AF - 36528�
City of � Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: ....De.c..e.mb e.x___2�_.,_._1.�.7..2..�._..._._. ._._._
Owner: __Ri chard _ Mi 11 e r_ Home s___. _.__.___ SAME
-- Builder ____---______.,._�
Aaaress ...1.60_0__ Rice Creek Road SAME
- �� •--------------�-••----•----•-------•-------•---------•-----------.._ Address _---._�___
� � �
LOCATION OF BUILDING
No. .---._.b.1.7..-5------.-.-- street --------�ri�.rc��,.l.�......CQ1d.I'�...-.---.------------. Part ot Lot
........................... Addition or Sub-Division ._._..__._._.�1d�S�31�_.__.
Lot .--�� ....�... ------_..._.. Block -----�-------� 3-�-�-- -
Corner Lot ...................._......_ Inside Lot _.�----•--_X--.---••-----.-.-•--.. Setback •-••_3_5 �---.._....____._ Sideyard .__ 5� and 10 �
�e�']€�Elevation .....----...------.9Q8...3Q.----------�---�-....----�-----�---------�---�--�---7e'#��3'03( Elevation .------Y911...30...M;n;n,,,n,
ye Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dw e_l.l i n_g... ---.. -.-- -- �ont _._3. � t._. Depth __.2 4�---- Height 2_�_ �_.__ sq. F� 7 8 8 cu. Ft 15 , 7 6 0
;
� a r a g e---.- ....._ .............. Front ---?-� ' Depth __?.2. �---_ Height 1.�_t___.. Sq. Ft. 4 4 0.._ cu. �. 4, 4 0 0
Type of Construction _._.�4ia_p�j,.__.F.�,IA.e__..._.. Est. Cost .�3..�..r.ls..%_.._5.5�___... To be Completed �I.U,II.� 1 9 7�,
STIPULATIONS: provide a hard surface driveway. Provide a verifying survey before
capping. Storn sewer escrow of $339.00 is due when water meter is taken out.
WATER LOCATION: Stopbox 11.5' South of Sewer SEWER LOCATION: "Y" 40� South of Manhole
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
'Ehe proposed work in accordance with the description above set forth and in compliance with all provisions oP
prdinances of the city of Fridley. ,, '
, 1 13
_ ��CC��T��: ;k^1��-�:�
$15.10 State Surcharge
In consideration of the payment of a fee of ��5.....QO —, permit is hereby_ granted to. R�]�r�, M i 1 1 P T H o me s
...__...._.....__.__..._..._ ...............................__ 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 worl�nen, in all woTk
done in, around and upon said building, or any part thereof, shall conform in all respects �to the ordinanCes oi`
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
I ��:Z'�-e-� � ��2•� .— Building I1�spectoT
DARREL CLARK
NOTICE:
lfiis permit doss not cover fhe eonstruction, installation for wiring, plumbing, gas heating, sewer or water. Bs sun to sN`
fhe Building Inspector for separate permits for these items. �
r"
AF���C�TIQN �Q� RES�AE�TTA�, A�T�R,RTIAN,
Q� ADpTTTON B�ILDING P�RMI�
�iTY pF �RI���Ye MINN��OT�
Q4�TFB' S NAi!�E : BU ILDER :�c w4.i2q�,,, /�'� c ��-er *„�" �"h ��,
ADDRESS : ADI�tES3: ll�,Z_�'+ca Ct'te��,� ,�Dl-QY
'�a.e • �% I �%� �S .i�L'' �+�ii B � iQ �D'�j,_E �� U v -t
�
�'r: 3 �LOCZ�: �. ����zo�; r�� FP�t �
�R LOT; �I4S�AE LO'�: ��c S�TBACKF �,; r SIDEYARD: S� /d �
��.�,c�4t a,�#.ac�i �a ��+Ar�_� Certificates of Survey of Lot a�d proppsed
buii��g �.acatiox� d� o� t#�se Certificates, !
��SCRIPTION OF BUILDING
� �e I3sed l�s :
t�;.; � 1 I r v�.a �= 37 ` D�ptia • 2-4 � ��.ght - Z-�'
�
Sq�are F�e�;Y 7� Cubi�e �'�et; l s� 4� ,
'f'
�y,,.,,.�.44 � �'rca�t : ZD � Depth ; ZZi Height s (f? �
.�.. � �
�qua��t ��et; Cls-Q Cubic Feet: cGL�(X)
,
�Y�+ of �onatruc�ioA; ��� Estimated Cost: $ CJ, Q�C�
� . —�-� � ,
�r� � +R�aa�p�.���d� C�-� l _7 � � ... � � ��- �
.�
� u�t+�rx#�$ued hereby makes ap�lica�iont for, a pe�ni.t for th� wo;k hsrein
�pe�i�ied, agxee�.ng ta d� a�I t�v7rk in sttict accordanee witt� the ��.ty Qf
F�Cit�l�t t�x'd�.�a�ces �d aCuli�s �f #�s Departneen� of Bui,�dings, a#td hereby
��axe� �, a11 zhe� �acts a�d ���resentatione sxated i� �his ap�lication
�s tx'ue a,�xd cu�rec�, .
