PRE 2010 DOCSCity of Fridley
r SUBJECT ® NO.
AT THE TOP OF THE TWINS BUILDING P E R M 113848
RECE
•______ COMMUNITY DEVELOPMENT DIV.
p��J
r ~ PROTECTIVE INSPECTION SEC. 7 d
1 i i
1 CITY HALL FRIDLEY 55432NUMBER REV. DATE PAGE OF APPROVED BY
612-560-3450
910-F15 10/28/76
JOB ADDRESS 6064 McKinley Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 1 Zander's Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jerry Keller
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Dailey Homes, Inc. 8510 Central Avenue N.E., Mpls. 784-3910
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
f NEW ❑ ADDITION ❑; ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK ����
Construct a 32' x 60' Dwelling and a 20' x 25' Garage
ore $g ng calf local OHM
SFpERATE PERMITS REQUIRED RM WIRINGS TELEPHONE - ELEC . A5 E
9 CHANGE OF USE FROM
HEATING, PLUMBING AND SIGNS. REQUIRED BY AN
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. Obtain variance to
side yard setback from 10 feet to 5 feet for living area, or reduce size
of family room to comply with Code. Provide vapor barrier in ceiling.
SEWER LOCATION (Approx. 10' Deep) 66' South of Manhole (S. Inv. 928.75)
WYE ELEV: 929.87 TOP OF FOOTING: 932.87
WATER LOCATION: 10' South of Sewer Service 1111t""
SERVICES OFF OF MCKINL—
EY STREET tmRn
�'A:,i'C
THE CM OF. F=Iff =0 MOT QUARIIM91 TME NOTIFY THE FRIDLEY ENGR.
ACCURACY OF VMRY LOCAIRM AND REVAIK3 4 DIVISION REGARDING CURB
THIS DATA IS FOR INFORMATION PUMOM ONLY AN3 (REMQVAL AND REPLACEMENT
PEM$ONS USING IT SHOULD VERIFY THF" WOR"noN AT DRIVEWAY OPENINGS.
ON TME WIL
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. Wood Frame
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 R-1 1580+532 36,920 Total
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 $46,755 $23.38
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $147.68 $350.00
STRUCTION 0H PE FORMA C OF CON�S U•'CTION.
,rjyrQcI� l�'PLAN CHECK FEE TOTAL FEE
le -s76- 7e $36.92 $557.98
SI TUREOFCONTRACTORORAUTHORIZEDAGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG INSP DATE
N
%r e V— .
REGISTERED PROFESSIONAL a LAND SURVEYORS
Telephone 561.25051
sus t t ,sago
VILLAGE NORTH PROFESSIONAL BLDG
7420 UNITY AVENUE NORTH
BROOKLYN PARK, MINNESOTA 55443
FitWETV OF Howard Thorson
described as 1?oI Iona
Lot 6, Block 1, LANDER'a 1ST ADDITION, according to the
plat of record thereof, Anoka County, Minnesota.
GR.
®JIF( THE fRID iNG CURS
DIVISION RD L,CEMEt4T
RpApV�l_ ENINGS'
�T pRIV�
JA116
lot gltlg call local uts etc.
�� = ELECTRIC - �
�R��• BY LAW
law
1 hereby certify that this survey, plan, or report was prepared by me or Scale : I inch e0619•••.5"0,,,,,jeet
under my direct t;Upordision and that I am n defy Registered Land Surveyor o - Indicates Iron WIlim"at Set
under the laws of the State of plfnnet.oto o - Indicates Iron Meftesnl Fawt/
P{ ''• , Book . PaSe ........dok file..
Data - _ Reg Ho gO�¢
�y
- - --?
CAU T I ON
e'VISION SAFETY CONTROL ZONE"
-- - - -- T -1
DIP NOT PLANT OR PLACE ANY-
TAING IN THIS AREA WITHOUT AR-
Zyl
PROVAL OF THE CITY OF FRIDLEY, -
0-1
138:_95
- -
THE CITY ®F LEY
ACCURACY UWUTY
DOES NOT GUARANTEE THE
-
I THIS DATA # INFORMATION
LOCATIONS AND ELEVATIONS.
