AF - 46775City of Fridley, Minn.
BUILDING PERMIT No = ----- -
4699 �
Date: `" "
....._�.--.-----.--.� ................-� t�
. . .-.-.---.� .._........._...__._..__.. .__
�� � � . � �
Owner: ...�'.'�!t-r:.�:�'.._.. ...:..i�'"`::""��-�.�^.'��.:�4F'.'J Builder ...._...-----
� ---...-- �------. .._.._..._...._..-�- -•-•--_...._....._ ............._...........___.----
Address _---- ............._..---.._. _.
... ....._ .............••--�--........__.___.....____._—_--•--- Address ......----�---- ----_....�.
LO TION OF f. UILDING
/,�'"' --
No. .,F---�.t-� �-- -• Street __._��.-� - ...._.... Part o t -- -- -� �---
/ __.._._......._...-•----�- E�! ��.0`
. _. _ ---� ..
Lot .._.----- ................__. Block .-------- .1....--_.---._..._---...-------- Addition or Sub-Divisiott - �
.. .. ...... . .. . ---•�
s .. i a� .. �
Corner Lot .............�'.'�...... Inside Lot _...___.......__ _ --- .. Setback �-��---��-�----_.... Sideyard ....._.. � .��-- ......._..- -
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: . -
+ '` � f `
x
j �.
..
' f , � � t .{ � : ,« Front �� f ;. De th ` r � `:�,_- '� � f � ,r ;'
� ,
, ,
� , _ - �� � � ,,,, ;_ p k-:....� ��. Height F . _.�.�:. Sq. Ft. 1�._� 1 t.. Cu. F�, ..... �. � :.r':
__.._.... _ ..._. _.. __ � _ Front Depth x.. �eight ___.._. Sq. Ft. ..._. .... .._.. Cu. Ft.
.
__
_� �,_��, rt . _ ______..
Type of Canstruction f`;�, ��� � f{� . Est. Cost .� �r� �..�'� ""`_,'""To be Completed
�'�y1.✓T'„1 � U t�� r ��t � :
TH�c }�Er P,,��;,- _ _._., _�_ _--` `--=`-�
• ., : :Y �. _.
O;d Or -''a, J �' ��: -; r,':�Ri� E VCi1L.!:�-
r,� . � � ;J^� .f i P �
- ' ��r�._; �„ _ , t; � "t' ����'��ErvafvrS ����in
_ ,, '�vs.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the propnsed wo�k in accordance with the description above set farth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of •
$ --__------, Pernut is herebY �ted to....._.._ ...................... --��- -
...._..---� ---
----------•�-•-----------------------.-_------ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, emgloyees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
��e• city limits and this permit may be revoked at any tim�e �n violation, �of any of the provisions of said
Building Inspector
NOTICE:
This permi� does not eove� tbe eonstruetion, installafion for wiring, ptumbing, gas heafing, sewsr or wafsr. Be sure to see
ths Building lnspector for sepanfe permils for these kems.
o� 4
r � � ��
\Ti�+
C
�
��
�
'd
v �
�
o �
�
U
�
�
�
�
M
�
�w
0 0
30
O�
za
E+ �
M
� W
w
A �
�
z
�
�
0
U
.� � �
v � w m
.0 y .�
N� �
o ..
� �
� � �
U �
�
�N Y � O
Y�+� G
�3b�
���°'
ti���
; ox w�
Q�����
u � � +`
� � � U�
a
����
�n
x N�� .
�� ��
w � '�
�� �y
o °' N
y � W
� eo A
� � y �
Y
� O �
� bp w
���a
��� �
N W N
:.
J �
A
�
� o
� �
, � "�
�
�
�
�
d
�
�
O
�
�
'�
N
Y
'-�i
�
0
U
v
.�
Ey
�
a
�
...0 �
Q �
U
�s 3
v
R �
w O
w
J
�
W
2
U
N
W
Q
J
r
Q
a
�
�
�9
i
�\
` !
x
]
O
a
� I q
�° 4 �
E., I .
O
E+
� � ����
� � N O N O CV
(�' .� .� .�+ 09 N Lh
�
k x x x x x
o��
: : : : � :
: : : � � an
, � � O �
�
Ri .� ' N
H � � � ° o
C�
GG •;; � O : � �
�
W �' � d � a�i �o
,r➢�C
1�i k � � y �
� � � x ti
� � � w � � �
v 3 .� W 3
x z� z � 3 z
o�
�
�
a
z
4,
�
�
N
���
���o
.-� Gq
fI!
x k x
0
z
� �
. o
0
0
' k °o
. � N
��+
1/J d i�+ +�,'
�Wi, k p �
� M � a
H � � �
N �
�
4
�
P
n
A
n
f
�
0
�
. W
. �
H
b -
U :
0
.. :
o �
W '
�
�
O
4
a �
W O
a Q,
4 �
� �
d
a A
4
�G
SuBdEC7
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� �L � COMMUNITY DEVEIOPMENT DIV.
r j � PROTECTIVE INSPEC710N SEC.
