AF - 47555City of Fridley, Minn.
BUILDING PERMIT
N° 141
Date: _..._..������ _.._.
Owner: Builde _. _._----•---_.__..__.._._..._._..._..._....._...._...�
Address_.__._.......__. _._._ �.._......_..___.__.._..__..___.._ Address _._..._....._._._...___wW__._..___.__.._._..��.�..._.__._...�.
�oc�►Tip F B
No. ��_ w.w Street _ .. _ _ ... .. �art t ._....�..._.. _
• •--�-- -
. . ._ . _. Addition or Sub-Divisioa �
Lot �.�. Block ._.._..._..._.�.__._. _. . ... _.
._ . �
�.+!
Corner Lot _.__._..._..._....._ Inside Lot ._._.�!!!"'_'"'�___..._ Setback _..{,�.l�-_..._.__._ Sideyard _...1!�_.� .-�...�__..._.. -
Sewer Elevatian _�..__r..._._:._........_...__._._._..__...._.w..__.._..___ Foundation IIevation ._..___ —..�_ ._._..
DESCRIPTION OF BUILDING
T Used •
_ Front Q Depth �...__ Height �.�rc Sq• F't. �.� Cu. Ft ��
_ __ Front ...� __ Depth _� Height _ SQ. Fk _�� Cu. FL �•���
Type o nstruction �.._: ._. . _ _.__ Est. Cost ._�..3.��o be Completed _.._....._...�..:
� ___._
In consideration of the issuance to me of a permit to construct the building de�cribed above, I agree to do
th� proposed work in accordance with the description above set forth and in compiiance with alI prov3sions of
ordinances of the city of Fridley.
�
In comsfderation of the payment of a fee of �...�. """ ., permit is hereby granted to._._
to construct the building or addition as described above. This permit is gi'anted 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 upon said building, or any part thereof, shall conform in all respects to the ordinances o�
Fric� ey, Mix�nesota regarding location, construction, alteration, maintenance, repair and movinS of buildings
within the city limits and this permit may be revoked at a�y upo� vio1� of any of the provisions of said
ordinances. �w /1 ,/ 1
Buiidin8 InspeMa�
NOTICE:
ihis p�emif do�s nef eewr fM eomMucHee, hu1a11Nkn fer �rM�W Mlu�nbhiY. �a I�N�, i�+rw� er �rabr. !� wer te s»
fh� BuiWing Intp�� for »puah p�nails for fh�» fhna.
., � . . .r .
�
• �, k � _ e
APPLICATION FOR BUILDING PERMIT
CITY QF FRIDLEY, MINNESOTA
Owner's Name Builder �
Address Address
LOCATION 01� BUILDYNG
No. Street Part of Lot
Lot Block Addition or Subdivision
Corner Lot Ynside Lot Setback Side-Yard
�EWI3R ELEVATION FOUNDATION EZEVATtON
Applicant atCach to this form Two Certificates of Survey of Lot aad proposed
building location drawn on these Certificates.
To 'be used as:
DESCRIPTION OF BUILDING
Front Depth �Height
Sq. Ft. �Cu. Ft.
- Front Depth Height
Sq, Ft. Cu. Ft.
Type of Construction Estimated Cost
To be Completed
The undersigned hereby makes application for a permit for the work herein �
specified, agreeing to do a11 work in sCriat accordance with the City of
Fridley Ordiaances and rulings of the Department of Buildiags, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATS SiGNATURE r (/� /
(Schedule of Fee Costs can be found oa Che Reverse Sid .
s ♦ s R • •
n. . . t
City of Fridley
App�licafiian for P"lumbing and Gas Fitting Pern�it
Dep� of Bldgs. Phone $U 4-7470
DESCRIPTION OF WORK �-� .p! �
Number, Kind and Location of Fixtures Locsiioa L
? t i WATER HTR.
� p ��� � m i2 Z�; � n� 3 S Q����Z `� °' � Z 7 a R N GAS ELEC.