. �. �
�1AT$; (%c? S, � Z� f ( �,7 2 S�GNATURE : �..G .� „ ` , � � �
��e� R+�►e�ee 3�.ci�et Fo� �ddit�.anal Iniastq�ation. )
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BUII�AIN� P�RMIT F�� ��H�DUL,E
����'�QN �, Z'he I�lapecto� pf �ui,ldings sha11, befoxe i.asuing gennits for �he
ex����on o� ar�y building ox etructure, ox for any addition to any sacisting
i��.��:�ci��.,� ox struGture, ox fox any alteration or repairs to any exi.s�ing
�,r_�i���I.�a� or stxucture, upon app].i.Cation therefore, require the payment by �he
��:��.ic�.t fvx such permit o� fses to the amount herein below set forth $r�d �.n
�;n� m�a��ex hexei� p�ovided �o-w�.� s
UATdFORM �UZLDING COI�E F TyPe 1 R 2& 4- $2.15 �or each axte khous�rtc� cubic
�e��, pT f�actian the�ceof, in such cubical con��ents. �.'ype 3& S- ��.,85 �o�
�ack� pne t�ousand ��h�.c feQt„
�I�D�T�flI�IAL �AiFO�MATION
Fo� tl�� pu�pQSe of �cnnpu�ing �ees for building permits, the cubical contents
of any building or addition, iS determined by mui�iplying the ground area
cQVS�e+� ��om a poi�ct s�x (�ij inches below the floor line of the basement
� tbte �Ce�la� to the average heights of the upper surface or to the average.�
�;�t �� �s �oo� �,u�face of the main gab�e of a pitched xoo�,
�� ��i�s ox a1���ea�ions �a� an existin� srructure9 �►� fee shall be a+� the
xat� of $3 � OU �se� eB�Gh f�,Ve h�Adred dol lars ($50Q, 00) � f���tion thexeof in
t.ii� cq�� o� al� }tTc?�lASed Wo��,
��o cat�e sha�l th� �ee ciaa��d fox �ty pez�it as set �Q�th i.0 Se+��ian 2 be
�r� ��n $5 . AU.
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V�R����ATiQN OF ��9UNDATION
NQ�s Permits �ox �c�tstxe,t���on will be iasued a t��.t;#.mu�► v� Z4 hours f�am the
�S o� application, �o a��aw f,ox pra�re� review of the pxopose� s�x'�,�ture �d
p� �e �stxu�tian si�e.
�, Ce���,�i�� su��y c�� �h� ls�, i�3��ing t% �,aeati� af �h� �aundatio�: ��e �t
�a� ��� ��s�u�t�d�, wi�.l ba �rec�aired be£ore proceedin,� w��h the �r�i�g,
C�R°TTFICA�'� QF IJC�ilPAN�Y
Agapli��zia€t �e>r a�e���.�3.s�t+� a� occupancy shall bs mad�s �en (1Q) d�y� px�ox
�o �h� use o� occupax�y o� ar�y st�.cture fax which �, build�.ng �ex��,t has beert
isst�ed; ,�d s��d s��tu�'e �i�alz T�ot be used a� occu�3ed ux�til a C��tificate
af OaGUpa��y has bee� �seuesi.
�
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�a„� Pi��,,,,;,,,, �/!�!/ I/"III / �s�s H�W�� No. es +�.E.
lond 1u�v�Y���y • • ( M�nn�upOliti�
So,�, ,.,,,,,9 ��ll�/Jl�'f'IIlI�, •�l«'. M,,,,, ss,��
C,v, I Enq�n�r. ��y Telepl�one I�4 -AOOA
M��vc�Val Fnymrerinq Etl�ineers & Surveyors A�eo Cod� 012
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Certificate of Survey for /�%,_� �,r:i .'-�� �.=� .y?M�-,�
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1 h�..by c+rrfiy �hae ►h�� ii a l.us o.�d c�rr�c� r�pi�7�A�olion o1 a s�rv�r ol �h• bovndo�i�ti �i th� ob�v•
d��c•�b�d Innd, ond oi tl�e loco��on el olt bvfld�nq�, eh�r�o,n, ond oii vitiibl� �M(►00(tiTCnft� �1 •ny, from s� o�
taid land 0.� w�veyrd try rne th�s day ol d.� •t_. J___A D. 1V71.
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SUtURdAN ENGlNEERING, INC.
eny�n.�.� Su.v�ye.s
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560-3�50
l�`�t o ��id�ec
� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE December�, 1972 FRIDLEY, MINNESOTA 55421
TO WHOM IT MAY CONCERN:
Whereas the City � Fridley has issued a building permit to construct a
s truc ture at �/��.5 � Z� �t�� C( C'� �, �,��(�c�,
Whereas the permit is dated prior to January 1, 1973 and the City at
Fridley did not collect or receive any "Service Availability Charge".
Therefore if for any reason the Metropolitan Council and or the rietropo?itan
Sewer Board assess or bill the CitX of Fridley � Service Availability Charg2 ror
this structure or sewer hook up, we the undersigned agree to and will pay the
City of Fridley for said charges. :`�
� % .
�
!, S igna t� , e .
Witness
" Company /
� /
T tle
/
560-3450
+��� /
� �� it o �Nid e
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6431 UNIVERSITY AVENUE NE
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TO WHOM IT�MAY CONCERN:
ANOKA COUN7Y
December'�, 1972 FRIDLEY, MINNESOTA 55421
Whereas the City of Fridley has issued a building permit to construct a
structure at �(Q.���-r�.c.G� � �� g�a -- �y� '`:"�i9/� -i�, �`�i� 9�9�• �G, �'�i4:x'9_ ��95.�
. Whereas the permit is dated prior to January 1, 1973 and the City ot
Fridley did not collect or receive any "Service Availability Charge".
Therefore if for any reason the Metropolitan Counc'_1 and or the rletropolitan
Sewer Board assess or bill the City of Fridley a Service Availability Charg2 for
this structure or sewer hook up, we the undersigned agree to and will pay the
City of Fridley for said charges. ' ��/�
.. .... :/ / / n �
Witness
Signa
�
�
� Company /
/ ,.
T tle
�
�ity of Fridley -
�►PP�ication for Pl�q and Gas Fhii�q ��n�
Dapt. of Bldq�. Phon� 9e0-3�.Y0 -
DESCRIPTION OF WORIC �/,'� ��,p�R� � �� �Q � %—'
Kumb�r, Kind and Location oi Fixtures ���0° f� �
N
T,' C� �� pg jZ �' Zri
� �3 � i� i � �? o�
Bast � �
Ist � !
2nd
3rd
4th
• Futus� Coua�etba Op�ai�qs
* N�w Fixlur�, Oid Op�ninys
� I� �iV �I< �IU' �Il�! �IU �I ► I N IG STEN MEC.
