AF - 36511f
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City of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: December 22, 1972
: - � �
� �11848
p��; Richard Miller Homes Builder _.._Same __ _�__ _........._V.___.__
Address 1600_.$ice. C�reek Road N.Et�.,�.._. Address _.__Same �.______�.._.__...__.-.----.--------
LOCATION OF BUILDING
No 6145 Street _..�Briardale _Court N.E. _ _ part of Lot
Lot 6 Block __._.�..��.._._.....__. Addition or Sub-Division .__����dalg_.�,..ddition ______
Corner Lot .� _ Inside Lot �_?� .._.---� Setback _..--••-_35-�-----•-----_ Sideyard __._l� �_. §� 6 � _._...._..__._.
,�e�i�sfeF/Elevatian ______._._�.Q9_�_4.�__._____......_...._..`.___ H�ciui�I�l�6ii��a�iFi�i .._._ 912 .45._,Nlinimum _. �_. _.�,�
�elve Ton of FootinQ
DESCRIPTION OF BUILDING
To be vsea as:
Dwellix�g _,... Front 42 �---• Depth 23 � 6" Height ._ZO' _.__ Sq. Ft. 1031'� �. Ft 20� 268
�.6ar.�g�e. .�.._._ Front ._..19 �_.._ Depth � Height .---._1.Q'.__ Sq. Ft. .....4.1$'_--_ Cu. Ft 4.3.a..$.Q'.
Type of Construction __W o o d.._F r am:e....�._.. Est. Cost ...� � 4.a 6 � 3-.-.--.--_-----.------. To be Completed ---_ Mayy_._19 7 3_____
1
'�tipulations ; Provide a verifying survey before capping. Provide a hard surface
driveway. Maintain 5' & 10' sideyards at right angles from lot lines. $406.50 storm
sewer esc�row needed when water meter is taken out.
WATER LOCATION: 10' South of Sewer Service.
SEWER LOCATION: 12' North of manhole (Inv. 909.52)
In consideration of the issuance to me of a permit to construct 'the building described above, I agree to do
'ihe proposed work in accordance with the description above set forth and in compliance with all provisions oP
Orclinances of the city of Fridiey. � `
,�i.��.�.� �L's�_,C���'f/�
12.34 State Surcharge
$ , permit is hereby granted to..�i�h�rd Miller Homes
In consideration of the payment of a fee o# _..
•-__.__._.__..._.__._..._._.......__ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all wox'k
done m, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildillgs
yyithin the city limits and this permit may be revoked a t any time upon violation of any of the provisions of said
ordinances. � _ � ��
�_� fi�� � �
= "` ------ Building Inspector
naRR�• CT.ARK
N0710E:
This permit doss nof cover the construction, installafion for wiring, plumbing, gas heating, sewar o� water. Be sur� to sN
ti;s Building Inspector for aeparate parmits for thase items.
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En�ine�r� dc Surveyors "••° c•�' �}�
C' �,(f / r// L �,.'~.' �7 v/�/G'S
Certificate o! Survey for i� U, k
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II� 6431 UNIVERSITY AVENUE NE
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TO WHOM IT�MAY CONCERN:
ANOKA COUNTY
December'�, I972 FRIDLEY, MINNESOTA 55421
Whereas the City of,�Fridley has issued a building permit to construct a
structure at �/�/� ,(y�',(c����l'��C� �!P-t,c,'�
Whereas the permit is dated prior to January 1, 1973 and the City of
Fridley did not collect or receive any "Service Availability Charge".
Therefore if for any reason the Metropolitan Council and or the rSetropo?itan
Sewer Board assess or bill the City of Fridley a Service Availability Char�a for
this structure or sewer hook up, we the undersigned agree to and will pay the
City of Fridley for said charges. /=' � �
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- City of Fridley
r �T jll[ Tp� Of TME TMIINS
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1„�ar����—� 60YMVNITY OEV[IOPMEMT DIV.'
�. ' 1 i �ItOrECTtYE N3PECTION D<PT.
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�..«�: �,� e!='if0'SISO MIa+SER
Builder
Address
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BUILDING PERMIT FEE CALCULATION
pEV �DATE
Total
Fee �
Permit Fee �
= Iength x width x((number of floors, includ. bsmt. x 8) + 4) x$1.85 Res./lOQO
$2.15 Comm./1000
�/ . .
�- �. �. $ �- , '/7 X
�Ll�c
l �t �c z2
Plan Check Fee
= Permit Fee /2
/2
�� X o� �T`'��X.
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0
Valuation �� r ,d,.,J�
b
= length x width x average cost per square foot (taken from chart)
Do separateiy for basement, each above grade floo� and�gara� e p�
accessory building. rr, fl ; 7
7 �
���`.��;� � ( 3�/,� D
=_�� �— X 1 � � 3 . .� �
x x
X X
X
(No. of above grade floors)
Surtax
I Z.
