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Plumbing Fixture Rates: N0. RATE TOTAL
Number Fix tures � x$2.00 /$ c�:��
Future Fixtures � x $1.50 ,���
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
Water Heater-99,000 BTU i x$3.00 3�'�
Ground Run Old Bldg. x$3.25
E1ec. Water Heater x $2.00
Gas Fitting Fees:
ls t 3 F ix tures �` x$2 . 00 �' 4�
Additional Fixtures x $ .75
Gas Range-199,000 BT[T x $5.00
Repairs & Alterations
See
Deacription: Code
State Surcharge .50
r
TOTAL FEE $ ,��
The undersigned hereby makea application for a permit
for the work herein specified, agreeing to do all work
in atr3.c� accordanca w ith the City Ordiaances and rulin
of the Depaxtment af �uildinge, and hereby declare that
a1}�the facte and repreaentatione atated in thia
ap'�li�cation ar� true and cor�ect. _
t
k
.SUBJECT P: R M����� ,_
City of Fridley o�:
' , AT THE TOP OF THE TWINS g � I L D I N G P E R M.I T � �
� � R EIPT NO. �
COMMUNITY DEVELOPMENT DIV. �. ,.a`
r � L � PROTECTIVE INSPECTION SEC. r r,� ����) .
1 i � �C�'le� C1
1� /"�1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
"-•� � ,'� 812-560-3450
910-F15 5/23/73 � �
JOB ADDRESS g104 Eaixmont Circle N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. S 1 Bourdeaux's Spring Brook Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
William Gorman
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
� Castle Homes Inc. 7613 Central Avenue N.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
'� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 26' x 40' Dwelling and a 22' x 24' Garage
8 CHANGE OF USE FROM TO
STIPULATIONS provide a verifying surveq before capping. Provide a hard surface drivew y
WATER LOCATION: 10 feet west of sewer
SEWER LOGATION: 105' east vf ma.nhole
TOP OF EOOTING: 852.04 minimum
SEPER�TE �'�'���i� �������D FOR 14VIRIiV�,
�1�Y1�8C, p�-��������� 1��� it6i�S.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBINCi, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOd Fr2IR0
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R'�- 132$
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $24 164 ZL . OS
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC N OR THE PERFORMANCE OF CONSTRUCTION. S3.00 L%S.00
. PLAN CHECK FEE TOTAL FEE
` ` ,g � 2 3 - :Z �. 340 . 08 r, ; �
SIGNA7URE0 CO iRAC RORAUTHORIZE AGEN7 IDATEI WHEN PROPEFiLY A ATED THIS IS YOUR PC;AMIT
l� ��e�.1�J
SIGNATURE OF OWNER IIF OWNER BUIL�ERI IDATEI BLDG INSP DATE
��
AP.k��,�G,A�'IPJ�1 ��A �tE�IAENiT�.�,. �+'T�l�lT�t3P1,
Q� ,ADA�TTO�i �iJILATIVG P�RM�T
G�TX 4F FRTTl�,�Ys MINIV��QTA
�� s N� :� LI�_ � o;.,�.,c��/ Bu�r�i g � 1P �, -o �f.�p s
� ,�, �..r,
AnD�tESS : A�1�tESS i„�� / '� I� L , , �@;tl7;►�,d� �x l, �
�t�:a�„ ��`` i� ��, �i� S�� ��! 1 � ��t a a�` ,_ � � � � l �e
�� J� BLOCK� / ��I�ATa„�ovrd,e,OvY� �or�k�oe/� ,e��
��R I,0'� : �� IA� i�s._,.,SETBACK� ?� 7, � SIDEY�11tD :��� j,p �.,�ye
9
���,�t �,�� �p, �€rp��,io Certi�icates of SuYVBY of Lat a�d propo�ed
�,�,�3� �.+�Lion d�t p� t�ese Certifica.tes,
�
-�O � [3�e� Aa :
��se���TZO� oF �sui�,nz�c
�'t�� i/e �,o.�+ r l X
e 2 (a Depi� : O ,�igt�t :
�s . ., � ��---�--�� --� �
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Sq�are �'+���, f -�� Cubi�c �'�et�3
wir/r%�Q/� SivitF�i � o!� e ��iLil� a� T Hei$hti .
