PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 7110
Date: �6 " pL—_.4
Owner:eZea
��� ���`• Builder
Address Address
LOCATI9,N O ILDING
No. Streetart of Lot
Lot _......�..�__ Block Addition or Sub-Divisdon . Z.LMd
le I�g ti e
Corner Lot _ Inside Lot _dam Setback Sideyard
Sewer Elevation
Foundation Elevation
,-e'17,Pa
DESCRIPTION OF BUILDING
To Used
Front !� Depth Height zo Sq. Ft. Cu. Ft. vao
&A-loa Front Depth Height Sq. Ft. Cu. Ft. -00
7 400
Type of ction Est.J _ —'To be Completed
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 proviaio�s of
ordinances of the city of Fridley. A a //
In consideration of the payment of a fee of $,1(4 j , 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
witi i nthe, city limits and permit may be revoked at any tune upon violation of any of the provisions of said
ord
NOTICE:
This permit does not corer the construction, Installation for wiring, Plumbing, gas heating, sewer or water. Be sure to see
the Buihiing Inspector for separate permits for these items.
CITY OF FRIDLEY
APPLICATION FOR PU)MBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening_
x
$2.00
0
New Fixture, Old Opening
Water
ut
m
m
x
mq
$
w
H
e
m
A
W
+
n
w
Water Softener
x
Heater
.°'a
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
a
1st 3 fixtures
x
►�
$
Additional Fixtures
x
O
a�
O
❑❑
•.1
x
•�
Xp1
A
N
r.i
•.1 O
O
O
W
�roro
$5.00
$
each add. $100.00 or fraction
y
U
b
M
Ul
3
A W
W
F -1U
to
O
3as
lee
1st
2nd
3rd
4 th
(R) - Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening_
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
14MiNMIrt"141IN P -MM
($10.00)
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. %Y/
OWNER
KIND OF BUILDING
USED AS�� _
TO BE COMPLETED ABOUT 127`7
i — t
ESTIMATED COST Q
OLD -NEW BUILDING PERMIT NO. PERMIT NO.
i
Company
r�
Signed By r
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT I $7.50 PLUS $.50 ST` SURCHARGE
City of Fridley
Application for Plumbing and C"m Rtting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
� x
$1.50
$,--0 �.
Future Fixture Opening ................
',Q� x
OJ
8
1O-�
7
New Fixture Old Opening ..............
x
U'
Z
d
•
F
•
N
WATER HTR.
GAS
ELEG
Water Heater (Up to 200,000 BTU) ......
Z x
2.00
$ A E
New Ground Run Old Bldg . ............
x
3.25
$
a�
NO.
RATE TOTAL
1st 3 Fixtures ..........................
C90
$1.50
$
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
Base
1st
2nd
3rd
4th
• Future Connection Openings
Connected with
e New Fixture, Old Openings
Sewer
I Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
� x
$1.50
$,--0 �.
Future Fixture Opening ................
',Q� x
1.20
$ Z, 6!!!�d
New Fixture Old Opening ..............
x
1.00
$
Catch Basin .... .....................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
Z x
2.00
$ A E
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ........................................... $
TOTAL FEE $-1-
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do alll 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 applicatiop are true and correM.
Fridley,
Owner vrf*LT=- 4..
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old Ne B ding Permit
ROUGH I. 3 I b 4
FINAL
1941-47V
0
City of Fridley
SUBJECT
F-1749:6
AT THE TOP OF THE TWINS
BUILDING PERMIT
16
RE
`L ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
7��
1 )
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
s---- �'� �•J 612-560-345010/18/78
910-F15
JOB ADDRESS 5240 Lincoln Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
2
Marion Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Eugene Peterson 5240 Lincoln Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Ironwood Construction 1145 Polk Place N.E., Columbia Heights 571-1709
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 22' x 12` Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
WARIVING
80011 digging call local
utilities
TELEPHONE
- ELECTRIC - GAS Etc.
