 2 0 4� � N�c �:g wal! �/ 5�' 1?'
Int. wal)
Ceilins
Floor ' 7 �
Total Btu.
Required sq. h. E.D.R. or �q. in�. W.A. L.eader area
FI. Room Len�th / Width f�' Height
Nlindows and Doors--�Cracka�e snd Arca
IAth H�ht No. ot Llneal ft. Area
No. oCpan• o[ D��� U��b ot rRCk •. ft.
�: . , s
�- / � i 3
Z ��- a� i �y i�
Coef.l Btu
Iniltratan j
Glau Q
F.�tp. wall •
Net e:p. waq
Int. wdl
Ceiling ,Z / s
Floor
Total Btu.
Required yq. ft. E.D.R. or sq. ins. �.A. Lesder srea
FI. ' Room ( Len�th Width / o
Windows and Doora--Crackage and Arca
Wldth M�I�ht No. ot Llna�l t. Area
No. ef p�n� o! pane Ilthb ot crack p. [t.
2 � � � � � ? 1 /3
/
Coef.� Btu
Infiltratioa � �' °
Glaa
Exp. wall %O ' U
Net exp. wall ""
lnt. wall
Ceiling // li
F loor /l G/
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. L.eackr area
/
U_�
Int. wall
Ceiling
Floor
Total Btu.
Required �q. ft. E.D.R. or tq. in:. W.A. Leadet area
/ Fl.l �...e+� Room I L..en�th F w�a�h
Windows and Doors--Crackage and Area
WtdtA Heltht No• o[ Lln��l !t. Ar�a
No. ot p�n� ot y�n� {1�hts ot cr�cw p(t.
� ..� 3 1. � /,p S
1 l
In6ltr�tion
G{a�s
Esp. wall �
Net e�. wall
Int. w�ll
Ceiling
Floor
Toeal &a.
Required p. h. ED.R. or aq. in�. W.A. Le�der area
%
/ Fl. .� Room 1 Lengtfi VVidth //
Window� and Door}-Cracka`e and Arca
WIdIA Hd�ht No. o[ Lln�al I[. A��•
No. ot D��• ot D�ne Il�hu ot cnck p. tt.
x. /� �/ u
.x /� 1y � �9 9
_ I l
' 1n61trstion
T Glass
Exp. wall � �J'�
Net exp. wal)
� Int. wall
C Ceiling • /
� , Floor
i Total Stu.
Heighc
�
Coef.l Btu
Required sq. ft. E.D.R. or aq. ins. WA. Leader arra
� :;ri.
.
p�t6 d�vs - �
t�r i.�ss cA�.cv�arror�s ��:;�� r� �: L� �:a ��: {z�.�,�. � V; x ��i ��. ���=�, ,� � ����,r�
_____ _._
_.
----� ==- -.-- � _ _ � � _
weatherstripa A. ..V. . �.:ocxatrucR; t' �f i`'a'' �t'' .
Guide ' � __ . _., �. ___ . � __ . �_._.�.._ _�_
_ ._ ,_ . µ ----
�iadow� Doora Refuence Out. Wall Int. Wall Geiliag E:�3f � �'4;:u� {'s �i��c£ , �caear �°�p�! �c� �
� ---- -- -- . _._. . __. __ _ . ._____.e__ ____._�,_
le�o es—No 19� � .��.. .;-. ._:—.
Fl. Room L.enQth Width // Neisht dc'� FI.� Room L.ea�th Width �Neisht
�tindows and Doors—Cracka�e and Area Windows and Doors--Cnckage •nd Area
Wldth HOiRht No. ol Lln�at It. Area Wddth Hei�At No. ot LIeN� tt. Ar�a
No. st Dane ot w�e li[hta pf crack W� tt. No. ol D►n• of Dan• it6hh of cracic sC. tt.
1 i �% �,/ � / .7S, /L __
l�fikration
Glai�
Fap• waU �
Net e:p. w�U
lst. waU
Ceilins
Fioor
Toeal Hcu.
Required sq. h. £.D.R. or �q. ia�. WA. L.sader �re�
/ Fl Room Len�th l Qlidch /
�'p�dowt a�d Doon—Cracka�t �nd Arca
fdt► st� t No. e 4teaal tt. Ar�a
N�. o! N�� K Pa�� Ilshb ot craek' p. tt.
�
tnNtratioa
G{ua
F.�cp. waU
N�t e:p. wall
L�t. wall
Ceilin� �
Fbor
____--
T�tal &�.
Rearirei .o.
