AF - 45206City of Fridley, Minn.
BIJILDING PERMIT NA s o 5 0�
Date: _��� � ' �• � %�"° "
O�nner. _ °`;�e ���1' .�'.t/�'_�� Builder � ___...�
f
Adare�s Addrese _
� O N� UILDING
No. �� ____ Street �� { Part t
Lot /' �__ Slock ,�""'�tion or Sub-�f , on :,,�,� - '�`�.a✓r � �
Corner Lot —_ Ineqde Lot �lrtback ideynrd
� �
Sewer IIevation � F dation IIevatian
DESCRIPTION OF BUILDING
To � v �:
' Front �"` Depth Height �— Scl. F'L s�� Cu. Ft �.�'_.���"
Front � Depth eight � S4. F� ��� G�. F't. �-���
of Conatrucl3on F.st. "�� o be Completed -----
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In consideration of the isauance to me of a permit to construct the building described above I agree to do
ffie pmposed work 9n accrordance with the description above set Porth and ffi compliance with a�l provisiona of
or8inances of the dty oP Fridley.
. �
In consfderatYon of the payment of a fee of $� , permit fa hereby granted to
to construct the building or addition as descrlbed above. This permft is gTanted u�n
the express condition that �Fhheperson to whom it is granted and lua agents, einployees and worl�en, in all work
done in, around aad upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley� Minnesota regarcifnng local3on, conatruction, alteration, maintenance, repair and moving oE buildiugs
within the dty lim�its and this permit may be revoked at aqy time upon violation of any oE the provisions of said
oPdiIISIIceB. s*"+a _ � .. �
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NOTICE:
lhis p�rm(t doa aof eowr ths coe�trucNoe, InshUaHoe fe� vririeo, �t�mbtea ps 6.aNea sawe oe vrat�r. 8� �un ro sN
fh� Bn(Idieg Inspeetoe for aparafr p�rmiis Por fhu� it�na.
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CIZ`Y OF FAIDLEY, MINNESOTA
Owner's N uilde
Address Address
OF BUILDING
Alo. ��--� Streef �
Lot � Block`�Addition or Subdiv sion
Corner Lot�Iaside Lot�back
£rEW.BR
Part of Lot
� �
Side-Yard �
E"�EVATIOAT
Applicant atCach to Chis form Two Certificatea of Survey of Lot aad proposed
building location drawa on tthese Certificates.
DESCRIPTION OF BUILDING
To used as:
Frone_��� Depth_�fleight / �
i^ —
Sq. Ft. Cu. F�. ,�' ���
Front Depth Height % �
" Sq. Ft. ��_Cu. Ft. �
Type of Conatruction Eatimated G t�/�� x�
To be Comp],eted '
The undersigned hereby makes application for � permit for the work herein
specified, agreeing to do aLl work in strict accordance �vith the Citq of
Fri.dley Ordinances and ruliags of the Department of Buildin�s, and hereby
declares that all the facts and repreaentations �tated in this application
�re true aad correct.
DA � � � � � SZGNATiTRE
(Schedule of Fee Costs can be found on the Reeerse Side).
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BU]ZDTNG PERPZ{� FFE SCI�BiT�LE
Sectioa 2. The Tnspector of Bu3ldin�s shall, bc:for.e isauing any permit for
the erection of any bnilding or structure, or for any addition to any exise-
iag building or sCrucCure, o� �or any alterations or repa3re to any euis�in�
building or�seructure, upon appl�.catiion therefar, require the payment by the
applicant for such permit of fees to the emount herein below-set fosth aad
3.a the manner herein provided to-wi,t:
2.1. For aay such permit for �he erecCioa of any fire-proof bui,lding, other
tlian a garage� warehouse, factory or graia elevatoa, or for the es�ection of
any fire-proof addition� for s3mflar occupancy, to any existing building
ehall be at the rate o£ $1'.40 fc�r each one thausand cubic feet, or fraction
�hereof, in such cubical contents.
2.2. For any such permit for.rche erection of any f3re-proof �arage, warehouse,
factory or grain e�evator, or for Che erection of any fire-proof addition,
for simi].ar oacap�ncy, to any existing buildiag shall be at the rate of $1.25
�or �ach one thousand cubic feet, classiiEied as °'fireproof1° bq Section 502 of
the Minneapolis Building Code.
