PRE 2010 DOCSa
(IN of Fridley, Minn.
BUILDING PERMIT N° C4180) -l"
Date:
Owner: ............ . ............ ....... __.._ ...- ----------- -----
Address
, a
Builder
Address
........ ...x..... _
-))"'Z-'L CATION OF BUILDING
N ........... • •
..__. Street ___..�. �; __...... Part Part of Lot ...... _................. _........ __............. _.,..---_.._....._.._
Lot ..a 19 t "I ; _........ Addition or Sub -Division ... .............
_.._.... Block ....._..:--------•-- 1 rY }
Corner Lot ............ _,A.............. Inside Lot ..... .............. _................. Setback .............. Sideyard ............ ........ .... ........ _. -• .
Sewer Elevation Foundation Elevation .. ... -.................. .._.._.__..._...........
DESCRIPTION OF BUILDING
To be Used as:
- -- b
Front . ._.. Depth ;;"`i :' .'.
•
....._
Height .... . �..,
>
M F} 115
�t. Sq. Ft. :.af :'.L Cu. Ft. - -
..... ............... ............. _................ ......
Front ............... Depth ...................._..
Height ........................
Sq. Ft....................... Cu. Ft.. .................... _..
Type of Construction ......:....
' :? :: " - ......-........ Est. Cost .........:...
. `'� 60, ....................
►-
P ...................
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 theayment of a fee of $.. .•.. .......... ._...... rmit is hereby P� Pe Y 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,r�onstruction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
— - -.-- Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder w �'` `'t �J•
Address Address
3olg G•lrft Ste.
LOCATION OF BUILD G' .
n i
No. ` $tidet C e Part of Lot
Lot Block l Addition or Sub.Div.,/i
i
Corner Lot Inside Lot Set Back 3 d Side -Yard ti r l
SEWER ELEVATION._ FOUNDATION ELEVATION___
Applicant attachAothis:.form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as': -
Front. 6 Depth Height 2 1/
Sq. Ft. -� �°� Cu. Ft. a
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction �a
Estimated Cost.
To be completed �{'� • `�' �'. '
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to,do allwork in strict accordance with the.City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true:and correct.
DATE Y 'b SIGNATURE.
(A Scheduld.'ot Fee ,costs can be -found on the Reverse Side.).:.
An,
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK ��eg
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
.............. x $1.50 s-46 ..�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x
Water Heater (Up to 200,000 BTU) ...... x
New Ground Run Old Bldg . ............ x
3.25 $
2.00 $
3.25 $
GAS FITTING FEES: NO. RATE TOTAL
l)
1st 3 Fixtures .......................... x $1.50 $ % 5
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$ _
TOTAL FEE • Q c'
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 are tru and correct.
.4Fridlev. Minn. 45f. 19-6--2117
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Old—New. Build
ROUGH D E C 2 3 1959
FINAL
4 2 2M 7-59
tsusmess rnone iv o. -
..
Z
n
Nj
w
2
•
•
WATER HTR.
aQQ�
'O
8
aa
O
F
N
GAS
ELEG
+3
3 d
3 i
o
U
<
Base
1st
2nd
_
3rd
4th
• Future Connection Openings
Connected with
Sewer
New .Fixture, Old Openings
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
.............. x $1.50 s-46 ..�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x
Water Heater (Up to 200,000 BTU) ...... x
New Ground Run Old Bldg . ............ x
3.25 $
2.00 $
3.25 $
GAS FITTING FEES: NO. RATE TOTAL
l)
1st 3 Fixtures .......................... x $1.50 $ % 5
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$ _
TOTAL FEE • Q c'
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 are tru and correct.
.4Fridlev. Minn. 45f. 19-6--2117
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Old—New. Build
ROUGH D E C 2 3 1959
FINAL
4 2 2M 7-59
tsusmess rnone iv o. -
City of Fridley, Minta. N° 8480
BUILDING PERMITS y
Date: September 23; 1965
Owner: Roman Nerriges Builder Owner
Address 5402 Madison St. N.E. Address
LOCATION OF BUILDING
No. 5402 Street Madison Street N E _ Part of Lot
Lot 14A - 14B Block 1 Addition or Sub -Division Lyndale Builders - 4th Add.
