AF - 45735�
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City of Fridley, Minn.
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� � , OCATI QF BUILDING � � �
No������� Street � Part Lo
Lot �_ Slock �_ Addition or Sub-Divisi�pn � 3'�-�'��� � '�
Corner Lot � Inside Lot .._._. S.etback .�L.�—..�._. Sideyard _. e��
3ewer IIevation .���r?�� , _ F.�n IIevation ��� .t� �
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DESCRIPTION OF BUILDING
T � e Use �
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Front ��6� Depth ��� Height ,�.� S4. F't. �l��:s.v� Cu. Ft��
' Depth � ITeight ___.� Sq. F'L Cu. F�
Type of Constructlon � � F�t. Coat �� ���►���. �be Completed
In consideratton oP the fssuance to me of a permit to cons et the building described above I agree to do
the proposed work in accordance with the d�scription above set orth and ia compliance th a�l provlsions of
ordinances of the dtq oE Frldley. � � /� �
Ea cona4derat4on oP the payment of a fee oP $c�� , pernvtt 9s hereby granted
to canstruct the buflding or addition as d�cribed above. This permit ia granted upon
the exPress c�ndition that theperaon to whom ft is granted and hia agents, employees and worlmnen, in all work
done in, around and upon satd building, or anypart thereof, shall conform fn all respects tfl the ordinance� of
Fridley� Mfnaesota g lacation, construction, alteration, maintenaace, repa3r and moving of buil�dings
within the dty liaoits��� this permit may be revoked at aqy time up� violatioa of aay of the prov9aiona of said
ordin8nces. �. ,,» �� �'1
Building Inspector
NOTiCL�s
i6b ps�mtt doa eot corsr t6s comlroeltoe, Im�atlaHae fee �rtrie8. P��+�9► 6n hufta�, arrar er rralsr. B� wes 1e �
16a Boildtep lesp�etor foe a� p�emhs fer fh�ss N�ms.
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APPLICATION FOR BUILDZNG PERMIT
C�ITY OF FRTDZZEY., TM..�VESO'CA
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LOGATION OF B?'�DZNG
"1�TTa. _ � � � 7 Stre�t ; f�/� �„ �.��_ar --:._-;,�. �' -�Part of Loe
_ �V
Lot Block A� � AddiCion ox Subdiviaion► ,���,�k ���-._�� f� -�''`�� `;f' �_fly�
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Cbr.a.�r Lot�_Ins3de Lot_ Setback '�1 Side Yard ,��� � �
SE61EYi ELE9ATION FOUNDATIOIQ ELEPATI(�T
Applicant attach to this form Two Certificates of Survay of �ot and proposed build-
ing location dra�wu on these Certificatea. '
�
DESCRIPTION OF SU�DING
To be used ae:
� f�sr k°� � � Front ;.�'" �� Depth :;���;� eigh+e � `�' -
� �" � � Sq. Ft . 1_T �, � Cu . Ft . � �� .�_ ,� �
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4
i Aeight
Sq. Ft. Cu. Ft.
�ype of Constructioa Estyma�ed Cost �, ,��'� ��_ , _� b' �
,�
To be Completed ----
�he undexsig�ed hereby makes application for a permit for the work�herein specified,
agree3ng to do all work in strict aceordance with Che Citq of Fri�iley Ordinances and
aul�ngs of the Depastmsne of �uildings, and hereby decZares Ehat all the facta and
sepreRentatiaas �tPted ia this application a.re Crue end correct. •
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DATE ,� � °— � - � SIG �-��� f_ � F'' --�.��r�� � l.'� � _�,��- �.�
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(�chedule of Fee Gosts can be found on the Reverse Side). �'�
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BUILDING PEIiM[T FEE SCHEDULE
Section 2. The InspecCor of Buildin�s shall, before issuiag �ay permit ti�r'
the erecCion of aay building or stru,cture, o� for any addition Ca aay exist-
ing building or strucCure, or for any alterations or repairs Co any exio�ing
build3ng or s�ructure, u�oa application therefor, require the gayment bq �he
app23cant for auch_.permit of feea ta the amount herein below set forth �nd
in the manner herein provided to-wit:
2.1. �or any auch permit for �he'�rectioa o.f anq fire-proof buildiyng, othex
than a garage� warehouse, factory dr grain elevator� dr for the erecti„oa of
any fire-prooi'addition, for sim�.lar occugancy, to any existing build�ng
shall be at �he rate af $1.40 for each one thousaad cubic feet, or fraction
ghereof, in �such cubical coatenta.
2.2. Eor any such perm�:t for the erectioa of anq fire-proof garage,�warehause,
f�.ctory or graia elevator, or f�r the erection of aay fire-proof addition,
for similar occupaacy, to any ex�.stin� bu�tlding shall be at the rate o£ $1.25
for each oae thoueand cubic feet, clasaified as °1f3reproo€" bq Section 502 of
' �''- Ehe Nlinneapali's Building :Code. ' ,
IIOUSES .
