AF - 35903City of Fridley, Minn.
BUILDING PERMIT
N° 5902
�
Date: .......�... �./....�.. .`..�_�.P---�
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Owner: .--��--�---........_.L....�••L•-.--- •----...------- �---•-•-�--- �- -. Euilder ._. ......
Address .......................................��-•-�-•------.....................................................---..._...- ....... Address
--��----•-��-------- ............................_ ---...- ............---......------�---................_... �- -- � ...
�,• � OC BUILDING
�� �..0 Street .. -.. _ _.... ... - - Part -----�----�--�---�- ............._...--
No. ------ .. ......... _ ...... . ...... ....1.- -•• - � --� -- --- - -------�-�-- ._. .
Lot ....._..��...._ ................. Block -----....._ ....-�--�-�--------.._.........--.. Addition or Sub-Divis'o ........... .---- )-/--�-�-�.`,i-�! ... -� ..
Corner Lot --�- --•--.........-•-•---_ Inside Lot --��-.1�........--�--�-�-- - Setback _.....x�....�-�------�--- Sid - ....-. je.iR+.. .-�t---�-�--..1--'..f.._. �........------ ---- -..
Sewer Elevation .--•-- .............-•--•-•-_---._--•--.._--..---•-------.._..---•-_--.._...._........_........ Foundation Elevation
DESCRIPTION OF BUILDING
To Used a • �
-- -- -- . Front �l�i_ Depth .��.. Height ..�f.�.. Sq. F't. ..�..�.�0 Cu. FL���`.L�
...._--------•-�-•--_..._._.._....._....�Fro t•---_.......--•---_ Depth _.__.----��-- H i ht ....._...... Sq. Ft. .--��---....._...._.. Cu. F� ._-•--••..---�----•
Type of Construction _. ....---- •- -. ._ _.......-•--- Est. Cost _.��5�/._..� o 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 forth and in compliance with all provisions of
ordinances of the city of Fridley.
...!1......_...__..__.._____.___
In consideration of the payment of a fee of $.�_'_.u/"'�......_._, 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
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
o dinance�, city limits and this permit may be revoked at an�e upon vi�ati� of any of the provisions of said
.w/ 1
Bufiding Inspector
NOTICE:
This psrmit does not eover �hs constroetion, installation for wiring, plumbing, gas heafing, sews� or water. B� sur� to see
fhs Building inspeetor for ssparats p�rmitt for th�s� ihms.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Buildar � ��-�
Address Address
LOCATION OF BUILDING
No. �j� j'�' Street �:�>- i ���� Part of Lot ,
Lot�_Block �i Addition or Subdivision � �
Corner Lot Inside Lot_� �' Setback ��� � Side-Yard ?l� �f��,.�-c��
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location 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 a!1 work in strict accordance with the City of
Fradley 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 �� SIGNATURE �
(Schedule of Fee Costs can be found on the Reverse Side).
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BUILDING PERMIT F$E SCHEDiTLE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
in� building or structure, or for any alterations or repairs Co any existing
building or structure, upon application therefor, 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 such permit for the erection of any fire-proof building, other
than a garage� warehouse, factory or grain elevator, or for the erection of
any fire-proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubfcal contents.
2.2. For any such permit for the erection of any fire-proof garage, warehouse,
iactory or grain elevator, or for the erection of any fire-proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feeC, classified as °1fireproof" by Section 502 of
the Minneapolis Building Code.
F?OUS�S
2.3. For any such permit for the erection of any non-fireproof building other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
eact► one thousand cubic feet.
GARAGFS
2.4. For any such permit for the erection vf any non-fireprooF garage,
warehouse, factory or grain elevator, or for the erection of any non-fireproof
addition, for similar occupancy, to any existing building or for each such
building or addition - ninety cents ($0.90) for e2ch on� Chousand cu'�ic feet
or f�action thereof, in the cubical contents th2reof caith a minimum of $4.00.
For the purpose of computing fees for building permits, the cubica�. contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inches below the floor line of the
basement or cellar to the average height of the up�er surface or to the
average height of the roof surface of.the main gable of a pitched roof.
2.5. For repairs or aZterations to an existing structure, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
th�reof in the cost of all proposed work.