PURPOSES ONLY AND
PERSONS El< �O ff SHOULD VERIFY TH
ON THE s
IR1F0
5 OOT @N
Dashed line•denotes
drainage and
utility easement. I
<�
E
1 hereby certify that this survey, plan, or report was prepared by me or Scale : I inch e0619•••.5"0,,,,,jeet
under my direct t;Upordision and that I am n defy Registered Land Surveyor o - Indicates Iron WIlim"at Set
under the laws of the State of plfnnet.oto o - Indicates Iron Meftesnl Fawt/
P{ ''• , Book . PaSe ........dok file..
Data - _ Reg Ho gO�¢
//C , 5'r,
� ��'. �N✓. 9�f1'-75J
r�a�uvuc--
J
0
�=-,i ,,-- ,f..
1,-1-7-6
CITY OF FRIDLEY
APPLICATION FOR. RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME: BUILDER:
ADDRESS: FR l I= ADDRESS: S'S -/O Z Ale /U
Cay,, TEL. NO.: 79 V- 39 / 0
NO: D & STREET: /' G r,��r ,-, � W
LOT: BLOCK: l ADDITION: Z iau b p i2
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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:
C00 Front: 302 Depth: Height:
Square Feet: I5-0 1� Cubic Feet: j%l 6O
Front: aJl Depth: Zy Height: 6
Square Feet; 53Z- Cubic Feet:
Type of Construction: LOoocF etch Estima
.To Be Completed: C\o ,Z) P`( .S
S3 Zea
The undersigned hereby makes application for a permit forte wort aerein
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
/
ar true and correct.
XN r
TE: A) W , 1R -j 6 - SIGNATURE:
(See Reverse Side For Additional Information.)
14/1) z
sx% 9a
rVA/ _
a�;k8sls �i
As,10�
WINTER & ASSOCIATES INC.
REGISTERED PROFESSIONAL a LAND SURVEYORS
Telephone 561.2505
SUITE 306
VILLAGE NORTH PROFESSIONAL BLDG,
7•?0 UNITY AVENUE NORTH
h-5 �/Z r''P S�liC✓�� BROOKLYN PARK. MINNESOTA SS"3
Certificate of Survey
PROPERTY OF
c a'iD4 ; •�iti'�c/oEie 157-
described as fol lows , -� ;
cc
k
i
6/5T N A VE,
_ - 1/3a. 9±;, - - _
136.94-
I
36.94
1 hereby certify that this survey, plan, or report was prepared by me or
under my direct supervision and that I am o duly Registered Land Surveyor
under the lows of !�q Slot* of Ati e*, aj'
Y. ®.,�'`.•.•� , ; � /vf��''
Dote�La--z / e 7 Pe`, .Rog No ` � +
0
26
Scale I inch equals.,,,,,,®het
• - Indicates Iron MOM Mot Sot
O - India*%$ Iran Momtesttt %tt1
Book . Pop ......... Job No... J..�.......
o.
r i -
�N
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I�
Irl
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CITY .OF Iridleyt' 01M 'v;PXW'0:WW -1
14
COW UTA T1()t('-:
y E� RA
a
Idi
(To be sulmi t J
0 wve r
tir two f aml-ly, dwelling.,
I ipther14t Zander ,
Sitc.address Lot Blocki".
r* Ad l
Da 16
Utor
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ft., aboye
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Joiry, Keller
0 par
y"��a�'`.�% yr��t" �
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e ��421%rfi y
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Jerry Keller.'
'i, i k f i r "°•? ��°k f w i '"5+r{:.5'�i, r"t y ;!}� v ,a,; r
•, � { !� '�, r I £ 1 F i 1 f P 1 �� Y +�C �b � . 4, t jJ.�
{ ', .0 ., ..... .,1.�,d , r...:�. '° i 'I` i + i., a a•S'' `r`f' . $ f j', �; F _s�,�^.tib},'^� °'§
� � I tl y
zorlvl' 40.0,
.. -` Rdt '�` j' y :h }....�r:.Lv. w"Fh'1;I4 .<i li •t �a,{Syd-A
O.W.t ,.�r r.� 400'
�" � 1� . p. � {� �i �7f " wiw ��: ' �. ,�M�� { � �n. r ./1' d 1R";:,' � , � • C''.' - A� ' y �''
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okjry
all
4'SF '� r:' iiR.�. : -. t•W�+�'7�p'iM�!.p�-.�, £` r ��' < �W'�': 4. ,; n}� ,;{ �'
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40AI.%
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AW
,'Q ? 4:.. �J�M G�•V - (...«dS � w �A aq� R'� Swl. � �.��q� t •}: w- i • �F 1 3-Y t i t i A '.
