PRE 2010 DOCSUILDING PERMIT
Vill ge of Fridley, Minn. N° 2227
Date 16411 .................... ..........
Owner -�� ^:� F .......... Builder _,,'''......
Address J�•: y '. ' rl�!Ofk% Address .....................................
LO41= ATION OF BUILDING
No../34$2...... Street % ..... `*"S ....... Part of Lot .......................
Lot ........ ..... Block ....... `... Addition or Sub -Division .. � ................
Corner Lot ............ Inside Lot .. ...... Setback a,,,�.�:3ir' Sideyard .
DES4RIPTION OF BUILDING
To be Used as:
........ Height
-&Wal ..
Front . A# I
....................
Front ........
Type of Construction .
e?4_P:+—.
In consideration of the issuance to
the proposed work in accordance with
ordinances of the village of Fridley.
considerat' a payment of a f
.. to construct the
• e.express condition that the person to v
done in, around and upon said building, o
Fridley, Minnesota regarding location, coi
In the village limits and this permit may 1
ordinances.
.e.. Height.. Sq. Ft......... Cu. Ft. ........
3epth
........ Height
.........
Sq. Ft......... Cu. Ft........ .
Cost
....
To be Completedo
of a permit to construct the building described above, I agree to do
description above set forth and in compliance with all provisions of
a of $, : ''�',.,�, permit is hereby granted to � �...... .
wilding or addition as described above. This permit is granted upon
nom it is granted and his agents, employees and workmen, in all work
any part thereof, shall conform in all respects to the ordinances of
truction, alteration, maintenance, repair and moving of buildings with-
, revoked at any time upgn viglation y of the provisions of said
Inspector
NOTICE:
This permit does not cover the con truction, installation or alteration for wiring, plumbing, gas heating,
--er or water. se sure to see the suil�iing Inspector for separate permits for these Items.
City of Fridley, Alinn. N® 7656
BUILDING PERMIT
Date: June 11, 1965
Owner: Waverly Peters Builder Reco Construction
Address 6350 Madison Street N. E. Adm 1311 South 5th Street
LOCATION OF BUILDING
No. 6350 Street Madison Street N. E. part of Lot
Lot 5 _Block 5Addition or Sub -Division Christie Add.
Corner Lot _ Inside Lot _ __ Setback — Sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front r _ Depth Height Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Est Cost $3 ,* 000.00 _ To be Completed
Storm damage repair
In consideration of the issuance to me of a permit to co et the
the proposed work in accordance with the description above se ; forth a
ordinances of the city of Fridley.
I agree to do
provision of
I/ a
In consideration of the payment of a fee of1$ 0•00 permit is hereby granted to Reco Constr. Co.
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 regardinglocation, construction, 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 ii—BM
ordinances.
Allen Jensen Biding Inspector
NOTICE:
ihb parrot don W eorer the contracHm, inst&Wm for v hb& phnnbine, an heaHee, sewer or water. Be sun to we
the Buildh* Inspector for sepaMa pwWft for thus Hams.
1
OWNER'S
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEYP MINNESOTA
ADDRESS_ (o � 6 G' d" -'d L -i ADDRESS �®cl P%`
LOCATION.OF BUILDING
No._ ao dart of Lot
LOT BLOCK ADDITION OR SUBDIVISION
Corner LotInside LOT ,_Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates. ®®�
H] r7 DESCRIPTION OF BUILDING �0 W
To be used as:
Front Depth _ Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft.
Cu. Ft.
Type of Construction Estimated Cost 3 0 ® ®
To be completed
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.
kca a 0
r
DATE ' —SI GRATURE
(Schedule of Fee Costs can be found on C a Reverse Side).
A . -
Permit forPLUMBING AND GAS h i TING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for
inspection shall be phoned in to the plumbing Inspector, SM -3450 giving number of this permit.,
Number. Bind and Location of %=tures
Story
RW
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q
Z
m
Z
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m
Y
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= Y
Y F
Z 7
w
O
C m
O z
S m
m
z K
Vy
IA y
N
m 2
WATER HTR.
GAS
ELEC.
V
aa
m F
m
0
= F
G ILdj
IJi. O
tF
u m
C J
i ILL
C Q
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O 6
Basement
1st
2nd
3rd
4th
Connected with Sewer -Cesspool
Gas Piping for Openings
Permission is hereby gran CLQ to do the plumbing and
gas fitting in the building described in the statement her attached, upon 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 aany-time-upon the violation of -any -of the-provisions-of—wdordmnces,
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
42 JM --6.69.V
N? 501'7
Ws 7G"-"
Permit
Fee $
City of Fridley
Owner "
Location 3
Kind of Building
Used as
To be Completed o , 19-(---,
Estimated Cost $ / f-5-. a -e)
Old -Nem. Building Permit No.
