AF - 45058�ity of Fridley, �!Zinn.
BUILDI�IG PE��MIT
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Corner Lot ...___ Instde Lot ' Set�ack ..,,�� ._._._ SfdeYard , '�`. °�' �`
Sewer Elevation _ _ Y Fpun�aatla�t -Elevatiaai ��� �� �,�,� �
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, Ia co�si8erat%n of the is�uance ta t►�e af a permit to consfxuct �Ethe bwiidiaS �bied a� � a�1l�':
e
� PrpPased work in accx�rdance with the d�script4� abov� set forth and �ts compti�taee �tlt t�l ', �. #
t�rdinances ot the dty of Fridiey. . .
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In consideratioa o! the payment of a fee of �.. .._._., permi ere gran ..._ ,.
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to c�oa�struct the buildfng ocr addition as described above. This t is gt�ptt�d l�
the express c�tdition that thepersan to whan ft 5� granter3 and i�is a�en#s, esm� ���- e�'�de �g '�� ;.
�}one in, around and upori said tiuiliing, or any �art thereof, shali conf�m in s�epacb. �► t� ._ aq� "
Frtcuey, Minneeota res�►B �►ti�, cwnstruction, ;alter�tion. mair►tenamo�, rs�s;r s� m� �[ ;,.
�vithin the dty ]irnits a�cl this permit maY be r�,woked at any ttpaa► vi o! aa�► qt tbe �` ` :
ordinances. • �e � ' �ry,��
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Au Mii� 4ap�elor fe� ap�rat� pp�Ns for tlaa I�aer . , '.
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APPLICATIODI FOR BUILDING PERNIIT
CITY OF 1'RIDLEX, ARI1�iT�TESdI'A
Owner ` s Name 1�-t v R�"tT "�, iZ ! c:, iG s c, N Bu ilder S� M� ______
Address (0 3 b � �, B�E S i,�, '�. Address ___r___ 5��
LOCATION OF SUIT�DING
No.��i � 3treet �,� �(�,,,_„��„�.- Part of Lot
�����,
Lot `� Block ��- Addition or Subdivision_____
�d�_-�..2�
Corner Lot Tnside Lot Setback,�Side-Yard �
SEVTER ELEVATION FOUNDATIOriT ELEVATION �
Apglicant attach to th 3s form Certificate of Survey of Zot and
,proposed building 3.ocation.
DESCRIPTI�N OF BUILDING
To be used aso
� �
,�,����'Z'� �ront �� epth C� Height � �
� �
✓` Sq. Ft. �� � Cu. Ft. �ZGs (o ?�a
__.,�' r—
'� Front Dep�h Height
Sq. Ft. Cu. Ft.
Type of Construction ��,.�A,� _ Estimated Cos� �/� d c��_
-�`�
To be Completed
The undersigned here'�y makes application for a permit tor the work
herein specified, agLeeing to do all work in strict accordance with
the City of Friclley Ordinances and ruling of the Department of Huild-
ings, and hereby cieclaxes that all the facts and �epresentations
stated in this apnlication are true and correct.
DATE :�� f �� �--� SIGNATURE ,r,�,;�����.%r� kZ����
(Sch`dule of Fee Costs can be found on the Reverse Sidej.
� ' A . - � - . , .. . .
HARVEY A. CARTWRIGHT
ANOKA GOUNTY SURVEYS
HENNEPIN COUNTY SURVEVS
MINNEAPOLIS SURVEYS
8d10 PALM STREET N.W.
SUNSCr 4-7655
OWNER
INDUSTRIAL - JUDICIAL
BUSINE55 - TOPOGRAPHICAL
CITY L075 - PLATTING �
Thure ��;r. ic�cson
c��c�T & o�soN
LAND SUR ��EYORS
REG16T6RiD UND[R LAWB OF STATE OF MINNESOTA
LICENLEO BY ORDINANCi OF CITY OF MtNNEAPOLIS
326 PLYMOUTH BUILDING FEDERAL 8-8721
HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA
�urbepor's c�ertificatc
COMBINING THE IiECORDS OF
J. E. HILL, Ctvi� ENGINEER
ES7ABLI6NED 1l96
C. F. SANDHOFF
CIVIL ENGINEER
ESTABLtSHED 1Y09
JAMES NELSON
SURVEYOR
ESTABLI6MED 1Y22
METROPOLITAN LAND
SURVEY�RS. [STqBLISMED �P51
T;2VCICP 2�. j7r
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SIGNED �� _ � .! ' e' � •',, 'r t. f-- � ...
C WrancaHT wHO OL90N ,
� �.. � � „ �,
City of Fridley
Application for Plumbing and Gas Fitting Perm�t
Dep�. of Bldgs. Phone SU 4-7470
DESC$IPTION OF WORK �
Number, Kind and Location of Fixtuses Locaiioa�.
< O I � � �5 � I � I Z����� O� 3 7:� � I U`� O � I� a I v'Z Z I v1 ?g� F� N I G STER ELEC.
3 i� � m �'n 3 f- o� v' ! k o m < 3 c9 � c9 Sa (7 O
Base �
lst � � ,�,
2nd �
3rd
4th
• Fulure Conaectfon Openings
* New Fixture, Old Openings
Connecied
PARTIAL RATE SCHEDULE
Sewer
Cesspool
PLIIMBING FI]CTURE RATES: NO. RA1"E T�TAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . �� x $1.50 $���
Future Fixture Opening . . . . . . . . . . . . . . . . x 1.20 $—
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... . ................. x 3.25 $
Water Heater (Up to 200,000 BTLJ) . . . . . . —� x 2.0� $_�— �
New Ground Run Old Bidg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. AATE TOTAL
_�
lst 3 Fixtures . . . . . . . . . . . . . . . . . . ;,. . . . . . :� x $1.50 $ .,/• -�
a �:
Additional Fixtures . . . . . . . . . . . . . . . ; . . . . � x .50 $
Gas Range to 200,000 BTU . ....... .... .. x 2.00 $
REPAIRS & ALTERATIONS—Refer io Code
Description ................................... ..........$
TOTAL FEE �� �
City of Fridley:
�r
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 hereby declares that all the fact
and representations stated in this applicatio�pc are true and correct.
Fridley,
Owner _— ►.� ��
�
Kind of Building ✓
Used as
To be completed about
Estimated Cost, $
Old 1lTe B lding Permit
ROUC3H / � � �' �+ �
FINAL
az 4M
-�n� -
����
��
Pe:�
ne
�
By
Business Phune No _
�
J
1s b'Z
Applica#ion for Power Plants and Heafing, Cooling. Ventiiation. Refrigeration and
Air Conditioning Systems and Devices
PARTiAL RATE SCHEDULE
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 120,000 BTU . . . . . . . . . . . .
each add. 60,000 BTU .. ........ . .. ... ... . .. .
Replacement of Furnace .............................
Repairs & Alterations—up to $506.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . .. . . . . . . .
Sl'�AM os HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDft Steam .....
'P'urnace Shell & Line—to 640 sq, ft. EDR Hot Water ..