,rLP FR Vet .14*iwR i 1104 fi s „
i z✓ / • (i' �A . O'.!R 6 F7 jC ° 5 f '+ n t : ;9 rq 'n
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F
AP -ALL SLrTIONS
NOTE: Use SM of opaque wall area for
frame construction
PASIc K "�
VIALL I I
FIG. #
FIG. 42
-1.L �nT,; L rA
riphe al
FP..11',E WALL
Page T<vo
M/•e T,970 A OAv2 S /;P.# AJ i
Construction R -Value
1.
2.
3.
4.
5.
6.
1.
2.
3.
5.
6.
1.
2.
3.
4.
5.
6.
I.
2.
3.
4.
5.
6.
SLAB 014 GRADE
antex or air film 0.6Q
/* 6.YPAoeterp .4i;
" inches soft wood 30
le v /
Exterior air film 0.17_
Total
Interior air film 0.60
4$
u o
p>:tcriva- air film 0.17
Total
l� /R1.d7
Interior air film 0•GB
Z"Fitz R�� 7oi•�� /•08
?.oG
�iS C.Ftrri�' �ti/NG ~.�/
Exterior air film 0.37
Total /lo,4,
i
u-%•'.aG
Interior. air film 0.68
1,Z Caa1G FSC' /•��
Exterior air fi3n, 0.3.7
Total
ra
I(l._._ '
it tt � Jrr
/r/
FIG. $4 Irl tilit
/J r
JIB _ Irr _ Ire
NOTE: Indicate t�•ve, "?:" value, death and
placement of insulati0:1-
X13•
antex or air film 0.6Q
/* 6.YPAoeterp .4i;
" inches soft wood 30
le v /
Exterior air film 0.17_
Total
Interior air film 0.60
4$
u o
p>:tcriva- air film 0.17
Total
l� /R1.d7
Interior air film 0•GB
Z"Fitz R�� 7oi•�� /•08
?.oG
�iS C.Ftrri�' �ti/NG ~.�/
Exterior air film 0.37
Total /lo,4,
i
u-%•'.aG
Interior. air film 0.68
1,Z Caa1G FSC' /•��
Exterior air fi3n, 0.3.7
Total
ra
I(l._._ '
it tt � Jrr
/r/
FIG. $4 Irl tilit
/J r
JIB _ Irr _ Ire
NOTE: Indicate t�•ve, "?:" value, death and
placement of insulati0:1-
172%
JWTALL SErTIONS
NOTE: Use !R of opaque wall area for
frame construction
Q
tASTC
WALL
FIG. 01
FIG. 42 A
F?ME WALL
._ripheral �,•
---` _,�1
Page Two
M.4 -rrX /d L IF�AC AT q r oC.,r
Construction R -Value
1.
2. /Z .I a wy QoR.ey
3. 4" inches soft wood
So 9XC/Ar
6. Exterior air film 0.17
1.
2.
3.
So
6.
i
SLAB 014 FADE
2.
•
—,
4.
So
6.
Interior air
film
0.68
•{,7 �1
2.
3.
•
4.
-i/ iw�'j
//.off
6.
i
SLAB 014 FADE
-- �� Total 16-17
Interior air film O.68
8"r-OMG .��i< /
A'Ac1-0 MAC, Ile . 3d
Extcrior air fila 0.17
Total
use •�7
FIG. 04
I
NOTE:
/rt to a TIM
�r� , • � Ill^
�r r
!l� � If f � lil � •
fit x
Indicate type, "Tt" vrAltle, denth and
placement of inSulatioa.
Total
'R. o f
u = �A�_
Interior air
film
0.68
V"...v
=9
, 4y
�/t"Gl./e1f?f Fi/3�Ir
-i/ iw�'j
//.off
r%terior air
film
0.17
Total
/.4,74
interior air
filn
0.68
•iii
AACIS Agli,- C
. 3l
Exterior air
film
0.17
-- �� Total 16-17
Interior air film O.68
8"r-OMG .��i< /
A'Ac1-0 MAC, Ile . 3d
Extcrior air fila 0.17
Total
use •�7
FIG. 04
I
NOTE:
/rt to a TIM
�r� , • � Ill^
�r r
!l� � If f � lil � •
fit x
Indicate type, "Tt" vrAltle, denth and
placement of inSulatioa.