, , ,
,
`.�_.� f"'�,� CITY HALL FRIDLE� 55�32 NUMBEH aev-
i 612-571-3450 910-F15
lOB ADDRESS 150 Hartman Circle N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADOITION
DESCR. $ 1 Sandhurst Addition
Z PROPERTY OWNER MA�L ADORESS
C. H. Jones 150 Hartman Circle N.E.
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL AODRESS
6 USE OF BUILDING
Residential
7 CLASS OF WOHK
O NEW
8 DESCRiBE WORK
Reraof Dwelli:
OATE I PAGE OF
6/10/85 / �
571-6119
ZIP
ZIP
ZIP
PHONE
PHONE
_ 18053
� 9 9�
AVPROVED BY
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
PHONE LICENSE NO.
❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be the 2nd layer but not the 3rd. Ins.tall zidged galvanized
valleys.
SEPARATE PERMITS ARE REOUIRED fOR ELECTqICAL, P�UMBING, HEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING. Flb@rCJ�.d
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTqUCT10N
ON WORK IS SUSPENDED OR ABANDONED FOR A PEFlIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L 8E COMPLIED
WITH WHETHER SPECIFIEO HEREIN OR NOT. 7HE GRANTING OF A PERMIT $550
OOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $lrj. QO
S�GNAiUFEOF ONiRACTORORAUTHOFIZEDAGENT 1DATEi
� �!0 .��� � _
iGNATURE OWNEA�IFOWNEA8U�l0ER1 �-
SO.
STALLS
GROUP OCCUPANCYLOAD
CU. FT.
OFFSTREET PARKING
GARAGES
SURTAX
$. 50
SAC CHARGE
I�OTAL FEE
$15.50
Y VA ATED THIS IS YOUR PERMIT
�'�... , � � i . � . _
NEW [ ]
ADDN. [ ]
/►I,,TER. [ �
Construction Address: �`� �
Legal Description: �o-'t` �
City of Fridley
R-1 AND R-2
Building Permit Application
/ C� �'�
✓�G� /
Effective 4/1/84
������
Owner Name & Address : � � � ' �� /.�?J /-���-�uH-r, � ` Tel . # � 7/ - G // �
Contractor• Tel. #
Address:
LIVIIiG AREA:
GARAGE AREA:
DECR AREA:
OTHER:
Attaeh to this application, a Certificate of Survey of the
lot, With the proposed construction draWn on it to scale.
DESCRIPTIOP OF IMPROYEMENT
Length Width Hei,ght
Length Width Height
Length Width Hgt/Ground
d_ . � � .
Sq. Ft.
Sq. Ft.
Sq. Ft.
� Corner Lot [f�3� Inside Lot [] Ft. Yd. Setbaek Side Yard Setback
Type of Construction:
�r.�i�._D____�% � Estimated Cost: $ �'��`� �,
Approx. Completion Date: � rnd �
Alt. A Alt B
Proposed Drivexay Width If New Opening Is Desired: � �
See Back Page for Explanation
l�° /d �S� APPLICANT: Tel . # -��/ - G // �i
AATE: .____
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
r �'� �7_�_
STIPULATIONS:
CITY DSE ONLY
$ �S - D U Fee Schedule on Reverse Side
$ 25x of Building Permit Fee
$ �Z a.50l�1,000 Valuation
$ ��125 per SAC Unit
$ Fee Determined by Engineering
�
Agreement Necessary [ j Not Necessary []
� /S . S7�
_ .. ,. -
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
! ` _
; �L � COMMUNITY DEVELOPMENT DIV.
r j • � PROTECT�VE INSPECTION SEC.
� � �
l•---� ��"' �'� CITY HALL FRIDLE� 55432 NUMBER HEV.
i 612-571-3450
910-F15
JOB ADDRESS 150 Hartman Circle N. E.
T IEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. $ 1 Sandhurst Addition
2 PROPERTYOWNEH MAILADORESS
C.H. Jones 150 Hartman Circle N.E.
3 CONTRACTOR MAILADDRESS
Same
♦ ARCHITECTORDESIGNER MAILADORESS
5 ENGINEER MAIL ADDRESS
6 USE OF BUILDING
Residential
7 CLASS OF WORK
DATE
5/3/88
ZIP
ZIP
PAGE OF
� �
_ 19437�',
��
APPAOVED 8Y
SEEATTACHED
SHEET
PHONE
571-6119
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
D NEW ❑ ADDITION ❑ ALTERATION Xp REPAIR O MOVE ❑ REMOVE
8 OESCRIBE WORK
Install Vinvl SidinQ
9 CHANGE Of USE FROM
STIPULATIONS
TO
SEPARATE PERMITS ARE f;E�UIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OP CONST.
VENTILATING OR Aiq CpNDIT10NING.
THiS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTHUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AfTER WORK IS COMMENCED.
� NO. OWLG. UNIT
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION
ANO,ORDINANCES GOVERNING THiS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT SS�3OO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pEHMITfEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION Ofi THE PERFORMANCE OF CONSTRUCTION. ySH�..00
OF ;RACTORORAUTHORI2EDAGENT IDAT— E� �—_ � W
� � �'�'
OWNER�if OWNER BUILDEi71 IDATEI e,
NCY GROUP
a�. r i. I CU. FT.
OFFSTREET PARKING
STALLS GAqAGES
SURTAX
$2.65
SAC CHARGE
TOTALFEE
$83 . 65
RLY IDATED THIS IS YOUR PERti
IOAD
� � 7 City of �Yidley EEfective 5/L88
� [ 7 R-1 AAID R-2
ALRER � ] Building Permit Application
�nstructian Address
Legal Description:_
/ _. � -
� ,
, , . i,�
Owr�er Nane & Address: � �✓
Gbntractor : � - •�O � •
Adc3ress :
� / �. : ;+` •
r• ; : � ��.