&u
COl�. � �I
ft. E.D.R. or p. ins. �V.A. l,esder arsa
Fl. ' Roea ( Len�tb Widch
�Niodsw� aad Door�--�Cruk��e and Area
IdtA /l�1iAt 11�. ot 1.1s�sl tt. Are�
}��. �f y�M Of P��� 1{tbl� O[ C�tC: M. :t.
C
lailentie�
GIsN
��
Akt a�p. wad
� v►��
Ccilie�
Fleor
7'otsl &u.
Reqwnd p. ft. E.D.K. or �q. ins. W.A. 1.e��ler area
G..._
kki=ht
Btu
Coef.l &n
In6ltrataa
Glass
�p, wall
Net e:p. wall
Int. w�ll
Ceiling
Floor
Total Btu.
Required w• ft• E.D.R. or W. in:. �A. l.eader area
Fl.l Rcom ( Length Width
R/��ws and poors--Craclui�e and Area
tdth H�1�ht No. ot 1n��i tt. Nr�f
Ns. �t N� o[ pas� ll�ht• oL er�ck �V. tt.
Ie6lvatioa
C,{sa.
Facp. w.it
Net e:p. wall
let. w�l1
Ceiling
f'Ioor
Tatat &u.
R�quired rq, h. E.D.R. or sq. iir. �lA. Leader area
Fl.� Room ( l..en�th Width
Windovin aad Doors—Crscka�e and Atea
Wth �bt No. ot Llnu! tt. Area
Ne. et an� ot N�� IS�ht� ot crack p. tt.
�nfiltratan
Gla�
Esp. wail
Net e�. wall
I�t. wall
Ceilin�
Floor ,
Tota) &u.
Required sq. ft. E.D.R. or sq. in:. WA. L.eader area
�
Heisht
Btu
�
.�
_ �.1�/ O� FI'IC��@�/ �
ApP�c�rtion for Plumbing and Gas F'itting Pernut
Dep3. of Bldgs. Phone SU 4-T470 �
DESCRIPTION OF WORK i/2�l $ble '�Tee'� I+1.E.
Number, Kind and Location of Fixtuses Locatio�
� I y � ^� VI � Vl ]L M- OC � S� W
'�+ F�/1 z. s,,, z'� xr zz '� Rz uz ox .�
O<OJ z i-m 1`/� Z�vS O� 3a� 4~ �� `�a�
^ � u � �� m UI � F- � LL N LL � V� �� CJ �
Base 1 � 1
lst 2 1� 2 1
2nd _
3rd '
4th _
• Fuiurs Coanection Openin,gs
* New F'ixture, Oid Opeaiags
���
(9 WATER HTR.
W ? � i
� � .O F N GAS ELEC.
PARTIAL RATE SCHEDI�LE
Z
3ewer
Cese�000l
PLIIMBING FIXTURE RATES: � NO. RATE 'tOTAL
Number Fixtures .. . . . . . . . . : . . . . . .. . . . . l� x $1.54 $ 1�•0�
Future Fixture Opening ................ x 1.20 $
New F'ixture Old Opening . . . . . . . . . . . . . . x 1.00 $
..
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTin ...... x 2.00 $ 2-�
New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures . . . . . . . . . . . . . . . . . . . . . . . . . . x $1.50 $ 1 •S�
Additional Fixtures ....:............... x .50 $
Gas Range to 200,000 BTU . .. ... .. .... .. x 2.00 �
REPAIR$ 8c ALTERATIONS—Refer to Code
��...
Description ................................................$
TOTAL FEE $ 1 � _!'9�
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 I3epartment of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, ivtinn. .�inuaTy li , lg �2
Owner �ul �'Ghwart2 COttSt. Co.
Kind of Building �T'���
Used as �elling
Ta be completed about �r'i 1 15 � 1962
Estimated Cost, $ S�� ��
O1d—New. Building Permit No�_ /°� °��'� Permit No.
STA�"��ARD P�LU�i�I�� & %����r«`�� ��
, SignecL
BY � � r
Busin s Phone No. we a���� -_
ROUt3H � � .�� ' b �'"
FINAL
4
r
,, <
a z zM r-sv
d
i
_
. � .
, � �
.
. . �
�ity o� �ridlQy -
��;�� �i �`��:� �� ���� �d ���c ����� ���:� _ '
Dep�t. of Bldqs: Phon* SSO-3450 .. �
DESCRFPTIOPI OF WORK � U�"//` U` Q �' �—
Humbar, Kiud u►d Zoca2iea ot Fixiures ' ' i'O��— �
'" wwren �.r�. City of FtidIey
� `C' � � y i�Z � `=��z o� ~ � � • • �
0 1#� �_ � *�� a� � g�����+� � 7< 7"4' • N c�s c�cc. The undersigned hereby makes application for a permit for the vso:ic herei
:.� . � �n ;r o� �c � t� u�a uc7 . . . . . . . . ... . .