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00.
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���, � ,�N D E R S O N • • • �ui�a�er . . .
C U S T O M B U! L T H O M E S
LIGHT COMMERCIAL BUILDING
8413 CENTER DRIVE • MINNEAPOLIS 21, MINNESOTA • PHONE 784-7520
-','-,^ M17' 1 i. , l y h'"l_
Conceil of rridley
6431 Universit�T Avenue Northeast
Minneapc;lis 21, I'-!innesota
�ear Courcil P2emb��rs:
In my reauest to move my hnase, from
1225 I�:ississippi Street P�ortheast, to Lot 3 Block 3,
'�'haffers Sub Division. In request b,y the Building Board
I will supply Two Hundred Lollars, (9�200.00� escrow and there
is the fcllowing thir�s I am �oir.g to do to this house.
l. Rer.00fin� and change roof line.
2. Add on.e bedroom
3. Completely redecorate whole hnuse.
4. '�iring a,nd plumbin� will be meet by �ity �ode.
�rlYien the house is set down on the new foundation, it s:�a.11
be brou;ht up to co�e in every respect.
Yours very truly
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D. L. A1�TDERSON
6061 Woody Lane I". E.
I�Iinneapo?_is 21, riinn.
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City of Fridley, Min.n.
� ����� PERIVIIT
N° 590�
Date: .���."...�...�I.---�.. 4Y....._..s�.'"..----------�------.......--_....._
Owner: ......__...---- ------....---� -�--...... ...- �-- •---��--�--_......--- �-•-------�
Address----------�� ..................................----------�---------..._.......----...._.......... --�---�--�---..._..... Address
.��+ � 1��J_�...�_.¢._..`..00 . ._.-- -. .... F„�UILDING
No. - ---.. „y� .._ Street . . . ��...l...--��-- -....... Part o --�--�----- --�- -_........._...... - ..............�--�--•�--•-----��--�----
• :C
Lot ....._....1��1_---•---_....---. Block ....._..__�...._ ............._..�"Addition or Sub-Divi�iori -.--. --- •- --... .. . - �.�.----.�..._.....t.....
i- �r- r
Corner Lot --�------��-----._........ Inside Lot ....._�r ---�-----�--�-••--�--�------ Setback ---�--�.� V---�--........ Side .- .....-�-- �---�-----.,��..--------�-------
Sewer Elevation .-.-•---....._....-•---.--.--...--------_--.--..._.._...._......._...._..---..-•----_..--.--. Foundation Elevation
DESCRIPTION OF BUILDING
T U .
. _ .. _.... Front pL.(Q._.. Depth �� v Height .!_..`_L�. Sq. Ft�.�..f....�-- Cu. Ft�l.._�
..---_....-•---�--._............_._ .. .............. Fro t_.._........-•-••--- Depth _----_....._. Height _-- - Sq. Ft. ....._..--•--•-�---- Cu. F� ._.._..._.._...._..
. �
Type of Construction9����!��!!� ..._.. Est. Cost l�.i►'G�./_ ............._........ 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 the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
.....!l...._...._.__...___..._.._._.�._.�
In consideration of the payment of a fee of $..,C..Ll. v , 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
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked a t any time upon violation of any of the provisions of said
ordinances. /'1 w /i
Inspector
NOTICE:
This permit doss not eover fhs eonstruction, installation fo� wiring, plumbing, gas hsafieg, sewer or water. Be surs to sN
th� Building Insp�ctor for ssparete psrmits for th�s� it�ms.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No. Street Part of Lot
Lot Elock AddiCion or Subdivision
Corner Lot Inside Lot" Setback Side-Yard
SE[+IER ELEVATION FOUNDATION EI,EVATION
Applicant attach to this form Ztiao Certificatea of Survey of Lot and proposed
building location drawn on �hese Certificates.
To be used as:
DESCRIPTION OF BUILDING
3
l�ront Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Eatimated 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.
DATE SIGNATURE��'� _- ��.�,�J..� � �
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(Schedule of Fee Coats can be found on the Reverse Side).
