PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT . N9 5 z
Date:
Owner: BuilderLee —
Address Address
LOCATION BUILDING
No.treet P of Lot
Lot Block —Addition or Sub -Division
on
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To Used
it -
Front r Depth.Height Sq. Fit' Ca
cigewg of Fron Depth Height G Sq. Ft. Cu. Ft.
Type of ... Esti � ___
--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 provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ ,.r+► permit is hereby granted to
to construct the building or addition as described above. This permit is grantedupon
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 allrespects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any tune upon violation of any of the provisions of said
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sura to sae
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Owner 'sName Builder C,EM{®N, INC.
N. Z�
2800 22nd Ave.
Address Address c ,s .inn.
LOCATION OF BUILDING
No
of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot___.Z Setback :fid _Side -Yard ®0
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
i1i�'�'�,•/®�,�° Front_j�e Depth Height
Sq. Ft.100 �� Cu. Ft.
Sq. Ft. - -Z -�s Cu. Ft.
Type of Construction �$, �� Estimated Cost %g�� !°d
To be Completed 4'-" 45
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, fimd hereby declares that cts and repress,t��'
stated in this appli ion a true and correct.
DATE a � SIGNATURE '
(A Schedule of Fee Costs can be found on the Reverse Side.)
Application for Power Plants and Heating. Coding, Ventilation, Rahigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU_ 4-7470
A
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
.each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ....... :......
RATE TOTAL,
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $ `.
2.00
$ _
0.00
$
5.00
$
2.50
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $
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 $
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 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FFE $-1
ROUGH
FINAL
N
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 arp true and correct.
1962
Owner
Kind of
Used as
To be completed about 41
Estimated Cost, $ C ✓ p d
Old Ne � Building Permit No. S,2 Permit No. 1 �+
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Y NJ, Wr"LTER HEATING CE
Signed 46 7 CHICAGO AVE,
By Nur-gNLAPnj IM 7. t4iNNESl]�+A
Q� 4 P2 7-59 Business Phone No `✓ orBre/
DESCRIPTION OF WORK
HEATING or PO
PLANTS-SZ�Z�
Hot Wa Warm Air>
o
��
Z-0 Ar
Trade Name ��'r
Size No
Capacity
Sq. Ft. E.D.R-
Vo BTU
H.P.
Total Connected Load
�,
Bind rue'
of
BURNER — Trade Name
Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Y NJ, Wr"LTER HEATING CE
Signed 46 7 CHICAGO AVE,
By Nur-gNLAPnj IM 7. t4iNNESl]�+A
Q� 4 P2 7-59 Business Phone No `✓ orBre/
City- of Fridley
Application for Plumbing and Gas Fitting Perndt
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
$ ,D O
Future Fixture Opening ................
x
1.20
$
F
N
WATER HTR.
GAS
ELEG
Catch Basin ............................
x
3.25
$
,na-�0
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
A �J®
1st 3 Fixtures ..........................
!
x
$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
I
Sewer �
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures ......................
x
$1.50
$ ,D O
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
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
A �J®
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 V--
City of Fridley:
✓i
I
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
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No / Permit No. /
Signed z
By—,ZZ-
Business
y -Business Phone No.�
ROUGH 17-5-W 0 • -
FINAL
e a 2M 7.59
ADD
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