HOUSESS
2.3. For any such permit for the erection of ebny noa-fireproof building other
than a garage, warehouae, factory or grain elevator, or any noa-�Eireproof
addit3an, for similar occupancy, to any existiag building - permit $1.00 for
each one thousaud cubic feet.
CARAGFS
2.4. i�or any such permit for the erectioa of anq non-fireproof garage,
warehouae, factory or grain elevatox, or for Che e�rection of any non-fireproof
addition, for similar'occupancy, to aay exiating buildiag or for each such
� building or add3tion - nineey cents ($0.90) for each on� thousaad cu�ic feet
or fraction thereof, in the cubical cont�nts thereof c,�ith a minimum of $4.00.
For the purpose of computing fees f�r building permita, the cubical contents
of any build3ng osc addi�Cion to a uaiform height throughout by mul�iplqing the
. ground area covered fram a poinic s�.x (6) i�,chea below the floor liae of the
basemeat or cellar to the aver�ge height of the upner surface or to the
average height of the roof surface of the main gable of a p3�ched root.
2.5. For repairs or alteratione to aa exis�ing structure, the fee aha11 be
at the rate of $3.00 per each Five I�undred Dollars ($500.00) or fraction
thereof 3n the coat of all progosed work.
2�6. Izi'no case shail the fee charged for any permit a� set forth fn
Sectioa 2 be less th�a $4.00.
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Caty of Fridley, Minn. ��1T° 9� 20
BUILDING PERMIT
^ Da�: August 25, 1967
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p�r; Peter L. Crema g�� Same
Ad�re�a 100-G��b�a Gibraltor Road �,d� Same
LOCATION OF BUILDING
No. lOQ S�t Gibxaltor Road ._._.... part oE Lot
Lot .l� __ Block 2 Adclition or Sub-Divisian _ Cazlson � s Summit Ma.nqr
Coraer Lot _ Ine�tde Lot � Sstback .+._ Sideyard
Sewer IIevation ____— Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Addn,, to Ritchen �nt 14' �p� 5' Height 5q. FL Cu. FL
Front Depth FTeight Sq. Ft Cu. F't.
�pe of Construction �rame �, �_ 1200.00 To be Completed
In canstderat3on oP the issuance to me of a permit to construct the uilding des�lbed above I agree to do
the proposed work in accordance with the d+escription above set fo com ce �, af1 provisiona cp
ordinaacea oY the dty oP FiYdley. �
> �' �
In �deration of the payment of a fee oP $ 7• 00 ���t q� �by �� .� Peter Crema
to conatruct the building or addition as descrlbed above. Thiap�� t is granted up�
the express candition that thepe�on to whom ft is gi�aated and his agents, employees an� worl�►en, fn all work
done in, around and u�n said building, or anyp�r� thereo� ahall coffiorm ia all respects to the ordinaacee oE
Fridley� Minnesota regar�iiag location, construction, alteration, maiatenance, repair aad moving of bufl�n�
ordivaa� dty ]imits and thia permit may be revoked at any tilme upon violation of aay of the P��ona oF sa�d
CLAREIQCE BELISLE 8�� �
NOTICE:
'fleb psrmh doa net eewr 1hs eonsteneHee, testapafioe te� �rtdng, plumbte0, Aa 6�aNna, sswu or waf�r. B� wn to t»
f6a Bntldh� les�ctor for qpuata p�rmiis Io� t6as tMm�.
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A.°I"�,JCC3?:i.fi:� ��i2 311�'i,D �PIG ��� � �T
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C;..'ti'� OT' r�ta.il:j��, r�'Ih`�;ESCTA
OWNER'S NAME ��� ,� _� /% As.;:;��.�ER -/
ADDRESS �� �� � � AD�P.ESS ,
- - - - LOCATION QF BUILDI�+G -
,,,., .. .
N0. r'� ��? „ STR�ET �s �' �' ' PART OI�' LOT
LOT____���BLQCK ADi�ITiON aR SLiBD�.VISION ��-�/
CORNER LQT INSIDE Ld1 SETBACK SIDE-YARD
SEWER ELEiiATIOIV FOUIVDATI01'�T EI.EVATION
Applicant attach ta this form Two Certifica�es of Survey of Lot and propasad
building location drawn on these Certificates.