�■ � ■ i
$c�ytax� �'�et ; c�'� E� Cubic geet t
��
D� �'i01�6�T1�C��.{1i� a,� � FiBt��� C08�: $ � � �a � � � ?�a==�,
�� ..�.._—� -�. '
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'� t���tgn�d hereby �aea a�►l�c�tivrt �or, a pe�.t fax rlf� w�xk ��reiu ,�
#ps�3,�t� �'ee� fis da all i�ct�iC iu stt�.ct accosdanee with the G:Lty s�
$�l,�dl� t1;�d�a �d t+��.�� �� �t Degart�te� qf Bu��d�ln�a, �d �e=eby
d��asa� � all :khs �acts �d ��resenta�ions stated i� fi�is �ppl�,�atiaa
� � e�$ cprrec� -
�
i�9��3= r.,a ��...�..., a� •� i�e`Z�� Nrbr.z�+veal++S . / /,
� Y ��S%l � /'Y�G �° �
�� �t�,r�e ��� Foa Add��a�ai Infos�ation,�)
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BUI�DTN� PERMIT F�� ��H�DU�E
���7'�O�T � � 'The I�epecto� pf �ui.ldings sl�al�., befox� i.asuiag germi�� fe� �he
������.on oi a�y bu�lding o� st�'ucture, ox for any addition to any �eist�.ag
��i�d�� ox s�rtic�ure, or fv�r any altera,tion or xe�airs ,to any ex��tir�g
��;li,���,� o� stx�uct��'e, upou �pp13,�ation thexef��e, require the pagm£n� by �he
�.��p:�.i�s�t �p� such. perr�nit o� �ees �o the aatount herein below aet fr�r�h �d #.�
��►� r�a�un�� h���ei� p�qvided � �o��•wik t
UN�FOIt1�'I �u�LIITNG CODE� �pe �.t 2��+ -$2.15 for eaeh a�ae zhous�ud cubic
�e��� p� f�ac�ian tb;a�7��a�� in aue� cubical co�,��nts. �pe 3� 5-$�..85 fo7e
ea+�b o�.Q t�ousand �bic fese�, .
�1�D �'T �flNAL � N�1�#iMAT � ON
Fp� �� �u��ap�e of ��anpui�iag #ees for building perenit�, the cubical contents
o�' aay building or addition, i� dete�rmined by mui��p1}�in� tiie �;round area
�ve�� �pm a. pai�� s�x (�ij inc�es below the f�oor line 4� the basement
t� t#e �C�:�lar �o �c�e average he�ghts of the upper surface or to the avera��.r
��� �e �oa�E �t�face o� �he u�iA �ab�e Qf a pi�ched xoo�.
�' �,�i:ts ox a�i���a�$ot�� � aa existin� srru+�tu�e4 �ae f�e shal� be �� �c�
�c�.�� v� �3.t� �ear e�� f�ve h�dared dollar� ($300o0E}) � f��ti.on th�xeof in
�� c4a� o� 8�.� p�4�uDi9ed wo�#c�.
I� � cat� sh��l �b� �+s� fo� �r pe�i� as se� ��� �Cn S���i,on 2 b�
� t.��A $�.�.
�
V������TiQN 0� �t��tNAATI�N
��s P�ts �o� �c�st�u���[o� wi11 be f�sued a���,muffi o� �4 hc�urs �xam �hs
�1e o# a,��iicatio�, �o �t��aw fox prape� review of khe p7topo�� a�:�u�ture �d
��` �e s�struction aite.
* �����i� fi���' v�' fi,l�� lc�� �,�� t3� �.oca��, oi th� �auadatir�, o�e �.t
�a� 8�� ��s�t�d� wiii � gec�uir�d be£o�re t�rocee� s� w�.�h th� fr��g.
