PRE 2010 DOCSX16 363
City of Fridley, Minn. N° 10149
BUILDING PERMIT
Date: March 24, 1969
Owner. Falk Construction Co. Builder Same
Address 2516 Central Ave. N. E. Address Same
LOCATION OF BUILDING
No. 7450 _ Street Lakeside Road part of Lot
Lot 5.111' of 1 _ Block Addition or Sub -Division Aud --- Sub #19-9
Corner Lot Inside Lot __ Setback 3 7 _ _ _ Sideyard — W S 9'
Sewer Elevation 894.51 897.51
Top of Footing
To be Used as:
Dwe 11 ing Front .
Garage Front
Type of Construction
Ffame
DESCRIPTION OF BUILDING
42' Depth 26' Height 20' Sq. Ft 109.2_ Cu. Ft _21,.8/x.0
20' Depth 23' Height 10' Sq. Ft 460 Cu. Ft . 4600
Est. Cost 23 , OOOIM To be Completed
SEWER LOCATION - 74' South of Manhole(just a wye, not stubbed into the property.)
WATER LOCATION - A tap will be necessary
Use 5/8" plywood for sub -floor
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 777, -,
and in compliance with a'il provisions of
ordinances of the city of Fridley. ��•�
! ��/J///l_�C_._
$100.00 S
Gdhnection Char
In consideration of the payment of a fee of $ 40.00 , permit is hereby granted to
to construct the building or addition as described 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 upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within � city limits and this permit may be revoked at any time upon violation of any -of- h a provisions of said
ordinan
NOTICE.
'fids permh does not ewer As construction, installation for wiring, plumbing, gas heating, sewer er water. Be sues to see
fire Building laspector for seperafs permits for these hens.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER 'S NAME BUILDER FA Uk L' e v S T R c-3
ADDRESS ADDRESS o`Z S 1(7 C Q ` A •�
LOCATION OF BUILDING
NO. ^N5-0_ STREET
LOT, - /// Bi, K/ ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK -� 7 SIDEYARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front ( Depth Height z 0
Square feet /,' ?2- Cubic Feet
o Front Depth
Height 16
Square feet V(e 0 Cubic Feet
0
Type of Construction 7 J? AAj L Estimated Cost yL �� ®® v
To Be Completed
2 (--x c.;The undersigned hereby makes application for a permit for the work'
herein specified, agreeing to do all work in strict 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 correct. /2
DATE SIGNA�A
(Schedule of Fee Costs can be found on he Reveroe Side.
o
BUILDING PERMIT *FEE SCTEEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits
for the erection of any building or structure, or for any addition to any
existing structure or building, or.for any alteration or repairs to any
existing building or structure, upon application therefore, require the
payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner. herein provided to -wit:
Uniform Building Code: Type 1, 2, & 4 - $1.75 for each one thousand
cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 -
$1.50 for each one thousand cubic feet.
For the purpose of computing fees for building permits, the cubical
contents of any building -or addition to a uniform height throughout by
multiplying the ground area covered from a point six (6) inches below
the floor line of the basement or the cellar to the average height of
the upper surface or to the average height of the roof surface of the
main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be
at the rate of $3.00 per each five hundred dollars ($500.00) or
fraction thereof in the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section
2 be less than $5.00.
NSSSD Connection Charges based on location - Area 1 or 2.
it Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ..........................$10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 ......... .... 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
$10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
... 10.00
$
Each add. 200 sq. ft. EDR Steam ......................
3.00
$
Each add. 320 sq. ft. EDR Hot Water ............. .
. . . 3.00 $
OIL BURNER—to 3 gal. per hour ........................
6.00
'$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOT1�L
1st 3 Fixtures ......................
x$ 2.00
$
Additional Fixtures ................
x .75
$
Gas Range to 199,000 ...........
x$ 5.00
$
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL— r
See Fee Schedule
$
TOTAL FEE $�� —�
Dept. of Bldgs. Phone 560-3450
� � ✓_'mss_-_ �� �
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,
Owner u `v
Kind of Building
Used as
To be completed about
Estimated Cost, $ / Z) 0
Old—New. Building Permit No. Permit No.
DESCRIPTION OF WORK
19
HEATING or PO NTS --,Steam, Hot Water, Warm Air— o
Trade Namel'_ Size No. 6- //�
Capacity Sq.
�Ft. E.D.R.
� / O BTU �y H.P.
Total Connected Load �` '�—y y` /9��O//xind of Fuel
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
PERMIT for Power Plants and Heating. Cool.