= Valuation x $.SO/$1000.00 .
x $.SO/$1,000.00
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APP��C�TIQ� �QR RE�I���TTA�. A�T�R�TI�N,
Q� �DA�TiO� ��ILDING P�RMT�
�ITX OF �RIA��Y� MINN�sOT�
OWNER'8 NAMEt BUILDERr IeicN4lZp M�LL� N0�1��
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annx�ss: �,ao►�ss: icQOO K«e c�Er� ,��o F����cY
�Q.*� (.(� jT'� ..g�'�i 1J2�Q��i�C� �CJ��r`�
LaT: � BLOCI�; 5 AAA�TION� k3(Zi/� �DQi-E.
�GQ�tNER LOT : �N$ �E LOT .,_ '�C , , S $TBACK g �5 � S I DEY�RD : !D i �o � +
��i,�t �#�c� ����ra�,,,ia Certificatea �f SuxvEY of Lot a�d propp�ed
�tti�.��g �acati.otl dr� Qa �se Certificates.
���CR�PTION OF �UILDING
Q'�a �e t3s�d A€, :
i
D�n.+:°_I I i n �#� 2-` De�+� : 2 3= l. Aei�ttt : "L �
Squaze �'s8����,"��S Cubia F�eC: 1��=="�� .
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G�-t-�,s}L�E Fraat * /� Depth ; ZZ' Hei�ht • lC�'i
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�qua��a �'eet; 4-18 Cubic Feet: 9-( g0
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�y#� °f �oA� truc�ioA# �iC'A 1�`l t= Es tisated Cos t: $�3�,� (��
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�c� � �vapi+q�+��i= „ `' - ( - 7 ��
�et usd�xsigx►ed hereby a�akes ap�licatirnt for, a pe�ai.t for th� wo�k b+arei�
�ge�i�ied, agxeein� tt� do a�l �tC►s'� in sttict accoxdance with the G�.ty of
F�t��.�' �x'd�.�ances �nd ruli�,gs a�E �he Departnten� Qf Bu��din�e, � i�ereby
��ax+e� �,� a�l the� ��tcta as�d ���resentatione s�ated ��his appli.catian
a�� �z'ue a�d cv�rect,� .
�aA'7,"�i; � �-. - / � - 7 _"" $�VNATUR� i �C,�„_.._t(^,,.�,,.�- _;c.'1R� ���..."-... � •
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��+� �t�ve�es S�d� Fo� �dd���.anal Inios�ation.) ; � ; ; ;, ' � � �`'
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BUI�AIN� P�RMIT F�� S�H��ll�E
S�C���� �. The Inepecto� pf auildin$s s�al�, befox� �asui�g permi�� for the
��g���on of any bu�lding p� s�ructure, oz for any addition to any �zcisting
����dimg ox stxuGture, ox fo� any alteration or repairs to any ex��ting
�;�ir���� or stxuct�re, upon appli�ation therefore, require the Pgymen� �y �hs
a�.;�lic�t fp� such pex�n�t o� �ees Co the amount herein below set �pr�� ��d �n
�in� manr�ex h�xei� p�ovi�led �a-wi.z:
UNiFORM BU�LIIING CODEt 7.'ype 1�, 2& 4� $2.15 �or each ane khousatrtd cubic
,�eeC, py� f�action the7cea�, in su+ck� cubical con�ents. Type 3& 5=$�.,85 �o7c
�ac.h �na ti�oussnd c�hj.c feet„
��p�T�ONAL �NFO�MAT�ON
Fo� the �uxgvse of ramputing �ees for building pennits, the cubical contents
of any building or addition, i8 detsrmined by muitiplyi�ng the g;round area
�ave�eci ��om a poi�th s�x �(4) inches below the floor line of the basement
p� �e C��lar to the average heights of the upper surface or to the avera�e�
�i�t �f �he xoo� �,t�face o� the main gable pf a piCched xoo�,
��i.rs ox al��xations fio an existin� srn�ctuz�e, the f�e shal� be a��. the
�ate o� $3,flfl �e� eat+�h five h�dred dollars {$500.Q4) or fraction thexso� in
t,i�� co�� a� all pTc��sed wo�'k.
��n catae shaitl t}�e ��e ��d fox �y pez'atit as set fo��h �i.n S��tit�n 2 be
l,QSS ti��n $� . 4tl.
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V�R����ATiQN �F ��1UNDA'iION
D�?�s YeTcnits �ox �cs�st�u�t�on wil7, be �.ssued a t+�ini.mu,m of �4 hours ��atp �he
��S o� application, �a a��cyw �ax Praper �eview of �he p7ropos�d a�ru�t�,xe �d
�� t�e �struGtion �i�e.