REQUIRED By LAW
SEPERATE PERMITS
REQUIRED i=
HEATING, ORIIRIIVG,
PLUMBING AND
SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
]
STALLS 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,
$8,088
$4.04
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$21.12
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
1 $30.44
SIGNATURE OF CONTRAtTO906R AUTHORIZED AGENT IDA E)
WkfE P PERLY VALIDATED THIS IS YOUR PERMIT
BLE) r DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
, % SV
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
owi m;1uTyeAze &%�rso, BUILDER: �j-aN�yuu� �v•�S�^ucjl®..�
Address .5 L! 1*j t d�• JT -0` -JC' Address: HEIS- PO
Tel. No.:
No.: aLto Street:• Z-! )&tiJ Sf
LOT: c;t_ BLOCK: ;L- ADDITION: �� %�"1®� �tl //S
CORNER LOT: INSIDE LAT: SETBACK: SIDEYARDS:
Applicant attach to this form lVo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
• j
DESCRIPTION OF BUILDING ,
To Be Used As:
ell
7 -
(G 'J Front: r5 -.)-Lo" � C' `` Depth: � �- L � � Height:
Square Feet: Cubic Feet: '6-280
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: r`$ Estimated Cost: $ T_ ��•
To Be Completed: 1
Alt. A �,1t.�Bs
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: �d -�� —�� SIGNATURE:
Stipulations: g0k>//4
BUILDING PERMIT FEE SCHEDULE
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 building or structure,
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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $17.20
W11 1 0110i MAN @us\
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined 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 heights 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 tier 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 $7.50 plus $.50 state surcharge.
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
_► 1 1X$1112.11,1
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
x�
awborter,
41
ACKSON
C R90i UNDER- LAWS; CW, STATE Cir MjNNZ M
CD, tY,ORDINANCI[ .OIC CITY OM' MIMNtAr01
yv,- Q
r -NO
4,
I- --
M 11 , %, p
�
ra
Z.
Ila
N'
-AM,
g
00 4 Zlst
,T
l
A
VO
43
t
-C 4!`-•
I
at LV A
WZm�
^M`
4e4
RN
T 410w 1�� Vm.
HERESY 'CERTIM,,M
l�
OF Ave z1
pe
Lot
2 Bloei
2 Marian' 1, ills
Anok& C ouat y Kinn
A
t.
of
V
S SURVICYRD By'UK THM 19th DAY'
a
P lit
A
Ot"
w
�4
101
io
t 49
q
"4 J
"J�
:$rf
,gf
M
yv,- Q
r -NO
4,
I- --
M 11 , %, p
�
ra
Z.
Ila
N'
-AM,
g
00 4 Zlst
,T
l
A
VO
43
t
-C 4!`-•
I
at LV A
WZm�
^M`
4e4
RN
T 410w 1�� Vm.
HERESY 'CERTIM,,M
l�
OF Ave z1
pe
Lot
2 Bloei
2 Marian' 1, ills
Anok& C ouat y Kinn
A
t.
of
V
S SURVICYRD By'UK THM 19th DAY'
a
P lit
A
ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
PLANNING AND INSPECTION DEPARTMENT
CITY OF FRIDLEY, MINNESOTA
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION
DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure constructio�nJl is per approved plans.
JOB LOCATION:
OWNER/CONTRACTOR:
ADDRESS:
PHONE:
A. Determine the Total Exposed Wall Area as follows:
1. Total wal window area
2. Total doo area
3. Total sliding glass door area
4. Total fireplace wall area
5. Total wall framing area(average'.100)
6. Total net wall area above floor(average 900)
7. Total rim joist area
Subtotal: Total exposed wall area above floor
8. Total foundation window area
9. Total net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 =
C. Determine the Total Exposed Roof/Ceiling Area as follows:
10. Total skylight area
11. Total roof/ceiling framing area (10%)
12. Total net insulated roof/ceiling area
GRAND TOTAL EXPOSED ROOF/CEILING AREA
Item I
D. Multiply the GRAND TOTAL EXPOSED ROOF/CLING AREA X .05 = Item II
� I-
E. Determine the "U11 value of each segment (1-9) and multiply by the area as
follows:
l . z x fluff
2. X hull
3. ®,. x IIT711 f" 6—!5,
_
4. X 117711 � Z =
X II TUT II
6. � �3 _ X 11{711
7. X IIUII f f3j
8. x stuff
9• . L / X ItUli
ADD 1-9 FOR TOTAL WALL SEGMENTS T = IlllT00/EM___ III
F. Determine the "U" value of each segment (10-12) and multiply by the area as
follows:
10. X fluff _
11. x hull =
12. x 1'Ull =
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State. Building Code 6006 (c) 1.