Date
ti
e
DESCRIPTION ®t WORK /�y _ C "�`A W .
Number. Kind and Location of Fixtures Lowti.� l� 3 15_0 s � d
U' WATER HTR.
6, �( Za epi p <z Q�? O z ® a
0 O P RI GAS ELEC.
Easr-
2nd - - -- - - -- - —
31-3- - - -- - - - - —
4th - —
° Future, Connection Openings Connected with — -- ---
e Now Fixture, Old OpeningsI CeSewer
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures
x $200 $
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 $3.26 $
Electric Water Heater
: $200 $
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures .... .. ... ........
x $200 $
Additional Fixtures ..... ..............
x $ .,M $
Gas Range to 199,000 BTU ..............
x $5.00 $
REPAIRS A ALTERATIONS—Refer to Code
Description ......... .....................
...........$
TOTAL FEE 2 ��—
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 fac9
and representations stated in this app'c tion ar true and correct
1
Fri �-, Minn L
Owner /_&/
Kind of Building
Used as
To be completed about
Estimated Cost, $
�D/17
(61 New. Building Permit No.—_ - _ _Permit No.
Signed.
By-. --
Business Phone No- 6�
ROUGH
FINAL - l % - ? �cj
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work ..........................
8.00
$
Replacement of Furnace .............................
5.00
$
Repairs & Alterations—up to $500.00 ..................
5.00
$
Repairs & Alterations each add. $500.00 ...............
2.50
$
NECK. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 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 $
LTERAT S &REPAIRS TOTAL FEE $
S -
ti
ROUGH
FINAL
Dept. of Bldgs. Phone SII 4.7470
Location e5 '3'5-0 oe-.;7 i�SO �• :-
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 true and correct.
Fridley, Minn 19 —
Owner 6,1)14 Ye'
Kind of Building �'-
Used as
To be completed about
Estimated Cost, $ J�
Ol New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS --Steam, Hot Wate , Warm Air No 4i
Trade Name Size No
Capacity.
Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.B.
(REMARKS -OVER)
Signe
ByNO AIR TIONING ING.
4410 EXCELSIOR BLVD, MINNEAPOLIS 16,
42 2M Business Phone -No- wA. 6-6567
HOUSE HEAT TESTING DEPARTMENT
Auth. No Folio
Alccount- TEST RECORD Date 7~
Address ec- 6- 642 Apt Town Year Built
f -/-
Heat Loss Estimate MCF,
Meter Set Date
Phone
Phone /'��
CF/DD
Insulation: Walls Ceiling Date
Weatherstr'p: Doors-;
oors M
SOLD BY ;' ��
." - ''f ' � Installed by
Date
Electrical Work by Gas
Reset by
TYPE OF HEAT G. D. Conv._ MAKE Je S ez
Modell I C/ � /�� I've Serial 7 Br/ /4 CIO Z / 3 Input — 00
Conversion: Make of Plant Model
Serial Firepot Coil
Controls: Thermostat�!'Y�Heating Plug. Valve 4 -Limit�elay
Trans.: M ke Model Sec. V V. A.
Pilot Type e- Make_��� Model
Liner: Kind Size Riser: Size Lengtl+ Ells
Reg cF L W. Cut Off
Vent: Size Lengths—,
engths Ells D. H
Filters: CL ° Rep. Size Z!� e Number
Chimney: Location s O ®� �'�� Constructio Flue—
d�
Flue Size -- Condit' d
Pressure c -- Smoke Bomb — Reset FilterR
P
Test "'T'ag
-i egrit <-
Input Z C;Lo ' Pilot Timing 4/J7q Wiring
Low Water CO Inst. Card�-
Stack Temp Fan Setting Controls,
Fuse Size 1 � � Gov. Seal
Percent CO2 Limit Setting / 7 t
Salt Cap Sea --Meter Size
Percent 02 Draft -ell, -,r- t Hood - • e
Meter Seal Dam
Percent CO2 6011 Door Pressure Liner
Meter Statn _
Write Orsat Reading for other Sections on other side.
w1A SwE -
CHIMNEY AND STACK VERIFICATION
VENT DAMPER INSTALLATIONS
LOCATION C4 `��� �� DATE
OWNER W ,`�,jlt� 5 ADDRESS
Y-eSChimney properly sized and in safe condition
Is liner installed yes no
_ Heat exchanger test yes no
_ Vent connectors properly sized yes no
_ Vent connectors need replacing yes Vl'no
Vent connectors properly supported and fastened lyes no
_ Furnace/Boiler replacement necessary —7' yes no
Are other appliances tied into vent V yes no
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodged within /2
4. That it is securely supported
5. That it meets present current code 5
requirements for size and total BTU connected
6. Total Heating BTU 2_!rl' X00
All other BTU �$� 1®O
TOTAL 1 6 6
Diagram of existing installation: (include proposed damper location).
