AF - 47155BUILDING PERMIT
Village of Fri��ey, Minn. N° 2 5� 1
� �r` �i/� r � � . + . .
E�S �i���C�"�
Date ....� .............. ,,...... ..................................... �
Owner ......���.�..'�'�~ .. ...... Builder �
Address ... ��i�+ .....�........... :���'� ..... �+5� It.� �i�',�.�iAG�.�.,,�
Address. .......... ....
� Q� L T(ON OF UILDING
No. . . . . �� . Street . . . �� . . . ."'�",iG�,"`..1�,% •
.......... .. Part of Lot .......................
Lot ................ Block ............. .. Addition or Sub-Division . .... ..... �
Corner Lot ........... Inside Lot .....�.. Setback .....:.... .Sideyard ...�.....�� �`
DES�CRIPTION OF BU[LDING
To be�Used as� * � �,
t.�'`,fi � . �"" �" ..�; � �
� _ ,.. � �' � o �; � ��
. . . . . . '�: . . . Front . .. . . . . . Depth . . . . . . . . Height . .. .. . . Sq. Ft. . . . . . . . . Cu. Ft. . .. . . .. .
. . .. . . . . . . . . . . . . . Fro t . . . . . . . . Deptl� . . . Height . . . . . Sq. Ft. . . . . . . Cu. Ft.
��' ���
. , . ...2. �•�.-� ;.�,.�' '`�� �� t?:' ,� ys�
Type of Construction . . . . . . . . . Est. Cost . . . . !! . . . . . . . . . . . . . To be Completed . . . . . . . . . .
;.� �, �,�� ..�.�:- �-'.��
.
� �����
In consideration of the issuance to me of 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 of
ordinances of the. Y�lage of Fridley.
��'��, ���:�
- - - -- --------"��=.......... ... .........� ...yr.
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co 'd�� the payment of a fee of $. . . . . , permit is hereby granted to . . .-., . . . .. . . . . . . . . . . .. .
. . . . . . . . . . . . . . . . . . . . . to construct the building or addition as described above. This permrt �is graxited upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, arounci and upon said building, or any part thereof, shall conform in all respects to the ordinances of
�"ridley, Minnesot�. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this perrnit may be revoked at any time upon violation of any of the provisions of said
ordinances. �
- ��•
. . . . . . . . ,�+►. . .. . . . . .r.. ., .. . J..,. .. .,dr ,�iflding/'.�sPec'tor
NOTICE:
This permit does not cover the construction, instailation or alteratian for wiring, plumbing, gas he�ting,
sewer or water, Be sure to see the Building Inspector for separate permits for these items.
I
Original • �
PERMIT for Power ants and Heat�ng, Cool-
in.g, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Neuting Plants to be i:estalled—altered repaired
Make ����'� ' , Size �3 d mf� ;
Oil fired� Coal fired ; Gas �'sred ; Gas Authorization
Remarks
y ��-a.J
Approved by
Final InspECtion Date , 19_
Inspector
�����
P�t N° 4604
Fee $ %, �--o -
Of�i�e of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.; I Q-� o , 19�
Owner ���-aJ .�G�ca.�c.�
Location �9 D i:�e�,�c (T�_.
Kind of Building
,
How Occupied
Work to be Commenced v""`^ �� ,19�
To be Completed � � ,19�
Estimated Cost, $ � � � � �
�ld-New, Building Permit No.
Permission is hereby granted to � '� to install—erect—use the material and devices described in the
above statement. This permit is granted upon e express condi ion tliat the person whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and an th.e operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of t)ce devices kerein named, and to the speci ations set forth in th.e approved application for this
permit on file in tlae ofj°ice of the Inspector of Buildings. '1 � ��� • �
\1.N:�-c.c,,c-,�r�.; � , i�c� , Inspector of Buildings
<Z sM�t�v
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�� � � � �a N.aer�, c��, r«�-�., R.�.�A �
A� Con�tioeing S�s a�d Devie�s
PARTIAL R�TE SCI-IEDULE
a��►v*�r�r waax �►ia: iu►ra zari►i.
� s�en a� n�c� wo� . . . . . . . . . . . . . . . . .=io.00 �
placement ot Fu .%QOG� BTZI -lP%1P.�1'%% , e.UO ��`� � ;�
epaus Alterations--up to �500.00 6.00 i-- -_ __._.
