AF - 44094City of Fridley, IViinn.
BUILDING PERMIT N� so9�.
Date: "ri►. ��'r'�
/ � . .
Ovvner: Builder „.
Address ...._._..._...._........._._.. .._........ ____ Address ._._ -
No. �� LO ON OF d���G �
.. : ' Street .. ` � ��•-- -/P o! Lot -
Lot _._...__ Block _.�..._._.. � w_,,,�,ddition or Su vi�� _..
M,,,,r,r••�-
Corner Lot �_._.._.._........ Inside I.ot _.__._. _.. Setback .��..�_ Sideyard
Sewer Elevatio� ...__..__._...__._._ ..........._._._ Foundatiou IIevation _._._.�..
� r ��
� � • r ? �'�' t�ES�RfPT10N OF�_ BUILDI�VG, �` j � ��
T _ Fr�►t �=yDe th A Height Sq. Ft' Cu. P't.`.' �
� P ""`�� ``� .
t Depth ;_._..y t: F't Cu. 1+'t.
Type of tructia���""�'�ii�M�� ��, _.._.. o Coaipleted
�
a
� �., , .
x.,,., i, , � ` �
=' r ,
.. F. y: _ , � .
In consideration of the i�sssuance to me of a permit to cos�struct the buildin8 describcd above, I agree to t'�
th� propoaed work ix► accordance with the d�scrlption abave set forth aad in ooinpliance with all p�avis�nns o�
ordiaances o! the city of Frtdley.
�
In caosideratio� of the payment of a fee o! ��_ �., Pernutt 9s hereby 8ranbed to�..
to covstruct the building or addition as described above. Thia t is �raanted upat
the exPress condition that the Person to whom it is 8'raated and hfs a8'��, �P1oY�8 ����r�. ���
dane in, around and upon said building, or anyp� thereof, shall oon4arnn in all respects to the ardinaaoes at
Fridley, Minnesota regarding lacatian, c�structfion, alteration, maintenanc�, repair and mo�vin8 0[ b�
within the dty lirnits and this permit may be revoked at.any���violabp�f any o� tlie p�+ovidaa�s o�
ordfnances. � �
��s.� ^i''e�'r���"� _
.�.+.. � ,��•
NOTICE: ,.�M��
ilds p�rndl doa aet eewr fM eons�ro�ites, hu�Non fer ���ii6tN, ��1`��Nso, sw�e �r �: M� f� sM
f6� EniWioa In�e1�s� for s�p�raN p�eeAils fer ibw i1w�s. ,� !
. . M �
•
n - -
APPLICATION FOR BUILDYNG PERMIx
CITY OF FRIDLEY, MINNESOTA
Owner's Name �✓ i `� ilder / i/ �>�
Address Address ��� � �t ✓�
LOCATION OF BUILDING
No . v`� �-- 2� Street ��u� L�c� -�v�/ /l�/�rt of Lot
Lot ,� i� El.ock�_Addition or Subdivision /� tt- 2� G� �; �<c-�G.►
Corner Lot Inside Lot Setback ��� � Side-Yard
SEWER ELEVATiON FOUNDATION II�EVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as•
�`��� /� �7i
l�.�t'�� � l� �� ,` �Front � '-� Depth ��- Height �
^_ C J
Sq. Ft. Cu. Ft.
Front � � Depth ��- Height /��
Sq. Ft. Cu. Ft,
Type of Construction �i/U-�.vt�L� Estimated Cost /��i,� d�' d
To be Completed �� � � �!�. �,�,y
The undersigned hereby makes appZication for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department o£ Buildin�s, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
� .
City of Fridley
Application for P'lumbing and Gas Fitting Permit
Dept, of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK �"' � � � � v � � � „` � �� ^��c
Number, Kind and Locatioa of Fixtures Location
rp in � CN'! WATER HTR.
��, � i� x� zz `� Q�z �z os � i� Z • •
W
� < � � 1`/� Z � � p = j a� ~< 1`I� � � � G°, �Z Z( � °' i N GAS ELEC.
