AF - 45902City of Fridley, 1Vlinn.
6431 University Ave. 1�. E., Minneapolis, Minn. 55432
BUILDING PERMI�
I�ate: — GPptPmber 1?i �_7�.
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Owaex: �bs?�._,_.DeGa�c�ne,�., Const. Builder ...Same_.... .__._....____._......._..._...-----•-------
,Address ._...Z9�4....E�a.s..�.�ive�,�toad_..N.E.__,�T, Ad�s _Same
LOCATION OF BUILDING
Na - b22LL__ Street ..�Al.clen_..�ela� I�I...E_._.___._.-----------=::_..__---------- Part of Lot _____._�._.__
Lot 1 Block _�_._?._.._. _.__.___.__.._._ Addition or Sub-Divisian _ A1 Rase Addition
Corner Lot ._ X�__ Inside Lot _...__..._._._.._____�..... Setback _...__...._G.Q.!.....____._ Sideyard _....__6.�. £� ._._........_._.._.___
,�e�e� IIevation � 823..b2R.___._ ___._.____ FJq(yfiA�+�o�►�,�e'�,���i/-__ 827,_10_1Kinimum .:___._._...._
Wye Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Tka 1 1 i mg _ Front ___�8 �_ Depth 26' 4�� Height ..._20.�_.___ Sq. Ft. --------•----..._ Cu. Ft ._._
Ga-� Front 22 � Depth 22 � Height •---10_�._...._ Sq. Ft. __..4�4' . cu. F� 4840'
Type of Construction _ F1.00d.. Frame . Es� Cost ...�9.z24�.__..____._......_ To be Completed _._...._6__months �
Stipulations: Provide a verifying survey before capping. Provide a ahard surface
driveway. Per Darrel, Front yard setback 40 feet.
WATER LOCATION: 67' ESE of Manhole� 33.3' West of Mai�hole
SEWER LOCATION: 4.5' S. of Manhole located center of curve (Inv. 823.63)
In consideration of the issuance to me of a perxnit to construci the building describ�d above, I agree ta do
'�he proposed work in accordance with the description above set forth and in com,pli�e with all provisions o!
C�dinances of the city of Fridley. (� �,� ,i-�� /��
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In consideration of the payment of a fee of $y.�.._QQ._..___, permit is hereby granted to_..._.De�ar�*� P�. �_�� t.
to construct the building or additio�n 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 sIl work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of
I�'ridley, Minnesota regarding location, construction, alteration, ma.intenance, repair and moving of buildingg
Syithin the city limits and this permit may be revoked a t any time upon violation of any of the provisions of said
oxdinancea
�• .__. Buildin8 It�spector
DARREL CLARK
NOTICE:
Thiz �permit doas not cover fhe construction, insta(fafion for wiring, plumbing, 9as heafing� sawer or water. Be sur� to s�s z
th� duilding inspector for separafe permits fo� these items.
APP�ICATION �OR R�SIDENTIAL, ��T�RI�TION,
OR AllDI��ON BUILD�NG P����
CITY OF FRIALEY, MINNESOTA
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OW�`i� � S NAME : ' � � ' � y � � C''� BUILDER : � �'- �C�� 'ti`' � i�% C 1�
t�DDRES S: �CJ ; r f � ADDRES S:
�4 : ? �,Z 2- � S TREET • %�% � �1.� �j,.{,1 � �� �� �
� : BLOCK : �- ADDITION t �' (` S" �
,. ,......
CORNER LOT i� INS IDE LOT : S ETBACK : SI DEY.l�T) i,,,,,,,,,,,��
Applicant attach to thia form ltao Certificates of Survey of Lot and pxo�c�s�d
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
�o Be Used As:
, , Front :
Depth• Height• �' '
- Square Feet: Cubic Feet:
' Front; �� Depth• Height:
Square Feet; Cubic Feet:
�pe qf Construction: Estimated Coet: $ � '� .�-' ... � : ..
. .. � ■�� I�I��R
�a Be Campleted: _
The undersigned hereby makea applicativn for a permit fbr tt�e .wq�k '��7�+��,�!
spec�,fied, agreeing to do all work in ettict accordance with the C�ty q�
F�i,dley Ordinances and rulinga of the Department of Buildings, 8na ���c�b�►
d�clares that all th ,facts aad representations stated in this appli��t��ot�,
are t�ue and �correct% /
�T$ ;
� SIGNATIJRE
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(See Reverae Side For Additional Info�tmation. ) `� / �� ------
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APPR�ation �O+' Povi►t�r Pta�M's dnd HsaNng. Cooling, Yentilat�e. R�ig�ra�ion aed
Air Condhioning SYstNns cind D��ric�s
PARTiAL RATE SCHEDULE
GRAYTTY WARM AIR: �� T��
lh�rnace SheU & Duct Work . . . . . . . . . . . . . . . =10.00 i
Replacement of F1u�nace . . 6.� �
Repairs & Alterations--up to =500.00 g.pp �___ _ ____
Repairs dc Alterations each add.:500.00 . 3.pp ;________._
MECH. W11RM 11Ilt
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I+ius►ace Shell d� DuM Work to 190,000 BTtJ . . . . . . . . . $10.00 ;_L�
each add. A0�000 BTU ............. ... .... .. 3.W i
Replacement of F1�rnace 6.00 E
Repairs d� A2terations--ap to ;500.00 6.00 �
Repairs & Alterations each add. :500.00 3.pp ;
STEAM or HOT WATER SYSTED[
�rnace She21 & Lines-b 400 sq. it. F.DR Steam 110.00 �_______
FLrnace Shell & Line-to 640 sq. ft. EDR Hot Water 20.00 $_.___
Each add. 200 sq. tt. EDR Steam �,00 �.__ _____
Each add. 320 sq. ft. EDR Hot Water 3.pp a--
OIL BIIRDiER-to 3 gal. per hour
over 3 gal. per hour-See Fee Schedule
GAS BURNER (up to 199,000 BTU)
over 199,000 BT[J See Fs� Sclt�dul�
GAS FITTING FEES:
lst 3 flxtures
Additional Fixtures
Gas Range to 199.000
AIR COIfDITIO�IItG
FAIt HEATI1fG SYSTEM
VE1tTILATIIfG SYSTEM
11LTERATIONB � AEPA1iM
ROU�3H
�u. 9-3-7�
6.00 �— —
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b.00 i�
NO RJ►TE � O�I.
- X� 200 E-�.---
_ x .�a s —
_ := b.0� ; _
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See FN seh�dnt�
TOTAI. FE8 ;._G.L=�G
(SiJR�HARGE $ _.50)
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n.pt. of �aq.. �.�.. eeo-�sa
.o�edidn �A �C/ r��%/h //��V [J//`/�' // /�1r�
City oi F�fdley:
The undersigned hereby makes application for a permit for the work hereir
specified, agreeing to do al1 work in strict accordance with the City Ordinance:
and ruling of the Department oi Buildings, and hereby declares that aI} t6e Lacts
and representations stated in this application are true and correet. ,
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owner _�! J_ � �?%CA C��,f %
Kind �f Building _____ ���/���
rJsed as . --- .��%C �i�j //C�G�
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Ta t�e completed about ___-_�Q'!. --- ��
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Estimated C�t, �__----- - . ��r _ --- ---
Old-� Building Permit No. —. P•rmit No. V
DBdCAIPTiOlf OF WOM
HEATING or PO R PL.ANTS--.Steam, Hot Water, arm Air No. /
Trade Name� �PhG�C"- Size No_ ��iv�/
Capacity.Lld�%�--�. FL E.D.R g� p
Total Connected Load �� Rind of P1u
BUItNER - T�ade Nam � Siu No
Capacity-.L`�—���, �'t. E.DR BTU �P
(REMARKf-OVER)
Sign�.� R�• WEL i'ER HEATING' (`�,'
4637 CNICAGO AVE,
gy '�n7{ EA t O' ! S
Buslnms P6oae No��`�
53-a�-s-915.51
City o�F FridteY
Appliccr��on I�or M�bi�q aad Gas RtfL�q ht�t
— .,.a...s�..�..�.... _ a.�c_ .e ae�.., r�.�. �ec-3+�o
�cscax�rao� o� �roas
��.Re K;�a a� �a� �t �txt�Y�� . " t«.� 6220 Alden Way NE
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s�o� l�t� c� . . . . . . . . . . . : =t.ao �_ .