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BUILDING PERMIT FEE SCHEDi]LE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
in� building or structure, or for any alterations or repairs to any existing
l�uilding or structure, upon application therefor, require the payrnent by the
applicant for such permit of fees to the amount herein below set forth and
in tlie manner herein provided to-wit:
2.1. For any such permit for the erecCion of any fire-proof building, other
than a garage� warehouse, factory or grain elevator, or for the erection of
any fire-proof addition, for similar occupancy, to any existing.building
shall be at the rate af $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire-proof garage, warehouse,
factory or grain elevator, or for the erection of any fire-proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as °1fireproof" by Section 502 of
the Minneapolis Building Code.
HOUS�S
2.3. For any such permit for the erection of any non-fireproof building other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non-fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non-firegraof
addition, for similar occupancy, to any existing building or for each such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof caith a minimum of $4.00,
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area 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 or alterations to an existing structure, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all p.r.oposed work.
2.6. In no case shall the fee charged for any permit as set forth in
Section 2 be less than $4.00.
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City of f�ridley
Ap�licatian for P"lumbing and Gas Fi�ting Pern�it
Depl. of Bldgs. Phone SU 4-747
DESCRIPTION OF WORK � � � �
Number, Kind and Location of Fixtures Location
F y U' WATER HTR.
� W � = VI Y Z � � Z = Z 2 (� = � �
J
�' O Z H m uj Y '^ Q?� 3 O<<�� O� Q a�< < a i N GAS ELEC.
3 U � o F�- m v� 3� o�, u=i � � � U m < 3 U' < U' � U' O
Base
t
lst
2nd
3rd
4th ---1—
• Future Connection Openings
* New FixYure, Old Openings
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number F`ixtures ......
Future FYxture Opening ................
New Fixture Old Opening ..............
Catch Basin .... . . ...................
Water Heater (Up to 200,000 BTU) . . . . . .
New Ground Run Old Bldg. . . . . . . . . .
Sewer �
Cesspool �
N� RATE TOTAL
�5 x $1.50 $—,� O U
x 1.20 $—
x 1.00 $
x 3.25 $
x 2.00 $
x 3.25 $
GAS FITTING FEE3: NO. RATE TOTAL
lst 3 Fixtures .......................... x $1.50 $
Additional Fixtures . . .. . ..... .... ... ... x .50 $
Gas Range to 200,000 BTiT .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer !o Code
Description .... ..................................$
TOTAL �EE $ ' v v
City of F'ridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and herPby declares that all the faci
and representations stated in this application,_ are true and correct.
Fridley,
Owner /�-� �
Kind of Building v
Used as
To be completed about
��,��
�/l�
Estimated Cost, $
Old ew. Building Permit
ROUGH
FINAL
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By
Business Phone No.�
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Application for Power Plants and Heating� Cooting. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . .
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
R.epairs & Alterations each add. �500.00 . . . . . . . . . . . . . . .
MECH. WARM AIR
Furnace Shell & Duct Work to 1?A,000 BT[T . . . . . . . . . . . .
each add. 60,000 BTU .......... ... ....... .. .
Replacement of �rnace ...................
Repairs & Alterations—up to $500.00 . . .. . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .
RATE TOTAL
8.00 �
5.00 �
5.00 $
2.50 $
8.00 $ @�Q�
2.00 �
5.00 $
5.00 $
2.50 $
3TEAM or HOT WATER SY3TEM
Ftzrnace Shell & Lines—to 400 sq. ft. EDR Steam . 8.00 $
Furnace Shell & Line—to 640 sq. ft. EBR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
C,�L BURNER—to 3 gal. per hour . . . . . . . . . . .
' over 3 gal. per hour—See Fee Schedule
1
G;AS BURNER (up to 400,000 BTU) . . . . . . . . .
5.00 $
5.00 $ ��
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ..................... .�_ x $1.50 $�
Additional Fixtures . ............... x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING �
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE �� �4� _ `
ROUGH
FINAL
Depi. of Bldgs. Phone SU 4-7470
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 Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
✓
Kind of
Used as
To be completed about v 1�
Estimated Cost, $
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Old-�Building Permit No. �� oo Permit No. ��Z �� �
DESCRIPTION OF WORK
HEATING or POWER PI.ANTS�team, Hot Water, Warm '—No.�_
Trade Name�// ,f � Size No.