--Additional work necessary on existing installation
--Install combustion air per SBC 7722 (Note fireplace and exhaust fan
�= installations that may create back draft conditions on chimney or vent.)
--Electrical-work necessary for installation (list). (Electrical permit
required, for electrical work.,)
s" --Installer certification when required by vent damper manufacturer
sA'1fiw.h
--Contractor license when required by municipality
Vent damper installation instructions must be left at job site.
REMARKS:
Heating Permit #
SIGNED
Licensee
By
Address
Telephone
License #
7
SUBJECT
-
P
City of Fridley
-_
0 7446
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIP O.
• COMMUNITY DEVELOPMENT DIV.
.......
r � � PROTECTIVE INSPECTION SEC.
t �
i CITY HALL FRIDLEY 55432
,.j
NUMBERREV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
14/9/84
JOB ADDRESS 6350 Madison Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
5
5
Christie SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
B & L Home Improvement Inc. 1161 - 79th Avenue N.E., SXpX2Xg Spring Lake Park
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
780-4533
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE OF USE FROM TO
ST PULATIONS
Roof can be the.2nd layer but not the.3rd. Install ridged galvanized
Valleys where necessary,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Asphalt
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
1
ISTALLS 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
$750
$.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
NY OTHER STATE OR LOC LAW REGULATING CON-
$15.00
RM F RUCTION.
MTION:EPE
PLAN CHECK FEE
TOT$IaFE50
NATURE OF CONTRACTOR OR AUTHORIZED AGENT '(DATE)
WHEN PROPERLY VA TED THIS IS YOUR PERMIT
BLDG )NSP ` 11AT '
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
7
NEW
[ ]
City of Fridley Effective 4/1/84
ADDN.
[ ]
R-1 AND R-2
ALTER.
[ ]
Building Permit Application
Construction Address:
Legal Description:
Property Owner/Address: G 3 0 Tel. #
Contractor: B4 L 1'19'r e _____Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground
Sq. Ft.
OTHER:
/�- oo
%2 /z aF-
Corner Lot [ ]
Inside Lot Dq
Ft. Yd. Setback 'SZO Side
Yard Setback
a"
Type of Construction: l&go � ' Estimated Cost: $ 7-5 0 -
Approx. Completion Date: y
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: L� APPLICANT: Tel. # ��G `/� 33
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
$
$ /S7 '(� ?)
Fee Schedule on Reverse Side
25% of Building Permit Fee
$•50/$1,000 Valuation
$425 per SAC Unit .
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Building
$ 91A5 -
%APlan
BUILDING
Permit NO.: -- , 0(c3
Inspections
$ -3
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$ �, tir-1
CITY OF FRIDLEY
$
DATE
YOUR E-MAIL ADDRESS
Erosion Control
SITE ADDRESS ('9 35ZJ
Park Fee
THIS APPLICANT IS:
❑ OWNER > CONTRACTOR
$
PROPERTY OWNER/
NAME: A I H G
TENANT
ADDRESS: / o • CITY
STATFf!±tIP--M.32—
PHONE: '7k;? - 577713-71,1 — —
CONTRACTOR
NAME: P (Lt t (® (- / c t T
SUBMIT A COPY OF
STATE LICENSE # C� O 6 (ca 3 (p 7 EXP DATE ?131 l 0 e
YOUR STATE LICENSE
ADDRESS: 13 J�1— e E � ov 6l E �� Irf( Aam CITY MF�D�;�R7S. STATEA1'1IP SJ'�dp
WITH APPLICATION
PHONE b f -I - G S6 'Y (a 9 FAX
c
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH )°ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING❑ HOUSE ONLY
NUMBER OF SQUARES 2-5—HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
11 ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
2.
Two sets of construction plans
FVIlVDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OFWINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
2 (USING THE 1997 U.B.0 FEE SCHEDULE)
30V TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
$ 91A5 -
%APlan
Plan Review
$
Fire Surcharge
$ -3
Surcharge
$ 1,52-1-
.52-1-License
LicenseSurcharge
$ �, tir-1
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$ /661-W-11
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
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 which requires review and approval of plans. / /
SIGNATURE OF APPLICANT PRINT NAME Ce ti �T DATE 6 / 14 ` ,