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . .
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . .
8.00 $
2.00 �
5.0� $
5.00 $
2.50 $
8.00 $
$.00 $
2.50 $
2.50 $
OIL BZTRIVER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal, per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
GAS FITTING FEES: NO FtATE TOTAL
lst 3 Fixtures ..................... x $1.50 $
Additional Fixtures . ............... x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.OQ $
AIR CONDITIONING �
FAN HEATING SY3TEM See Fee Schedule
�/ENTILATING $YSTEM $
ALTERATIONS & REPAIRS TOTAL FEE �
ROUGIi
FINAL
Depi. oi Bldgs. Phone SU 4-7l70
, �..a.:�� �� 5 0 / �
0
�
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do ail work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representatibns stated in this application are �rue and correct.
EY�idley, 'nn.�
Owner
Kind of
Used as
To be co...Y.,. ..... .........
Estimated Cost, $
Old New�uilding Permit N��� � �
19 �? z--
�
Permit No. � ��
OF WORK
HEATING or POWEit NTS—Steam, Hot Water, Warm Air—No.
� /
Trade Name Size No. �� b
o c� a
Capacity Sq. Ft. E.D.R.���� BTIJ .P.
Total Connected Loac� �..� Z� ��� 7 Kind of Fue �
BURNEft — Trade NamP Size No.
Capacity Sq. Ft. E.D.R. BTU H,p.
(REMARKS—OVER)
�'wn'�,o a z 2M
Business Phone
_ a,�o �,l,lr� '
D-?6 ' 9 ,. � � �.. � • r�L�Q G I�+ '�l �%� S�i �I'� �
HEAT LOSS CALCULATIONS � DEPART'MEI�T '0�''BUILDINGS l�'�N �� SS�'" 1���� �`�,
Weatherstrips ,w '4'�• Conatruction Na Iuaulation
Guide �
Windowa � Doora Reference Out. Wall Int. Wall Geiling Roof Floor Kind I�ow. A�
Yea—No I Yes-No 19—
/aT'Ft:1 �. , y Room Length ,Z � Width �3• Height �6 ' /ST Fl.� R� Room Lengtl�= :,,�,;;. �"x� � H '
Windows and Doors—Crackage and Area Windows and Doara--Cracluye a� ��t Y�=
Width Helght No. ot Llneal t. Area Wldth Height P11b ti. JR7�it '+
No. ot pane of pane Ilghte ot crack W..tt. No. ot ysne ot paas ti, .�� . tt. �:
$ �[� 1� l Z,_ 6$ ��
' ! G� �o I L �
Coef.l Btu
Infiltration ) p
Gle:s 6� b �1
Exp. wall
Net exp. waU �$ 3 1 O i$ 3
Int. wall
Ceiling 28 Z.go
Floor �, — z�j On
Total Btu. 1, g Z
Required sq. ft. E.D.R. or aq. ina. W.A. L.eader area �'- g
�SiFl.��rAN� � Room�Length z/ Width /�� Height $''
Windows and Doora--Crackage and Area
Width Helght No. o[ Lineal ft. Area
No. ot Dane ot pane lighta of crsck �. tt.
z � g �� � c.
�f / 8 �S / c-
Coef. Btu
In6ltration j � g
Glaaa S GS 3 0�,a
Exp. wall
Net exp. wa11 z/S /O .2 �"o
Int. wall
Ceiling ,Zy� /� ,2
Floor
Total Btu. / p , 3 �
Required sq. f� E.D.R. or aq. ina. W.A. l.eader area /� ' 133
I s�• RO`� n�rR �� ��ngth 7 Width /S Height/D —
Windowa and Doora—Crackage and Area
! Width Helght No. ot Lineal tt. Area
� Na o,f pane ot pane IiShb ot crack �q. ft. .
� 3' 7� ��
� �z k� e�
/ �n S�f 1 �
� �
� Y 8 S / �.. Coef. Btu
Infiltration -1 3� 3 � L
; Glaaa gl 68 5 So �.
� Exp. wall
Net exp. wall /d /a /oC7
Int. wall
Ceilin8 / D S /� /t7.5 c�
I�loor /pS j �y
Total Btu. /a , g� ,
Required aq. ft. E.D.R. or aq. ins. W.A. Leader area /6' 83
I
Infiltration
Glaaa
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�� ' �`
�I �. . ��'=. •. '�
Exp. wall - q : " �.,- s.��
Nct ezp. wall �#
Int. wall {" _
Ceiling ''
Floor
Total Btu. �'�.'��
Required aq. ft. E.D.R. or aq. in:. W,A:: i� "`'
/ SrFi.l �C.. F! y 1Zoom ( I.ength Wit�th ,.:;i^�ht ff
Windows and Doora--Cra hage and Atea
Wtdth Helght No. of Lfnea ft. ' Fu.
No. of Dane of pan� If�ht� o! cnck [t.
� �s a � i ' _
_ �
_�—
Inilltration
Calasa
Ezp. wall
Net exp. wall %, �
Iat. wall �' '
Ceiling
Floor
Total Btu.
Required aq. k. ED.R. or aq. .ins� �'
� Sr F'l.) 3 R ttaou►1 t.er�k� :_
��
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�
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Wincbwa aasi Dao ka � .��
>
Wtdth Halihc o!
Na ot pane ot.ysne t� ' �'
� zd 3 6 �. �: .
:�� �.
� ,�
�,:
�A,• , �
Infiltration / / / �
Glasa ,, f,�
Exp. wail
Net eap. waA Z
Int. waIl
Ceiling �,S S'$'8
Floor �
Total Btu. � �
Reqnired sq. ft. E.D.R or sq. ius. WA. �r ar�ea y ��
D,� � s � . ' .
_. .-�
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatheratrips "�� A'S'H' ' Construction No.
Guide �
Windows + K Doors Refereace Out. �all 1nt. Wall Ceiling Roof F7oor Kind
Yes—No � Yes—No l9—
/ST' Fl.� T� � p � I Room Length Width � Height /Sr Fl.� �•� -,�j= � Room � Le
Windows and Doora–�-Crackage and Area Win�ws and Doorr--Crac
Width He[Bht '�. No. ot LlneallR. Area Width HelBbt No. o,
� No. o[ Dane � o[ pane ��. lighta of crack eQ.1t. No. ot pane ot DAne !lShti
- �.o ys / �. ! 6 �a < <
i �I_ yS /�..
Coef. Btn
Infiltration � g f,j p
Glasa / S GS �2 2�/
Exp. wall
Net exp. wal! ? O ! b o O
Int. wall
Ceiling S �' 1 � �So
Floor Sa' � �12 �—
Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area �� 33
/STF7•� �,Z, c Room � Length � Width /p� Height g'
Windows and Doora--Crackage and Area �
SYidth Hefght No. of Li�eai tt. Area
No. of pane ot pane ', 1[shts ot crack �q. ft.
� zo �s � �L
�- i� � g i �
Coef. Btu
In<ration 3 7 �$ l� D
Giasa �1 � S / Co � 2..
