AF - 35307:
_
;
>
.
�
a
I
O
<
�
�
�
1
�
�
�
r
,-:
�
�
�
�
�
�
�
�
�
�
�
�
��
Q
�I
�
�
�
�
z
m
�
0
�
�
�
� � �
� � �
O
� � � p
����
�����
� �
�
�.-.,�-
�
i
� �
� �
�.
_�
.�
�
�
:��
�
rn
ni
�
2
is I
�
G��,
��
� y
�
� °°
�a��
� � W �
��� ��
�
s � � ,..��" o
�� �
�� � �
m
� �
•
�
i .
�
«���
.�
p�a��
MNi �
- �
I �
�' C o w
m � � �
w
� o �
�� � �
� � d �
� '3 �
�, � � W
� � �
� �
,
� �
' , ��
� � �
� �
����
o �
,
� �� � b
�
�
a
�
0
�
a
�
°< �
M I
W�
��
��
� �
? y
C �
"1 �
UI ro
eb�
�
�
�.
�
� �
� �
� �
�1
w
g
�
I
0
�
�
��
0
0 �
��
{y
�
�
O
�
�
� � �
� � �
� � �
a a � � 5C
� o a eo "1
�� ���
��� d �
�
�����
OA ,0 � �J
� � � � �i
� �.
�
� �
x �'
o�
��
�
�
w:�oo
s�sg
����
1i1
I
I I I
,
a
O � y
a � o
� � o
�
� � A
�+ �D
� O.
� m
� I �
A M
� I �
» �I
o �
�
I � � i�
0
�
0
�
�
�
�
� �
�� �
� �
� � � �
�a� ��
� � ��.�.�
oo���
���ga
�' � Oi�
a �► �
� � ' C1
� � � �
���wo
s'sa�s
N �6►
�
�
C �
� �.
� �
i\ ` �
�V.
� I
IA
0 �
I �-"u N
; ��
�
�
�
��'� ��
R� R� � � �
��o��
��"��
����
� � � �
7 �
O� � .
� � .
g $ . .
8 : :
a
w��o�
sag's�
� I Sp�
� 'y7
� r
I I
$. o.� �
b��� �
A � �. �
� m ~� �
O A � �
� d� �
�'y �
.°: .m, a�. a'
r� � o �
� �
5���
�
a �o E
� y ~��
� ���.�
b.:��
����
a' �'�
A��p
���
��
A p� m
�� �.
a�
� !�r r.
���
�2�
� ���
� �
� � �'
i�..�
���
�
�
D
'�
r
�
T
�
z
�
c°
�
�
M
�
i�
1
�
�
4
�:,
�
� �
�a
�
N
��
� �
�
�
D
e
�
O
�
w �.
_
City of Fridley, Minn.. � ��� �
6431 University Ave. N. E., Minneapolis, Minn. 55Q32..:
� I�UII.DING PERMIT
r �
v
.n Q%' /�'� te: December 9 s_]„�� .
i, � �,
04vaer: �Sot?t T�n� RQ�1.�� Builder S me
Address 1 o�ddress ---Same
�a� �
LOCAT10iV OF BUILDING
No. _..._ G.�.,�$�.. Street $�n More 1�riyg ]�.E, . Part of Lot
�� -------5.. Block _.__._.],....._..�_._,.______ Addition or Sub-Div3sion up �+-H o v u; 11 a e��, an
Corae�r Lot _---.._._...__._.. Inside Lot — �L Setbaek 35' ,____. Sideyard _ 7 n� � 5'
,$�'gb�r/IIevation __919_59 7�'b1�d��l�i���i�dn- A92 SA Mi��IlIlIL1.�_,...�.,
o n noi-i g
i
DESCRIPTfON OF BUILbING -
To be Used ea:
�Dwalling ____ �ont �9 Depth 28 Height 20 Sq. Fi, 1462 �, g�, _33�$32 Total
_Garage __ �nt 20' �p.� 26' Hei�ht _ 10' Sq. F� 520 �, �, 5, 200
Type of Construction Wood Frame ��t $27, 50Q TQ ��pleted Ma�* 197�
27 072
Stipulations: Provide a verifying survey before capping. Provide a hard surface
driveway.
WATER LOCATION: 10' South of Sewer Serv�ce
SEWLR LOCATION: 103' Northeast of Ma.nhole (Inv. 920.00)
In considera.i3on of the issuance to me of a permit to construci the building described above I agree tg do
�he praposed work in accordance with the description above set/�ortlYlan� in yompliance with a�l provisiong pf
Ordinances of the city of FridleY• // �,[ /
13.54 State
Yn consideration of the payment of a fee of $�.3.._Q�,._,_permit is hereby granted try South Towne Realty
to construct the building or addition as described above. This permii is granied ugpn,
the express condition that the person to t�vhom it is granted and his agents, employees and worlunen, in, a11 Work
done in, around and upon said building, or atty, part ttiereof, shall conform in al1 respects •to fihe orc�inanCes oi
I+'ridley, Minnesota regarding location, construction, alteration, maintenance, , repair a,nd movIng of bwlldiIIgs
��� city ]imits and this permit may be revoked at upon v3;o1 n f any oE the prov3srlons of said
Buil�ing Inspector
RRFT� C RK
NOTICE:
Thls permit does not eove� the eonatruction, insTallatfon for wtrine. Plu�bin8. eaa heating� �trer or water. He sure to 1�9
t6s Building Inspeeto� fo� aepa�aie permhs for these items. ,
f
.m=
APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : BUILDER s—� � -� / �i� �/ �
ADDREa� S: ADDRES S: J ��f/ � i� /� �/�
/�� ��.� � � �G ly i � �� � � / ! �
No.. ��a�� S�T: � � � , ^ �r..