lrev ?iad�e Old Op�nitr= . . . . . . . . . . x =1.5� i
Csteh Baalpr . . . . . . . . . . . . . : . . . . . . _ �',Yi i
Rater Ke�ter :Up to Yl.09a HTUf • • • • : =i.Ad �
Nnr Cro�md Rua dlt Htds: . . . . . . . . • : �3.SS f�
- i�retaie R�tarl6elrr . . . . . . . . . . . . . s �t00 t
Gwi tTlTDtG 1'ECf: � 1F�TC T�OTiL
liE i �ha�tes . . . • • . . . . . . . 1 z �t06� t, 2. 00
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1i�lfoOr l:sd■!s .. ............ s s 75 f
Q�t R�o�r b 2lRAAb Hi'i) . .... . . . ... : �ir.00 c
State Suraht=ge • $ .St1
acr�as f ac�u►no�er—a.� ,. c.r.
p�,Q�� Install. �l).G: S.L:gh:...=..........� 3•00
iatiL�lR . 0
c;a oc n�.�.:
Tht umdersi�ed her�y msl�es .ppYlcaiion tor a peraut tor tPfe e=�s Aceo �
specified� a�'eeini to do aII �aar� la strict �co�damee w�itA tix Q4 O��nancrr
and *ulint oi tAc Departa�t at Buildi�. ssd hereb� declarss t2►at dl 4Ac [sri=
and reDresentatloot atated in t!� apoiieatio� arc ttut �od torrcet
,� ,�, JUN 51973 � »_s -
�� John Pederson }
xind oi Huildi� Frame
Uxd as Res.
To n� �� ,e�,t 6/l0/ 73 I
fstimated Cost, t 10.00
Oid--iMe�?�iluildio� Pl�renit � ' !►�It �
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�, �dIL�GA�CO
H�si�a�s l�r�e �
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SUBJECT P
City of Fridley ° 3401
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � ECE�PT NO.
� ; y _����_ COMMUNITY DEVE�OPMENT DIV.
f � � PROTECTIVE INSPECTION SEC.
1 �
� � �/'��; � CITY HALL FRIDLEY 55432 NUMBER � REV. DATE PAGE OF APPHOVED BV
�"-'�' �� 612-560-3450
910-F15 3 4 76 � �
JOB ADDRESS
6220 Alden Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 1 2 p�]. RpS� AC1C�l't].Ori SHEET
2 PROPERTYOWNEA MAILADORESS ZIP PHONE
John Pedersen 6220 Alden Way N.E.
3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO.
Chuba & Yentsch 7939 Humboldt Avenue North, M ls.
4 ARCHtTECT OFl DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO.
6 USE Of BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 14' x 26' Addition to dwellin
9 CHANGE OP USE FROM TO
STIPULATIONS provide truss design. Comply with energy requirements.
SEPERA?E PERN9liS R�QU�RED FOR �fil�RtNE��
HEATING� PLU�1BlNG AND StGNS_
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� Fidl[te
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 ABANDONEO FOR A PERIOD OF 120 DAYS AT R^1 364
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHE HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �7 i SOO 3.75
DOES NO RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIO S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTI N R THE PERFORMAN,�E F CONSTFUCTION. $29•OO
' PLAN CHECK FEE TOTAL FEE
� �
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<�'� $32.75
SIG A7UFEOFCONi ACTOROqAUTHORIZEDAGENT � � tonre� �� HEN PROP LY VALIDATED 7HIS IS YO R PE IT
• - ' �) s-�( ��,.�` `'�
-- SiGNATU� OP OWNER IIF OWNER BUIlDER1 IDATEI BLDG. iNSP �` DATE
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Sl3RVEY F'OR, y, . �
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QEGARDNER REALTY� INC. . ,
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`WE H•EREBY CERTIFY THA7 ON 7HE �3TH DAY OF SEPTEMBER� �g7Z`,�;°;''Mf�� `
LOCJ1T�13 THE BUILD1Nf3 ON THE A60VE DESCRI6ED PROPERTY ANU '1"�iAT �
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THE ABOVE R£PRESENT'ATION IS TRUE AND CORRECT.
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OR AllllITION. BUILDIi�G P�RI�IIT
CITY OF FRIDLEY, h13NNESOTA •
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O�dN�R .
• ADDItES S:�=� �L._,I�iC1�l �t,'/� li ADDR�S S:'7 �/.3 �/ %� U l`'l %C�-/J�T 1 ��,
NO: . � � � O STREET : • � � /� �" /l� C,�� � 7 �
I�OT: •� BLOCIC: °� ADDT.TION: �
CORIv'ER LOT:_� INSIDE LOT: SETBACK: _ SZDLY�IP.D:
Applicant a.ttacl: �o this for:ra �•�o Certificates. �f Survey.of Lo� and.proposed
buildin; location drawn on these Certificates. _
HESCRIPTION OF BUILDING
•
To Be Used As : : � l L"'
/� � De th • � ��' iiei ht • �
/ '' �-/u;N� Fxont• p �-y- .g
. Square Feet : <',�L�iCubic . Feet : �� � �
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• B�S� �? �"'�� Front : l� Depth • Z� Height : g
.. _ Squaxe Feet; .�6 y Cubic Feet: Z 9� �-
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�pe� of � Cons truction : /�l :_ Estimated Cost : $ ��Q
To Be Completed: . �f;N� /;�7" �c�,��, . � . .
� The undersi�ned hexeby makes applicativn for a permit for the work herein
specified, abreein� to do all worlc in stiict accordance toith the City of
� Fxidlcy Ordinances and rulinss of tlie Department of Buildings, and her�by
� declares that all tlie iacts and representations stated in this application
are true and corrcct. �
� • ��i��i�-.� / �
• AATE. � ?G SIGN�iTURE: �
� ,. � �� �;���L �L�-' _
• (See �everse Side For Addit�onal Information.)� �j�,��,
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r•.Y.�:t�o,�.ti`«�a'y :� �wr.��4.v w ....�ca �' -'�r3 �� t� �,�,s, �eaw,a;.. y�e f�c Lcsc,r.arars�� C'�W....:L.�.,.�sti�r6L�.� `ts'a.:'v�t
,�{ �"f �+ C t�'':^ � �� �n.MiA .. Sr f^'r%� t S^' �l4.^. .
� d�"',i� @�L�a�. �a�Lvr.i..t���...y a.�i�<..r.�.n.,i.;+ w:Jrl L*r l�;',+Q�sv,�:t>
P�RTi�;,€. �T� ��i���JE?L�
GRAVT'i� .�tliR?4 A2R: 83.::a Ti3`?I4.L
R:zn�rc StrTI e'� I'iuM Pi''ork .. �10.00 3
Rr�lsc�rment of ��rr.sre �.pp $
F,�pair� & A�tc: a;.ons-- up to SSJ0.00 6 Op S
Repa:rs Lc Ai:Aratie^s each add. t504.Cd . 3� ;��
�ffZCH. 1�iAR�+I l�.�t
}lurac� S2:el1 ti hirt v'Vnr',c to 13�,040 BTU
�t3z add. 60,G'rJ4 B'N .