Capacity Sq. Ft. E.D.R. BTLT H.P.
Total Connected Load Kind of Fue
BURNER — Trade Name r Size No.���_
Capacity Sq. Ft. E.D.R.� ���'�� BTLT H,P.
(REMARKS—OVER)
�{`w<`.r�;i�s� a z 2M
SUBURBAN HEATING & SNEET METAI
8419 CENTER DRIVE li. E.
Signed
,
sy
Business Phone No. �
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HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows DooTS Reference Out. Wall Int. Wal! Ceiling Roof F7oor • d
e No e No 19�. o Z _ Q
Fl.� Room � Length �� Width Height �" FI. Room L.ength l Width Q/ Height� /
Windows and oors—Crackage and Area Windows and Doors—Crackage and Area J3
\Vldth Hefght No. o[ Llneal ft. Area Wldth Height No. o[ Llneal tt. A�ea
No. ot vane of Dane lights of crack eq. ft. � No. ol Dane o[ Dane IlBhte of crack s4. tt.
� � �� O Y
3�0" 6 �`� . , D �� ���
.�
2 � Coef. Btu Coef. Btu
Infiltration ,O �O In6ltration �',. '�-D �"�
Glass
Exp. wall �Z
Net exp. wall Gf �
Int. wall
Ceiling � �Q
Floor
Total Bcu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area •�
F7.� Room � Length � r Width Q� Height /
Windows and Doors—Crackage and Area
Wfdth Helght No. o[ Ltneal ft. Area '
No. of pana o[ pane IfgDte ot crack �a. ft.
� � �
Coef. Btu
Infiltration , �
Glass
Exp. wall ip
Net exp. wall � Z Q
Int. wall
Cei�ing GJ �
Floor
Total Btu.
Required sq, ft. E.D.R. or sq. ins. W.A. L.eader area
Fl. Room � Length Width �
indows and Doors—Crackag and Area
Wldth Helght No. ot Llneal tt. Area
No.�, ot pane o[ pane , Ilghts ot cnck ep. it._
Glaas
Eap. wall
Net eap. wall
Int. wall
Ceiling
Floor
II Total Btu. �
��
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �
Fl. Room I L.ength ' � Width / Height /
►ndows and Doors—Crackage and Area —�O /
Wldth He18ht No. ot Llneal ft. Area
No. �o[ pane o[ pane 116hts ot crack eQ. ft.
�
��
Coef. Btu
In6ltration �, `�,Q �' �p
� Glasa
Exp. wall
�� Net eap. wall
Int. wall
�7� Cei�ing
Floor
� Total Btu.
�j
Coef. Btu
Infiltration �
Glass —j �p
Exp. wall
Nec exp. wall �/ �,p
Int. wall
Ceiling �3
Floor
Tbcal Bcu.
Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area
/ I
ZO I
`�
IRequired sq. ft. E.D.R. or sq. ins. W.A. L.eader area
i �
� Fl. Room I Length / Width / Height /
indows and Doors—Crackage and Area
Wldth He1Qht No. of Llneal tt. Area
No. o[ pane ot pan Ilght• ot crack �Q. [t.
1 ��`l �.- � 1�1. 7 5?, 9 �,
,
.�—
Coef. Btu
In6ltration
Glass
Eip. wall
Net exp. wall
Int. wall
Cei�ing
Floor
Total Btu.
IRequired sq. ft. E.D.R. o� sq. ins. WA. Leader area
r�
s�e�ecr PER
City of Fridley 2 9408
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
r
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• COMMUNI7Y OEVELOPMENT DIV.