3d �' �° x � gm <3 c�� c�� c�o
Base _ _
lst
2nd __ _
3rd _
4th
• Fuiure Coax►ectioa Opes�ings Connected wilh
1 3ewer �
* New Fixture, Old Opeaiags ��pool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . .� x $1.50 $ � D
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... . ..................... x 3.25 $
Water Heater (Up to 200,000 BT[J) ......� x 2.00 $ -1+��
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEE$: NO. RATE TOTAL
ist 3 Fixtures . .. . . . . . . . . . .. . . . . . .... . ..�— x $1.50 $___J.�Z—
Additional Fixtures .................... x .5U $
Gas Range to 200,000 BTLJ .............. x 2.00 �
REPAIR3 & ALTERATIONS—Refer to Code
Description................................................�
TOTAL FEE $—!��
City of Fridley:
�
��
�
�
The undersigned hereby makes application for a permit for the work herein
s p e c i f i e d, a g r e e i n g t o d o a ll w o r k i n s t r i c t a c c o r d a n c e w i t h t h e C i t y O r d i n a n c e s
and ruling of the Department of Buildings, and hereby declares bhat all the facts
and representations stated in this application are true and correct.
/J Fridley, 1VIinn _�.1�� � � , 19��
Owner
.
Kind of Building
Used as �� =° �D '
To be completed about �`'z"' "�' Z -- -
Estimated Cost,
Old-1Vew. Building Permit N
�-
ROUGH
FINAL
a z sM �-ss
Business
No. � �
f). �
Application for Power Plants and Heating. Cooling. Yentilation� Re#rigeration and
. Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . .. . . . . . . . . . . . . . . . . 8.00 $
Replacement of Furnace ............................. 5.00 �
Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . 2.50 �
MECH. WARM AIR
Furnace Shell & Duct Work to 12d,000 BTIJ . . . . . . . . . . . .
each add. 60,000 BT[T .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $50U.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. $500.00 . . . . . .. . . . . . . .
8.00 $ ✓
2.00 �
5.00 $
5.00 $
2.50 $
3TEAM or SOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. FDit Steam .... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURIvER—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 R.ange to 200,000 BTU . . . . . . . . . . , x 2.00 $
AIR CONDITIONING a
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM �-1 ' \
ALTERATIONS & REPAIRS TOTAL FEE �
ROUGH
FINAL
Dept. of Bldgs. Phoae $U 4-7470
0
�
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.
�-, F`ridley, Minn. �� v, � , 19 6 7''
Owner � �--�
Kind of Buildine
Used as
To be co
Estimate
w. �uilding Perxnit No. �� ��/ Permit No. '-�'°7-�f�ir—
DESCRIPTION OF WORK
HEATING or WER, PI�ANTS-�te , Hot Wate Warm Ai • No. �
Trade Nam� '��'�`-�'��� Size No.���L � d
Capacity Sq. Ft. E.D.R. BTiJ H.P.
Total Connected Load `�' �. v`�' � Kind of Fue ��--'
BURNEft — Trade Name Size No.
Capacity.
(REMARKS—OVER)
��oaz YM
Sq. Ft. E.D.R. BTU H.P.
RAY N. WELTER HEATING CO.
Signe
46 •
gy_��M��P�LIS 7. MINNE50TA
Business Phone No- � �� � �� �
SUBJECT PERMIT NO.
City of Fridley o - -
A7 THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� `�. ----- � ,/
r j � PROTECTIVE INSPECTION SEC. D y
1 i /
I
1 � /���1 � CITY HALL FRIDLE� 55432 NUMBER fiEV. � DATE PAGE OF APPROVED BV
� ----�: �.' 612-571-3450 9�0-F15 7-31-79 / /
�os aooRess 529 Janesville St. N.E.