,
C�}t�'�F�GA3'� i�� Q��PAN�X
+���i,c,���aft �� � Gsx����at� �� Oacu{�ancy �hal�. bs ma�,a ��a (1Q3 day�s prior
�� �h� �se Qx Qc�upa�ee� ai� �cy. �r�w.et�ure f� which a build�.zi� penai� has b�sn
i�sstaed; � satid s���tx� �ita}.� �ot be used a� occ�p�ed until a�����fi.cate
c�� Qa�upaa�ey ha� bee� �ssae�d,
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HEA$� OS� CAl��1JLATIONS � E�4TI�IG � Aot� C���iT10�1 C7 �.eO. �MINNEAPOLIS, MINN.
Weatherstr�ps A.S.H.V.E. Construction No. Insulation
Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind HowApplied`-.
Reference
Yes-No Yes-No �g
FI.�-�� �� Room Length Width Height FI. /��;�����; �- Room Length � Width Height
VJindows and Doors-Crackage and Area Windows and Doors-Crackage and Area
N�� Widrhi Heiyht No. of Lmeal ft. Area No Width HeiBht No. of Lineal ft. Area
of p,�n�� i of pa a �ights of crack sq, ft. of pane of pane ligh[s of crack sq. ft.
_ .-L_ � �( i��{ 3 _ 4`�. .r L! [� �
/ �:4 � �l / /� ,
Coef B tu Coef B tu
Infiltration � � ��^ � Infiltration � �`
Glass !��" S� /. Glass l �5 �;
Exp. wal I-� E ��iL Exp. wal I�`/` R ��
Net exp. wall ��'•�;" / � Net exp. wall ��� �� ��
Int, wall Int. wall
Ceiling � � � 0� �' Ceiling � //� � �
Floor � t� Floor �
Total Btu. �% Total Btu. r
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or'sq. ins. W.A. Leader area
FI.�N��-� Room Length, Width Height FI. ���/�' -� Room Length�� Width Height
Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area
Width Height No. of Lineal ft. Area Width Height No. of Lineal ft. Area
No. of pane of panQ lights of crack S4• ft. NO' of pane of pane lights of crack sq. ft.
�
Infiltration
Glass
Exp. wall �°
Net exp. wall
Int. wall
Ceiling C
F loor
Total Btu.
�
■r��r
�
B tu
Required sq. ft. E.D.R, or sq. ins. W.A. Leader area � �
FI. L��� G Room Length � Width J3 Height
Windows and Doors-Crackage an Area
No. W�drh Height No. of L�neal ft, Area
of pane of p,�ne lights of crack sq. ft.
,� �
/ �f� �� % �/X l ,
Infiltration
Glass
Exp. wall ��
Net exp. wall
Int, wall
Ceiling� ��
Floor
�
Total Btu.
---- — -- - -- _
Required sq. ft. E.D.R. or sq. ins. W:A. Leader area
�L'
Btu
Coef B tu
Infiltration
Gtass �� �j
Exp. wa i I �
i
Net exp. wall /�
Int. wall
Ceiling � � /� Z-�
Floor /��
Tota � stu. "'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room Length Width H�ight
Windows and Doors-Crackage and Area
No. W�drh Hefght No. of L�neal ft. Area
of pane of pane lights of crack sq. ft.
`l^ � d �— / `% / �
Infiltration
Glass �
i
Exp. wall
Net exp. wall
Int. wall
Cei I ing
Floor
Total Btu.
Required sq. ft. E.D.R, or sq. ins. W.A. Leader area
B tu
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� HEA� LOSS CAL��IJLATIONS HEATIlVG& AIF� C�IVDITIONING CO. MINNEAPOLIS, MINN.
iWeatherstrips A.S.H.V.E. Construction No. Insulation ,
Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind HowApplied -
' Reference
Yes-No Yes-No �g
�' FI�L?�,y%E' �j�'/�P,00m Lengthl Width Height F.�� �'��,C.C''Room Length Width� "��Height
YJindows and Doors-Crackage and Area Windows and Doors-Crackage and Area
No. �✓��Th I He�a^t No. r�f Lmeal ft. Area No Width He�ght No. of Lineal ft. Area
of pane of uane lights of crack sq. ft. of pane of pane Gghts of crack sq. ft.