Repairs dc Alterationa each add. fS00.00 . 3.0(l i�--.-._
1fl•ClI. W1111M AU
lLrnace SheU St Duct Wori to 1l0�000 HT�T . . . . . . . . . . . E10.00 �
e�eh add. A0.000 B1V .......... ... ... .... .. 3.W i
A�eplaee�r� of lh�rnaoe . . . . 6.00 �
�en��, a� wnera�on�—uo to ssoo.00 . . . . . . �.ou �
RaPai�'s dc Alteratlons each add. f 500.00 . . . . . . . . . . 3.00 �
sTEU�t � HOT WATEA 3Y3T�f�
P't�rnace She}1 � Lines--to �00 aq. ri. IDR Steam �10.00 a-
FLrnace Shell d� Line—to 640 sq, ft. EDR Hot Watrr 10.00 �.
Each add. �00 sq. ft. EDR Steam , A.IMI �_.�.
Each add. SSO eq. S. IDR Hot Water g.pp �,_
OIL BIIRNER—b S gal. per hour 8.0� ; ._
over 3�al. per hour—See lree $chedule
GAS sIIR1�ER tuD to 199,000 HT[T) . . . . . . . . . . . 6�.00 � �� 0 G
owr 19�.000 B1V EM F�. ieMdul�
GA3 FI1TIIiG FEE3: 110 Al►TE ?OT1►L
ist s 1�]xwres ....... xs zoo : a,, o 0
ARWitional P'ixtures .. ...... : .76 i
G e b 199.60��PX �_ =i 6�0� __�
�n cc�m ���� � / � , o d
� r« s�a.a.r
v�tn.nsua aYS�
�u.r�u►riows s �r�rns �ro�rai. ss� �,
novox
rnu►t. ,�� � -� 7
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•�• � ' �_/ i � � �
ctty at !lidley:
The uncieraigoed hereby makes application for a permit tor the worl� hereir
specified, agreein� to do all work in striM accordance with the City Ordinance:
and raling ot the Department of Buildin�s� aad hereby decLres that sIl t�e iacts
and representations stated in this application are true and eu�rect,
0
C�'�*i�'�'�,
Kind of Huildins
P4�idley�
0
14 hG
Used aa _.Y_(,,[�_71� � --.
To be completed about 1/���Z� /� �i i it �_--1
Estimated Cost, __�.�_,�__
Old�iew. BuildiaQ Permit No. P�rmit No. �� �
D�1Pn0lI O! 1II�
AEATING or POWER PLAN'PS—Steam. Hot Water� Warm Air—No
Trade Na�++' g� �
CaPadtY Sq. !'t Lr.D R- B'1'�T H.P. '
Tota1 Connected Ia.d � � ��
BURNER — 11'ade I�i�•� g� 1w.
ar.dtr sq. r�. a.n-R- s1v �
(MMARRf—OtlER�
� � ��._� i ��/
: � �► ��.�.,� I / i .
. 11_
SUBJECT � P E .
City of Fridley � 16 2 5 6 '
AT THE TOP OF THE TWINS g U t L D I N G P E R M I T �
r
; � RECEIPT NO.
� ; L _____ COMMUNITY DEVELOPMENT DIV. ����
r � I� PROTECTIVE INSPECTION SEC.
� � �
' � r'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE }� PAGE OF APPROVED BV
�----� • •'� 612-571-3450 910-F15 6/�e!$/81 � �
J08 ADDRESS 690 Helene Place N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 9 Donna.y's Lakeview Manor SHEET
2 PROPERTY OWNEA MAIL ADDRESS 21P PHONE
El1is Griffith 690 Helene Place N.E. 571-6484
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Mark Wales
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUIIDING
�Sl�P•11t131
7 CLASS OF WORK
0 NEW � ADDITION ❑ A�TERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 16' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OP CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR GONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED I& NOT COMMENCED WITH�N 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION �- 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 GAANTING OF A PERMIT $�6fl $. 5O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STRTE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y5%. SO
PLAN CHECK FEE TOTAL FEE
� y�`l.. 88 Y�. 88
SIGNATUR FCON7R CTOFlORAUTHORI2 DAGENT IDATEI WHEN PROPEFLY VALIDATED THIS IS YOUR PERMIT .