2.3. For any such permit for the erection of aay non-fireproof buildirtg other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
_ - -ac���t�i�in, ° for s3milai � occupa�cy,- �o any ex�eti.ng buildin -- -
each on� thousend cubic feet. g' PBrmit $1.(10 for
GA�AGES
2.4. For any such permit for the erection of anq non-fi�epraog garage,
w�rehouse, factory or grain elevaCOr, or for the erection of any aon-fisepraof
add3t�oa, for similar occupancy, Co any existing building or for esch such
t�9ld3ng or addition - ninety cents ($0.90) for each oaQ thousaad cubic feet
or fraction thereof, ia the cubical conteats thereof with a minimum of $4.Q��
For Che purpose of co�nput3.ag fees for building permite, the cubical coatenta
of eny buildiag or addition to a uniform height throughout by multiplying the
ground area covered fr�n a point six�$.;(6) inches below 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 p�tched roof.
2.5 . Fvr �epai�-s -ar-�.3-t�rati-ona to- �n �cfstiag _s�ruEt�re, the fee shail bs
at the rate of $3.00 per each Five Hundred Dollars ($500_00) or fractioa
thereof 3n the coat of all proposed work.
, �< �
2.6. ?.t�, no' c��'e _she1L'�t�i� fQ¢'. chargad for anp pern2i� as eet forth in
Sectioa 2 be less than $4.O0. '
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-. Z�tiereby certify that t�e above is a true and correct plat of a suz�� ,�.
Lot ss� (�) , s�ocx Tr�ree (3) , os�x�s �i�► n�ni�zox, ano�a c4�x��� _ _
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sue��tr MIT NO. °°
City of Fridley 2� 3 9
;� 572���i�� THE TWINS g U I L D I N G P E R M I T qECE1PT NO.
� ; L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � f 9�
� _ �
' ����� � CITY HA�L FRIOLEY SS132 NUMBEi1 pEV OATE PAGE Qi AVPROVED 81I
�"""� � �'' 612-571-3450 910-F15 / /
10 23 98
J08 ADDRESS 6950 Hlckor Drive NE
t LEGAL �07 NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 3 Ostman's Third Addition SNEET
2 PROPERTY OWNER MAIL AODRES$ ZIP PHONE
Paulette Prentice 571-6475
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Thermal Window & Sidin Co. 2005 Bush Ave. S
4 AiiCMITECT OR DESIGNER MAIL AOORESS 21P PMONE LICENSE NO.
5 ENGINEER MAIL AODRESS 21P PMONE LICENSE NO
8 USE Of BUILDING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
6 DESCRIBE WORK
Reroof house and ara e(20 S Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment msut comply with the State Building Code.
TYPEOFCONST OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING.
YENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING S0. fT CU FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOFi A PEFiIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED NO DWLG. UN17S OfFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE FEAD AND EXAMINED THIS APPLICATION STA�LS GAFAGES
ANO KNOW TNE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS Of LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITM WMETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1]1�{ �.HFj
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEL THE pERMIT FEE SAC CNAqGE
PROVISIONS OF ANV OTHER STATE OR �OCAL LAW REGULATING CON•
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �S6.7S Fire SC �1. %1
PLAN CMECK fEE TOTAL FEE
License SC 5.0 64.32
S�GNATUpEOFCON7fiACTOAOAAUTMOAIZEO4GENT �DATE� WMEN PROPER ALDATED TMIS IS YOUR PERMIT
� (v/
S�GN4TUAE O� OWNEA��� OWNEp BUq0E�1i �0�1E� Bl0 �NSp t � p�tE /
JL+L-�B-iy9� �:'� �Rr7M CIT'~' OF F�IL�LEY Tp ?�a2641� r�.�1� ���2
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
CC)MMnN VFNT� VFNT .nl`I` _T�R AI�D _nMAIISTInI� �41R t�RIFI ATIAI`
When rp la _in9 an xic+ing, �ran�p, �e undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where requi�ed. Yes (� No ()
The venting system is plasticJPVC and meets all current codes and manufacturer
specifications inGuding sizing, length, number of elbows and termination.
The undersigned also verifies that the replacement unit is a listed assembly
and meets the cuRent codes. and manufacturers specificataons. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natura! draft appliances.
The pYicting cem6 ��tien air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to ins au a n w_�r„e����n a�r„it will be sized and installed
to meet the current codes and manufacturers specifications.
Whe� ins allinA a new ven+inA�cl�,�m, �e undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does inGude AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed coRectly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes (�) No ( )
1'
�'eS t ) �o ( )
Yes No ( )
Yes �No ( )
Yes � No ( )
Yes� No ( )
� • � . � ' • ' . � • ' • 11 11 • � " � . / • ' � • � / ' M • � • /11 . • �
Appiiance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type .Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
� : � •► �- ..-
HEATING CO:
Signed By:
�/i ��� �- - � _
�.