� J .1 � � l. '� . -.��,� .- �; i 1 � � � � � � /5
� Infiltration
�
� Glass
r
! Exp. wa I I �
Net exp. v�rall
� �l
B tu Coef B tu
'�� ,�` Infiitration ,,�L: t�/� C �
-� Giass � �-
Exp. wall � �
�j � Net exp. wal I � Li �
� � �
Int. wall Int. wall
� Ceiling � �L) r Ceiling � ��- '�Z /G� �J �C�
� Floor 1 Floor ��� ' `�
� Total Btu. Total Btu.
' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � Required sq. ft. E.D.R, or sq. ins. W.A. Leader area
FI. Room Length Width Height FI. Room Length Width Height
Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area
j No. V�lidrh Height No. of Lineal ft. Area No Width Height No. of Lineal ft. Area
of pane of pane Iights of crack sq. ft. of oane of oane liahts of r.rar.k sa. ft.
Coef B tu Coef 8 tu
" Infiltration Infiltration
Glass
Exp. wa I I
Net exp. wall
Int. wall
Ceiling
Floor
Total Btt►: - - - - - h
Required sq, ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room Length Width Height
Windows and Doors-Crackage and Area
No. 'Nidth Height No. of Lineal ft. Area
of pane of pane liphts of crack sq. ft.
Giass
Exp. wall
Net exp. wall
Int. wall.
Ceiling
F loor
Total Btu_ -- _ --- - _ _- _ - -_-- --
Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Roam Length Width Height
Windows and Doors-Crackage and Area
No. W�dth Height No. of L�neal ft. Area
of pane of pane liphts of crark sa. ft.
Btu
Infiltration
G lass
Exp. wall
Net exp. wall
Int. wall
Ceiling
F loor
Total Btu.
Reyuireci sq. it. E.D.R. or sq. ins. W.A. Leader .vea
Infiltration
G lass
Exp. wall
Net exp. wall
Int. wall
Cei I ing
F loor
Total Btu.
Required sy. ft. E.D.R. or sq, ins. W.A. Leader area
B tu
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HOUSE HEATING TEST RECORD D-20621
ADDRESS 8104 Fairmont Cir. N.E. APT. FLOOR CITY SUBURB �'idley
OCCUPANT �illi�m L, GO�,II OWNER Ye8
HEAT LOSS DATE HTG. INST. GAS C0. METER BADGE Ed�3.t3k Htg.
SOLD BY INSTALLED BY ,
Eleetrical Work By Gas Line By � �
TYPE OF HEAT GA FA � HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE W].11ia�0Y1 MAKE OF BURNER
Model 1117-ZO-5 Model
7521106
Serial Max. BTU Rating
INPUT lOO;sOOO BtII . MAKE OF FURNACE
Model
CONTROLS
THERMOSTATCffi 26 Heat P��a Vent Size � S
n
Valve Meg• �UDa KIND OF LINER �1��" SIZE 6� NONE
Limit �behaw RS�, 750n Draft Hood Vertical Regulator M���'ol 325-3
Limit Setting 200�f Filters Size 16M $ 25°t Number 1
pa� �ff��g 90�f & 120°f Chimney Loeation Inside Yee Outside
Pilot Type r+OIIPle Chimney Construetion Metalba�tea
Pilot Make
Pilot Model Smoke Bomb Wiri�g
Pilot Timing 90 S�OTlda Draft �g Test Tag Ye$
L.W. Cut Off Door Pressure Lighting Inst. Yes
Pressure 4��"�aC• PercentCO2 S�"��' DateTasted 1��,8,f'73
Input CFH 10� Pereent OZ B _ Company Testing
Staek Temp. 4�� � Pereent CO �•� Name of Tester
Form 235
�.� �i�� d���-�- -
560-3450
�� f o r�d'l�
� �
6431 UNJVERSITY AVENUE NE
�l: L. Gorman
8104 Fairmont Circle N.Eo.
Fridley, Mn 55432
Dear° i�ra Gorrnan e
ANOKA COUNTY
FRIDLEY, MINNESOTA 55432
February Z4, 1976
ihe City of Frfdley just recently received a permat application
for a new house to 6e located just west of your home at 8102 Fairmont
Circle N.Ee �
The certificate of survey submitted with the application indicates
tF�at your driveway encroache� about 6'° into the lot adjacent to and
t�esfi � of your 1 ot.