�F'atcrnes: of r lrn3ce
Rcgairs & A'te�-atiars--up to 5500.00
Rq',�.ain !,� AlteratiocLS each add. �5�?0.00
STEAM cr HO? i�+AFLR S78TE*�
��rr:acr 5hcil Sc Lzres---to 400 sa. ti �'.I?� Stearz
F�raace Sh�;l & L�ne,-•tc+ 64G sq ft. cDR Frot Water
Each add :00 sq. ft EnR S?eem
Each add. 320 sq. ft EDR Hot 'vPate:
.Sld o0 S
3.irJ ;
fi.90 S
0
6.40 ��
3.00 5
�: Q.�?
20 00
:i Ml
�•
3
�
S _
OIL SIIRF�R-to 3 gaI. per kour G.QO S.
over 3 gal. per hour-See iee Schedule
p0
!- GJ;.S StTR?:"�R (�p :o L�.O�F BTU) 8.� a-�
a�tx 2S`3.M�0 B'I'�J 3ae Fee f�tkod::.ls
G.t3 FITTINC _T'F,F.�: �40 R1ti1'� TOTAL
Ist 3 flxtures �._ z� �p0 S�
Add,:loaaT F7ztvres _._ x .78 S_._. _.
Gas Ran� tv I99.0+."� a$ d.� S
Ai�i �a�iliiQ�di.'�'
f�.� 1"y�2i: i 4� Q�� 3� 1Ar�ii
?E�'EZLw.Tt;"L'v 875:'"1�$
1tL's�.?."?'r'CF:3 '�r F.E'PJ�.:�S
xovax
�.��.�/, 3 - � %
State Surcharge � .50
^'
80� Feo �c�t�3s
�--.
'Ft�iAE. � ��
r�+�4. o� i3la,a, r''::�zv, :s�-3:�a
� �
�
V � i=
Ci2y o4 Frld:c7�:
The �:nder4;j{r.c+� hereb�� makes applicatio� for a q�rr:�it for the work t�e.-err
spec�fied agrcr:r.g ta dc ati w•ork �n s;rict accordar.ce with Lhe Ci:y Ord:s.anc�
�nd nt�:r,g of :he Depattm�nt of Fiu�l3ir.,�s, an3 hereby d�cls:�s thst z:7 :hr i:�Sf
and reur���vntatiur�s slatrd in tt�►s applicaUon a:r tn:e aad CarrecL.
Fridley, ;tSinn�d� � 18/,�, .
f?wner ��. 1ozaL,.t�
Kind of Buildiny .� ��►'� �
Used as . ��G��1„".d
To 1>e compieferf abeut � � �� ` `� -
pJ 9 �}. . �
Es!imated Cos� S � �(� .�• � d'[t�,�,a.ns..� C'-�•,,�. su,� aZ�O Ov� �Q�
Old-New. Building Prrntst No. -•-- •_ — F•rmit No.�/0� /J
�.�;:;.v�c1:r"'i IrJ' 3`i aF t`3�3�ii^s
HF.ATiNG or FO:'TER F'y�N'I4',r-SLe�s. Pet C'ater, Wxr�ca ASr-23o
`� �� 1
Tradr Ivame���`�.uee�c�C/,Rne�'�,�Size P10- � �" "�
Capacity, .--.---. ,_ Sq. 7!'t. F U.R��.� BTU HP
TotaI Connected Laad._l��Q Kf�ad ef F�x
BUF.I3EF. - 'IYm�ee Na� , Si:.t No
CaL*���Y � 3ct. Ft �:.D.R II1'U 8�
cr�moxaxs-corE�}
ti � �,i'� �_, ' �,� /. �-
i .�. .r.'/
r
.
. ���✓i�ic+"`� " _ � � 7 �' � .
��oZO �( �
ass :: '., a z �
HEAT��LOSS CALCULATIONS DEPARTMENT OP BUILDINGS FRIDLEY, MIN�i.
Weatherstrips A.S.H.V. . Conatruction No. I11511I8hOA
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How A�lied
Yes—No Yes—No 19�
FL� :;/ �. Room Length � Width /z. Height y FI.� Room Length Width Height
Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area
�Yidth Height No. ot Linea! ft. Ares Width Helsht No. ot L1net1 !G Araa
Na. ot pane o[ Dane lighta ot crack �Q. tt. No. ot yane ot pane Ilghb ot crack W. !t.
2 �;e 3� � l�i•G //•L
Coef.l Btu
Inhltration 1� ,
Glaaa
Exp. walt
Net exp. wall / 7
Int. wall
Ceiling
Floor
Tota! Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl.� � Room � Length Width /
Wi ws and oora—Crackage and Area
Wtdi.h Hel`ht No. ot Lineal ft. Area
No. ot pane ot Dane li[ht� ot crack �a. ft.
Infiltration
Glaaa
Exp. wall
Net exp. wall
Int. wall
Ceiling
�Floor
Total Btu.
�
Hcight
Coef.l Btu
ft. E.D.R. or aq. ina. W.A. Leader ares
9' Room ( Length Width
and Doors—Crackaee and Area
No. ot pane
�
In6ltration
Giaas
Exp. wall
Nec esp. wali
Int. wall
Ceiling
Floor
Tbtal Btu.
�
Coef.l Btu
Required aq. ft. E.D.R. or aq. ina. W.A. Leader area
�
In6ltration
Glass
Exp. wall
Net ezp. wall
Int. wall
Ceiling
Floor
Total Btu.
. ft. E.D.R. or aq. ina. W.A. I.eader aroa
Fl.l - _. Room ( Length Width
Windows and Doora—Crackagt and Area
Wldth Selsht No. of Lineal [t. A�sa
. o[ oana o[ nane I1�hU ot crack w. tt.
Glaaa
Exp. waq
Net ezp, wall
Int. wall
Ceiling
Floor
Total Btu.
Required aq. k. E.D.R. or aq. ina. W.A. Lesder area
Fl.� Room I Length Wi�h
Windowe and Doorr—Crackage and Ana
No. onan• of � n� Itthtt ot c�ack w.�tt.
Glass
E�cp. wall
Nec e:p. waq
Int. wall
Cei�ing
Floor
Total Btu.
h. E.D.R. or sq. ina. WA. I.eadu arsa
Btu
Btu
e__ _____
P��ge 1 of 4
�
EXTt'RlOR ENVP:I'�OPE 73VERAGE "U" COAIPL'T7ITIUN „�,yJ� f,�.�
� _._-__ y r GE,✓ � N � -
oc�r�t�� : nA 1 F
� .���c.,�-
_ c��.
szTr �r�D�ss: � � �'. � ��°� �' Pxoia�:
(:ONTRACTOR: ` `-- ,,�LL�' � �_.1..E ��� ��
�� �
Determine warking scivare footage of each
i3, G x 3'i�
].. Total ex��oseci wall area...... _��'G~.� sq. ft. x .17 = ,l� 3, �3
2. Toal roof/ceiling area ...... ��e � sq. ft. x .05 = /�� `L.
Tota1 exposed wall area abave floor =
a. Total. wa11. window area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �p�%, (� ,�fi. Z
b. '?'otal door area ...................................... ._._ D
c. To�al sliding g?-.ss daor ar�u ......................... .-..
d.. Total fireplace wall ar.ea ................ ........... � d,o� a.
e. Z'otal wa17. fr_amirig ai-ea (average 10%) . . . . . . . . . . . . . . . . . . .57. �
f . ToraZ rim joist area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �jl,�e"'.O o `�°
g. wall area above flo�r ..........................
h. wal.l area above floor .......................... ,�'-j %,
i. �aall area above �laor .............. ...........
j. wall a.rea above rloor ....................... ..
�rrx-��--- � >, aa
Total e::posed .foundation area = ��
k. Z'otal f�tzndation window area ..........................