1 LEGAL LOT NO. BLOCK TfiACT OR AODITION SEE ATTACHEO
oesca. 11-14 B 1 E Riverveiw Heights SHEET
2 PROPERTY OWNER MAt� ADDRESS ZIP PHONE
529 Janesville 5t. NJ�. 786-5291
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
4 AqCF1l7ECTORDESlGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO.
6 USE OF BUI�DING
Gara e
7 CLASS OF WORK
❑ NEW ❑ ADDITION �] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOFK
Ex and ara e and t w f
9 CHANGE QF USE FROM TO
STIPULATIONS
1. Use treated bottom plates
2. Install �" anchor bolts at 6' O.C.
3. Remove all sod fro�n �der slab
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPAfiATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. OOC�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AU7HORIZED IS NOT COMMENCED WITHtN 60 DAYS, OR IF CONSTRUCTtON
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT j�l 1
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDiNANCES GOVERNIMG THIS TYPE OF WORK WfLL BE COMPUED
WITFi WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY 07HER STATE Op LOCAL LAW REGUL.ATING CON- �
STRUCTION OFi THE PERFORMANCE OF CONSTRUCTION. Q,
PLAN CHECK FEE TOTAL FEE
r �
r�
NATUREOFCONTRACTORORAUTHOR12EOAG NT IDATEI WHEN PROPERLY VALiDATED THIS IS YOUR PERMIT
� . � r7" ?-�/ - 7�
SiGNAT F OW il E BUILDERI IDA 1 BLDG WSP �A7E
CITY OF FRIQLEY
APPLICATIOf� FOR RESIUENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWN�R: ��j�_��O/PZ�lU6L,cJS l�J BUI LDER :
ADDRESS: Sc� � �'���SU/L�.�'].� ADDRESS:
TEL iVO: � Q 6—���' � ' TEL N0:
. Construction Location
STR�T NO: �p STREET: �����L� �' S I• !V * C-
, r
LOT: � — � � $LOCK: � � �- ADDITION: ,�}�)lt) 4.c � Q.tc
T
Corner Lot: Inside Lots � Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOtd OF CONSTRUCTION
r � �
� t Front: � Depth: a� � Height:
� Squa.ne Feet: 1 7� Cubic Feet:
Front:
Dept1�; H eight:
Square Feet: _ Cubic Feet:
C��� �� � �,� �,-, $'
Type of Construction: �1�-� � Estimated Cost: $���'O
�-
Zb Be Cbmpleted. � • �� /� %�
Proposed Driveway Width If New Opening Is Desired:
Alt. A Alt. B
$ $
SEE REVERSE SIDE OF 5HEET'.
The undersigned hereby makes application for a permit for the wnrk hexein specified,
agreeing to do all worlc in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildinqs, and hereby declares that all the facts and
representations stated in this application are true and correct. "
�
DATE:� v� SIGNATUF�:
Stipulations : �,�
;� �` �,��
�,� �c
n `/
1��� �� ✓ ' �J
.
� �
9.�J
��.
,. �Z �
� • �
� C�,� , � �
� ������
�. .
.�
,. �._..___�...� ._....�._....�.�..
__._ ;.._.w-- --, .._
� i � �
/ } �
I``i� . � � �
. .- - - -- _ -- � : ;
, . �
i i
. ;
� . �
, � i
, , j
�
� _
i W
�
� I
� i
I ; i
i ��c�
� —
1 . . ...1 .._ ��
� i
( � �
J {
1
� � i
�� i �
c
�
�
,
I
'
'
a
�
,
{ �
�
_ ; �r }
_.. .y._ .-�----1----•i _�
i � `� �
� � j � �f
��_ . _.�.�I _=-----
i
; � � �
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 Universiry Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residentiat
Furnace Shell and Duct Work, Burner -
Also Replacement �urnace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
Rate
$ 20.00
JOB ADDRESS �Z.�I ✓ F� �tl £ SfJ/G G� �7- N�
The undersigned hereby makes application for a permit for the work
TOTAL herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
$�� = that all the facts and representations stated in this application are
true and correct. ��^' � % ,1991
$ 10.Oa $
$ 10.00 $
$ 10.00 $
*Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1�/o of Value of Appliance or Work � $
CommerciaUl ndustrial
1% of Value of Appliance or Work
State Surcharge
TOTAL �EE
$
� .50
O
$_�
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR COND�TIONING PERMIT IS $15.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTION FEE $30.00
OWN
BUILDING USED AS �i�'4/{'C�
ESTIMATED COS� �� � PERMIT NO. �l � j��I
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_�. Circle One (Steam) (Hot Water) arm Air)
Trade Name �D�f��`T'./���+�C� Size No. �U� O
BTU G HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANYf
Signed By ,,���
Approved By
�
�z -- �,� �'
Rough-In Da inal pate /'O /7 ` 1�
*Air Conditioners can not be placed in a side yard withoui
written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACR VERIFICATION
The undersigned hereby vexifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. Has no foreign objects lodged within
4. Is securely supported
5. Meets all current Code requirements for
size and total BTU!s connected
6. Has total heating BTU's of��� pop
Al l other BTU' s �� _ C7 d C7
—�
TOTAL BTU's ��� O�a
Remarks
Yes (� No ( )
Yes (� No ( )
Yes �j No ( )
Yes f�c�` No ( )
(`
Yes (� No ( )
List Alterations Beinq Done:
HEATING COMPANY ����� ��
Signed By ���- �,
T
Date `'� `--,,��- ��
• �
SuB�ECT
City of Fridley
AT THE TOP OF TME TWINS g U I L D i N G P E R M I T
r
� .