�aM; :;� :
�ay:i�;
Q�iG�'%�-=.-,
Tel. #S7/ G //
Tel. #
Attac� to this appl ication, a Certif i�cate c�f �uvey of the
lat, with the prop�soed �onstruction dra�m on it to scale.
L�.SQtIPPION � Il�ROVH�
Length Width eeight St�. Ft.
Length Wi.dth Height �. Pt.
Length Width egt/Gro�nd St�. Pt.
O�rryer Lot [�'1 Inside Lat [] Ft. Yd Setback
Z�ipe of Gbnstructian: � � o i��
Approx. Compl etion Aate : �� / 9��
_ Side Yard Setbacks
Estimated Cost : S � 30 �
Alt. A Alt. B
Propos�ed Driveway Width If New Opening Is Desired: S S
Width + 6' See BacJc Page
DATE : 3 �� APPLI(3�NP : Tel. � �� / "G // �
QTY OSE �I.Y
Fermit Piee
State Surcharge
SAC Qisrge
Drfveway Escraw
Park Ftee
Sewer l�ain C�arge
Z�OTAL
3PIPtlI�It�iS:
S /.
$ �.loS�
& �
S
S
�
S c��.�5�
I�e Schedule on Reverse Side
5.50/51,000 Valuation
5550 per SA�C Unit
A1� '�" or A1t. '�" Above
�e Determired by �gineering
Agreenent 13eoessary [ ] Nat Neaessary [ ]
.� � . ,..
�
± , _
r�
�
�
a�
�
c
co
�
C
0
�
>
.�
N
�
Ll 1
:.a:
Z
O
E_-
�
z
w
>
� �
Z W
J U
oW
on
a
� z
Z ¢
W �
w
2 �
� �
Z �
a Z
C� z
�' O
Z �
�p
Z
cr O
I
5 �
a a
0
[t Q
�
Z
Z �
� �
� 4
Q �
U w
�
J
a �
a w
Q a
> �
Q
Z �
O p
U �
W �
� W
� � �
Z �
> N �
Q �
J �t�
Q � ln
� � Z .�
� •C � O
� � � m
� C'7 ,C7 N
�r � r�
C� cfl tL �n
�
�
W
�
�
�
Q
m
O
-,
W
J
�
�
W
2
U
�
LLI
H
Q
�
�
c m �
�� � � rn
� � c
Y U N ^�
3 � �
a� v a�
� � Y
� — U
� �
� L � i
O
E '3 � �
� N �
� V � C
Q. C � cif
ca � � Q?
U �
O O � :
� U � Q?
O m � as
.� ` � o �
v_- a�.
� N L �
Q C � .0
� Y �6 Q
� o � � �
3 o v,
� ` N Y
as '
� � Q � �
�
� O � n�i
� �
�°'-�
��m�
a>
rn��, o
.� � � .�
� � � � w
� � �
a� a�i • Q
L Q � � �
E- � �
�
a
n
w
�
�
C�
Z
�
J
�
m
vV
�i
�
\
�
z
F--
�
�
W
CL
V
�
�-
�
0
U
a
u�l
�
F--
�
w
J `c' I
Q Q
O �
� � � � �
a>
� O O O O O
� �O� O O O N
� � �9 � �
�
a�
c �
� E
m x �
Y U �
� �,
� °' m �
ttS � �
� � � 3
� � � �
a>
� c � -r�
� � �
C Z
�
� � � � �
C V N � C2.
N � [r � �
-� C O cn
fn � (n (�
� t� Q C�
�
�
C
c�
�
N
�
�
a`>
�
�
�
cu
�
�
a�
N
�
Q
1
rn
C
.�
_O
�
C
O
�
Q
«
Q
€ i
�
N
>
0
= O 0
Z W RS
� N �
� � a
d
� �
� c
� c
O °
�' � �a
� o
v � �
_
�
��
�
c � �
_� �1
Z
o �
ci � ��-- �
zf--mu�
� �
Y
U
Q
m
Z
O
H
�
J Y
��c
o •--
0
� U
� �
Q .
�f Q
N Q
`� o
Q
� 7
� j
QT
L �
o�
r
Q
�
�
0
a�
U
C
c�
.� Q
� Q
iJn Q
� o
v
C ?
