AF - 46970SUBJECT PER 14609� � �
City of Fridley
AT TNE TOP OF THE TWINS B U I L D I N G P E R M I T
F � CEIPT NO
� `��_��� COMMUNITY DEVELOPMENT DIV,
r � � PROTECTIVE INSPECTION SEC. �
' i '
� �""9 � CITV HALL FRIDLEV ��85432 NUMBER REV. � DATE PAGE OF APPROVED BV
�,•••�'� ,•� 812-660-3450
910-F15 3f 29%78 � �
JOB ADDRESS 5871 Arthur Stseet N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION 3EE ATTACHED
DESCR. 2g AUd. Sll}�. #92 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Gorham Construction 9050 Collins Drive, Anoka 421-0998
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE ���CENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE C�� ��.
Before digg��g calt loc�1
6 USE OF BUILDINO 'r���Q - � `A`
Re sidential e�"� �;� � i� vr
7 CLAS30F WORK -
❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 57' x 46' Datelli. and a 26' x 24" Gara e
9 CHANOE OF USE FROM � �tPlR�D FOR W!R((V��
STIPULATIONS p�vide a hard surface driveway. Provide sod in the front and side
yards. Provide � verifying survey and truss design by 4/30%78. Provide combustion
air to furnace. Provide site inspection and compaction tests on any fill placed.
NOTE: Sewer not instxeet.
SEWER LOCATION: (Approx. 11' Deep in Street) NO EXISTING SERVICE, Extend service
fro�n M.H. on Arthur Street southsaest of south property line.
WATER LOCATION: MUST BE TAPPED. 6" Waterma.in 5' W. of W. line of property.
DRIVEWAY DEPRESSION COST: 17' + 6' x$14.50 =$�$ (�j(�1 Y�Qr'C� I�
Tr9E GITY pF FRIDLEY DO�S N OT G t 1 A � t A N T E E T H F . �+V. R E Q U I R F� ���TY � t�''��'
ACCURA6Y OF UTtlIN LOCATIONS AND ELEVAiIO N S. �E M O V q� C U p��
T N 1 5 D A T A t S F O R 1 N F O RMATiCEN PUP,POSES ONIY A N r J °��� �K����, y� r`ti�;, ,.,
P E R S O N S U S I N G R S HOULD VERIFY THE INFORMq� � T D a I VF�/,4�j, Q� �� VI
G`N 7}i� 5lT�, ����GS•
SEPARATE PERMITS ARE RE�UIFED FOR ELECTRICAL, PLUMBING, HEATINQ, TYPE OF CON3T. OCCUPANCY OROUP OCCUPANCY C6AD
VENTILATING OR AIR CONDITIONIN�. WOOC� FY'dlYl@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-T 1241 + 689 31,350 Zbta.
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
� HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ]. STALLS OARAGES
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 HEFEIN OR NOT. THE ORANTIN(3 OF A PERMIT $44,590 $22.30
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINO CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ' S12S.40 S4OO.O0
PLAN CH CK FEE TOTAI FEE
�►'�/ �-�2.9�)� $ 31.35 $579.05
SIGNATURE CONTRACTOR OR AUTf+ORIZEDAGENT tDATEI WHEN PROPE Y VALIDA D THIS tS YOUR PERMIT �'
�� �1����
SIGNATUREOFOWNERtlFOWNERBUILDERI �IDATEI y BLDG�INSP DATE � ��
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o DENOTCS 1,2'�;':' :'.' �:°- -
PARCEL 1 .
The South 72 feet of Lot 28 as measured a*_ riih± �r:;les :
thereof, in AuGitor's Subdivisicn Nc. 92 ^:� ::�rt�, '
to the rights of the City uf Fridley t� r-h:.r `-re�_t '��.
PARCEL II
. The North 72 feet cf the South 1G4 feet c` l.tt "t:: as.:�=`
anyles to Lhe South line thereof, A�ditcr's SFt'::'-�y' .
County, "'innescta, s�bjrct to the r��:his :: ----.
Arthur Street I�ortheast.
PARCEL III
That purt of Lct 2&, A�ditcr's Sub�i+� r�� "� "h``4`
lying ��orth of the �cu:h 144 feet as r�e� � � .�
line thercof, tcgethc•r wi+.h that par* cf ;�.r� �� �° �
to the ri��hts of tile Ci'y of Fri�tey i.^. ,r`_r�_: .,_rc:ct '�
Avenue.