� 3 � �� m N ; F- � LL N LL 0 u m'C 3 U� ` C� K U O
Base � � � � 2
ist � / � �
2nd
3rd
4th _
• Fuiure Conasction Openings
* New Fixture, Old Ope�gs
Cot�nected
PARTIAL RATE SCHEDULE
3ewer
Cesspool
PLIIMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures . . . . . . . /�` sd
. . . x $1.50 $
Future Fixture Opening . . . . . . . . . . . . . . . . � x 1.20 $ � • L�d
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... .......... x 3.25 $
Water Heater (Up to 200,000 BTLT) . . . . . . � x 2.00 $ � � �
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEEB: NO.
� lst 3 Fixtures ..........................
Additional Fixtures ....................
I Gas Range to 200,000 BTU ... ........ ...
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares bhat all the fact
and representations stated in this application are true and correct.
��; � �: ��3F�
Fridley, Minn. , 19_
Owner �/` � � r T %
Kind of Building �' �
Used as - � �'
To be completed about � /� � 3
Estimated Cost, $
Old—New. Building Permit No.��PeL�it No. �--�-T_/
Signec� � '• "� _ � .Y . . , ... � , . _ . ' � C � ,
By � . , - �v'�^ �-a
Business Phone No.
ROUGFi � � ` Z 3 " � Z-
FINAL
RATE TOTAL •
x $1.50 $�
x .50 $
x 2.0 �� �,�-Q
� �
I REPAIRS & ALTERATIONS—Refer to Code
,S.S' dn
IDescription ............................................... $—_�
TOTAL FEE $� �
.z �► :;� �,�!� � .
/�'r
� �`_
Application �or Power PIaM�s and Heaiing. Cooling, Ventilation, Refriger�rtion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 �
Replacement of Furnace . . . . . . . . . . ... . . . . . . . . . . .. . . . . 5.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .. 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTIJ . . . . . . . . - . . .
each add. 60,Q00 BTU .................... ...
Replacement aP Furnace .............................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $506.00 ..............
8A0 $_ �
2.00 �
5.00 $
5.00 $
2.50 $
3TEAM os HOT WATER SYSTEM
Fumace Shell & Lines—to 400 sq. ft. EDR Steam .... . 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURNER—to 3 gal. per hour . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $�
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ..... ........... x $1.50 $ `�
Additional Fixtures . ....... ....... x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
n AIR CONDITIONING a
FAN HEATING SY3TEM See Fee Schedule
i VENTILATING SY3TEM $
ALTERATIONS 8c REPAIRS TOTAL FEE � ��
ROUGH
FINAL
Deg2. of Bldgs. Phons 3U 4-7470
//•�-
I
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
D Cl 1 `� 1�
�
Fridley, Minn , 19 —
Owner ��C�� /.-�FL/� i�����-4
Kind of Building
Used as
To be completed about
Estimated Cost, $�� __- J_
, _�
�e�lding Permit No.
Permit No. �
DESCRIPTION OF WORK
HEATING �LAi�i'i'S'--Srtex7�i; �%t-�a�er, Warm Air—No. �
,P ` /' • �
Trade Name • Size No/S� �'� 7
Capacity Sq. Ft. E.D.R'� �� BTU H.P.
Total Connected Load � y Kind o! Fue
. �
BURNER — Trade Nam Size No – �
Capacity� Sq. Ft. E.D.R - BTCT H.P.
GEO. SED ICK HTG. & AIR-COND. CO
�-f���� i001 Xenia Av. S.
inneapoiis 16, Minn.
Signe
� / . -
By
�� 4 z 2M Business Phone/ o.
�
(REMARKS—OVER)
�. . . �� � ���� �� �����-�' .
° D-SQ '`�' � w1 �. 3�",:
It.f�G''1� �►��"� A y �°
HEAT LOSS CALCULATIONS DEPAEtTMENT
Weatheratrips A'S' ' ' • Conatruction N
Guide
Windowa ( Doors Refercnce Out.'Wall Int. Wall Ceiliag
Yes—No � Yes— 0 19`
Fl.� Room Length r' Width Height �
Windows and Doors—Crackage and Area �
R'Idth . Helght No. ot Ltne81 t., Area
No. ot pane o[ Dane Ilghta ot crack sq. ft.