__ specitied, agreeing to do all work in strict accordance with the Cit� Ozdinar.ce
ge� and ruling of the Department o1 Buildings, and hereby declares that alI the tari
— '. and representations stated in this application are true and correct �
lst
tnd � lh-idleq� Mina l8._
3rd
Owner V %T�� U C� /"
4th Kind of Building ��o o�/•
' i'utu:� Cona�cf3oa Openi:sQs Connscsod aiih
, Soa�r � Used as ' �i � �� � a !� � � :
+ llcw Fixtur�, Clld 4P+nin9s � � , • � .
Gcros l / ,
� To be compleled about f�.— � L �.�r
�G , m �
PARTIAL RATE SCHEDULE est�m3c�a cosc, s
Oid--New. Building Permit PIo. Psrmi! 1Qa. �� �/
?LUMBING FIXTURE RATES: `NO. RATE TOTAL �� /�
Number Fixtures . . ....' . x 32.00 a___.,__�__.� Signed C�J� ��
... .,.. ... �
, ,.,�� �
Flature Fixture Opening . . . . . . . . . . . x 31.50 s ,. � gy / d P %� L u � d � � _
�y �- vaYs
New Fixture Old Opening. ....:... . x$1.50 i_-_..-.. Business Phune No s �
Catch Basin . . . . . . . . . . . : . . . :�. . . . x 53.25 � . .
Water Heater ;Up to 99.000 BTUt.... t x$3.00 $ �. �
:Vew Ground Run Qld Sldg. . . . .-. . . . —._,..._ x 33.25 $ ROUC3H �
%ixtric Wat�r iis�tss. . . . . . . . . � a2.00 = FINXL �9 - /G .. 75
�J18 FITTING FEEB: NO. RaTE TOTAL - _
lst 3 Fixtures • • • • • . • _.�....,. x 32.00 ; ' . - .
Additioaal Fixtures . ... . ..... . . .. . x y .75 �
Gas Range to 195�000 BTU .. . ... . . . ... x 55.00 � . .
AEpJ1TRS � 11LTERxTI02t8—Roi•s to Cod� ` , 54 State Surcharge .• � � "
. Description . . . . . . . . . . .. . . .. . . .... . . . . .. . . .. . .. . ... . .5 '
TOTAL l�EE i � ' � '
�
- SuBJECT � R �
City of Fridley ' 6 2 6 7
AT THE TOP OF THE TWINS B U I L D 1 N G P E R M 1 T
f
� ` RECEIPT NO.
� • COMMUNITY DEVEIOPMENT DIV. ��� O
� LV��'���
r � � PROTECTIVE INSPECTION SEC.
� _ �
� /'�'1 � CITV HALL FRIDIE� SSI32 NUMBER pEV. OATE PAGE OF APPROVEO BV
�----�• •'' b12-571-3450 9t0-F15 6/17/98 / /
108 ADDRESS 6281 Able Street NE
1 LEGAL �OT NO. BLOCK TRACT OF AODITION SEE ATTACMED
DESCR. IH,19 2 Moore Lake Highlands sHEE?
2 PROPERTY OWNEF MAIL A�DRESS ZIP PHONE
Hyvare 6281 Able Street NE 571-3025
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO.
Schoenborn Construction 5107 Drew Ave N, Brooklyn Center, MN 55429 533-9686
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PNONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION C� REPAIR O MOVE ❑ REMOVE
B DESCRIBE WOqK
Reroof House & Garage (24 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUL� ANO YOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WOHK IS COMMENCED. . NO. OWLG. UNITS OFFSTREET PARK{fJG
I HEREBY CERTIFV THAT I HAV� READ ANO EXAMINEO THIS APPUCATION 1 STALLS GAiiAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VAlUAT10N SURTAX
AN� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO @
WITH WHE7HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W2fOO1 �l.00
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMITFEE SACCHARGE
PROVISIONS OF ANY OTHE STATE OR LOCA� LAW REGU�ATING CON-
STRU R THE PERFO A E OF CO TRUCTIO� �74.75 Fire SC �Z.00
/ /+/�j PLAN CHECK FEE TOTAI FEE
l �% License SC $5.00 $82.75
- SIGNATUAEOFC N� TOAOAAUTMOpIZEDAGENT IOATEI WHEN PROPERL� UDATED THIS IS YOUR PERMIT
w
r
�_ SiGNATURE OF OWNEF Uf OVJNER BUILDE1ii �OATEi 8 G iNSP IFTE
NEW
ADDN
ALTER
[l
[l
[)
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
�� d0
Q �°�3�
ConstructionAddress: � � U � PjLS�-~ �I f �
Legal Description:
Owner Name & Address: '�►Z S N A- U�l- �L Te1. #,7 %/- 30�.5�
Contractor: IJ �(�� MN LTCENSE# �3Op3a,C�`7 Z
Address:�( � � -C�C.c� C� ,n �S. � Tel. # S�3—�t fo �,
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTIQN OF IMPROVEMENT
Length ��L`� Width �-j � Height �_ Sq. Ft. / d O
Length / 7 Width � Height ,_� Sq. Ft. 000
Length Width Hgt/Ground Sq. Ft.