~^ Iz
Page nvo
NOTE; Use M& of opaque wall area for
frame construction Construction R -Value
Interior air film 0.68
2. /2 "G yP. fv,peO 4S
3. inches soft wood
t ANq z 5/3'z " BviG rei i►� 2 o_G
tcnictr --
6'1A " GYP• /4a,v�o SG
WAI.I. -- . 6. ni.r
�e Total
-FIG,. 1 TO. rpV:rlt: OF 0$1 .2
--- F."I ME MALL 1. Interior air filen 0,68
3.
4 r f 5. VA., C.Ylp
a +� 6. Ritterier air film i.jT,c,Crol7) �G
FIG. 42 Total
u 1�=_ o
1. Interior air fi.ln 0. rig
IM
4. 2EMIr"gurj7,�',rn� ?,oG
r -..� S . B�! "G y10, BarlWA? y"
nr 6. Exterior air film(�vTi�lr�o�c (p•�
--��- '
V.
Total
1. Interior air film 0.68
2.
.a?�17dTY0;1 �: f, �a• 3 •
4.
6. Ext�:rior air film •
Total ? 4 7 u
" + � SLAD ON GRADE uSN_ 47 �•G�M/� ,JAS
• " .A J�
� FIG. r- � � !• /�l
111 i
lit
" NOTE: Indicate type, "Tt" Value, denth and.
• placement o'_' insulation.
ROOT /CEILING
D; -O
IIS(! "�
VMI -L
V'entec,
Heat f lcw
f' up
r7c. r
V V
Heat flog up
F1 C. C6
Page Three
1040✓ �.
Construction
A -value
—:
l: Interior air film
0.61
2 . -- y�
OAA
4. T:�o���".r, film
--------------_.
s�
o.
Tonal
23. 743
u � �A - %3 �d. • o4t
I. In'Zcrlor air film 0.61
2. -
Y' 3.
4. Exterior air -i m t5Vi
Total
vented
• 2:Oa-�rLNTED
Heat
flow up
Ms. 47
9
1. Inside air film 0.61
2.
3.
4.
5. Outside air film 0.17
Total
Note: Use additional sheets if more space is
needed for d(--.ta3.ls and calculations.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUNIBING FIXTURE RATES: NO.
RATE TOTAL
Number Fixtures 1 4. x $3.00
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
x
$2.00
x
y
x
$5.00
�
y
x
ro
x
u
x
41
x
$5.00
Water
�c
C
A
i
a,
H
01
Heater
y
w
y
N
11
N
H
•1 b
�-i
N
fd ►4
W
•ri
$4 o
zc
"n
m
x aj
o
$4
x c
•M
1c:
PN
N
,q
.11
j
y
1
O
O
!O)
4� N
N
N
N
x..
m
U
D
O w
c'cn
w
U PC
3
U
U
o
as
lec
t
L
c
t
l
lst
t
2nd
'D
1
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUNIBING FIXTURE RATES: NO.
RATE TOTAL
Number Fixtures 1 4. x $3.00
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
x
$2.00
x
$2.00
x
$5.00
% x
$5.00
x
$10.00
x
$7.00
x
$5.00
x
$5.00
x $3.00
x $1.00
x $x:0.00
$5.00
$2.00
State Surcharge
TOTAL FEE
REINSPECTION FEE
($10.00)
$ 06
$ j 0d
$ .50
$ oy
Job Address 60 49 17"A
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. 10'L
OWNER V
KIND OF BUILDING
USED AS
f/
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD BUILDING PERMIT NO. PERMIT NO. d"
ROUGH INSP.
Date
Company 0.
Signed By
Tel. NO.
FINAL INSP. �`10`71/
Date
APPROVAL FOR PERMIT _1�1I
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
1st 3 Fixtures
Additional Fixtures
Gas Range to 199,000 BTU
AIR CONDITIONING
F XTST AtS
RATE
TOTAL
$12.00
$
7.00
$
7.00
$
4.00
$
$12.00
$
4.00
$
7.00
$
7.00
$
4.00
$
$12.00
$
4.00
$
7.00
$
6.00
$
$10.00
$��
10.00
$
$10.00
$
x $ 3.00 $ 3
x $ 1.00 $
X $10.00 $
Ai HEATING SY E _ See Fee Schedule
VENTILATING SYSTEMS _`
ALTERATIONS $ REPAIRS
State Surcharge
TOTAL FEE
ROUGH INSP. REINSPECTION FEE _
Date (.$10.00)
FINAL INSP. " l"
Date
APPROVAL FOR PERMIT z
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
$
$
.50
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 truce and correct. 2
'Fryley, Minn. /� / �� , , 19�
OWNER
KIND OF BUILDIN i
USED AS
i
TO BE COMPLETED ABOUT
ESTIMATED r...ng.T � J
NO. / PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name !/ Size No. / Z 4 A2
Capacity Sq. Ft. EDR BTU�HP
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Suburban Air Conditioning -@c-6—
$419 tenter Drive comp
Minneapolis, MinnesSigotans�By
Tel. No.