Exp. wall
Net exp. wall /0� /t� /O �, 0
Int. wall
Ceiling / ' !p / 3 S�b
Floor J3a S Lo ]5
Tocat Bcu. 6 i z I
Required sq. ft. E.D.R. mr aq. ina. W.A. L.eader area /o' 3
/S .3- �� Room ILenBth /3 � Width /,2,� Height $ '
Windowa and Doors--Crackage and Area
Wldth Height No. oL L1nea1 tL Area
No. of yane o[ pane lights ot crack sq. tt.
1 !0 4� `� / �- .
/ 3 S' �
Coef. Btu
Inhltration / g 22 Z
Glaas `-f 6 $ 2 -s�
Exp. wall
Net exp. walt / 7� I 7 L �
Int. wall
Ceiling / b y / p / 6 Z. 0
I^loor / 6'�- � i� I b
Totai s�u, y �.:
Required aq. ft. E.D.R. or aq. ina. W.A. Leader area / y� $3
�
Infiltration
Glaaa
EaP. wall
Net eap. waU
Int. wall
Ceiling
Floor
Totat Btu.
. �`r
ARIIVAiEA
Inaulatioa
How. App�ied
1.L' _ W'dc!' tZ� Hc'$hc �'' .
sad Atea �'
nui ft Aeea �'
crsek rq. !G
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sq. ft. E.D.R. or aq. ins. W.A. LL�.sd�t at�ea► t0'
i s
�•I FA�►�r�,�v ��,
Windowa and Doora—�
Wldth Het�ht ;
ot nane of rsn�
� �
In<ration
�
? O �� �r�7,�'
��
A�ai tt.
Ier�ck �4.ft- �
� 4 '
Glaas � !� t .�
Eap. wall �� � �
Net exp. wall a- �� �'° � z°
Int. wall
Ceiling
Floor 2y /20 � -
Total Btu.
Required aq. f� ED.R. or aq. ina. W.A. I�ear�tr �a .' /-t /$-
i�S •� ,L c R Room I Length z �"Klth. /�._ Height :– ;
Windowa and Doora—CrackaQe and Area �
Wfdth Hef`ht Nm of LfnMl tb Atra
No. ot Dine ot pan� litAt� ot enck p. t!.
2. 2g iS /L
�
Infiltration
Glasa
Exp. wall
Net ex . wall
P
Int. wall
Ceiling
Floor
To�a� Bt�.
�;oer. e�u t ��
� `� _.;.�
� 0 l. t `�o
� S' 13 S�D
���s
�. e.u.�. ar �. ;� w.�. �a� � •
D46 ' v +" , .
y: e. y .,:.. .
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLI:
Weatherstrips r A.S.H. . Construction No. Insulation
Guide
WindoNrs �Doors Reference Out. Wall Int. Wall Geiling Roof Floor Kind Hoiv,Appl�
Yes—No ( Yes—No 19—
6S�Fl•� �No,��—(�oom Length Width /p_ Height 7— F1.) Room Length �fiic�
Windows and Doors—Cracicage and Area Windowa and Doora—Crackage and Area
�Vidth � Helght No. ot Lfneal f.. Area . � Width Hefght Na oL LlneallQ Ataa� .
No. of pane ol Dane lights ot Crack sp.1E. No, ot pane ot psne llghts ot CraCk . tf.
� zS � $ ��
Coef. scu C.oe�.
Infiltration cj $ ,3 Infiltration
� Glaaa g o Glaaa
Exp. wall Exp. wall �
Net exp. wall ;. �'° ��v Net eap. wall
Int. wall Int. wall
Ceiling Ceiling
Floor S� ,> z7� Floor
Total Btu. /.i S Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area `$3 Required sq. ft. E.D.R. or aq. ins. WA. I.ea�der uea
d��-F7.� — Room � Length Z� Width '''� Height ' �,� �� (�n� �� q/'�
Windows and Doors—Crackage and Area Windowa and Doora—Craelta�e and Ana
Wtdth Hefght No. oL Llneal tt. Area ` 2p t`U �Q Width 8elaht No. oL Lfneal fE. bt�ea
No. ot pane of pane 11ghU of crack �q. tt. No. of Dine OL pan� 11 hti oGci►ct . iQ
� Y 7 DHt� �Q� „ •-
� �g � g r � ���
Coef. Btu '
Iafiltration $ y 3 g -L In6ltration
Glaas I l� 8 -� Glaaa % L —
Exp. wall Exp. wall
Net exp. watl Q-�i � jL 3`� 51 6, ii Net eap. wal! � / o '/!� '
Int. wall � 2 $g � � Int. wail a . — �iy / �
Ceiling Ceiling OD 3'�L- '
Floor S'(.p ,S �. b o v Floor
Total &u. zl S�fB Total &u.
�
�
�
,
�
Required sq. ft E.D.R. or aq. ina. W.A. Leader area 30� PS Required sq. k. E.D.R. or aq. ine. WA. I.e�der ar� ,^ �,
Fl. Room � Length Width Height �.� Room I L,e�gc� Width ' �ht
Windows and Doora—Crackage and Area � �/indowa and Doore—Crackage and Area.
Width Helght No. oL Lfneal tt. Area Width Heisht No. ot Lfn�al ft Arq
No. 01 Dane ot pane lishu ot crack sa. ft. o�
Btu
Infiltration �
Glaas
Exp. wall ,
Net exp. wall
Int. wall
Ceiling
Floor
Total $tu.
Required aq. ft. E.D.R. or sq. ins. W.A. Leader area
_�_��
�_�_�
_-_-�
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� �-�
' ��
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.'_-�s� - -'�,�
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� . �i� � -
I Total Btu:
�rea aq. rc. n.u.a. or aq. wa. w.A. u�qec a�a+t �
� -
53-s�-s9i5.5i
�ity af �idley
le►PP�icaRion I�or � and Gas F'�i�q rin�if
Dept. of Bldqs. Pho� 5�0-3490 -
DESCRIPTION OF WORIC L��� 7501 Aldex Wa.y N E
I�iumb�r, Kind at�d Locat�oa oi Fixtures
(� • • WATE0. NTI1.
a
;� � S� � � � F O�. � � 6 I V �� 3 6� U' K C) E � N GAS ELEG.