PARTIAL RATE SCHEDULE
PtIIMBING FIXTURE RATES: / NO. R1►TE
Number F'ixtures . . . . . . . . . . . . . . . . �� x a2.00
F�ture Ftixture O��ening . . . . . . . . . . . � x �1.50
New Fixture Old Opening . . . . . . . . . . . x a1.50
S�w�s
Cssspool
TOTAL
a iz� ��
s�. �� �
s---
Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 �
Water Heater 'Up to 99,000 BTU) .... �_ x 53.00 ; 3' ��
New Ground Run Old Bldg. . . . . . . . . x a3.25 $
ElectrLc Wat�r ii�at�s . . . . . . . . . . . . . . : :2.00 s
:,AS FITTING FEES: NO. RA'fE TOTAL
lst 3 Fixtures . • . . . • • • • • • • • • • • x S2.00 ;
�Ja d V�
Additional Fi�ctures . . . . . . ... . . . . . . x = .7b ;
Gas Ran�e to 199,000 BTU ...... ..... x a5.00 i
REPAIRS k ALTEAATIONS--R�i�: to Cod�
City of 1�Yidley:
The undersigned hereby makes application tor a permit for the �oak herei
specified, agreeing to do all work in strict accordance with the Cit,� Qcdinance
and ruling of the Department of Buildings, and hereby declares that all the tact
and representations stated in this appllcatioa are true and correct
Owner
-- Kind of
� Used as
Description . . . . . . . . . . . . . . . . . . ... . . . ... . . .. . . . . . . . ._ . � 0 S Ci
TOTAI. !'EE � `�
3
To be completed about � �
� �� G` �' .�
r ^�-
Estimated Cost, a
-Oie�–New. Building PPrmit No. Psrmit No �
Signed ' ^ G' f
By �7 ty.�=�
Business Phune No. � � G � �-��V
ROUGH
FINliIL S' 7- `{ ' � 7
�
�►pplica�'ia+ lio+' �ow�r Pla�ts and Hta�ing. Cooling. Yentilal�ion. R�ig�rafion aed
Air Conditioning Syst�n�s c�d Deric�s
PARTIAL RATE SCHEDULE
GAlIV!TY WARM AIA: �� T��
lhunace Shell & Duct Work . . . . . . . i10.00 i
Replacement o! P1�rnace . . . . . . . . . 6.00 �
Repairs & Alterations—up to =500.00 6.pp s--_— -._—
Repairs d� Alterations each add. =500.00 , g.p� ;__ ___.____
KECH. W11RlR AIA
P�rnace Shell & Dnct Work io 190,000 BTU .. .. . .. a10.00 ;�Q. 00
each add. A0.000 BTU . . . . . . . . . . . . . . . . . . . 3. W ;
R.epLcement of Fiarnace g.pp �
Repairs de Alterations--up to ;500.00 6.0p �
Repairs & Alterations each add. =500.00 3,pp ;
STEAM or HOT WATER SYSTEi!
FLrnace Shev dz Lines--to 400 sq. ft. F.DR Steam �2p.0p S ___ __
F�unace Shel] & Lin�to 640 sq. ft. EDR Hot Water 20.00 S--_
Each add. 200 aq. ft. EDR Steam g,(1(► _.. __ ____
Each add. 320 sq. ft. EDR Hot Water 3.pp i--___
OIL BIIRNER—to 3 gal. per hour
over 3 gal. per hour—See Fee Schedule
GAS BIIRNER (up to 199.000 BTU)
N
over 199,000 B1'U See FN Sciudul�
GA8 FIT'IING FEEB:
lst 3 FSxtures
Additional Fiatures
Gas Range to 199.000
AIR COl�DI'ROIfIlfO
FArr rt�►�xc aYS�t
VE]�TILATI1fG SYSTLId
ALTERATIO?IS � REP11lRs
ROU(3H
�'INAL J� — l�— / �
6.0� E— --
a.00 ; 5.00
I�10 RATE TOTAL
- Xa 20o t 2.00 _
_ x .76 i
- :i 6.0� _ —
D.pt. of Bldqs. Phon. 56�-3490
�.� 6175 Briardale Court
City oi Frldley:
The undersigned hereby makes appllcation for a permit for the work hereir
specified, agreeing to do all work in strict accordance with the City Ordfnance:
and ruling of the Depa1•tment of Buildings, and hereby declares that aIl the lacts
and representations stated in this application are true and correct.
F1�idley, Minn_ Aug�� r� 4%? --� lS
owner RICHARD _�S�LIF�t HOMES
Kind of Building ._ f2'BtAA
Used ag ___2'eS�Q]�t�Sl ---- --_
To be completed about __��0�_?�___
Estimated Cost, a_ _���15�OQ,___ ___
Old—New. Building Permit No. _. Pumit No. � n�. ��
DEdCAIP'1'IOIf OF WOM
FIEATING or POWER PLANTS-�team, Aot Water, Wum Air—No_ 1
Trade Name WESTINGHOUSE Size No FGUB-110
Capacity�� 000 Sq, Ft, E.D.R g� gp
Total Connected Load�� �'� Rind o! lhul Gas
BURNER — 1Yade Name—SA�'. AS ABO�iE g�z� No
CaDacib' S9. !'t. EDB BTU FyP.
�' SAIESMAN: John Borry JOB �4520
8i p'� ��� COPY OF HEAT LOSS ATTACHED .
� . 0 SURCHGE
roTUi. rae s 17.50 si� _
GT&�'"
NEATING AIR CONDITIC�'
B1�f� PhpD! Np 60 G m Av�. ' 929-0% '
� �qri� aAc� Mmn�tota -
(REMARKS—OVER)
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HE�T L05S CALCULATIONS y
=r—
�;+�eatherstripa A•S•�•v• • Constrnction N
Guide
Windows Doors Referenr.e Out. Wall Int. Wall Ceiling
Yes—No I Yes—No 19_
;-` Fl.� Roc�m � Len�th Width Hei�ht .