` � CE���,�i�� �u74�ey v� �he ip�, �ar�it►$ t�e �,oeat�.a�t Qf �h� �aundatiact, ��e ��
}�� �,� �o�.s�t�d�, wii� ba �rec�u�.red before proceedin� w�th �h� fr�ni�g,
C]�RT�FI�A�'� QF QC�i�PAN�Y
�.�►�li�,��ic�� �Qx a��x�i�3.c�� �r� Q�cupancy shal� bs made �e�n (1Q) d�ay� �xiox
�o �h� �tse px r�c�up���r o� ,axcy at�.cture fax which a bui.�d�.n� pernnifi has beer�
isst�ec�; �d s��d s���tu]ce i�hal� �at be used a� occup3ed until a�exkificate
af Op�up�cy h�� beer� �.seued„
Applicotion for Pow�r Ptan�s and HeaHng. Cooling. Yenh'lation. Ref�iq�rafion and
Air Conditioning S�st�ns and De�ric�s
PARTIAL RATE SCF-IEDULE
GRAY*'1'Y WARM AIR: E�►T*' TOT�l.I.
Furnace ShelI & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . a10.00 �
Replacement of F�rnace ............................. 6.00 :
Repairs & Alterations—up to a500.00 . . . . . . . . . . . . . . . 6.00 � ---
Repairs dc Alterations each add. �500.00 . . . . . . . . . . . . . . . 3.00 �
![ECH. WARM AIR
Furnace Shell dc Durt Work to iZ0,000 BTU . . . . . . . . . . . .a10.00 s 10•Q�
each edd. 80,000 $TU ....................... 3.W i
RepIacement oi �rnace .........................._.. 6.00 $
Repairs d� Alterations—ug to �500.00 . . . . . . . . . . . . . . . . . 6.00 �
Repairs & Alterations each add. ;500.00 . . . . . . . . . . . . . . 3.00 ;
STEAM or HOT WATER SY81'EM
F�rnace Shell & Lines—to 400 sq. !t. EDR Steam ... .$2Q.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 �
Each add. 20Q aq. tt. EDR. Steam . . . . . . . . : . . . . . . 3.0(1 �---
Each add. 320 sq. ft. EDIi Hot Water . . . . . . . . . . . . 3.00 �
OIL BIIRNER—to 3 gal. per hour . . . . . . . . . . . . . . . 6.00 �
over 3 gal. per hour�ee Fee Schedule
GAS BIIRliER (up to 199,000 BTiA . . . . . . . . . . . . . '. . . . . . . . 6.0a ; 5. 00
over 199,000 BT[7 8ee Fe� Sch�dul�
GAS FITTING FEEB: It0 RATE TOTAL
lst 3 Fixtures . . . . . . . . . . . . . . ... . . . zi 200 � 2.00
AddiUonal Fiatttres . ............... z .7b ;
Gas Range to 199,000 ...... zi �00 i
AIR COlEDITiOlfIlfG
FAN HEATING SYSTEI�E
VENTILATIl�G SYSTEUI
11LTERATIONB t AEPAlAB
ROU(3H
�F�Ii.�rI. i "� �
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S�e ' F« SeL�dnt�
� .50 SURCHGE
roT�►r. � � 17.50
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Dspt. of Bldy�. Phon� 5�0-3430
Loc.lfon 61.1i5 BI`i9.Y'dSlA C011Y't
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City of Fridley:
The undersigned hereby makes appIication for a permit for the work hereir.
specified, agreeing to do all work in strict accordance with the Gity fhdinance:
and raling of the Department of BuiIdings, and hereby declares that aIl the facts
and representations stated in this application are true and rnrrect.
�ic�tey, Nrinn- July 31 � , i�73-
Owner Richard Miller em�,g .
Kind oi Building frAMe
Use�i as resiAen -i 1 _
To be completed about 8/30/73
Estimacea cost, g 1.500.00
Old—New. Building Permit No. Permit No. �.�r� •/�
DffiCAIPTION OF WORI�
HEATING or FOWEB PLANTS�team, Hot Water� Warm Air—No 1
Trade Name �STINGHOUSE Size No F(',jjR_l ��
Capacity 110�000 Sq, 1+'t. E.D.R BTU H.P.
Total connected Loa�1 60. 0l0 Rind oi lwe, Gas
BURNER — Trade Name S�1N'IE AS ABOVE Siu No
CapacitY &1. !'t. E.D R- BTU 8P.