� �
� ; v ___._ COMMUNITY OEVELOPMENT OIV.
r � � PROTECTIVE INSPECTION SEC.
� _ .
� �""1 � CITY MALI FRIOIE� 55132 NUMBEN
�"'"��� ,'� 612-571-3450 9�0-Ft5
�oe Aooaess ��'a � �n A �
.IGrv
t LEGAL �OT N0. BLOCK TfiACT Ofi ADOITION
DESCR. 1Z,12,13,1 E Riverview Hei
2 PRO ERTY OWNEF MAII ADDRES$ ,
S Larx
J CO 7RAC70 �All ADDRESS 4,901 ZOS�7
c
�j
4 AR MI?ECT OR DESIGNER MAIL A ORESS
5 ENGINEER MAII ACORESS
pEv
O�TE
8/10/99
NE Circle PfY�
55014
IIP
21P
VAGE Of
/ /
'30038
� v /
RECEIPT NO.
`�� �
�PVROVEO 9Y
SEE ATTACMED
SHEET
E
PNONE
pMONE
LICENSE NO
�7%
LICENSE NO.
LICENSE NO
Residential
7 CIASS OF WORK
O NEW O ADDITION � ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (24 Sal Tear-off
9 CNANGE OF USE fROM
STIPULATIONS
TO
Underlayment must comply with the State Building Code.
TYPE OF CONST
SEPARA7E PEfiMITS ARE iiEQUIqED FOR ELECTRICAL, PLUMBING. MEATING.
VENTI�ATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NUIt AfVD VOIO IF WORK OFi CONSTRl1CTION ZONING
AUTHORIZEO IS NOT COMMENCED WITMIN 60 OAYS, OR IF CONSTpUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOR A PER100 OF 120 DAYS AT
ANV TIME AfTER WOfiK IS COMMENCED. NO OWLG. UN
I HEFEBY CERTIFV TMAT I MAVE REAO AND EXAMINED TMIS APPLICATION
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION
ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMPLIED
WIT►i WMETMER SPECIFIEO HEREIN OA NOT. THE GRANTING OF A pERM1T 2098
OOES NOT PqESUME TO GIVE AUTHOiiITV 70 VI A7E OFt CANCEL THE pEqMIT FEE
PROVISIONS OF ANY-OTHEi: STA7E OR LOC � W REGUTATING CON- .
STRUCT70N OR N PEAFORMANC CO C710N 83 25
� r- PIAN CMECK fE
S�GN�TU ON'�1 . Op N i AGENT ID�TEi N
��S�GNStUQEOaOWNEQ���OwNEABw�DEQ� �O��E� ii�llf. �a:
OCCUPANCVGROUP OCCUPANCV
S�. fT CU FT
OFFSTREET PARKING
STqLLS GARAGES
SURTAX
1.22
SAC CMARGE
i
T AL FEE
1
ALV ATED T IS VOUp PEA iT
/ �j�l „�,E�'
.
NEW [ ]
ADDN
ALTER
.
Effective 5/10/99
[ l CITY OF FRIDLEY
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
Construction Address: _
Legal Description:
Owner Name & Address:
�
Contractor: �
Address: � '7
LIVING AREA:
GARAGE AREA:
DECK AREA:
01'HER:
�� �a
�•
�� - \
�
MN LICENSE #
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
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �C- � �� � �� �} � Estimated Cost: $ � �
�p .
Driveway C�rb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ �
�Q% � �c
f
DATE: ` APPLICANT: � ��U � Tel. # � �r �.. -- .
� 0�l�.��
as�
CITY USE ONLY �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ .�,o�.�Fee Schedule on Reverse Side
$ S .001 of Permit Valuation (1/lOth%)
$ � � � $.50/$1,000 Valuation
$ /— $1050 per SAC Unit
$ _�'l,a $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 [ ]
TOTAL $ •
q�� q�
STIPULATIONS:
e