Corner Lot — X Inside Lot — Setback _ Sideyard
Sewer Elevation __ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Dt _ Garage Front 24' Depth 22' Height 10' Sq. Ft, 528 Cu, Ft. 5,280
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost $550.00 ---Tobe 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 a& provisions of
ordinances of the city of Fridley. . -
In consideration of the payment of a fee of $ S _ nn , 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, eonstru on, alteration, maintenance, repair and moving of buil In—
within the city limits andht s permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This pare& does not emw the eondmcgon, insWWae for wiriae, phmbfne, hes hoatine, sewer or water. Be sure to as
the Butidhre t*eetor for apwafe pwndit for thea hems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME. -,: �� , BUILDER
ADDRESS �' , �• �n� ADDRESS
LOCATION OF BUILDING
NO. ,y% STREET u� nA PART OF LOT
LOT _ r BLOCK ADDITION OR SUBDIVISION
CORNER LOT�INSIDE LOT SETBACK SID YARD
SEWER ELEVATION FOUNDATION ELEVATION
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;
-,� FrontDepth�Height
Sq. Ft.
Cu. Ft.
Front Dept h Height
Sq. Ft.
Type of Construction
To be completed
Cu. Ft.
Estimated Cost •�
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.
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
5244-S915-51
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SM -3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
y
N
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3
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7
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Z $ � � � 8, �
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N
WATER HTR.
GAS
ELEG
Base
$
Electric Water Heater
x $2.00
Insl
Gas r r
NO. RATE TOTAL
Ist 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
1st
Gas Dryer
1
5.00
REPAIRS & ALTERATIONS—Refer to Code
Description ...............................................$
TOTAL FEE $ 5.00
2nd
3rd
4th
• Future Connection Openings I
* New Fixture, Old Openings I
JJJ
Connected with
Sewer El
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
x $2.00
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
Ist 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
Gas Dryer
1
5.00
REPAIRS & ALTERATIONS—Refer to Code
Description ...............................................$
TOTAL FEE $ 5.00
Location 5402 N E Madison St
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, Minn 4-14-69 19_
Owner Roman Herriges
Kind of Building frame
Used as res
To be completed about 4-19-69
Estimated Cost, $ 10.00
Old—New. Building Permit No • erm No. 7g�'�'
Z --
Si
-Signe
By NN AAPOLIS CCAS M
Business Phone No
ROUGH
FINAL - l �
J
42
N° 5105
Permit for PLUMBING AND GAS ATTING # S-1097
N.B. When work covered by this permit is ready, the Plumbing Ordinance Permit
y g requires that request for Fes $
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit.,
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
City of Fridley a ,19..4
Stories
m
E W
o
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Z
Z
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m
m y �'
Z
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W
LL m
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S m
3
W
WATER HTR.
a
F m
m
z
a s o
O LL
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rarc%
m a
m Qz°
OAS
ELEC.
3 U
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4J. O
U m
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f Ii.
O a
6 K
Basement
1st
2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
Permission is hereby granted, d -L& 1 .2 "A2� to do the plumbing and
gas fitting in the building described in the statement hereto attached, upoA the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
4e IM --&69.V
Owner• 1 I/
Locationa)
Kind of Building .J?.�Qo
Used as
To be Completed 1° �-� o�J , 19-0 0
Estimated Cost $ % 94'0-6
Old- Building Permit No.
Inspector of
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2001
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES L
JOB ADDRESS (,,; 172C,01- 5C22
RATE___ SCHEDULE
Residential Rate
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace, $ 10.00
but not replacement)
Gas Range $ 10.00
Gas Dryer $ 10.00
*Air Conditioning - All Sizes $ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
mof Value of Appliance or Work
Commercial/industrial
1.259 of Value of Appliance or Work
State Surcharge
TOTAL FEE
,MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $ 50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
}Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
OWNER /;,? ® C—k4a_ _e__1 r
TOTAL
BUILDING USED AS -
ESTIMATED COST PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
$� No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No. —_
BTU HP EDR
Fuel Total Connected Load
Burner trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEA
!3
DATE.-��
TEL # %6k3 2RZ 6 /
Approved By/IS4 Rough -In Date Final Da
BACK SIDE MUS1 BE FILLED IN ON VENT SIZE, VENT CONNECTOKJ
AND COMBUSTION AIR VERIFICATION
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When reola:Ina an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
Yes No
{)
and is securely supported and firestopped where required.
The venting system is piastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes ( ) No { }
The undersigned also verifies that the replacement unit 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
Yes( No( }
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the current codes
Yes () No ( }
and manufacturer's specifications.
When required to install a new combustion air. it will be sized and installed
Yes (} No ( }
to meet the current codes and manufacturer's specifications.
When installina a new venting system, the undersigned hereby verifies that
and meets the current codes and manufacturer's
it is a listed assembly
specifications. This does include AGA-GAMA Category I Central Furnace
Yes {) No ( )
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
Yes( ) No ( }
separately as per current codes.
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type (%,e� (R a V -BTU Input an 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 Length ft Diameter in Type
ALTERATIONS: Describe
HEATING CO:` -
D to
Signed By: a