AF - 47668•
�
Date:
•, :
�
City of Fridley, Minn.
BUILDING PERMIT N� 6 5 5 4
:.. �����'�
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[�.e� ._.. _. . Builder ...w. ____. [._...._....._._._. _._.
Address ___._.�_..�._._.___._ __._____..__._.._...._._._ Address
���� LOCATION OF UILDING
No. _ ... _. treet _�,��,��-��L� -�-� �P of Lot _ __.. ._�
Lot ....._....,I�_..____ Block _._�_.....�..._.._..._.._.._. Addition or Sub-Divisi� .. _ . . . � .t�!� �
Corner Lot ______.__._ Inside Lot __ R�� .__ Setback ...�._._._..._._ Sideyard .__._�.___�.t._ _.._..._
Sewer Elevation
Foundatian IIevation
DESCRIPTION OF BUILDING
To v�a r
�. ' l��� /� �y�/[
.- _ Frant ..... ��...�.�Depth �_ ...._ Height ..�.__..�..�_ . Sq. F't �l1�Cu. Ft !'LI.L..ffd d
. _ Front _�..�.: � Depth _._�. I�eight ��...� Sq. Ft. _..,���..�Cu. F� _�o���
_ .
Type of truction .����..�.._:_�'._� ..__.. Est. Co .�,�,l.._�,.�1�To be Coanpleted ..�..
In consideration o! the issuance to me of a permit to c�
th� proposed work in accordance with the d�scription above
ordinanoes of the dty of Frfdley.
In co�sfderation oP the payment of a fee of
in
permit is hereby
I agt+ee to do
ornvisions of
to— _ _---
to construct the building or addition as described above. This permit is Sranted upon
the exAress condition that theperson to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said buildin or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location,gconstruction, alteration, maintenance, repair and moving of buil �"
within the dty limits and this permft may be revoked at any t�e u��on of an,y of the provisioas of sa�d
ordinances. / �1>a
Buildin8' InSpeCta�
• NOTICE:
ihis p�eniil dea aot eowr Na eonslrveNoe, ts�all�Hon ter wWsY. P�Y. Yas bwtM�, t�w�r er wN�r. d� wn M s»
fln dutldino Imp�elor for np�rat� p�naiq fer fh�n il�s.
„ � �/
4�7PT.''�. S NAME `/ C
APP'LICATION FOR BUILDING YERMIT
CYTY OR FItI�,EY, MTNNESOTA
0
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L
AI3D���S ADDRBSS � 7'� �/�—� �/�L /� G�
LOCATION OF BUILDING
No. �� Street � �'1 �. �� part of Lot
Lc� � Block � Addition or Subdivision /�/���O�tlLi��(/p.f Z h�`
�, .�
Corner Lot Inside Lot � Setback -� � Side-Yard J
SEWER ffi,EVATION
a � � FOUNDATION BLEVATIO*1 ` �� � '
Applicant attach to this form Two Certificates of Survey of Lot and proposed bui�.d-
ing location drawn on these Gertificatea.
DESCRIPTION OF BUILDING
To be used as:
.
�`►�°`zt £� " Froat Depth Seight.
� Sq. F�. Cu. Ft.
� �"�""� � Front Depth Reight
Sq.. Ft . Cu . Ft .
Type of Constructfon � Estimated Cost
To be Completed � . / _ � �
The undersigned hexeby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances �nd
rulings of the DepaxtmPnt of Buildings, and hereby declares that all the f&cts aad
representations stPted in this application are true aad correct.
�... r
DATE � - I/ _ � � SIGNATURB ;
(�credule of Fee Costs can be found an th��Reverse Side).
�..��i • � .. �
City of Fridley
Applic�ation for P`�umbing and Gos Fitting Permit
Dep2. of Bldgs. Phoae SU 4;\
DESCRIPTIOTT OF WORK n � ��
Number, Kind and Locatioa of Fixtures Lxatio
U�' WA7ER HTR.
y� y� �
� � Y = N Y Z K � Z V Z Q S W Z r �
;� ��� �? 3� o� � g� c��.<'3 �g �� c`�ao s N cns ELEC.