Base 1 sti �
ist
2nd
3rd
4th
• - -Fu�u� Cona�c3los Oy�nin�s
# l�l�w Fixtur�, Old Op�ni�s
PARTIAL RAT� SCHEDULE
S�w•r
CMSpool
BLIIMBING FIXTURE RATE3: NO. RATE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . x �2.00 a
Future Ftixture Opening . . . . . . . . . . . x a1.50 ; -
New Fixture Old Opening . . . . . . . . . . . x 31.50 5---
Catch Basin . . . . . . . . . . . . . . . . . . . . x �3.25 E
Water Heater ;Up to 99,000 BTU� •••• X�3•�4 8
New Ground Run Old Bldg. . . . . . . . . X E�.� $
Elect�3c Wat�r H�at�r . . . . . . . . . . . . . . s s2.00 =
GAS FITTING FEES: NO. RATE TOTAL
Ist3Fixtures ••••••••••••••• • xS2.00 ;
Additional 1rUctures . . . . ... ..... . . . . . x i .75 ;
Gas Raa�e to 199,000 BTU ...... .... .... x 55.04 i
G�a Dryer 1 5.00
REPAIRS �c AL?ERATIOIfb—R�i�r fo Cod�
Description . . . . . . . . . . . . . . . .. . ...., . . . ..... . ... ..... .... .i
TO�P�1I. l�'FE = 5 � �
City oi PYidley:
The undersigned hereby makes application tor a permit for the �ork hcni
specified, agreein8 to do all work in strict accordance with the Ci4� (hdinance
and ruling of the Department of Buildings. and hereby declares that alt the tact
and �representations stated in 12�is application are true and rnrrect
Fridley, Minn 8-13-7� ts,
T Erickson -
Owner
�T'i1�tC
Kind of Building
res
Used as
8-18-70
To be completed about
10.�0
Estimated Cost, a ---
Old—New. Bui2ding Permit
ROUGH
FINAL
By
Business
No.
. _.�.:��
� SUBJECT . , .
City of Fridley � 12232
AT THE TOP OF THE TWINS g U I L D I N G P E R T '
f
; i ECNPT NO.
� • COMMUNITY DEVELOPMENT DIV. �� ���
�' ; L �"" � ' .
r � � PROTECTIVE INSPECTION SEC.
� �� /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. � DATE PAGE OF APPROVED BY
` ""J "� �.J . .
si2-56o-saso 910-F15 c 7/13/73 � �
JOB ADDRESS 7501 Alden Way N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. � 2 Elwell's Riverside Hei hts Plat Z SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mr. Philip R. Lund 7501 Alden Way N.E.
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
�i NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Construct 24' Diameter Swimming Pool
9 CHANGE QF USE FROM TO
STIPULATIONS See Health Inspector's Memo Dated 3uly 11, 1973.
SEPERAT� PERMITS REQU�RED
NEATING, PLUMBING AND StGNSFOR �'VIRI�f(�,
,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTAICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OF IF CONSTRUCTION
OR WORK IS SUSPENDED OFt ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME 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 OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �. OOO . SO
DOES NOT PRESUME TO GIVE AUTHORITY TO V10LATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
�
z : 6. 0
NATUREOFC N'RA TORORAUTHO ZEDAGENT IDATEI WHEN PROPERL VA A TH �IS YOUR PERMIT� . .
, � � � � �I
iGN URE F OWNER E ILDERI IDATEI SP � DATE �
Swimming Pool Stipulations
Mr. Fhilip R. Lind
7501 Alden Way
Plan Review:
n
1. All gates and doors to pool area must be self-closing and
self-2atching.
2. The outside faucet used to fill pool shall be provided with
a backflow preventor approved by the Plumbing Inspector.
3. All electrical work must be approved by the Electrical Inspecto,r.
4. Pool should have two inlets instead of one inlet. The one inlet
will be accepted. The location of the one inlet adjacent to
the skimmer is poor. The entire 18,000 gallons of water shou�d
be filtered at least once each 12 hours. No pump or filter
• rate is shown.
5. A•small platform should be located at bottom of ladder to pool
to help remove dirt and grass before entering pool.
6. Provide a minimum of some safety equipment such as a gole and a
life buoy with a rope. -
7. Pump, filter, and skimmer must be N.S.F. approved.
8. Keep chlorine in pool, run pump 24 hot�rs a day and use your test
kit.
PLANS APPROVED JULY 11, 1973
HARVEY J. MCPHEE
HEALTH INSPECTOR
�
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ApPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
n ��', uifol«�•T
OWNER' S NAME : •,!� _ �y�,� �g .,� ou 6�Y6v y�ODLI
ADDRESS : %SD! ALDE�v CC//ii�/ ADDRESS :
NO :. S TREET :_7S�I � AZD�'IV �.t�l� y
LOT• BLOCK• ADDITION•
CORNER LOT: INSIDE LOT: SETBACK: SIDEXARD:
Applicant attach to this form T�,ro Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Uaed As; ��p(!�a C�20vN� �Wt ►�+ vk� �' G `Oa`.
Z y' ��` p' Front t Depth : 5= L Height :�i� o �bo��
/ % Ooe G.�-//c�►.1 t'
Squaxe Feet : p�pp.u�c„ � C_'-_�-�- � 3 p, ppp �W, � 4,�I,T7��t,
Front: Depth• Height:
Square Feet; Cubic Feet:
ew
Type of Construction: Estimated Cost; ,S /, DOD �
To Be Campleted; -t� �o l��a.yt
The undersigned hereby makes applicativn for a permit for the work herein
apecified, agreeing to do all work in sttict accordance with the City of
Fridley prdinances and rulings of the Depa�tment of Buildings, and hereby
declares that all the facts and representati�ns stated in this application
axe tx�ue and co�rect.
. '
DATE : /O / i' % � S IGNAT[JRE : /�•
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(See Reverse Side For Additional. Znforniation.) �
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a a�t;Iy auti�orized r�e�isterc:ct Lar.ci Surveyor undei the la�.,s of tne �taCe of �tinri€:sct�. `
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• PARTS LIST �
FOR MODELS ;
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Doughboy Recreational � Domain Industries, Inc. 10S59 Jersey Boulevard, Cucamonga, California 91730
;
CI�Y OF FRIDLEY
HEALTH AND SAFET�Y INSPECTION
BUSINESS NAME: �� � - �... -- �./ DATE: ����. /�'!� 7 �
OPERATOR: TEL. �
ADDRESS : �,� 1 f�_.� _�,,,,.,/I/ __`; TYPE OF BUS .:
On this date, the health authority made an investigation of the subject facility.
The deficienciea noted at this time and the necessary corrective measures are
given below. Tf you have any questions concerning this matter, please feel free
to call on us at our offices (City Hall, 6431 Univeraity Avenue N.E., Fridley)
T�lephone No. 560-3450, Ex. 41.
,. . _ _ n � _ _e._ •
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RsceiY�d '�y ► Hsa].th Authoz�ity ,�,�,�„/
sue�ecr PERMIT
City of Fridley . 12349
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� �y--��-�-, 7
r � � PROTECTIVE INSPECTION SEC.
1 �
�4 , /���1 �� CITY HALL FAIDLEY 55432 NUMBER REV. - DATE PAGE OF APPROVED BY
""'�' ,�� 612-560-3450
910-F15 7_0 1G 7 � �
JOB ADDRESS
1 LEGAL �OT NO. 'OCK TRACT OR ADDITION SEE ATTACHED
DESCR. � SHEET
2 PROPERTYOWNER MAILADDRESS ' ZIP PHONE
3 CONTR TOR MAILADDRESS � � � Z�P PHONE LICENSENO.
4 ARCHITECT OR � SIGNER MAIL ADDR ' ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
7 CLASS OF W RK
❑ NEW �C] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
'x21.' addition to carage
9 CHANGE QF USE FROM TO
STIPULATfONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIFi CONDITIONING. -
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS OFFSTREET PARKI G
I HEREBY CERTIFY THAT 1 HAVE READ ANO EXAMINEO THIS APPUCATION 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 COMPIIED C�rjO. 3O . SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON- S. OG
STRUCTI OR f HEs ERFORMANCE OF C� TRUCT�ON.