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants W O-Ae z dt2J to be tered—repaired
Make
Oil fired ; Coal fared ; Gap fired Z ; Gas Authorization No.
Remarks
Approved by
Final Inspection Date , 19_
Inspector
Permit N° 4686
Fee $ 1'7,00
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.,_djqCd a2�/ , 1910
Owner�1�CT/ ®A)
Kind of BuildinJg/ Fie A M
How OccupcJ F–LL1 N G
Work to be Commenced—, 19—
To be Completed _TLt= )& ® ,1916
Estimated Cost, $ 966,od.
01djoBuilding, Permit No.
Permission is hereby granted to !9 l to install—erect—use the material and devices described in the
above statement. This permit is granted upon the express coNition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operatiM opera'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 the devices herein named, and to the specific t' set orth in the approved application for this
permit on file in the office of the Inspector of Buildings. q ' nn
Inspector of Buildings
4z 2M11.67V
Z
"--/-s1®a�
City of Fridley, Minn. N9 10592
BUR DING PERMIT
Date: XM March 31, 1970
owner: Valk r ons tr,i tion rMpany Bid Same
Address 9 516 rentral Avenue Address ,,$fie _
LOCATION OF BUILDING
No. 7450 Street .— Lakeside Road Part of Lot
Lot _S� 111 aflBlock Addition or Sub -Division bt;oX's Subdivision #129
Corner Lot _ Inside Lot — Setback 37' — Sideyard 15' 9"
Sewer Elevation ____ _ — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Dwelling
Front 42
Depth 26' height
20' Sq. FL 1092'
Cu. Ft 21,840'
Garage
Front 20
Depth 23 Height
10' Sq. Ft. 460'
Cu. Ft 4600'
Type of Construction
Frame
Est. Cost _;L20,000____
To be Completed
July 1, 1970
RENEWAL OF BUILDING PERMIT #10,149
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 setforthcomp ce w1�th all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 20.00 permit is hereby granted to Falk Construction
to construct the building or addition as described 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 upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
withinn� city limits and permit may be revoked at any time upon violation of any of the provisionsordinaof said
rig inspector
CL' AREIVCE BELISLE
NOTICE:
Ob permit does not cover the construction, hm&Won for wiring, plumbing, gas heating, sewer or water. Be wre to see
the Building Inspsaor for separate permifa for these items.
--,
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S . NAME : _ f d G1 s-� _.,__BUILDER: _ 7-�7� /l- e�&a laz
ADDRESS :_2-S/ to Lam, e a P ,Qu,, ADDRESS: A S-/ C, �4
NO:. % SCS STREET: J- A k E S ( A3,i �a0
LOT : S ( ® BLOCK: ADDITION:- J / 9'
CORNER LOT: INSIDE LOT: SETBACK: T 7 / SIDEYARD: %.57
Applicant attach to this form Two Certificates of Surv2x of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
-e uJ I_ L Q T� Front: CV Z Depth : 2 Height: O
Square Feet: % 0 q -2— Cubic Feet: 2 0-41- y O
Front: Depth: Height: 16
Square Feet; (�0 Cubic Feet: 0
Type of Construction: Lle e Estimated Cost: $ 200 0 -V -o
To Be Completed: 0
The undersigned hereby makes application for a permit for the work herein
specified, 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 correct.
DATE : ',Oet4 31 If 7-0 SIGNATURE: �
(See Reverse Side For Additional Information.)
No 5114
Origin Permit f®r PLUMBING .AND GAS FI ING -j/-- S % -.2- i`2,
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that Permit
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit, Fee $ cZo7• 0,
DESCRIPTION OF WORK II
Number, Bind and Location of Fixtures
Stories
�
f
a J
U
�
2
Z m
r
a
m F
z
Q
m
x
z
0
m
a Q
M.
3 t
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m
3
o
x
(p
z
o a
J z
LL O
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► m
4 a
V in
z Dl
rc
Q a
K-1
V
m_ X
E 6
.i
an d
a 6
0 a
a z
a s
O K
WATER HTR.
GAS
ELEc.
Basement
1st
2nd
3rd
4th
Connected
Gas Piping for Openings
Permission is hereby granted v S to do the plumbing and
gas fitting in the building described in the statement hereto attache , pon the express condition that
the person to whom this permit is granted, and his agents, employee and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection
Inspector.
-OMPP42 IM -4669-v
City of Fridley 6LRL
Owner C" _19-►'l�
Kind of Buildi-L ,
Used as
Aj
To be Completed , 19j—d
Estimated Cost $_ A 060-06
Ol�Building Permit No.