DESCRIFTIQ�T OR BUILDING�
To Be Qsed Aa;
� �, �� . . . .
i Front Depth Height
Sq. FC. � Cu. Ft.
Front • Depth Height
� Sq. Ft. - Cu. Ft.
Type of Construction.�%r� Estimated Cust ��,� U� �
a
To Be Completed �
The undersigned.hereby makes appiication for a permit for the work harein specified,
��reeing to do all work in strict accordance witlx the City of Frid�ey Ordin�nces.
and rulings of the Department of.Buiidin�s, and hereby declares that a11 tha facts
and representations st�ted in this apgiication are true and correct.
DATE �� � �— � �
(Schedule af Fee Costs can be faund on Che Reverse Side).
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of structure, or for any addition to any existing
building:or structure, or for any alteration or repairs to any existing building
or structure, upon agplication therefore, require the pay-ment by the applicant
for such permit of fees to the amount herein below set forth and in the manner
herein provided to-wit:
Ur.iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or
fraction thexeof, in such cubical contents. Type 3& 5-$1.50 for each
one thousand cubic feet.
For the purpose of computing fees��for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches belo�� the floor 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. .
For repairs or alterations to an existing structure, the fee shall be at the
e rate of $3.00 per each Five Hundred Dollars ($SQ0.00) or fraction thereof
� in the cost of all proposed work.
• In no case shall the fee charged for any�permit as set forth in Section 2 be
less than $5.00. � .
NSSSD Connection Charges based on location- Area 1 or 2.
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SUBJECT P
c�ty of Fridley � i3448
�
AT THE TOP OP THE TWINS g U I L D I N G P E R M I T
� � RECE
COMMUNITY DEVELOPMENT DIV.
r � w � PROTECTIVE INSPECTION SEC. �("'���'�{ �
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'l ����1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED 8Y
l•�"� � ,•� 612-580-3450
910-F15 4 9 76 � �
JOB ADDRESS 100 Gilbra�tar Road N.E.
1 LEGAL LQT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1% 2 Carlson's S13IIIID].t MdIlOZ' South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Abraham 100 Gibraltar Road N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSE NO.
Kings Brian Construction Co. 5516 Regis Drive N.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF V110RK
� NEW �O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 12' x 4' Addition to rear of dwellin
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERATE PERMfTS REQUfREL� FOR �IR11VG,
H.EATIIVG, PLUI►I��II�iG ANQ SI(aiV�e
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCl FY�P
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R l. 4$ ].92
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION 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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GHANTING Of A PERMIT $2 �$OO 1.. �O
DOES NOT PRESUME TO OIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OH LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � S1G. SO
� ,, PLAN CHECK FEE TOTAL FEE
` �°�` �°'�-� g `� �, _ `% °� � ` � $I8 . 2 �
SIGNATUREOFC rancroRORnurHOaiZEDnGe�,, (oa7E� WHEN PROPERIY VALIDATED THIS IS YOUR PERMIT
; ��� �-���� -
SIGNATU � E OF OWNER IIF OWNER BUILDERI IDATEI BLOG INSP pATE
APPLICATION FOP. RESIDENTIAL, ALTERATION,
OR AllllITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NA@'I� : �: �. ���� -�-_. BUILDER : ���, !;�a ' - _, �� ��.-�� .
ADDR�SS : /� �� ,��� � �� ADDRESS : �5�/� /���,` ��-�
NO : . % �D �
STREE'T : � � �-� ���
LOT: BLOCK: ADDITION:
CORNER LOT: INSZDE I,OT: SETBACK: SIDEYARD:
Applicant attach to tlii.s form Ztao Certificates of Surve of Lot and proposed
building location dra��n on these Certificates.
HESCRIPTION OF BUILDING
To Be Used Ast
�f'.�_����v �'ront : 0 � � Depth s � � Height : � �
Square Feet: `�� Cubic Feet: % ��
• Fxon�: Depth: Height:
Square Feet; � Cubic Feet: / ��i
�pe of Cons�ruction: O� n,x,g �� �e Estimated Cost: $,� ,� e' ���'
.