� PIAN CHECK FEE TOTAL FEE
/'d $5.5G
SicNA7ua n a0 .�r on7e� PROPER VA T THIS IS YOUR PERMIT
,: �u d �l
SIGNATUREOPOWNEFUFOWNERBUILDERI IDATEI BLDG.INSP � ATE
� �.oN - � o
�PPI,1Cf�TION FOR RLSII)ENTI.l�L, ALTf:Ra'I'I���`,
OR �1i)lll'I'1�N 13UII,I)INC PERMIT
CI"1'�' OF 1-1:1DLf��', ?1INNF�Si�'j'�
�w��a � s NarrE : �:�.1 �r.�t � � i � � BUILDER : ^T' - �1� �,'4 I�.l`�U tC.��.1 C_Q
��nt�ss : '1 �( L�t���J ��/,�.. ADDRESS : �.G3 � i��c.�: �CL-`I �
�
�1�/ s• / v D/ STREET e
� � n
T,Q�'; [3LOCK; � ADDITION: �LGCIE /�,�5 0'�fJ� !'LAT �
CQRNER LOTt INSIDE I,OT: ✓ SETBACK: SIDEYAi:D:
Ap�l�.can� attach to this Lorm 'Itao Certificates of Survey of Lot and proposed
btt�.ld�zig location drawn on these Certificates, �
�ESGRIPTI�N OF BUILllING
To Be Used As; �
�=�I��> Fxont: %O � Depth: a% � Height: ��
-:
Square Feet: Cubic Feet:
Front: llepth:
Height:
0
Square Feet; Cubic Feet:
�`yp� of Constxuction:C�-�(.�.._ �� Estima.ted Cost: $ E
�Q $� Campleted: �af� . �� �z� ��.c����'�c�t,i ���1. �
T17,e tladeXSigned heareby ma.kes applicativn for a permit for the work herein
spe��.fied, agreeing to do all work in stTict accordance with the City of
F�'idley Qrdinances and rulings of the Uepartment of $uildings, and hereby
declares that -ill the facts and representations stated in this application
axe true and �.>rr�ct,
� '1 � _
nATF: Q���_�_ l__�� stc��alvxE. � �.Q.
(Sea Reverse Side Fox Additional Information,)
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MINNEAPC7L15, MINNESOTA 554ZB
INSURANCE REPAIi2S - F�RE & WIND
REMODELING �
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E:LW�LL'S RIVERSI�E HEIGNTS PLAT 2
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SUBJECT PERMIT NO.
City of Fridley ° 3051
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T •
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l-__• A �/'��;,j CITY HALL FRIDLEY 55432 NUMBEF REV. DATE PAGE OF APPROVED BY
L �� 612-560-3450 g10-F15 � �
JOB ADDRESS
7501 ALDEN WAY N.E. FRIDLEY MINNESOTA
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7 2 ELWELL � S RIVER PLAT 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
PHILIP LIND 7501 ALDEN WAY N E. FRIDLEY MI E T
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW �1 ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
CONSTRUCT PORCA
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. FRAME
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED �S NOT COMMENCED WITHW 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STAILS 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 OFi NOT. THE GRANTING OF A PERMIT $1� %SO $Z.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yS].Z.00
PLAN CHECK FEE TOTAL FEE
14.00
NATUREOFCONT ACTORORAUTHORIZEDAGENT IDATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
- � � � � G -713 ��/ ,7UNE 26, 1975
SIGNATU E OF O UF OWNER BUILDERI IDATEI BLDG INSP fiATE
� ... , - � � a. 4 � �i
.
.
•APp�LICATION FOR Rk:SI'D}:NTIAL., ALTL'RATION,
OR AllllITTON. BUILDING PEItI�1IT
CITY OF FRIDLEY, I�iINNESOTA •
: �� � U Lv�x: o�. �. r� � �-c-- � ��,,r
OWI3ER S NA1�1E :�� L�{� � f� t' B I � S
ADDItESS : 7�C� / /� �►— �•v i� ADDRESS :,���/-�2.�,� � /'u' r` �'
H0: . � STREET : � ►� hn � i�-g �� 9 v�C .
LOT • � BLOCK - Z— ADDI.TIOI� : C�C/�;c�-[':rt.-,�J �� ��i�'' �
CORNER LOT: IN5IDE LOT: SETBACK:, SID�YAP.D:
Applicant a.�tacl: Wo this for:n T�ao Certifieates. :�f Su• rvey �of Lnt and _proposed
building location drawn on these Certificates.--
0
➢ESCRIPTION OF BUILDING
a
To Be Used As : �
'. ,
�� Front : 2� ,'�� Depth :� l �� �'� v Height : 0�
r
Square Feet: � � Gubic.Feet:
�
Front: Depth: Height;
.. . Square Feet; Cubic Feet: � �
Type of �Construction: (d���2�-� Estimated Cost: $ /, 7s�
To $e Completed: Z �'�'� � � � .
The undersigned hereby makes applicatinn for a permit f�r the work herein
specified, agreeing to do alI worlc in stric� accordance caith the CitS of
Fxidley Ordinances and rulings oi the Depaxtment of Buildings, and her�by
declaxes that all the facts and representations stated in this application
are true and correct.
� DATE: (� �- Z�a — �.S' SIGNATtTRE:
(See �everse Side Fox Additional Infoz�mation.)�
� �vj . ' .
' / .
�'�1��s—,�-�-�'� ��—r� _ / � , u I�
C�/'' _ `� . U V .
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0
0
SUBJECT PERMIT N
City of Fridley � 1836
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
, ,, RE EIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� � ti: - �
r � � PROTECTIVE INSPECTION SEC. �
� �
i
� � /"'1 � CITY HALL FFiIDLEV 55432 NUMBER REV. DATE PAGE Of APPROVEO BV �
�"""�" �'' 612-571-3450 9t0-Ft5 3/31/86 � �
JOB ADDRESS 7501 Alden W�y IQ. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % 2 Elwell's Riverside Heights Plat 2 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Philip Lind 7501 Alden Way N.E.