1Vindows and Doors—Cracka�e and Area
R'�d[h Helght No. of Llneal tt. Area
No. oC pane ot pane 1lghts ot crack sp. Yt.
"„ -' . ` .... . .
COCE. BtU
Inhltration ' -
Glass ; �:r . . .
�xp. wa�� . ' �
x
IVet exp. saall •-f ::_, , ` • :
In4. wall
Cei�ing / " '
Floor � :. . .
Total Btu. �
Required sq. ft. E.I�.R. or sq. ins. W.A. Leader area
Fl.� Room � txngth Width ' Height �"
Windows and Door�--�rackagt and Area
Wtdth Helght fvo. of Llr�eal ft. Rrea
No. of Dane of pana lighta ot crack ep. fi.
� � � �� �'�
Coef. Btu
In6ltratian
Gl�aa ,' ,,, � �
Exp. wali ,
Plet exp. wall . p - -� _...
Ini. wal!
Cei�ing ;
Floor - -
Totai Biu. <�
Reguired sq. ft. E.D.R. ot sq. ins. W.A. Leader area
F1. iZ�� i i,�n�th ' l�Jidch H�ight ``
Windqws and Doors—Cracitage and Area
Wtd:h He1gAt No. of Ltneal [t. Area
No. ot Dane o! pane Ilghts o[ crack ea, tt.
- �J
-- , � .
Coef. �tu
lnbicration - . � ? '-� ,
C,laaa `°~ �
Exp. wall - '
�ei ezp. wa�� --, _ . .
-
lnt. ��[l ' �
Ceiling - , - � � �
F loor
lrotal Btu.
•�
-
, �-� .
r YIII
�, `,
i�equired sq. ft. E.D.R. or aq. ins. W.A, 1,eaatr area
<' F!• Roo�s, � LenBeh �f�dch H�ight
Windows ana' IJ�oors—Craelcage an� Area
' 'i�'tdth HeignB No. of Llneal ft. Area
No. o! parn ot �¢na Ilghte of cr�ck eQ. ft.
Coef. Btu
Inbltration �
�llas�
Exp. wall .
Net cxp. wall ;> ; � . -
Int. svall
Ceiling _.. , ° �
;
t�lour . _ __
Total Btu. '
_ Requ�red sq. Fc. E.D.R. e�r aq. ins. W.A. L,eader area
... � , � �
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; . : , .:: .
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, .,,,.,,.,
, , _, .
i
�. Inaulation '
Roof Floor Kind How Applied ;
' FI.� ,. Room Length Width ,'" Height
Windows and Doors—Crackage and Area '
Wldth Hefght No. ot Lineal tt. Are�
No. o[ pane ot Dane Ifghte ot ceack sa. [t.
.. . , , r , / � .
COtE. B�li �
Infiitration � " '
Glass , �-. c .:.j %i ,-. , . '
Exp. wall , , .; :. ,, '
Net exp. wall ;> — f!,' 9; '
In4. •aall - '
Ce��ing - � /=;�� t �.'
Floor
Total Btu. -�� - '
Required sq. ft. E.D.R. or sq. ins. VV.A. Leader area 1~ '
� F1.1 .: Room I Len�th Width '. Htig t �
Windows and [)oors—Crackage and Area
Wldth Hefght No. ot Lineal Ct. Area �
No. ot yane of Dane It�ht■ ot crack ey. tt. I
' /' , !
Infiltration �' �_;
�
.Glass / ;f ^ � � ,
Exp. wa(I " ,�/ �
Net exp. wall "�' �
�,,.
Int. wall I'
Ceiling i � r',,� .� "
�
Floor -"`��
Total Btu. � ',;4? .� r�.
Requiced sq. ft. E.D.R. or sq. ins. W.A. Leader area �'
F1.� Room I Length �� Width Height
Windows and Doors—Crackage and Area
Wldth Helght No. ot Lineal tt. Area
No. ot pmna of Dane Itghte of cnck �Q. tt.
, ;. / - - � i
Coef. Bta
lnFiltration �� �r '
Glass , .; ;� �'
Exp. wall <
h
Net exp. wall ;' 't ./ .r � �: ;,
Int. waU `�
Cei�ing !� "� %r�t �,�
Floor ' -
Tota! Btu. ;;:,� c`;`
Required aq. Et. E.D.R. o• sq. ins. t�lA. l.�ader area
•' Fl.� "' � � RoomlLength �o Width /Y Height
Windowa and Doors—Crackage and Area
R'idth Helght No. ol Llneal [4 AteiC 4�1
No. ot Dane ot Dnne Ilghts oY crack �Q. Lt. -�i � �
� . . . . ,,-� �a .
/ ' -� �� � n 1 � i
`, � �, i ,
Coef. Btu
In6ltration / � . -• , '
_ _
, �,
Glass y"' � -
Ex wal
1
P•
Net cx . wa
Il
w�,
P ,=j =-: ,� i
Int. wa11 " �-
�,
Ceiling
Floor �;6�' ; � �r - •�
,.
Total Btu. �f �� , ;.�
Requircd sq. ft. E.D.R. or sq. ins. WA. Leader area
53 -�1�-5-915 . 51
City of Fridte�
�lpplic,a�i�+ 1or M�aabi�q aad Ga�t RttL�q �t
�- n�.ac. a a�... n...,. eeo-�
��� ��� • y�� 6175 N. �,. �riardale �ourt
xrsi.r. Kir � L«� .t i'lst�.� �
!�� � _� � ���=!s�f�l$��s�
1 � � � 1 �
Base
tst
�
�
+� f t l I I I f
' t�a�� Cww11r O�..i�
• ltw ��,. Qii O��iya
� �� �� o�
1
..
� �.
► 1� W►S tltC.