�SiGNA%!�O�/�FO�UILDE� �DATEI BLDG iNSP , Ea
CITY Of' FRIULEY ' . .� Z � .' � .�,�0
Af'('LIC/1'fIU'd FOft Rf;SIUEf�ITllli_ C3UlLDIi�G f'GfL"'TTS � � D� � ar �-
(We�•r, All:er.�tions, /ldditions, or (;ep��irs)
' � oi�r��ca: _� ! i is j,� ��n G Y ; � � ; t-1� �UI LDER : �'i% a r �' Gc%a %s .
. '-, �..
, IIDDi;ESS: j� �j U I�, �.� � �. PI��� AUDRESS: �1� %cI �'or1,�_� C' ,� .
t �
�. TEL �l0; � i I- o�( :�'L/ TEL I�dO: �a l��J 8"S"
' Consi:ruciion Location ' �
''�C • STRI�T NO :..._S�_ta..�� S7.'REET: ��. I e i� e P�.
L07.': Z BLOCK: �� ADDITION: A�IV/`i�� • �
Corner Lot: Inside Lot: `� Setback: Sideyards:
Ap�licant attach to this form two Certificates of Stitrvey of lot and
_ proposed building location drawn on certificates to scale. � .
DESCRIPTIOi� OF COPlSTRUCTIOFd - �
� �i'ront: �� Depth: l CQ Heiqht:
�
Squane. Feet: � �i Ciibic Feet:
. - �ront: Depth: Height:
. Square• Feet: � Cubic I'eet:
Type of Construction : W(x� �t#� � Estima�ed Cost: $��OV� �a
Rb Be Cbr,�pleted: � II�•i%�l�t . . -
, . ' Alt. A Alt. B
Prapdsed Drive�•�ay Width If New Opening Is Desired: $� $
, ., S�� R�VERSE SIDE OF SiIEET .
• .
��ie undexsigned hereby make� applic�tticn for a permit fcr the t:vrk� herein specified,
. aqr.eeing ta c?o ,all work ir� strict accordance Y�ith the City of I'ridley Ordinances and
ruli�igs o� i:11e Department of Buildia�gs�, and hereby declares tha� all tl�e iacts and
rapresentations stated :n this application are true and COrrect.
D�'iT�: � - � 3 - � � SIGNIITUF•E:
SL•ipulations : � �
r'f, Sv
p�- t,BX
S, e, s�
�
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,
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S1::C'.CX01�� ?.. 7.'1iL� 7n�.:��ccLor of� 13u�.1c?.i.n�Jc: ::1►nJ.l, hcfar.r, i.c�:u.i.�1cJ J�crnnzL:; tor t:lic crccL�.on
Uf ��ny l�u:;.l.�l.i.n�� c�x :,i:��uct:�u�c, w- !'a�.' t�ny �zc1clS.i:i.on !:o ai►y t:rS.�t:in�J I�tiilcli�icj c��; stxuc(:ur.e,
. c�Y. i:o�� cu,y t�l.t:er.:it:ion or. l�c�,uir.:, t.o •any c>:a. ;1:inc� )n�i.l.di.iui ar �Lr.ucturc, uj�c,n �r,j��,j.cat.i.on
�ttir_l:�:f.�or.�c, r.c�c�u_i.re tJ�� l�tiymc��t: 1�y tlie aY,Z�].i.car�t: to�- ::ucl� per.mi.L• 01.� tee.^, to tlic arno�ant
hex�s.in beJ.c�r� sc:L• for.th and S.n L•)ic manr►ez hcze�.n ���:ovidac; L•o-t:�aL:
�
1•Jl:l�l CnN�:'I7;UC'SIOt�: ;ing],e ).'ami.l.y Ilotnc:� and Gar.�zc{e ,: Yd . 00/J., OJO CUL"�.0 ietet:. •
I?7.T::d Cli):CI:: 25 l�ercer�t: of buz.lcli_ng }�er.mzL ie�.
U1t�:Vl:l•;115.' llL1'Ri:5SIOtd: (C�ncreL•c, C�irb �L-rccLs Only) � ' �
' Al.�crn�-�t:e n: Ite�noval and re��l.ac�ment• of concrete curb and
gui:ter only; l�riveway width , p).us 6 feet x$13. �0
1�lternate B: Ftnmoval. and reylacemcnt of concrete curb and
• gut•tez and iiist�ll a 3 L-'ooL- F�ic�e apProach c.�ith :'
.� 6 inch depth; Dra.vcway �•�idth �plus G feet x.$15., 75 .