� ] �
LOT:_� BLOCK: / ADDITION:_ �1 � r¢ �l�-�� /;�e ��i
CORNER LOT: INSIDE LOT:�gETBACK: r� SIDEYARD; � '��
-�.�� J S
AppliCant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
BESCRT�TION OF BUILDING
To Be Used As : �� S �� i�,�. ; ✓{- � � +� �� ��� � c
��AQA6�- t
� � �� < < :
�_, Front - ��P� =� `�° fq �v�e Height • ' r' �
Square Feet• Cubic Feet: �,^
'� � `� • � y p ; �-, Front ; _�. r; Depth : � � r �
----= Height • � _..�
�_.
� Square Feet; '� _,y� Cubic Feet: '
� , Type of Construction: -� �✓� j� �� ��
Estimated Cost:_,� � �'� �
To Be Completed; ��� / ���'? � � �
�}---
The uadersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in st�tict accordance with the City of
Fridley Qrdiaances and ruli�gs of the Department of Buildings, and hereby
daclares that all the facts and repxesentations stated in this application
are true aad correct.
, ,�� � r
--_ __�
�TE: SIGNATURE:
/
(See Reverse Side For Additioaal Information. ) � .�� � , C ���, ��� � �' �°`��`�'�� ,1��'� �
� �_ f -� � ��-. .— �
� s _-
;:�
/�. � �
� ^����
_ _ _�..�...�,�
�� �� y
;- �� , s � -° C�
e
�
3 '
�
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permita for the
erection of any building or structure, or for any addition to any existiag
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in
the manner herein provided to-wit:
UNIFORM BUILDING CODE: 1�pe 1, 2& 4-$2.15 for each one thousand cubic
feet, or fxaction thereof, in auch cubical contents. Type 3& 5-$1.85 for
each oae thousan.d cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permita, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floox line of the basement
or the cellar to the average heights of the upper surface or to the average.*
height of the roof surface of the ma.in gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
V�RIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a mini�m of 24 hours from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot,.showing the location of the foundation, onc� it
has beea constructed, will be required before �roceeding with the framing.
CERTIFICATE.OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten, (10) days prior
to the use or occupancy of any structure for which a building pexmit has been
issued; and said structure shall not be used or occup�ed until a Certificate
of Occupaacy has been isaued. •
S
� S
�
�1
(s\
�11
� r�'� �' f��� � �*'���t���f � ttin�� �� � �,� t`&€,� �, �. � :� � �'"�'�� .:: #���^ � ��� r���1
� '"�- ��,� �z�� � n'� �' �:ysr ��6 � x : a'a� � �i- � t y"�c';�,r ��.
�F � � o- .[ � �°' �. vt + �' x . `",�. � �. � E� � � ,y ' ��� �� .` r : ,�F �w �+�h.,� y c� �:
yab
���� � H } � ss � � � '� f ;'� . _ � . � .' � s.,� 4 1��� � ;�� �' r .
t � ���
% ,�'„-` 3 .�+ �. � Y'q.. � � : Y :� � � � Y
' ry� � '� � .�' F �: `�; s h� ra4 .��'� � v.
r� `� 4n? hr,g � �� � .,. m � i u{ � '� ''�i'-, �. � �"aY' ��i.Jgi �
� �
F " `+. ? � '�+� ` • ,� v� 3s� �'�
-.. � ` y �:i �` � y,'` � r �` F' � �;, � r�, r� t y �_ -� �9,€�.-it �
�t,�„ � �, � ^'� � ��f � � . � t• a � � �.��'e�Y+Y. ,q 4 y , 7f 3+x.
+pyN �'1 1-� . :��,i �.j ��� '� � � �- S�' � d .� A '13,� '� :,
d .` �j. � � �'' $'.�° ` +7.z ���r`� y' T y �� � r "�� � � } ,p.'z `y k '' � ��s„t�"�`"' �r' .r}, q��w
„� . �_ : o ;; _ � ;� _ '_ # � :. '1 �P� t' � t � � � > � # �$ k �.
: N � :.� �� �,Hr�,g�� �,
3 `p�•'G ��`5 � +.r� �.w�.�.i..� � .wl�+.�� . i � � +,y. 5..� 4 .. 'i4' .'GSW4 �
ry_' at t � , �} i-. �syE / .��T , '�' ,�'t = � "� {,.� � 1a� �i �. �".11.��.�.�,.