� �` _ � ��-� °i�
Construction Type: ��e � � oT Estimated Cost: $ ��..�'t� ��� /
(Fee Schedule on Back)
Driveway Curb Cut.Width Needed: Ft. + 6 Ft = Ft x$ =$
DATE � r�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ l "7.�
$ .��D�
$ l<�Z�
$
$ S.-D�
$
$
$
$
�
� S
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Pemnit Valuation (1/lOth�)
Tel. �` �.33 —g% �
$.50/$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 [ ]
...•-
BUII..DING 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
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,041 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
, .
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000 �
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
0
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 pius $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW .
(Concrete Curb 5treets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus' 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
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 the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation oACe it has it has been constructed
will be required before proceeding with the framing.
r . ,
r r !�I ��� / . `�l �+� �� N � �tUl�% ;� (�7� ' ��N ,V � j % H-°`"t, r �.( �. `�IYI U� �/�/Jl
,,. , �"� ` -
� �� ��
�f �
� � ;
ITY OF FRIDIEY INSPECTION DIViSION � •
431 University Ave NE � �
ridley, MN 55432 APPl1CA710N �'OR POWER PLANTS AND 1�EATING� COOLING, VENTILATION�
63•572•3604 REFRIGERATION A�ID AIR CONDITtONING SYSTEMS AND DEVICES
RAiE SCNEDULE
esidential
Furnace Shelt and Duct Work, f3urner •
Aiso Reptacement Furnace
(Side Vent • Fill Out 8ack)
Gas Piping (Needed with new turnace,
but not replacement)
Gas Range
Gas Dryer
Rale
$ 30.00
$ 10.00
: $ 10.00
$ 10.00
TOTAL
$ �,�
$
$
�
"Air Conditioning • All Sizes $ 25.00 $
All OlhersJRe�airs & Aiterations (LIST ON BACK)
l% ol Value ot Appliance or Work $�
;ommerclai/Induslrial
1.25qo ol Value ol Appliance or Work
State 5urcharge
TOTAIFEE
MINIMUM FEE FOR ANY HEATING/COOLING/YENTIlATtON
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/4ir
"Air Conditioners can not be placed in a side yard without
written perrnission Irom adjoining properly owner.
Ettective On .lanuary 1, 2001
JOB ADDRESS — LP �-� l i� � L�e �f- I�I-� �
VWNtR 11-%V V � � r' � � 3�l VG(�f/ -� •:
6UILDiNG USE� AS Vl�'i '
ESTIMATEO COST ,%`� C�D � � pERMIT.NO. �
DESCRIPTION OF FURNACE AND OR BURN�R
No. of Heating Units�,_ Gircle One (Steam) (Hot Water) ( arm '
Trade ame_[� t1�..�1� Size No. 3g3;i�}-VU 9 i
B7U��.U.—��3 HP EpR
Fuei l� . t� • Totai Connected Load
Burner lrade Natne � Size No.
F3TU NP EOR ' �
$. 7he unctersigr►ed hereby malces application tor a permit tor the work herein
specilied agreeing to do all work in slrict accordance with the City Godes an
$ .50 rulings ot ihe 6uilding Division, and hereby decla�es that all the facts and
$�� represeniations stated in lhis applicalion are true and correct.
' �ATE �� � �� C�� �
HEATING CO '
Signed �
�
Anproved 6�
t�ACK SI�'
ANd COMBUST
HTQ. AlC ELECT. 1NC.
c:ENTRAL AV�. �I.E.
