AF - 42357City of Fric�.ey, inn
��LDING PEY�MIT N� � g 3
nate: `'� �,�, � .
,y
r
Owaer: � ` uilder .� _____
Adr7ress � Address 1
�, �O�TI �JF BUlLDli�tt� . -
No. -�� Street ,,��--� ___ —� Part of Lo� ._
. ^ 1�
Lot �..�..__ Slock �ddition or -DivIs�to$ ` � '� � ��
�n
Corner Lot _ Inside Lot Setback �.� ._._._ Sideyard _ ��":�-,�v-
Sewer IIevatfon � � Foundation IIevation
DESCRIPTION OF BUILDING �
To,' v +' ��
j • gh � F'��-�
'� �' Front �� pth � Hei t Sq. Ft Cu.
Front Depfih �` Height � Scl. F't. Cu. Ft ��'�:'�'�-�►'
Type of nstruction F�t. .��r+'����� "'�To be Completed
In consideration of the issuance to me oE a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions oE
prdinances oY the dty of Fridley.
�
In consideration oE the payment of a fee oE $,A�. � permit is hereby granted to
to construct the buflding or addition as described above. Thia permit 3s granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part thereof, sliall conform in all respects to the ordinances of
Fridley� Minnesota regarding location, construction, alteration, maintenance, re and moving of buildinga
withiu the city ]imits and this pernut may be revoked at any tune upon viola�i�n�any of the provisfons of said
ordinances. .� 1r,►.� �
Building InaPector
NOTIC�:
T6is permit does aof cever t6e eoasA�uetten, lestallatlon Por wiring, Plumbieg, eas 6eaHng, eewe� o� water. Be sur+� ro see
ths Buildfeg laspeetor Por aeparate psm�Ns for t6ese ttem�.
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APPLIG�TION FOR BIIILDIlQG PF�MIT
CITY OF FRIDIEY, NQ�02A
,
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o�� ► e �e �w -��,. � Bui.la� - � �
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�aaress � �`�lc� �l �✓�� ����> Aaaress � �'� � .
LQCATION OF HUILDTATG
No.
� ��� 3treet,����� ��'�.�` Part of Lot
rA 1 : �' �'^``�'
?,ct �� Block �° dddition or Subdivision �°' -*��' �" � �
,
� � 9
Corner Lot ��_Ineide I�t � Setback ��� Side-Yarcl ��� �" �� �
g�g,�, ��►��p� FOUNDATION ELEVATION
�pplicant attach to this form Certificete of 3wrvey of Lot and proposed buildirig
loce.tion.
To be us�d as:
� � e
"f ��(%G'Z�.y
DESCRIP'TIOIQ OF BIIILDING
� / Heieht �
3q. Ft. � � � � Cu. Ft.
�'ront� Depth Aeight
Sq. Ft. Gu. Ft.
�.� '�;� a, � _
Type of Construetion - -'�-- Estimated Cost
To be Completed �
The undersigned hereby makes application for a permit for the wark here3n spec3fied,
agree3n� to do all work in atrict accordance w3:th the Cit� �dinances and ruling of
the Department of Buildinge, and hereby declaxes that all th� faats and representation�
atatad in thia applica.t3on are true and correct. �
DA� �'���� I c'l � SIGN�TUA� �`�O"�',�,►��, •��.
� �
(A Schedule of Fee Goats can be found on the Reverse Side.)
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HIIII�ING PERMIT FEE SGHEDUi�
Section 2. The Inspector of �.iil.dings eha11, before issuing ar�y perm3t for the
erection of a.ng building or structnre, or for any addition to anX existing build-
ing or structure, or for a.ny alterations or repairs to any exist3.ng building or
structure, upon applics.tion therefor, require the paymeat by the applicant for
such permit oP fees to the amount here3n below aet forth and in the manner herein
provided to-wit:
2.1. For ang auch permit for the erection of aag firo-proof building, other than
a garage, warehouae, factory or grain elevator, or for the erection of any fire-
proof add3tion, for similar occupancg, to any exist3ng buitding sha].l 'be at the
rate of �1.1,A for each one thousand cubic feet, or fraction thereof, in such
cubical contents.
2.2. For any such permit for the erection of ar�p fireproof gerage, wa,rehouse,
factary or gra,3n elevator, or for the erection of any fireproof addition, far
aimiler occupaney, to ang exiat3ng building sha].7. be at the rate of �7..25 for
each one thousand cubic feet, classified a� "fireproof�� by Section SD2 of the
1�linneapolis Building Code.
HO_
2•3. For any such permit for the erect3on of an�r non-fireproof bu31d3ng other
than a gara�e, werehouse, factory or g►rain elevator, or any nor�fireproof
addition, for sim3lar occupaney, to any existing building. Permit �1.00 for
e�.ch one thousand cubic feet. °
�i'.f' � H
2.4. For any such permit for the erection of any nor�fireproof garage, warehouse,
factory or grain elevator, or for the erection of any non-fireproof addition, for
similar occupancy, to any exiat3ng buildin� or for each such building or addition.
Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical
con�ents thereof with a m3nimum of �4.00.
For the purpoae of computing fees for building permits the cubical contents of ang
building or addition to a uni�orm height throughout by multipl�ring the ground area
covered from a�o3.nt s3x (6) inches below the f"ioor line of the basement or cellar
to the average height of the upper surface or to the average height of the roof
surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fse ahaa.l be at the
rate of �3.00 for each Five Hundrsd Dollars ($504.00), or fraction thereof in the
cost of all proposed work.
2.6. In no c�.se shall the fee charged for ar�r permit as aet forth ia Section 2 be
lesa than �L�.00.
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� MINDER ENGINEERING CO.,INC.
ENGI NEERS AND SURVEYORS
L�.ND �UR`JEY�NO
Civ�L 8�. MUNICIDA�. ENOINEERWO
. 6418-5GT" AVENUE N.
MIMNEAPOLIS 2Z, Mll�lN.
KE 7- 3637
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LANO PLANNINO
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L�-�r 5 ��f{.a� 2 ����s��N� ����r�����P �����r�s ��'n����.
W[ HEGtEOY CERTIFY THAT THtS �S A TRUE ANO CORRECT REPRESENTATION OF A SURYEY OF THE BOUhIDARIES� OF THE
LANO ABOYE OESCR14Ep ANO OF TH� LoGATi0t+1 oF ALL BUlL�1NGS � IF AwY, THE[tEON , AND AIA. VISlBLE ENCROACHMENTS,
�F AN,r, FaoM OR ON SAID LAWD. MINDER ENGINEER�NG CO., INC.
OnTED TniS D�Y oF ��-°������r A•�•��5 9 ENG11d ANp SuRVEYORS
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CRONSTROMS HTG. & AI R CON D.� I NC. 1ob Name ��'�" , R '� �� �` � �'' �'
�,s6 4410 8zeelslor Boule�ard, Mianeapolie 16, Minn.
28 H�A7' L088 f�AL`71LATIONB Job Address
Weatherstrips A.S.H.V.E. Construction No. ( Insulation
Guide
�lindows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor I Kind How Applied
Yes—No ' . Yes—Np 19—
r FI.� � �:A, y '�`.; c�in� :�ength �Width �' ' Height �� Fl.� ,+; ° Room Length f �r" Width %,,,� Height �
Wi dows a"�� oors— rackage and Area Windows and Doors—Crackage and Area
�Vidth Helght No. ot Llneal it. Area Wldth Hetght No. 01 Lineal ft Area
No. ot Dane of psne Ilghte ot crack eq. [t. No. of pane ot pane Ilghte o! ccack eQ. It.
c`-'� ..r�-r`:� �.^a ?1 .,.{4 ��N ��, �'`96�-,h� / ��"s^..' ��:� �a� � �s, ,Apf�
Coe% Btu
Infiltration �',�. �� �' �:'. , ;;; � ,� �;
ro � f� �:
GI883 �� fa t� e�' ,,�� 4 �u �, �,,°
Eap. wall '
Net exp. waA � ;;�_ ,� �� :� <� `� .^
Int. wall z ��g��;° r,�; :�,�, ��
Ceiling
Floor :��1' I �;' �:����.r
Total Btu. r� -s ��'j �>' �
Required sq. ft. E.D.R. or aq. ias. W.A. L.eader area
F7.� �r �.:. _`�`� Room � Length �' Width � r' Height �
Windows and Doora—Crackage and Area
Width Hetght No. ot Lineai IG Area
No. of Dgne ot pane llghte ot crack ep. ft
/° � : �:{' � ��' �sr �, °,'
Coef. Btu
In6ltration � _.�;; � �" � �-: �
s- -
�855 c 9^.�A ,',U,'�'P:;y
�. WB�� ' � , � � � � %
Net eap. wall � a; ,�' � . '
°-' "� , �'` �
:a
Ine. wau
Ceiling � x; �' ` � � ;:° p. e::;
Floor `'
Total Btu. " ����`' � �y<r
Recryired sq. k. E.D.R. or aq. ins. W.A. Leader area
Fl. ��','' Room � Lengt6 �� Vf/idth c� a� Height E�
Wiadows and Doors—Craekage and Area
Wldth Helght No. oL L1aea1 tt. Aree
No. of vane ot pane Ilghte ot creck ep. [G
i ..:8 � i.at � �>A���:� � 'r::.
Infiltration I �'�' '��'�
Glaaa / �v -
Exp. wall ,�d �!'" ,s� `�:� � �' �
Net eap. wall �� F:� � ��� � �'
Int. wall
Ceiling /F�g� r�_� p �
}'100� � . �..
Total Btu.
Required aq. ft. E.D.R. or aq. ins. W.A. L.eader area
Bc� ` � �� I
� �_
��I8t10�
CJasa
�. Wau
Net esp. wall
InG wall
Ceiling
Floor
Total Btu.