Date
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS BUILDING PERMIT
I. .......COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432 NUMBER REY
612-571-3450 910415
JOB ADDRESS 7450 Lakeside Road NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. Pt. 1 Auditor's Sub. 9
2 PROPERTY OWNER MAIL ADDRESS
Roger McGowan 7450 Lakeside Road NE
3 CONTRACTOR MAIL ADDRESS
Marcon Inc. 1908 Timberline Spur, Mtka 55305
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL
DATEI PAGE OF
9/15/92
PERMIT NO.
RECEIPT
�46
APPROVED By
SEE ATTACHED
SHEET
786-1132
ZIP PHONE LICENSE NO.
591-9291 3642
ZIP PHONE LICENSE NO.
PHONE LICENSE NO.
6 USE OF BUILDING
Res iden tia 1
7 CLASS OF WORK ❑ NEW 0 ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install masonry fireplace; new-
9
ew
9 CHANGE OF USE FROM
STIPULATIONS
TO
Before digging call for
all LUtility locations
454-0002
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.CU.
BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT. FT.
THIS PERMIT
IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
AUTHORIZED
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
I HEREBY CERTIFY
TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND KNOW THE SAME
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3,300
1.65
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$63.O
sire SC 3.30
STRUCTION T PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEETOTAL
FEE
License SC $5,00
1 $72.95
L�VA
D THIS IS YOUR FERMI I�
1 GNATUREOFCONTRACTOR ORAUTHORIZED AGENT
IHEN R
_._...-....�,.� ..,...eo.c nwNFR Rl11LDER1 IDATEI
BLDG INSP MATE
NEW [ j Effective 3/1/92
ADDN (] CITY OF FRIDLEY
ALTER (j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 71-/,5-0 -I/re 4' we Le
Legal Description:
Owner Name &Address: 6,0y 144c Tel. # 756— f/z 2
Contractor: /1%re„�•� MN LICENSE #
Address: 77nZ,-,Z, Qe �LsEQ-T� 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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Wim. ,2.22a.r 7. �� ocv �e P/. e .!' �
Comer Lot [ ] Inside Lot (] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. + b Ft =
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
APPLICANT:
License. Surcharge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
r
TOTAL $
STIPULATIONS:
Side Yard Setbacks
Estimated Cost: $ -3, 3DD �—
(Cost on Back)
Ft x $ = $
Tel. #
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ j Not Necessary [
SUBJECT
RMIT NO.
City of Fridley
21604
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
• COMMUNITY DEVELOPMENT DIV.
�,;------,
r � � PROTECTIVE INSPECTION SEC.
7
i '-';-� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
----
L J\ 612-571-3450
910415
10/14/92
JOB ADDRESS 7450 Lakeside Road NE
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR.
S 1111 O
1, AuditO l s Subdivision #129 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Roger McGowan 7450 Lakeside Road NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Larry Beach. Construction 6951 Knollwood Dr, Moundsview MN 55112 780-5608 7759
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
Residential
6 USE OF BUILDING
Reroof Dwelling (20 squares.) Tear-off
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 0 REPAIR ❑ MOVE O REMOVE
8 DESCRIQE WORK
See above
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with. the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED 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
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,060
$.5.3
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS O ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$2.x.00
Fire SC $1.06
STRUCTION THE PERFORMAN E OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
�f
1 -
License SC $5.00
1 $33.59
SIGNATUREOF ONTACTOR OR AUTHORIZED AGENT (DATEI
WH P PE LY A ATED THIS IS/jYOUR PERMIT
BL&G INSP DATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER[ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
I q s:1
J.&Ve-
S 4e
Legal Description:
/ / / ` e / i i)
Owner Name & Address: '2nc
e- a IM c !� a L,3c� r,.
Tel. #
Contractor:
e c
MN LICENSE # moo- y��
Address: Co 9 S I
cJ i e w Tel. # 27P®
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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width _ Hgt/Ground Sq. Ft.
OTHER: 12e "b 0 � � � � / f fl 1Z C
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard_Utbacks
Type of Construction: /-) e' 1 i Estimated Cost:
Approx. Completion Date: V
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE16Z / ZZ :APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 10th %)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
01
SUBJECT
MIT NO.
City of Fridley
21693
AT THE TOP OF THE TWINS
P,
BUILDING P E R M I T
I
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
I✓ PROTECTIVE INSPECTION SEC.