To Be Complet�d: �� =.�- ? �
The unclersign.ed }iere�y m2.kes appli.cativn for a permit for the woxk herein.
specified, u�?-eei.ng to do a..11 work in stiict accordance with the eity of
Fxi.dley 0-r.dinances aT1C1 x-ulings of the DeparL-n►ent o� �3uildings, and hereUy
declarws that all the far:ts and rapxesentations stated in this application
are true and corr.ect.
_ ,? ��-
DAT� : % �- � �' �G SIG�TATURE . �1 `�
�See Reverse Side For L�c�ditional Informa�ion. }
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I�M� 2.� x�•�. lot,'—� t%•��
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BUILDING PERMIT'FEE SCHEUULE � a �,6
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SECTION 2. The Inspectox of Buildings shall, before issuing pexmits fo "
erection of any building or structure, ox for any addition to any exist ng
building or structure, or for any alteration or repairs 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:
iJNIFORM BUILDING CODE: �pe 1, 2& 4-$2.15 for each one thousand cubic
feet, o� fraction thereof, in such cubical contents. 2`ype 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL I.NFORMATZON
For the purpose of computing fees for building permits, ihe cubical contents
�c any building or addition, is determined by multiplying the ground area
covexed from a point six (6) inches Uelow the floor line of the basement
or the cellar to the avexuge heights of the upper surface or to the average:�
height of �he roof surface of the ma.in gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cos� of all proposeci w�xk.
In no case shall�the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Pexmits for construction will be issued a minimum of 24 hours �rom the
time of application, i�� allow for proper xevie�a of the proposed structure and
of the construction site.
A Certitied Su2vey of the loi., . sliowing �the location of the faundation, once it.
has been constructed, will be required beiore. proceedin� with the framing.
CERTIPICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy o� an} structure for which a building pennit has been
issued; and said structur4 sha11 not be used or occupied until a Certificate
� of Occupancy nas been issued. ��- - •
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SITE ADDRESS : ��� �` �/'�,.6,,,�,l�._ •
CONTRACTOR: �/�_�„� � ..� �..-�- -� �` � .
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EXTERIOR ENVELOPE AVSR2IGE "U" COM�'UTATInN
Page i oz 4
DATE � � � '^• �C
PHONE : ,�� � � � .� �
� Determine working square footage of each
. . � � • 93
1. Total exposed wall area...... i�� sq. ft. x .17 =
2. Toal roof/ceiling area ...... � S�' sq. ft. x .05 =
Total exposed wall area above floor = /� 7
a. Total wall window area. . . . . . . . . .� `: �'2 : .'=': :"���• • • • • • • • • •
b. Total door.area ............................ .........
c. Total slidinq glass door area .........................
d, Tota.l fireplace wall area .... .......................
e. Total wall framing areat (average l00)....... .........
£. Total rim joist area ..................................
g. wall area above floor ..........................
h, wall area above floor ..........................
i, wall area above floor ..........................
j, wal.� area above floor ..........................
Total exposed foundation area =
�.
� �-_g��� :,�.
�
�' .
�
�� `I 2 , g
�
, .
� �1�� .
k. Total foundation window area ...........................
1. Total net foundation area above grade ................. ��
.
�
Determine "U" value of each wall segment
(e.g. wi.ndow, door, each separate wall section)
a. / j� � �J'� g °Un � ��� = C ' v �
b. � � • � X uUn � ( � ' � , / .
��,/ g uUn � �P = P � �
C . �_,
d. X nUa , _
�
� X "U" _
e. . - --
f. _� g ��U�� _
.
g. ,P ` � � }� °U�i � � � � L ��
./
h. g ��U�� _
X "U" °
i. -
3. X ��U�. _ -
k. g ��U�� _ m
�
1. ��v g ��U�� � j � � � � � �
................,...
TOtal ° Z�� ��'
�r►
�/
P'
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t¢
�
If item #3 i�s rhe� v.'�me a�,
or less th�1n item }!1, you
havo met thc int�nt o�
�BC 600G (�) 2•
�zterior Envelope Averaqe "U" Computation Page 2 of 4
..
