PRE 2010 DOCS1
City of Fridley, Mian.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: June 11, 1971
Owner: — Lee Anderson Builder Russell Scott Construction
Address____fit% 1 t cam_ Lane N&, Address 1055 -93rd Avenue N_W_
LOCATION OF BUILDING
No.. —6631 Street — Lucia Lane N.E. part of Lot
Lot — _ _ b —_ Block Addition or Sub -Division — Al 1 ce Ad rl it inn
Corner Lot ___.__ Inside Lot — Setback Sideyard
Sewer Elevation
To be Used as:
Foundation Elevation _..._
DESCRIPTION OF BUILDING
Garage & F.a n i l_y Room Front —24L Depth 361 Height _ 18' Sq. Ft. Cu. Ft.
Front — Depth Height Sq. Ft. Cu. Ft.
Type of Construction — dame Est. Cost ..._ $9, 000 - 00 To be Completed Arran th a
Provide a hard surface drive. Subject to providing fire wall between house & garage.
Elevation set by the Engineering Dept.
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 tqrth and in compliance with ail provisions of
ordinances of the city of Fridley. " -f
In consideration of the payment of a fee of $ 27.00 , permit is hereby granted to Scott Gonstmetion
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 ordinkmew of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving ofbw11d3ngl:
vyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
C LAREN¢E BELISLE
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: L &J"", BUILDER: de �—-
ADDRESS :_ 0/0/ 3 / ADDRESS: /y53- -? ye -j P ,Cu,
NO:. STREET:
LOT: 6s, BLOCK: / ADDITION: Q—Lt-� 1�L -
CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD:
a
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Depth: �
Front: 2�J p 36 Height:
ht:
A,,-yg/ $Nuic
o
Square Feet: sf-X 33 Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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:' D 7% SIGNATURE: I .�
(See Reverse Side For Additional Information.)
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CITY OF FRIDLEY BUILDING INSPECTION
3431 University Ave NE
=rldley, MN 55432
763-572-3604 FAX 763-5711287
Iesidential
-urnace Shell and Duct Work, Sumer &
also Replacement Furnace
aas Piping (New Furnace, Fireplace, Insert)
aas Range
aas Dryer
"Air Conditioning - All Sizes
kil Other Repairs or Alterations (List on Back)
L% of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
mprovement whichever is greater
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS ll/ ILU Cj 12D �I
-.o-Qr,
Owner 1�
$35.00 $ Building Used As��
$10.00 $ ESTIMATEDCOST3�4��-® PERMITNO
$10.00 $ DESCRIEPON OF FURNACE AND BURNER
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$10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name- F in nyC,.) - I Size No.
$25.00 $ �� �� BTU HP EDR
Fuel CG ; � 4)q I 4 Z Lf & k -A Connected d
$ Sumer Trade Name Size No.
BTU HP EDR
Commemlal/Industrial/Institutional
L.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge
TOTAL FEE
1EINSPECTION FEE $50.00/HOUR
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.
'Air Conditioners can not be placed in side yard without written approval
°rom adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
HEATING
Signed Tel # !V-74 --q6)
FAX # UDate _6'
Apprc
Rough -in Date Final Date
�Ic-
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VERIT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace the undersigned hereby verifies that the
venting has been examined and is free from nom, detenoration, obstructions, Yes () No ( )
and is securely supported and firestopped where required.
The venting system is plastic/PVC and meets all current odes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes ( ) No( )
The undersigned also verifies that the replacement unit is a fisted assembly
and meets the current codes and manufacturer's specifications. This does
Include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No ( )
When required to install a now combustion air, it wdfi be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a now venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ( )
Appliance Type and SLWCommon Vent and Vent Connector Information
Appliance #1 Type
BTU input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted 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
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
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Building Job nepo 't
ADDRESS
i •
OWNER
BUILDER
DATE PERMIT NO.
DESCRIPTION
INSPECTION RECORD
` DATE REPORT
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Poll
ck—
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OWNER - REP. INSPECTOR
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Su9jECT
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
27909
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RECEIPT
`v COMMUNITY DEVELOPMENT DIV.
- ___
r � � PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/21/98
/ /
10B ADDRESS 6631 Lucia Ln NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
1
Alice Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Leland C Anderson 55432
574-0203
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Owner Same
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
O NEW O ADDITION O ALTERATION] REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (21SQ) Tear-off
9 CHANGEOFUSEFROM 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
v
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
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
$1 79900
$.90
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEEFEE
TOi
$59.45
Si NATU OF CONTRACTOR R AUTHORIZED AGENT iDATEj f&�-ENAROWq
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V LID D THIS I O E IT
' " ST NATO OF OW NER,.F BU�IDE R� IOA iEI
B INSF'
()ATE
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NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: �j u C Iq Aa n 2
Legal Description: /
Owner Name & Address: la nd C t9 ✓Id e- r 5 av--- Tel. # '7 y —0 ,�, 0'3
Contractor: 3 G ve R n Q MN LICENSE #
Address: 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: V, rood a u g e g r a 4 2 "� l� 0"d
Construction Type:
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: �a-
APPLICANT:
Tel. # �,' 7 Y 0 3
CITY USE ONLY
Permit Fee
//
$ Cc. °%
Fee Schedule on Reverse Side
Fire Surcharge
$ A e�)&
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 96)
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$ �i�• ���
STIPULATIONS:
10%
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