�
ca �
�v �
� O
� �
0
E N
O
U '-
I�
0
W
O
Z
N
N
(J�
a
�� _
�
�
z
a>
�
c�u
H
a�
`
m m
o{ �
u��
1 ,
�:
�
�
r �
� �
� "-
� �
v Q
�
� O
\
�-
�
�
OO
�
Z
�
Q
w
_
�4
�
�
O
Z
a>
>,
�
�
a�
c
�
�n
�
�
�
�V
V
�
�u
C
�
Z
�
z
O
a� E_-
p U
C u-
i �
� �
� >
� Y
o U
� Q
F-
�
w
oZ
w Q
�
m � �
-� Y h-
� U �Z
o m �
Q � cw3
� �
O
J a
W
t.� rr
Z'�
1
�i o
i°
iri
�-�f N� �
y�� �
Z� �t L
W � �3
�� F-- � �
.Z') �i j� C
`J � a> o
O a `. -� �
C�
U; Z w � ai
Zi Z � � �
O Q
Q H U � a�
,_, m c
= Z CL Z f2 C
}. O c�/� o � --°a—
Z U w t�i o ca
Q (� F- � c �
O Q �I W � o
t� Z � � � o
twi� O o O c u�i
� �69 �
= W -p Q
� � f--' �
��� � ��
Z
��a. � a 3
�'
�
�: •
; , .�
:a��Q
:.tg pau�is
�o� �ufi�x
.��a m� suo�.�x�t�d �S�-�
:�s��a�
() oN () sa� la��a� ia��nn io3 PaPtnosd uaa� .�re uoqsnqcuo� seg • g
i) o.�I () sa� ia��aq xa��nn io� l�aPtnoid uaaq aauti � s�g • �
S�I1,Lg 'I�1.O,L
S�11Zg �a�o TI�7
3� S�tl.Lg ���I I��� s�H 9
( ) �l� f ) �� _ - � S�I1Lg"I�� P�
azis io3 s�aataannbai apo� �aa.�m� �� s�aay� • S
i) oN () sa� pa�oddns �Iamaas sI •�,
( ) �l�I ( ) �� �tm Pa�poj s�fqo u�iaio� oII seH • £.
( ) �rI � ) sa� uoq�ur�aP �o �sn.T cuar3 aa�3 sI "Z
4) ori �, )�� Pemm�aca ��an� ua� s�g .I
:��als io �a�ami�i� ��a � � �3!�a� ��T� Pau�is.�apun aq.L
AiOI.L���3I2I�A, x�H.LS QI�I'f� ��AB�1IIH�
� �
�.
; GLASS
� ��- s � ��- ��
H�AT TRArti'SFEA CALCULATIONS
FIF�AT LOSS (95° TD H�ATING3 IiE:AT GAiy (ZG` I"D LOUL,'
SQ. F,Tt COCF. BTU's SQ. F7'_ COE�F. t;"iG�s
-6��- �� �:�I � s
9C f �. GL.-.5
n�nings S�ade _.-_ 2� -----
tio Awn�nas y/ f
� . � v �� � �
� ;
�W -; %��' f
. s _�� �o ��!�� ;
__ �OORS ,.�. �OOQ ea. 1 �.!'�'�"_� 2. �OORS � �UO:'ea . '��.�
� _ CEILING _. C�iLiNG ` �
, ;
i'" - - = -- �- - ! '�_.` �
o / � � � � �= T---. z ;
6 � ,�- ��_ � � a� _ ��� ,�. .�t-�--"�
3 $ _ � -- __._---
►.�iALLS �. t�A�LS `
y - / ���/y V ,' f� � ����
j�. j_� 1 d f f_1 . [-l� r_
/
27 1 R
�- : _�— � _—� -- -----
' 6StitT �. F�OPLE .;G�? ���;,�1% ,
� �
Heated l �-4 I� /��v
Unr,eaced 7 0. =.2P! tA�'�1Cc�
Crawf Space 9
6. Subtotal r�i� l� %` �. Subro�ai
t.
i �iCE
a—?�D i
:. ATTEC. CRA4L'L DUCT4l'ORK 25 __� 8. ATTIC: CR?.WL GUCT«.'ORK 1` _- ----
8_ TOiAL _ 9. 7t7TAL ��;,�-"
9 FURNACE Si2E . ��"
10. FURt�iACE MODEL lo. A C t�SC)[7EL
._.�..._---.
�.
rn
�
r
r
�
f0
�
c
m
-�
C
�
a�
>
�
N
W
�
�
z
O
f'-
U
W
� �
z �
Q' M
v
0 H �
t�i > Z
v
LL �� � c°o
O � � �
F- '
U � ti u�i
��
L
�
-�.
�
�
w
�
0
0
¢
�
O
�
O
�
U1
H
Q
�
c
.� � �
.0 � ��
Y U d
� � �
y v �
� °� a
V Y �
O +r
""' r N
� ' C3
E � N
N U U
Q C N
� � �
� � �
.o
'� U d
� � t
� � '�
U ': C
.Q � �
a c c
� " o
� O H
>
� � �
� lIf LA
C
� � U
� O �
N .. �
S �
'p C �
� N r
d� � O
.N � �
�, � �
v
� � �
d a�i v
� w �
�
rn
Y
�
�
1
\
�
�
a`�
c
3
O
�1
N
Q
�
a►
�
�
rn
c
v
m
C
�
C
Z I
1"'
�
Q
W
a C
'J
�
N
0
U
a
°;
�
E
W
�
�
� �
TA�
` V
�
v
U m
� m -�
z
� w a
� Z �
�
a m aac
O 4 O O O O O 0 O O O C? G]
O O O O O O O � O O O O O
t� 'O N h h. I� 1'� O n: O O O 1n
fA tR tFl d! tA fA V! � df � y� H
z I y I���� i y�. ( lZ 1
N
N
}
v
a�
Q j U V d
[C � ,Y � ._ * cL
W � ` �.a� � �
� ►- a
� � a� W C7 �
X Z a� c � c p� I f �i .
Il. N Ol C 41 C J•Z ��� `y � s p.
