PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 6861
Date: &
y
Owner:_ .ice Builder
Address M____ _ to,—f"
Address
I LOC TI OFWLDINNo. _ _ Street rt Lot
Lot �� �J _ Block Addition or Sub -Division .
Corner Lot _ Inside Lot r Setback ._...._...._ Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To sed as:
t Depth Height . — Sq. Ft. Cu. Ft.
Fron _ DepthHeight _._ _ Sq. Ft. Cu. Ft.
Type of Construction ___._. fe— Est..Confl*r_To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
thordinaacof twork in he city of Fri edl y with the description above set forth and in compliance with all provisions of
v
In consideration of the payment of a fee of$ 7 = , 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 ordinance=s of
Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
within city limits anad s permit may be revoked at any time up� of any of the provisions of said
NOTICE:
This permb den not cover the construction, hutaBatlen for why, phnnhine, on hating, nwar or water. Be acre to no
the Buihiing Inspector for npwaN pwm& for these iMna.
I
City of Fridley
Application for Plumbing and Gas Rffing Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... _ x $1.50 $ 6 • L? Q
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... ....................... x 3.25 $
Water Heater (Up to 200,000 BTU) . .... x 2.00 $ . 0
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
X $1.50 $
X .50 $
x 2.00 $
Dept. of Bldgs. Phone SII 4-7470
Location 4- 3L O yi G 1 /L_O
City of Fridley:
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 application are true and correct.
Fridley, 1Vlinn- ! c Z7
Owner 71 a e Y- Soh J h
Kind of Building ` r
Used as
To be completed about
Estimated Cost, $
f0ld)New. Building Permit No Permit No. n;�
ROUGH --4-:: (� ^ y - � i
FINAL
Description ................................................$
TOTAL FEE $ / 00 42
Signed Itiq CSR(Gnon PLuti ar. Ap Cigna,,-�1,,°n
By /
Business Phone No—MIDWAY $2112
a6
N
; R
O LL
LL O
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�O
•
F
•
N
WATER HTR.
GAS
ELEC.
Base
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
I
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... _ x $1.50 $ 6 • L? Q
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... ....................... x 3.25 $
Water Heater (Up to 200,000 BTU) . .... x 2.00 $ . 0
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
X $1.50 $
X .50 $
x 2.00 $
Dept. of Bldgs. Phone SII 4-7470
Location 4- 3L O yi G 1 /L_O
City of Fridley:
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 application are true and correct.
Fridley, 1Vlinn- ! c Z7
Owner 71 a e Y- Soh J h
Kind of Building ` r
Used as
To be completed about
Estimated Cost, $
f0ld)New. Building Permit No Permit No. n;�
ROUGH --4-:: (� ^ y - � i
FINAL
Description ................................................$
TOTAL FEE $ / 00 42
Signed Itiq CSR(Gnon PLuti ar. Ap Cigna,,-�1,,°n
By /
Business Phone No—MIDWAY $2112
Date:
Owner;
City of Fridley, Minn.
BUILDING PERMIT
Buil
Address
T 21i I M. 0 0 0, 4? tiwo
MR MMi
C;2 142 a-3
N° 7004
Lot 211,Block __ Addition or Sub -Division . -Cn
Corner Lot Inside Lot — �--�� Setback Sideyardd
Sewer Elevation—��Z_&__� _— tlaSIIevation Z
DESCRIPTION OF BUILDING
T:o V �
LAA
Front �� Depth Height Sq. rt./ -z Gti. Ft
Front Depth Height ____ Sq. Ft Cu. Ft
Type of ConstructsS6t6Est CAAt / �W To be Completed
In consideration of the issuance to me of a permit to construct the building described aboveI agree to do
the proposed work In accordance with the description above set forth and In compliance with a'll provisions of
ordinances of the city of Fridley.
op i 5-;;
In consideration of the payment of a fee of 90s 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 reg location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and permit may be revoked at any time upon violation of any of the provisions of said
ordinances. --- �% _
Nonce:
We permit does not corer the conshuWan, installation for wiring, phm bing, gas hating, sewer or water. Be son to me
the Bnildtng Wgwcfor for separate permits for these items.
City of Fridley
Application for Plumbing and C%n Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location 22L3 l o h o a Z Q LU
p1
ou.
uZ
�G
U
<3
(�9 °d
�z
UN`
�O
F
N
WATER HTR.
GAS
ELEC.
Base
LL
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
I
Connected with
Sewer ❑
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures ...................... 19 x $1.50
Future Fixture Opening x 1.20
TOTAL
$
$
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $ d
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $-1 ' 115
Additional Fixtures x .50 $
Gas Range to 200,000 BTU ..............
� REPAIRS & ALTERATIONS—Refer to Code
x 2.00 $
Description ................................................$ .
TOTAL FEE $
rrvv�s � 7,� f6
City of Fridley:
I
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 application are true and correct.
