PRE 2010 DOCSO
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Visage of Fridley,, Minn.
�U1LDING PEDM
O
754 Office 4f INSPEGTOB OF BUMDINGS
No.�.�
Lot
Fridley, Minn.,��
OF BUIIZING
Part of Lot
ii
Addition or Sub -Division
r*,V4zr4T?TT rrTn1%T nw RTTTT.nTNf'S
Front' Depth ='�" Height
Stories " Manner of Construction
'as `
" Cosu�
To be usedm -
I
u
To be completed---.';- Estimated
* � ``"
Permit is hereby granted to,,"'-' ^- -^ +
�. to
described in the above statement. This permit is grant
the building
upon the express condition that the person
to whom it is granted, and his agents, employees and workmen, in ,
the work done in, around and upon saidiIbuilding,
or any part thereof, shall conform in all respects to the or
nances of Fridley, Minn„ regarding the 'Ionstruction,
alteration, maintenance, repair and moving of buildin
within the city limits, and this permit my
be revoked at any time upon violation of any of the provisions of sa
ordinances.
_ �.. Tnspector of Buildini
AGREEMENT
AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley
the above permit, I hereby agreed do the proposed work in accordance with the descriptio
above set forth and according to the provisions of the ordinances of Fridley, and, being first du
sworn, I hereby state and say that the facts stated by me and contained in the above permit a
true as therein stated.
Subscribed and sworn to before ale at Fridley, Minnesota, thistry =
day of .. ,�_ A D 19
Ciiy of Fridley 915.51
Application for Plumbing and Gras fitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK 4651 RTE BQain
Number. Kind and Location of Fixtures Location
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— x $1.50
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— x $1.50
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WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer ❑
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ...... .....................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg . ............
Electric Water Heater
GAS FITTING FEES:
— x $2.00
$
— x $1.50
$
— x $1.50
$
— x $3.25
$
— x $3.00
$
— x $3.25
$
_ a $2.00
$
NO. RATE TOTAL
1st 3 Fixtures ....................... .. x $2.00 $
Additional Fixtures .................... —x$.75 $
Gas Range to 199,000 BTU..............—� x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
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 facl
and representations stated in this application are true and correct.
Fridley, Minn 18 Dec 67 19—
Owner E Schultz
Kind of Building f'
Used as res
To be completed about 22 Doe
Estimated Cost, $ 5.00
Old -mow. Building Permit No Per it
Si 2-/
By MIE04K GAS
0
Business Phone No
ROUGH
FINAL
Description ................................................$
TOTAL FEE $-��' 42
R for Power Plmft aw Heabs Cooffm Vownewas Rehose Oo mid
Air oning Sydom and Dovkns
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work
$10.00 $
Replacement of Furnace
6.00 t
Repairs & Alterations—up to $500.00
600
Repairs & Alterations each add. $500.00
300 $
MRCIL WARM AIR
Furnace Shell & Duct Wort to 125,000 BTU
.110.00
$_
each add. 60,000 BTU .....
3.00
; -
Replacement of Furnace
600
$
Repairs & Alterations --up to $500.00
6.00
$
Repairs & Alterations each add. =500.00
3.00
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. FMR Steam $10.00
Furnace Shell & Line—to 640 sq. ft. EPR Hot Water 10.00
Each add. 200 sq. ft. EDR Steam 3.(n $ _
Each add. 320 sq. ft. EDR Hot Water 3.00 $____—_
OIL BURNER—to 3 gal. per hour 6.00 g _
over 3 gal. per hour—See Fee Schedule
GAS BURNER (UP to 188,000 BTU) &00 $
over 199,000 BTU Be* Fee Schedule
GAS FITTING FEES. NO RATE TOTAL
1st 3 Fixtures ---. _ — x$ 200_—
Additional Fixtures ` x .75
Gas Range to 199,000 :$ 6.00 $
AIR COR DMONING
FAX HaATING 5T6=N
VENTILATING STSTEM
ALTERATIONS & REPAIRS
ROUGH
Stage Surcharge„ s .50
see Fee Schoch"
$
TOTAL. Pae
Dept. of Bldgs. Phos. ei904M
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 Ordinance;
and ruling of the Department of Buildings, and hereby declares that all the facts -
and representations stated in this application are true and correct.
Owner.
Kind of
Used as
Fridley, Minn �/ 3 01>:`i3
n _
To be completed about
Estimated ('ost, $ 9-
Old—New. Bwlding Permit No. Permit No.
HEATING or POWER PLANTS -Steam. Hot Water, Warm Air=No
Trade Name____-
Size
Capacity— _ ___---
_ -- Sq. Ft E.D.R BTU H.Bb�
Total Connected Load__
,__ Rind of Fuel
BURNER — Trade AL*++n
Size Not
Capacity— --
Sq. FL E.D-R BTU 8�
C/ , r
Sinned_-_ -ems
Budom Pboee N06
(RE111ARRf—OVER)
SUBJECTPER
City of Fridley
o - -16258
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
I P.
I `L COMMUNITY DEVELOPMENT DIV.
��^
r I PROTECTIVE INSPECTION SEC.