� .. 1- i�,'}�i�41� R�y1� 4�.y � �#�' � � = t � +� � �- "'`` � `�
�}'"�'` �:'r ��,P�S*�[�'� - � �a„ a k� ro X^,,,�,
* ;' i • K , - � -x" � �:
�l �'i 3 .+'fi �l � �� L � '
�`�d � `J � � �{ ''.+'k � ' �p y� � � } �
��. "� �4 S ` ... � ..y "L "SD `y �. ":
t �6 y',� i.` - _ fi,} '!" .. � �Y7-
�� .�X ' J '� 'IF� �'9'� � � '�� f �.( Y �: ��Fk 1''Jgk �! � `g
� � � � ��,��,�f
k � J : �'� � . . Y , �a ¢ � � � . � e'�}` �
�
�• �ry W ; . � k 3 '� �f
P . � - �' z . h e� 'f E.� �, v -. a -� : � �- ���$ t �.
� ` �i � r e �
�U`„{ ��, w �. ` � h. �k � �. �" ���"�� i
� . _ { . r t- �. •
s �_�y `�� *•� - _ rsN. �_.: �r �! ,n.,l .
� ��.: .F� �-. � - � �ey r1 � � , Y ^lz�S,s.
5 fl ' ` .. �' ui �'+�
.r r' n.e6 . � `� -j�E t }" F {', a �' �r5 C.
!".r ,�F _ � -.i ' i o�7
�'1 f '` ;} _ � '� p ti �
�� �': _ � i t _ � � � �� i �{ ����3�.
. . ! �'i�P , 4 k y i
Aei x �:� r �5 ¢,. � � ° - �-"'� �i �:z�� ��F ,�� ��e
i'ir v fA `` a "i f _ X r i; z rf 1?� ;
� _ � �*,. i t;' '�<Y,a
�� ,�.��� d .i
� �� l' � t.��{/�` � � ' t � .'
� >� � �� j'• , ' � w `h ,` }
i.
' �.. 7 4 � - �''� �� , �. �i+l r { f ;� � 'k'� i�;�.�
e.' r _ - _ , ' '+�,e!
r�` , � � i
�, " �,� � - � � k � �� _ �-$��;.
4, � ���j�'t���#�¢ rie"�`" ,�y �,f � ' � �
� .r, .- t ; _. � x . Y"". �"i' � `ai . F m r 1f' ° �' c
j. ._. _,y£ AN „ xs. c�.� � r F� S3 R ti�n
��A��� ���! �� ��O+i ' . � ���s � {•• "t / � +Y �+ � ro a. .
r 9
� 'a � `= °D , ,�, � : �'` � . „�, fr��z �?%,� �
,
� � '�t�- � �.,�h ��� � x ' ,�� �' " �'� � �'`
: a - r ; { ��{ ' � � t ' ,�� ;r� � r
) T`* ��.. ',j�i_ � ' = - � ° �'tSk'�f�y '
�_
_ -���4 ` �� - . `• ���,��pk,�,,k>,
'� ' �f �`,� h' � �g.� r i�-�. �TMi � i .
i�y ` 1* 'µ.� � �i . �t � � e � �
_ _ 1P� ' � �,; � # k$� .Y�' ry_�"' � a '�
�� •
� �
� � � � �:! � � J� 0. r -��� 4� `� �� ��
� �
� �
t. � ; „. ,`a2 a � r � r.a N� � � 4��
� � ,� d'�: � := rx ,�.- �
., ' 3,' �C/ j '. `� � i .;
Y� ; ..y
" � � fi ��' S. °., t +� xa t "�i'yy4�f`.
s1 � � f' - �i � � � ar "�`,,i`-f
E� =�'� ;3y =`�-#� �s ����" �,1'lt��p Cf.�.`�1',.Ol� F�'�.dXe��',-1►�.��t�0'�,i�,r :,, , ��, ,
` �. � �.A ���
? v � - '� > :: '� '°` n
r � � r �_ � �� s "� " � � 4 �., � �
k � � " . ;� t � ; _ � .: j 4 , v` �jg� y� �'� �
� *'� 4 c'° �, e �, �',�, T 1, °_'� $ wy�%: �; ^ +- "� r �:'�'3+� � rr e � ?` ; "� � i
, a � t ; P, — : � ,- , , � ,s . : �' � ,,�4 �, ' fr 4 _
C#i'x`�'3.f�`' �;�t �� �t�'��it� med�# s�+�a�`s?� ti�rl`+elCG , irtx�� s�j,� � �� � � �� �'r�` ��;
�� #RMMil��_Nf��' ��,�ir� Fi' b—;• � 1IJ���r F�� +� gRtqi 1a � ��� �+'S Mye fF .�.
; � � � �i#►��� A tol Q� �4��7�'� � +. ,� �a� W
� z'
� �� �' �-i Y•'�'m �, d3�� .�,'.
�' x� � � �' y FirE � n Y � ,i � �
p;•"-':'.� 4 tf�•�t � S � :� "w 4 '�a � ��ry��' � � •4.
