PRE 2010 DOCSVillage of Fridley, Minn.
BUILDING PERMIT ° 1865
lei
�.
Date: j,.'6 .........
caner Builder.��'...........
�
Address...................................... Address .............................................
LO ATION OF BUILDING
No. ............. Street le
.... !' ........ Part of
Lot ........... .... .
Lot ... O . ..... Block ..... �......... Addition or Sub -Division ... � rc e'C:"'� ::"f
Corner Lot ........... Inside Lot ... / ... Setback i..... Sideyard ... ....................
DESCRIPTION OF BUILDING
To be used
✓.� - .� Front :VA.. Depth ��c �� : ?— Height 'S Sq. Ft. ........ Cu. Ft. ........
..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
0 .;oa t0
Type of Construction Est. Cost . .. .:............ 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 village of Fridley.
In consideration of the payment of a fee of $e.l. permit is hereby granted to 41
......................... 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, construction, alteration, maintenance, repair and moving of buildings with-
in the village 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 t construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
BUILDING PERMIT
Village of Fridley, Minn. N° 2773
Date .... tel f?f .
Owner ...f/
Address
o�r C /
70
Builder ... .......
Address
LOCATION OF BUILDING
No. ...��j��.. Street ... .. .-. .... ted'.?.. .,, . Part of Lot .......................
s
Lot ............. Block .... 5........ Addition or Sub -Division ..... .... I��.%� .. ��.. �� .......
Corner Lot ............ Inside Lot ....Z.100'.. Setback ............ Sideyard .....r...
DESCRIPTION OF BUILDING
To be Used as:
... Front .. A Depth .4mQ . Height ......... Sq. Ft. r Llai Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........
/J!rr?LZ� y 00yc�
Type of Construction Fst. Cost .... /�. ���.... ... To be Completed . �. >5070 "��'�J
(�14 t�_r**'O`
1
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 village of Fridley.
11014r_. )
.....................................
conside ° on o the payment of a fee of $. y�.` 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, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
. �.� .... . uilding Inspector
NOTICE:
IThis permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
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SUBJECT
PER
City of Fridley
20417
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
,'�
L 612-571-3450
910-F15
6/8/90
JOB ADDRESS 5740 Madison Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
14
8
Donnay `s Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jerome Olson 5740 Madison Street N.E. 571-6664
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House. & Garage (23 Squares) -
9 CHANGE OF USE FROM TO
STIPULATIONS
On aU new roofs or tear -offs and replacement roofs,
State Code requires that 2 layers of 15 ib. felt,
mopped together, be installed to a point 24 inches
up from exterior walHitl>f;° 0fr � ,� of other
approved underlayme*-memlxaA`;
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,150
$.58
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$29.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$29.58
IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDAATTEI
HEN R V DATED THIS ISYOUR
QpPERMIT
-A' DG INSP DATE
NATURE OF OWNER OF O NER BUILDER) (DAT
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NEW [ ]
ADDN [ ]
ATS [ ]
R-1 AND R-2
Building Permit Application
Effective 1/1/90
Legal Description:
Owner Name & Address: '0 L=7f2® PUS e cy L �) ® �11 Tel. # S71-144 y
Contractor: CS EL F7 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DFSCRIPTICK OF
LIM G AREA: Length Width Height Sq. Ft.
GARAGE AREA: Iength Width Height Sq. Ft.
DECK AREA: length Width Hgt/Ground Sq. Ft.
OTS:-r-=-A-v _ jo Fr- -L- �� P, ton F-%�.3 S*4—
Corner Lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost:
Approxi Completion Date:
Proposed Driveway Width If NewIs Desired: Ft. $ $
Width + 6' See Back Page
DATE: _� g q0 APPLICANT:T-
sz;;�Tel. #l- G to
CITY USE ONLY
Permit Fee
$ c79,00
State Surcharge
$
SAC Charge
$
Driveway Escrow
$
Park Fee
$
Sewer Main Charge $
STIPULATIONS:
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
CITY OF FRIDLEY
f 6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 YAX: (763) 571-1287
PERMIT NO.: 2004-02127
DATE ISSUED: 11/18/2004
ADDRESS :
5740 MADISON ST NE
PIN :
233024130071
LEGAL DESC :
DONNAYS LAKEVIEW MANOR ADD
:
LOT 14 BLOCK 8
PERMIT TYPE :
PLUMBING
PROPERTY TYPE :
RESIDENTIAL
CONSTRUCTION TYPE :
ADDITION/ALTERATION
VALUATION :
$ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS
0
VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS) 0
# GAS WATER HEATERS
# GAS DRYERS
0
# GAS RANGES
# OF NEW FIXTURES
0
VALUE (FOR MINIMUM CALC)
# WATER TRMT APPLIANCES
0
APPLICANT
GAVIC & SONS PLUMBING
12725 NIGHTINGALE ST
COON RAPIDS, MN 55448-
(763)755-6468
OWNER
BRUCE ABFALTER
5740 MADISON ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
re const'-ction or the performance of construction.