C 7 �.� a m•�, � c°� i � e" o c' 3 �* 3
m � a N� m �� H i= R�' �° �
ii. � 0 L� Q, ��� pC p a
�� ` V C � �.�+ .�. .4+ (/1 Ul Yj �
,J N'� N p�•i0 � c6 �C i0 cp �0 etf
a z O m m U ct cn 3 3 3(7 C7 m
�
�
Z
O
a
w
J
Q �
Q U
Z �
Q •_
� a
¢ °-
a
� a `o
O � 7
�
� O LL
d � o
� Z �
LL Q �
� w �
� � o
NO,?�
G .
� Q �
0
�
�
N
�
..
�
t
.V.
�
�
°;
�
�
�
�
�
w
w
LL
�
H
0
i
I
i
I
i
1
I
f
i
�
f
i
�
t
C
L
C
e
°
J
�
U
�
I
(���
b
�
�
�
W
�
�
a
Q
m
O
�
�
�
w
F-
Q
Q
O
z
�
w
F-
Q
Q
W
�
�
f-
X
�
C7
Z
�
�
�
J
d
c
�� �
a`� m �'i
���
Y U �
3 � Y
m U �
� m �..
� +-� L
O t a+
Y ryI
� �,
3
� �, �s
� U U
n. � m
� � �
� � a
0 0 �
U �
C U �
o R ,_
U'� �
� C
.Q N �
a c =
� '- o
� Y •N
Y � �
� 3 0
� � rn
� � C
�, a �
� o �5
L � m
-p c L
� 'a� r
� °' o
.N � y
� � �
-6 � c
c ;� `
3 U
a� a� �
� � �
1
�
rn
rn
!
M
V �
2
_ �.
U
�
�
�
�
�
O
z �
1--- 1
� •Y
� �
W
a �
� � �
� \
h �
��
� N
� Q Y
-� �n
0
u�i U
� �
rn �
� c w
� � �
Om' w
}
Z
Q
a
�
O
U
(`�
Z
m
�
�
J
O..
�
O O O O O d o � o O O O o
O O O O O O O � O O O O O
� v �ri n n n. i. o r., o 0 0 �ri
Fn vi E» 4n �» v� rfl y3 E» i�_ �± ir3 s�
� � 1 � I 1 � � � 1 I Z
m
�
r
v
�
� � �
7 U �
X Y � •` # �
ii � ._ � �
� Q � � �
°3' � ~ Q W � m
Z � � ro � � � � `
N ' � ' #
N � C � � '� �� � � d * a d
Y�c a m '�n a`, �� ca �s a� �
N rn � � � � � � � � � p
'_� Q Q� � F- _= c� �' N
3�� 3 ��� a� a� a� � � Y�
z O m m U� v� ���(7 c7 m~
�� �
M p�
� �
i q
a�
N
a
N
o �
z i�
J I
W
�
a
m
�
17J
Z
�
�
�
�
�
Z
O
Q
�
w
r
J
Q �
p o
z =
Q .�s
u� n-
� �
` Q ¢
= a `o
a � �
o �
7
�
� � LL
� Z o
� Q u�
7
° w >
� Y O
m O �
c �?
� Q �
�
�
0
c
I
t
U�
�
0
�
�
a
m
�
�
>
O
Q
Q
Q
�
¢ �
lll W
a =
U
v� z
c¢7 c�
� w �
rn
m Q N
� = u;
J � �
a = � ,
� �
� z
¢ Q �
� F- Q .
0 � I
L1. �
o w
� � m
W u� Q
� W ~
� ~ Z
� ¢
Vi Q
� a o
�
z
0
H=
U
W
O �
i°n � I g
o� �
�� 2
� � W
N
�
�
�
U
�
�
�
�
�
d
�
W
�
>
O
�
a
w w
m
W J
� �
Q a
�. z
O °'
f-- CC
¢
z
O
F
�
m
�
O
U
�
. � _� � �'a �'
' � � - HOUSE HEATING TEST RECORD /
ADDRESS .jZ� APT. FLOOR CITY_��UBURB �
OCCUPANT D � S OWNER �
HEAT LOSS f`7/7 Y DATE HTG. INST. GAS CO. METER BADGE #
SOLD BY Cronstroms Heati 8� Air Conditionin INSTALLED BY Cronshoms Heating & Air Conditioning
Electrical Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESlGN
MAKE
Serial
INPUT
OF BURNER
Max. BTU Rating
MAKE OF FURNACE
Model
CONVERSION
� CONTROLS � i
THERMOSTAT Heat Plug Vent Size �
Valve I 1 KIND OF LJNER J M' SIZE NONE
Limit Dra�t Hood Regulator
Limit Settinq (l'' Filters Size `�' '� Number
Fan Setting Chimney Location Insid � Outside
Pilot Type Chimney Construction ,6+,�9 �
Pilot Make
Pilot Mode) Smoke Bomb Wiring
Pilot Timing DraR Test Tag
L.W. Cut Off Door Pressure Lighting Inst.
Pressure � Percent CO2 '� Date Tested
Input CFH Percent 02 Company Te 'ng onsh ms eatin & Air Conditionin
Stock Temp. Percent CO Name of Teste
O
O
O
N
C
ca
-�
c
O
>
a
�
W
\
\\
=0
�
.
0
Z
O
H
U
W
aW
� Z
Z
N
W Q t�i
J
� �N �
� � Z
��G�o
O � � M
U � �i �
�
�
N
�
l
m
O
-�
J
Q
�
�"
a�
3
O
�
\
�
W �
�
w
a
�
1
y
Q y
v o
� U
a 'v
c emo
v �
m' ti
�
Z
d
�
O
U
(7
z
m
�
�
J
a
W O O O O O O O O p O O O O
�,,, ►� � t[j 1� f� 1� P: O� O C C �
� d� d�? V3 fA fA (A t/3 � t!� �! ff! N! ER
z Ilfli{{-�IIII I
0
Z
....