3 CONTFACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Western Remodelers. 2520 W. Larpenteur, St, Paul, MN 55113 645-1411
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION F�7 ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Install aluminum txim
9 CHANGE QF USE FROM TO
STIPUTATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GFiOUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT, CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTAUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFIEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
ANO 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 GFiANTING OF A PERMIT $�-/�79 $.g9
DOES NOT PR U TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PR VISIONS F AN OTHER STAT R LOCAL LAW REGULATING CON-
ST TION O TH PEFFORMAN F CONSTRUCTION. $32. SO
� �y PLAN CHECK FEE TOTAL FEE
- $33 , 49
, SiG TUR FCONTR TORORAUTHORIZEDAGENT IDnTEi — WHEN PROPERLY V IDATED THIS IS YOUR PERMIT
( G
$IGNATUREOFOWNER�IFOWNEABU�LDERI iDATEI B�DG iNSP � OA7E�
��.�_ �
NEh [] City of Fridley Effective 4/1/84
ADD2� . [] L R-1 AI�D R-2 j
pLTER. [ ] Buflding Permit Application
Construction Address
Legal Description:
Owner Name & Address:
Contractor • �� � �
Address:
j�� (� ��
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(,/� �� 1�'1 f.
,
i �WJ ��Yno� �c�
_o �� - � i��� �� �
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�
�
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction draWn on it to scale.
DESCRIPTIOp OF IMPROVEMENT
� �
Tel. • S���p L/�
T�1. # �,�`" � I �/
Yh,�. S Sl ,'�
LIVING AREA: Length width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
' DECR AREA: Length Width Hgt/Ground Sq. Ft.
OTHER : I � �� 2� ( -� ti_tl' 1'�'l �►1 � � �C 1�� --- —
; 'Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
Type of Construction: _ Estimated Cost: � ����
Approx. Completion Date:
Alt. A Alt B
Propo�ed Dr�veuay Width If New Opening Is Desired: _� 3 _ �
See Back Page for Explanaticn
; .
� ��� -�, ��� !� ��
�% DATE: � APPLICAIdT: �- �, �� Tel. �
Y OSE ONLY
Pertnit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Se�rer Main Charge
�t��"r��
STIPULATIONS:
� �. �U
�
a 49
3
$
a
� �,''`r=�
��
W�. � �j
�
Fee Schedule or. Reverse Side
25� of Building Permit Fee
$.50/�1,000 Valuation
a425 per SAC Unit
Fee Determined by Engineerir.g
Agreement Necessary [] Not Necessary [ J
� SuB�ECT � ..L11SJ,.,,..�,.
City of Fridley 313 5 7
AT TNE TOP OF THE TWINS g � � L D i N G P E R M I T
r
� .
� �
� ; � _ COMMUNITY DEVELOPMENT DIV. �/
r � � PROTECTIVE INSPECTION SEC. �j�/
1
i•-•-����"' �•� CITY NALL fRIDLEV 55�32 NUM9E� nEV O�7E v�GE Oc •6vnOVED Br
1 612-571-3450 910-F15 $/30/00 / /
J08 AODRESS 7501 Alden Way NE
t LEGAL LOT NO. BIOCK TRACT OR ADDITION SEE ATTACMED
DESCR. � 2 Elwell's Riverside Heights Plat Z SNEET
2 PROPERTV OWNER MAIL ADDRESS ZIC PHONE
James/Pam i,aupan 7501 Alden Way NE 763-571-0152
3 CONTRACTOF MAIL ADORESS ZIP PHONE LICENSE NO
Same
d ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAtL AOORESS 21P PHONE UCENSE NO
Residential
7 CLASS OF WORK
� NEW O AODITION ❑ ALTERATION ❑ REPAIR � MOVE � REMOVE
B DESCRIBE WOfiK
Construct a 24' x 9.5' Greenhouse
9 CHANGE OF USE FROM TO
STiPULATiONS
See notations on plan.
VI/AR�I I G
Before digging cail for
all utility Incatians
45400U2
REQUIRED BY LAW
SEPARATE PERMITS ARE REOUIRED FpR ELECTqICA�, PLUMBING, HEATING, ��
VENTILATING Oq AIR CONDITIONING
THIS PEFMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENGED N/ITMIN 60 DAVS, OR IP CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONEO fOR A PERIOD OF 12Q DAYS AT
ANV TIME AfTER WOi;K IS COMMENCEO. NO OWIG. UN
I HEREBY CERTIFV THAT I HAVE FEAD ANO EXAMINED THIS APPI.ICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL PROVISIONS Of LAWS VALUATION
ANO OROINANCES GOVERNING THIS TYPE OP WORK WILL BE COMP�IEO @
WITN WNETMER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT W1 �SOO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEI THE PEqMIT FEE
PROVtSIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING coN- �54.00
STRUCTION OR THE PERfORMANCE OF CONSTiiUCTION
� Pl,/1N CHECK F
S�GNATUQE O� CON"aaCTOp Op 1UTMOQ�2E0 �GENT IDAiE� ' E
�� y - �3� � �
$�GN4TUqE O� NEA�iG OWNEA BUiLDERi i♦TEi n� .�r,.
S RARATE pER�I
EQUIRED fpR. TS
P�M/ BING' N�TI
AND S���IS
OCCUPANCVGROUP IOCCUPANCVIOAD
SO.fT CU FT.
OFFSTREET PARKING
STA��S GARAGES
SURTAX
$.75
SAC CHARGE
Fire SC $1.50
TOiAI F E
$ .25
LIDATED =S IS�F P MIT
�
nnrE
NEW [}
ADDN [)
ALTER ( ]
Construction Address: /S O�
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
� �a
Effective 1 /1 /2000
(763) 572-3604 Bldg Insp
� �
; , �� ! � �����
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�
Legal Description:
Owner Name & Address: f•0.n�� oZ I��C1,�a�1 /�'U/0.�(,'..✓ Te�. 6%a 571-0! Sa
Contractor: S �%L/� MN LICENSE #
Address: %.So) /� LL��.�/ �/t�L'� N E�. Tel. �/d1 � S7J ' � /..5�
\
Attach to this application, a Certificate of Survey of th - f'
lot, with the proposed construction drawn on it to scal .
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height S� Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA:
OTHER:
�,►
Length Width Hgt/Ground Sq. Ft.