•o'
;,� . Total�exposed roof/ceiling area =
m. Zbtal skylight area ............................
n. Tota], roof/ceiling framing area (average 10�)...
o. Total_net insulated roof/ceilinq area...........
Determine "U" value for each roof/ceiling segment
m. X ��U" -
.. A
n. X "U" _ � , •
� �
o. X ��U�� -
. / �� .
4 ...................... ... �otal = � . � �� / �
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 .(c) 1.
. Alternate Buildirig Envelope Design
To utilize the total envelope system method, the values established by the sum o�
items #3 and #4 shall not be greater than the sum of items #I and #2.
1. + 2. _ '
3. + 4. _
0
0
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• WALL SECTIONS '
NOT�s Use.10� of opaque wal.l area for
°' frame construction
.:
.FSG. #3
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Page 3 of 4
Construction . R-Value
l. Tnterior air film � 0.68
a. ' _�-� °`�
. � ,�� a .� ,� .�,� -� �'
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4 . „��.�'-� _ � �
5 . ���+R�l � �c-r. ° c �' ,?
---- �
6. Exter3or air film � ��
To�,.l �7 . � �
�si �
1. Interior air film 0.68
2 . � � � _ _ .�.� �� , O� � `��r �
3 . �" `�
.
4. '�
-� °'�. %-- � �
5. �,� a�'����, � ��
6. Exterior air film p,l�
Tota]. j ���
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1, Interior air film 0.68
2 . _ � � � �� � _ �- .�.�
3 . �z `��r�f ��`��'� ' � � e �'S
4 . -�=-��-�-,_.. � � '� . �.� �_
5 . �:�.�--..i ��u�. [=� • ,� �
6. Exterior air film d`, �
�� Total � �Z .
r
/J���; �6�
l. Interior air film 0.68
. ; 2. � !r/P/
3 . ��_ �� s�����--�� �'a�� � �� �•.� �--
4. ��
5.
� 6. Exterior 'r film 0.17
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: � . �'
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Page 4 of 4
Canstruction R-Value
l. Interior air film O.fil
2. � f �� .t�����/ � � - �s'
3 . _ �� ". ����. � - - � .:a . ,
4. Exterior air film (still) 0.61
Tota1 � l4 � ��
1. Interior air f ilm ' 0. 61
2.
3.
4. Exterior air film (still) 0.b1
Total
. --- — - - - ,
• - i
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}:ent flo�l up : . �, ;•vented
. ." , . . � .' . .
• _ ,FZ�*• �5 �.. ... . . � ' •. , ' . 1. Insicle air film � 0. 61
.. . . � _� -------- -- ' . • + I 2 .
. � . � . . --� � ,
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� � ��, �,�o�,_ , �: 4 .
� t�t°�Il.�=;?-:�%•�., . �� '
' r��y.�t�`.�-:����• :'• -�..'"'�, 5. Outside air film 0.17
.�s�'```i3'=:�':•'.�-•..:+' �- .�
�'.::%.:�:=�:= ;..t-��� ',�' ���� •i� . Total
�-��~/�� � , . . ' � ��
�;� • Note: Use additional sheets if more space is
�'���� 1 � n • /n needed for details and calculations
�J . . ' •.�'. . ,M.� :,•.�' . � . .
' • � N0�?-t�'.T"'..,D� . ' . ` . , .
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.�
SUBJECT P .
c�ty of Fridley 2 6 3 4 4
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
; � RECEIPT NO.