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips Guide V' Construction No. Insulation
Windows Doors Reference Out. WaU 11nt.WaU Ceiling Roof Floor Kind How Applied
Yes—No I Y— e5= o 19_
I FI.I Room' Lenath % Width 1 Heitht II 7/1-4.1 7-7 r m I Lenath Width Height
Windows and Doors—Craekage and Area
�
Width Helght No. of Lineal ft. Area
No. of pane of Dane llghte of crack sq. ft.
36
gpane
d
Coef. Btu
ICoef.1 Btu
Infiltration
Q
Glass
0
Exp. wall
Net exp. wall
00
Int. wall
Ceiling
Floor
Q
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
i Fl.I Room I Lengthwidth
Wm"d&i and Doors—Crackaae and Area
Na 1 of nano 1 of mine 1 llghte 1 of crack 1 an. tt. 1
Btu
Exp. wall
Net exp. wall
Int. wall
Ceiling Floor_
Total Bta
Re4uired sq. ft. E.D.R. or sq. ins. W.A. Leader area
% F11 Rmm I Length /"LWidth -h-'MIeiaht
Windows and Doors—Crackage and Area
�
Width Height No. of Lineal ft. Area
No. of pans of pane lights of crack eq. ft.
'Of CL
gpane
d
Coef. Btu
Coef.1 Btu
Infiltration
WaPs
Exp. wall
Net exp. wall ,
Int. wall
Coef. Btu
Ceiling Q
Floor
0
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
and I
HE
i of
Area
Coef. Btu
Infiltration 7,0
Glass
Exp. wall
Net exp. wall
int. wall
Ceding 0 all,
Floor
Total Btu.
Required sq. h. E.D.R. or sq. ins. WA. Leader area
/ F1.1 I / Room I Lentth Width /' Height
Windows and Doors—Crackage and Area
�
Width Height No. of Lineal ft. Area
of pane lights of track m f
No. oft.
gpane
d
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. Wall
Coef. Btu
Infiltration
Floor
Glass
Exp. Wau
iUJI,
Net exp. waU
Q
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room 1 Lenath 77—width 7 7 Heitht
Windows and Doors—Crackage and Area
Width Height No. ofLineal ft. Area
No. of pane of pane llghte of crack p. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. Wall
Ceiling
All 0
Floor
Btu.
or sq. ins. W.A. Leader area
BROOKLYN PRINTING & ADV. CO.
April 5, 1977
'5901x s�1'j
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Dailey Homes
8510 Central Avenue N.E.
Spring Lake Park, Mn. 55432
Re: Final Inspection at 6064 McKinley Street N.E.
Dear Sirs:
TELEPHONE ( 612)571-3450
A final inspection was made on April 4, 1977 of 6064 McKinley Street N.E.
and the following items were noted which must be completed before the
structure can be finaled out;
1. Provide a hard surfaced driveway by June 15,1977.
2. Provide sod in the front and side yards by June 15, 1977.
3. Provide a verifying survey by April 14, 1977.
4. Provide house numbers on structure by April 14, 1977.
5. Provide handrail to basement by April 14, 1977.
6. Provide door closer on door between garage and house by April 14, 1977.
7. Provide garage floor and steps by April 14, 1977.
We will expect the above items to be completed by the scheduled dates when
reinspections will be conducted to determine compliance. If you have any
questions on these items, please feel free to contact me at 571-3450.
Sincer ,
RON HOLDEN '
Building Inspector
RH/mh
CC: Mr. Jerry Keller
. RECEIPT •
Cts o/Jridlev
6431 University Ave. N.E.
Fridley, Minnesota 55432
Tel. 571-3450
RECEIV OF $
ADDRESS
FOR It'd
k4r2? �o C-- .
FUND
CODE
AMOUNT
Marvin C. Brunsell
Treasurer
By..........................