� �. :� _ -"n�=-e,a ' � - - y„ . . � ,1C�d
. k. '�� ` '� � � ' st` •s*
5�' ;. � N � � ` M3'� . A z �}� y kf�•, �. , � a �� i�+� �.� � t �i �L
a �, .� . ,� �, �v '"`� t "=� g ± Y�j � � ' �� $t ;:
2�,,'a ,,.rr! a x x' ' ' 1�. - ��
�'^�' i�`! e�' j , ��` �,�'.. +� � :-� ` �{ . � ��g'�r� z
�{�5 �� _ .�`�,. , �° 4:-' � �� �']•��'��,,,.�� f�• �,��r� ;��stt'���l� - pg � }� �' � ..� �E..
¢y�ya� c �'�, � ` �i � s � t +�`�:.
t :xf � A� �, � yr_ k 5'`� �� � �* �A��a ���lr �7{i� - �,._:' �4 � r ��s?���a 1* }
Y ` � + �' �
gy� ��'j �, � '�u' , R � a r. � �} `R? �:; �a � .k� � M„'�° �'� �� i
�$ �71'/ � i . -a �� ,aK ` y �+ ^e`a�� � +a' i ; ,�, g � . t v K .�s ,"°• y k� � -^ +` fs ��"}t ".
� i' -a ri
����t� ,,:. � g$ ' �� �w � � , ��� a �a �,z� � �� � r {yl¢=9� s ��'k����` �' .
a zi% .� � . - b.. T f � �� �k� �i. � � "1 '
f�: S F '"K-y�' ' '��i b h� t: � = y � �`as� � 3. �.,: °`� "'� `� '�% �r� �` � a.r�'�`r b � ��z .
�`� ��' a .�z�: i . r �, 9,�'� Es w � �,, � �� t' � � - ,' � � b >:Y ro �" ': ,� n ;- e +,�f � �
= �E' � � mf.� ` S �:. �.t� � �' t x t�;> � �, ^ir �y�,� : ' �„ �`" .�" � T ,� .,�''�, � � v�a�'f��� �F�
R �r � x p, � f" ,� n, �'�r` �" n. � '. ^r p � �� + .t � x � � r ,s
�'`�'� �� r � : � �3 ¢ ° rt� i���� Y s � '� .s� "t� �', U � � �"� ��� �v � � 1 � r�w �, F,
� lc ��, � ' 3� `� ? � � t, � °.� x = � d j�; � N 4 � � �� � . �i �
�{� "R - n 4 � M ..s d^ i n ;b _ . . . v" �" -'' ,� �. � ,� J {a" a ��..
`�"��-��,� -� � � � � +�" � � w �a� � ' ,� � � r '� 4 , �,� ��y� " c�3� #�� �' �
�� �� ��� � � � � � ��
�4.� �°`t� ^ � �s= � `q° '�`� ""�a, � -.: �. �-`s`<.;.�H� "? a�..�.t;'��' ..,=,t.., 4., _r.., ., _ .. . .,trn.c��:, a.P,� ..z�'���*'s . . ,+,,,r�`r� . .. �Yt
�B
\, � '
1 �a 3 �lo �� � � �-s-�
w� � �: ���� � � y. s�
�
�—G� �'� (�oo�'e ��
� �� ,�� r m l�
� ��, g � ��r��
�e �
� � �/ . H'' fi �� V a � � � R, � }. �% e fJ
e
�' � �► � ��� � � ✓� ��� �''�' ��� /Z
�
a
�.
�
�
�
_�..i�.�.`. � �e� '..-'�'*_z"'¢"�"'+f` ,. > . ".'.�.`i?�.
� ��� ' � 7 #r.,`. ���� ,y � ' N r�� � Q �_ �: F � � � x �. .�r� .s- g .. � ♦a �� � � r x - .,
� ' i , � a'k'-��: a �° �`";',`" x' ���.s
���� ��� �� �� � � � � e '�. � ��_ '� . ��F� �- � i "�'"� "' / a� � :'�
.
�„ � ` , �,: � .i �� ��� �� �: ,� �. � *�y�
�� �,� �F� � _ '� i ;--x � �Y �c^ ��, ��'� 4 M � �?��'
�� .� �..� - v.. _ �� . ��� �� �.m �r�F�'1�➢� x ,� ..�A ,�d*,
� �; �� �`tt K t h ����►�lr«14� ���iiA`` � � '��r'
��" �y �� d � - - � ' � � ' £�.. � � �,j�l £�' a ��• d � ��:.
C �"� �3� � . .. - � . . .� -�q;-..
}$a �� �: �� - �` � � . _ - � � 'p,� ,tg�n.
.��a�« - -. e '�� . . .; x - � � ' �
�
��` � �'� � �� � ��� � .. . � � � ��'.
s • a _ .� '"r""' ""+' . - . • .
� "�' � �` �%�,�ir�� L%� � � _ S ` x�
a t. �� � ' . �:�` _ risl�s�%�� � ' � �� �� .a
� "'� � . _ . _ �. ' ` :_f�'; '.s ��'
ti e . . , .. 4- .;
� t'�'� � ."r _ - . �: ;,.��. . � �:: J . � fio;� "� ,
2s � �r I a " � 9 , , , C �}„' � '�3
�r -��E"f �' r ` - �= -. _ t � .!' * ��� _ d ' �4:
� ,�^ �+`.; r' S -� 1 � '� _ ,�-'� . d .�, �:
. .