Ti�is does not violate any City code, however°, we do feel tha�
notifying you af tfie situation was proper. since the owner could legally
ask�you to relocate your driveway off from his proper°ty.
if you have any quesiians, please feel free to call me �,t 57T-3450�
DG�de
Attachment:
Sincerely,
DARREL CLARK
Corrsnunity Dev�lopment Administrator
,
DATE: March 19, 1997
TO: FILE
� Q� �,��,�,�` ���,c��..
MEMORANDUM
PLA1�Tl�TING DIVISION
FROM: Michele McPherson, Planning Assistant
SUBJECT: Nonconforming Properties Adjacent to East River Road
As a result of Anoka County acquiring additional right-of-way for expansion of East
River Road, this property was rendered nonconforming. Please refer to the attached
chart which indicates the extent of the nonconformity.
l /�T11 Q�
M-97-137
EAST RIVER ROAD PROPERTIES AFFECTED BY ANOKA COUNTY RIGHT OF WAY
ACQUISITION
ADDRESS EXISTING NEW , REQUIRED SETBACK CONFORMING
USE SETBACK SETBACK SETBACK TYPE
7845 East 97.02 ft 89.1 ft 35 ft front yard yes
River Road
apartments
Apartment 46 ft 38.28 ft 35 ft front yard yes
garage
321 79"' Ave. 53 ft 36.3 ft 35 ft front yard yes
apartment
7948 East 32.34 ft 17.49 ft 17.5 ft side comer yes
River Road
132 28.38 ft 27.Ofi ft 17.5 ft side comer yes
Stonybrook
7950 East 34.65 ft 28.7 ft 17.5 ft side comer yes
River Road
Garage north 24.75 ft 23.76 ft 35 ft front yard no, before and
of above after
8051 East 41.91 ft 30.36 ft 35 ft front yard no, after
River Road
305 Liberty 93.06 ft 72.93 ft 17.5 ft, side comer yes
440 Ely Street 79.2ft 61.38 ft 17.5 ft side comer yes
8161 Fairmont 93.39 ft 65.01 ft 35 ft front yard yes -
Circle
450 Hugo 73.92 ft 43.89 ft 17.5 ft side comer yes
8191 East 71.28 ft 40 92 ft 35 ft front yard yes
River Road
500 Ironton 55.11 ft 31.15 ft 35 ft front yard no, after
97 Craig Way 47.5 ft 23,1 ft 35 ft front yard no, after
7680 East 37.95 ft 93.5 ft 17.5 ft side comer no, after
River Road 38.94 ft 23.76 ft 35 ft front
119 Craig Way 63.69 ft 40.92 ft 17.5 ft side comer yes
50.82 36.3 ft 35 ft front
7942 East 49.5 ft 33.3 it 35 ft front yard no, after
River Road '
8080 East 58.74 ft 33.9 ft 35 ft front yard no, after
River Road
8100 East 50.16 ft 50.16 ft 35 ft front yard yes
River Road �
Laundromat 31.68 ft 1.65 ft 35 ft front yard no, after
499 Glencoe 38.28 ft 8.58 ft 35 ft front yard no, after
ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING
USE SETBACK SETBACK SEiBACK TYPE
8164 East 43.56 ft 14.19ft 35 ft front yard no, after
River Road
8180 East 37.95 ft 8.58 ft 17.5 ft side comer no, after
River Road , ,
8182 East 38.28 ft 14.19 ft 17.5 ft side comer no, after
River Road
8184 East 38.28 ft 94.52 ft 35 ft front yard no, after
River Road
8200 East 34.98 ft 9.9 ft 17.5 ft side comer no, before and
River Road after
510 Janesville 38.61 ft 12.54 ft 17.5 ft side comer no, after
421/432 39.27 ft 8.58 ft 17.5 ft side comer no, after