COPY OF HAT LOSS ATTACHED. SAIESMAN: John Borry
(REMARKS-OYE�)
i� �3 �y� 9
S
�s FRED voGT � c�n,
HEATING & AIR CONDITIONIN6
FRED V�� �'� �� �� A�` � 929-6767
HEA?ING d� AIR CONDITIONING ���' M��M"a 5sazs
xii0 GehM Aw. • 919-6767
�L �� M. Mi�o1� 3i416
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�i � OS3 CA1,CtJt.ATIQNS �._.. ,_,._,�...�. _._.._.
� Weatherstrips A.S.H.V. , Conatruction N�
Guide
Windowa I Doors Refcrence Out. Wall Int. Wall Ceiling
Yes—No Yes—No 19_
/ Fl•� ff - �_ ... ; : Room Length � Width . " Height .
•Windows and Doors—Crackage and Area
\Yldth Helght No. oI Lineal tt. Area �
No. ot pane ot Dane 1lghta ot crack �Q. ft.
� � % ` �
c_ ��
� r .
�r ' F
j� .
Coef. Btu
Infiltration _ � ,�•.- ,,
..� �.
Glass 7. � .-
u
FJ(P.Wd�I _.- ' ."r_,,�,,. �, •
Net exp. wall � •
Int. wall
Ceiling - . � , . � �' �,,- � ,, _
Floor
Total Btu. ' ;; ;. .-- �
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
l F1.� c`i;',;�f�. ;% Room� Length /__ Wid►h.!,.i--. H�►ght -
Windows and Doors----Cracicage and Area
Wldth Hef�At No. o[ Lineal !t. Are•
No. ot pane af yane Ifsht� of crack w. tt.
�° ". _. , . _�: �, �.: '� _._ !% n
Coef. Btu
Jn6ltratioa � -
;-, ,�_�
Glass
�tp. wall i ,� f �," .
Net eap. wall � _ � _,.
Int. wall
Ceiling --.- ° - ,
/i �' :. '� Y .
Floor
Total Btu. � ,�
Required sq. ft. E.D.R. or sq. ina. W.A. Leader area %
' Fl• : �; Room � Length ; ; Width ,� ,i Height ;
Windowa and Doors—Crackage and Area
�� Wldth HsiPAt No. ot Llneal ft. Area
. Flo. ot pana ot pane Ifsht� ot crack ■p. tt.
�" " . � . . _. . , _ _
Coef. Btu
In6ltration
�$03 ,�,: " r
,r�.
�p. wall e • � y, � .
Net e:p. wall ,- �
Int, wall '
Ceiling - ' _
- �-"
Floor
Total Btu. �� � � ,.�,
Required sq. ft. E.D.R. or aq. ins. W.A. L,eader area
/ Fl. . . :', Room �Leng:h VUidt� ' � `rieight ' ' '
Windows and Doors—Crackage and Area
Wldthe. Haleht No. o[ Llneal ft. Area
No. of pane ot pane 116ht� of cnck •p. Lt.
_. � F � .. . , .
��
Coef. Btu
Infiltrntion " , - - . ,, ��
Glaas
Exp. wall , j - �
' �, ..
Net ezp. wall , : ,- ,• - - - �
�_, -; <
Int. wall
Ceiling . ,+ .' _
;:, .
Floor
Total Btu. J (; �� ;�
Required aq. ft. E.D.R. or aq. ins. W.A. L.eader area %
y.1 _. ._. -.�..— __�"� .�..�^!
�._ _ - _ _ _ nsu ation a
Roof Floor Kind How Applied
/ FI.� �' Room Length „? / Width /,1 , Height °
Windows and Doors--Crackage and Area
Wldth Helght No. ot Lfneal tt. Area
No. ot pans ot Dane Itght■ � ot crack �Q. tt.
`> / "� '-r- � �G! . �''
w7 �
Coef. Btu =
Infiltration ;% ��'- � �/ �,,
Gla�s ,��;"�,;!_. , � -� y
' G' U`!.J
Exp. wall ' t'� `
CY"
Net e:p. wall ,7 `'t �- ^ •y
Int. •✓aU '
Ce�iing ';;=.`' ^ i� ,% ;"� /,G.
Floor ; � � � ¢,
Total Btu. Z
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ FI.I .,�",', �- Room � Length ��'? Width : f Heig t i
Windows and Doors—Crack'age and Atea
Wldth Helght No. ot Lineal tt. Ares �
No. o[ pane of Dane If`hu of crack sa. tt. -
,,.� C � l ��• f /. . ..
1 n 1 J �,z
f
In5ltration �,.,1. c; .,.- �-
Glass „d i' � "
Exp.wall �`;'s ,/�,-
Net ezp. wall � -�-�,� �T
Int. wall
Ceiling f E'r� r'
Floor ,/�' 4_ "-+
Total Btu.