�
l. Tota]_ riet toundation area above gracie ................. _� D
Determine "U" value of each wall segment
(e.g. window, dcor, each separate wall section)
a. �� y ��o�� . 36"" _ �.3 3 .00
b. .�o . X ,.U„ , 3 Q _ � �''a
C. ��, i X��,,,� o, � i� = G, i`�
d . _ `f� X „U,. D�/ % �i = - $'• o i
e, ��'�}, � g ��U" iCi�o�o = ��1%��%
f. �
g• � �
� u U,:
e
X ,.U„ , �� �_ - �z , 6G .3
h. X "U" _
i. ..�___..__--_______ � ��U�� _ _ � .:�
_ a y uUn _ _ _
� � ��u�� _
a.. X „u,� _
�. ....�......�:�:� ::............. ��a44� _ ��., �s�T
�
Zf item _;#3 is the same as,
or less than ite-m #1, you
h�ve met tlZe i.nt:erlt of
snc 60C�6 (c> z.
Exi�erior �nvelo�e Av�erag� "LI" Computation
'Potal exposed roof/ceiling a.rea =
Page 2 of 4
m. Total sY.ylight area ............................ _
n. Tota1 roof/ceiling f.raming area (average 10�)...
- -- —
o. Total net insulated roof/ceiling area...........
Determine "U" value £or e.ach roof/ceil.ing segment
m. ��i e% � ��U,� O<0-�� _ �%,, �1 ' Gr�'��'��� �,
n. x „U�� = G� , � ..,
. �
o. x ��U�� _ . i C�� ,
4 ........................... Total = ��
Tf total of ##4 is the same as, or Zess trian #2, you hav� met the intent of
S�sC 6006 (c) 1.
Alternate Building Envelope Design
To utiliz� the total envelope system method, the values establis}icd by the sur.i of
items #3 and #4 shall not be great�r than the sum of items #1 and #2.
�. + 2. _
3. + 4. _
WALL SECTION5
N�3�'E:: Use 10� of opaque wall area for
' f.rarne construction
F".� G . �� 3
_._ __._._..�.�.?,� .,s . -4 � ` � �� �.
� ,
, � o _ < <_�-
� � c
. . • �
r � - ' - t - � � �!; '
Paqe 3 of 4
Constructiaii R-Value
1. Interior air film 0.68
2. � ��S "� , �
3 . �''t, �` t,,n�.�,/ :,� p
4. -��"" L .2,a 6
5 . _"`°" �
6. ExL'eric�r air f ilm 0.17
Total � y—�,�'
K = D, // 1
1, Interior. air film 0.6$
2. i ' • y�
3 . /�. 0 �
4 . l, a�
5. ',�/
6. Exterior air film Q.17
Total ����
,�,�,5 D�WG
1, Interior. air film 0.68
2 . y " c�,��o �, Qq
3 . _ '�i �- _ �' ° �
4 . � �r,t...,,.� � �I
5.
6. Exterior air f ilm 0.17
Total � � G �
Lt. = d /' �
1. Interior air f. ilr� 0. 68
a. � � z'� dvLoG/�- J� z S�
3. / � y�
�. �—
5 . ;,
6. Exterior air film 0.17 .,3 9
. �69 �tal �, �,3 �P'�
� u = D,
, � � , r- . . � u
l-���f= ' � tj ' � . �
. .�sC�- � r i �� � . , ' , � , ,
rrf� , �' : - ' � .
:--- .
,
V �
^ t . 6 , ' � � �►1 =--
�- . , .--
��� : •` . • - . �i .= � � t
' �--- ` ' ' /(/ � .
I'IG. �69 " /' � ` � � ,:= " /�(
'. /C( t� ' •. tr --
. r' -_- • a� /f.! �
( f � � x�� _ �.� .r ��r
. . /� ( _ i r r _ ,,, _ �
. NOTr•.: Irrdicatc tyi,e, ��n�� �val.ue, cic�-i�2, a�id
placci��nt oi is�su.laL��an.
" , ROOF/CEILING
` .
-
Page 4 of �
Constructian R-Value
].. Interior air film 0.61
2 . /9. ,1`v
3.
4. Exterior air film (still) 0.61
Total � �� � Z
� `\\\V� �� ' �� �
. -%; �--� � � .
� . . � � � � . . � tt d,oyp�
Vent��i i3eat fiow
1 up
k'IG. ¢�5 � .
. �. � .. 1. Interior air film 0.61
• - - . � � 2.
7.ii1�! j.�.�.'•� !-_�' ti_'�l i'_��::[:�P�'.S� �.rS.'LS�'.l'^.�-�t. �T,C..� 1 .
- -- � �._..:_...�......_ i��r=--=--�t. 3.
/� , S 4. Exterior air film (still) 0.61
/ , " � i/.� � Total
:` � �7 3 �„ . � . . _
�
}:eaL- floc�� v}� . , •�vented
- •�T�'• �kh �� • • . � � 1. Insicle air film 0.61
� . �---�_�__ _� : : 5-- �.. 2
�
� � �. ,. � j e � � _t = >'i-�-�a��' 4 .
, ' � . ' n1 f%-0.S'.'��'- ,,.. • ' ^ =
�.�R,�t�,:;'.`�': ^� /��� 5. Outside air film 0.17
n i f 4. \'L'� '.�:�A' _--'•. '. ; . . � .. � '„ 1
�r�;,:^:-'`;.: ;i•.•:..:•• • Total
.� ��' J "—�±,� /—,�"i 'tl
., . • � r-
� _� .�,%`�- . �,I .
� ,��� � • Note: USe additional sheets if more space is
�� • needed for details and calculations
%� � . 2 ,' .
'!/ � - • .� . . •
�"� • h 0:?—PiT�'T"tr7 . ' : , �
. , . , . .� .
. � �tee�t � . , . _
, , . £iow u�r _ . • . ;
•):`7:t�. A7 � • • . : .
..,,�,�,.r
.,� .
CITY of FRIDLEY
f>431 LTaivessity Ave. N. E., Minneapolis 21, Mian.
PHONE:� E
STOP
REMARKS:
� , ,
��.Qci�2-�f [� o�
ADDRESS
rwrcprr!�rnA
DATE
,,x G ,,
� � �<:y '�
WORK
d
.
Si � �1, ,�1 �'"�.
,�,��+,o,F.�, iJ��o �',o
r, d F 2 �D ��� U/ FF Y !.t �.
' , , 1 �
; . ,� � � c -t_/ �'
�"�.�1
r
� � ./�
C
� -
SCHAFER'S SPECIALTIES MPLS.
� ��
.�' � '-
% .,�».._. _ . . . _ _. �;,
.� _ . �,a ,_., �
� a��
�; �m� . . �.
, � �, f
� July 18, 1977
�
`�
. , �'f:: � .,
Ci"�"1( C)F �RIDLIEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
.��
�
. `�
. �,�,�
�
�
Mr. Brian Pederson
7530 105th Avenue N.W.
Anoka, Mn. 55303
. �
l4� `
Re: 6220 Alden Way N.E. - Fireplace Defects
Dear Mr. Pederson:
7ELEPHONE ( 612)5?1-3450
0
I am contacting you directly in the matter of the fireplace construction
at 6220 Alden Way N.E. because we discussed it on the phone last week.
As you are aware, this particular fireplace brick faci.ng has separated
from the firebox and frame wall over 3/4 of an inch irL some places. The
second story face brick extends to the ceiling and appears to have "bowed"
due to excessive hsat.
We are contacting the homeowners, Mr. & Mrs. Peder.son, today and asking
that they not use their upstairs fireplace until it is repaired. The
present condition of �he fireplace brick makes it hazardous to fire and
life safety provisions of the Uniform Building Code.
�.
Please be advised that you, as the masonry contractor, are hereby required
to repair the face brick on this installation and return it to a safe and
functional appliance. I would suggest that replacing the face brick and
incorporating new brick ties or replacing only half (�) of the brick and
installing a mantle over the fireplace are acceptable alternatives. However,
considering the weight of masonry involved, I feel the latter alternative
may prove to be the most satisfactory to the homeowner and easier to
guarantee in the future.
Please contact me within 10 days and indicate the type and scheduling of
correc tive measures you plan to take. I feel a deadline of no later than
September 30th is appropriate due to the length of our long heating season
in Minnesota.