�
Coef. Btu
/�,
'�F. , a.°.3p% y�
¢r-,�
,�; ,; ; � x,; � �; ,�, ,,
�
��
� �' �=' ���° �� i �`, re�8
!t'n: /��� �� ��'�:_:��
Required sq. k. E.D.R. or aq. ins. W.A. Leader area �
,a
� Fl.l �� r:��•� Room ( Length �r=��� Width '�i� Height �k �
Windows aad Doora—Crackage and Area
Wldth Helght No. o! Llneal tt. Area
No. ot ysne of pane llghta ot crack eQ. [t.
1;�..: �� yf . 'i' "-�
Cflef. Btu
E�., a�.
In6ltratioa �' ��,� � � �- w ��+�-y�
�835
Eap. wall ---- – � . � _
Net eap. wall
Int. wall
Ceiling
Floor
Total Btu.
■��
��-
���
�_-
��� .
���
Requued aq. k. ED.R. or aq. ins. W.A. Leader area I
;� F1.� ;��`�� _ Room I Length .,�' �� Width � He�ht �
Windowa apd''Doora---Crackage and Area
W(dth �iefght No. ot Lineal !t. Ares
No. o! psne ot.pane, Ilg}�ts of crack eQ. tt.
y� ff d��_ � � �.�.:: "� � `�%� y ' ,t?';;;
;�� � �� : �v,
Coef. Btu
Infiltration d��'n q ��`;^.,
��t' � r_; Calaaa
Eap. wall
`\,� , ta Nec eap. wall
In� wall
' ,r . � Ceiling
Floor
_; � �,� : Total Btu.
t��`�`'
_ ����-�'' � �d'=°, � � ry � �..,
��� `�
, ;� A '•;� � �, .:,, .r
,� r� '�dt
ued aq. ft. E.D.R or sq. ias. QI.A. l.eader arra
��I�
��������
����E�1�'B�L AP�L��A�'�(�P�
��i� �� �radle�
P10'iE: FF PROPERTY 6S M�T QWNElZ/OCCIJPIED- A L10EN8ED Ci}�iTRAC70R ibIUST OBTAIN'�HE P�t2MR
DATE
SfTE AODRFSS � ���
7HE APPLiCANT iS: {CBiCL� OHE�
YOUR E-AlAi�
C�i,I�;i
NAINE �tJ. %/
PROPSR�N OWN�t?J ADDRESS �% ��,��' ��� ���'
C�TY �Y / /./ �� /J STATE
w�ont� rt ��e `�� � 1 � � I � �
' � GQAii'RACTOR
�a�r �e
l7PE OE WOR1(
L"i�w��s."�
�E River City Plumbing Co uc�,�sE �
„�o,� am t. .E. # 39 �
cmr t� ey, MN 55432 srArE � zrP�
PHONE # 4-2199 Fax (763) 754-�.
'a SINGLE FAMILY
❑ NEiIH
� .
OF WORK �I,S+ �f.��
714►0 FJ11lpLY
�C REPLACEMENT'
� FEE9 � BASED ON 310.00 PER FD�TURE, 6�CCSPT iMf�RE NOTED
RtKTURE9: pNDlCATE'faTAL NUMBER OF �
9ATN Sq+IKMY F�OOR DRAqdS SHOWER WAZER PIPiMG
B/4TF1'TUB GAS PIPINO (Nea� C!!y Uce�e) SWIMlIi1NQ POOL iNA'�i SCFTEt+tER tf95)
C7.OTMES WASHER KITC�lEN SiNK WATER t�OSEI' 9ACKFLOW FREV. (:18)
D6R11WASNER tAl1NDRY TRAY �jA/AiFR N�R (� FaR IRRIGA710N
� WATER M6i6R QTHER
Perrrflt Fee� $��J- �� MINN4IUM: S1B.00 or 3%of cost of the irnprovement-whichever is
PlBn Review S gceaber on work less Ehan $3�Q
Surcharge S ,�p
TOTAL DUE S�_� Make ch�cks payabie to: City vf Fridley
'PHI81S AN APpl,lCATION ROR A PERMIT— P1pT VALID UNTtL PRO�SEp
I herebY ePP�Y for a piumbin9 perrrlit ami 1 adcnowledqe tttat the irdotmauon abov�e is oomptete and aocurate; thdt lha w�k wiil be In canfOrmance �att►
the ordinanoes and cades of the Cd1�r ot Fridley arn! with the Mi�neSOta Consbucd� Codes; that � undets�nd lhig K not a p�mit 6ut only an
appli�tan for a pempi and wnrk is not to sfart without a pemHt that the w�k wiU he in aaoortisnoe wifh the apprav�ed ptan in the case of aU work whtch
require� revfevr ana approv:d oi plana. „
NAME OFAPPUCAN7'
�
SIGiVATURE OP APPI.lCANT
DATE --���=s.__� aT
TOTAL P.HS