. �rcr�1, _ T EL # � � � �i"� r� 1-�(lc�-O�
Rough•In Dale Final Date ��-� C�
3� �ILLCD IN ON V�Ni
A1R VER{FICAt10N
�, VENT CONNECTOR5
�
�
r
COMMON VENT., VENT CONNECTOR AND COMBUSTtON AIR VERlFiCATiON
s VVhen ret�(acirt� an existinq furance, the undersigned hereby vertfies tfiat the
ventir�g has been examined and is free from rust, deterioration, obst�t�ctions,
and is securely supported and firestopped where required, Yes� No ()
The venting system is ptastirlPVC and meets ai( current codes and manufacturer
speci'�cations including sizing, length, number of elbows and termination. Yes (� Na ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifica�ons. This daes
include AGA-GAMA Category ! Centra! Fumace Venting Tables for fan
assis#ed and natural draft appliances.
The existin� combustion air is sized and insia((ed to meet the current codes
and cnartufadurers specificabcns. .
When required to install a new combustion air, it will be sized and ins�aqed
ta rr�eet the current codes and manufadurers speafications.
When inst�llinc a new venti�q svstem, the undersigned hereby verifies that
it is a listed assembly and meets the c�rrent codes and ma�ufacture�s
specifccaiions. Ti�is does inciude RGA-GAMA Category t Centrat Fumace
Venting Tables for fan assisted and natural draft appliances.
1s the cammon vent artd vent co�nedors s'rzed artd instaUed correctly after
an appliance has been removed from the comman vent and vented
separateiy as per current codes.
Yes � No ( )
Yes No ( ).
Yes �� No i )
Yes�) No ( )
I`
,
Yes ( No ( )
A�qiiance Tvpe and Size/Common Vent and Vent Connecto�lnfortnation
Appfiance #1 Type "'�U�YY��-Q. 8TU Irrput � ` fart Assis�ted or Nat_� ��- ,
Appliance #2 Type BTU (nput ` Fan Assisted or Nat _
Appliartce #3 Type BlU tnput � fan Assisted or Nat �„
Totat Appliances � Total Btu Input
Camrnon Vent Type Vent Height Diameter_ind�es
Apptiance #1 Vent Connectar Height ft l.ength �ft Diame#er .!n Typo-____,_
Apptiance #Z Uent Connector Height ft C.ength ft Oiameter . in Type _,____ �
Appiianc� #3 Vent Connedar Height „_ft Length ft Diameter,�in Type =
ALT�RATIONS: tDescribel � �r .
BWINE HTG. A!C ° ., tNC.
13562 CENTRAL AV�. N.E.
HEATtNG CO: N 5�3oa � _ . .
Signed By: e^' Date : C1—� t� �� �
�
._. i
�
HEATII�lG
a�R comm�iTioN�NG
AND ELECTRIC, INC.
ADDRESS Y►1 � C� V d.V -�.�
OCCUPANT �n �—'R�J �C 'S i �U. � �
HEATLOSS � D T TG.INST. �-?O �
SOLD BY v � .
Electrical Work By �:�— -� C..-�C..
TYPE OF HEAT GA FA_�, HW STE M SPACE HTR.
GA DESIGN
MAKE
Modei Z d
Serial �� f_�% �. 4 l �
INPUT Q"� �9•Bt7
CONTROLS
THERMOSTAT �_��� a Heat Plug
limit Se ' �
Fan Settin
Pilot Type
Pilot Make
Pilot Modei
Pilot Timing .?� S'.¢G .
l.W. Cut Off
Pressure Peraent COZ �
Input CFH Percent OZ �
StackTemp. ?i� PeroentCO
HOUSE HEATlNG TEST RECORD
APT. FLOOR CITYI �`� SUBURB
OWNER S �W�.��
INSTALLED BY SoliH1.[
Gas Line By S�.-::- °
UNIT HTR. _ OTHER
CONVERSION
Vent Size 1` ,
KIND OF LINER S12E NQNE
Oraft Hood Regulawr
Filters Size �%�C2�Y Number �
Chimney Locatlon Inside ,Outside
Chimney Consvuction C �..5 C �S
Smoke Bomb Wiring �/.�S
Draft Test Tag _
Door Pressure Lighting I�st.
Date Tested �— �'^
Company Tesung � ' �.
Name of Tester
Pressure Peroent COZ
Input CFH Percent OZ _
Stack Temp. Peroent CO_
�
_
CCIYOF
FR[DLEY
FRIDI.EY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FittDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 16, 2002
Ms. Bernice Hyvaze
6281 Able Street NE
Fridley, MN 55432
Re: Final Inspection at 6281 Ab1e Street NE
Contractor: Blaine Heating Air Cond Electric Inc.
Dear Ms. Hyvare:
A mechanical pemut was issued on October 1, 2001 to install a furnace at your address.
According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on
the work authorized by tlus pernut. As of this date the inspecdon has not been requested.
The pernut fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763j 572-3604.
DJ/mh