PARCEL IV
Lct 38, Aac?'.�r'S �J} :�yi .inn I�c. S2 .:�re:�::_'.
righLS of the City of friciey in ;:r.hrr ..._, _
We hereby ceRity that tAis ia e 2rue and tonecl reWese^tatian ol a aurve.'
and o5 the lxatia� ot ail buitdinqs �havex�. eeW tll v�s�c�e enc,�ecnme����:s. ��
prepared by me or under my dired supervis'io�r n-d thaae �o z a„�y Fya�i�. ��
ot Minnesota As surveyed Dy me this Y
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CI�Y OF �=(�IUL�:Y .
!�d'}'LI C/1'!rI UJ� 1'OI� itES I llt_t�7' I11l.. �U I LD I �!G f'ClZl�11 TS ,
' ii`�GW, �LTLRl�T1U(J5, /1llDI7101JS, OR RE('/�I(7S)
owraLR: G� r.��. cr � s ry� . ?3UILll1.�i: �� •��. r CaN.a-�"; ..
�aar��s:�: ' Address: fa�c� C��I,�� D�• �(NOKo� '
Te 1. IQo . : �/� / - Q 9' j � . �
Ho. :_ v�'�a 7 j Street: /"1 %4�it�r �
LOT: a � }3 CY.: ` , ADDITIOP] : °�� ��� ��
C01211}:R LOT: ITISIDE LOT: _�_ SETI3ACY.: 3S � SIULY11I2DS: /Cl� a•..c�J'
Applicant attach 'to L-his form 'Ilao CerL-ificates of Survey of Lot and proposed
building loca�ion dra�m on these Certificates. .
0
xo 13e Used As :
DESCRI PTIOhd Of= BUI LDI i�G
.����• /�rr����, Front: .�S" 7 � Depth• �� � Height: � -
� �, Y / C/
Square I'eet: �� Cubic Feet: -� �T6 �
I'xont: a„�� Depth: �_ 4� Height: � a
� Square I'eet: � Cubic Feet: fa ���
Type of Construction: (No�� ��a,� � ��unated Cost: $' Q,o�
�- � � ��t ,�'a �+
To J3e Completed: c�v/� A1t. A A1t..B
/ �
i
Proposed Drive�aay Widt;h It I�ew O�ening Is Desired /% ^ $ $ -
(S�� F.�VERSE szn� ar SHEETj
The undersigned hereby makes application for a permit for the work lierein
�specified, agreeing t.o do al.l ��ork in strzct accordance wit.h the City o£
Fxzdle�� Or.dinar;cr-.s and ruli»as of. the Dcpar+.:niellt of: Builaings, and hereby
declai:es that alI Lhe �acts and represent.ations st�ated in this appl.icaLion
are true and correct. See reverse side rar c?C�(�l.t:1021�11 1.I1�O:i111t.1017.
D71TL: � _'� _ �G STGIQIITUP.E: �v�/ b�
Stigulations: , . . `� /a J. y0
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BUILDI(dG PERl�1IT FEt SCNEDULE
SECTION 2. The Inspector of Buildings shall, before issuing pern�i�s for �he erection-
of any build:ing or structure, or for any addition to any existing building or structure,
or for any alteration or repairs to any existing building or stn;cture, upon application
therefore, require the payment by the applicant for such permit of fe�s to the amour�t
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic fee�.
PLAN CHECIC: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17.20
:11 • � � �' � �
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or thQ cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an exist.i.ng structure, the fee shall be at the rate
of $3.00 �ier each five hundred dollars ($500.00) or fraction thereof in the cost
of all propcsed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
' � � � � �1� �j
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedi.ng with the framing.
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• � CiTY Of= I�fZII)�EY
' /1PPLIC�'fIOiJ FUR RGSiI)f=NTI/1L Bl1i(_DING f'Ef2MITS . c?a..3�7
� ��'�EW, �L.TLR/1TION5, ��DDITIO���, Of� �EPAIIZS)
OWi1�R: _ _�: rv .1.�� �'r, ,v _ T3UILDLR: � � ��c r•-� .� e � � C� .J
.T.._._._
Address . �i �` i j /�1 �`f� .;. �' nddress . `i(' �S � �� 1 �r�" J /�!----
Tel. No. ���j'ri''•_-� .
No. �"�'�� StreeL-: A t�!, ��,- � _
LOT: ,��' BIACY,: ADDITION: � �rr�, v,1 �} j� ��
CORIQ�R LOT: INSIDE LIJT: �" S:;TBACY.: SIDEY71Rri5:
Appl.icani: attach 'to this foYm �vo Certi�icates of Survey of Lot and proposed
building location drawn on these Certificates. .
To Be Used As:
DESCRI PTIOfJ OF BUI LDI P�G
Fron t :
Square Feet:
Fron t : �
Square I'eet:
Depth :
Cubic Feet:
Depth: �
Cubic Feet:
Height:
Height:
a
Type oi Construction: Estimated Cost: $
Tc� �e Completed: Alt. A Alt. B t
i
Proposed Driveway t9idth I£ Ne�a Opening Is Desired � $,�% .S� $
(SE� RE;VERSE SIDE OF SHL•'ET)
The undersigned herek�y makes a}?plication tor a permit for the war}: herein
specifa.ed, agieeing to do all work in strict accorc�ance �aith tl�e City of
Fr�dley Ordiziances and rulings of the Department of £tiildinqs, a�icl hereby
declares i:hat all tlie facts aiid represeritations �tai:ed iil this ap}�lication
are true ��d correct. See reverse side for aclditional infoz�nation.
DA�'i: � SIGNTITUP.E: �� � ` -�--�
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--='�c� �-�Ci = c�s rc�s�j' �
, CI7�' OF �RIDL�Y . .
�PPIICQiIOiV FOR PUIMBING AND �iAS Ft�t�� P�r�tr
,� �. � tll � � U % • tl
C[ 0�' L1 �1 4 C�.�i ' tll Q � !L (�a�i �
G7 .-� H v! E� d 1� - m rtl i.r SL �
++ � � 9 C Cl x L 3� .0 K� c� FC G� 1�
fr � m c ,� +i ,1( x C C 3 �+ v«� o.c U v
..f.; O..�1 iJ O1 C N •.i � O O ++ N�:Jl N N roN
tn � U � � c� v� 3 4 u�. v�i t�+. U w a 3 (ro7 � c7 O
G. � ( �
lst c� �• � � � i
2n3
3rd
Y:.1
(R) = Future Connection Opening, Ccnnected with Sewer
(*? = Nex Fix�re, Old openfng Water
Water Job Addres$ � � 1 ( � �
Heater ,
Department of Buildings
City of Fridley
as lec Tel. #571-3450
The undersigned hereby me�ces egplication !or a permit !or the �rozk hereia
specified agreeing to do all work in stzict accoxdance with the Cl�y Cbdes
and rulings of the Department of Huildings, and hezeby declares that a12
. the facts and representations stated in this application are true and cor.rx�
' Q� n/ FridleY. Mn. �—� S . 19�0
r�
PARTIAL RATE SCNEDULE
PLU�SBING FZXTURE RP,TES: N0. RATE TOTAL
t�.�saer Fixtures �i� x 53.fl0 $ �•v�
Future F3xture Opening _�x $2.00 $ �.pd
2de�.r Fixture, Ola Openinq x $2.00 $
. .
Ca�ch Basin x $5.00 $
S±ater Heater - to 99,000 82V �_ x $5.00 $�
100,G00 BTil to 199,000 STU x a"10.00 $
' S:ater Soft�ner x $7.00 $
New Groun3 Pun Old Bullding x $5.00 $
Eiectr:c Water Heater x $5.00 $ ,
GAS FI:'Tii�^v FEES: � .
. lst 3 fixtures �_ x ' $3.00 $ ,U�
, a:]ditio�al Fixtures x $1.00 $
Gas Pange to 199,000 BTIJ x$T0.00 $
REPAI�S f� ALTERATIONS
Pirst 5100.00 $S.�Q $
mach add. 5100.80 or fractian � $2,pp $'""—""—
� ;:tate Surchar9e S .50
TOTAL FEE S ��-5-�
HT:tNr:t�r.�^rt,�r; �•r.r:
_._ _._---__ ..__
�
OWNER
RIND OF BUILDING
USED AS � •
TO SE COMPLETED ABOUT � l"' ��-
ESiIMATED COST ' '
OLD NEW t3iLDING PERMIT N0. PERM2T NQ. _ /J�i � �
CbmPanY I � � �/���
Signed By
Tel. No. a�-� 3� Y
ROUGH INSP.
� Date
FIN}1L INSP. �' �S - %�
' D3te
APPROVAL FOR PERMIT -����o��Z�
MINIMUM FEE FOR ANY PLUMHING PERMIT 23 $9.50 py� ��50 3TATS SU�'g
0
�
.�I
�� it: �is� f—Ra:�Lf_Y
APPIICATION FOR POW�R PLANTS AND HEATING, C�OLING, V�NTIlATION, REFRIGERATICN AND
.AIR �ON�ITIONING $YSTEMS AND D�VICES
PARTIAL RATE SCHEDt1LE ' __ .
�% G��U
cRnv��nt wa� AiR:
Flirnace Shell b Duct Work
Replace..ent of Furnace .
Repaizs & Alterations-up to $500.00
Re�airs & Alterations each add. $500.00
MECHANICAL WAR�1 AIR:
PU rnace Shell & Duct Work to 100,C00 BT�I
each add. 50,000 BTU
Replace:.ent of Fuznace
Repairs b Alterations-up to $500.00
Repairs 6 Alterations each add. S500.00
ST'rAbf OR tiOT Vu�TER SYSTL-'�t:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
8oiler only up to 100,000 BTU
each addn. 50,000 ETU
OIL BUR��R- to 3 qal. per hour
each add. 3 gal. per hour
GAS BUR\ER- froQ 100,000 BTU to 199.999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTI;r'G f�EES:
lsc 3 Fixtures �
Additional Fixtures
Gas Fange to 199,000 BTU
AIR COA'DITIO\I�'G �
F�\ FIE�TING SYSTG?fS See Fee Schedule
VENTILATIh'G SYSTEhiS
ALTERATIONS � REPAIRS
RATE TOTAL
512.00 $
7.00 $
7.00 S
4.00 S
Job Address
Department of Buildings
City of Fridley .
Tel. #571-3450
�. ��
/ ,r�7 The undersigned hereby makes application for a permit for the vosk herel�s
$12.00 S{' v� specified aqreeing to do all work in strict accordance w3th the City Codes -.
4.00 $ and rulings of the Department of Buildings, and hereby declazes that all the
7.00 $ facts and zepresentations stated in this application are true and correct.
7.00 S / • ,
4.00 $ `.� �Fridley, t4inn. (r��y-� , :9�
OWNER �l ���� �:�C/ 1,�G� s�C ^
S12.00 S
4.00 $
7.�0 S
6.00 S
Sio.00 S
10. 00 $
$10.00 S
S
x S 3.00 $
x $ 1.00 $
x 510.00 S
State Surchazqe
TOTAL FEE
S
S
S
S
S .50
S�
RAUGH ZtiSP. REINSPECTION FEE
Date ($10.00�
PB3AL ZNSP. �/ � 2__.e� � ' - � �f�..L-L r'�f✓ZJ
Date l ,C�C��� }7 � ,� t'''�C� -
-J' r I
JIPPROVAL FOR PERMIT ��� �? ��1�2/-+i
� .
lLiNIMUM FEE FOR A2�'Y HEATZDTG PERMIT 2S S7.50 PLUS S.50 STATE SURQiARGE
KIND OF' HUILDING
USED AS
TO SE COMPLETED ABOUT
ESTIMATED COST ` � G�l/iG���}
OLI�NEW_BU�7L�DiNG PERMIT NO. PERMIT NO. j 3��
, DESCRIPTION OF FURNACE/SURNER
HEATING or POWE ;PLANTS, Steam, Hat Water, Warm AiY- No.
/
Trade Name � _ Size No. ,����L�� �
Capacity Sq. Ft. EDR BTU iiP
Total Connected Load Kind of Fuel .l-�/i�-�"
BURNER - Trade Name� Si2e No. •
Capacity Sq. &t. EDR BTU HP
Company
Signed 8
Tel. No.
A.J.tf.V.t..
Weathcrstr�ps G�i� Constrnetion N
��lindows � Doora Reference Out. Wall Int. Wall Ceiling
Yes—No Yes—No 19_
% F7•� � Room Length / ' " Width V` '� Height � �
�indows and Qoors—Crackage and Ana
WSdth HeSght Nc. of Lineal tG Ans
No. ot D�no of Dane Ilvhte � ot cract W. t6
y' 2+� C`a o /� 2 CI
Cacf. Bta
Inhitratioa �' 7.,� � ;� e f � �
Glass ca a� 2� O�"'
Exp. wal� ,'�
Net exp. wall '7
Int. v�all
FlooT r' _�, � �
Ctl�. � �j�'!+ ' �
To�i Bt�. � 6
Required sq. ft. E.D.R. or sq. ins. W:A. Leader area
F7.� Room ( Length Width Height
Windows and Doors—irackage and Area
Wldth Helght No. ot Lineal ft. Area
Na ot pane ot Dane 1lehta ot crack sR. tG
Coef.l Bcu 1
Infiltration
Cdasa
Exp. wall
N�t exp. wall
Int. wall
Floor
Ceil.
Total Btu.
Re�uired sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. � Raom � Length j�" Width He:ght r
Windows an Doors—Crackage and Area
Wldth Helqht No. ot Llneal fi. Area
No. ot Dane ot pane IIBht• ot crack eq. [t.
� t �1 R Pt � 7
- t F� Z
�. 0 4
Coef. Btu
Infiltration � � �jp ,/ ;� � ,�
Glaaa
Exp. wall
Net exp. wall
Int. wall
F7oor
Ceil.
Total B:u.
r - I
� .� �» ..a �� . �
�,� «� .� , , �;
_G�-_'�
' Required s:�. f�. E.D.R. or sq. ins. VT.A. Leackr area
�, In�lation
Roof Floor Kind No�+'
Fl.� Room Length Width
Windows and Doors--Crackage and Area
Width Helght 1Va o[ I.tnesl fA Area
No. ot Dgne ot Dane I1sLts o! ¢ract sd: ft.
Btu
In5ltration
Glass
Exp. wall
Net e,sp. wall
Int. wall
Floor
Cea1.
Tocal &u.
Required sq. ft E.D.R. or sq. ins. W.A. l.eader area
F1.� Room ( �ns� Width Height
Windows and Doora--Crackage and Area
Wldth HefBht No.�oi Lln�at tt. Area
No. of Dape ot pane 116bts ot crack p. [t.
Coef. Btu
Infiltration
i'slass
Exp. wall
IVet exp. wall
Int. wail
Floor
Ceil.
Tota1 Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.� Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height Na of Llneal tt. Area
Na ot pane ot�pane IIBht� ot crack sq. it.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. Wall
Int. wall
Floor
Geil:
Total Btu.
Rtiq��irecl sq. ft. E.D.R.,or sq. ins. W.A. L.eader area
Wcathcrstrips `���.v'r'• Con:traction N
Guide
1►lindow: ( Doora Reference Out. Wall Int. WaH Ceiling
Yea—No � Yea—No 19 `_
� F7.� F' �� � Room Length / Width i c� `` Height � t
Winc�ows and Doors—Crackage and Ana
WSdtli Hetght No. o: Llnul tt, Area
No. ot Dano ot pane liviits ot cract sd. it
i. 4� � � � � . 4 �
Cocf. Btn
Inhitration 2 t��
Glass � q � � Cy
Exp. wal� � ?
Net exp. wall � D 0
Int. v�all
Floor � �' ^� �"'
Ceil. O S° „`�
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W:A. Leader area
Fl.� �„��. ` '�'r p Room � Length �� .� Width // ° Height �' �
Windows and Doors—Crackage and Area
Wldth Hetght No. o[ Llneal ft. Area
No. of pane ot pane If¢hts o[ crack �a. [t.
Coef. Btu
Infiltration ��,, ��s / �� �
Glasa :�` c� �r� /�.^� c:� C'
Ezp. watl �p �
N@t CXp. Wdll =� y �`/i r
Int. wall
Floor
Ceil.
Total Btu. .
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
� Fl. ,�� Room �Length �„' Width (,' Ne:ght �
Windows and Doors—Crackage and Area
W1dth Re1Rht No. ot Llneal fi_ Area
No. of Dana o[ pane Ilaht■ ot crack eo. [t.
Bc� I
In<ratioa (
Glass
Exp. wall
Net exp. wall �, ` p
Int. wall
E7oor � �j � 4 ?
Ctl�. �f �? j '
Total B.u. / � �;
' Required s:7. fi. �.D.R. or sq. ins.1�1.A. I.eader aren
�, Insnlation
Roof Floor K;nd NoW �
/ F7.� /Y) � Room LeaSth /G �� Width
Windows a� Doors—Crackage and Area
Wldth Helght iVo. ot I.tnwl LL Area
No. ot Dgne ot paes 11shU ot ¢rack s�: tt.
� 2� Z �D
(
Infiltration 2,
Glass :..Q
Exp. wall �'
Net esp. wall � 2
Int. wall
Floor �'s
Ce.7. .�
'fotal &u.
ReqaQed sq. #t. ED.R. or aq. ins. W.A. L.eader area
F1.I /'(`i T/�/ Room I 1-�nS� /�"Width
Windows and Doora—Crackage and Area
Wldth HelHbt Na�oL Llneat 1t. Aroa
No. of Dane ot pan! 116b� ot crsck p. [t.
2 2.a 2
c
Infiltration � �
Cilass f
Exp. wall
Net exp. wall
Int. wa11
Floor
Coil.
Tota1 Btu.
��
��
��
�
� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F7.I alN/ N c°s Room I Length p�(e "Width �9'
Windows and Doors—Crackage and Area
W[dth Helght No. ot Ltneal tt. Area
Na o[ oane ot.uane IlBhts ot crack sa. !t.
_��
,
Btu
•io6r S'i /
.�_
v�
Coef. Btu
Infiltration /
G1ass .Z �r ..5'tl sa t�
Exp. wall '� ;i.
Net exp. wall ,�,
Int, wall
Floor �,;s! ;� - "f' � f y
.,
GQ�. �i .' "' ��"l',
Total Btu. ,2„
Reqcirecl s4. ft. E.D.R., or sq. ins. W.A. Leader area
Wcatherstrips A'��.v�'• Constrnction No. In:ulation �
Cuide
��lindows �' Doors Reference Out. Wall Int. WaN Ceiling Roof Floor Kind How Applied
Yes—No Yes—l�io 19�
Fl.� �7r, �� Room Length /,� `j," Width Height � /3 F1•� U� l f Room Length � ' Width ` Height 8' �
�'Jindows and Doors—Crac3cage and Area Windows and Doora--Crackage and Area
Widtli Heieht No. o: Llneal tt 6rea w�nch Helaht P(o. ot I.laeal fb Ares
Cocf. &a
Inhltration ,Z (e �,�, �
Glass � � �''',� /� a
E7CP. Wd�� � '
Net exp. wall � � ,
Int. v�all
F,aar /.�? a �
Ceil.
Total Btu.
Requirecl sq. ft. E.D.R. or sq. ins. W:A. Leader area
�t FI•�1�� �l�'�'f?itd oom � Length ` Width �<.-�6 " Hei�t Fl
Windows and Doors—�rackage and Area
W(dth Height No. o[ Ltneal ft. Arsa
No. of pane ot pane llahts of crack p. tt.
t �Ot f' � ���
Coef. Btu
Infiltration yGl / �
Gla� .5`D ?_ � c� �
Exp. wall � �¢
Net exp. wall � c� f
lnt. wall
Floor +" �'� ° ,�., ' ,;;� �"`
Geil.
Total Btu. . r�-�'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
�^ Fl. � e.t �°�,�; °'':� Room ( Length `�7'�; Width ;:; ' He:ght F' ,
Windows and Doors—Crackage and Area
Wl�lth Helght No. 01 Llneal ti� Area
No. of pane o[ pane Ilght• ot crack e4. [t.
�
Infiliration �
Glass
Fxp. wall
Net exp. wall �,� � `.�`
Int. wall ,
Floor ' 1 � � T
Ceil.
Total B.u. '� � , .'"+
�
' Required s�. fi. �.D.R. or sq. ins. V/.A. Leader at�a
Coef. Btu
In6ltration
Glaas
F7Lp. WaU
Net eap. wall �`�
Int. wall
Floor � 3 '%.. �
Ce�.
Total Btu.
Required sq. �t. E.D.R. or sq. ins. W.A. Leader area
Fl.� (� � ty oom ( Length 2 G Width �' �" Height �
Windows and rs—Crackage and Area
Wldth Helght Na�ot Ltneal [t. Area
No. of Dnue ot Dane 116bu ot crack p. tt.
2 2SA+ /� / i% �
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wa11
Floor
Ceil.
�
1
�
�
0�
��
��
��
��
��
Tota1 Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.� Room I L.ength Width HeiSht
Windows and Doors--Crackage and Area
Wl�l[h He1Bht No. ot Ltneal tt. Area
Na ot nane ot,pane lishts of crack eq. 1t.
lnfiltration
Glass
Exp. wall
Net exp. waq
Int. wall
Floor
Ceil:
Total Btu.
� Raq•�irecl sq. ft. E.D.R.,or sq. ins. W.A. l.eader area
BtU
/
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLtNG, VENTILATION, REFRI6ERATION AND
.AIR CONDITIONING $YSTEMS AND DEVICES
PARTII�L RATE SCHEDULE
�/,
GRAVITY WARM AIR: RATE TOTAL Job Address �� �/� �'r,.�:�-�`u,U�_, 9�F��l.�" �
fl�rnace Shell & Duct Work $12.00 S ,
Replacement of fUrnace 7.00 $
Repairs & Alterations-up to $500.00 �•�0 S Department of Buildings
Repairs & Alterations each add. $500.00 4•00 S City of Fridley
Tel. #571-3450
MECHANICAL WAR,�f AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Reolacement of Furnace
Repairs & Alterations-up to $500.00
Repairs & Alterations each add. $500.00
STFAM OR HOT WATER SYST17�4:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100.000 BTU
each addn. 50.000 BTU
$12.00
4.00
7.00
7.00
4.00
$12.00
4.00
7.00
6.00
S
$
S
S
$
S
S
S
$
OIL BURNER- to 3 qal. per hour S10.00 $
each add. 3 gal, per hour 10.00 $
'r C
GAS BURNER- from 100,000 BTU to 199.999 BTU 510.00 $�_
(over 199,999 BTU see Fee Schedule) S
GAS FITTING FEES: •
lst 3 Fixtures ! x $ 3.00 $,3-GC .
�dditional Fix tures x $ 1.00 $
Gas Range to 199,000 BTU x$10.00• S
AIR CONDITIONING
FAN HEATIIvG SYSTE�lS
VENTILATING SYSTEDI5
ALTE�TIONS $ REPAIRS
FtOUGfi INSP.
Date
$
Sea Fee Schedule $
S
S
State Surcharge $ .50
TOTAL FEE $ � . ,-�`� C
REINSPECTION FEE
/�''��
($10.00)
The undersiqned hereby makes application for a permit for the wozk hereiz
specified aqreeinq 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 corzect.
Fridley, Minn. �fJ (_'� G,�_. 19 %�
OWNER
KIND OF BUILDING �h�%ys��
USED AS /',lyGGi°.����
T
TO BE COMPLETED ABOUT ��- ..�� - 14
G _
ESTIMATED COST -� c� Q C1 �
OLD - NEW BUILDING PERMIT NO. PERMZT N0. ----�1-���-
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Rbtal Connected Load Kind of Fuel _
._ ..�.,.. . ,.
BURNER - Trade Name� Size No. �
Capacity Sq, Ft. EDR BTU Hp
FINAL Z23SP. l`� � � �v � �P�+Y �!/-�,�:%!r1 � L4GGB 7 (X/ G°'/if /
Ddte � 1 y��G�,�� C� -
� Signed By � �
� �QO ��� � ,: �,Tel. No. S%I -'�JJ�
APPRfJVAL FOR PERMIT � G� _
� � � 1 t' •'` r ��TD. � .
/3/'�� �� �� � a � .
MIbSIMUM FEE FOR ANY HEATZKG PERMST ISI$7,50 LU�% S$,50 STATE SURCHARGE � t
STATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETT6 ROAD
///� o/ 8T. PAUL. MINNESOTA SS101
/! Q(O
Date
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RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject:
Name of Day Care Home Ap icant
S� �//.� �� }; �l�
Street Address �
6���� �� %'�21 v`-5�3�
City State Zip Code
�r�����
DHS-2722 ( 9 b8 ��
PZ-02722�02
1�-
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Type of License:
Family Day Care
Group Family Day Care �
Licensed Capacity /a
Phone No. �%�-%�a%
This is to inform you that we are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2), Family Day Care and Group Family Day Care
this license is subject to compliance with the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, known as
the Department of Human
You should note that under Minnesota Statutes� Section
3� a licensed day care facility serving 12 or fewer
considered a permitted single family residential use of
purposes of zoning. Subdivision 4 of the same section
licensed day care facility serving from 13 through 16
considered a permitted multi-family residential use
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
� ��// � �� , il �.I �� � i . /_ � �
- • • - � �
Street Address
245.812, Subvision
persons shall be
property for the
indicates that a
persons shall be
of property for
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNI'fY HEAL7H & 30CiAL�
SERVICES DEI'ARTMSNT
cavxtv o� �NOxw
COURTHOUSE. FOUR7N PI.00R
ANOKA. MtNNE40TA f590i
Name of Agency/Organization
City State Zip Code
l �� �' �f� ' � i ��' ,'
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AN E�UAL OPPORTUNITY EMPLOYER
�. �to � -;���� 560
o �' -T �;���
�� CITY OF FRIDLEY
PUBLIC WORKS DEPARTMENT
TAPPING APPLICATION AND PERNIIT
FOR INSTALLATION OF WATER & SEWER SERVICE
I) This form to be completed before a tap is made to any ezisting water or
sewer line. �% , �
Lot�lock Addition � ` � �� ���"` '� � �
Address `�`i � � '�� r� 4 -Z6%'�� � ..��` ,��, �� .
Owner a�.Ga- -'c ^ . � .�,- � /�,.. ;,Y- ��� ' -G�
Plumber �%L � s� �� �.� G� � `y�= /��
CHARGES TO BE PAID BEFfDRE TAP�IS MADE — WHERE
ASSESSMENT HAS NOT BEEN LEVIED AGAINST PROPERTY
II) Water & sewer connection permit must be registered before this Tapping
Permit can be issued.
City supplies all material and labor for 1" or under water tap. Con-
tractor supplies all material and labor fot water tap over 1", and all
sewer taps.
WATER TAP: Materials Used: $ �� ��' �n
Street Patch: �_'� x�: $ :% �`�' � �`2`
TOTAL: $ =�-���' ��
SEWER TAP: Street Patch: x :$
III) If this property has not paid a full Lateral Charge for its share of the
water and sewer system, additional charges will be placed against it.
'This will be in addition to the normal connection and tapping permits,
meter deposits, etc. / - �
( W�� ���
ASSESSMENTS TO BE LEVIED: Lateral: $
0
Sewer Lateral:
TOTAL ASSESSMENT:
Clerks Signature L�1��za `J �,t� / �—��
;,
- ; ;
Supt. of Public Works �✓` ���'�''` �''�����'��'�`-�"-��`�`��
� / s� '
M/P 3/76 White P.W. Canary Finance Pink Prop. Owner Goldenrod Plumber
� � SU9�EGT .. . . .