- " � �PDI31C?��ILL INi=0R��1117IOrt
Tor the pur�bse of computi_n� tees for_ building pezmits,. L-he cubi.cal contents of any
buildi.ng or. addition, a.s deter.:ni_ricd by rnultiplyir�g t:he ground area coverecl fro:n a
. pc�a.nt sir. (G) inches belo°f� the floor ].ine oi tlie basement or th� cel2ar to tiie
averac�e heiqhts oi thc �upper surface or to Lhe average height of the roof. surf:ace
oi the ;1ain gab].e of a pitcl�ed roof .
Foz xe�aixs or a].ter�tions to an existi.ng structure, the fee shal�, be at the xate
� . .of $3'.00 �iex cacli fivc hundred doZlars ��($500.00) or fzactio �- ->
. n ..tiei o
c. f '
a.n �2e cosfi
oi all proposed wor.k. ,
Tn •no case sha�.l the fee cliarged f-or any pennit as set iorth i.n Sectipn 2 be less �
than $7.50 plus $.50 state surcharge. . •
.. I F I C�TI Oi�t OF F(1U� 1 I O_
" NOTE: Permits fox cansti-uciion ��zll be issued a minimtun ai' 24 hours fzom the tlme
n� a��lication to��allocv for pro�?er review of the proposed stxucture and oi ihe
constnzction site. .
) . L . . � . � . �
h Certificatc of Survey of the lot, shocaing the location of tiie foundatian ance S.t
has been cons�nicted �.*ill be required bef_ore proceedii�c� �.��� �he framing,
. �BTIFIC�TE OF ���UP, At�___!��'_ - -
' hrpli.ca�ion for a Certificate oi' Oceu}�ancy shall be made ten (1Q) d�ys prior to the
uce or. accupaizcy of- any stxucture for �a]�ich a l�uilc�ii
g perr�it }.as bcen a.ssu�ci; and
s.-�icl struct:uxc s1i�11. iiot be used or, occu pied L:ntil a C e r i:�,�ic��e o f Occurancy has
bcen i.ssued. .
,
. . �_
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�I
sua�ECr PERM
City of Fridley 16 9 3 7
AT THE TOP OF THE TWINS gU I L D I N G P E R M IT �
r
; � RECEIPT NO.
• COMMUtJITY DEVELOPMENT DIV.
i iV ������� . .
r � � PROTECTIVE INSPECTION SEC. �� 9�,
1 � �
' � ����1 � CITY HALL FRIDLE� 55432 NUMBER REV. . DATE PAGE OF APPROVED BY �
�"�'"��� ,'' 612-571-3450 910-F15
3/10/83 � �
JOB ADDRESS 690 Helene Place N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 9 Donnay's Ia3ceview Manor SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ellis Griffin 690 Helene Place N.E. 571-6484
3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO.
Leo 0. Sanders 7813 Jackson Street N.E. 786-2860
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL AODRESS Z�P PHONE LICENSE NO.
6 USE OF BUILDING
12E.' S1C1P.Tl'tld�.
7 CLASS Of WORK
❑ NEW C] ADDITION �7 ALTERATION p REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install drain ti.le inside of basement
9 CHANGE QF USE FROM TO
STIPULATIONS
Electrical extension cords can not be used as part of the power source to the
P�P •
TYPE OF CONST. OCCUPANCY GROUP OCCUPpNCY. LOAD
SEPARATE PERMITS ARE F;EQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECQMES NULI AND VOID IF WORK OR COtJSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKtNG
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PFOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED �2�lOO �`I..O�J
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DO NOT PRESUME TO GIVE AUTHORITY 70 VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PRO SIONS OF NY OTHER STATE OF LOCAL LAW REGULATING CON- �*38. SO
STRU ON OFi E PERFO ANCE OF ONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$39. 55
I TUREOFCONTRACTOFIORAUTHORIZEDAGENT 1DATE1 WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
la c�.7
SiGNATUREOFOWNERIIFOWNERBUILDERI IDATEI � BLDG WSP � �pTE
CIiY OF FRIDLLY Effective �ug. l, 1981
APPLICATI�� f0�i RESIDLNTI/tL BUILQlf1G PLRi4I7S
(N�►v, Alterations. Additivns, or Repairsj
�
OWNER: ` 1 ' Bu��o�a: - .