Base t � � [
lst
2nd
3rd
4th
• Fuluze Connsc3fon Openings
* New Fixture, Old Openings
PARTIAL RATE SCHEDULE
3ewer ❑
Cesspool j'�
PLIIMBING FI]CTURE RATES: NO. RA1"E TOTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . .� x $1.50 � v � O
Future FYxture Opening . . . . . . . . . . . . . . . . �-- x 1.20 $ °'Z � U
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... . ..................... x 3.25 $
Water Heater (Up to 200,000 B1'in ......�x 2.00 $� � a U
New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .......................... ,1— x $1.50 $ / •�'S�
Additional Fixtures .................... x .50 $
Gas Raage to 200,000 BTU . .. ........... x 2.00 �
REPAIRS & ALTERATIONB—Rafer to Code
Description ................................................$
TOTAL FEE 5�=�.c-..�-U
t�
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 that all the fact
and representations stated in this applicatio are true and correct.
Fridley, Minn � , 19�T
Owner �/-�./D
Kind of Building
Used as
To be completed about —
Estimated Cost, $
Old New i ding Permit
n ,43
ROUC3H + � I
FINAL
� a a �I„1
��
By ��
Business Phune
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0
--cJ t 5`� 7
✓
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Application tor Power Plants and Heating, Cooling. Yentilation. Refrigerafion and
Air Conditioning Systerr�s ond Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ...........................
Replacement of �rnace .............................
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . .
Repairs & Alterations each add. a500.00 . . . . . . . . . . . . . ..
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTCT . . . . . . . . . . . .
each add. 80,000 BTU .......................
Replacement of Furnace .. . . . . . . . . . . . ... ... . . .. . . .. . .
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . .
Aepairs & Alterations each add. $500.00 ..............
AATE TOTAL
8.00 � • �l�
5.00 ;
5.00 $
2.50 $
8.00 $
2.00 ;
5.00 $
5.00 $
2.50 $
�TEAM or HOT WA1'ER SYSTEM
Fumace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $
y 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 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 $ < <% v
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ...................... x$1.50 $ 1, �5�
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONIMG � �`f �
FAN HEATING SYSTEM See Fee Schsdule
VENTILATING SYSTEM a
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH
FINAL
Depi. of Bldgs. Phone SU 4-7470
City oP 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.
h � F`ridley, Minn. �— � L% , 19 4�
Owner
Kind of Suilding �,� �g- p -
� _ �, _ .
Used as
O '
To be completed about _�.� � �
Estimated Cost, $ � 5.����
Old New uilding Permit No. � Permit No. �-� �`�'J
DESCRIPTION OF WOAS
HFATING or�ft PI.AN15—Steam, Hot Water, Warm Air—No.
Trade Name � Size No,�L.� %D ,�
Capacity Sq. Ft. E.D.R. � BTLT H.P.
Total Connected Loacl ���.. �� 3 Kind oi Fue �q
BURNER — Trade
Capacity
(REMARKS-OVER)
a�q�, � sM
Size N
Sq. F`t. E.D.R. BTU H.P.
�� � ��
� �G
Signe
: � s�,���r h��r�c
By_ 8419 CENTFR i;,.',��
MINNEA�tIS �2, i's;ii,i'��ES;;TA
Business Phone o-
, __. �C�v � ^ � �� .- y � ' . . .
IrORM BD
HEAT LOSS CALCULATIONS BUILDIN� DEPARTMENT , MINN.
Weatherstrips A. .H.V Constrnction No. Insulation
Guide
`;�'ndows I ra Reference Out. Wall Int. �Vali Ceiling Roof F1oor K;nd How Appli«i
es No Y No 19T
F7.� '' oom Length '�'didth l'Height �� Fl.j _ Room L,�agth j � Wis�th � Height �
Winc�ows and oors—Cracisage and Area Windows and Doors--Crackage aad Area
W1dth Hetght No. of Lfaeitt ft, brea Wtdth HeigLt tQo. ot Llneal tt Area
No. ot pane ot Da�e � Ilvhta ot crack sq. LQ , No. of Dane ot DRne ltghts of arack s�: LL.
V 0. J , � � .
� �0_.,, _ � � �. /_ � ia � �_ d _
Cocf. &n
Infiltration
Glass ~
F�cP. wal�
Net exp. wall a
Int. wall
Floor
� Ceil. �
Total Btu. �
Required sq. ft. E.D.R. or sq. ins. W:A. Leader area
Fl.) ` Room � Length �� Width � Heisht
Windows and Doora--Crackage and Area
Width HetBht No. oL LI4ea1 ft. Area
No. of pane ot yane lighta ot crack eQ. tt
,a � _�� .