I. Add Item I
+ Item II =
J. Add Item III + Item IV =
K. If the sum of Items -III and IV are less than Items I and II, you have met the
intent of the Code for total envelope system.
The undersigned, as applicant for a building permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate; and hereby
presents the information with required plans in support of the building permit
application.
By:
DATE:
631-708f
SUBJECT
PERMI
City of Fridley
17 6 7 3
AT THE TOP OF THE TWINS
BUILDING PERMIT
' '
R
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
���
NUMBER
T5E7DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/21/84
JOB ADDRESS
5240 Lincoln N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
2
Marion Hills SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Eugene Peterson 5240 Lincoln Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Metropolitan Fireplaces Inc. 7670 - 138th Street, Apple Valley, MN 55124
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 ❑X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install masonry fireplace
9 CHANGE OF USE FROM TO
STIPULATIONS Provide frost footing for fireplace. Outside air to fireplace or
existing furnace must be provided. Provide fire alarms in sleeping area
and in lower level.
W31 �'��1it+es
SEPERATE PERMITS REQUIRED FOR WIRI1j(,, Before in Call
HEATING, PLUMOW6 ,At4o SIGNS, SELEP�i�tIE-
bi "r LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
Masonry
OCCUPANCY GROUP
OCCUPANCY LOAD
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
STALLS 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
$2,600
$1.30
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRE ME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$38.50
RUCTIONHE PERFO MANCE OF CONST UCTION.
4
PLAN CHECK FEE
TOTAL FEE
4$39.80
SIOWTURE OF NTRACTOR OR AUTHOR] ED AGENT (DATE)
WHEN PROPERLY I TED T S IS YOUR PERMIT
BLDG INSP fJA
SIGNATURE OF OWNER IIF OWNER BUILDER] IDATEI
631-708f
NEW [ ]
City of Fridley Effective 4/1/84
ADDN. �R-1 AND R-2
ALTER. 17 wilding Permit Application
Construction Address: MEWL�'� ole /`'
Legal Description: L
112
Owner Name & Address : ca so.,.) Tel. #
Contractor: di`1�� i n����►� A- A I TZJie V (tA��P` +-Tel. #
Address: 1e`10 8&
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.
Length
Length
Lengtb
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width _ Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback _ Side Yard Setback
Type of Construction. aJ Ae4 Estimated Cost: $
Approx. Completion Date: S� D
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: 9-dl-- F176,
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
APPLICANT: LTel.
CITY USE ONLY
,ej Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ �i� ® $.50/$1,000 Valuation
$ - $425 per SAC Unit '
$ ® Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
i
..moo rA,,c'1
George- mewbort erOr. 5280
z. 153-46
' �. w : w •° ,::'a mer Via► a lti - y' '•,spa .� . t • r N aFr• _r
_
X'k SURVEYOR4Y, r ,p _! Vi-R[�i1fT[Rt0 YND[RLAWf OP •TAT[ MINN[fOTA i►�jr' S may r • + �` uc[N![D /T-.ORDINANC[ OR 'QTY Mile ZAPOLIf 1c�E A .i <c • r'? i .. ~ t
s 'i. a- �.: ` `Hr %i y . � .' .i .I '_ .� � � J a 3[t:�y rl.{.,��i'• '►. i•'d'n { :1'i � ♦ P 15.� ?�_•e.'
.j • .. 'r .Ti, �6 •N's •` y t:-;o+'�- .�.i �+�"., : v c: S :<^T Z+'�s *-. I�r.�<..:.P' ..-_ ,P at -t .: at c1.a,1�- t•. r. °Tp J.� � - �,,. ,. t •a..• ,1 'r .yr.