ADDP.ESS: �Qo � �►onruss: 7�'/ .� �� a.�, � �
TEL 110: �' ��`Z � -- � i� �� ___-___— TEL N0: ��"� -- � 8'� t�
—
. Constructian location
- STRITT I�: 6TItEET:
LOTs BLODCs lIDAiTI01�1:
.-----_�
Corner Lot: � Inside Lot: 6etback: � Sideyards:
11,p�licant attach to t>>is fosm two Certificates of bl�rvey of Iot and
pxoposed �flding locativn dzawn on certificates to scale.
OESCRIPTIOi�t OF COIISTRUCTIO��
_
________ Front: Depths ilefghts
Square FaeLs Aibic Feet:
, Front: Depth: lieiqhts
Square Feat: Q�bic Feet:
�YP!� of Corstruction s ~ � r EStfmatl�a COStt t d/� �/� �
�
Zb 8� Cbr.�pleted:
l�it. �► Alt. 8
Proposed Drivc�►�ay hiath Ii New Openinq Is Desiredz S� S
, . SEC REVER;E SIDz QF SHEET
. . • • .
Zi�e undez�igne8 hereby make� applic�+tion for a permit for the wark hereiss specffied,
agreeinq to do ,all work ii, strict accordaince Mith the City of Fridley Ordinances tnd
rulings of the Deik�rtmc�t of IIuildings, and hereby declares that all tJ�e facts and
=epres�t�tfens stated � this Application ay�e true au�d correct.
a��: ._ �-� � a f� sicN�►1v�= ��
Stipulations: � �� �_ �
t
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`9 '��- S'�
_ .. .
CITY OF FRfDLEY INSPECTiON D{V,
6431 University Ave NE
Fridley, MN 55432
572-3604
RAT� SCHE�ULE
Residentiai
A►PPLICATIOIV FOR POWER PLANTS AND HEATING, COOLIWG, VEN7ILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS A�ID DEVICES
Furnace Shell and Duct Work B!�rner —
Also Replacement Furnace
(Side Vent — Fill ut Back)
Gas Piping (Needed with new furnacE}
Gas Range
Gas Dryer
Air Canditioning — All Sizes VfM ► 1�
GO1�A� Z
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appiiance or Work
Com morcial/I nd ustria)
1.25% of Value of Appliance or W k
State Surch
TOTAL FEE
Rate
$ 30.00
$ 10.�J0
$ 10.00
$10.00
$ 25,00
Effective On March 1, 1996
JOB �4DDRESS v 1O ff V f j`�7 !V ��i ,t��
The undersigned hereby makes applicatian for a permit for the work herein
TOTAL sp�ecified agr�Ein� to do all work in strict �ccorc�ance with the City Codes and
� rulings of the Building Division, ancl hereby cleclares that ail the facts and
$ representations stat�d in this application are true and correct,
, � � 1� ,1996
$ �
OWNEFI
� n��..� l l : ._ „,
$
$-�Z��
BUILDING USED AS
ESTIMATED C�ST
RMIT NO, �� �C � %
I� SCRIPTION �OF FURNA��E AND OR BURNER
$ No. of Heating Un' � Circie One (Steam) (Ho W ter arm '
Trad�r Na Size No.
BTU HP ���_ EDR
$ Fuel Total Connected Load
��
� ����_,LSC
MINIMUM FEE FOR ANY HEATING/COOLING 1�/ENTILATION
REFRIGERA710N/AIR CONDITIONING PERMIT lS'.�25 00
PL.US THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
�Air Conditioners can not be piaced in a side yard without
written permission from adjoining property owner.
Burn�r Trade Name Size Nra.
BTU Hp ��E�C.�-AIi�
HEATING C M � ���NS�� Ay
T
Signed 8 / CI;��, Te�
Approved By Rough—In Daie Final Date ���
FILL OUT BACK SID� R STACK VERIFICATION ON l��
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has be�n carefully examined
,
2. Is free,from rust or deterioration
n
3. Has 'no foreign objects lodged within
4. Is securely supported
5. Meets'�� �urrent Code requirements for size
and tot�l�TtJ's connected /, .