1
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
12/10/92
10B ADDRESS 7450 Lakeside Rd NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
S 111' Of
Lot l/ All
tor1S Subdivision #129, SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Roger McGowen 7450 Lakeside Road NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Larry Beach Construction 6951 Knolhamorl Dr, Moundsview 780.5608 7759
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install egress window in basement
9 CHANGE OF USE FROM TO
STIPULATIONS
Egress window must comply with the State Code for egress windows.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED 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
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$680
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -
$�5�00
Fire 6C $.68
10 OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC $5,00
$25,18
IGNATUREO CONTRACTOR OR AUTHORIZED AGENT IDATEI
NHE PRO LY Vq IDAT D THIS IS YOUR PERMIT
LlAe /Z - 7-Fz-
BLDG is 4aiE
SIGNATURE OF OWNER IIF OWNER BVILDERIIDATEI
01
NEW [ j Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: h L4 kKe s; A e. 2 d
Legal Description: S / , Ali
Owner Name & Address:. MA. C in Tel #
Contractor: . I MN LICENSE # cDo }l n 69
Address: 1,-,'9s-1 n9ell"oma � o�:��Sy.�^' Tel. # '1$O -S1
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 Height
Length Width Height
Length Width Hgt/Ground
Corner Lot [ ] Inside Lot { ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed:
APPLICANT: Tel. # 6? -
CITY SE ONLY
DATE: k Io
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
Ft. + 6 Ft =
Sq. Ft.
Sq. Ft.
Sq, Ft.
Side Yard Setbacks
Estimated Cost: $ 68Q
(Cost on Back)
Ft x $ _ $
$�,� no
$ 60
$ �O
License Surcharge $
Driveway Escrow $
Park Fee $,
Sewer Main Charge $
TOTAL
STIPULATIONS:
•o 0
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ j Not Necessary [ ]
'.ITY OF FRIDLEY INSPECTION DIVISION
Effective On January 1, 2000
1431 University Ave NE
=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
J013 ADDRESS `I 19D-- LZ—�)l
Q t'�Cu�
RATE SSHEDULE
iesidential
Rate
TOTAL
Furnace Shelf and Duct Work, Sumer
BUILDING USED A$
Also Replacement Furnace
$ 30.00
(Side Vent - Fill Out Back)
ESTIMATED COST
PERMIT NO. 7
Gas Piping (Needed with new furnace,
$ 10.00
$ _
but not replacement)
DESCRIPTION OF FURNACE
AND OR BURNER
Gas Range
$ 10.00
$__ _
No. of Heating units _ Circle One (Stearn) (Hot Water)
Gas Dryer
$ 10.00
$
Trade Nanne
Size No.
BTU_ HP
EDR
*Air Conditioning . All Sizes
$ 25.00
$� �
Fuel------ Total Connected Load—
All Others/Repairs & Alterations (LIST ON BACK)
Sumer Trade Narne_.
_. Size No.�
1% of Value of Appliance or Work
BTU_-- HP
--ED
:ommercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
UNiMUN FEE FOR: ANY HEATINGdCOQLiNQ/VE, I1TILATIQN
iEFRIGEAATIOWAIR:CONDITIONING PERMIT -35 S25 OQ
0LUS THE L 50 STATE SURCHARGE
:EINSPECTiON FEE $47,00/lir
Air Conditioners can not be placed in a side yard without
fritten permission from adjoining property owner.
0
3
9
0
n
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do elf work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct. 0
n
DATE
-v
Y
m
N
Z0'd -MJ.01
COMMON VENT, VONT CONNECTOR AND CONI USTION LUR VERIFICATION
Whenepi lacina an existing furancethe undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions.
and is securely supported and firestopped where required. Yes (-Y'No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications Including sizing, length, number of elbows and termination. Yes (0 No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA -LAMA Category 1 Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes WNo
The existing cornbusbon air is sized and installed to meet the current codes ,/
and manufacturees specifications. Yes (0,1 No( )
When required to Install a neve combustion air it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes W No ( )
When Installfog as new ven_tina system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does Include AGA -LAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes {-YNo ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the =mmon vent and vented
separately as per current codes. Yes (-f No ( )
Apaliance TXpe and Size/Common Vent and Vent ConnecWr Information
Appliance #1 Type BT11 InputEU Fan Assisted or Nat
Appliance#2 Type STU Input I a isted 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 it Diameter. in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
�1 � >t�� l 1 � � ���1 /J��r• i�r i �� 1
I■�i
HEATING
Signed By:
ZO/ZO,d S09868L 01 A31QI8d dO AlIO W0NA BSaZT 0002—iZ—r)ON