If you have any questions, please feel free to contact me at 571-3450.
Sin ly,
�
kON HOLDEN
Building Inspector
CC: Mr. & Mrs. John Pederson
Mr. Denni;s Chuba - Contractor
�.T
�°
� �� , _ � .
� �� �
,� �` �� �.. .�,��.��;�'
��`� ��'� TM � t
,��` �`,o ,f
:�� �� July 18, 1977
F�
�.
�,
;•^ � f'`
� �� �„ ;��.��r�
84�1 UNIVERSITY AVENUE N.E., FRIDLEY� MINNESOTA 55432
� Mr. & Mrs. John Pederson
�� ,
� 6220 Alden Way NE
Fridley, Mr�. 55432
Re: Use of Defective Fireplace at 6220 Alden Way NE
Dear Mr. & Mrs. Pederson:
TELEPHONE ( 812)571-3450
a
'Phis letter is to inform you that your fireplace is hazardous due to
faulty construction and should not be used until it is repaired. The
separ.ation of the face brick in your upstairs fireplace is enough to
allow dangeraus amounts of heat and fumes into the room if fired up.
0
IFm enclosing a copy of a letter to the masonry contractor who constructed
the fixepl.ace requireing that hP repair it within a reasonable time.
Please note that I've suggested a deadline of no later than September
30fih, 1977. If this presents some problem for you, please contact Mr.
Pederson at 421-3267 to make ather arrangements.
I've suggested an alternative "style" of fireplace which may }�e more
sound in this particular instance; namely replacing only half (�) of
the face brick and installing a mantle. This would reduce the strain on
the fzreplace due to the weight of the bricks and mortar. Our main
concern in making the repairs i.s that the fireplace is restored to a
safe condition for your family's use.
I also would like to formally apologize for my failure to meet you at
our appointed t�ne, Mrs. Pederson, and for the mix up in phone messages
here in our office. I'm sorry for any inconvenience this may have
�aused.
If you have any ques�ions, please feel free to contact me at 571-3450.
Sincerely,
RON HOLDEN
Building Inspector
CC: Mr. Darrel Clark, Com¢nunity Development Adm.
Mr. Dennis Chuba - Contractor
s.
sus�ecr PER
City of Fridley � 6 71
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
� �
, � RECEIPT NO.
� • COMMUNITY DEVE�OPMENT DIV. �y Q (�
r �~ PROTECTIVE INSPECTION SEC. � V p C7
� �
� �
i
�l � �'��l � CITY HALL FRIOLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
`���'�i �.J
612-571-3450 9�0-F15 8/9/82 / /
JOB ADDRESS
6220 Alden Way N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 2 A1 Rpse Addition SHEET
2 PROPEFTYOWNER MAILADDRESS ZIP PHONE
John Pederson 6220 Alden Wa N.E. Fridley 55432 571-6488
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO.
li 0 Palomino Dr. A le Valle 55124 454-4448
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LtCENSE N0.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUI�DING •
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
� � n existin deck.
9 CHANGE QF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMI7S ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WQpd FYdX[lE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R--1
ANY 71ME 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 3 300.00 51.65
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFM1T FEE SAC CHARGE .
PROVISIONS OF ANY THER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TH PFy1�FORMANCE OF CONSTRUCTION. 44. SO
/� LAN CHECKFEE TOTALFEE
l._ � ��� � ..�� 57.28
Si Nr+ FcoN'Rnc oa n TH RIZEDAGE T IDATEI �. � WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
SiGNATUFEOFOWNERUFOWNERBUILDER� IDATEI � BLDG iNSP DP7E
_ _ __ _ __ _
� _ _. __ _�_ _.._.,_.._._.� -- � - � ----- _---# ; ; , . ,_ _ ' c �. � � �y�;
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DESCRIPTION; LOT �� BIOCK Z� AL ROSE ADDITION. ,�
WE H•FREBY CERTiFY 7HAT ON THE �3TH DAY OF SEPTEMBER� �97Z� N►E '
1OC11TED TNE BUILD1Nti OP1 T�tE A80YE DE5CR16ED PROPERTY AND THAT ,'
�� TME ABOVE REPRESEN7ATION IS TRUE AND CORRECT.
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CITY OF FRIDLCY Effective Aug. 1, 1981
APPLICAT1R�l FOft RfSIDCF1TI11L 6UlLDIilG PCRiiITS
(t�c��, Alterations, AddiLions, or Repairs)
� /I1 �%�.' ._�.i.., /�%.� ! i �.
�� '
, ._/' � ��' i ��_,�_�
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STJtI�TrT NO: � O
STTtEET:
t3UI LDER
AOD1tCSS
TEL t10:
C0115t1"UCt10� LOCdt10[t
IAT: HLOC7C : ]1DAITION :
Corner Lot: � Insii3e Lot: SetbacY.: Sideyards:
Ap�licant attach to t)�is fona two Certificates of Survey of lot and
pzoposed building �ocation drawn on certificates to scale.
���SQ� DESCRIPTIOi� OF C01lSTRUCTIO�i
' c�+� C2�`�f! J f�� Front: �C% ` Depth: �C� � Heiqht: �eZ- /
�� N'✓i�r�'R Square �`eet: �Q t�ibic Feet:
. Front: DePth; Height:
Squar.e Feet: Q�bic I'eet:
2a � x C� .3i�► = 3�a� � �� 3� s �
Rype of Cor,struction : �� `�Q Estimated Cost: �
ZU Be Wr.�pleted: ,,,�0 ��'L��`=�`.
Alt. A Alt. B
Proposed Drive�ray Width If New Opening Is Desired: $� $
, SE� RiVER�E SIDE OF SHEET
Tiie un3ersigned hereby ma3:e� application for a perrait fcr the »erk herein specified,
ngreeinq to co ,all work ir, strict accerdance r�ith the City of Fridley Ordinances and
ruling� of the Deik�rtzn�nt of Duildings, and hereby declares that all the facts and
re�resentatiens stated in this application are tzue correct. �
D.�T�• a , � SIGNATI3Iit:
Stipulations:
P
P.C,
�ly. �'d�
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2nd
3rd
9th
(R) = Future Connection Opening
{+►) = New Fixture, Old Opening .
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
u x w
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+� o, u+
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1� 1� N N U1 W �'.
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RATE SCNEDULE
PLUMBING FIXTURE RATES: `N0:
Effective Aug. 1, 1981
Water Job Address
Heater
Department of Buildings
City of Fridley �`•
as lec Tel. N571-3450
The undersigned hereby make�appllcation f� a�permit for the work herein
specified ac�xeeing to �d all w�rk in�'st�i�eC`�accordance with the City Codes
and rulings bf ,the Depgrtment,:�of B� �nqs, and hereby declares that all
the facts and representations�s�a4'Eed in this application are true and correct
„�<'s''� .FridleY. Mn. ,.J� ��) , 19�
s
i '"'A " �' J� `
owrr�R ` <r�,/�YJ/ti-YI A Jl' -GJ � f�'�-.. ,_'
with Sewer
Wa ter
's
RATE TOT/!
�
New Fixtures - L $ 5.00`
Future Fixtures ���""�.�
Old Opening, New Fixture g—�-
Beer Dispenser �_ g ."�q�pp
Blow Off Basin -'$ 5.00
��
Catch Basin r� g 5.00
Rain Water Leader $ 5.00
Hydraulfc Valve S 5.00
Sump or Receiving Tank �*r� S 5.00
Water Treating Appliance � $ 7.00
Hot Water Heater %�r _� g 5.00
Gas Range / $ 10.00
Gas Dryer l g 10.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1$ of Value of Fixture or Appliance
State Surcharge
Reinspection Fee $
($15,00) TOTAL FEE
S
$
S
S
S
S
S
S
$
$�
S
S
SJ�'�
$_�S
rr
. KIND OF N
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�,�' TO BE COMPL�TED
.rt' �
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�� �LD - NEW BU�LD
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ROUGH INSP.