� d
� � „ �
_ Coef. Btu
Iafiltration
Glass _
Exp. wa11
Net exp. wall % t
InG wall
Floor
Ceil.
Tota! Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader arca
Fl. Room � Length � Width �'
Windows and Doors—Crackage and Area
WWth . Height No. 01 Lineal fL Aroa
No. of yane ot pane llghts ot Crack eq. fQ
fi .� / ?i /
n. � O� � 7. / 1 P',.S/ as ��
Yn6ltration I
Glass ,
Exg�. wall
Net exp. wall
Int. wa11
Floos
Ceil. .�
Total Btn.
Required s:�. ft. �.D.R. or aq. ina. W.A. Ltader aren
Coef. Btu
Infiltration • i
G1ass
F�. wall
I�iet eacp. wall –
InG wall
Floor
c.�. l
Total Bt�.
Required sq. #t. E.D.R. or sq. ina W.A. Leader ana�
Fl.I Room � Length // Width f Height �' �
Windows aad Doora---Crackagt and l�rea
V✓tdtD Helght No.'oL Lineal it. Ares
No. of pane ot pane lights oi Crack q. [�
Infiltration
Glass
Exp. wall
Ide! exp. wall
Int. svall
Fioor
Ceil.
!G�',7■
Tota� Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. L.eader area
� Fl.� Room 1 I.ength � Width � Height �'�
Windows and Doors--Crackage and Area
Wldth Hefght Na ot Llneal fQ Area
Na ot pane ot�pane 118hts oL crack sQ. iG
Btu
7 9�- Infileration
�� °S'_ Glass
�_
Exp. wall
�i7`_ Net exp. wall
r_
Ia� wall
Floor
��
rG il Ce�7:
�
�
Btu
I� Total Btu. _ �••:
f Req�:ired s4. ft. E.D.R., or sq. ina. W.A. I.eader area ,
-- � �
APpLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME :��2Y �H � L` � BUILDER: ��m L
ADDRES S:���CI� N A� l � N�� ADDRES S:
NO•. STREET• �
LOT : -�. BLOCK : 3 ADDITION : ��� 0 W L� 1� OS ��p laD�,
COKNER LQT: INSIDE LOT:�_SETBACK: SIDEYARD:_
Applicant attach to this form �ao Certificates of Survey of Lot and pxoposed
building location drawn on these Certificates.
f3ESCRIPTION OF BUILDING
' To Be Used As: 1
p � ,� J /1
6�'� Front : il� � Depth : ? Height :
Square Feet:
Front• Depth:
Cubic Feet•
Height:
Square Feet; Cubic Feet:
c �
Z�pe of Construction: Esti.mated Cost: $ J4 ��
To Be Completed:
The undersigned hereby makes applicativn for a permit for the work herein
�r��iiii-c.34y agreeing to do all work in stTict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares'that all the facts and representations stated in this application
are true and c�rrect.
,
DATE: � Z SIGNATURE• �`
(See Reverse Side For Additional Infox7nation.)
SUBJECT
c�ty of Fr�aley "�- 17 6 0 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
r
; � R CEIPT NO.
� • COMMUtJITY DEVELOPMENT DIV.
' jV ������, �
r � � PROTECTIVE INSPECTION SEC.
1 � �
� � � ��'�'1, � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� '""�� �J 612-571-3450 910-F15 / /
7/13/84
�oa AooRess 6740 Kennaston Drive N.E.
LOT N0. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. 2 3 A'IP�OZd,IlCIS Znd Addition SHEET
2 PROPERTY OWNEFi MAiL ADDRESS ZIP PHONE
Gary Munson 6740 Kennaston Drive N.E. 574-9694
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Gary Jansick dba Jansick 6480 Squire Drive, Fridley, NIld 55432 574-9679
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW C� AODITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 16' x 20' Living Area Addition and a 17'6" x 13'9° Garage Addn.
9 CHANGE QF USE FROM TO
STIPULATIONS
Provide fire alarms in sleeping area.s and bas�nent of existing house.