/,41
1--'-� i 9
® PRANZMEIER INC; ST-PAU4 MMSOTA
1977
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Gerald Keller
616 84th Avenue NE
Spring Lake Park, MN
55432
TELEPHONE ( 612)571-3450
New Fence Construction Request
Lot 6, Block 1, Zander's 1st Addition (6064 McKinley St.)
Keller:
Per your letter of March 16, 1977 requesting permission to construct
a privacy fence within the existing street right of way, it is City
policy not to allow any new construction of fences or other struc-
tures within existing boulevards. But in consideration of this
street where the 50 foot total right of way width is not consistent
along the south side of 61st Avenue from McKinley to Benjamin Street,
and that the City has no foreseeable plans for the existing 20+ foot
boulevard area along the north side of your property, we will allow
this requested fence construction with the following stipulations:
1. The fence is to. be set back a minimum of 7 feet from the south
back of curbing of 61st Avenue NE.
2. It is understood that should the City require this fence and
any other amenities placed within this right of way to be re-
moved or relocated, the existing property owner will assume
all related costs and responsibilities.
3. You relinquish any right to claim damages inflicted upon your
fence by any City maintenance vehicle or employee.
4.' No other permanent structure shall be placed within this
20+ foot street boulevard area to the north of your property.
5. You will notify any and all future buyers of this property of
these stipulations thereby relieving you of any future
maintenance responsibilities.
6. That with the construction of the fence, you thereby uncon-
ditionally agree to these stated stipulations.
If you have any questions regarding the City's position regarding
this request, please let me know.
Sincerely,
Q�,o,_UT10Jhomas A. Colbert, P.E.
�i Assistant City Engineer
U m
TAC/jm
d1 0
March 16, 1977
TO: FRIDLEY CITY COUNCIL
SUBJECT: NEW FENCE CONSTRUCTION
Gentlemen:
I am submitting a request for the construction of a fence
on Lot 6, Block 1, Zander's First Edition, at x064 McKinley
Street, Fridley. This is a new home that I would occupy
April 1, 1977. The fence will extend up to my neighbors
fence, it would be 40 feet running east and west, attached
on opposite end to my home. I understand that the property
of my neighbors fence and my proposed fence would be boulevard
property of the City of Fridley. This fence can and will be
moved at anytime that the City of Fridley desired, if the
occasion arises.
Thank you f your consid ation in this matter.
�-
'7
Ger Keller
616 84th Avenue N.E.
Spring Lake Park, Minnesota 55432
After April lst:
Gy
60.65" McKinley Street
Fridley, Minnesota 55432
•
97-8-h416051
ilf-PLICATION
FOR PUJMDING AND GA5
PIT-ritiG PE:Ic';1
r
v
N •�
n I o J
'1
9 y
Al
w S
mater
Joli Aaatr,s 60 LI ASE McKinley Street
•i I c r,� I'
;; ; ? L
n
c p
? a u Ci G
..
R u
IA
�k
c1
—,—
Dr -pa rLit, r:nt cf ba
..
s Imo . ;
_. X 4 ii
� C
,4s :lec (
Cltjr rt [ ridluy -
il`I
Tel. U571 -j.150
Tha�undorn1911�d C.:rcL• ::kl:a
..
epnClf/ed a. rt:cln. r "er:tlt .:r th5 ►+erk Lerttr,
J
_
w da al work lr. Sulct c:_ r�sr.:a rltl. tLr Clt' I L,,,!
and rulings cf th Ge,:arlcrent
I—
.
of e�>:�tn_ erCc
'� r .e late, tt.al al!
tha facl8 a,,d rc1r,,c„rtattonn ecatad
1^ chlda .:tack.: oro t,.,a and x,.II
5-6-80
OWNER Keller
rJc.:tl:.a GI.¢n:r .j
C, .:.«cal with
Sewer
KIND OF IIUIL'uI::.;- 'frame
I - gee- t lett.tn, Gld Ciptn:r.]
water
t
USED AS res.
TO BE COMPLETIL0 h:.;;Ur 5-13-80
T I
Cr•.'� Ing ';r:
y ..r'_....�C
N
ESTINATLD COST 50.00
TE
"- =
fru •
RATE
TOTAL
OLD - 1ILw IIUILGI:I.; PLI.t•1I� � h
x52.00
—
x
g
•c• t l...te, GiJ Gpe .l:.a
x
$2.00
S
t:alll
eQ
x
$5.00
5
sl]ne.t 6y
cu 57,000 6T`U
x55.00
g
dJJ GIu W 15 CLO 6:U
x
$10.00
$
:al, wa.