6 Has total heating BTU's of 7 �""
All other BTU's /
TOTAL BTU's ' � C� V V
7. Has a liner been provided for water eater
8. Has combustion air been provided for water heater
Remarks:
List ALTERATIONS Bein , Done:
HEATING CO:
Signed By:
Date:
Yes�(/j No ( )
l
Yes�j No ( )
Ye�NoO�
Yes �No ( )
Yes (/�No ( )
Yes ( ) No�
Yes ( ) No ( )
G
sue�ecr IT NO.
City of Fridley 2 6171
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T
r
� ` RECEIPT NO.
� • COMMUNITY DEVEIOPMENT DIV. �/� �
~ PROTECTIVE INSPECTION SEC.
� "' �
r S �;
� 1 ,
� 1 �"'1 � CITY HALL FRIDLE� 55132 NUMBEN REV OATE PAGE OF APPROVED B�
�""� � ��' 612-571-3450 9�0-F�5 6/9/98 � �
JOB AODRESS 690 Helene Place NE
1 LEGAL LOT NO. BIOCK TRACT OFi ADDITION SEE ATTACMED
DESCR. 2, g Donnay's Lakeview Manor SHEET
2 PROPEfiTY OWNER MAIL ADDRESS IIP PMONE
Ellis 6riffith 690 Helene Place NE 571-6484
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
American Gutter 5ervice Inc 19512 Co Cir E Ro ers MN 55374 420-3107 EXEMPT
4 ARCHITECT OH DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL AODRESS ZIP PHONE UCENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITtON ❑ ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside House & Gara e(Vin 1)
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and call for inspection of same.
TYPE OP CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PEFMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OF AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION ZpNING SO. fT. CU. fT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 OAYS AT
ANY TIME AFTER WOFiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIfV THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WILI BE COMPLIED
WITH WHETHER SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT �3,616 �1.H1
DOES RESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TME pERMITFEE SACCHARGE
PRO SIONS O Y OT STATE OR LOCAL LAW REGULATING CON-
STR CTION OR THE FORMA CE OF CONSiRUCT10N. �87.25 Fire SC. �3.62.
PLAN CHECK FEE TOTAL FEE
lo '-� 9g' City License $92.68
SiGNnrua ON'f7ACTOf70RAU Ri2EDAGENT iOATEi WHEN PROPER ALI ATED THIS IS YOUR PERMIT
�� � ���
S�GNnTUqE OF OWNEA ��F OWNEA BUiLDERi� iDATE� Bl �NS� � �
NEW [ ]
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Effective 1/1/98
�\
�
BUILDING PERMIT APPLICATION
�� j��
ConstructionAddress: ��, %O r`t�fc� � �"L /U � �
Legal Description:
Owner Name & Address: �/�� s �,e� ��� �J`, T�l. # �
Contractor: �-l��r21 C,�4�) �u �%� S�v � C,� .�ru C., MN LICENSE �
Address: / 9,�/ � Co �,v -�kw ��,2 �' l�oc�Q°s i'I9�J �537 � Tel. # .
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length �(_ Width � Height
GARAGE AREA: Length 2 2 W idth /(,D � L� Height
DECK AREA: ng Width Hgt/Ground
OTHER: CS /l, � Q�S �-�� I�/
�
Construction Type:
Estimated Cost: $
> 7t lo� �Sl
�G'' /�'
�20 3to �
Sq Ft.
Sq Ft.
Sa. Ft.
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: (, - � �' APPLICAN'T: Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Chazge
$ <`` ,�r
$ � -��-
$ . c� �
$
$ "``..,
$
$
$
$
TOTAL $ � _�o�
�� � c%�
STIPULATIONS: -- �� � ' �<�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
/
��f2o 3to'7
_
_
C�ZYQF
FRlDLE.Y
FRIDLEY MUNICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
December 30, 1998
Ellis Griffith
690 Helene Place NE
Fridley, NIl�i 55432
Re: Construction Without Obtaining a Building Permit
(Reroof at 690 Helene Place NE)
Dear Mr. Griffith
According to Section 106.1 of the 1994 Uniform Building Code as
adopted by the City of Fridley, no building or structure regulated
by this Code shall be erected, constructed, enlarged, altered,
repaired, moved, improved, removed, converted, or demolished unless
a separate permit for each building or structure has first been
obtained from the Building Official.