WARNING
$�fOt@ digg,i�tg Call lt�l ��E��F2s SEPERATE PERMITS REQUIRED FQR WIRING.
T����Q[�E-E�.E�R�-�kS Etc. HEATING. PLUMBING AND SIGN$.
REQ����ED BY LAW
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIREO FOR EIECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITiONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHOFIZED IS NOT COMMENCED WITHIN 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 OFFSTFEET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �.. STA�LS 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 $18,650 yS9.33
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 57-34. SO None
, PLAN CHECKFEE TOTALFEE
-/�o- 33.83 � $177.46
REOFCONTRACTOR R HORIZEDAGENT IDATEI EN PROP L I T THIS IS YOUR PERMIT
i �r
GNATURE OF OWNER iIF OWNER BUILDER� �DAT[-�' � lDG �NSP DA7E
NEW [ �
City of Fridley Effective 4/1/84
ADDN. � �R-1 AIiD R-2
AL,TER. [ l Building Permit Application
Construction Address : �a %'� � Il '� %) h a 5 ' " - "
Legal Deseription: t r�i �,� �l_._�� %�l� � r7 LA-�t�S �-�+.� AIJ
Owner Name & Address :�' A-�' y mu � s e-�� �07� o K.e � ha s�-� ' Tel .#�� �� 9� p�
Contractor: �a"►"� G�S' �� �Bf� Vqv1�i �� �� Tel. # s�7.�
� . , i . .. �
Address:
LIVIPG AREA:
GARAGE AREA:
DECH AREA:
OTHER•
-e
�•
Attach to this application, a Certificate of Survey of the
lot, with the proposed construetion draWn on it to scale.
DBSCRIPTION OF IMPROVSMENT
Length " Width 2 �� Height Sq. Ft.
Length ! 7� �` Width �_ Height Sq. Ft.
Length Width __ Hgt/Ground Sq. Ft. �_
1j,ci�L �' � Co�1i� � _
Corner Lot'[ � Inside Lot � Ft. �d. Setback Side Yard Setbaek
Type of Construction: � 1'a�n'�! -� o o cL Estimated Cost :#
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: � �
See Back Page for Explanation
DATE: z-
Permit Fee
Plan Check
State Sureharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
APPLICANT: C.� �PC/ �Gi n S J C./C Tel .#��'=9�79
CITY IISE ONLY
$ I .� Fee Schedule on Reverse Side
$ 25x of Building Permit Fee
$ �.50/$1,000 Valuation
$ �425 per SAC Unit
$ Fee Determined by Engineering
� Agreement Necessary [] Not Necessary [ 7
$ �
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sue�ecr PER .
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City of Fridley 2 0 6 2 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� • COMMUNITY DEVELOPMENT DIV.
� � �: -----
�/li S._
{ � � PROTECTIVE INSPECTION SEC.
� � /'��1 � CITY HAL� FRIDIEv `jS4$Z NUMBER REV. DATE PAGE OF APPqOVED B�
�'""'� � �'� 612-571-3450 910-F15 10/15/90 � �
JOB ADDRESS 6740 KennastAn Drive N.E,
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2 3 Meadowlands 2nd Addition SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
Gary/Karen Munson 6740 Ksnnaston Drive N.E. 574-9694
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Beitler 8uilding S:yste�s 21789 Old�ield Avenne N., Scandia, MN 55�73 433-5802
4 AFiCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
6 USE OF BUILDING
Res ident ia,l
7 CLASS OF WORK
O NEW ❑ ADDITION �l ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace kitchen catzinets.
9 CHANGE OF USE FROM TO
STIPULATIONS
S.ee. notations. on plan
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTHUCTION 20NING SO. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTHUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEfiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UAT�ON SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED $'] �4Q0. $3. 7Q
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOI.ATE OR CANCEL THE pEqMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $g�.OQ ire SC $%.4Q
ST N OR THE PERFOfiMANCE F CONSTRUCTION.
PtAN CHECKFEE TOTAIFEE
L � /�' �-/s- ya io.lo
� i N EO CON'RACTOAOAAUTHOR4EDAGENT IDATEI WHE PROPE Y A ED IS IS YOUR PERMIT
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SiGNATURE OF O�NNEA i�F OWNEA BU�LDEN� IDATEI G�NSP �1ATE
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Oonstruction Addr��,s:
Iegal Description: _
Owrier Name & Ac]dr+ess:
Oontractor: y� OJ,
T.i.i , c.7.� i �/ / a
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r� • • h • •���
��aw• � �.