� `� � COMMUNITY DEVELOPMENT DIV. � a a�
r � � PROTECTIVE INSPECTION SEC. E J
L---. ��'��,'� CITY HALL FRIDIE� SS43P NUMBER i1EV DATE PAGE OF APPROVED BY
i „ 612-571-3460 910-F15 6/25/98 / /
108 ADDRESS 100 Gibraltar Road NE .
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCF. SNEET
2 PROPERTV OWNER MAIL ADORES$ 21P PNONE
Nadine Holly 100 Gibraltar Road NE
3 CONTRACTOR MAIL ADDRESS Z�P PNONE LICENSE NO.
Premium Roofing 6680 Lucia Lane NE, Fridley, MN 55432 571-3973 20097688
4 ARCHITECT OR DESIGNER MAIL ADORESS 21P PFIONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION AE7 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFiK
Reroof House & Garage (32 Sq) Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS •
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCY(3ROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIREO FOR ELfCTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SG. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTpUCT10N
OR WORK IS SUSPENDED OR ABANDONE� FOR A PER10D OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFV TNAT I HAVE READ AND EXAMINED THIS APPLtCATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILI BE COMP�IED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2f67O �1.33
DQES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMl7 FEE SAC CHARGE
P VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
ST UCTION OR THE PERFORMANCE OF CONSTRUCTION. �7�F.7S Fire SC �2.67
` ` � PLAN CNECK fEE TOTAL FEE
� � ��'° License SC $5.00 $83.75
SIGNAiUREO:CONTRACTOpORAUTMORIZEDAGENT IDATEI WNEN PROPERI ALI TED THIS IS OUR PERMIT
- � ����
S�GNATUAEOfOWNEAt�iOWNERBUILDEA� IOATEI 8L �NSP f�pTE
NEW [ ] Effective 1/1/98
ADDN [] CITY OF FRIDLEY a j
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 ANI) R-2 ��'rQ
BUILDING PERMIT APPLICATION �� � 0
� .�b
ConstructionAddress: / �D C� �/.I�Pe��7E/P l�.'TJ F�l �Jf� `t
Legal Description: T�A� --��f'(= �-i1 E�l�'I'CYJ�
Owner Name & Address: �/�.�,z�' l�oc� �- Tel. #
Contractor: �k'�/�t �t��t �cr ���uG MN LICENSE # �7C�' ��S��l
Address: ,/� g'U �. v� /�4 L. �v �f , �.� �l � �.e.� �S.Zd' � -�- Tel. # ,� �/-3 �'��
Attach to this application, a Certi�icate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IlVIPROVEMENT
Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width ` Hgt/Ground Sq.. Ft.
OTI�R: �� s�i
�
Construction Type:�C� �!ti(� Estimated Cost: $ �(,�
(Fee Schedule on Back)
Driveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: lo `�,j � APPLICANT: � Tel. # 7�// o�l%lo
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
. STIPULATIONS:
$ % . 7,�
$_�. G %
$ /� �3
$ �
$ 6�
$
$
$
$
$ 3• 7S�
CITY USE ONLY
Fee Schedule on Reverse 5ide
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1(�0 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 [ ]
BUII.DING 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 $5(�
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,�1 to $500,000
$SQ0,001 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.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet tunes'$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.
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CHIlVIlVEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully exam.ined Yes (�No ()
2. Is free from rust or deterioration � Yes � No O
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 ��i � U�
All other BTLT's D �
TOTAL BTU's G ��,D ��
7. Has a liner been provided for water heater Yes (�No (}
8. Has combustion air been provided for water heater Yes �- No ()
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
ROYR�LT���� ��:��lr�� a, �°��w_9i°tiG
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CIIYOF
FRtDLEY
FRIDLEY MLTNICIPAL CENTER • 6�31 UI�TIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 8, 2002
Nadine Holy
100 Gibraltar Road NE
Fridley, MN 55421
Re: Final Inspection at 100 Gibraltar Road NE
Contractor: Royalton Heating & Cooling
Dear Ms. Holy:
A mechanical permit was issued on February 26, 2001, to install a furnace and air conditioner at
your address. According to the 1991 Uniform Mechanical Code, a final inspection shall be
conducted on the work authorized by this permit. As of this date, no inspection has been called
for.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Code. We will keep your permit open for another 30 days and if we do not hear
from you within this time to set up the inspection, we will mark the permit "no inspection called
for" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/ls
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CITYOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 7, 2003
Ms. Nadine Holley
100 Gibraltar Rd NE
Fridley, MN 55421
Re: Final Inspection at 100 Gibraltar Road NE
Contractor: Lindman Plumbing
Dear Ms. Holley:
A plumbing permit was issued on April 9, 2002 to install a water heater at your address.