�. ' . , . .� , _
ti
,
� r � - -•_ - �",�
;,:� 4 � � �" �'
�� � ��` ,: . � � � "� � �_ �
r�n. ;, rt — - -.- - - � � _ _ , , �_ , -- - _ _ _ - _ _ �_,�-,� -
��- . �►�� s�` ' , _ _ � � �., �"' �
��' .- � ' ��' ,�
� - �', � � _ ��` �
� �� t� 4 , f�� �;;
� �. �
t � �3 . . - .. .. :, � � :r
� �4 _ � � r,��o � y .� m��
�� �. ��, $�����,��. � � ,`� ¢�JR �,',
� t. ° �. J 0�" � R,, x,
� ��. - ,p. � .
a t��not� � j,��n ��, ��� q _ . .,�,''` ��z z ���e ;
,s�i��,fJ,� ��� � - ' � � ��
� ,x �'�� � _ - �_ �;
�� ,� `�_
� � . . ���% -
p �3 . - � . �.'
t � y .� da
0.
` '�',� -- �� '` �.�
�4 _ , ,r. _ Y, ,
� _ - . �.� ��
a;,,, � ;� ;�
, , ,, „
�q.., . . , . � . � �
'° �
. � : : , :'
� ., e
, � .���
. , . . . t , , � ..
i . . .. . . ... . ° ....- ., - _
"� � .. � � . � -., . . . . ' _ - , '� - � w
c �-. , ;��$i��ii�ir�i'-j� �OC rJ� B�,O�iC x� $�C�il�' ��.��:11* C��jT€1� '�`j.t�.B�T� ��„"SO�B• z �. �
� , . . _ , _ . . . „ _;a�
-
�y .. . _ __ _ - - --- , -� -- - � � -- � : .�- -� --'P' ' -r� � � �
- .. , ' . . � ,. � _ �, �.
; z�.-. . .._. '• . e '. . . ` .r . .
�r
. � � � �.� � � � � �� �. �
� k
'. rJ ...,� � .' ''' � .'. � '". -,:, . ' ���
T ♦
. ' '. _ � � `. , -. ''»�
.... „ . .. � �..
�
. r .
, , .. , . . - :. . :; , _ 9
- . � � -. . � � . . �. - . - :.t ... . .
° - - �� - y - 4> � �t- �k�:
�� � t�ireby "��ar�if� t�at t�f.t� s�►ey v� m4d� +�m�te� n� -slit'e� �u�ervfsi�r ��t I �--� ��
, a� a� c�?:y +�t�a+a�iat�3 Rsgi.s��r��i LaAd S _�m�sr. �
.
• �r�ar � +�f tbe `S�tt� c��
� � � � ��.
.
.,
���,s� . .
.,
.
� �
: �, � ,��
�� .
.. . -� � o _ ,
; - .�
,; ,
ks " ' `'� - � � , � - - y ����
� � �� , i � �
� . � � . � - ti%�.x:��il�l �i s , ;�!Q'.i'� f - � �. �- � � �� �:
,� � . 4 , - � . , _ ��#na. i�+ing. i�r• Cfi�% .
.
� � ,, _ �
�t�a: ,��g �:8, �.��3 � ' � � � � � �.. _ _
�. � : 4
, � ,
:
...
,
. . . . _ , . ,..
.
:
� �
� �,
_ _ ,�
_ . �
� ��x T : � � �4� �° ;�
,y � h :9` ''�._ - . .I� _ . . - +;x � ��_ } �
� �`� ' k� x � � ; k �t'Y'i` � Y � �,� - i � � � � J
�g� �.y Z -.TM �i' � 5 �+ ��� j���� � $ �4. �L d'n
'@�`...a' d..l- i G i^� � _ .c.� .._ _. �. , Y.r .�.."� ..r �' Y. .�. . 1� . r 'S'.. . ,. „ Lu. . ... -ra. _ ., 3FDS��6.���.,. . .wr._�.. . -.... � , � ��s iJL
City of Frid�ey
� 4T TIlq TOP Of TII� TM�IN�
�
� �
.
�'L-'�-^-� COMMVNITY pEVELO/M�NT p1V,
� �! � MOT�CTIVR wt�CTlpry ONi
i �
` �- - i CITY MAI.L iA101.Rr �M�
1...«Jl.� �.J N�'b�0-3a�p
Contractor
i
i
�
I m
..
I� i�"�
'p o
� o
O •�
osi
�a
e
��
a"
C
Buildin
on Date
��_..y,.o '
� 11
� ;
o I!