..ac�r a_Itcnac
-
�� x
57.00
g
r�CV ,.Iv .,.f R.Ir• • Gld b�llSlr.]
x
55.00
g
.
AOUGII I IISP .
:lC.lrl_ Nal Ce Iledtde
x
55.00
g
i
Da to .
:; IllfihG FEES;
'
HIML IIISP, / —JCS - FO
1. 1.IIll.r.�a1 FI. tVrd•
x
5].00
S
�—'�'�—
Da to
-
-�, ta.,,a• w 395,GOJ 61U
$1.00
5
x
$10.00
S
_
APPRUVAL 16It I-Llu•1Ir
AI.TtkAThDu5
:,.i, .a�. il�,...,� .:c Icacucn
$5.00
$
.
52.00
$
M111111U11 I'LL• Ir.p 1.1'i FLUI:uIII:. Fttu;TT
State S„rct.ecgoFLUS
S
,..p :;t.TY 6UtIC1u.1 1f,C
r rr.L , .t
s
5.00
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
RESIDENTIAL RATE
TOTAL
Job Address
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $ 20.00
$
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
Gas Piping $ 10.00
r'�
$ /,C).
City of Fridley
Tel. 0571-3450
(piping needed with new furnace)
Gas Range $ 10.00
$
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
Gas Dryer $ 10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are.true and correct.
• Air Conditioning (all sizes) $ 10.00
S
Fridley, Minn. 19
All Others/Repairs and Alterations
OWNER Z
li of Value of Appliance or Work
$
KIND OF BUILDING
COMMERCIAL/INDUSTRIAL
USED AS
li of Value of Appliance or Work
/
TO BE COMPLETED ABOUT
ESTIMATED COST 1/1
State Surcharge
$ .50
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
FEE
$�`,
Ti]T)�
Reinspection Fee ($15.00)
$
DESCRIPTION OF FURNACE/BURNER
Rough Insp.
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Q -D -a
Final Insp.
Trade Name Size No.
/ (o/te
Date
Capacity Sq. Ft. EDR BTU HP
Ap roval for Permit
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
Company
PLUS $.50 STATE SURCHARGE
,
Signed By
Tel. No. k';;7 ® s !
*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
CHIMNEY 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
Da to
City of Fridley
SUBJECT
P
24510
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RE— NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SECg970
I i
/'-'1 CITHALL FRIDLEY 55432
Y
NUMBER
REV
DATE
PAGE OF
APPROVED BY
t.; 612-571-3450
910-F15
8/28/96
/
JOB ADDRESS 6054 McKinley Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
5
1
Zander's 1st Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mark/Susan Gustafson 6054 McKinley Street NE
571-0365
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
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
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
COnstruct a 5' x 13' deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
WARNING
Before digging call for
all utility locations
454.0002
REQUIRED BY LAV
SEPARATE PERMITS REQUIRED FOR
WIRING, HEATINGs PLUMBING AND SfGft
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
1 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
$576
$.50
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-
$23.75
Fire SC $.58
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
$24.33
SIGNATURE OF CONTRACTOR OR U ORIZED AGENT (DATE]
PROPER ALIDATED THIS IS YOUR PERMIT/%
10 !PIC 40
AWHEN
1011
S,G TUBE OFO NER OF RI iDATE1
D 'INSp
GATE
9
11
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application���
ConstructionAddress:
Legal Description:
Owner Name & Address: ��,¢,l/
•' J osti.� ��s f o�s�
Tel. # r7l
- 63 63 -
Contractor:
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
s Width /3 ' Hgt/Ground 5-o " Sq. Ft.
0
OTHER:
-�
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: ����,/ Estimated Cost: $ �j
Approx. Completion Date: AO- //
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE: APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Tel. #
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
3uilding
BUILDING
Permit No.:
nspections
RESIDENTIAL APPLICATION
Received By:
163-572-3604
CITY OF FRIDLEY
Date Rec'd:
)ATE —ZCp —(� S YOUR E-MAIL ADDRESS
ITE ADDRESS
C 54 -
'HIS APPLICANT IS:
I#WNER dCONTRACTOR
PROPERTY OWNER/
NAME. r�,'u� �S
TENANT
ADDRESS:(e 044 PC-k4J:1-RT AJCITY I
STA ZIP
PHONE: -7U
U
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
FAMILY/NEW CONSTRUCTION SIZE
PROPERTY TYPESINGLE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMITTYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ) -ROOF ❑ DRAIN TILE
❑ DECK ❑SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ ADDITION
CS/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: N 6W r oO -e-
3IZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
GOOFING
❑ HOUSE ONLY
\UMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
3ARAGES
11 ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
?ROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
'ROPOSED HEIGHT:
3IDING
D Vinyl
�I❑Soffit
FOR NEW CONSTRUCTION INCLUDING DECKS.