Date
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FINAL INSP.
Date
APPROVAL FOR PERMIT Y-�/
�
PIINIPIUM FEE FOR ANX PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
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CITY OF FRIDLEY
APPLICATION FOR PWMBING AND �AS FITTING PERMIT
a� a �ro u . K d Water
u�i a� �-�i � m H��a � Q y a w a w �g Heater
•.+ m ro a m a+ a� �, .c a E w�¢ 'a'' H
H W u! R �•i .0 � R ; U•a 8.0 U W
� r� � 3 A w m $ v aa � 3 c� � u� o as lec
y � a �ro .� ro s+ o.c .� ro ro y ro � u
lst
2nd
3rd �
4th
(R) = Future Connection Opening Connected with Sewer
(*) � New Fixture, Old Opening Water
RATE.SCHEDULE
PLUMBING FIXTURE RATES: N0. RATE TOTAL
New Fixtures�
Future Fixtures
Old Opening, NeW FiYture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain water Leader
Hydraulic-Valve
Sump or Receivinq Tank
Water Treatinq Appliance
Hot Water Heater
Gas Range
Gas Dryer
—�
�
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
li of Value of Fixture or Appliance
Reinspection Fee S
($15.00)
g 5.00
$ 3.50
S 1.50
S 9.00
$ 5. 00
g 5.00
S 5. 00
S 5.00
S 5.00
$ 7.00
g 5.00
g 10.00
g 10.00
State Surcharqe
TOTAL FEE
s l6�00
s
S
S
S
S
S
S
S
$
$ �� Ud
S
S
S
S .50
S��
Effective Aug. 1, 1981
�
Job Address `� Z� � c�
Department of Buildinqs
City of Fridley
Tel. M571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. ��Z, '� , 19��
�-^1 .
dWNER
KIND OF
USED AS
�
TO BE COMPLETED ASOUT �7j �� O
ESTIMATED COST ��[�,
OLD - NEW BUILDING PERMIT NO. PERMIT NO. V� D�'7�
� _l����_.
�
�
ROUGH INSP.
nate
FINAL INSP. �' p20 ' �
Date
APPRONAL FOR PERMIT ���
!1INIMUM FEE FOR ANY PLUMBIN(
PLUS THE $.50 ST?�TE 5URCHAR(
sue�ecr ER 0.
City of Fridley 19 3 4 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
t
� . R�
� �
� • COMMUNITY DEVELOPMENT DIV. � ��
r � ~ � PROTECTIVE INSPECTION SEC. �
� ,
� � �"'1 � CITY HALL FRIOLE� 55432 NUMBER � REV. DATE � PAGE OF APPFOVED BV �
�----'�•' ,.� 612-571-3450 910-F15 3/21/88 � �
JOB ADDRESS 6220 Alden Way N. E.
t LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCF. ]. 2 AZ ROSe �C�L].'tlOII SHEET
2 PROPERTY OWNER MAtL ADDRESS ZIP PHONE
John Pedersen 6220 Alden Way N.E. 571-6488
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDFiESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS Of WORK
❑ NEW 0 ADDITION �7 ALTERATION ❑ REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Install bas�nent whirlpool
9 CHANGE OF USE FROM TO
STIPULATIONS
IN�PAR E .
RIN�� y P RMITS
FA T�N�. P� M U�RED F�
BI�� A� S
��
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF /20 DAYS AT
ANY TIME AFTEfI 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 Z.SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S3 �OOO �
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. $3S.SO
PLAN CHECKFEE TOTALFEE
r $40 .00
si�Nat R OFC RAUTHOR�ZEDAGENi ioniE�.'' WHEN PROPER Y V D TED T IS IS YOUR P RMIT
P � 0
SiG TURE OF OW EA iIF O�NNER BU�LDEAI iDATE� �D �NSP � E .
NEw [ l
ADDN. [ J
ALTER. [ ]
Construct3on Addr�
City of Fridley Effective 4/1/86
� R-1 AND R-2 �
Building Permit Application
Legal Description: G�Bf i t 1'�\D�K2— A-L j�r�Si� '��F-rf dtT1D1l
Owner Name & Address: �-�-��^�-���(l�� � -� Tel. � �--�1.�0
Contraetors � ►9�v1�- � Tel. #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construetion drawn on it to seale.
DESCRIPTION OF IMPROYEMENT
Length Width Height
Length Width Height
Length Width H t/Ground
►,�c ^►�I I rA 7�� ;a 1 c�FS�( i�i�►-, 4�-, �f�( ( �`7n1 A-r �
Corner Lot [� Inside Lot [] Ft. Yd. Setback
Type of Construction:
Approx. Completion Date: 2 LU-e-E.l`C.•
Proposed Driveway Width If New Opening Is Desired:
DATE: �"`���$� APPLICANT:
Permit Fee $ c�c� �5 d
Plan Check $
State Surcharge $ /. S D
SAC Charge $
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ G O
� -J�
._..
r, . %� � ' J �
IISE ONLY
Sq. Ft.
Sq. Ft.
S Ft. -�---
��A-� L .r�
Side Yard Setback
Estimated Cost: $ ��lr11�7
Alt. A Alt B
$ $
See Baek Page for Explanation
Tel . # �``7/ "� �i��
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$ 550 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
f .. .
��
�`
sue�ecr PER T NQ,�
c�ty of Fridley 2� 17 2
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
� � RECEI .
� � COMMUNITY DEVELOPMENT DIV.
, . ��s-�Y
� LV �'���
r � � PROTECTIVE INSPECTION SEC.
� , /"'1 � CITY HALL FRIOLE� 55432 NUMBER REV. DATE PAGE Of APPROVED B�
�"'"�'� �'' 612-571-3450 910-F15 12/11/91 / /
JOB ADDRESS 6220 Alden Wa17 NE
t LEGAL LOT NO. BLOCK TRAC7 OR ADDITION SEE ATTACHED
DESCR. 1 2 p� RpS2 Addition SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
John Pederson 6220 Alden Wa NE 571�6488
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Scott Constxuction 3359 - 36th_Ave S, P�ipls, MN 55406 721-3311
4 ARCHITECT OR DEStGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z!P PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Repair watez damaged sub�ioox & sheetrock
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBiNG, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHOFIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTpUCTION
OR WORK IS SUSPENDED OR ABANDONED FOfi A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UN�TS OFFSTREET PARKING
I HEF;EBY CERTIFV 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 OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�- /OQO $ a 5Q
DOES NOT PRESUME TO GIVE AUTHOAITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHAiiGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $25eOQ Fire SC $1.eOO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$26,50
SIGNATURE OF CON'RACTOR OA AUTHORIZED AGENT IDATE� NIH PROP L AT THIS IS YOUR PERMIT
. ,, . . �/ 2-/��'L-_
SIGNATUREOF OWNER�IF OWNERBUIIDER� IDATEI iNSP �1F7E
�W [ �
ADDN � J
�.'rER [ J
Cansvuction Address:
e
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
� � � � " /� �� � � �(� 'F
Effective 1/1/9]
I.egal Descri�ion: .
OwneT Name dt Address: �� � � �� � � �; s � � Tel. � s �/ - � Y � d�
Contractor: � c �°� C 6 n s��% ��� T�U "' Tel. � 7 z../ - 3 3 l/
Address: 3 3 S � - 3 � � /� U � . � c; .
Attach to this application, � Ce,rdficate of Survey of the
lot, with the proposed oonsdvction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Lengt� Widih Hgti.Cnound
� �, 7��� 2 S o iv �t,c�3 �C�a � , �t-���'7-�e
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot ( l Inside Lot t) Ft. Yd Setback Side Yard Setbacks
'Ij►pe of Construcdon: �2 A�n �. Estimated Cost: S/�o �� �
Approx. Completion Date:
�a.. ��
nri�eway c� c�c w�a� x�a: Fc. + _ �c x s = s
�
DATE: %� ii 9 APPLICANT: � � � - Tel. � 7 �-- / -3 3 /j
Permit Fee S �� . �'�
Fire Surcharge S . S�
State Surcharge S �' � �
SAC Charge S
Driveway Fscrow S
Park Fee S
Sewer Main Cbarge S
TOTAL S � �' � ��
d�
STIPULAI'IONS: ___ _..___�__---j -----l..�
��� � �
•�rr � .