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R-1 AND R-2
Buildir�g Permit Applicatioaz
- .,
A
Effective 8/16/90
��
J �e1. # 37�l-y'69�
�, # h�33-,s 80 2
�v, �.J,(�. ��0l3
Attach to fh,is applicatioal, a Dertificate of S�tvey of the
lat, with the prq�ed ca�stnicti� drawn aaz it to scale.
�IPTI�1 O�' Il�ONH�TI'
Ler�gth Width I�eic�t Sq. Ft.
Le��gth Width H�eight Sq. Ft.
L221C�1 � ` k1]�t11 �GrOA]1'1C1 SQ. F't.
Corner Iot [] Inside Lo�t [] Ft. Yd Setback Side Yazd Setbacks
Zj�pe of O�nstruction: Fstiunated Oost: $ �h�-�� °�
Approx. �letion Date: `/ %5 9v
Pro�osed Driveway Width If New Ope�vrig Is Desired: Ft. $ $
Width + 6' See Bac�c Page
L1ATE: D i! D APPLICAN'I': , Z�e1. # h�� �-�8 � 2
CITY IISE �Y
P�eYmit Fee $ �
Fire Surcharge $ ���
State surch,arge $ �'�i tl
SAC c�arge $
Driveway Escraw $
Park Fee $
sewe.r rRain Charge $
. �.
sri�oNS:
s �14
Fee �le ori Reverse Side
.001 x P�ermit Valuation (1/lOth �)
S.so/S1,000 vaivatiar►
$60o per sP,c vnit
Alt. "A" or Alt. "B" �bwe
Fee Det�e�nined by �gineexir�g
�ent N�essa�Y I ] � N�LY I ]
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572- 3604
Basement
Floor 1
Floor 2
F1oor 3
Floor 4
APPLICATfON FOR PLUM8ING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLUOR
��th `: Wash p�irik;'.:;::>::: Floor >G�tGi�::::::: Auto.
Urinal Tu:4� `: Shower :S[nk ` Trav �o�ilat..... :: Drain 8as.in Washer
P�UMBING FiXTURE RATES: NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank�
Water Treating Appliance
Water Heater -Electric
Water Heater - C3as** 1 .
Gas Range**
Gas Drye�** �
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.o0/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.596 of Value of fixture or Appliance
State Surcharge .50
�
TOTAL FEE $�QrJC�
Effective On January 1, 1997
Gas ,M:i.�c,i;;.; ater
Ranae �Fixt. .:: !: Gas
Elec
i N
i1UN�;l�(�i �;AR�` ; �
r�,a�? f�'ENMN -:TC�h� ��R I UE N��iRTHER� T F�_
JOB ADDRESS_ �F� � i�i.E`.` �54::,� s 7� �y 0°$�
� ��'�-�;�::+=i a 572-��12� C7� yuS
The undersigned hereby makes application for a permit for the work herein �jw��Z
specified agreeing to da ali work in strict accordance with the city codes
aa�a�
and rulings of the Building Division, and hereby declares that all the facts ��a��
and representations stated in thi, application are true and correct. �Q���
NORBLCt.1 i'�dJA16."!3 �O. ����;od
DBA VENTCO�p►PPLIANCE IhiSTALLERS � �� p i 99�� �-"Z
(612) 827-4033 �
�gp5 AARFiELD AVE. SOUTH ay ��
__Own�tNNEAHOLIS, MN 55408 ' �
G
Building Used As
Estimated Cost ��'v� PERMIT NO. / `;`�'�
__� .NORBLOM PW�ABINO CO. � -,
P LU M BI N G C{� M P/4NY . DBA VEN1�/MpJA1i1LF INBTALLERS
SIGNED BY
ApproVed By �l( .I if� Rough-In Date
TEL N0. �Z7 7 U� �
Final Date
**COMBUS110N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SGl INCHES.
�
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cm� o� ��r ��s�cr�o�v onr�oN � t,.;� �`} `'� � ` ..`
6431 Univen�ity A+re NE
Fr�dI�Y� NAd 55432 AP�'LlCAT10N �R P0114ER pLANT& AND HEATINQ, aUOIJNG, VEN71lATiQIY,
5J2-3&04 {iE��iATION ANp AIR OOI+DITIO�lING �y'YSTEMS AND DEYICES
i♦:�� �
fiesiderit�l
�t�n� SneN arxJ Dtu:t1'Ua�, Bumer —
A� ReplacemerN F�rrraQe
(Side Ve� — �iA O�t Be�
�' Y'� l�a9d w�il �eM► �JmaCej
Gas Range
Gas Dryer
*Ait Condit�r�ing — AA Sines
�_,��� �airs & A�eta�o ns (UST pV qAC�(j
Ae
196 0! Y�e of � or 4Yrotk
Comrnenisl�ndtJ�(�?
1.259G ot Y� af A�plia�e nr 1Mork
l� �-�-'l�'�-�
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Rste � TOTAL
$ 30,00 $
� i Q00 �
s �o.00 s
s,o�o s
$ 25.G0 $
$
9tat� S1ii `c.l�tge
TOTAL FE�
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'�raortidticx�rs c.ai1 t�at bs pl�ced i1 a sic� yard Yvl�olt
� p�mis�or� fiom �aninp P�oP�y �
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�ilective On January 1, 1�9T
�r •�i-� ' �
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The ����Y �s ap�Nca�ion ios a petmit for the wr>rk herein
s�c�fied egreeing b tb af! v�ark in strict acca��laryce �f�h the Cfty Cades and
��ings athe a�, Dlvls�,, and r�re�y aeclarestt�at � th� racrs and
r�epr�esentationa st�Aed in this appicatton are t►ue encF c�r
(1D J��� '
,�
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BUILDING USEQ AS�� � C.��
ESTIMATEO COST � PEf�AMTNO, 1� ��
�ES�R{P71l3N OF FUFiIVA{� ANp pR gl�lER
No. r,T He�ing Unks t�nde One (Steam) (Hoi Wat�'1 (Warm qf�
Trac]e N�ne � Size No
� � EDR
F� Tota► Cor�ected load
Bu�r Ttade Name Size No,
� �' E�R
HEATI�tG
��
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Tel Na.� �n Sg �
�_ Fiila� Date
FILL.OUT BAiCdC S10E P� STACiC iIERiFICATICM[ OPI
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C�MNEY AND STACK VERIFICATION
The undersigned hereby verifies that t�.��g �h�ey or stack: .
1. Has been carefiilly exam�
Y��� N� ( )
2. Is free from ivst or deterioration
. Yes (� No ( )
3• Has no foreign objects lodged wit� �
4. Is securelY supported
5. Meets all cc�rrent Code reqt�irements for size
and total BTU's connected
6 Has total heating BTU's of �,7��p v�— 3�pm�
All other BTU's
TOTAL BTU's
7. Has a liner been provided; for water heater
g• Has combustion air 1�een provid� for water heater
Remarks: .
�Lk S ��.1 It �
� r.e �� (,Ph'{' �t re ��
Yes (� No ( )
Yes (� No ( )
Yes (�) 1Vo ( )
Y� ( ) No (�
Yes ( ) No �%)
List AL1'ERATIONS Be � � Done: .. . ; . ,
_ ya:;
HEATING CO:
Signed By:
Date:
_�_
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� SVBJECT � " �
City of Fridley � 28535
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
' ��72-36�„�
RECEIPT N
UNITY OEYELOPMENT OIV.
r � L � PFOTECTIVE INSPECTION SEC. 5��
� � �"'1 � CITY MALL FRIOLE� SS132 NVMBER AEV O�iE P�GE O� •vvnOVEO 9r
�----�•' �•' 612-571-3450 9t0-F15 11/5/98 � �
10B ADDAESS
6740 Kennaston Drive
1 LEGAL LOT N0. BLOCK TRACT OR AODITION SEE ATTACHEO
DESCR. 2 3 Meadowlan 2n SFIEET
2 PROPERTY OWNER MML AODR�S$ ZIP PHONE
Gar Munson
� CON7RACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
New Haven Construction -
� AHCHITECT OR DESIGNER MAI� AOORESS ZIP PMONE UCENSE NO.