ADDITIONS. & PORCHES SUBMIT:
:3Aluminum
❑ Trim
1. Site
Plan/Survey showing the existing structures
3 Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
R'INDOWS
3. Energy Calculations
N EXISTING OPENINGS ❑Yes
❑No LOCATION OF WINDOWS
DR 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 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ -0 OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ ( (.0005) times the total job valuation - Minimum $.50
Fire Surcharge $ 3.i.001 x Permit Valuation (1/10%)
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks payable to: City of Fridley Attach Stipulations
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 whi94 requires r"w and approva)of plans.
SIGNATURE OF
TE / O -.2,i�, — �S
l y7 / 6d.3 0031 0 W/ �!
Building PLUMBING Permit No.: ?bl 604 i
Inspections RESIDENTIAL APPLICATION Received By -
763 -572-3604 CITY OF FRIDLEY Datd.
763-502-4977 FAX EFFECTIVE 1-1-2010 n n
DATE___6 t(.�" I� 2cgzo YOUR E-MAIL ADDRESS f 7""OZ25
SITE ADDRESS �° l N
THIS APPLICANT IS: %OWNER OC NTRACTOR
PROPERTY NAME: 4LI A") r d'S r- d e-
OWNER/ ADDRESS: 6o ,Ie r,J-r/4EECITY F' STATE /'NZIP��T'(
TENANT
PHONE: Y - S7(
CONTRACTOR NAME:
SUBMIT A COPY OF STATE LICENSE # EXP DATE
YOUR STATE
LICENSE, BOND AND STATE BOND # EXP DATE
CERTIFICATE OF ADDRESS: CITY STATE ZIP
INSURANCE
1)��GLE
PHONE FAX
PERMIT TYPE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: I 0 NEW v�t.EPLACEMENT
DETAILED DESCRIPTION OF WORK Hd
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAV
_FLOOR DRAINS
_ SHOWER
R PIPING
—BATHTUB
_ GAS PIPING (NEED CITY LIC)
POOL
ATER SOFTNER ($35)
CLODISHWASHER SER
ATUNDRY
��S1�'WIMMING
BACKFLOW PREV. ($15)
_
TRAY
t/ WATER EATERCLOSET ($35)
FOR IRRIGATION
WATER METER
OTHER
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 theCity of ridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an ap 1' tion for a permit and or is not to start without a permit on site; that the work will be in accordance
with the approved plan ' ase o hic�equisreview and approval of plans.
SIGNATURE OF APPLI( PRINT NAME Xy, A,0 f®WS 7`�!cC DATE
City of Fridley _0
Building Inspections Department i0
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: 1�
763-502-[4977 FAX
EFFECTIVE 1-1-2010
DATE O I 1 - oP- v / CD YOUR E-MAIL ADDRESS i"
SITE ADDRESS fJA4CW41e-4S
THIS APPLICANT IS: KOWNEIV ❑CONTRACTOR
PROPERTY
'NAME: E2dj 7
OWNER/
/r N4cITY i' Qce STAT)/il ZIP
TENANT
ADDRESS:
PHONE:
CONTRACTOR
COMPANY NAME:
CONTACT PERSON:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: CITY STATE ZIP
APPLICATION
PHONE FAX
dSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
PERMIT TYPE
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK /'� ✓�/�1� �� e U� f.
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FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUALJ 2006 ASHRAE HANDBOOK
Equipment Installed MFG: r'� MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
$25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
,XA/C
TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _,NEW GAS GRILL $10.00
_AIR
$35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
ZiAS
_BOILER
CHIMNEY LINER $10.00 DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
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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 ap ion for permit and is not to start without a permit; that the work will be in accordance with the
approved plan in the case of al or h ,ll— revi w and approval of plans.
SIGNATURE OF APPLICANT ' PRINT NAME gif IFj DATE O CI - 1 e2 -a010
APPROVAL INSPECTORS SIGNATURE
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City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977