�p :•. =ta, i. y:.ldld EAST S.STM STREETSPA i4-4681
_ '.mac � . A �.1 r S ��.w i- �rJ.. d+�..a°• �_.:i 4'. .r - a r• .•,$i~•[.�.a � d-.i1�•; �sn►a
ti��IgLE s .30 • _ „ {",+ t r ti i in Z'�i
a' ••:..fv-�.i'.�:Qs�•'•�MtY�1.•� �t �.T'.�N'1�".-i .j�•` t `*ti..G �r2 r Y•1 - J aA .�74i
4XJS�/NG EL6r✓.-. t n : ♦ y.-4 r }jr* a as9 ^R•, la 1
r < .: yt:� ; �t�� [. �Ra r.•r#Y,`as 4�•'�� s t!
•- `r ,cv- {. Om a.P/edl•1Pt�Si�O F..L�✓;_.y�'e� � }. .��✓,a• �3.7� r� ^. =�s.r' d
R'ky' •.=rte L �'._: j«.� t e� '
.li +t •-' ,�.sr _i+' ;-.•.. �}°4./. 4i `� 'i`I '� � ''� iS ,.•:!r a�, < a. ti.r moi. -S �1'.
•; ••-'Y :� w. [.t � AiSti.=;�',r}c�L�,'^'�<�..•�. •C>.Z •:. ri..'v`.y `,i.• '�%. -'.. .. {" � yr�''�--►� , •° a?q t yl u.w P,, .S .,• ��� �R ��yp t
I • A _ �°c�� r'�4 �" rt 3 rE .rrarrs
�..`'. r�0/�T•. .: a. e- ._;.r � +F a r x%33 90 ��_••'�.��'s.��`l. r'� r-.'sem.. Oj� r;4�'`r ♦��+' �;L lGIZ.Sj
/; x d� J Y� e Y A' . ..1 ! •L. N y.i '' •` 't.. •=t
.rrs• R 4.2 ~.I `T�' '�' `."e 'S*�l �y=1,�iyl SZI. r
47; kl yy `w 4`,• W+.!. -
a., :f *• i. _-�.rt�- !• y ,+y jl l�'� ; a •}?
�re y y f f7!'M' alb • `.
.. '� �'I�. •T�. - _ Y!<�. -•�. • OIZ , P . .,ry :.••R•'T;1MS"'" a ' .. • i1 ,
7t=•.moi • N t..�1 •t�'' r+,-ry'�,#� :I.'
'�. _ q. 1 i,t�.p•t ♦ R 'tom ` - .�.� \ � _'• � a+'_, _ �l 1 t �
a � -- t Litt % . ari .(` ":• _ .`rlL 4, ''� -
Q
tA
Pit
:. /Ofd S3, - o,'•.; .. +
• L . � •.` , 4 . /� poi/.
'-:� �� z —� ,•.- - � ..w•a fir. ••.•' .�•;=' -� '� �- �?M. .�.o o __
1 N[R[fT CtRTIIY THAT TN[ ASOV[ If A TRY[ AND OORR[CT PLAT OR A'SY Y[Y OP ". s`•' '..r,
�. 'J!1 - `� - .' ' _mow i.•t - •. <• �`'t t l .. . - a
Lot 2 Block 2,- Marian Hills _
Anoka C ounty,Minn. ; ' • `_ - .
•Yt THIf 8t}t DAY OIJll$a_ �.D. 1094
�``4= 4: 1CSON MINN[foT ��2t fTRATIOM. NO: y3600 h`
RESIDENTIAL
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
` RATE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
li of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work
$ 20.00
$ 10.00
S
$ 10.00
$
$ 10.00
$
`
$ 10.00
$ 11
State Surcharge
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit use
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00.
PLUS $.50 STATE SURCHARGE
S
$
$ .50�
O
S °�o
Job Address 5 WA�) U � �V - F—
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. 5-
" 13 . 19 0a
OWNERlJe,
KIND OF B/UIL�DING 4F
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST Lam®
OLD - NEW BUILDING PERMIT NO. PERMIT NO. _< �i o20�4 J
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air-
qNo.
Trade Name `—�('��Q Size No. J O'�> xnsC�
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Oa
Capacity � Sq. Ft. EDR BTU3(), DCl(:-) HP
`� ��flf� s►� � 4�L �
SiqrTd
i •
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Fill out back side for stack verification on replacement furnaces
CHIM14EY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No ( )
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed By
Date