r � y � PROTECTIVE INSPECTION SEC. ,� ��'� �
� � �
l_--_ �'��'��;'; CITY MALL FRIDLE� SS�3I NUMBEp REV OA�E PAGE OF ACPROVED 8►
L l` 612-571-3450 910-F15 5/6/99 � /
JOB ADORESS 7550 Able Street NE
t LEGAL LOT NO. BLOCK TFACT OR AODITION SEE AT7ACHED
oesca. 3 3 Shaffer's Subdivision 4�1 SHEET
2 PFOPERTY OWNEFi MAI� ADORES$ ZIP PHONE
David Lawson 7550 Able Street NE
3 CONTRACTOR MAIL ADDiiESS 21P PHONE LICENSE NO
Four Season Roofing & Remodeling 7930 University Ave NE, Fridley, MN 55432
� ARCHITECT OR DESIGNER MAII. AOOi;ESS ZIP PNONE LICENSE NO
795-9410 20138780
S ENGINEER MAII ADDFiESS ZIP PHONE IICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION OX REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof House (17 Sq) Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
TYPEOFCONST OCCUPANCVGROUP OCCUPANCVlOAO
SEPARATE PERMITS ARE REDUIRED FOR ELECTHICAL, PLUMBING. MEATING.
VENTI�ATING OR Alq CONDITIONING
TMIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT
AUTMORIZED IS NOT COMMENCEO WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OFfSTREET PARKING
I HEREBV CERTIFV THAT I HAVE AEAD AND EXAMINEO THIS APP�ICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VA�UATION SURTAX
AND ORDINANCES GOVEANING TMIS TVPE Of WORK WI�� BE COMPLIED
WITH WHETHER SPECIFIEO HEREIN OR NOT THE GRANTiNG OF A PERMIT 1 456 . �3
DOES NO1 PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CNARGE
PROVISIONS Of ANV OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION Of7 THE CERfORMANCE OF CONSTRUCTION ��F8.5� Fire SC �I.�F6
,� � PLAN CHECK fEE TOTA E
����1 ! � Li $5.0 $55.69
S�GN4 UAEO�CON'FACTOQOQAUT OA�2EDsGENT iO�TEi ME P O VALIOA �IS IS V,Qllil P�'PMI
�,�� I
S�Gaa7UAEO�OwtiEA���OWtiEABU�LDER� iD�TEi OG �ti5� ri��E
NEW [ ] Effective 1 / 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION , I��
11�1
���-� I
ConstructionAddress: 7 S� �}� �-� S�� `
Legal Description:
Owner Name & Address: +� /�J �� L�,��„s,� ? SS� �� L� ST Tel. #
Contractor: c p� �'�,,�So.v 5 -�o o� �,� �.�d�-� �2 ,o�E-.U�/G MN LICENSE #
Address: � �/'3 o t� PJ ► V�� � � 1-�-/ /� � E �, �. Tel. # 6( 2- ?4 �- 4' Lf l o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
o�R: R �� � �-�-a � s �- � � � � o ,
Construction Type:
Driveway Curb Cut Width Needed:
Estimated Cost: $��'� �7 �S�
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$
_ $
DATE: � APPLICANT: � Tel. #�� J� i q s—`��F(�
Permit Fee
Fire Surchazge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ ��.�� Fee Schedule on Reverse Side
$ , (p .001 of Permit Valuation (1 / l Oth %)
$ $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ � . b� $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
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
$100,001 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
$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 plus $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 �rst $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 Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "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 $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minunum 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 once it has it has been constructed
will be required before proceeding with the framing.
� -,�d'Il,Zo
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 1999
6431 University Ave NE
Fridley, MN 55432 AI�PLICATION FOR POWER PLAiVTS AND HEATENG, COOLING, VENTILATION,
572-3604 REFRIGEFu4TION AND AIR CONDITIONIN�a SYSTEMS AND DEVICES � �� �
�: � .�� � �i��� s
RATE SCHEDULE
Residerrtial
Fumace Shell and Duct Work, Bumer —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Plping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All `�, thers/Repairs & Alterations (LIST ON BACI�
1�
191► of Value of Appliance or Wor1c
�
Commercial/I ndustrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.C�0 $ �'c ' ��
^, .�?C
$10.G0 $
$10:00 $
$10.00 $
$ 25:C0 $
$.
$
State Surcharge
TOTAL FEE
$ .50
$ � � �, ��
MINIMUM FEE FOR ANY HEATING/COOUNGNENTlLATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permisslon from adjoining property owner.
JOB ADDRESS_ _ . _ _ . _ __ _ _ _
Th� undersigned hereby makes application for a permit for the work herei�i
sp�,�cified agreeing to do all work in st�ict accordance with the City Codes and
rulings of the Building Division, and h�reby declares that all the facts and
representations stated in this application are true and correct.