!- �
. w��r
Coef. Btu
Infiltration � �' ,7 �` .
Glas� ;�, ,�,
: Exp. aral[' � � X y�
Net exp. wal! / �' j
Int. wall
Ceil�ng :
Fto� -. .�'1 '1 G3 / � .
Tota! Btu.
Required sq. ft. E.D.R,. or aq. ina. W.A. Leader area ,� j
• F1.� Room � Length ,� Width �; Height
Win ows and Doora—Crackage and Area
Width Helght No. o[ Lineal ft. Area
No. of pane o[ pane liBhts of crack� �Q. tt.
� % �
�.
Coef. Btu
. -,In6ltration ,2 �.. � „�
Gtaas i .5G► e�
Exp, wall Gl
Net exp. wall ,�jr �'r
Ipt. wall
Ceiling
Floor � -+ /� / „2pp�"y
Tota} Btu. / � G
Required sy. ft. E.D.R. or aq. ina. W.A. Lea�r area
Ft. � Room � Length Width /,p. �' Hei$ht
Windows and Doora-Crackage and Area
Wldth Height No. ot Lfneal 1t. Area
No. . ot Dsne ot pane tlghte ot crsck eq. tt.
�
i �/. =t.�" i // I.
Infiltration � �
Glaaa .
Exp. wall
Net exp. wall
Int. wall
Ceiling
rloor . f .� f G �.t7 J
� To�a� B�u.
Required aq. fE. E.D.R. or'aq. ins. W.A. L.eader area
:oef. Btu
� � . �.,e
.2a �
T_ . �... -.. ._.. _ .... .x ._.:L . .._.._. . : .. .,
�t�� ° . -
��-��'�.�
OF BUILDINGS M�IWVEAPCit�i� 1M�Q�T.
o. � . Insulation
Roof F1oor Kind How. Applied
' FI.� �.. Room i.ength ., Wrdth I 3
He`
Windows and Doors--Crackage aad Area
wia�a Helsbt No. ot Lloeal tt. rkras
No. ot pane ot DaAe 116bb � o! crack q. tw
� �� / � �� '
�.� �� i ' �� f:�
a�.�G �[Y
In&Itration � J��: �
Glasa % �
Exp. �wal� .�C'
Net eap. wall
Iat. wall '
Ceiling
Floor ' ,,,� - /
Total Btu.
Required sq: ft. E.D.R. or aq.�ins. VUA. Leada� atea
FI.f ' ,� !`�r Itoom (1.e� /�A �'� ::. . �t �
Windows and Doora—Craclr,age and Ace+N
Width HetgM No. ot Linral l4i'!M . � •-
No. ot Dane of pan6 H�hti ot craek !!i, � '
�G % � . /f�;'
� � � � ,
�� `"r `'�
...�
.: a
Inbltration /
Glaaa �'; �: �,�
F�cp. wall 7 _ :..��
Net ezp. waA
Int. wall T '
Ceiling
Floor iQ "� � ���
Total Btu. :_� ,7t. .
Requued aq, k. E.D.R: or aq. ins. 'WA. Leader �
F Fl.� � nr rv't�✓6 �► I�� ' w� I�kkip�hc
Wiadowa and Doors—Crackage and Ana
Width Heliht Na ot Llaeal !L AsM
No. o! Dane ot Daae Itthts ot cesck iq. it.
D Q � _ � - `: "
�bCf. Bhi '
In6hration � r'
� Claaa ��' ",� �-,�"
Exp. wall '',�.
Net exp. wal! ,l� ;
Int. wall -
Ceiling � ,':;
Floor ¢ ,r
Total BEu. . �► "
Required sq. k. E.D.R. or aq. ins. W.A. l.eadtr arra �.
f �a M • a 1 .� .. ' . . .� . ` � . . '
�� �. � . 9 . ''� i�E�.` , v► ' . � , . .. . � . . . � � .
. . .. . . . ' .. . . � - � . - . . 5 , . . • �
HEAT LOSS CALCULATIONS pEPARTME.tVT' Ofi BUILDINCS "' MINN�APL)LIS, MtM+i.
Weatherstrips AS. .V. . ' Construction Na Insulatioff
Gutde
Windowa � Doora Reference Out. �1Va11 Int. Wall Geiling Roof F7oor Kind .
Yea—No Yes— o i 9_
Fl.� �� Room Length '�. Width /` Height � FI.� Room � Length W
Windowa and Doors—Crackage and Area � Windows and Door�–Crackage aad Area
Width Hetght No. of Ltneal f. Area Wldth 8eight No. ot Lln�atlt. I
No. ot Dane ot Dane lighta of crack � sq.�ft. . .. � No. ot Dane ot Dsne lfghta � oi CKCt �
!�C 1 � �.i` � � _ � - f � �`� .
V � �
�f. Btu
Infiltration .�% / t� Infiltration
C�l � '
aas �. .. ' 1..� Glasa
Exp. Wall :�, �l r Exp. W811
Net exp. wall '/ ' !.�' ,� Net eap. wall
Int. wall Int. wall
Ceiling Ceiling
Floor ' ` ` �: �;" 1 ,� � / 7
Floor
Total Btu. � "' �' :�-� Total Btu.
Required sq. ft. E.D.R. or aq: ina. W.A. Leader area Required aq. k. E.D.R. or aq. ina. WA. Leader atea
. Fl.� Room � Length Width Height �.I Room I Length Wi�h Hei
' Windows and Doora---Crackage and Area Windowa and Doora-�Crackagt and Area - _
Wtdth Height No. ot Lineal 1t. Area Width HeigEt No. o! L1nea1 tt.
Na of pane ot pane ilghta ot crack sq. tt. No. ot Dane oL yane 1lshb ot crack �q.' �
Bill
Infiltration
Glasa
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E,D.R. or aq. ina. W.A. Leader area
Fl. Room � Length VUidth Hei$ht
Windows and Doors--Crackage and Arca
Width He1Bht No. of Lineal tt. Area
No. ot Dane ot psne Ifghts ot crack sq: fL
Coef. Btu
Infiltration
Glaaa
E7lp. WB�� --
Net exp. wall
Int. wall
Ceilin
�loor
Total Btu.
Required aq. ft. E.D.R. or aq. ins. W.A. Leader area
�
Infiltration
Glaaa
Exp. wall
�' Net exp. wall •
Int. wall
Ceiling,
Floar
Total Btu. �
Required aq. k. E.D.R. or aq. ina. W.A. Leader area
F1.� Room I i.ength �Vi�6 Height �
Windowa and Doors—Cracicage and Ana
Width Iiei�ht No. of Lineat it. Ar�a
No. of Dane ot.Dane 116hb ot cn►cic pf.lG .
�OE�. �Il
In<ration
Gtaaa
E.Xp. Wd�� �� a Y .x � �,'
Net eap. wall `''X '�'�'�
,4
Int. wall -
Ceiling : ;:
Floar
1'otal Btu. _ :
Required aq. ft. E.D.R. or sq. ias. WA. I.tader stea �
53-��-5-8? 9. ol
Cil�► of Fridte�
�� �����r�
� n.v�. a s�,.. r�.,. �ec.sa�o
o�rrno� or �ro�c ^
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f �!i i
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;� � s� � � ��?;a�, �,��
Bax
tsi
wareR .w�.
a s
�r. � 6.es r�tc.
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� ■�����r��■ ir���r��
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I'�tmA6li t:I�xes . . . . . . . . . . . . . . . . �,�. s i1Q� i
11�oee ![st�e t�e� . . . . : . . . . . . : i1.6Q 9�_ .
Ne�r tistrnc dd O�esin� . . . . . . . . s ;t.6Q t
Cslc� Ha�6r . . . . . . . . . � . . . . . . . . . . : �Ji i
�Iater Ne�ter :Uv to 0l:09b HTU� •-•- : A04 i
Newr Ground Rua ON 81d� . . . . . . . . r =313 f
ti�etsir 1�atrr B�e�rr . . . . . . . . . . . . . a �jlp0i i
�►s eintwa rt�a: ,�o� s,►n ro�r�t.
� � ���Sii ♦ � � � Y � f � 1 � � � � ♦ ! M • Z � ���
�arlloOr �'ht,.� . . . . . .. . . . . . . . s s ii i
c.. R.o� m ttroAa erv ......... ______.7._ :�.�os t�3.��
State Surdissgs � $ .SO
m�1s f �tT�t�tiar�-�a.�.r r GN.
Oret1/fi� . . . . . . . . . . . . . . . . . . �. . . . ... . . . . .. . .. � . �
�o�ra�. !a t..�..�
r � : ._...
cia ot n�m.s:
rne u�derai�nce nerEby m.krs .qpticatiw� cor r pe�re,it tor e)se �?►e�i �, ',
SPcClfltd. =tMt�Dj t0 d0 i%i �Of� �I! i'it�l: �CCOf'Qint! 1�i�t Lh! �;7 �
and rulinj Ot tAc Deyart�t d 9ui3dit�s, aM hereb�► deelares thst sii tAa tsd: �
arx! represer�tatlaos stated la ti�h apptlenio� �re tn�e eted correct ',
n�T �e 6-18-73 _„ �_.� .
o.,nxr _ _�3 Sherrv �
tcir,a ot �u��ai„� Fr�.me _
uaed as - �e , . -
To Ib! c+oebplete�d abont 6-25-7�
Gstimated Cott � 1Q.�� - �
Old—ric�►. ttui{din� P�rtnit � r..�1t l�w �o�� ,
� � � �~ .
�E..i , ✓'Yt_
. �
9�i�eas l5ie �
,�::. ��- �- ��
- - - �_,.._.._._�
Cl��s "A° �rcharge .50�
r
�� �o • �� o �
�ITY OF FRIDLEY INSPECTlON DIViSION ,;���� t � f �� i1�� ���/�� Effective On January 1, 2000
6431 University Ave NE �� f ��a'� (� �-iSS�S
Fridley, MN 55432 APPLICA710N FOR POWER PLANTS AND HEATING, C�OLING, VE�JTlLATION,
572-3604 REFRIGERATION AND AIR CC1Nb17tONING SYSTEMS AND C�EVICES '
JOB ADDRESS ��'� A��GC--I'/�'r�A�� �T' �-��
RATE SCHEDULE
Residentia!
Furnace Shell and Duct Work, Burner -
Aiso Repiacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not rep(acement)
Gas Range
Gas Dryer
*Air Conditioning - A!I Sizes
A(I Others/Repairs & Alterations (LIST ON BACK)
1°Jo of Value of Apptiance or Work
Commercia!/Ihdustrial
1.25 Jo of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE F�R ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITtONING PERMtT IS �25.00
PLUS THE $.50 STA7E SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
TOTAL .
, ,a
$.
OWNER ��� � �t��
BUlLDING USED AS �w �u'�^�
ESTIMATED COST d��'�� PERMIT N0. �����
DESCRIPTION OF FURNACE AND OR BURNER
$
No. of Heating Units_ - Circle One (Steam} (Hot Wate Warm Ai
$ Trade Name G��c� Size Na��'��u�7�
BTU_ � �, � _ HP EDR
$ Fuel �� �,'�s' Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the�City Codes an
$ .50 . rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ ��°�`O SUP:.�l�R G'flNTRACTO�S. iNC.
612f 42E�:7AVENlJEN03ATE !�-9 ��
CI4YSTRt, MN 554�22
HEATING
Signed
Approved By
.
, ;.
Rough-In Date
TEL # �� ��� �4��/
c���
Fina! Date ` " /Z�J
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacinq an existina furance, 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 () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including 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-GAMA Category I Central Furnace Venting Tabfes for fan
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installinq a new ventinA svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed coRectly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
App�iance #2 Type 8TU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input •
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
A�.TERATIONS: Describe c��f � � � � ,�.� �vG ` � �� �--
�,C,�'S ,(� U�—zs7'_j IJc � ti' �1�2� A--C� ff�� � xl� ��
� � � �At�u.S'��a/ A�l2
SUP�t!'�R �•.7NTR;=.0 � t)�i:i� ltiG.
612142f';"3 AVENt�E N0.
HEATlNG CO: '�T��N `2
Signed By: � Date : � �-��/
. +
�
3
3
0
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_
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C["IYOF
FRIDLEY
FRIDLEY MUNICIPAL CEIVTER • 6431 UIVIVERSITY AVE. N.E. FRIDLEY, MIV 55432 •(763) 571-3450 • FAX (763) 571-1287
August 23, 2002
Mr. Gary Major
5220 Buchanan Street NE
Fridley, MN 55421
Re: Final Inspection at 5220 Buchanan Street NE
Contractor: Superior Contractors Inc.
Dear Mr. Major:
A mechanical pernut was issued on November 13, 2001 to install a furnace at your address.
The fmal inspection conducted on November 21, 2001 noted the following correction:
Fire stop where common vent passes through the floor.
We need to reinspect to verify the correction was completed. To set up the reinspection or
to have any questions answered, please contact the Building Inspection Division at (763)
572-3604.
�
D��JENSEN
B il g Inspector
DJ/mh
SuBJECT
City of Fridley
AT THE TOP Of THE TWINS g � i L D i N G P E R M I T
�
� •
� �
COMMUNITY OEVELOPMENT DIV.
r � L ��� PROTECTIVE INSPECTION SEC.
i �
� � �'�'1 � CITY NALI FRIOLEr 55�32 NUMBER AEV DATE PAGE Of
�""'�� �'' 763-571-3450 910-F15 9/5/02 / /
3'3047
RECEIPT NO.
�1�
•vnpOvED Br
J08 AODRESS 5220 Buchanan Street NE
1 IEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
oescR. 25 1 Marian Hills Addition SMEET
2 PROPERTY OWNEFi MAIL AOOfiESS Z�P PHONE
Gary/Lynne Major 5220 Buchanan Street NE 763-574-1599
3 CONTRACTOR MAII. ADDRESS ZIP PHONE IICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 952-933-6300
a ARCMITECT OR OESIGNER MAIL AOORESS ZIP PHONE �ICENSE NO.
Exempt
5 ENGINEER MAII ADDRESS Z�P PHONE IICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGE OF USE FROM
TO
C� REPAIR O MOVE O REMOVE
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 3i0.9.1.2 of the 1997 Uniform Building Code.
permit Inspec��on Cards
Wiil Be Mailed
To Homeowner To Post
TYPE OF CONS
SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAL, P�UMBING. NEATING.
VENTI�ATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION 20NING
AUTMpR12ED IS NOT COMMENCEO WITNIN 60 DAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOFi A PERIOD OF 120 DAVS AT
ANY TIME AfTER WORK IS COMMENCED. NO DWIG. U
1 MEREBY CERTIFV THAT I MAVE READ ANO EXAMINEO THIS APP�ICATION 1
AND KNOW TME $AME TO BE TRUE ANO CORRECT. ALL PAOVISIONS OF �AWS VA�UATION
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMPLIEO �3 303
WiThi WNETHER SPECIFIEO MEREIN Ofi NOT THE GRANTING OF A PERMIT s
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS Of ANY OTHEFi STATE OR I.00AL LAW REGUTATING CON• @97.25
STRUCTION OR THE PERFORMANCE OF CONSTiiUCTION W
PLAN CMECK!
Licens�
S�GNafUAE OF CON"AACTOp OQ AUT�OAi2EO sGENT IOATEi
S�GtiaTUAE O� OwNEa ��c OWtiEa BuiLDEA� iDATE�
�N
SO.FT
STALIS
N/
i V VA
GROUP OCCUPANCVLOAD
CU f T
OFFSTREET PARKING
IGARAGES
$1.65
SAC CHARGE
Fir SC $3.30
TOT � FEE
102.20
JHIS IS Y1�UR PEQ�
NEW ( ]
ADDN [j
ALTER ( ]
Construction Address:
Legal Description:
Owner Name 8 A�
Contractor.
Address:
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY Effective 1/1/2002
6431 University Ave NE, Fridley, MN 55432 (T63) 572,3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R•2
BUILDING PERMIT APPUCATiON
���
� v Tel. # �� �7y l5y�
�
MN LICENSE # � .�2
���5�1 �Tel. # �/�� �l ��— OU
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Fk
Length Width Height Sq. Ft
Length Wdth HgUGround Sq. Ft
r,' ? �
Construction Type:� S�-c, � O vV�A�a�,t/S Estimated Cost: $ �,��i��o
_� f���
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: �G f� O APPLICANT: o �ZCC-�C Te�. #�� '� �
-��-�
Call (763) 572-3604 for Permit Fees if mailing in applicati or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
a5
$ 7� Fee Schedule on Reverse Side
$_ �5.7" .001 of PermitValuation (1/10th%)
$ (.(>S-_. _,....,_.$.50/$1,000 Valuation
_,__.__-
$ � $1.?�T0 per SAC Unit
$ °` 1C� �f���.Q�' (State Licensed Residential Contractors)
$ .__.._ __. _.-Alt. ,�A�� or Alt. "B�� Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
.?�
$ • STIPtJL.ATIONS:
/Q�. ��J'
��� �
�
sue�ecr PERMI
City of Fridley 1, 7 5 7
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
� � RECEIPT NO.
� �
� • COMMUNITY DEVEIOPMENT DIV. -7
� ; .: ----- � �S /
r � � PROTECTIVE INSPECT�ON SEC.
1 �
( � �'��1 � CITY HALI FRIDLEv 55432 NUMBER REV. DATE PAGE Of APPROVEO BV
�""�� ,�� 612-571-3450 910-F15 3/4/93 / /
JOB ADDRESS 5220 B.uchanan Street NE
t LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 25 1 Marian Hills Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 2�P PHONE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Citywide Home Tmprovement 1005 W B.roadway, Mpls. , MN 55411 529-2489 3013
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res i den ti: al
7 CLASS OF WORK
O NEW 0 ADDITION O ALTERATION � REPAIR � MOVE O REMOVE
8 DESCRIBE WORK
Reroo� Dwelling (23 Squares)
9 CHANGEQFUSEFROM TO
STIPULATIONS
Underlaynient must comply with State Building Code if a tear^of�. Roofing
can be the seconrl layer but not the third.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARA7E PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED W�THIN 60 DAYS, OF IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AfTER WOfiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
! HEREBY CERTlFY 7HA7 I HAVE REAO AND EXAMINED THIS APPL�CATION I. STALLS GAAAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVIS�ONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEi±EIN OR NOT. THE GRAN7ING Of A PERMIT $1►242 $� 62
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY 07HER STA7E OR LOCAL LAW REGULA7ING CON- 31.00 Fire SC y�1.24
S7RUCTION OR THE PERfORMANCE OF CONSTRUCTION. �
PLAN CHECK FEE TOTAI. FEE
License SC $5..00 $37,86
S�GNATUF7E OF CON'RACTOA OR AUiHOR�ZED AGENT IDA7E1 W P p Rl VA A7ED THIS IS YOUA PERM^17
� _ � ^/ �
SiGNATURE OF OWNER iiF CWNER BU�LDEA� iOATEi BL �NSP ��uTE
. , .� _ _
_.__ . ..� . � . . ��
��N�.� -�]
ADUN [ J C1TY QF FRIDL�Y
ALTER �) 5IN(il.B PAM�l,Y AND DCJPLEXI:S R-I AND R-�
• Building Permit Appli�tion
Ganstruction Address: ,_ __,. . w�l���� ' �
0
l.egai Desc;ri��tion:
�
._� �_.�.'° .. � ,
Etfec;tive �l�l�.�
��7
Owner Name & Address: � ��� r� � i�- � Te1. �„�,�`�,�I
' MN L1C�NSE # �, �
Ccrntrxcior: .. - - - - —
Address: � � ���! � . � .. .... �'el. # �� �" `i
Attach tc� this a�lic�tion, a Certificale of Surve�+ of the
Ic�t, with the pra�sed construcdon drawn on il to sc,-�1�.
Ll'V1NCG AREA:
GARAGi's AREA:
DLCtt ARFA:
QTHER:
D1?SC{t�PTION OF IMPROVEM�NT
Length ! _ Width �, Hei�ht �
L�ngth Widtlt " Hei�ht ,��
IRngth ._._ ..._ Width _ _. Hgt/Ground �
Sq. Ft. �
Sq. Ft. rr_y___r__�_
Sy. Ft. �
C�rn�r I.�t �] Inside Lot [] Ft. Yd Setback � Side Xard SeLbacks
Typc of Construction: , . ,� _ �stimated Cust: �_ , _
Approx. CompY�tion 17dte: , .,. .
(Cos� on Back}
Driveway Curb Cut Widih Neede�i: Ht. + 6 Ft =,_„^_�t x$,. _� _
1`�ATE: ��,,: �.� APPLICANT; ��-ti�-----�
�
p��t �� � 3 � � o�
Fire Surchar�e $ /. Z��
5t�t� Surcharge S_.n„ , . ��
SAC Chdr�c $ _ .
Lic�nse Surcharge $_ .,_ D�
Drivevvay Fscraw �i_.
Park l�ee �-- -. . . ,
Sewer Main Char�;e $__ . _ __
.� 1�
'�'(7TAL $ ��
_ ��
� _. � �cet. ��� - N�
�� �
� ,
Nee Schcdule on Revcrse Side
.001 of Permit Valuation (1/lOth9b)
�. SO/$1,OOQ Valuation
$7UQ pc;r SAC Uait
$S.OU (Stste I..icensecl Residential Contractors)
Alt. "A" or Alc. "�3" AUove
Fe� Delermin4d by �ngiiteering
Agrec:ment Neeessary ( j N�>t Nece;�sary [ �
, S'l'IPUI.ATIONS: '
,
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57"1-36U4 l+'AX:
: 5220 BUCHANAN ST NE
: 253024210038
: MARIAN HILLS
: LOT 25 BLOCK 1
: BUILDING
: RESIDENTIAL
: ROOFING
571-1Z87
PERMIT NO.: 200402041
DATE ISSUED: 11/05/2004
VALUATION : $ 2,743.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE (23 SQS) TEAR-OFF.
STATE LICENSED CONTRACTOR 1 ,
APPLICANT
CRAFTSMEN HOME IMP INC 20270884
7455 FRANCE AVE S# 194
EDINA, MN 55435-
OWNER
MAJOR GARY L& LYNNE E
5220 BUCHANAN ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This pernut becomes null and�void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
���
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
83.25
2.74
1.37
5.00
92.36
o�rr�ict� i n r�tuvit t J tc�11u11CC1! t' VK W Vt(K V 1 ri�lt 1 riAN ll�Jl;Klt3�ll At3UV�. ,
7455 France Avenue South #194 • Edina, MN 55435 • 952-930-3777 • 651-229-4045 • www.CraftsmenHomelmprovements.com
Dave,
These pictures are pertaining to the job at 5220 Buchanon St. the home of Gary and Lynn
Major. Would it be good to keep these pictures in your file in case future consideratio�i is
necessary? Would you please ca11 me at 651-464-1406.
Th�xtk you,
Dan Bydlon
(th� pictures a�th� ice and water shield are at the jobsite with the permit.)
. . .. � � . . . . j'. � � . . . . . ... _. � ..� . . . . .