You have been notified of your need to obtain a building permit and
have failed to comply as of today's date. As a result, a special
investigation fee will now be added to the permit, equal to the
permit fee. The City of Fridley will give you 30 days in which to
comply before turning this matter over to the City Attorney for his
legal consideration.
Please contact me at 572-3603 if you have any questions on this
matter.
Sincerely,
B RY ESC
Buildirtg Inspector
BR/bk
� � ' SuBJECT .. "
City of Fridley
�
AT THE TOP OF THE TWINS g u I L D I N G P E R M i
� �
� �
� • COMMUNITY OEVELOPMENT OIV.
r � ~ � PROTECTIVE INSPECTION SEC.
i �
l•---����'�' �•� CITY MAIL FRIOIE� 55�32 NUMBEN
� 612-571-3450 910-Ft5
JOB AODRESS
690 Helene P1
t LEGAL �07 N0. BLOCK TRACT OR AOOITION
OESCR. 2 �
2 PiIOPEiiTY OWNER MAIL AOOFES$
� AFCHITECT OR DESIGNER
5 ENGINEER
6 USE OF BUILDING
Residentia]
7 CLASS OF WORK
8 DESCRIBE WOfiK
9 CHANGE OF USE FROM
STIPULATIONS
MAIL AODRESS
MAII A�ORESS
MAII AODRESS
REV � O�TE
ZIP
�
� 28817
IPT NO.
D�0 �l
Of APPROVED BY
�
PMONE
PHONE
SEE ATTACMED
SHEET
IICENSE NO
LICENSE NO.
LICENSE NO
❑ NEW O ADDITION O ALTERATIiDN �C$ REPAIR O MOVE � O REMOVE
�8�3�X��Kx�1iz��iHgXn�cB�axi�8��$i��x��f�xxgX��
Underlayment must comply with the State Building Code.
SEPARA7E PERMITS ARE REOUIRED FOR ELEC7RICAl, PLUMBING, MEATING,
VENTILATING OR AIR CON�ITIONING.
THIS PERMIT BECOMES NULL ANO VOID If WQRK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCEO NJITHIN 60 OAYS. OR IF CONSTRUCTION
OR WpRK IS SUSPENDED OR ABANQONED FOR A PERIOD OF lZp DAYS A7 °
ANY TIME AFTER WORK IS COMMENCE�. ' NO DWLG
I MEREBY CERTIFV THAT I MAVE READ AND �XAMIN�D THIS APPIICATION
AND KNOW TME SAME TO BE TFiUE AND CORRECT. ALL PHOVISIONS Of LAWS VALUATION
AND OROINANCES GOVERNING THIS TYPE OF WORK WI�L 9E COMP�IED
WITH WHETHER SPECIFIEO HEREIN OR NOT. TME GRANTiNG OF A PEAMIT 2056
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CAMCEL THE pEqMIT FEE
PpOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING GON-
STRUCTION OR TNE PERfORMANCE OF CONSTRUCTION ]/{.]S
PLAN CMEC
Sy N�TUp�F CON' ACT00.0A �UTHOA�2E0 �GENT IO�TE�
f �
.
$�GHaiuAEO�OwHEQ�� NEpBUI�OEAt IOATE� � ' � Bl0
SO
UNI7S
STALLS
ROUP OCCUPANCY
CU fT.
OFFSTREET PARKING
IGARAGES
0
NEW " f� ] Effective 1/ 1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 ,��
BUILDING PERMIT APPLICATION ��� ���
.• , ��
� , �.
u
ConstructionAddress: ��1� ��<-�� � ��k � �
Legal Description:
Owner Name & Address: ��S � � � %� FF� �1( Tel. # �%f � � � y
COIItI"dCti
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width
Length Width
Length Width
�? G_Q G 6 F ,�nUS� ��iL iCf`� [o �
Height
Height
Hgt/Ground
�
�N J� �i
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft. �
Construction Type: Estimated Cost: $ � ��� °
(Fee Sche ule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �/ '� � � APPLICANT: � � ���;��n Tel. # �7!-i �� y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
r
$
$ 2.�
$
$
$
$
$
$
$
•
�
CITY USE ONLY
Fee Schedule on Reverse Side
. 001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1050 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 [ ]