� i
O i
I
�
I�
I
I
w �
eo
'a
i�
� i
�
�
a�
� �
� I
i
�
� . ���i�
i��EGT -
�
PLUMB I ��r, PERf1 I T aPPL I CAT IO��
� plv. pATE ��iE OF I► OY er
- 0 2 15 73 i �i soo
� . ��
se
S P one
S P one
��� x���_-
0
� �
_ _/�'°v._- - --
Plumbing Fixture Rates: Np, gATE TOTAL
Number Fixtures —. � X $2,00 $ �� oe
Future Fixtures � X $1.50 �
New Fixture-Old Open. x $1.50
—__
Catch B�,atn x $3.25
Water Heater-99,000 BTU _� X $3.00 �
Ground Run Old Bldg. x 3.25 ,
-�.�._ $
E1ec. Water Heater
Gas Fittin Fegs:
lst 3 Fixtures
x $2 . 00 �
x $2.00
Additional Fixturea x $ .75
Gas Range-199,p00 BTI7 x $5.00
Repeirs � Alterationa
See
Deacription; Code
State Surcharge _ 50
TOTAL FEE $ �
The undersigned h�reby makea application for a permit
for the work herein apecified' agreeing to do all wark .
in strict accorda,nce wit�t �he City Qrdinances and ruling�
of the Depaxtment of $uil,dinge� and hereby declare that �
a1l�the tacta and repxeaentations atated in thia l
applicati�/ are �ie and correct.
'� �` %�
Date
. � -��'��
��� �
�
Y
IiOUSE HEATING TESY RECORD
A�DRESS ���� si��s�oi�G� � APT. OOR Ci S RB
OCCUPANT ONINE '�
HEAT LOSS DATE HTG. INST. GAS CO. METER BAD
SOl.D BY INSTALLED BY � -��
Elsetrieal Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
G DE �'s i CONYERSION
MAKE , MAKE OF BURNER
Model �� � �,� � � [°. � � Model
�ia� -��'� � � �" �.�� Max. BTU Rating
ONPUT �`� �� MAKE OF FURNACE
AAodel
��—�' CONTROLS ,�y
THERMOSTA ___!�� p�ug Yent Size
Yalve +� L KIND OF LINER SIZE NONE
Limit ��_ - �� Droh Hood Regularor
Limit Setting -��' Filters Size Number
Fan Setting O� ��� Chimney Location (nside—L-- Outside
Pilot Type Chimney Construction
Pilot Make ` p�
Pilot Model Smoke Bomb Wiring ��^
Pilot Timing �'� Draft �� Test Tag C�
L.W. Cut Off Door Pressure Lightirtg Inst.
Pressure �>� Per ent CO" ���� ���pte Tested °� ���
Input CFH ��/ P�� �� `�� "eompany Testing � �
2
Siaek Temp. -�-5� Percant CO �`� Name of Tester
Form 235
�
T
�
�
I
T
�
z
�
�
�
G
1
�
N
0
�
x
t�" CM ,�b ►��+
H x x �
�, r � o�
�-yi H �
O ,.�.. M '"
y � � o
� � � w
� M y '�
b �� �
� .�
�
fA
�n
�
o �
�E
m
�
�
� � �
�nP "m
w � z;'°
O � °b
m �y
►y �jrn'.+.
q1
"1
1
�
,�
,a
c�
n
O
�
m
�
�
�
c�ay y
y a' r' N
� � �
�°� ��
� ~ G [�*1
o �1, � M
N � N
o�
O y ;
O �
� .
� .
�e ,e ,e o
N �
po���,
.� � .� �
0
�
r
� � �"�' �
�
+� :: m
'4 0 �
�d p
� �
�
�
� b
z �'
� �.
� � �
;o
� r� �
� �
� W
0
Q o
� �
� a
� � M. bd
O � �
�
C
�
w
�
b b
�
�A
o�
�
�
x
�
r.
0
�A
0
0
O
O
O
�
�
�
0
0
.�
y
�
�
�
�
O
W
t/J
0
t'
o�
�
pd
�
°c �
�i
w
oa G'
m pq
�--� '�-+
�
�! �
�' y
� �
H o
� r,
�
�
�:
�:
�:
��
�.
�
�
b
�
��
O
�
0
0
�
�
�
�
°x
M
0
�
�
w w � �
� � �
w w � � �°+
¢ a `° `° x
� � o
0 0 =° � H
`C � R° R° �
� � � � �
G G� I y
e� Fed O �j* W
� fD O O �
�
��� ��,
�
�. M �
H : � �
. . eh± `"i
� x �d
. o �. �
: � �
: � :
NN��
��oo
0000
.��.��
i�+ �
� �
� a
� �
� �
� �
� Q
o �
�
�
rt
O
n
�
0
m
0
�m
W
g
�
�
�
Vsl
�
� � � � x
����� ��
R° R° � � � �
�. �
� � �' � � �
� O � � F
o �
� °
� � � O Dyi'
a, � � '� o
�. � : �
o:.
$$: : °
O
� � � � �
N��N
� o 0 0 • o
0 0 0 o s
.���
�.
� �
a. p�.,
� o
m H,
bd
�
OQ
-�-
�
� � � � S
ao v � �
� � � � �
0
r� � y
a�.��
� m o "'
� a�i ~' R° �'
� ~ � � �
�� �
m � � �
� � : �
�
� � : :
� . .