According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be
conducted on the work authorized by this permit. As of this date the inspection has not
been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pernut open for another 30 days and if we do
not hear from you wittiin this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to ha.ve any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
DJ/mh
_
_
C� 1 I �F
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 28, 2003
Mr. Pau1 Marihart
100 Gibraltar Road NE
Fridley, MN 55432
Re: Fina1 Inspection at 100 Gibraltar Road NE
Contractor: Lindman Plumbing
Dear Mr. Marihart:
A plumbing pernrit was issued on Apri19, 2002 to install a water hea.ter at your address.
According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be
conducted on the work authoi-ized by this pernut. As of this date the inspection has not
been requested.
The pemut fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pernut open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the pernut "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
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�
CI"IYOF
FRIDL�,Y
FRIDLEY MLJNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 7, 2003
Ms. Nadine Holley
100 Gi'braltar l�d I�
Fridley, MN 55421
Re: Fina1 Inspection at 100 Gi'braltar Road NE
Contractor: Lindman Plumbing
Dear Ms. Holley:
A plumbing permit was issued on Apri19, 2002 to install a water heater at your address.
According to Section 4715.2800 of the Sta.te Plumbing Code, a final inspection shall be
conducted on the work authorized by this permit. As of this da,te the inspection has not
been requested.
The permit fee that was paid covers the inspection to make sure the wark was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the pernait "no
inspection called for by homeowner after notification" and take no further action.
'I'o set up fi�ie insp�c�ion � to �.��� any questions �usw�ed, please co�ta.ct the Building
Inspection Division at (763) 572-3604.
Sincerely,
DJ/mh
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City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
. �o� "� ����
Mechanical Perm�t#
Residential Application
City of Fridley
See Back Side For Required Information
/3 Site Address
The applicant is:
Property Owner.
Owner
City: F�: �t i�c -� State: /� e� Zip: SS `/� /
Phone:_7(r3- Sa�- l 3o S� Cell: Fax:
Contractor Information /1 iU
Company Name: ��a� � �l� � L � ����
Contact Person: �di (p� � �
,4ddress: � � r "
City: ��Ia�.�1 tate: Zip:
Phone: Cell: Fax:
Email: MN Bond# 8� Exp Date
Type of Work (circle one): �New � Replacement AlteratioNRemodel
Detailed De`��`cription of work: � ns� II I�Pc e g¢G.,,�;,� �, v�r�d� s�o v�
w/ /� r'O 1' � iJ * �
Equipment Installed: MFG: [�r.�c�r�. � reModel: ��al� S�tp�'�PSize/BTU:
MFG: Model: Size/BTU:
MFG: Model: Size/BTU:
Please check all that apply: Fireplace (gas) $15.00 New Gas Grill $10.00
A/C $25.00 �Fireplace (wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00 Fumace $35.00 _Pool Heater $35.00
_Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10:00 _Gas Piping $10.00
_Duct Work $10.00 Gas RanAe/Oven $10.00
Permit Fee $ �� � Minimum fee $15 or 5% of cost of improvement
Surcharge � 50 whichever is greater + surcharge
Total Due $ c��.� Make check payable to City of Fridley
This is an application for a permit- not valid until processed
I hareby apply for a mechanical permlt and I acknowladge that the informa8on above is complete and
accurate; that the work wfll be in conformance with the ordinances and codes of the City of Fridley and
with tha Minnesota Construction Codes; that I understand this is not a permit but only an application
for a permit and work is not to start without a pem►i� that the work will be in accordance with the
approved plan in case of all wor�C which re�uires review and approval of .plans.
Signature of
Approval Inspector
Date: � °S
Date• �
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
: Revised 6/14/2005
f `
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW FlOMESJADDITIONS EXISTING HOME MAKE-UP AIR
REQUIRED FOF� NEV'V/EXISTIWG HOMES
1. Combustion Air (See note below�
� Oil or solid fuel IMC Chapter 7 with NIl'd Am� dments T�M ��MM
b. Natural Cras or Propane/IFGC Chapter 3 with n�l���d���
.�► �nls� .M OOi�
2, Make_up Air (See note below) et �!n ��
a IMC Chapter 5 with MN Amendments
3. Ven.tin.g �
a. Gas appliances �GC Chapter 5 with MN Amendments
b. Fuel other than gas 1MC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC i 346.0312
5 . V entilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
N4TE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations