AF - 47422City of Fridley, Minn.
BUILDING PE�MIT
N° 5756
Date: _....a�._�-...� :::...�.._� ..l.� .�__._______._......._.
. ..
,
Owner: ._ _-�. _.. Builder .._..� __ .. �����[ ._---- .............___
� _ ._.. � _�._.. ---_. ._. _---
Address.----•._.-•----_._..._..___..__.._.._....._....._..___.......-•------.._...._._._..-•----... Address _.._.___._.._..._...�_._---.._..._.._.._....___..._..--•-----_._.�___.___..._.
� � �� CATION F BUILDING
Lj�yr ..
No. '��ft� ..-.�... .._�.. Street -- - - - ----s•�L3L3-�....,.:::. i'art of Lot _....�. :.....__.._.__._.._.._.._..�
I.ot _..__.... .._. ... Block ____�__. •----------. Addition or Sub-Division . _. ._ t °��'\.
� _.._._. _. . ._..._...------- - � �.�'
Corner Lot .....��._._ Inside Lot _._---....._..._..._...----.._. Setback _... � . Sideyard ---�._......�__�____....�____��-��
�-.._. _
Sewer Elevation _._._.._.._.._...----____..._..-----•--......__.._.._.._._.._._ Foundation IIevation _...__.__...._._._---•--_..._._.�._.__._.__---
f.
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DESCRIPTION OF BUILDING
To v�ea
_ ._. .. Front �(�---•--• f Depth .�l��._ Height _.�.fr!.. Sq. F� ��
._...�_.. nt .r' _� Depth _�_ Height _!! _� Sq. Ft. ,�.�.�
Type Construction ..._..._ . ___.. Es� ����--� _'_'.:."�o be Completed •--.
Gt1. FL
C:u. Ft.
1� �.�,�r�!'�
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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 city of Fridley.
.�_.w.�_
In consideration of the payment of a fee of $.�, «":.:.'_�� permit is hereby granted to._._.._.._... ._
..;.__._._.._..._.._.._.._._..__�._.._.._ to construct the building or addition as described above. This permit is granted upan
the express condition that the person to whom it is granted and his agents, employees and workmen, fn all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
�'ridley, Niinnesota regarding location, construction, alteration, maintenance, re and moving of buildings
within the city limits and this permit may be revoked a t any '�xpm;,viol���a�y of the provisions of sa�d
ordinances. ��F J
Buildin8 Inspecta�
NOTICE:
Thts psrmit do�s not eowr !h� �onmueNon. fnNa!lafion for wiring, plumb�p, gas h�afina, sew�r or watsr. B� wh fo tN
NN Buildin� latp�efor for s�pan» p�rmits for thp� it�nu,
. � � �4 • .�: ,. r:.
APPLICATI4N FOR BUILDING PERMIT
CIZ'Y OF FRIDLEY, M:LNNESOTA
Owner's N ���C�N' Buil.der
Address Address �
No.
LOCATION OF HUILDIN6
i � �i � :
Lot,� �,�g1oc . __ __ _ Addition or Subdivieion�
Corner Lot � xnside Lot Setback.,,,,_,.,�,Side-Yard
SEVaER ELEVATION D�J 0 FOUNDATION FLEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
To be used ase
Type of
To be
DESCRIPTION OF BUILDING
�- .,r
Sq . Ft
�' Height 1��
.,.�..� . _._._.,.....
Cu. Ft.
� Depth�_���ielght /Q_,_,.�,
. Ft. Cu. Ft.
stimated Cost
The under�igned hereby makes application for a permit for the work.
herein specified, agreeing to do all work in strict accordance with
the City of Frid].ey Ordinances and ruling of the Department of Build-
ings, and hereby declares that all the facts and r e$entationa
stated in is a plication are true and corre
DATE Y7 � � SIGNATURE -
(Schedule of Fee Costs can be found on the Reverse Sidej.
�� . . s • . ,�. y + ` v+ . . ....
Application �or Power Plants and Neating. Cooling, Ventiiation. Refriger�afion and
Air Conditioning Systems ond Devices
PARTIAL RATE SCHEDULE
GAAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 $
Replacement of Furnace ............................. 5.00 ;
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
R.epairs & Alterations each add. �50U.00 . . . . . . . . . . . . . .. 2.50 $
MECH. WARM AIR
,,
Furnace Shell & Duct Work to 12U,000 BTIT . . . . . . . . . . . .
each add. 60,000 BTU . . ........... . .... . . .. .
RePlacement oP Ftirnace .....:.......................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.OQ ..............
8.00 $�
2.00 ;
5.00 $
5.00 $
2.50 $
STEAM or HOT WATER SYSTEM
1 E�Zrnace Shell & Lines—to 400 sq. ft. FDR. Steam .... 8.00 $
4 Fumace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
E
; Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER <up to 400,000 BTU) . . . . . . . . . . . .. . . . . . . . . . . 5.00 $ '��
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures .. . .. . .. . . . . .. . ...... .� x $1.50 $ °��
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONIMG
FAN HEATING SYSTEM
VENTILATING 8Y3TEM
ALTERATIONS 8t REPAIRS
ROUGH
FINAL
�
See Fee Schedule
�
TOTAL FEE ��
Depi. oi Bldgs. Phone SU �-7470
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City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn. , 19� �
Owner -� i��i6G '
Kind of Building
�������
Used as
To be completed about � �
Estimated Cost, $
Old� Building Permit No. Permit No.
c �'
DESCRIPTION OF WORK
HEATING or POWER i'I.ANTS�Steam, Hot Water, W* ;*—*?�,�_
Trade Name� �� ! Size No.., :�"L�,! � �i
Capacity Sq. Ft. E.D.1�D� BTU H.P.
Total Connected Loa Kind oi �e
� J
BURNER — Trade Name Size No �;�����
Capacity Sq. Ft. E.D.Rf� �,�BT[T H.P.
SUBURBAN NEATII�G & SHEET META[
8419 CENTER DRiVE N. E.
Signe M�NNEAPOLIS 21, MIN�;,
By
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.��<z sM Busine�hone IQo
(REMARKS-OVER)
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D46 � a z
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V. . Construction No.
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Ki�
No No 1 � �l, --� — /
Fl.� Room ( Length Width Height FI.� Room
Windows and Doors—Crackage and Area Windows and Doors—(
\Vldth Height No. o[ Llneal [t, qrea Wldth Height 7
No. o[ pane o( Dane lighte of crack sq. tt. No. ot pane ot pane 1
._� � � .
� Z � � V L�
� � ��� / `� -
Coef. Btu
Infiltration Infiltration
Glass � � 09
Glaas
Exp. wall Eap. wall
Net exp. wall � ..S 1Net e=p. wall
Int. wall Int. wall
Ceiling �" Z: �
Ceiling
Floor Z
Floor
Total Btu. u�/ Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
Fl. - oom � Length � Width Z/ Height / �,� Room ( Length 1/ Width �
Windows and Doors—Crackage and Area Windows and Doora—Ctackage and Area
Wldth Helght No. o[ Lineal tt. Area Wldth Hetght No. ot Lineal tt. Area
No. o[ pane ot pane Ilghts o[ crack sq. tt. No. ot Dane o[ pane 116hts of crack sq. [t.
/ �,( 7i �i / � (� /i_Yt% '� *� O' -�a, , —. 7 , i—
FRIDLEY, MINN.
Insulation
How Appl
�,3 Width Z(
e aad Area
Llaeal tt. Area
ot cracic p. It. ,
Infiltration
Glasa �
Exp. wall
Net exp. wall � � � yZ
Int. wall '
Ceiling � 2� �
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l,eader area
FL Room � Length / Width �-� Height �' �
W►ndows and Doors—Crackage and Area
Wldth Helght No. ot Lineal tt. Area
No. of yane ot Dane I1Bhts ot crack, ea. ft.
Coef. Btu
Infiltration �3
Glaas ' '
Exp. wal)
Nec exp. wall
lnt. wall
Ceiling
,
Floor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area
Infiltration
Glasa
Exp. wall
I Net exp. wall
Int. wall
Ceiling
Floor
?otal Btu.
Required aq. ft. E.D.R. or aq. ina. W.A. Leader area
FI.� Room I Length � Width
Windowa and Doors—Crac�age and Area
Width Hef�ht No. ot L1nea1 1t. Area
No. of csnn ot caos I1cdt� ot crack w. tt.
Infiltration
Glaas
Eacp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
ft. E.D.R. or aq. ins. Q/A. I.eader area
Btu
. n. �
Btu
City of Fridley
App�ic�ion for P"lnmbing and Gas Fitting Pen�it
Dep� of Bldgs. Phone SU 4-7
DESCRIPTION OF WORK
Number, Kind aad Lxation of Fixtures Locatio
3/ .
� Z + + WATER HTR.
W �. x i� x} Zz 'a �z �z ox � c� z `�
30 j�� � �n 3� o� ��a. U� 43 �<� �gn �p F N GAS I ELEC.
�V�� n�1�1
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PARTIAL RATE SCHEDULE
3ewer �
Cesspool j�
PI.UMBING F'IX1'IIR£ RATES: NO. RATE T�dTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . . � x $1.50 $�
Q ,� �
Future Fixture Opening . . . . . . . . . . . . . . . . � x 1.20 $ °� `
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... . ..................... x 3.25 $
Water Heater (Up to 200,000 BTtJ) ......—� x 2.00 $� � v U
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEE$: NO. RATE TOTAL
lst 3 Fixtures .......................... —� x $1.50 $
�/. � �
Additional FYxtures .................... x .5Q $
Gas Raage to 200,000 BTLT . . ... . .. .. . . .. x 2.00 �
REPAIRS & ALTERATIONS—Refer !o Code
Description .............................:..................$
TOTAL F'EE � � �
city of Fridley:
�
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The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares t3�at ail the fact
and representations stated in this application are true and correct.
�Fridley, Niinn.s �— Z' , 19_�
. �- �
Owner —
Kind of Building �
Used as
To be completed about
Estimated Cost, $
Old New uilding Permit
•
By-�..d.�1J
Business Phone
Rouox J � 2 3 " (. 'Z
FINAL
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City of Fridley, Minn.
BUILDING PERMIT
nat�: ?'�''??�._1965 ___.__._.
�r: �s. Peter Tdoux Y�
Adaress 66�1 _ Jackson St. N. E. ___.._____..
Erco Inc.
Builder � ...._
.� ��" d �
N� '7554
aaare�s ���_..Ce�ral A�e. N. E.
L4CATION OF BUILDING
rro. ..�.��.._._..._ st��eet �_Jacls�on 3treet N. E. --------_.._..__.._.._._ Part of Lot .
Lot _.._...1....__.._._..__ Block __..:_. �__._._._.__._._... Addition or Sub-Divisi� �88dGif1.8YiC�8� 211d. AdC�•
Corner Lot
Sewer Elevation
Inside Lot __._._.._.. Setback _..._.._....___ Sideyard
�____ ._.._._.. ...._...._�_ Foundation IIevation _
D�SCRIPTION OF BUILDING
To i� v�a as:
w_. ._._ Front _.._.. Depth ..�_�.. Height _�_____ Sq. Ft
_.._.__._..._. ._._.� Front ____._..� Depth _.._ Height _.__.�� Sq. Ft .
Type of Construction _.._...____. __�____... Es� Cast �_ �t 500.00 ._........ To be Coaripleted
a�. �
Ctt. Fk
StOrm D�emag@ Bepai.r:
In consideration of the issuance to me of a permit to cons ' g deecribed above, I agi+ee to �o
th� ProPoaed work in accordance with the d�scription above pliance with all praviuions ot
ordinances o! the city of Fridley.
In ca�sideration o! the payment of a fee of �.�L..�_._..._._., permit is hereby Sranted to�'CO ISC.
to c�nstiuct the building or addition as descrlbed above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upa� said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota �gardfng location, construction, altera.tion, maintenance, repair and moving of buildin$a
within the dty limiffi and this pentnit may be �voked at any time upan violation of ax�,y of the provisions of said
ordinanc�es.
— SuilafnS 7�o�eCtQe
NOTICE:
ihis p�rmit dea not eowr th� eoaslwcNay ie�allNien fer wieinY. PWwbieW Yn 6wt6�W a�ww er waNr. M sen to sN
fh� doildiaa Iny»elor for s�p�raN p�nnits for f6�n i1�n.
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APPLICATION FOR P�RMIT
�,
CITY OF FRIDLBY: �iNN�90TA
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o�R� s Nar� �12s � .��.�x suit,n�x ' -'� ��
�� �� �`�,�
. LiOC/kTION OF B�ING
No� �v �? J,r Stf�et r Part of Lv���`;
�L'��
Lot Biock Additio�C or Subdivisieq%%%f,c n/'t t.y��//A �� 9r��/ �//,(/�
• . . . .I/+.r�i�Tl�l r�l�i��r�'
Goraer Lot Inside Lot _�:�et�k 3ide Yard -' . '
SEWER F�,EV'ATIPN gOUNAATIpN g%�V'Afilp�.�....; _.�._.,� _
Appli�ant att�ch to thi� forn� Two Certificates of. Survey of Lo� snsi p�aposed`bafld•�'
ing location dr�wn oti these C2i�tificates . � _
/I ���Qlu.•�, ,�� .. %�� � ��.s�t_
� .
� �3CRIPTION OF BtIII,DING
�
JTo e used 8s:
�'rrmC,� - Depth H�igkt � � ;
3q. Ft. Cu. Ft. .
��'rant Depth Heigh�
, St�. F�t . . Cu . Ft . � ,
1�►pe of Construction _� Estimated Cost �,,,%1� '��
. •�
��
. �_
The undersigned hereby makes ap}�li�ation for a permit for the u�ork hexein specifiec#,
agreeing �c�c�o all work irt strict accor�iance with the City of Fridley Ordi�ances and
xulings if che Departm��t-�of Build�ngs, and hereby deelares fhat all the f�cts atid ,
represen�t.at3.ons stated ia this application � t�µe and correct.
„%� � � .�
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�Scbedule:of �'se Costa can be fouad on the Reverse Side).
.� _ . �.
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SUBJECT ,
c�ty of Fridley ; . i4s97
AT THE TOP OF THE TWINS B U I L D I N G P E R I T
r
S � RECEIPT NO.
� • COMMUNITY DEVELOPMENT OIV. �
' � �: ------� �
r � PROTECTIVE INSPECTION SEC.
� �
� . �
,4 � �"'1 � CITY HALL FRIDLEV 5$432 NUMBER REV. DATE PAGE OF APPqOVEO BY
""'� ♦ ,�� 612-56�-3450
910-F15 5/12/78 � �
JOB ADDRESS 6631Jackson Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 1 4 Meadowlands 2nd SHEET
2 PROPEFiTY OWNER MAIL ADDRIESS ZIP PHONE
Timm A. Lovaas 6631 Jackson Street N.E. 571-9703
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEEfI MAII ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 32' Gara e addition
9 CHANGEQFUSEFROM TO
STIPU�ATIONS px.o,vide garage dpor opener. Provide 8° x 20" frost footings 42"
be.law grade. Provide hard surface driveway. Variance on s�de yard setback
on stseet side of corner lot approved to 15 feet.
. , ������
SEPLRATE PERMiTS REQUIRED �OR IAIiRlNC, $e�b����'g����°�al utii ies
hiEATiMG, PLllM$iNG AND StGN�'�55. r����HONE-EI��fiRrC-GAS tc.
� R�r�i:1�R�� ��' t.�?1
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCl FidM@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, �R 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 AND EXAMINED THIS APPLICATION �- STAILS 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 HEREItV OR NOT. THE GRANTING OF A PERMIT $7-2tOOO $F).00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- '72 � OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $
PLAN CHECKFEE TOTALFEE
$%8.��
SIGNATUREOFCONiRACTORORAUTHORIZEDAGENT IDnTe� � HEN PROPE Y VALIDATED THIS IS YOUR PERMIT
a� �ii'J��;�-� - Id�-.�-� � -�a `'Ir�
SiGNATURE OF OWNER OWNER BUILDERI IDATEI BLDG INSP DATE
. . CITY 01� t�iZIl)��:� ,
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A�'i'L I r/;T I Ui� f'Of< (t[=S i i)I=tJT 1/1L �U I LI)1(�!G f'f�(ti1 I TS
���LW, �LTL"R/1ilU(dS, �DilIT10fJS, OR ��f�f'AI(ZS)
0
Ac3dress: (�(03l �A�\ZSo.� Address: ,
. Tel . I�o . � %/ .9%O ?i'
No. : t� � 3 l 5treet : �' R� \.z.s � ►,� .
J..O'P: � BIACY.: �� ADDITIOi�: ��'P.��l�-3 t_IS1�1 i�lS `�N�
CU1211ER T�OT: _y L= 5 IIJSIDE 7AT: S:s`PT37,CY.: SIDI;YIIRDS:
—r----
1�pplicai-,t attach 'to i:his fornl '14�0 �:ertificates of Survey of Lot and proposed
bu�.ldir�g location dra�m on these Geri.ificates. �
D�SCRI PTIO(d QF B{�I LDI I�G
To I3e Used As:
a�A� Front: (�7 Depth: t3�- � HeS.qht: /d
Sc�uare reet: 76g Cubic I'eet: 7� ffU
�
C�h� Fro . � Depth: � Height:
�� . .
Square %�eei�: Cubic Feet.
Type of Construction: �Qt� �M Estamai:ed Cost: $ j�'��v�>
�.b Be Completed: � Alt. A Alt. B
0
Pxt�posed Driveway tti'idfh If New Opening Is Desired $ $ '
(&�L R2;VERSE SIDE OF SHr'ET)
Tlae unc�ersic7ned hereby makes application for a permit for the work herein
s�ncifi.ed, agreeing to do all �.orl: in strict acco�_dance :ai.th the City of
�'x:id.lc�� Ordinunces and rul�igs of the.Ucpaa:ir,:ent oi Buildings, and hereby
declaz�s L-hat all the facts and re�.�resenta�ians si:ated in i:his application
ar� true and correct. See reveise side far aQditional infonnation.
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DAZ'E: �4� S� 5IGNI�TURE c � w�� C£ �e-� �-�---�.
s�.�yu����o��s: �i����. ��;�r� �. a�, ���� �
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�/�i;wh-�c $"�t zo •, �IC�j� �ran'n1Fj S
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STRUCTiJR�L INSPEC'�^IniV RE UII2ED
� ' By ihe City of rriclley i:�sp. Dept.
`` � Of.fice hou.rs are from 8:00 F..M. �� 5:00 P.M. lnspections are scheduled
betweer�. the ht�urs of 10:00 A.M. to 12:00 A.M. and 1:30 P.M. and 3:30 P.M.
Please allow at least four (4} hours advance notice time for scheduling.
` 1.'�k'OOTII3G INSPECTION: When all necessary forms, bulkheads, mesh and
°'�� reinforcing rods are in place but prior to calling for or rnixing
concrete.
�
�: �
l 2� FRAMING INSPECTION: When all structural framing members, sheathing,
v firesto
pping, roofing, and preferably plumbing are complete but prior
to placing siding, finish floors, sheetrocking, and when possible, prior
to insulating.
� FIREPLACE ROUGH-IN: At the time the damper is set in.
(4./INS[ILATION INSPECTION: When all in5ulation, flues, vents, baffles,
`� weather stripping, and vapor barriers are in place.
� FINAL INSPECTION: Prior to occupancy of the structure (even though
some items are incomplete.
!�, �� � � ,�dd��
� i9-�$
,
CtIY Or �RIDLEY
APPLICATION FOR PQWER PLANTS AND HEATING, COOLING, VENTILATION� REFRIGERATICN AND
.AIR CONDITIONING $YSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVIT'Y WARM AIR:
flirnace Shell s Duct Work
Replace�ent of Furnace .
Repairs 6 Alterations-up to $500.00
Re�airs 6 Alterations each add. $500.00
MECFiANICAL WAR.�1 AIR:
FUrnace Shell s Duct Work to 100,C00 STO
each add. 50,000 BTII
Replacexent of Furnace
Repairs & Alterations-up to 5500.00
Rerairs 6 Alterations each add. 5500.00
STFIL�f OR HOT hATER SYSTL-"�t:
Boiler S Lines up to 100,000 BTU
each addn. 50,000 BTU
Soiler only up to 100.000 BTU
each addn. 50,000 BTU
QIL BURYER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BUR\ER- froa 100,000 BTU to 199.999 9TU
�(over 299,999 STU see Fee Schedule)
RATE TOTAL
512.0o S
7.00 S
7.00 S
4.00 $
,
Job Address _��v,31 �����t� /J '
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a pezn+it !or the wsk hezein
$12.00 S specified.aqreeing to do all work ia strict accordance with the City Ca�'es •.
4.00 $ and rulings of the Department of Bulldings, and hereby declares that all th�
7.00 $ ,i Pc� facts and representations stated in this applicat n are true and cozrect.
7. 00 $ '7 • O [� �1 `�
4.00 $ Fridley. Minn. -S o�'7 . 19%
OWNER ��t.�N. S� �\t�.PcS -�----
$12.00 $
4.00 $
7.00 $
6.00 $
$10.00 $
10.00 S
$10.00 $ �D•4 �
S
GAS FITTIhG FEES:
lst 3 Fixtures � f x$ 3.00
Additional Fixtures x S 1.00
Gas Range to 199,000 BTU x$10.00
AIR C0.1'UITIO�ING � ' �
FAN HEATIrC SYSTt�iS sea Fen Schedule
VEyTILATING SYSTEhiS
ALTERATIONS f, REPAIAS
Stete Surcharqe
TOTAL FEE
AOUGEi INSP.
Dete
FIId11L ZNSP.
Date
11PPItdVAL FOR PERMIT �
RSZNSPECTION FEE
(510.00)
$ 3.00�
S
S
S
S
S .50
S.�•�
l4INIMU:4 FEE FOR 71lIY HFATINC FERMIT IS S7. SO PLUS $. 50 STATE SURQiAR�GE
KIND OF' HUILDING ��� l ��' 1JT �(� �
USED AS �O M t
TO BE CAMPLETED AHOUT S�'P`(
ESTIMATED COST
LD - NEW BUILDING PERMIT N0. PERMIT N0. ��
DESCRIPTION OF FURNACE/BURNER
HEJITING or POWER PLANTS, Steam, Hot Water, Warm AiY- No.
Trade Name (�'(Z��.t��T Size No. �
Capucity Sq. Ft. EDR BTU HP
Totul Connocted Load 1Cind o! Fuel
BURNER - Trade Name� �R��� Size No. �
Capacity Sq. Ft. EDR BTU HP
Company
Signed By��v�ni.....� ��Z
• Tel. No. C� I^°t i o�
CITY OF FRIOLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572— 3604
9��� r� �� � �� � � . .�. �31, � � .
�
APPLICATION FOR PLUMBING AND GAS FITfING PERMtT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effedive On January 1, 1998
PLUMBING FIXTURE RATES:
NO. RATE T07AL
New Fixtures
Old Opening, New Fixture
Beer D'+spenser :
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas** �
Gas Range**
Gas Dryer** `
Back Flow Preventer Required ()Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ .50
$
JOB_ADDRESS .3� /��,C��e� ��
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Buiiding Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
� °�� , 1998
Owner O�,f�1� � �//f�%/.rJ./'L�il�
Building Used As
Estimated Cos��T%Q. � PERMIT NO. �� �
__���
PLUMBING COMPANY �� �QT�'� �L.cl��/.t-�lr-
SIGNED BY
Approved By
""�'I'�'L N 0. -�S`/ � 4SS�S
. �
Rough—In Date � Final Date ' � ,".� .` ��
�
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 `°
PLUS THE 5.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PfiOVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 S� INCHES.
sue�ecr P
City of Fridley 283�6
AT THE TOP OF THE TWINS g� { L D I N G P E R M I T
r "V���
RECEIP
� ��7��_ NITY DEVELOPMENT DIV. ��� �
r � � PROTECTIVE INSPECTION $EC.
�
1 . �
`--_- �;�'��;'� CITY MALL FRIOLE� SS�3T NUMBER pEV DATE PAGE OF ACiqOVEO 8Y
i 1� 612-571-3450 9i0-F15 10/22 98 � �
IOB ADORESS
6631 Jackson Street NE
1 LEGA� L07 NO. 9LOCK TRACT OR AODITION SEE A�TACNEO
oesca. 1 4 Meadowlands, 2nd Addition SHEET
2 PROPERTY OWNER MAIL AQDRESS 21P PMONE
Susan M. Martinsen 571-9703
3 CONTRACTOR MAIL ADDitESS 21P PMONE LICENSE NO
Owner
� ARCHITECT OR OESIGNER MAIL ADDR�ESS 21P PHONE IICENSE NO.
5 ENGINEER MAII ADORESS 21P PMONE IICENSE NO
6 USE OF BUILDING
REsidential
7 CIASS OF WORK
O NEW O ADDITION O AITERATION �X REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e(20 S) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAp
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICA�, PIUMBING, MEATING,
VENTI�ATING OR AIR CONOITlONING
TMIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED WITMIN 60 DAYS. OR �F CONSTRUCTION
OA WORK IS SUSPENDED OR ABANDONEO FOR A PEF�100 Of 120 pAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO. OWLG. UNITS OFFSTREET PARKING
1 MEREBY CEATIfY TMAT 1 HAVE READ ANO EXAMINEO iH1S APP�IGATION STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VA�UATION SUfiTA%
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMP�IED ,
WITN WMETHER SPECIilEO HEREIN OR NOT. THE GRANTING OF A PERMIT 1]1L} .HG
DOES NOT PRESUME TO GIVE AUTNORI?Y TO VIOLATE OR CANCEL THE pERMIT FEE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGULATING CON-
STRUC�ION OR TME PERFORMANCE Of CONSTRUCTION 56.75 Fire �JCi 1.71
PLAN CNECK fEE TOiAI. FEE
�
� �-- �-+ /n .�n-�`'".+G"` 59 . 32
S�GHaru EO�CON'AACTOpOp�UTMORiZEOAGENT iO�rE� WMEN PROPERIV VA�IOATED THIS IS VOUR PEF1Mti
V�
S�G E OF OwNEa�i� OWNE BWLDERi � �O�TEi� B�OG �NSP ' ��<<E
M �
NEW [ ]
ADDN [ ]
ALTER [ )
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
, ����
�.� � .,
,
� ConstructionAddress: ��3� T c Xs a,.�: -�cf �/v � ri'L �ro�r� S s`/��
Legal Description:
)( Owner Name & Address: SG�-S'-��' ,1� �J.�`iz j'i�rs�'"� _ ____ Tel. # �� � / ' 4' > ��
�( Contractor: �� t� d- 12{ /� v7 ,�� c MN LICENSE #
Address: Tel. #
LNING AREA:
GARAGE AREA:
DECK AREA:
� OTHER:
Construction Type:
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 Height Sq. Ft. �
Length Width Height Sq. Ft.
Length Width _ Hgt/Ground Sq. Ft.
�
��a o.�i� 5" � � s� j , � 1-•t� - � � .!'o� � 1�r o.f�'
Estimated Cost: $ � � � �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
�DATE: `1-v � APPLICANT: �S'�`I�°`� J� %l?�2P-/�e�G /�° Tel. # s�� l � � a�
.H�
CITY USE Y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��, �S
$ %� %1
$ v��
$
$
$
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1�000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
$ F�e Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ S9. 3a.