Mr
C��I
PARTtAI RATE SCHEDULE
tLQN�iRG F1ZZVeL MTFS: 110� II�it TOrt�L
Nw�6e: !'t=o+tes . . . . . . . . . . . . . . . s :L00 i
11sou� l�tta�e chx� . . . . . . . . _ . . = i1.60 i�_ .
]reo �tstare Old Opre�nt . . . . . . . . . . . s i1.60 i
Cshk Bada . . . . . . . . . . . . . . . . . . . . : iS.i i
�Ia(er Re�ber ;Up to i�.DOO �'TtT1. ... : fiA� �
Ne� Crvund Rua OI! Btd� . � . . . . . . r �.�5 i�
ii�elaie �►atrr li�err . . . . . . . . . . . . . a �00 t
� �� �.: .o� �,►� ��.
� � s�a� . . . . . . . . . . . . . . . . . . : rian ��_�
�uoo.� l7stLees .. . . . . . .... .. . . : s 7i =
ff�r R�e�e to 1l�eeo B7'u .......... 1 s�p . 00
State SurdLarge • $ .SO
w��s f �u.tt�tai tcw�--a.t.r r cw.
Di.e�4Ai.. . . . . . . . . . . . . . . . . . . �. . . . . _ . . . . .. . ... . �
rarra` sa � 5.50
Cib d h�e7:
The �oaersi��a n� mai�es .pp�le.tion ra , p�mic ror cnc .ori� n�a :
sv«tned. ap�eeins to ao an .►ork m st:iec .�eord.oce .►ien cAe ay ord';na� �
and *ulins of tAe Departrne�t ot Buildiop� am hereb� decLres that aii tIu isd:
. and teprexntatloo� sfated ln tbis appiieatiw are true aod eorreR
� �'.fass °�A" Surcharz;e .�i;;�
�� �„s 9-21-73 . »� -
�� Richard Ati.11er �onstr. �o. _
Kind ot Hui3di� Frame . .
v,�a ., Res.
To br campie�ed ,eon: 9-28-73
Estimated Cast„ = 10.00 "
x�l�#le�►. BuiLdin� P�rn�ft �r.. R..�1t If.� D
,.�..�
I � ..— � �r� .
ST `
6wi�es !`r � ���C,A �?'°E!
.. .
� a -�3-� �
-- .
.
HOUSE HEATING TEST RECORD
ADDRESS >� APT. FLOOR �-CITY SUBURB
OCCUPANT '�'�; OWNER �'"
HEAT LO55 DATE HTG. INST. GAS C0. METER BADGE #
SOLD BY ` INSTALLED BY '""
Electrical Work By Gas Line By
TYPE OF HEAT GA FA {` HW STEAM SPACE HTR. UNIT HTR. OTHER
�. GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
Model �-' ' Model
Serial Max. BTU Rating �
INPUT MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT ��� Heat Plug Vent Size
Valve KIND OF LINER SIZE _ NONE
Limit Draft Hood Regularor �
Limit Setting Filters Size Number
Fan Setting Chimney Location I�side Outside
Pilot Type Chimney Construetion
Pilot Make
Pilot Model � Smoke Bomb Wiring
Pilot Timing ���;,f'� = Draft Test Tag
�
L.W. Cut Off Door Pressure Lighting Inst.
/`� �
Prossure � Percent CO2 Date Tested � '/
Input CFH %��''t' Percenf 02 ` Company Testing ." "'
Staek Temp.'`� ' Pereent CO Name of Tester
Form 235
r
� .
HEa4T LOSS CALCULATIONS
�'�Veatherstrips A.S.H.V. , Construction No.
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof
Yes—No Yes—No 19_
i .. .
Insulation
Floor Kind How Applied
� 1� . FL Room � Length Width ' Height Fl.� Room � Length Width
�indows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vidth Helght ho. oG Llneai [t. Area Wldth He1gAt No. ot Llneal tt. Are�
No. ot pane ot pane lighta ot crack sa. ft. No. ot Da�e ot Dane Ilghte ot crack �Q. tt.
. _ . y T 1-
Coef
Infiltration °
�_
Glass � y � �
�
Exp. wall
Net exp. wall �"?
Int. wall ,
Cei�ing
Floor
7'otal $tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
' �'1.� Room � Leegth ' Width '
Windows and Doors---�Cracicage and Area
Width Hetght I:o. ot L1neal ft. Area
No. o! pane o[ pane lt�hte ot crack ep, It.
' : _ , . . � , '7-
COtf
Infiltration a:. � ' 1� ,
Glaas -
Ezp. svall " ' ,
Net exp. wa11 / � ;�� �
lnt. wall
�eiling –
Floor , ; :, .:.;` _
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.` Raom � Length Width
Windows and �oars--�Crackage and Area
Wldth iielght Rlo. of Lir.eat [t. Area
No. of ysne ot Dana 1f6hts ot creck eq. tt.
Btu
`�: �'_ ::..�
�. _
- I
�
�= � '�' !'' ',
....� . , " i
, __ � �
,
Aht
BiU
�/_ ;- ,
���!.. .�.
,.:� ' i� ,-' I
.' ,
� „�
Coef.� Btu
In6ltration �
Giasa
Exp. wall
Net ezp. wall
int. wall
Ceilir�g
I� ioor
�otal $?u.
__ Required sq. ft. E.I�.R. ot aq. ins. W.A. Leader area
F1• Roosxa ( Length Width
Windows and Doors—Crac�age anci Area
R'idth He1gAt No. oC Llneal tt. Area
No. ot qane o[ Dane . ilghts ot crsck ea. [t.
ht
Coef. Btu
1n61dration
Glass
Exp. wali
Net exp. wall
Int. wall
Ceiling
Floor
Total 33tu.
Eiequieed aq. ft. E.D.R. or sq. ins. W.A. L,eader area
�
Infiltration
Glass
Exp. wall
Net exp. wall
Int. •oall -
Ce�iing
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
FI.I . Room I Length Width
Windows and Doors—Crackage and Area
Width Helght No. ot Llneal it. � Ares
No. of Dane ot Dnne llght• ot crack eQ. ft.
Infiltration
-Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area
Fl.� Room I Length Width
Windows and Doors—Crackage and Area
Wtdth Height No. of L1nea1 tt. Area
No. of pane ot Dane Ilghte of crack �c. tt.
Height
Btu
Height
Coef. Btu ..
Infiltration
Class
Exp. wall
Net exp. wall
Int. wall '
Ceiling
Floor
Total Btu.
4�equired sq. ft. E.Q.R. or sq. ins. LVA. Leuder area
Fl•� Room I I.ength Width Height
Windows and Doors---Crackage and Area
Wldeh Helghc No. ot Llneal ft. Area �
No. of pane ot Dane Ilghts ot crack �Q. tt.
Infiltration
Glass
Exp. wal!
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or
Coef.� Btu
ins. W.A. Leader area �
----�
APP��a� �' Powd' PIa�Ms and HsaNng, Coding, Yeneilat�n� R�ig�ralion and
Air Conditioning S�s ond Devic�s
PARTtAL RATE SCHEDULE
GR�V*TY WARM AIR: �� T��
Furnace Shell dc Durt Work a10.00 ;
Replacement of F�rnace s � �
Repairs & Alterations--up to =500.00 6.pp a--__-
Repairs d� Alterations each add. :500.00 . 3.00 =_ ____ __
l�ECH. WAAl�t AIR
Furnace Shell dt Duct Work to 190,000 BT[J .. .. . .$10.00 ;_
each add. A0,000 BTU . . . . . . . . . . . . . . . . . . 3. W i
Replscement of Fi�rnace g.pp =
Bepairs & Alterations--up to =500.00 6.00 �
Itepairs & Alteratioas each add. :500.00 g,pp i
STEAM or HOT WATER SYSTEM
FLrr:ace Shell & Lines—to 400 sq. ft. F.DR Steam �20.40 � �____
F�rnace SheU & Line�—to 640 sq. ft. EDR Hot Water 20.00 �_—_
Each add. 200 aq. ft. EDR Steam g,� �__ ____
Each add. 320 sq. ft. EDR Hot Water 3.00 5---_
OIL BIIRNER—to 3 gal. per hour g,pp a_ _
over 3 gal. per hour-�ee Fee Schedule
GAS BIIRMER (up to 199,000 BTU)
over 199,000 81`I1 $ee FM Scludul�
GAS FIY'1'ING FEEB:
lst 3 FSxtures _
Additional FiMures
Gas Range to 199,OOp _
AIR CO1fDI'RO�IIIG
FAN HEATIItG 3YS?EM
YEI�TILATI1fG SYBTEl1
ALTERATIOIfa t REPA7RS
xouvH
FtHU. / �1- i�
6.00 ;
NO AATE T07AL
- XE 200 E ---
- x .76 �
- :i b•0� _ —
�
SN�Y f�� n1� �
roz�►i. Fae ; /G • SO
Cj�U�jCi:':�..i:�.]� Y ��
_ � ��.
Dspt. of Bldqs. Phon� 360_34,90
Loe��n � 1% t 7 J ,
��
� `
'�
City of FYldley:
The undersigned hereby makes application for a permit for the work hereir
specified, agreeing to do all work in strict accordance with the City Ordinance:
and ruling of the Departmc�nt of Buildings, and hereby declares that aIl the lacts
and representations statc�cl in this applieation are true and eorreet.
Owner � _ _�
Kind of Buil ing ____ ___
, Minn lg
. � —
Used ac --- _ ._
To be completed about __ __.(7' � _ / ��
vd
Estimated Cost, E_ _.�?� -._�!'---------
Id ew. Building Permit No. � P�rmit No.� �•��
DEdCRIPl'IOIf OF WOAa
HEATING or POWEit pI,AN15..�4team� gat Water, Waria Air—No
Trade Name Size No
Capacity
Total Connected
Sq. Ft. E.D.R BTU gp
Rind of lhul
BURNER — 1Yade Name Size No
Capacity — 89. !'t. E.DR BTU �,P.
� � � ��� . (RFMARKf-OVtR)
Husfness phdk N
��vw,
��� �
- zG s`6
SS� o �
sua�ecr ER O.
City of Fridley _ 17974
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
f
; � EIPT .
• COMMUNITY DEVELOPMENT DIV.
' � ti: ----- � I � i�
r � � PROTECTIVE INSPECTION SEC.
1 � �
' � �'��1 � CITY HALL FRIDLE� 55432 NUMBER AEV DATE PAGE OF APPROVEO BY
� -'--1`.' `.�
612-571-3450 9� 0-F� 5 5/14/85 / /
JOB ADDRESS 6175 Briardale Court N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oESCR. 3 3 Briardale Addition SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
Joseph Krauter 6175 Briardale Court N.E. 571-5528
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 16' Storage Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OFi CONSTFUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED 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 COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $585 $.�jO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OA CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $1S.00
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$15.50
S�GNATUREOFCONTRACTOAORAUTMORIZEDAGENT IDATE� .� WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
v /`z� " � ��.e,C ��-t� � � °.�`
f NATU EOFOWNERUFOWNERBU�LDERi IDATE� BLDG �NSP f�nTE
NEi�f �
�
ADDN. [ ]
AI,TER. [ ]
City of Fridley
�R-1 AAD R-2
Building Permit Application
Effective u/1/84
Construction Address: �v� 7� '�� ���� u``�� � T
Legal Description: .�oT' -� ��° �� 3 ����� �1�� ���'
Owner Name i Address : Jo S-e��i �2�-� / r` �� Tel .• � 7/ .- S s �-!�
Contraetor: S'�`�"-� Tel. # �
Address• � � 7.5� �2�,.�-� �eQ c� 7—
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction drarrn on it to scale.
DESCRIPTION OF IMPROYEMENT
LIVIHG AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECb AREA: Length iiidth Hgt/Ground Sq. Ft.
OTHER: S % � �P,�-�,e � LrJ •� � �. � ! % �9,� �
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
Type of Construction: Gv� o� Estimated Cost: # ��� � c�
Approx. Completion Date: �-� -�-'
Alt. A Alt B
Proposed DriveWay �lidth If NeW Opening Is Desired: � �
See Back Page for Explanation
DATE: .5 - / 4 - � 5 APPLICANT: 'T�'� 2�`� _ Tel . � s� � - ' � '� �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
?OTAL
STIPULATIONS:
CITY IISE ONLY
� /S�OD
�
� S7�
�
�
Z
� /�.5�
Fee Schedule on Reverse Side
25x of Building Permit Fee
�•50/�1,000 Yaluation
=425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [] No� Necessary [ j
BIIILDIIiG PERMIT FEE SCHBDIILB
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 applicatio n
therefore, require the payment by the applicant for auch permit of fees to the amount
herein beloW set forth and in the manner herein provided to-xit:
Total Yaluation
=1.00 to =500.00
�501.00 to a2,000.00
�2,001.00 to �25,000.00
�25,001.00 to �50,000.00
�50,001.00 to �100,000.00
�100,001.00 and up
Feea
�10.00 (Minimum Fee is �15.00)
=10.00 for the first �500 plus �1.50 for eaeh
additional �100 or fraction thereof, to and including
�2,000.
E32•50 for the first �2,000 plus �6.00 for each
additional �1,000 or fraction thereof, to and
including a25,000.
�170.50 for the first �25,000 plus �4.50 for each
additional �1,000 or fraction thereof, to and
including �50,000.
�283.00 for the first $50�000 plus a3•00 for each
additional #1,000 or fraction thereof, to and
including �100,000.
�u33•00 for the first �100,000 plus �2.50 for each
additional �1�000 or fraction thereof.
DRZVEiiAY DEPRESSION ESCROii
(Concrete Curb Streets Only)
. Alternate "A": Removal and replacement of curb and gutter only - DriveWay width plus
6 feet times a13•50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot �ide
approach xith 6 inch depth - Drive�ay xidth plus 6 feet times �15.75
YERIFICATION OF FOQNDATION
Permits for construction xill be issued a minimum of 24 hours from the time of
application to allo� for proper revie�r of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, shoWing the location of the foundation onee it
has been eonstructed Will be required before proceeding with the framing.
a
CITY OF FRIDLEY INSPECTION DIV, Effective On January 1, 1993
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERA710N AND AIR CONDITIONING SYSTEMS AfVp DEVICES
RATE 3CHEDUIE
Residential
Fumace Shelt and Duct Work, Burner —
Also Rep{acement Furnace
Gas Piping (Needed w�°rrtea�rhrrnace)
fCr F iiF'rl.ic�
Gas Range
Gas Dryer
*Air Conditioning — Alt Sizes
All Others/Repairs & AReratfons (LIST ON BACI�
1% of Value of Appliance or Work
Commercial/Indust�ial
1% of Value oi Appiiance or Work
Rate
$ 20.00
JOB ADDRESS <^ ,� � �_���u-�vu� �^��"
7he undersigned hereby makes application for a permit for the work herein
TOTAL specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that atl the facts and
$ representations stated in this application are true and correct,
% � � ,1993
$ 10A0 $ �. "�C�
$ 10,00
$ 10,00
$ 10,00
State Surcharge
TOTAL FEE
� ���c�ti
� i
BUILpING�USED AS /�/ ,u-�������/
--T
$ _
ESTIMATED COST �,Z �^�� PERMtT NO. , �/��%`��`=-
$
$
$
���
r.s�
MINIMUM FEE FOR ANY HEATINGlCOOLINGl1/ENTILATION
REFRtGERATION/AIR CONDITIONlNG P�RMIT IS �15.Q0
PL.US THE;.50 S7ATE SURCHARGE
REINSPEC'fION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DE�CRIPTION OF FU,J�N�C� AND OR BURNEE
No, of Heating Units Circle One (Steam} (Hot Water) (Warm Air)
Trade Name ' Size No.
BTU MP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
f
,i'-{;v- �.G'`%c"� /�; - 1�� � t,��-<, -_
HEATING COMPANY ��✓Z�.�.L �d �1
,
Signed By � ` � .-� G� Tel No. `� �l � G' �" �-
,
Approved By �� '� Rough—In Date Final Date l�� 7"�
�
F1LL OUT BACK SIDE FOR STACK VERfFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VSRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or deterioration Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
4. Is securely supported Yes () No ()
5. Meets all current Code requirements for
size and total BTU's connected Yes () No ()
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
e
HEATING COMPANY
Signed By
Date
0
�I tY OF FREOLEI' IidSPEGTfON DIV,
643i University Ave NE
Fridley, MN 55432 .
572-3604 �
�rA� sc�Ea���
A�Pl3CA1�ON FaR POYVER PLANTS AND HEATING, COOLING, VENTiLAT��N,
RE�RlGERATION AND AIR C�N(31TIQNiNG SY$TEtuig AND DEVICES
Residential
FurrEace Shell and Ouct Wo�C, 8umer --
Also Replaceme�t Furnace
(Side Vent — Fill Out 8ackj
Gas Piping {Neecfed with new fumace)
Gas Rar�ge
Gas Orye�
*Air Cond�lioning� — All Sizes
A!1 OtherslRepairs & Aite�ations (I.ISi 4�! BACKj
1% af Val ue of App I iance or Work
Commerciai�lnd�sf rial
1.2596 ot Value of Apptiance or Work
Rate TO7AL
$ 30,00 $�
$10, 04 $____.�
$ � 0.00 $�
$ I O.OQ $
Effective On January 1, 1997
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JOBADORESS 1s�1 �5 ��s arda�� Cou►�l"
'i'�e undersigned hereby makes application fflr a perrnit f�rthe work herein
specified agreeing to do afl wa�C in strict accordance with the Ciiy Code�s and
rulings of the Building Divis�on, and hereby declares that afJ the facts artd
representatians stated in t�is applicatior► are true and carrect. �
���T3I ' ,1997
OWI►!ER �) d� 1�I�QU�-� S �/—,S S' Z B
- 8UI�DI�lG US�D AS �QS �► U.tUr� �0�
ES�'EMAT'ED COST �� �0c7 • � ��RM�TNO. �;.� �/�,�.
$ 25.00 $
�ESCRIPTIQN OF FUANACE AND OR BURPf�R
$ No. af Heating Units� Circle One (Steamj (Not Water) aan Air)
. Trade Name 'SP���T�4— S9ze �lo.
BiU j (�p, �� HP EOR
$ Fuel� Total Connected �road
State Surcharge $ .54 Bumer Trade Name Size No.
� BTU HP Eaa . .
,
TOTAI FEE � � .� -
MtNIMUM FEE FOR ANY HEATI�lG,�OOLlNGNENTILATIQN
REFRIQERATIONIAIR C4�EOIT�ONING P�RMIi' (S �25.00
PLUS THE �.50 S�ATE SURCHARGE
REINSPECTEON �EE $42.40JHr
'Air Cond�ioners can r�ot be placed in a side yard without
wrFtten permission (rom adjoining propetty aw�er,
HEA COM Y T� �►'�' � GQYI �� °� ��tAPP�.�
s��ne y Tei No. �� O— 3 Q3 0 O
Approved 8y Rougn—In Date Fi�al Date
FIL� OUT 6ACK SIOE OR STACK VERfFlCAiION ON
REPIACENiENi` FURNACE
Pe�-►�,� � �j��� ce�i /�t� �IUs/��
JUL-1t�-19� 12� 12 CIT''i' UF FR?DLE'(
C Y AND STACS VERIFTCATION
612 5?1 1287 P.02%0c
The undersigned hereby verifi�e.s tbat the.cxistinS chimntY or sta�k:
- _ .
1. Has been carefuUy examin�od ��:: � Yes (� No i)
2. Is fiee from nrst �'or de�ior�tion ." ' Yes (�` No O
3. Has no forcign objects lodg.cd witi�ia� Yes (� No (}
4
5.
6
Is sectireiy supporied
Me�ts ail current Code requiram�nts for siu
aad total BTU's connoctJed
�ias total heating BTU's o� �, � C�. �
All other B'Y'U's l5� '�J� �
TpTAL BTU's . I L4S ! ��
Yes (`'�No ( )
'Yes (!�a ( )
7. F�as a lener been provided for vvau�r b�eat�r 'Yes (�No ()
8_ Has combustion a�r been�R'��)" d�ed heat�r ()
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List ALTERAT7�ONS Beiva�Doae:
HEATING CQ:
Signod By:
p���:
rv�c�� .�ca�i�
10=3 \-��
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roTa� P.��
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sue�ECr P
c�ty of Fridley 061 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � `
� ` RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV. j� ////���/1
' ; V��'��� , ��"' V
r � � PROTECTIVE INSPECTION SEC.
� �
1 � /'��1 � CITY HALL FFIDLEV 55432 NUMBER REV OATE VAGE OF AVPROVED BV
�""'�'� �'' 612-571-3450 910-F15 5/18/98 � �
J08 ADDRESS 6175 Briardale Court NE
t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACMED
DESCR. 3 3 Briardale Addition SMEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Joe Krauter 6175 Briardale Court NE 571-5528
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Heiderscheid Bros. Construction 716 198 Ave NE, East Bethel, NIN 55011
d ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO-
434-4578 20060354
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ AODITION O ALTERATION �7 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFK
Reroof House & Garage (23 Sq) Tear-off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTILATING OFi AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT
AUTHORiZED IS NOT COMMENCED WITHIN 60 DAVS, 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 CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STA��S GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PFiOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING F A IT �1 �91H �.96
DOES NOT PRESU E TO E UTHO ITV T VIOLATE OR A EL T E pERM1T FEE SAC CNARGE
PROVISIONS OF V A �LO A�� LAW REG AT G CO -
STRU T N OR E P RF R F CO TRUCTION �G2. ZS F� 2 SC �1 . JZ
7 � PLAN CHECK FEE T T L FEE
� �� � Lice e SC 5 00 $70.13
SIGNATUAEOFCON'RACTOAOF7AUTHOA�ZEDAGENT IDATEI p V VA D THIS IS VOUR PERMIT
� —C � (
S�GNaTUAEOFOWNEA�iFOWNERBUiLDERi iDATEi OG �NS� ��°1E
NEW [ l
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Zegal Description: _
CTTY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
� � �i� %� �C�1�}- �� C' �� •
Effective 1/1/98
�� � �
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Owner Name & Address: � � � � 1� Tel. # J 7� '�.�� � �
Contractor: � ^ 6 S � MN LICENSE # � � �
C/ ^ ,,\ � L,
Address: 7�(0 l CJ r� '� 1�t (1Gr . JV .�� Tel. # ��.�C� 7.�7
�,IVING AREA:
GARAGE AREA:
1DECK AREA:
OTHER:
Attach to this applicatian, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
� � ��,�?� .
Height
Height
Sq. Ft.
Sq. Ft.
Sq. Ft.
, --�--, � c � �,.� _
t�onstruction Type: � � Estimated Cost: $ l?l�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = $
�ATE: � � APPLICANT: �� � Tel. # � �� � � /�
�'ermit Fee
� ire Surcharge
itate Surcharge
�AC Charge
,icense Surcharge
)riveway Escrow
?rosion Control
'ark Fee
�ewer Main Charge
TOTAL
;" CIPULATIONS:
$ . �S
$ �
$ � _
$
$ . C�
$
$
$
$
$ �.
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
$62.25 for first $2,000 plus $12.50 for each additional $1,000
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.