Ironton
461 Hugo 33.66 ft 3.63 ft 17.5 ft side comer no, after
Street
8114 Fairmont 36.96 ft 8.58 ft 17.5 ft side comer no, after
Circle
8102 Fairmont 33.99 ft 5.61 ft 17.5 ft side comer no, before and
Circle 33.99 ft 17.16 ft 35 ft front after
8104 Fairmont 35.31 ft 26.73 ft 35 ft front no, after
Circle
8027 Fairmont 21.45 ft 9.9 ft 17.5 ft side comer no, after
Circle 46.53 ft 17.16 ft 35 ft ftont
7899 East 52.8 ft 33 ft 35 ft front no, after
River Road 0 ft 20 ft hardsurFace
7663 East 64.35 ft 34.65 ft 35 ft front no, after
River Road
Fire Station 29.7 ft� O,ft : ;.� 35 ft _ front no, before and
• ' - � after
7701 East 80.19 ft' 62.37 ft' ;� 35 ft front yes
River Road � �
8061 Ea�t 90.09 ft 78.54 ft 35 ft front yes
River Road
� -
_ �
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE /� —�
SITE ADDRESg �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURAWCE
PROPERTY TypE
PERMIT TyPE
� BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
ADDRESS
OWNER OCONTRqCTOR
Pxox�:76 3 ?�S- 7��'ia� � "�
STATE LICENSE
ADDRESS:
SINGLE FAMILY/NEW CONSTRUCTION
TWO FAMILY/NEW CONSTRIICTION
❑ BASEMENT FINISH u Vn��
❑ DECK ❑ ROOF
❑ SIDING
TI'1'E OF WORK; p ATEVy HOME CONSTRUCTION ❑ SWr��G p�L
❑ MAIN'I'ENANCF/REppIR � ADDITION
DESCRIBE WORK BEING DONE: �� ODELI
SIZE OF IMPROVEMENT � � � �
OOFING LENGTH WID
NUMBER OF SQUARES ❑ HOUSE ONLY
G�G� —� ❑ HOUSE & GARAGE
PROPOSED SIZE: O ATTACHED GARAGE
PROPOSED HIIGHT; ❑ DETACHED GARqGE
IDING
C] Virryl
❑ Aluminum
0 Other
--__.
OSofiit
❑ Trim
❑ Fascia
EXP DA1?E
CITY
SIZE
STORIES �'
� DRA1N TILE
❑ OTHER
Permit No :il�i ��`"���
Received By: 6
Date R�^ ��� 1� �
STATE ZIp
�
BASEMENT REMODELING SUBMIT:
i . Existing Floor Plan
2. Proposed floor plan
3. List of structura► members co be us¢d
FOR NEW CONSTRLTCTION INCLUDING DECKS,
�DDITIONC .P. unu�rs�� �.....
.ra �un1v1IT
�• S�te PIaNSurvey showing the existing struatures
and proposed project � s
�WS 2. Two sets of consWction plans
IN EXISTING ppENINGS�Yes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGg_DESCRIBE SIZE OF 3• Energy Calculations
�PfiWING CHANGES & FOR WINDOWS — PROVIDE U-VALUE AND
TYPE OF WIN�W TO BE INSTALLEp MA�'4�� STICKER ON WINDpVy.
ALL FEES ARE gASED ON VALUATION, INCLUDING THE COST OF LABOR AND M
U7'AL JOB VALUATION ��''7/j� SING THE 1997 U.B.0 FEE SCHEDULE) ATERIALS:
Permit Fee —
Plan Review
Fire Surcharge
Surcharge
License Surchazge
SAC Charge
Cwb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
� �-9I ,�,.� - ..�,..,.,.�-.,.�.i T'YPF
� See �sack Page for Fee Schedule ---
$ 65% of Building Permit Fee
$ `�'� .001 times the total job valuation
$ '� � .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2000 per SAC Unit (Plans to MWCC for determination)
$ ft+6 ft=
$ __ftx$22=$
$ $450 Conservation Plan Review .
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
I � : � naaLe ,.�.--�-- - . .