.� .-;�2 '? - r i ,1998
OWNER
BUILDING USED AS
E��TIMATED COST y >_ PERMIT N0. �,�(�� ��
DESCRIPTION OF FUHNACE AND OR BURNER
-,�,
Nc. of Heating Units I Circle One (Steam) (Hot Water) aRn Air '
Trade Name Size No. _ C; ��ld 7D
BTU 1�' �DU HP EDR
Fuel -� Total C�nn�cted Load
�
B4rner Trade Name �.L'�; ��r�= Size No.
BTU �D.i>�>U � HP EDR
�
FiEATING COMPANY `'`��"a�!'1�1C �-l�t�TtnlC� & Al�i CC�ID�tlf�lt���i�-` hr
Signed BSr"� � Tel No. �'�Ql— �ODD
.�j'!"1,/jL
C�
A�proved By Rough—In C)ate Final Date �� �� J
SEDGWICK HEATING & AIR CONDITIONIR�G Cb. HEATING JOB NO.� ����
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECORD
ADDRESS �_ '�� � � `V S 'J ' " �
OCCUPANT ���� �� ��� � �H'1
SOLD BY --_s � Gp4 w•-- k
MAKE � � Y ti^ �
SERIAL NO. r�� �� � / 3 3 3�
THERMOSTAT ��`Y� �V `�
VALVE II�Y�'=-�I
LIMIT �Nh�T
LIMIT SETTING �• }� tU'
FAN SETTING �'�C�
PILOT TYPE /" �GZ �!'�L
IGNITION MODEL I! r ��^"�
PILOT TIMING f.� � t �}r' L
PRESSURE �'S^ w• L� PERCENT CO2 /
INPUT CFH � � PERCENT OZ �
STACK TEMP. ��D `' PERCENT CO b
FORM 235 (REV. 11/89) �
CITY ��"���y
OWNER s`•n'''�
INSTALLED BY 5 � �+'G
MODEL �7% C �T V (}�7'O 7 �
INPUT (9 6/OUO
,f 4
VENT SIZE
TYPE OF LINER ��`�'"'�
LINER SIZE f ry
FILTERS: SIZE �b X.15^� � NUMBER �
WIRING I�4t%�5��'1
TEST TAG �
LIGHTING INST. �`
DATE TESTED S - a��J�S
COMPANY TESTING st��W� I(
NAME OF TESTER �j�
FORM DISTRIBUTION: WHITE COPY - JOB FILE VELLOW COPV - CIN
0
° - ���.��
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridiey, MN 55432 ApPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONINV SYSTEMS AND DEVICES
RATE SCHEDULE
Reside�ial
Furnace Shell and Duct Work, Bumer —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Plpfng (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
A�I Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Com mercial/I ndustrial
1.25� of Value of Appliance or Work
Rate
$ 30.OD $
$10.40 $
Effective On January 1, 1999
JOBADDRESS `l�.�G ��,�.� ,,(l� � �
The undersigned hereby makes application for a pertnit forthe work herein
TOTAL sp�.�cified agreeing to do all wo�C in strict accordance with the City Codes and
rulings of the Building Division, and hareby declares that all the facts and
re��resentations stated in this application are true and correct.
� - . �= ��'� ,1998
$10.u0 $
$10,G0 $
$ 25.00 $ , S.G�U
State Surcharge
TOTAL FEE
Bl,`ILDING USED AS b�/'��/���
ESTIMATED COSTv � OS� � PERMIT N0. .� j'
� � i
DESCRIPTION OF FUFtNACE AND OR BURNER
$ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
TrG�de Name Size No.
BTU HP EDR
$ Fu��l Total Cann�cted Load
$ .50
$ : S. ��
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
' REINSPECTION FEE $42.00/Hr
�*Air Conditioners can not be placed in a side yard witho�t
, written permisslon from adjoining properry owner.
Burner Trade Name Size No.
BTU HP EDR
`���i{i"�'� a,-� �
HEATING COMPANY
Signed By Tef No. '
Approved By Rough—In Date Final Date �D '
FOR ST