Fridley, Minn_ J L; ) )/ ? /0 , 19611-
/
Owner & ® 7" e `� -Soh- r 1 - e
Kind of Building / k Q —
Used as e ll �� h 9,
To be, completed about
Estimated Cost, $
Al
Old New, uilding Permit No 470 Permit N.—. t Ste_
Signe = 1 r :ifs+ e
ByZ
Business Phone No_ /°,° •
ROUGH
FINAL
42
CITY OF FRIDLEY INSPECTION DIV, Effective On January 1,'1993
6431 UMversf y Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner – 60
Also Replacement Fumace $ 20.00 $ v� `—
Gas Piping (Needed with new furnace) $10.00 $
Gas Range
Gas Dryer
*Air Conditioning – AD Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
I% of Value of Appliance or Work
$10.00
$10.00
$10.00
State Surcharge
TOTAL FEE
JOB ADDRESS 4-e HO U/
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 Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
5_ _ ,1993
M ckr1Lcc
r
BUILDING USED AS F l ".LA e-1
ESTIMATED COST PERMIT NO.
DESCRIPTION U NE AND
$ No, of Heating Units. f Circle One (Steam) (Hot Water (Warm Air
Trade (lame Size No.
BTU / HP EDR
$ Fuel Total Connected Load
$ .50 Burner Trade Name Size No.
30 5-9 BTU HP EDR
MINIMUM FEE FOR ANY HEATING/COQUISIGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed In a side yard without
written permission from adjoining property owner.
HEATING COMPANY p�
Signed By W Tel No, U0 �Q
Approved By Rough–In Date Final Date `'LZ
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
.l. Has been carefully examined Yes ( ) No ( j
2. Is free from rust or deterioration Yes ( ) No ( )
3. Has no foreign objects lodged within Yes ( ) No ( )
4. Is securely supported Yes ( ) No ( )
S. Meets all current Code requirements for
size and total BTU's connected Yes ( ) No ( )
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY pAln
i Date Rec'd:
DATE —.2 /-0 YOUR E-MAIL ADDRESS CHF -CK t, Z T7 30
SITE ADDRESS 0�2 e �,l B/%� S� N E
THIS APPLICANT IS: ❑ OWNER &ONTRACTOR
PROPERTY OWNER/
NAME: -, rj I VVIN lel 1 1 rnuivlE REM
2 y3 ��^�' rAdw S" �� STATb"9
TENANT
ADDRESS: CITY -1
PHONE: 74Y s'%
CONTRACTOR
NAME: Mn n&*d V .... NE
SUBMIT A COPY OF
STATE LICENSE # EXP DATE MN
YOUR STATE LICENSE
ADDRESS: CTTY �lrl E_ZIP
WITH APPLICATION
PHONE FAX Aia also
9FSINGLE FAMILY/NEW CONSTRUCTION SIZE
PROPERTY TYPE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH j9ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIlaIlvHNG POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELING
--�//,,Z/❑
7`i� v
DESCRIBE WORK BEING DONE: t'-�
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES _ )qHOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS:& PORCHES SUBMIT:
❑ Aluminum ❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and code of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application f94 pe and rk is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work wh' equ' f re and approval of plans.�� Z4V
SIGNATURE OF APPLICANT J PRINT NAME ATE
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
/
Date Rec'd: !�
DATE 4-3:a2 YOUR E-MAIL ADDRESS
SITE ADDRESS cP3 L i*f // Sf A)
THIS APPLICANT IS: ❑ OWNER 0,CONTRACTOR
PROPERTY
NAME:
OWNER/
ADDRESS: CITY Fr-idlet/ STATEj&L)ZIP ,-:)
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE`���
STATE.MAZIP,,jCj!2
SUBMIT A COPY OF
YOUR STATE
ADDRESS: A0627,/) 1-A'n I0J/"2 '-Ytk CITY
LICENSE WITH
PHONE FAX
APPLICATION
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
ev
TYPE OF WORK:
❑ NEW 10PEPLACEMENT
DETAILED DESCRIPTION OF WORK r�p/_Dn D M4-rj: a`der
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINKILAV DRAINS _ SHOWER _ WATER PIPING
_ _FLOOR
GAS PIPING a&w cirrucevs) _ SWIMMING POOL —WATER SOFINER ($35)
—BATHTUB _
KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15)
CLOTHES WASHER _
_ _
DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER —OTHER
PEtIVIITFEE°R03E11 URS" l�0(1�
�^.,fi.,.ztu Vat
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $ _
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge = $ .50
Total = $ ,
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires re ie and approval of plans.
/
SIGNATURE OF APPLICANT PRINT NAME ��10� 6leT?_DATE77
�.
.;PLEASE NOTE S F ' �.'' R VJORT�4 �.
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977