� � : :
op$::
O • . :
N � � � �
�000
a000
.�
0
�
� ��� �
� ��� �
`t to � �' � �-�s
'y �, �
�� �
p��� a
� � M �
O�p�''
y d� �
��
�b �
��°�
� Csp��C
... �,,, �*
� ��y �+
� � ��A
�py�,�b
� �p �ro
04 w �
.°� aymE�t
��'�°a
^� �,. � w y
� ����
b
a�M
O � �g
� y �y
�� �
n
�� �
�(� �
�7 y
et �.
m ��
w��°
� � �k 5'
D
'�
r
�
�
m
�
2
m
C
m
�
� a
� �
�ro
,1,p' o
�
�
�
�
'v,
�
�
�
O
�
�
�: o'
o�
4�
o'
a =
�
�
�
� �
� �
0.�
fp q1
�• �
� Q�
O.
�
70
�
�
�
'
�
0.
�
*
F`D C�
� O
� �
m �-
� �
�' �
N �
N. �
O y
� n
-., a�
-. �
0
� �
0
�, r'
a�
`o_
�• �
�• a�
UU n
cD
� a
o �
m °1
'� Vl
.� a
o tD
� d
�
� Q
�
�
0
c
r.
�
m
z
�
'v
m
c�
-i
O
Z
�'I
rn
rn
�
�
v
0
0
�
_
�
� a u'•
� x °q
o �t Q
(D
Q.
�
K
� �
�
(
�
0
C
� �
�
0
�
--I
m
r
�t
�
�
�
�
�
�
� �.
�.
� 4
`�� �
�
� �
_
a
�
z
G�
c�
�
�
�
�
�
�
D
�
m
I
�
0
W
O �
�
D c�D
r �
� c
rn �
rn �
�
�
�
� o D
cNn3 �O
o � '�"` s
co
�
< °—i °� �
a� � c' 70
� �.
ifl fl. o �
� N � �.
D � � S�
� d . �
,:�.: D.
d , � �,
� .��..
c� o .�
° .� �
� O ^
o � r
� �
O
Z
D
C3
_ v
� � �
�
Qf � ; .
� � y �
��,��
����
� •c
� N �' �
a
� O p. �
� r. a� N
o � � �'
y � �, fD
_, � a
da�°�'
. ..
� � O �
t]., � p. Q
�•oo�
r. � °' 3
S tn� — p�
v� o � z'
d � � y
� � � �
— _ �� �
�� a �
N
� � � �.
� � � �
d � � �
c� a � -^
� � o 0
c �, � �
m .�
� � �
7 y � �
Q � �
c� � �. .»:
o -•�-�
� �, � o
�=s:
��c� �
�v c� �
��
0
N O s
°� � N
� �
a y c�
� _.
�
a
D a�i � � y C �
n v� N N o� a
p � � Z7 �� e� c�
� � � -o, u_? cu � w
� ro � � ca� � c/� au
� Q� C � � �
0�0 '" � "" �p °� '�
� . �-�r cdD -n " O. . .. . N
D • � a _ � p. � ,
f/). '• ' ' b "� Q �.n , _
� m
cNU� • . � s =-+,'. A: � .
, v.
N .��oocuo c
� �f c°'i � rrit
� '"' v
.� C W
v -c =
� �
d �
� �
� � � � �
N � r-� ►.r (,V
cn o 0 0 0 �
°o °o °o °o °o �
�
� � � � �
�
A� � a
V , � �
W � � � ��o
�.
c� �? c� o
� z
� � 2
c� O � �,
0. •p �p
d ° �c
m � ?.
� N
_ \
� .�. � n
d n
� �
O �
> >
� �
fD
n �
(/) p (n
N fl- (n f�D
m r N' c,
o amZ�
r^� �ar.
�..... �O
�
O' �
c�....
�
i "
�
1 �
D
m
�
�
�
D
--�
rn
�
c�
�
N
�
�'
�
rs
�
m
�
�
�
Z
O
�
��
!?��
C � O
W
� � �
Z �
G� �
C � N
� �
� � n
� � I�
� Q
�
�
'v
.-� -ry Ol n
W� W-�C
�
c1i `_� C �
v �
rv��•�,
WZcp �
0��,0
�A � �c m
W < �
N tn Z
Z N
rn �
m
�
�
O
Z
�
C
�
a �
'� Z
�
r
-�rn'!-Di
� O
G� Z
m �,
�o
D �
-i
O �
Z �
Z�
v
ab
� Z
O N'
Z y
v_z
�v
o=
zm
z -Di
� Z
� �
� n
m�
0
N Z
a
z�
vm
vZ
< '�
n r
a
N �
0
z
m
�
n
<
c�
O
_
�
�
�
�
d
`G
N
0
0
N
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPUCATION WILL BE RETURNED
C'nMMnN VF�T l�Fti�T _nf�l`F(`T(�R A��D (`C)Il�F3l ISTIC)I` AIR VFRIFI �4TI(�I`
WI1@t1 r� In a_in� an pYistin� furanc-P, the undersigned hereby verifies that the .
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required, Yes (�Q No ()
The venting system is plasticlPVC and meets all current codes and manufacturer
specifications inciuding sizing, length, number of elbows and termination. Yes () No (`�
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAAAA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
i1
The ex,�e �omh��t�on air is sized and installed to meet the current codes
and manufacture�s specifications.