N
}
.�
t/1 �
� �
LL � V �'
c
W � -Y N V •
� � c - � « •-
� �
F- y -�p ~ Q � (7 �
X Z a`� c � � rn W � a�i
� y � C .� � ` � �.. � � �` t Q.
m � � N � m � � �"' _ _ � � � �
� �- p � 3 � � £ °� :: .°: y � ,� �
a zOmmU��n��sC�C�m
�
� �
U
m
m
o �
z �
H �
m
�
0
c
�
s
rn
�
`� �°
m m_
w >
Z a
G�
tn Q
�
Z
O
�
�
J
Q
Z U
Q C
N
� a
Q Q
= W o
� � N
o � �
�O�
� � ii.
a� Z o
ti Q �
C � (d
oWi
�
�= o
a~ �
0
� J �
�Q�
p
0
' Y
d9
w
W
�
J
� �
N O
� ~
�
�
::
c�o
�
W
0
�
Y
Q
m
Z
O
O
�
Z
H
z
w
>
z
�
�
O
U
: a�eQ :/(8 pau6ig
�O� JNIIb�3H ''
aq���saa :SNOIlbR131"1d
ad�(1 ui �a�aweia � y�6ua� � �yBiaH �o�auuo�;uan £# a�ue��ddy
ad�(1 ui �a;awe�a � y�6ua� � �yBiaH �o�auuo� }uan z# a�uei�ddy
adl�l ui �a�aweiQ �} y�6ua� � �y6raH �o�auuo� �uan �# a�uei�ddy
say�ui �a�aw�iQ �y6iaH �uan ad�(1 �uan uowwo�
�ndui n38 I�lol sa�uei�ddy I��ol
�eN �o pa�srssy ue� �ndu� �18 ad�l £# a�uei�ddy
�eN ao pa�s�ssy ue� �ndu� �18 ad�l Z# a�uer�ddy
�eN �o pa�sissy ue� �ndu� �18 a��l 6# a�ue��ddy
uoi;euuo�u� �o;�auuo�;uan pue �uan uowwo��az�S pue a 1 a�u��� d
( ) oN ( ) sa� �sapo� ;ua.un� �ad se /(�a�e�edas
pa�uan pue �uan uowwo� ay� wo�� panowa� uaaq sey a�uei�dde ue
�a}}e �(�}�a.uo� pa��e�sui pue paz�s slo��auuoa ;uan pue luan uowwo� ay� s�
() oN () sa� �sa�uei�dde �e�p �e�n�eu pue pa�s�sse ue; �o� sa�qel 6u��uan
a�ewn� ����ua� � tio6a}e� ywy�-y�y apn��ui saop siyl �suoi�e��}i�ads
s,�a�n}���nuew pue sapo� �ua�n� ay� s�aaw pue �(�qwasse pa�si� e si �i
;ey� sa�uan �(qa�ay pau6is�apun ay� `wa�s s ui;uan nnau e u,y�e}sui uayM
() oN () sa� �suoi}e�yi�ads s,�a�n��e�nuew pue sapo�;ua�n� ay} �aaw ol
pape�sui pue pazis aq ��inn �i �ie uoi�snqwo� w►au e ��e;su� o� pa�mba� uayM
( ) oN ( ) sa,� �suoi�e��i�ads s�am}�e�nuew pu�
sapo� �uaLn� ay� �aaw o� pa��e�sui pue pazis si �ie uo�;snqwo� ui�sixa ayl
() oN () sa� •sa�uei�dde }}eap �e�n�eu pue pa�sisse
ue� �o� sa�qel 6w�uan a�ewn� �e�}ua� ��(.�oBa�e� ywy�-y�y apn��u�
saop s�yl •suo�������ads s,�am�e�nu�w pue sapo� �ua.�n� ay} s�aaw pue
/��qwasse pa}si� e si }iun �uawa�e�da� ay� �ey� sa�uan os�e pau6is�apun ayl
( ) oN ( ) sa,� �uoi�euiw�a} pue snnoq�a �o �aqwnu `y�6ua� `6uizis �uipn��ui suoi�e��i�ads
�am�e�nuew pue sapo� }uaa�n� ��e s�aaw pue �nd�i;se�d si wa�s/�s 6ui�uan ayl
() oN () sa� •pa�mba� a�aynn paddo;sa�� pue pa�oddns ��a�n�as si pue
`suoi}�rv�sqo `uoi�e�oua�ap `�sru wa� aa� si pue pauiwexa uaaq sey Bw}uan
ay� �ey� sa�uan �tqa�ay pau�islapun ay� 'a�ue�n� u�;s�xa ue ui�e+ a.� uay/N
NOtld�l�(a3/� al�d NOI1Sf18W0� dNt/ b01�3NN0� 1N3A 1N3A NOWWO�
ADDRESS .
PIN .
LEGAL DESC .
PERMTT TYPE .
PROPERTY TYPE .
CONSTRUCTION TYPE .