City of Fridley 3 i 393
AT THE TOP OF THE TWINS g U I L D I�� P E R M I T
� � ECEIPT NO.
� �
� • COMMUNITY DEVEIOPMENT OIV.
� LV ��'��
r � � PROTEC7IVE INSPECTION SEC.
� � �"'1 � CIFY NALL FRIOLE� SS132 NuMBER REv D�TE P�GE O� APV OvEO 8r
�'""�'� �'� 612-571-3450 9t0-F15 9/13/00 � �
JOB ADORESS 5871 Arthur Street NE
t LEGA� �OT NO. 9LOCK TRACT OR AODITION SEE ATTACHE�
DESCR. 2$ AUd1tOY'�S Subdivision '��92 SHEET
2 PROPERTV OWNEq MAIL ADDRESS ZIP PHONE
Dean/Barb Anderson 5871 Arthur Street NE 763-502-0436
3 CONTFACTOF MAIL ADDRESS ZIP PNONE LICENSE NO
American Building Contractors 12247 Nicollet Ave S, Burnsville, MN 55337
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P VMONE LICENSE NO.
952-707-6959 20169383
5 ENGINEER MAIL AODRESS ZIP PHONE IICENSE NO
6 USE OF BUILOING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof House & Garage (22 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST OCCUPANCY GROUP OCCUPANCV LpAO
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SO. fT CU FT
AUTHORIZEO IS NOT COMMENCED NIITHIN 60 OAYS, OFi IF CONSTHUCTION
OR WORK IS SUSPENDED OR ABANDONEO POR A PERIOD OF 120 �AVS A7
ANV TIME AfTER WORK IS COMMENCEO. NO DWLG. UNITS OFFSTREET PARKING
I MEFiEBV CERTIfV THAT I MAVE READ ANO EXAMINEO THIS APPLICA710N 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP�IED
WITM WMETMER SPECIFIED MEi7EIN OR NOT. TME GRANTING Of A PERMIT �2�2SO �1 .12
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMITfEE SACCNAFGE
ROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• $83..25 � Fire SC �p2.2S
S UCTION THE PERfORMANCE OF CONSTfiUCTION
PLAN CHECK fE TOTA FEE
., �"° �—� -Q Licens 5 $5.00 91.62
S�GN EOFCON'PA(;iQq RAUT RIZEO4GENT iO�TEi EN FOPER ALIOAT HIS I � PbF1 �( �:
� _�t'�/.� /
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S�GN4TUqEO�OWNEA��cOWtiEQBWlOEA� �D�TE� Bl0 �ti5 •�E
NEW [ ] ��� �
ADDN [ ] '
AL- TER � [ ]
Effective 5/10/99
CITY OI+' FRIDLEY
SINGL� FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
a
.� � �
1►
Construction Address: ��� � �-i��-%�L,l l�'C J`�. 1�L`,= '�`� ��� �' M I�.J 55�{3Z
Legal Description:
Owner Name & Address: � J°, �j nde.r�� n Tel. #��'�"�2���0
Contractor: ��L! j` � M L��I�C� �NSE /# � i) � 18�-3
Address: I��`� � i�.� l c 6(1��" Yl l,� e� 1� u� Ut i� /�'T�l. � �. -�D �'� 95
_ �:� �. �i
Attach lo lhis ilp�IlCl�lOt1, a CcrtiCcatc oC Survcy of tlic
lot, witli the proposed construction drawn on it to scale.
LIVING AIZ�A:
GARAGE AR�A:
DECK AREA:
OTI�R:
I..ength
Length
Length
D�SCRIPTION Or IMPRO'V�NI�NT
Widtli I-Ieight- Sq. Ft.
Width IIeight � Sq. Ft. �
Width Hgt/Ground Sq. Ft.
Constzuction Type: �c-E — r`�['� Estimated Cost: $ � ����
Driveway Curb Cut Wiclth Needed: Pt. + 6 Pt =__Pt x$
_$
DATE: ��C�C� APPLICANT: _ � jC(��� �,, � x �J -�, Tel. # ��� - �D �' � �
CITY US� ONLY Ci��
�
Permit Fee
Fire Surcharge
State Sur�harge
SAC Charge
License Surcharge
Driveway Escrow
�rosion Control
Park Fee .
Sewer Main Charge
TOTAL
STIPULATIONS :
$ �-���
$ �- ��
$ � /�
$
$ S.UU
$
$
$
$
Pee Sclicdule on Reverse Side
.001 of Permit Valuation (1/l0th%)
$.SQ/$1,000 Valuation
$1050 per SAC Unit �
$5.00 (State Liccnsed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Detennineci by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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