5 ENGINEER MAII ADORESS ZIP PMONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS Of WOFK � REPAIR O MOVE • O REMOVE
❑ NEW O ADOITION O ALTERATION
8 OESCii1BE WORK
Reroof house and garage (25 S) Tear-off
�
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
' ?VP OFCONST. OCCUPANCY GROUP OCCUPANCV�OAD
SEPARATE PERMITS ARE REOUIRED fOF EIECTRtCAL, PLUMBING. MEATING.
VENTI�ATING OR AIR CONOITIONING
THIS PEFiM1T BECOMES NUII AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTMOAIZED IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQONEO FOR A PERIOD OF 120 OAYS A7 '
ANY TIME AFTER WORK IS COMMENCED. ' NO OWLG. UNITS OFfSTREET PARKING
I HEAEBY CERTIfV TMAT I HAVE REAO AND EXAMINEO THIS APPLICA710N STA��S GAAAGES
AND KNOW TME SAME TO BE TRUE ANO CORIiECT. ALL PROVISIONS Of LAWS yq�VATION SURTAX
AND ORDINANCES GOVERNING TMIS TVPE OF WpRK Wlll 9E COMP�IED
WITM WNETHEfi SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT 2,11{2 1.O]
OOES NOT PRESUME TO GIVE AU7MORITV TO VIOLATE OR CAMCEL TME pEqMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHEFi STATE Oii IOCAL LAW REGUTATING CON-
STRUCTI OR TNE PERFOfiM NCE Of CONSTFIUCTION %/{. ]5 F re .SC 2. 1�!
�� A /���� PLAN CMECK FEE Al FEE
G f
n
S�GN4TUAEO�CO •Q . Op RAUTHOp�2EDAGENI �O�TE� M P RLV VA 10 TED TM�S IS V� PERMI---ye�/ �.,
- � LL�
S�GNaiuAE O� OwaEQ��F pWNEABU��OEA� �O�TE� . '� � � � �h o� - qarE -
c
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ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
Effective 1/1198
C`����`�3�
�n�.�� ���
Legal Description:
Owner Name & Address: � C�Q.�' �/ %i� U��%Z Tel. #�� � lD %
Contractor: ��%PGv �`7 L2.U�f'L �/�f?�7 � �/ /'�- MN LICENSE # o� �77`�Sv
Address: �ZD � �c3'� ��- .�D/ � �j . 1p Tel. ��/�-) S�v�O - SZ-2-�S-
� Attach to'this application, a Certificate of Survey of the
lot, with the praposed construction drawn on it to scale.
DESCRIPTION OF Il4IPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAG� �AREA: - Length Width Height Sq. Ft.
DECB AREA: Ixngth .. Width � Hgt/Ground Sq. Ft.
OTI3ER: . .
. ��� � �� f� .
Construction Type. / � � /Z D F� %?� � � o � Estimated Cost: $ /
. • . � � (Fee ScheduZ e on Back�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �.
DATE: /D - - % Il APPLICANT: �1�•� 1/�•c.��G�_��-� Tel. # �� lo ''��2�
Permit Fee
Fire Surcharge
State Surchazge
SAC Charg�
License Surcharge
Driveway Es�row
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� '7� �s"
$ �- ��
$ / 0
$
$ Svo
$
$
$
$
• �
�, �
C USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1J10th9b)
$.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 Ne��ssary I]
CITY OF FRIDLEY BUILDING INSPECTION
6431 UniversityAve NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater
�b �� I D� % D� EfFective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
�� �x;
JOB ADDRESS
- ��� 4,���,������ � �oY ��
Fee � / n � -� _ .
$35.00 $
$10.00 $
$10.00 $
Building Used As �� t�1�,[,!/!�"i.(A,� Y��'�
ESTIMATED COST� . U(� PERMIT NO
DESCRIPTION OF FURNACE AND BURNER
$10.00 $ # of Heating Units Gircle One {Steam) (Hot Water) (Warm Air)
Trade Name Size No.
$25.00 $ BTU HP EDR
Fuel __ _ Total Connected Load
Commercial/Industrial/Institutional
1.25°� of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/MOUR �Y���`/�� Q�G�ZL/
$ Burner Trade Name Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do a(I work in strict accordance with the City Codes
$ and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
$ HEATING
$ % •�
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
� �'�
��.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Tel # ��J`�' / >>�1%��
FAX # Date /��9� �
Approved by Rough-in Date Final Date