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
S.SO/51,000 Valuation
5650 per SAC Unit
Alt. "A' ar Alt. "B" Above
Fee Determined by EnBincering
Agreement Necessaiy I I Not Necessary I l
y� . _
CITY OF FRIDLEY INSPECTION DIViSiON
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572�3604 REFRIGERATION AND AIR �ONDlTIONING SYSTEMS AND DEVICES
RATESCHEDULE
Residential
Furnace Sheil and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fiil Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning • All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1 Jo of Value of Appliance or Work
Commercial/Industrial
1.25°�0 of Value of Appliance or Work
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
$ 25.00 $ as • °o
$
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATINGlCOOLING/VCNTILATION
REFRIGERATION/AIR CONDITIONING PERMIT 1S $25 00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yar'd without
written permission from adjoining property owner.
JOB ADDRESS b a Z
OWNER � ���
Effective On January 1, 2000
e
BUILDING USED AS ���-e �,,; Y� G
ESTIMATED COST ��UO . n O PERMIT N0. �L/�C >
DESCRIPTION OF FURNACE AND OR BURNER
No, of Heating Units Circle One (Steam} (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ ,50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ � 5O River City Sheet Metal, Inc.
9928 Bluebird St. N.1I�ATE �I —►1 -- o t�
HEATING COCoOn Rapids, MN 55433
�642 a�c
Signed ����� TEL #
�
Approved By �_ Rough•In Date
Final Date ���`/�� %
__.__ _.
CITY OF FRIDLEY INSPECTION DIViSION �� �=���=' Effective On January 1, 1998
6431 University Ave NE �� �+
Fridley, MN 55432 APPLICA;TI�N FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS � �� � L�! ��..� l,�J /..�-�
RATE SCHEDULE '
Residential
Furnace Shell and Duct Wor1c, Burne� -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs 8� Afterations (LIST ON BACI�
1% of Value of Appliance or Work
Commercial/I ndustrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $ �.v�
$10.00 $
$ i 0.00 $
$10.00 $
$ 25.00
State Surcharge
TOTAL FEE
/i:.�� ��;3
.
The undersigned hereby makes application for a permit forthe work herein
specified agreeing to do all work in strict accordance with the City Codes and
rulings ot the Building Division, and hereby declares that ali the facts and
representations stated in this application are true and correct.
7 � 2 � ,19�
�--`�� �� �,z.��� ^.
OWNER ;J o �-�✓ � : _ _ �
BUILDING USED AS �c� e � � .+� �,.,
E�TIMATED COST �v�, "% PERMIT N0. / �� �
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units / Circle One (Steam) (Hot Wat (Warm Air '
Trade Name ��� rf�� Size No. N�-� �
B� HP� EDR
$ Fuel ,nJ � , 7otal Connected Load
$ .50 Burner Trade Name
BTU
$ �3�,�.S�v
MINIMUM FEE FOR ANY HEATING/COOLJNGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
- REINSPECTION FEE $42.00/Hr
*Air Condftioners can not be placed in a side yard without
written permission from adjoining property cwner.
Size No.
I-iP
�
HEATING CAMPANY_L��Y�� G�,v �,cJ `��
Signed � � Tel No. yZi—e��Y�
_� _ `
Approved By Rough-In Date Final Date�� �"�'(` (� �-(� -01
FILL OUT BACK SIDE R STACK VERIFlCATION ON
REPtACEMENT FURN CE
�
CgIlVINEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
L Has been carefully examined Yes ( f�i�io O
2. Is free from rust or deterioration
3. Has no foreign objects lodged within
4. Is securely supported .
5. Ivieets a,ll s��*�s��nt C�e rPquiremer�ts f�r si?e
and total BTU's connected
:�
7.
�
Has total heating BTU's of �' 2" S`' � u�
All other BTU's �� ��
TOTAL BTU's � 0 �. f ��,'
Has a liner been provided for water heater
Has combustion air been provided for water heater
Remarks: .
List ALTERATIONS Bei.ng_Done:
HEATING CO:
Signed By:
Date:
�Lr� �'-���-�� �, i-��
.� �,' � f' �'
Yes ( �No ( )
Yes (�' No ( )
Yes ( �No ( )
Yes (�' No ( )
Yes ( } No ( )
Yes ( �' No ( )
�
_
C[TY'OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 12, 2001
John Pedersen
6220 A1den Way NE
Fridley, MN 55432
Re: Final Inspection at 6220 Alden Way NE
Contractor: Lakeland North Heating
Dear Mr. Pedersen:
A mechanical permit was issued on July 20, 2000 for the installation �bf a furnace at your
address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a final
inspection shall be performed on the mechanical permit. As of this date no inspection
has been called for.
The permit fee that was paid covers the inspector's time to check to make sure the
appliance was installed correctly. We also need to check for the installation of
combustion air, vent and connector sizing:
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, your permit will expire and any inspections on this installation will require
a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Si
DAV ��NSEN
Build' �g�lnspector
DJ/mh
ADDRESS
PIN
LEGAL DESC
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s�z-36u4 r�ax:
: 6220 ALDEN WAY NE
: 153024430010
: AL ROSE ADD
: LOT 1 BLOCK 2
PERMIT TYPE : SEWER/WATER REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER LINE REPAIR
571-1"liS7
PERMIT O.: 2004-01073
DATE ISSUED: 07/09/2004
VALUATION .
NOTE: CALL 763-572-3560 FOR INSPECTION AFTER LJNCOVERING THE LINE, BEFORE ANY REPAIRS ARE MADE,
AND AGAIN WHEN THE REPAIR IS MADE BUT BEFORE RECOVERING THE LINE. REPAIR WATER LINE.
APPLICANT
FIGNAR BILL PLUMBING
2844 JOHNSON ST NE
MINNEAPOLIS, MN 55418-
(612) 788-4288
OWNER
PEDERSEN JOHN P& SHIRLEY A
6220 ALDEN WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of war�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulat�' con ction or the performance of construction.
Annlicaht\ Date
: �: � �i�i�a�- � �,:a�
WATER LINE REPAIR/RELOCATION
TOTAL
PAID WITH CHECK # 21437
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
40.00
40.00
3uilding
rnspections
763-572-3604
�ATE ( 0 �
;[TE ADDRESS � LDr�-� �
i'HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
• - . , c". ,, 1
❑ OWNER
ADDRESS: Ce��� ��,� lnX��/ CTTY,
PHONE: � ,3 .5�� � � S� �
Permit No.:
Received By: �
Date Rec'd: " � �?