When required to ir,�ta�� A nP��� _-omh��Q±�en ��r�,itwill be sized and installed
to meet the cuRent codes and manufacturers specifications.
Wher1 insialling a new ��Pntir��yc Pm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does inGude AGA-GAMA Category l Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes � No ( )
Yes ( ) No (Xj
Yes � No ( )
Yes (� No ( )
Yes (� No ( )
� • • . • ' • ' . � • ' • /� �� • � ' � . � • ' � • � � " M • � • ■1� . • �
Appliance #1 Type v�.N+�� BTU Input ��o Fan Assisted or Nat ��4�
Appliance #2 Type _ t�a�re� I E�-r� BTU Input �� Fan Assisted or Nat�.l�
Appliance #3 Type �TU Input Fan Assisted or Nat
- - — fibfa�App-iiances-- -1'otaT�tu input m � �� -- ---
-- - - _ _
Common Vent Type �L�-�5 � Vent Height �S � Diameter�_ inches
Appliance #1 Vent Connector Height �O ft Length � ft Diameter � in Type
Appliance #2 Vent Connector Height f� ft Length -7 ft Diameter �in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
• :: 1�► .- ..-
HEATING
Signed By:
�'C�� �ss��z
Date : 7—lt -03
Building
Inspections
763-572-3604
DATE
SITE ADDRESS G
7'HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
�E oF wo�:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
E-MAII.
��!�1��.�ws�s.s����
r. • ■ • s •
i . /�
PHONE: %��—��� i{��d
STATE LICENSE #
� DATE
ADDRESS: CITY
PHONE
SINGLE FAIVIII,Y/Nf
❑ TWO FAMII.Y/NEW
FAX
0 ADDTTI4N ❑ GARAGFdSHED ❑ WWDOWS
� BASEMENT FINISH �ROOF 0 DRATN TILE
❑ DECK ❑ SmING ❑ OTHER
u
❑ ADDTPION
❑ REMODELING
Pernut No.: �� '
Received By:
Date Rec'd:
����J--
ATE ZIP
DESCRIBE WORK BEING DONE: ,jZ� � P l��,�% �,P�� ����� 4�8�� �/��'�� ����
SIZE OF
RO�FING
NUMBER OF SQUARES �
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT: S(( �
SIDING
"'� �3
❑ Vinyl
❑ Aluminum
❑ Other
LENGTH BJIDTH HEIGHT
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
�Soffrt
O Trim
❑ Fascia
WINDOR'S
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPEMNGS-DESCRIBE STZE OF
OPENING CHANGES &
Ft.
BASEMENT REMODELING SUBMIT:
I. Existing Flaor Plan
2. Proposed floor plan
3. List of strucinral members to be used
FOR A1EW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBARTI':
1. Site Plan/Survey showing the existing siructures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WII�IDOWS I
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(U5ING TI-i� 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$
$
$
$
$
$
$
$ _
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
$+6ft= ftx$20=$
$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 PERMTf-NOT VALID UAITIL PROCESSED
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 start without a permit; that the work will be in accordance with the approved
plan in the case of all work w� rey�ires r�� approval of plans.
SIGNATURE OF APPLICANT O� i PRINT N.4NIE ����iN` �! ���/��<;J�71`E / � D�
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official sha11, before issui.ng permits for the erection of any building or
stxucture, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Pernuts for constru.ction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
City of Fridley Building Inspectians Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit # o Dl�s -�`�v
Residential Application
City of Fridley
See Back Side For Required Information
Date %l b� �, Site Address: - r°e-
is: (cirlce one) Owner L Co
Property Owner. G ��r°e�
Address:
C�y: State: Zip:
Phone: ��' - .��d �fd �� Cell: __ Fax:
Contractor Information
Campany Name: p� a� T�
Contact Person: � � � �
Address: g� N, R� �.
City: State: ZA� �rpi�► Wli�i�f�
Phone: Cell: Fax: e�N�SSt
Finail• MN Bond# & Exp Date
Type of Work (circle one}: �New� Replacement AlteratioNRemodel
Detailed Description af work:
uipment f
�� �
MFG: Model: Size/BTU:
MFG: Model: Size/BTU:
Please check all that apply: ,�Fireplac� (gas) $15.00 New Gas Grill $10.00
A/C $25.00 Fireptace (wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00 Fumace $35.00 _Pool Heater $35.00
Boiler $35.00 Gas Dryer $10.00 _Ventilator $15.00
Chimney Liner $10.00 ,�Gas Piping $10.00
� n��r_t wrirk �10.0o Gas Ranae/Oven $90.00
Pennit Fee � (Total frorn above-Minimum fee $35.00)
Surcharge �. �� 0.50
Total Due $.�,� " Make check payable to City of Fridley
This is an application for a permit- not valid until processed
I hereby apply ior a mechanical permit and I acknowledge that the informa�on 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 Consiructlon Codes; that I understand this is not a permtt but only an applicaUon
for a permit and work is not to staK without a permi� that the work will be in accordance with the
approved plan in case of a(I woric which requires review and approval of plans.
Signature of Applicant: Date: f%�
Approval Inspector Signature: Date:
Please Note: Separate permits are required for Buiiding, Plumbing, and Electrical work