ADDlicant II Date
MOM. %.RRO — I- 11 a
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 10949
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
RJ
1
1
0
300
0.00
0.00
0.00
0.00
0.00
35.00
0.00
0.00
0.00
0.50
35.50
TY OF FRIDLEY INSPECTION DiViSION
w 1,31 University Ave NE
1) �6 kil-.5
idley, MN 55432 APPLICATION FOR 06WER PLANTS AND HEATING, COOLING, VENTILATION,
m 63} 572.3604 REFRIGERATION: AND AIR CONDITIONING SYSTEMS AND DEYICES
C�
LX (763) 571-1287
LO RATE_SCHEDULE
N ssidential Rate TOTAL
P •urnace Shell and Duct Work, Burner .
;1so Replacement Furnace $ 30.00 $ J0
(Side Vent . Fill Out Back)
nas Piping (Needed with new furnace, $10.00 $
but not replacement)
.3as Range $ 10.00 $
aas Dryer ry $ 10.00 $
%ir Conditioning • All Sizes $ 25.00 $
111 Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $
W
A )rnmerclal/Industrial
U- ..25% of Value of Appliance or Work $
U-
0 State Surcharge S .50
}
TOTAL FEE $
0
W
U- IHIMUM FEE -FOR ANY HEATING/COOLING/VENTILATION
N.FRIGERATION/AIR CONDITIONING PERMIT IS 125 00
..U$ THE S.59—ST—ME SURCHARGE
9 :INSPECTION FEE $47.00/Hr
N
it Conditioners can not be placed in a side yard without
•itten permission from adjoining property owner.
UJ .
E
JOB ADDRESS
January 1, 2003
OWNER rLJ L V ;)/&X 1J,, - �
BUILDING USED AS
ESTIMATED COSTO— PERMIT NO.
DESCRIPTION QF FURNACE AND OR BURNER
No. of Heating$�-Units Hot Wat _L Circle One (Steam} (Warm Air)
Trade Nme -7 -7. n Size No.
BTU --E2, HP I EDR
' Fuel ,�j/�� � Total Connected Load '7Q: 000
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 ai
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE -)Cj &
HEATING
Signed TEL #
FAX # 4Z
Approved By Rough. In Date' Final Date
ILL -OUT BACKSIDE E -08 -STACK VERIFICATION ON REPLACEMENT FURNACE
SEP -02-2003 12:33 FROM CITY OF FRIDLEY TO 9528911656 P.05i08
��
OW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR'THE
TION W LL BE RETURNED
When , the undersigned hereby verifies that the
venting pals been examined and is free from rust, deterioration, obstructions,
and is sects* supported and firestopped where required. Yes f? No ( )
The venting system is plastirJPVC and meets all current codes and manufacturer
spetafilt ations including sizing, length, number of elbows and termination. Yes (-Ao ( )
The- ,undemigned also verifies that the replacement unit is a listed assembly
and meets the comment codes and manufac turees specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes No ( )
The AwLelina immbusbw aic is sized and installed to meet the current codes
and marndacturets spec'fcations. Yes No( )
VM".required to a nnuu natnhiLcion 2i4 it will be sized and installed
to meet the current codes and manufacturers specifications. Yes (�No ( )
VVhSn , the undersigned hereby verifies that
it is a listed assembly and meets the cu t codes and manufacturer's
specifications. This does include AGA -LAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes (4 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 (; )
AWliance Tine and Sr�lCemrnnn 19 _enc and Vent Qnmetnr Infonnaiion
Aphl rM #1 Type ` —�` BTU Input 4 4- a Ce U Fan AssistedNat
Appliance #2 Type 3- -,i �1� BTU Input .R 0, V iu v.... Fan Assisted or at
Awe 03 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input 1 3 5 a OU
Common Vent Type
Vent Height Diameter_ inches
App>•isrloe #1 Vent Connector Height -a—ft Length aft Diameter 4L in Type rK ,�-NPt
Appliance #2 Vent Connector Height__,.t_ft - Length , ft Diameter _.T- Type L_
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
HEATING CU: la 1 AJ C—
Signed W. Date :
CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
(763) 572-3604, FAX (763) 571-1287
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas** l
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ __5'0
JOB ADDRESS S%i% /'lUdL soa Sf.
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.
DATE: OCA aa -12004
OWNER &410YQLIAr
BUILDING USED AS 6 we lit M
ESTIMATED COST 4�02. PERMIT NO.
PLUMBING COMPANY Sons
SIGNED BY / TEL N0. 763
Approved By
Rough -In Date
Final Date
$ 3S•� OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/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
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 new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new 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 Size/Common 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
s ®®3-74
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
/a"/
Tel. 6W2 A? f-fS—A 5 '
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
GARAGE AREA:
DECK AREA:
OTHER:
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft
Constructiqn Type:7'e� d# I - AW P , 6414'141 Estimated Cost: $ )0 S7S-
Driveway Curb Cut Width Needed: Ft. + 6 F $ _ $
2
DATE: 3 - 2 V -O 5— APPLICANT: G'v Tel. # 2 S
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
$ c;23.
Fee Schedule on Reverse Side
- an --mewl' �F"t
$ c9,3,
65% of Permit Fee
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ,,
$.50/$1,000 Valuation
SAC Charge
$
$1450 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Curb Cut 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
$
STIPULATIONS:
/47 d