Required sq. ft. ED.R. or sq. ins. W.A. L.eader area
y F7.� i ��j � Room I L.cngth .__. Width /`,
Windows and Doors—Crac�age and Area �
R'idth Helght No. of L1neal tt. Area
No. ot pane ot pane Ilghte ot cracfc �Q. tt.
�" � , , f '7< T' "�i �..�
Cocf. Btu
In6ltration -� .�
f= �',
Glass
- � �A� �.;
Exp. wall � �'i:�
Net exp. wall �-�.�:- T� •,� ,�
Int. wall
Ceiling � � - � �:
/ .�-�Q
Floor
��,;; �.
Total Btu. ; �
Required sq. ft. E.D.R. or sq. ins. WA. L.eader arca J
�'- Fl.� � Room I Length __ Width �' � Height ;�`r,.
Windows and Doors—Crackage and Area �
Wtdth Helght No. ot L1nea1 [t. Area - ���^^^ �
No. ot Dane ot Dane Itghts o[,crack �Q. tt. �� ,�;
, - , � c'a �� .�:
_ .� ,�._ , ,,
s� �
- ;' ;, . � � ;, 1 , r
_ `�r,
,,
Coef. Btu ;
Infiltration c� - �� �
Glass ,�
Exp. wall � " -'�'�
Net exp. wall ,;;, �_ ;_ . ''> j �„'�:; �,"_
Int. wall
Ceiling _
Floor " , � �
Total Btu. � �
Required sq. ft. E.D.R. or sq. ins. WA. Leader area /
.e... _, r t �, � �
a
�tES1i l�OS3 CALCUtATi�NS
Weatherstrips A.S.N.V. , Conatruction Na Insulation
Guide
/indows I Door� Reference Out. Waq Int. Wall Ceiling Roof Floor Kind How Applied
Yes—No Yes—No 19_
:%' Fl.� �, Room Length Width Height FI.� Room Length Width Height
`,;
.Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vldth HeiSht Iyo. oI Llneal tt. Arca Wldth Helght No. ot Llnea� ft. Are�
No. ot pane ot DB�e lights ot crack �C. tt. No. ot Dane o[ Dane Ilght• ot crack �Q. tt. � ��
` - . . � --- - . � !' : �.P
Coef. Btu
Infiltration ° _ � ( �=;' '� �. ,
Glass � � ' " r,•
Exp. wall _ ,r i,;
Net exp. wall � ,/ � ,r.
lnt. wall
Ceiling __.
Floor - ' � 1' �..
Total Btu. �� �" ,�;:' ,�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /
FI.� Room� Length :'.;-' Width :';� Height
Q/indows and Doors—Crackage and Area
Width HelYht No. o[ Lineal tt. Are•
NO. o[ pane O! psne ltsht• o[ ertck sp. ft. �
s � � � :. , ��,
�'� L� IJ' l� / , ^7 .
� Coef. Btu
a Infiltration � �
� i ��"'
� Glass / � a -�
� f.xp. wall �: �
" Net exp. wall � -I �'_ .
� Int. wall
q _ _
� Ceiling ..
� Floor � - �,�; „
� Total Btu. ,�-� , • �,
� -
'; Required sq. ft. E.D.R. or sq. ins. W.A. L,eader area /
FI. Room Length Width Height '
� Window� and Doora—Crackage and Area
� Wldth Heltht No. o! Llneal tt. Are•
� . No. of pan� ot pans Ilshta ot crack �Q. tt.
�' COtf. BtU
� In6ltration
:�
� Glass
�, ExP• wall
� Net exp. wal�
�,
� Int. wall �
�
Ceiling
� � loor
Total Btu.
�� Required aq. fc. E.D.R. or sq. ins. W.A. L.eader area
'�' Fl. RoeT � Length Width H�ight
�iWindows and Doors—Crackage and Area
.:
�'.� Wldt$-� HeiQht No. of Ltneal tt. Area
.. No. ot pane o[ pa�e 1f6ht• ot erack •p. tt.
Coef. Btu
Infiltration
Glaas
�: Exp. wall
Net ezp. waU
- Int. wall
' Cei�ing
`, Floor
Tota) Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Inhitration
Glass
Exp. wall
Net exp. wall
Int. •vall
Ce�iing
Floor '
I Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl.{ : Room I l.ength Width
Windows and Doors—Crackage and Area
No. ot Da e ofeDane Itght• o�f crec!c pr tt.
I '
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
rZequired sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.� Room I L.ength Width
Windows and Doors—Crackage and Area
Wldth Hefght No. o[ Llneal [t. Area
Vo. ot pane o[ D�ne Ilght� 02 crack �p. tt.
�
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Bt11
Coef.� Btu
�I.� Room I Length �iidth i-Ieight
Windows and Doors—Crackage and Area
R'Idth Helght No. of Llneal tt. Area
No. of pane ot Dane Ilghts o[ erack �Q. [t.
Inbltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. R/.A. L.eader area
Btu
�iiy of Fridley .
APP�ica�ion 1�or Ph�q and Ga� Fhii�q h�it
Dept. oi Bldq�. Phon� 9�0-3490
DESCRIPI'ION OF WORR �� �S � %��%
Numb�r, Kiad aad Loeatfoa ot Fixlur�s LOd�°°
� Is�4 �
� � ��3 � �" Zrz � �ZS �yZ Ok` z
� � � S � i � � � o � � � E � i I 3 � � u � u $
Base � j
lst f �
2nd
3rd
dth
� - -Fu�u� CoDa�etsoa Op�nit►ps Cona�ei�d w!!h
t li�w Fixt�r�. Old Op�attr�s
PARTIAL RAT� SCHEOULE
WATE� wT�.
• •
I N GAS ELEC.
Srw�r ❑
�«w�� n
PLQMBING FIXTURE AATES: NO. Rl►TE TOT11L
Number F`Ixtures . . . . . . . . . . . . . . . . � x 32.00 a `l. Ll
Ftiture Fixture Opening . . . . . . . . . . . x a1.50 = _
New Fixture Old Opening . . . . . . . . . . _ x a1.50 ;__._
Catch Basin . . . . . . . . . . . . . . . . . . . . x �3.25 f
Water Heater ;Up to 99,000 BTU) .... � x a3.00 i°� `�
New Ground Run Old Bldg. . . . . . . . . x a3.25 $
El�ctria Wat�r H�at�s . . . . . . . . . . . . . . : =2.00 i
3A8 FITTING FEE$: NO. RA?E TOTAL
lst 3 Fixtures • • • . • • • • • • • • • • • . _—.�_ x s2.00 ; � U J
Additional lri:tures . . . . . . ..... . . . . . x = .?b �
Gas Ran�e to 199.000 BTU ..... ...... x aS.OD �
City of PYidley:
;�'�'�1�- c�
���'`'���p ll
!,'�
.�
The undersigned hereby makes appllcation tor a permit for th� �sori herei
specified, agreeing to do $ll work in sMct accordance with the Cit1 Qrdinance
and ruling of the Department oi Buildinge, and hereby declues that all the fact
and representaUons stated in ihis application are true and conect
Owner
Kind of Buildiag
Used as "
To be completed about � �
Estimated Cost, a___r__�/ ��' � �
G�k--New. Building Permit No. P�rmit No.
� r � ,n,
ROUGH
FINAL �
REPAIRS � ALTERATIOIfb--R�i�s to Cod�
Descriptlon ........ ..................................
TO'PAL !'EE � � a
�-- �
, �"' °Z � �'�
Signed.
By �����
Business Phune
' Y /�L� v�t
v��
��
�
sua�ecT P
c�ty of Fridley
AT TME TOP OF TME TWINS g � I L D I N G P E R M I T ���� O
' ` RECEIPT NO.
� �
� • COMMUNITY DEVEIOPMENT DIV.
1 ; y_ _ � �
r � � PROTECTIVE INSPECTION SEC. O
� � �
� FRIOLEY SS�J2 NUMBER REV O�iE PAGE OF •vonOVED Br
�""�'��~��2-571-3450 9�0-F15 9/13/00 � �
10B ADDRESS 6145 Briardale Court NE
t LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. �j 3 Briardale Addition SHEET
2 PROPERTY OWNEH MAIL AODRES$ ZIP PMONE
Leo Otto 6145 Briardale Court NE 763-571-9716
3 CONTRACTOR MAIL ADDRESS Z�P PMONE �ICENSE NO
Nutzmann Bros Construction 736 1 Ave NW, New Brighton MN 55112 651-628-0128
� ARCHITECT OR OESIGNER MAIL AOORESS ZIP PHONE LICENSE NO
20043453
5 ENGINEER MAIL AODRESS ZIP PMONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW D ADDITION O ALTERATION � REPAIR p MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (23 S) Tear-off
9 CHANGEOFUSEFROM TO
STIPUTATIONS
Underlayment must comply with the State Building Code.