�AT��s y.��
SUBMIT A COPY OF STATE LICENSE il r�C ��,� �7' i� � ` EXP DATE 3� �I — � 7
YOUR STATE LICENSE ADDRESS: -�F e� 4 ,�5� f'� �wt CITY STATFrJ?+�IPS S� v3
WITH APPLICATION pHQNE Gs /—� �' �/:2 Sv FAX
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
�QSINGLE FAMILY/Nl
❑ TWO FAMILY/NEW
❑ BASEMENT FINISH
❑ DECK
�
DESCRIBE WORK BEING
SIZE OR IMPROVEMENT
ROOFIlVG
NUMBER OF SQUARES ,��
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
� Viny1
❑ Afuminum
❑ Other
��GE/SHED
OOF
SIDING
❑ SWIMMINGPO�
O ADDITION
PAIIt �ODELING
��� ��4j
LENGTH
�❑ USE ONLY
HO�USE & GARAGE
❑ ATI'ACHED GARAGE
❑ DETACHED GARAGE
ClSoffit
D Trim
❑ Fascia
WINDOWS
IN EXISTING OPENINC`rS ❑Yes CMo LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRTBE SIZE OF
OPENING CIiANGES 8c
❑ DRAM TILE
❑ OTHER
WIDTH HEIGHT
BASEMENT REMODELING SUBIvIIT:
l. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES Sl3BMIT:
l. Site Plan/Survey showing the exisdng structures
and proposed project
2. Two sets of construction pians
3. Energy Calculatiotu
TYPE OF WII�IDOW TO BE INSTALLED NUMBER OF WINDOWS i
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINCryTHE 1997 U.B.0 FEE SCHEDULE)
Permit Fee
Plan Review
Fire Surchazge
Surcharge
License Surchazge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Tatat Due
JOB VALUATION
$
$ ��
$ � .'1 3 _
$ � .(�� _
$
$
$
$
$
.--
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the tota.l job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
lations
I hereby apply for a building permit and I aclrnowledge 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 s without a permit; that the work will be in accordance with the approved
plan in the case of all work f plans.
SIGNATURE OF APPLICANT NAMF�/tl �+� �//� �DATE ��� � � v �
Building BUI�,pING Permit No.: `�C U l
Ins ections �'
1� RESIDENTIAL A�'PLICATION Received By:
763-572-3604 CITY OF FRIDLEY nat���t:
763-502-4977 FAX EFFECTIVE 1-1-2010
DATE 3'�l' ib YOUR E-MAIL ADDRESS GC�Qi�eti'L S�t��c.t'S CGv�iSSyc.�c.T�o.� L. Q T�Aat_. CAri.
SITEADDRESS Lov�-;2U Ati-A�� WR''�' r
THIS APPLICANT IS: ❑ OWNER �,iCONTRACTOR
PROPERTY OWNER/ NAME: a'C�1r� Q���t�S��
TENANT ADDRESS: (i�?-O A-W�3N 'W LLY CITY Frl,O`aY STATE�i�I ZIP .5��131
PHONE:
CONTRACTOR NAME: C�P1+�-1'l S�Ya,a+c,GS CE,r►sr�wc,t�or� l.l..L. -�A T�'�+��Q
SUBMIT A COPY OF STATE LICENSE #�b �U_i `i EXP DATE 'S' 31 � I O
YOUR STATE LICENSE � (
AND CEIZTIFICATE OF ADDRESS: �'; �O S� t`116{�.T W GPrC.�1 S r!u �+ CITY ST ``-�rtri,.�C.,S STATE �NZIP s�
INSURANCE PHONE I�---910 -.� � 7 FAX
PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE � ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FIAIISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER.
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
� MAINTENANCElREPAIR �REMODELING
DESCRIBE WORKBEING DONE: R�'M�D1aG> ha A"N .(��iTH
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT
ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES ❑ HOUSE & GARAGE
1. Existing Floor Pian
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 ADDIT[ONS. & PORCHES SUBMIT:
0 Aluminum ❑ Trim 1. Site Pian/Survey showing the existing structures
❑ Other ❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTII3G OPENINGS ❑Yes ONo LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE S7TCKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL N'L1;5 AKN; liASL�'U VN VALUA"1'IUN, 1NCLUll1NG "1'HE CUS"T UN' LAKUK ANll MA"l LKIALJ:
(USING THE 1997 U.B.0 FEE SCHEDULE)
AL JOB VALUATION $ "7�� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Bscrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �53•�S•
S 99.�
$ 7 .f�;7 .
$ 3� 6T�
$ .� . oe�
$
$
$
$
$
$ z�� • � �
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)
$2100 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary (
Make checks pavable to: Citv of Fridley
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
Attach
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 1 work which requires review and approval of plans.
SIGNANRE OF APPLICANT ��X� y�� PRINT NAME L Q'r � w� P DATE �'Q - I O
_ _ _
Building PLUMBING Pe�it Ivo.: ' �
Inspections RESIDENTIAL APPLICATION Received By: ri�
763-572-3604 CITY OF FRIDLEY Dat��'�d:�A� � �
763-502-4977 FAX EFFECTIVE 1-1-20]0
DATE �J �-S � YOUR E-MAIL ADDRESS IA � 1 L ��/ l.�O �Ll� � � 17 � . � �� ( L . c � �
SIT'E ADDRESS �i �- �`� � f C�� (�%J4i�
THIS APPLICANT IS: ❑ OWNER
PROPERTY
OWNER/
TENANT
NAME: ��_�•
ADDRESS: ,G�%�-J i�'le�e'.r/l C��4✓ CITY �/�<'�I
PHONE: ��� '��- `J �i �c� 5�i S l
STATE�"''lI ZIP S S �J3L
CONTRACTOR NAME: �O(7L� tn-il.� y�%L�
SUBMIT A COPY OF STATE LICENSE # � O� S �M EXP DATE � Z 3� l zo ��
YOURSTATE
LICENSE, BOND AND STATE BOND # 2 G- t o 5:� 6�-6�d EXP DATE �a-� 3 I J 2D�0
CERTIFICATE OF ADDRESS: �� 3 S I SS '� G- ^� ^�"J CtTY Rf}.a'rS STATE P1 �% ZIP SS O
INSURANCE pHONE b I Z - �- ( � -- � O �i ( FAX �o / � - � `� 1 �=� O I C( .
PERMIT TYPE
TYPE OF WORK: � � NEW
FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
❑ REPLACEMENT
DETAILED DESCRIl'TION OF WORK �I ✓w�6 � Fo2 a�tr(r} �2 � �u a �� ' Rw �- ��� � � �+►e-- �
� �,n1 1G —� 1,�Jit S v� o'�" Ven�e L —
FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$� — —
BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING
�BATHTUB _ GAS PIPING (NEED CITY L1C) SWIMMING POOL _ WATER SOFTNER ($35)
CLOTHES WASHER KITCHEN SINK �WATER CLOSET BACKFLOW PREV. ($15)
DISHWASHER J LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATTON
— WATER METER _ OT}iER
7'HIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT'IL 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 Fridiey 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 w�hich requires review and approval of plans.
SIGNANRE OF APPLICANT
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
1'b z'S t'O
Building
Inspections
763-572-3604
763-502-4977 F
DATE
SITE ADDRES _(
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
�
NAME:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-2010
C] OWNER
E-MAIL
eiTv
PermitNo.: '� 1 " r�`l
Received By: �L
Dat���eA�d 0
CONTRACTOR COMPANY NAME: � �
SUBMIT A COPY OF CONTACT PERSON: �
YOUR STATE STATE LICENSE # EXP DATE
LICENSE WITH ADDRESS:�r�3 G��� N A�� CITY%'�'%�%�� STAT�/zN�IP.
APPLICATION pHONE�(' "Z �Yo`zOg�_ FAX��o� O� �'��/�o
PERMIT TYPE �GLE FAMILY ' O TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW ❑ REPLACEMENT ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
+� �
�S%!�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HAI�IDBOOK.
Equipmentlnstalled MFG: ____��`�_v MODEL: SIZEBTU
MFG: � MODEL: �f�-b,--„�`-_./L�1 SIZEIBTU
MFG: MODEL: S�ZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEJOVEN $10.00
lAIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
�BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00
�CHIMNEY LINER $10.00 'GAS DRYER $10.00 _Pfa6L HEATER $35.00
DUCT WORK $]0.00 �GAS PIPING $10.00 �VENT'ILATOR $15.00 ,... i
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNT[L PROCESSED
I hereby apply for a building permit and I acknowledge that t ation above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City ri ley and ith the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and _r '_,__nQt to s rt without a permit; that the work will be in accordance with the
approved plan in the case of a u es r' and a oval of plans.
SIGNATURE OF APPLICA , PRTNT NAM�_�����/�%1�� DATE 02
A'
DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977