/
G/��.�v a�s� a Y � a�-G �x �-��_' wrob >C �� - �� rr
Construction Type: �0 5'T �.J��,r,.� Estimated Cost: ��so v� G�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ���G'�'�= APPLICANT: ��It �'l�'cS L�t�/oR�/
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Te1.�E61�, �7/�UIS�
Permit Fee $ ��0� Fee Schedule on Reverse Side
Fire Surcharge $ �-.� .001 of Permit Valuation (1/10th%)
State Surcharge $ � �� $.50!$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above �
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STfPULATIONS:
$ ��, aZ�
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�s
�Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE � V'V �� '� a/ YOUR E-MAIL ADDRESS
SITE ADDRESS % S[� � A(�°/J �¢Y
THIS APPLICANT IS: ❑ OWNER �ONTRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
Permit N
Received By:
,
Date Rec'd:
�
ADDRESS:�� r Ikl b�n% (.t) CITY f-(c� 0�y STATE�IP�
PHOrrE: �G�3 -S"�l— b/S�z
STATE LICENSE #
���.o
BXP DATE 5/ 3( /
h% � % CITY
FAX
�,,SIN'GLE�AMILY/NEW CONSTRUCTI(
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION ❑ GAR
❑ BASEMENT FINISH
❑ DECK
❑ NEW
❑ MAINTENANCE/REPAIR
❑ SIDING
❑ SWIMMING PC
❑ ADDITION
❑ REMODELING
DESCRIBE WORK BEING DONE: `% �e�2 D�r-F d- R-� roo �
SIZE OF IMPROVEMENT
x��r uvu
NUMBER OF SQUARES �
I GARAGES
PROPOSED SIZE:
I PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yes ❑No
OR FOR NEW OPENINGS-DESCRiBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
�HOUSE & GARAGE
1�ATTACHED GARAGE
[J DETACHED GARAGE
❑Soffit
O Trim
❑ Fascia
LOCATION OF WINDOWS
NUMBER OF
❑ wtt�rDOws
❑ DRAIN TILE
❑ OTHER
WIDTH HEIGHT
�
STATE�iJ'LIP�
BASEMENT REMOI�EL[NG SUBMIT:
L Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SLTBMIT:
l. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
A L FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
��'—E 3� (USING THE 1�97 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S� 1!� v.°" OCCUPANCY TYPE
Permit Fee $ �j'], See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
_F�e.Sur�haLge � a � QQ_Ltim�th�tntaLjflb_va111ation _
Surcharge $ �,-z .0005 x Permit Valuation Minimum $.50
License Surcharge $ <, ` p�} $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft+ 6 ft= ft x$21 =$
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary () Non Necessary ()
Totai Due $ . Make checks a able to: Ci of Fridle Attach Sti ulations
THIS IS AN APPLICATION FOR A PERMtT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which �eg�t'res rev' and approval of plans.
SIGNATURE OF APPLICANT`>`i'��— PRMT NAME�(Jl�ti �i�fbYJS4- DATE %Or� �v i —
- MINN�SC}TA DEPT. OF LABOR & INDUSTRY
Construciion Codes and Licensing Division
443 Lafayette Road N.
St. Paul, MN 55155-4344
tr�f� ��
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F -' �`i '�F"`��' r. �
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; .�,,.�����'�� '
RAUtUA KEVIN CHRISTOPHER
RAUMA EXTERIORS
8101 ASTH AVE NORTH #9
NEW NC7PE, MN 55428
S;ate of P�linnesota
Department of Labor and Iridustry
443 Lafayette Road N.
St. Paul, MN �it�5-4344
Construction Codes and Licensing Division
Telephone: (651) 284-5065
E-mail address: dli.contractor@state.mn.us
Website address: www.doti.sltate.mn.us
Re�identia! Buitding Contractor License
i_�g�! N�me: RAUMA K�VIl�! CHRtST�PHER
DSA: �p,UMA EXTERIORS
Address: g161 n6TH AVE NORTH #9
NEW MOPE, MN 55428
License ldentification Number: 20590466
I_icense Expiralion Date: 3/31/2008
_
O
Business Structure:
INDIVIDUAL PROPRIETOR
Qualifying Person: KEVfN CHRiSTOPHER RAUMA
Continuirig Education: 7 hours due by 3/31/2008
�
�
�
�� �
��
Form State of Minnesota
SP:C1 License Applicant Information
Under Minnesota law (M.S. 270.72), the agency issuing you this license is required to provide the Minnesota
Commissioner of Revenue your Minnesota business tax identification number and the Social Security number
of each license applicant.
Under the Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, we must advise
you that:
• This information may be used to deny the issuance, renewal or transfer of your license if you owe the
Minnesota Deparhnent of Revenue delinquent ta.�ces, penalties, or interest;
• The Licensing agency will supply it only to the Minnesota Department of Revenue. However, under the
Federal Exchange of Information Act, the Department of Revenue is allowed to supply the information to
the Internal Revenue Service;
• Failing to supply this information may jeopardize or delay the issuance of your license or processing your
renewal application.
Please fill in the following information and return this form along with your application to the agency
issuing the license. Do not return this form to the Department of Revenue.
Personal information:
Proof of Workers Compensation Insurance Coverage
Minnesota. Sta.tute Section 176.182 requires every state and local licensing agency to withhold tl�e issuance or
renewal of a license or permit to operate a business or engage in an activity in Minnesota until the applicant
presents acceptable evidence of compliance with the workers' compensation insurance coverage requirement of
MSS Chapter 176. The information required is: The name of the insurance company, the policy number, and
dates of coverage or the permit to self-insure. This information will be collected by the licensin�a e�nc,y and
retained in their files.
This information is required by law, and licenses and permits to operate a business may not be issued or
renewed if it is not provided and/or is falsely reported. Furthermore, if this infarmation is not provided and/or
falsely reported, it may result in a$2,000 penalty assessed against the applicant by the Commissioner of the
Department of Labor and Industry.
Provide the information specified above in the spaced provided, or certify the precise reason your business
is excluded from compliance with the insurance coverage requirement for workers' compensation.
❑ I am not required to have workers' compensation liability coverage because:
❑ I have no employees covered by the law.
❑ I am self insured (include permit to self-insure)
❑ I have no employees who are covered by the workers' compensation law (these include: Spouse,
Parents, Children and certain farm employees)
IF YOU DO NOT HAVE WORKER'S COMPENSATION INSURANCE, PLEASE FILL OUT BOTTOM PORTION.
�✓� l/�,dV l, /� � c� ; ��i ���.2 �S �-a.�e./L
ApplicanYs last narpe First n�m�e Middle name
�I D 1 �� ��' �ftJt N �� ��_U2J.� � h� Z
address
X' �l�'1.}- �5l �i�f0,�s
usiness name
C��� ( �f � �` �� /��
Business address
�
City � � State Zip Code
City
��✓ .�S`�Z�
State Zip Code
�0�23—D�
Date
CITY OF FRIDLEY INSPECTIONS DIVISION
6431 University Avenue NE, Fridley, MN 55432 CONTRACTOR LICENSE
(763) 572-3604/ Fax 763-502-4977 �, LICENSE TERM: May 1, 2007 to April 30, 2008
APPLICATION FOR CITY LICENSE -$35 LICENSE FEE EACH
*NOTE: IF YOU ARE DOING BOTH GAS AND HVAC WORK, BOTH LICENSES ARE REQUIRED
❑ Blacktopping
O Chimney Sweep
O Excavat'ing
C7 Gas Services *
❑ Commercial or Specialty ❑ Plastering
❑ HVAC * ❑ Roofing
❑ Masonry O Sign Erector
❑ Oil Services ❑ Wrecking
REGISTRATION FOR STATE LICENSED CONTRACTORS — NO FEE
❑ Electrical � Mobile Home Installer ❑ Plumbing
❑ Residential Contractor ❑ Moving ❑ Well Driver
TO THE HONOR.ABLE CITY COUNCIL:
I herewith submit an application for license to perform construction within the City of Fridley in accordance
with the City Code of said City regulating the same. I am over twenty-one years of age.
Submitted herewith is a Certificate of Insurance evidencing the holding of Public Liability Insurance in the
limits of $50,000 per person, $100,000 per accident for bodily injury and $25,000 for property damage, and
Workers Compensation as required by Minnesota Statute 176.182.