3�
� +
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/24/81
JOB ADDRESS
4651 Main Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
24,25
12
Plymouth SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Patricia Farber CLund)
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
X
8 DESCRIBE WORK
Resideellin
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Winyl
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 1 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
$2,300,
$1.15
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-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$16.15
�J���SIIGNATUREOFCONTRACTORORAUTHORIZEDAGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP C T
SI NATURE OF OWSI NATURE OF pW NEWNER BUILDERI IDAT ,q
CITY OF FRIDLEY
APPLICATION FOR RESI01-'NTIAL BUILDING PER14ITS
(14m, Alterations, /additions, or Repairs)
01•111ER �� y�� �I�p�� UUILDER:
ADDRESS: �`��.�� ADDRESS:
TEL NO: TEL NO:
Construction Location
STRERT NO:
STREET: �
LOT:r t BLOCK: ADDITION: W, \.A 'IA
Corner Lot: Insiae Lot: Setback,: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
��-=-
Front: Depth: Height:
square. Feet: Cubic Feet:
Front: Depth: Height:
•
Square - Feet: Cubic Feet:
Type of Construction: `,Wh Estimated Cost: $
7b Be Cbrapleted: l s
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ ' $
SEE EVERSE SIDE OF SHEET
'Me undersigned hereby makes application for a permit for the %:nrk'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: i S IGNATU: '
Stipulations:
!S' o�
f
CITY OF FRIDLEY MOVING [ ] DEMO [ ] PERMIT APPLIC;A110N
6431 University Ave NE
Fridley MN 55432,
(763) 572-3604 FAX (763) 571-1287 C�
e
Job Address: _
Legal Descriptic
Owner & Address:
Contractor:
Address : 5L
f
State License #
UY
Tel. #7 &0
Tel. #U(a LN1. I
v DESCRIPTION OF BUILDING
HOUSE: Length Width Height Sq. Ft.
GARAGE:Length Width Height = Sq. Ft.
OTHER: Length Width Height Sq. Ft.
Estimated Cost $ Approx. Completion Date
Cu. Ft.
Cu. Ft.
Cu. Ft.
CALL GOPSER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL
UTILITIES FOR DISCONNECTS BEFORE WRECKING MOVING STRUCTURE.
Moving Route:
APPROVAL(S) REQUIRED PRIOR TO ISSUANCE:
MPCA: NOTIFICATION OF INTENT.' TO PERFORM .A DEMOLITION ( ) YES ( ) NO
❑ Water Bill Paid: Yes[ ] or Collect[$ ]Signature
Bldg Official Conditions
Engineering Conditions
Fire Marshal Conditions
The undersigned hereby makes application for a permit to wrecklmove the building described above, agreeing to do all work in strict
accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the
property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application
are true and correct.
ALL DEMOLITON DEBRIS INCLUDING FO TION & gM, SEXLL BE REMOVED FROM SITE.
JAXDate Si e
Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction...... $1.25
Accessory building into Fridley ... $ 42.00 For structures which would be impractical to
Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost
Move a building out 01 City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00
ft -TO or fraction.
5�
PERMIT FEE: � MINIMUM $20.00 Office Use Only: SAC -D form completed
Effective 4/21/09
Building
BUILDING
See Back Page for Fee Schedule
Permit No.: 0" UO -
Inspections p
RESIDENTIAL APPLICATION
Fire Surcharge
Received BAu
763-572-Y6044977
CITY OF FRIDLEY
$ 5 Gj Q2.0005
Date f :15 200
763-502-4977 FAX
$ �—
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
EFFECTIVE 1-1-09
Curb Cut Escrow
$
DATE `— i ® YOUR E- IL DRESS
Erosion Control
lA
/
SITE ADDRESS 1 6, 'rte i'i r d d
$450 Conservation Plan Review
THIS APPLICANT IS: ,`DOWNER ❑CONTRACTOR
$
PROPERTY OWNER/
NAME: _ \A, P, '
$
TENANT
ADDRESS: CITY
STATE_1ZIP
Make checks Davable to: Citv of Fridlev Attach Stinulations
�^�
PHONE: ^_� 76, Pel _
fO
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
WINGLE FAMILYNEW CONSTRUCTION SIZE
❑ TWO FAMILYNEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION _&ARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR WREMODELING
DESCRIBE WORK BEING DONE: Ackw 01 e
SIZE OF IMPROVEMENT �' LENGTH WIDTH ' HEIGHTY"/ ( SQ FT d E
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES _-7 ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:I
.
Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
PROPOSED SIZE: ADETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIRING
FOR NEW CONSTRUCTION INCLUDING DECKS,
Vinyl t
ADDITIONS. & PORCHES SUBMIT:
13
❑ Aluminum 'Trim
WTri
1.
Site Plan/Survey showing the existing structures
y g g
❑ Otherand
(,$ Fascia
proposed project.
2.
Two sets of construction plans
WINDOWS
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 OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ I C;1_ (0 `� OCCUPANCY TYPE
Permit Fee
$ OOJ A
See Back Page for Fee Schedule
Plan Review
$ IN AD
65% of Building Permit Fee
Fire Surcharge
$ L
.001 times the total job valuation
Surcharge
$ 5 Gj Q2.0005
x Permit Valuation Minimum $.50
License Surcharge
$ �—
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = • ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ ' r`p
Make checks Davable to: Citv of Fridlev Attach Stinulations
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 on site; that the work will be in accordance with the
approved plan in the case_of all work which equ rev' w and approval of plans.
SIGNATURE OF APPLICANT % . (, PRINT NAM o DATE