tYPEOFCONST OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED fOR ELECTRICAL. PLUMBiNG. HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WOFK OR CONSTRUCTION ZONING SQ. FT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PER�00 OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED NO DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE REA� AND EXAMINED TFIIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE Of WORK WILI BE COMPLIED
WITM WHETMER SPECIFIEO MEREIN OR NOT. THE GRANTING Of A PEFIMIT �2,352 � $1.18
DOES NOT PRESUME TO GIVE AUTMOAITV TO VIOLATE Ofi CANCEL THE pERM1T fEE SAC CH GE
PROVISIONS OF ANV OT ER STATE OR IOCAL LAW REGUTATING CON• @83.25 F1Y C�2.35
STRU TION OR TME ERf RMANCE Of CONSTRUCTION y�
� PLAN CHECK F TOTA F E
J � m�
^ � -�`�1:� Lice C$5. 0 1.78
S�G 4 UAE O� CONCP TOQ OR �uiHOAi2ED �GENt �O�rE, W N E ALIOAT IS UR P MIT
r�
S�GHnTUQEOaOwtiEQ��fpwrvEABUi�DEA� �DATEi B�0 �ti5� � ����F
NEW
ADDN
ALTER
[]
[]
[l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: (p ��s �;°�i C'� /� �'til� �f' �
Legal Description:
Owner Name & Address: .
�
Contractor: i �i �)� �
Address: � ��(,r; - l �'��l �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Y-1 �
;l�)
� /'�,�L' �_ �,
e
Effective 1 / 1 /98
����,I�o�Q
Tel. # �71�3- �S 7/ - �� 7/(�
MN LICENSE # �(���3
Tel. # (o �7 - ��-Dl��
Attach to this app�ication, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVE�lZENT
Width
W idth
`1.i�f�1
Height
Height
Hgt/Ground
Sq. Ft. _
Sq. Ft. _
Sq. Ft. _
--� -� � -
Construction Type: ��i� - � Estimated Cost: $ .]
� (Fee Schedule on B k)
Driveway Curb Cut Width Needed: / Ft. + 6 Ft = Ft x$ _$ q,��°2
� \ � � -.�.�+._..
/ i
DATE: �I � �.' ( L� ) APPLICANT: � , r `�� �� Tel. # �j,S I �p�-d' (�'/ ��'
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��3 �S�
$ n ��S
$ /� /�
$
$ � -C�O
$
$
$
$
$ � �
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.�5 f�r first $2,000 plus $12.50 for each additional $1,OQ0
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
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 it has been constructed
will be required before proceeding with the framing.
From: City of Fr(diey To: 6516467388 Page: 215 Date: 3/26/2C}09 10:43:19 AM
Building MECHANICAL Permit No.� �
Inspections R�SIDEI�ITIAL APPLICATIOl'� Received By:
763-572-3604 CITY OF FRIDLEY �a��d
763-502-4977 FAX
tr•rtcTivt 2-i4-0�
llATt O(., � � YnUR t-MAIL ADUIZtSS
SIT� AUDIitSS
TH1S APPLtCANTIS: ❑OW�IEIi �CONTIL4G70R
PROPERi'Y �AMt: .
OWNER/ ADllKtSS: �t�
TEPiANT '- � ��rY STATE 'LIP
PHON�:
CONTRACTOR COMPANY NA `: INC.
SUBMITACOPYOF ��NTACTrtxs : a „�a�60Rn�Q
YOURSTATE STAT�LICtNStt� �-r' f7All1 N 55104XPUATt
LICE}VSEWtTH qUVxtSS: e��_Rq,�7�'� CITY STATE LiP
APPLICAT[ON
PHnNt r.ax
PERMIT TYPE INGLti HAMtLY � TWO HAMILY ❑ TOV1'NHOUSE
TYPE OF WORK' � ��� �:PLAC.'tMtNT ❑ ALT�RHTIC}N/KEMOUEL
DfiTA1LED DESCRIPTION OF WORK �—
F'�L�S AK� BA.SND OV S1Q.(k) PL�'It FIX"CUNL�',EXCLtP7� WH�P/:Rk: VO7�U. F7X-CUR�S: y�V �iC/A/y"l��'��� AL VUNBLtIl�}' L�'ACH B�LOW)
�:qui�nent lrt�talled MNCi: ��A Mt�ll�L- S;�-�C�-j-� �r � $i"LtJBTU
M H'G: MODtL: Sl"LtR3TU
M NG: M011EL: S IZt7k3TU
A/C $ 25.00 F l ILEPLAGE (C,AS) S 15_0(I GAS ItANG t70 V EN S! 0.00
Allt TO AUt EXCHANGEER 515 F'IKEPLACE (WOOU) $35.00 NEW GAS GKILl 510.00
_i301LEK s35.00 �h'UItNACfi S3S.00 GAS UNIT HTR $10.00
CHIMNEY LINtKS10.Ob GAS URYE}tS��.00 POOL HEATERS35.00
DUCT WOKK �)0_00 GAS PIPING �10.00 VthTlLATOK S 15.00
—.:... .___.._. _____.. _ _ _ __— __ __ _ _ _. . _ _ .:. __.._ ___. —___ _ __ _ _ _<_: _
_............_ ............._........................__..................... --- -- .. .__.... ...._._ _.....__......_._.._.._._ .__...._._........._................__... .. ...__............_...._......._...._..................