1. FILL OUT FRONT OF CONTRACTOR LICENSE FORM (AND BACK IF NO WORKER'S COMP INSURANCE)
2. ATTACH COPY OF CERTIFICATES OF INSURANCE FOR LIABILITY AND WORKER'S COMPENSATION
3. ATTACH COPY OF STATE LICENSE (RESIDENTIAL BUILDING AND/OR ELECTRICAL CONTRACTORS)
4. ATTACH COPY OF REQUIRED BONDS (MECHANICAL BOND FOR GAS/HVAC AND/OR PLUMBING BOND)
�/I.�caal �Q.,. ; �
Name of Liability nsurance Company
Liability Insurance Policy Number
Policy Term
Name of Workers Comp. Insurance Company
WC Policy Number
Policy Term
Minnesota License #/ Bond # Exp Date
Name of Company to be Licensed/Registered
Name of Contact Person (First/Last Name)
Address of Company
City/State/Zip + 4 digits
Business TelephoneBusiness Fax
For Office Use On1y:
Receipt # License# Council Approval Date
Building
Inspections
763-572-3b04
763-542-4977 FAX
DATE�L
SITE ADDRESS �
THIS APPLICANT 15:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
PERMTT TYPE
TYPE OF WORK:
DET
OWNER
PLUMBING
RESI�DEloITIAL APPLICATI4N
CITY OF FRIDLE�
EFFECT'IVE 1-1-08
NAME: �G{/i'VI.Q- P G�
ADDRESS: '1 SU_1�
PHONE: � 6 3' S� I'"� � S�" � _
STATE LICENSE #
S7ATE BOND #
ADDRESS:
PHONE
[�TINGLE FAMTLY
/'
o �w
ION O ORK
�- o� -�
O TWO FAMILY
Permit 1���� �c� �1
Received By: �
Dat�d�E� 2 � �
CITY �Yl Q� STA
EXP DATE
EXP DA'fE
FAX
O TOWNHOUSE
�3
ATE ZIP
0
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, insta(lation or replacement of a residential fixture, excluding the fixtures. (This should reflect onfy the cost of ]abor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $ l 00RPER FIXTURE, EXCEP'f WHERE NOTED. FIXTURES: (INDICATE TOTAL
11tJMBER OF EACH BELOV�. MINiMUM FE� $15.50.
BATH SINK/LAV FIAOR DRAINS _ SHOWER _ WATER PIPTNG
BATHTUB GAS PIPiNG (NEED CTTY LIC) SWIMMING POOL _ WATER SOFT'NER {$35)
CLOTHES WASHER KTTCHEN SINK WATER CLOSET — pOR IRRiGAT1�ON ($, $)
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35)
— — WATER METER _ OTHER
Permrt Fee� $ � � �� � �� Number of fixtures @ $10.00 x $ ] 0.00 = $
Surchar e G .50 Number of fixtures @$15.00 x$15.00 =$
TOTAL DUE $ . . �ZJ OR Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
(MINIMLJM $15.50 (MtNIMUM $15.50) Total = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL1D UNTIL 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 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 p1an in the f all work � ich quires review and approval of plans. � ��
SIGNATURE OF APPLIC PRTNT NAME ��� ��' `^�x """ I DATE
. ._ T
APPROVED BY
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
DA
, : � Building
" , Znsp�ctitrns
763�572-36p4
� � 7b3-502-4977 PAX
. DAT.F. �OiJ�+�,�!.�
SITEADDRESS 75� t
� � THiS APPL[CANi Ifi:
PROPERTY N�
OWNER/
From: unknown Page: 2!3 Date: 11/17/200910:39:23 AM
MEC�,��ZC.A►L Permit No.: v
I�SI�ENTTAL AP���C�TION �� � � B �
� �a���a!� . �
C�'�'X UF �'�Y:.D.L�X
O OWN6R
TENANT ^���ESS
R
SCIEiMIT A COPY QF
YOUR STA'P� •
LTCP.,�1SE Wf7H
APPLtC�1TiQN
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COMPANY NaMe:,aAl�
CONT�CT FCiLSON: Q�
STA'fG LlCRN4R �1��
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PHONG C`i�'�� ZIi��
Y[AJR. E-MATL ADaR�+SS �/I�C,ktItFS e�WC.(e� Qikl �,b�y.S:C.O`y►
1'�RMiT TYPT; �" 31NGL� 1'AMiLY ❑ TWO FAMiLY
TYPE OF WpRK! � �W �R�LACEMtNT
�XP DA1'E
Na�'� CTTY�
rnx Cr�+���{-75- 1
C7 TdWN}lOiJSE
❑ ALTERA7TON/RF.MQI)T'Y,
�
'����
DETAILED DESCRTPTfON OF WORK _��,p� �/'„�j ] ����� ,
—�._._
PC�F�S AR� RqSCD ON $ill.np rT:R i�IXTUR�, FxCErT W[fCRE N07"rn. F7XTL�RE3: bIC;r1TE OTAL NUMRF.R pR BACR 13EL�w) '
• Equipmcnt tnstnlled�.•, MRG: ' MOA�L:
�,�qP�X,bl+'j . '�r i' • S1zE/D7TJ ,,,����Q�i+� ".� `
!�0!•�1�°I�' IviFG: _ � MOACI.:. SiT.£/B't'U �
M�' M4�f:L: 3f7,F./DTU
_NC $25.O0 ' ' FIREPI„AGE (GA5) $15,p0 CAS RANr13/(IVEN T10.Ob .
ATR TO kllt EXCHANGE�R S15 �F IRfspLAGF (WUf?D) $35.00 �NL•,W GAS GR[LL $ IpAQ
�,,,Bt?TLER $35.00 _PURNACB $35,(10 ' �CA3 UN[T HtR $1p,00
, CHIMNEYUNER$1a.00 • ,,,�[ihSDI�V�RS10,0� I�OI.NEATCR$35.(Kl
AUCT WORK �i I p,pQ GAS PfPING S 1b.00 . • —ver��r„ e�rn� e, r M
�
" THIS iS AN nT+pLiCA7tQN F�R A P�ItMIT-NOT VALID UNTf1, PROCESS�n �
T hcteby apply for a building permit and i Acknowled�e thAt tlfe inf�rmAtion above is complete nnd aocurate; that thc work wiil be in
conformance with the ordinances ttnd cade� of d�e City�pf I�rtdl�y and with Yhe MinnesoiA Construction Codes; that I I�nderstand thls is
not � permir but on�y $n gpp�ication for a permit and work is not to start without a permik; that th� work wilt be in accordance with the
appr�pved plan in the �I wo�kwhich ' es rcvi�w and approval af plens: .
SiGNATlJREbFAPPT.TCA _ _,l�PhfNTNAMF,�iC�e���• +�KYiCc(dE pq7g �1 �'��� --
. . . Caty of Frid�ey _ —
�� . Bu�lding Tnspe�taans bep�Xtrnent
. � 6431 University �lvenue N�, Fridley, MN 55432
7�3�572-3G04 F�1X: 763-5Ua-4977