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED A�ch �� ulations
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the wor
conformance H,ltj� the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand th' '
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance ,I' be in
approved plan in the case of all w �s �s not a
hich equires review and approval of plans, with the
SIGNATURE OF AP ICANT /�G,��y� � p„ �' ��^�„ ✓ P�NT NAME— % / I
�ar
,.... ,:� c.��.� ��i��a`��� �`��, ° �'d17i�1'R� b�/1'I <F� DATE i� /� �
_ �'�"i }��'�`<i2x'�,%�iii*r�:�„�,�..w.�. ,..�::,� ,._
page 2- Building Residential Application
gUILDING PERM�T �E SCAEDULE
ermits for the erection of any building or
The Chief Building Official shall, before issuing p alteration or repair
S���re, or for any addition to any existing building or structure, or f ul� �e a ment by the
to any existing bui l ding or s t r u c t u r e, u pon a p plication therefore, req P y
ch ermit of fees to the amount herein below set fo rt h an d in t h e m a n ner herein
applicant for su p
provided to-wit:
TOTAL VAL�
$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
FE�S
$23.50 (Minimum Fee is $23.50 plus surcharge)
�23_50 for 1� $500 plus $3.05 for each additional $]00 or fraction, to and
0
Z,000 plus $14 for each additional $1,000 or fraction, to an
$69.25 for 1
$391.25 for 1`
to an_ d_ ��
$643.75 for 1
000
$25,000 plus $10.10 for each additional $1,000 or frachon,
$50,000
$50,000 plus $7 for each additional $1,000 or fraction to an
includin $100,000
$993.75 for 1�` $100,000 plus $5.60 for each addirional $1,000 or fraction o
and includin $SOU 000
$3,233.75 for the 1� $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,000
$5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional$1,000 or
VERIFICATION OF FOUNDATION
'ts for construction will be issued a minimum of 24 hours from the time of application to
Permi
allow for proper review of proposed structure and of the construction srte. • 1 be
ertificate of Survey of the lot, showing the locatio uses Onl isting foundat�on wil
A C v�,lth the framing. New Ho v
required before proceeding
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax; 763-502-4977
Building MECHANICAL
Inspections RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 2-19-09
DATE�(i
S[TE ADDRESS �
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
APPL[CATION
I � �[�uI1�111111��
OU D7AIL ADDRESS _ `i�
���-, {rc� �
�L OWNER �7CONTRACTOR
NAME: �
ADDRESS: CITY
PHONE: ��� ,�C��
COMPANY NAME: ��q7(�C�A ¢T f9� ���_�� ,�
CONTACT PERSON: ��� ���A/�iSA,
STATE LICENSE # EXP DATE
ADDRESyS�: � `r C�ITY�
PHONE 1 Yt��� G��l'� 'C� FAX _ �]� .
FAMILY 0 TWO FAMILY
TYPE OF WORK: � NEW �EPLACEMENT
V
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
Permit N
Received By:�_
�� �A��
ATE ZIP
STATE�IP:��
FEES ARE BASED ON $10.00 PER FIXTURE, XC��ERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELO �) ,/�
Equipment Installed MFG: MODEL: j�`�� � SIZE/BTU �_, �lV' �
MFG: MODEL:
MFG: MODEL:
/C $25.00 FIREPLACE (GAS) $15.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00
BOILER $35.00 FURNACE $35.00
CHIMNEY LINER $10.00 GAS DRYER $10.00
DUCT WORK $10.00 GAS PIPING $10.00
Number of fixtures @ $10.00 x $10.00 = $ :>
Number of fixtures @ $15:00 x $15.00 = $�
Number of fixtures @$25.00 l x$25.00 -�� `
Number of fixtures @ $35.04 x $35.00 = $
State Surcharge = $ .50 - -
SIZEBTU
SIZFJBTCI
_GAS RANGElOVEN $10.00
NEW GAS GRILL $10.00
GAS iJNIT H'fR $10.00
POOL HEATER $35.00
VENTILATOR $15.00
��ryy`
;
(MINIMUM FEE $35.50) Tota1= $ `3;.,=--�
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an appli t'on for a permit and w rk s not to start without a permit; that the work will be in accordance with the
approved plan in the case of or 'e roval of pla s.
SIGNATUREOFAPPLICANT PRINTNAIvIE QlWV DATE J�` �LJ
PLEASE NOTE:
City of Fridley
Building Inspections Department
6431 LJniversity Avenue NE, Fridley, MN 5543�
763-572-3604 FAX: 763-502-4977
.��
City of Fridley Residential Mechanical Application Page 2
REQUIItED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REOUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fue) IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.