_.. -- - – -- - -- __ -- _ _ -.. _ _._.._ _ --- - _.. _- - - _.. .____ _ ____ - _ __
_.... _._.._.. . .. _...._. . _...._. . ._ _ _________ _ __..._. _.. .._...... . . - - - _..___ .__ ___ _ -_ ___......__. ____.. _...
_ ........................__.._._............._._.............._................_._. .. _...... _..._._..._.. ..................._......__.__..__ ___. __.._..._._......_....._ ___.. __......__._._..........._.
_ . --____ _ _ __ -_ _ . __ _ _ _ __ _ _.__ .._. _ .__ _ _ _ _ _ ____ __ __ _
_.........._._ ....................__..................._.........._....._._ ._ ..._...._._......._........._......__ _............_........._......_.........._._ ............._.......
__ _ . _ .__ _ . ___ __ _ __.--._ _ _ _ - _ _____ _ . . __ ._ __ _ __ _ ____ ___ __ __.
;
,
�"dt#1Ik�3Gt g� �fttiF�r �4�,. �1 Q,�l _T„ 7C � � � �: �'^ . ; ;: >
;; _ ; ;
I�u�c,r.v�f?ttt�rca�a $L�.�. . . z $��#TE3 � '
; _ � >
Nz�mbct offixtz��.�,��� �10 x $3af�#: $ ;: '
,, _.
�u tu�w Of f x�as+� �r`,� $3a �(k z ��S tl£f: � > `:
Sraic ���c.#iar�c — $ ;5#}
;: - _
_ . _ -: ; ;
11�1.��i�iti�FE�:535.5t� Fotal .:� ' ; >
THIS tS AN APPLtCATION F'C�1Z A PE1tMiT-NOT VALtll UNTIL PKOC:tSSEU
1 hcrcby apply for a building permit and [ acknowlcdgc that thc information abovc is compictc and arcuratc; that thc work will bc in
conformancc with thc ordinanc�s and cadas of thc City of Fridlcy and with thc Minnasota Construction Codu�; that i undc;rstand ti�ir is
not a permit but only an applic ion for a p it and work is not to start wlthout a permir, that nc� woric witl bc in accordancc with thc
approvui plan in thc casc: of a work w� ' 'r�s rc ' proval of plac�.
SlridATUREC�H APPLiCANT DATE \
. . :�c..c',��' ��'[�: s�'�-1����>i��'��r , "+.���:t�' �a� a�i�::�%i.€�.�,;r''€.z"c.��[��.::��t��►'��'�a�r:�r«�.._w���€,: ::
Ci f Fridley
Building Inspections Departmeat
643I University Avenue N�, Fridley, MN 5�432
763-572-3604 FAX: 763-502-4477
HOUSE HEATING TEST RECORD
. � ,
ADDRESS '� ' �, � �� `�'�^�� �' � ' APT. FLOOR r CITY SUBURQ
OCCUPANT , ;.�{ '� .s -�' ; ,. OWNER ,:� ,' �` �:
HEAT LO55 DATE H•TG. INST. GAS CO. METER BADGE #—
� ,; ,
SOLD BY ,r� ' " INSTALLED BY �'`
Eleetrical Work By Gas Line By '
TYPE OF HEAT GA FA ��'� HW STEAM SPACE HTR. UNIT HTR. OTMER
� GAS DESIGN CONVERSION
MAKE -'> -•�' '' �'=�� <-�=-� `` MAKE OF BURNER
Model v'� ' : ,://�: � :: '1'�A 4'� :d� Model
Serial Max. BTIJ Rat�r,a
INPUT ���% �' } -�~�J �% MAKE OF FURNACE �
Model
CONTROLS
THERMOSTAT #'"���� Heat Plug Vent Size `-
Valve ``` �'<`'�� KIND OF LINER � ��'"�' � SIZE '" NONE
Limit �''{> ,(. �{' � � ""`E Droft Hood � = •' n Regulator ��
Limit Setting s-° ��� Filfers Size Number
Fan Setting %'� °'�-' �' Chimney Location Insid.p y' Outside
,�,,,
Pilot Type �'- Chimney Construetion f` -�� '" `
Pilot Make *:'' �' "
Pilot Model Smoke Bomb Wiring Nt�'�
Pilot Timing �zi�•=+f•t�r Draft �� Test Tag �
L.W. Cut Off Door Pressure LighTing Inst. '�
Pressure � ' � Percent CO2 �' � Date Tested ' � s " �1,
InpuT CFH r- - Percent OZ �"" Company Testing/
Stack Temp. - Percent CO ~° "�t Name of Tester %` -
Form 235