CITY OF FRIDLEY rE�IT o.: 2 93
6431 UNIVERSITY AVENUE NE 1"
FRIDLEY, MN 55432 DATE ISSUED: 03/29/2004 �, �� Y�
�63) 572-3604 FAX: (763) 571-1287 ri�
150 HA.RTMAN CIR NE
153024120035
SANDHURST ADD
LOT 8 BLOCK 1
BUILDING
RESIDENTIAL
ROOFING
VALUATION : $ 2,778.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE.
REROOF HOUSE & GARAGE {24 SQ) TEAR-OFF
STATE LICENSED CONTRACTOR
APPLICANT
BROS CONSTRUCTION INC
1532 164 LANE
HAM LAKE, MN 55304-
(?63)862-0616
OWNER
JONES CHARLES H
150 HARTMAN CIR NE
FRIDLEY, MN 55432
1
BUII..DING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 15487
AGREEMENT AND SWORN STATEMENT
This permit 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
applicarion and irnow the same to be true and correct. All
provisions of laws and ordinances goveming this type of work
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 cgr�rnyg!'fon or the performance of constructioA.
Bldg
�
SEPARATE PERMITS REQUIRED FOR V�ORK OTHER THAN DESCRIBED ABOVE.
83.25
2.78
1.39
5.00
92.42
NEW
ADDN
ALTER
� � 1 � i� �-��5���
(] CITY OF FRIDLEY Effective 1/1/2004
[) 6431 University Ave NE, Ftidley, MN 55432 (763) 572-3604 Bldg insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILD{NG PERMIT APPLICATION ��Q 2
�OD�t l�
i
Construction Address:
Lega1 Description:
Owner Name 8� Address: ��ol��°ri ,�U��' Tel. # 7�3 ",S71 "�%l9
Contractor: �t�i�Pr.sL'��i� �DS. ��mS'� MN UCENSE# ��Q��sy
Address: /i 30� � /�a.,. �-� /1/� �%i� P ��..�Y3 `/ Tel. # �'�j� —
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Height Sq. Ft.
Construction Type: Estimated Cost: $ �// D
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
��
DATE: � � APPLICANT: Tel. # %63 � -,3 39�
Call (763) 572-3604 for Permit Fees ii mailing in application. Fax to 763-571-1287 if using credit card and we wifl call
you for card number.
" ClTY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Controf
$ .as
$ .-�� `%g
$ /, ,3g
-�
$
$ S'. �
$
$
Park Fee $
Sewer Main Charge $
TOTAL $ , �
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
STIPULATIONS:
Building PLUMBING Permit r�o •
Inspections RESIDENTIAL A.PPLICATION R�iv� By:
763-572-3604 ��CITY OF FRIDLEY D��
,
763-502-4977 FAX E�cr��E,-,�a
DATE %�P<< ( 14. aC�S YOUR E-MAII. ADDRESS
S� �S �ho H�.r-trr�a.v► GirGe
TFIIS APPLICANT IS: � OWNER Gi�ONTRACI'OR
PROPERTY Nn1�: (� lZ5 7(71'1�5�
OWNER/ pDDRESS: CTI'Y STATE ZIP
TENANT PHONE: ��63� 'rJZI ' (D ( l �
corrr�c�roR x.�: Tim�s Qt�Gt,(itv 'P�[umbi�A
SUBMIT A COPY OF STATE LICENSE #(ij� � 0� Nl E}Lp' DATE la • 3t • UB
YOUR STATE -
L�cErrsE, �orm ,�rm STATE BOND #��.1 5q 0�-{S I EXP DATE o� • I�l ' G�
CERTIFICATE OF ,�D�ss:��r�tral �4ve crrr Os�� STATE MN z�r�
INSURANCE pxorrE (7�3) 571 • b-45�} FAX
PERMIT TYPE "� �INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: ❑ xEw e'x�i.nc�vT
DETAILED DESCRIPTION OF WORK 'R(�I0.CR VCt�VGS �f(7T� Q,h� O�.�PX 1MQ,t�X •
PER MS 16B.665 t�e permit fee is a minimnm of 515.00 or 5% of the total cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fi�cture, excluding the fixtutes. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. L,abor cost between 5300 to 5500 = cost of labor x.OS = plus .50 surcharge
OR
FOR PROJECTS WHERE LABOR EXCEEDS 5500, FEES ARE BASID ON SI0.00 PER FIXTURE, EXCEPT WHEItE NOTED. FIXTURFS: (INDICATE TOTAL
NUMBER OF EACH BII.OV17. MINIINUM FEE 515.50.
BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (NEID CITY LIC) SWIIvII�IING POOL WATIIt SOFTNER (S35)
CLOTHES WASHER KITCHIN SWK WATER CLOSET BACKFLOW PREV. (SIS)
DISHWASHIIt _ LA[INBRY TRAY WATER HEATER (S35) FOR IRRIGATION
WA7"ER METER O'Tf�R
� �iR r� sso+o- .`r�t�`i ��c� r�4'��c."�r�► c)v�R ssoa
Permit Fee ���.� Number of Sactures @ 510.00 x$10.00 =$
Surchaz e .50 Number of fixtures @ S I5.00 x$15.00 =$
TOTAL DUE $�_.�D OR Number of fiartures @ 535.00 x 535.00 =$
State Swcharge = a .50
MINIMUM $15.50 MINIMUM S 15.50 Total =$
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID LINTIL PROCESSED
I hereby apply for a plumbing 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 Uus is
not a permit but only an application for a pernut and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF ICANT PRIN'f NAME a.1C,�1 ��r�- DATE �' � �S
APPROVED BY DATE r'/ �
.; , , _: � �� � � ��'rtu�►i.. �► a�c�r��., wo�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502�977
�
��
� Inspections
I 1 ���� / L�J�U'T
c
QATE�,�. '
S11L A1�11RfiSS ��
THiS APPIdC:ANT LS�
PRAPE�fY OWNERI
TENANT
SUF�MLT A COPY Ut�
YOUR STA7'�! 1.ICFTIS�
WI7H APPI.iCATlQN
PROPERTY TYPE
I�EKMIT TYPE
TYPE OF WORK:
giJ�ILDING
�ESID��T'I'IAI. APPLICATIU�1
CITY OF �FRID�EY
� Y�UR E-MAt� ADDRh:yS .
:,-�c J�..�f�...��� ��-- .
❑ OWNN.R �G'�N'[RA(:fOR
�nDxFss�..`� �� =���'=7 �'O ct�rv.���
PI�UNt:�
NAMh:_ ` S'�-�- ,'� -/ -
STA'1'E L[CENSki �1_ .. ` .�IG,�-�., Y �`���� "�-`-�`
AUURESS: /� fAi� Q(� . �_ CITY., .�
F rAX � � �
_ �• r.,untt v/ucli7!*rnuv'TRik'TI lN SI'!•E.- --
O'1'WO FAMII.Y/NEW C:�7NSiTtUC:�'►c71�1
d AUf)IT107+1 O GaRAGE/SF
p �1.�6NT FiNISH O ROOt'
❑ DC�CIC ❑ 3IDINC;
O SWIMMINCi
C7 RFtvK1l.�:LR�iG �
1?ESCRtt3� WU1tK BF�i'NCr DUNE:_... � ,L
Sl7.E Ul� 1MPROVEMLNT L�:NGTH
K .. ❑ HUU5T.ONl.Y
NU� SQUARLS�..�. 0 l�OUS� dc OAR.qCi}i
•GARe4.GE� ❑ AI'"fACHEU rARA(iE
PROI'k�FD SSZt's:._ . G UEI'ACHP:6 Gr_RACf:
YROPt�51�{] ilE1CiH'1':
��a aSomc
❑ 'I3'im
❑ Alt�imim d }:uscia
Q C�tl�er _ .
����
C.cif�NiNCiS ONo LU(:ATlONU�WINIx)WS
Ult POR N�VJ Ol'liN1N UN RIB� Si7,� OF .
OI'}3h[NG GHANGBS &
ZYPE OF V�iiT6DOW TO BB 1Pi.4TAi,Lk.l"1 1vUMf3Eit OF �
ALL �EES ARE BA�D ON VALUATNUN, INICLUD'�
(L19[NG�-IE 199? �1.�.(
Perm�t Fee
Plan Itevie�v
Fire Surc:har�e
gtlr�ar�e
Licanse Surc:ha�'ge
SAC Ch�rge
Curb Cut �scrow
Emaion Control
per� Fee
8e�er Main Charge
�"6KAIN TiIE
0 U'I]-I�K
FF,E SCHEDULE)
Per�nit
!. e•.xisungr��
�, Fropax�l Qa
3. List af suuG
F(}K NL•1ti (`ANSTRU
ADi��T �L� -NS��.PCxiC
1. S'rtr PIsnJSu
� P�l�
2. 7Ww 9ets of
3. F.mrgy GG1c
AND MA'
v�LU��rion � � V44a�r s�••v a '__—
� , See Back Page for Fee Schedule
� 65'/0 of Suild'mg Permit Fee
S .001 times the tatal jab valuatian
� .OU05 x Permit Vxiaatiot� Minimum $.SO
�'� T� $5.U0 (St�tte Liocnsed Rasidesntia1 Contra��ors)
� $� �y75 per SAC i.Init (Plans ta MWGC far d�terrt
� ft+dfl��_, _ftx�2l=S__
$ $450 Cqnservateon Plan Review
�$ �'ee peurmined byEnginedring
$ A�reement naa�ssary ( ) Non Necesg�'y ( )
$ � Make check� a gble to: Cit of Fridl
1 VFP\ �Mc
'1'Ii1S fS AN �PI.KAT�(N�l PUK A PFRMi'f-NGT VALiI? UN't'IL Pit�CCSS
I hereby apply for a building permit and 1 acknaH�led�u that the informetion above is complete a�id accur
cx,rfformencc with tho ordiaaaces snd � i�d hwork s�� t�,1ey a�i�t a perrnit;ett et thc% w�wi 11 bedin ��
per.nit but ouly an '• tion for a pe .
pla.� 'sn the case of work 'ch ' s review end �� 1�• —S��"'�
pV'f' NAML.
SIC�11'I'1.�R1.' OF APPLIC , , ' �_, —,_,^r-.�
Ld Wd90:d0 Z� �Z '��O LB��tiLS�9L: 'Oh1 SCtJ�
�y; v
Au G � � 2�os �
� - 9
� S
A'T6V_lL1F� (
P��'
ut mcmbers to ba asod
70T� WG�•lJD1NG i}F�C�GS,
ey� existiagsirt�tures
KRI��
nsWction pkaas
that the work � ilf be in
1 unde�st�d this is nOt a
rdar�ce with tho appraved
FialPTa� ,to ��?�: WO��
�
L