PRE 2010 DOCSCity of Fridley, BE
Date:BUIIDING PERMIT N? (5:6:7:1�)
Omer: 'Builder.sem►'! :, .r'
AddressAddress
,. L ATI N OFILDING
No. Street_ Part Lot
Lot Block M..�
Addition or Sub-�D,i�visio — t
Corner Lot — Inside Lot $""� Setback e*_ _ _ Sideyard
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
TP Used
Front
Depth
Height
Sq. Ft. ! Cu. Fkr'—.c"-"
Front
Depth
Height
Sq. Ft. _ _ Cu. Ft.
Type of Constructio 1� 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 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
within the city limits and this permit may be revoked at any time upon vlaltion of any of the provisions of said
ordinances. 'A 1
Building Inspector
NOTICE:
This permit does not cover the Construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
.4S110.4
APPLICATION FOR BUILDING -ER=
CITY OF nrDr , •
Owner's Nsme,� Builder
Address ---
Corner Lot Inside Lot z,!� Setback_,,�Side-Yard f e)
SEVER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
6J
To beamed as:
DESCRIPTION OF BUILDING
62 40 Heieht C�
Sq. Ft. Cu. Ft.
Frontpth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
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 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.
s� r`
DATE SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
Ci f Fridley
City oe Y
Application for Plumbing and Gas Fitting Penult
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK '--=&
Number. Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL LL�
$1.50
��
$A
Number Fixtures ......................f
x
-
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
C7
z
•
R
N
WATER HTR.
GAS
ELEG
New Ground Run Old Bldg . ............
3 tjj
$
GAS FITTING FEES:,,
VI
1st 3 Fixtures .......... ,�b-+,��'-!.//�� ........
LL
$ � sa
LL O
x .50
3
Ci Q
U
i
Ci O
Base
1st
2nd
_
4th
• Future Connection Openings
Connected with
I
Sewer �
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL LL�
$1.50
��
$A
Number Fixtures ......................f
x
-
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU)
...... x 2.00
$
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:,,
NO. RATE TOTAL
1st 3 Fixtures .......... ,�b-+,��'-!.//�� ........
x $1.50
$ � sa
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description .....................$
TOTAL FEE
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. 9�v_�
Owner��
i
Kind of Building
Used as ,
To be completed about
Estimated Cost,
Old—New. Building Permit
��
ROUGH�,I �� b
FINAL
4 z 2M 7-59
Application for Power Plants and HeathiS Cooling, Ventilation, Re, 1-j- ration and
Air Conditioning System and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ...........................$10.00
$
Replacement of Furnace .............................
6.00 $
Repairs & Alterations—up to $500.00 .................
6.00 $
Repairs & Alterations each add. $500.00 ...............
&00 $
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & ]:.roes—to 400 sq. ft. EDR Steam .... .$10.00 $
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $
Each add. 200 sq. ft. EDR Steam ...................... 8.00'$—
Each
.00'$Each add. 320 sq. ft. EDR Hot Water ... . ........ ... 3.00 $
OIL BURNER—to 3 gal. per hour ... . ' ... ... .. 6.00 $
over 3 gal. per hour—See Fee Schedule
c�
GAS BURNER (up to 198,000 BTL) ......................... WO $ a'
over 199,000 BTU See. Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ Z00 $
Additional Fixtures ............ x .75 $
Gas Range to 199,000 is 8:00 $
AIA CONDiPiONING
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $-
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH
FINAL, 5 a v - i `3
Dept. of Bldgs. Phone 560-M
Location /V� 4 -
City of Fridley:
The undersigned hereby makes application for a permit for the work hereie
specified, agreeing to do all work in strict accordance with the City Ordinancek
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_ MAY 14 1971
Owner
Kind of Building ✓��''�"�
Used as
To be completed about
-7-0-71
Estimated Cast, $ 0' 1 n
Ol New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No
Trade Name oi�r%P�� �s� G. Csse/ Size Nozi6-49
Capaci Sq. Ft. F-D.R BTU -Z-%--" ` o H.P.
Total Connected Load Rind of Fuel �-
BURNER — Trade Name Size Ns -
Capacity Sq. FL ED -R- BTU H.P:
Blue Flame C®ntraet-ar. $
6989 Washin tan
B AVS,psy.
Edina, Minn. 043;
B
Business Phone N
(Ru►■Ks-OVER)
0
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
Effective Aug. 1, 1981
RATE
TOTAL
Job Address 5-1-16 ► r l ct &A -Ag r A) V r.
$ 20.00
$
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
$ 10.00
$
Tel. #571-3450
$ 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
$ 10.00
$
and rulings of the Department of Buildings, and hereby decl res that
all the
facts and representations stated in this applicatio are a and correct.
$ 10.00
$
Fridley, Minn./ ` ,
19
OWNER /dr ei'i C e Sw 4i /f'� Q r
$
KIND OF BUILDING Jrr-' nW'
USED AS A �J d/ / oji J
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCHARGE
$ TO BE COMPLETED ABOUT J,
ESTIMATED COST ® Z ®®
$ .50
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
$
Attach stack verification form with replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
DESCRIPTION OF FURNACE/BURNER
HEATING r POWER PLANTS, Steam, Hot Water,arm No.
/
Trade Name < Size No. —go
Capacity Sq. Ftp.. E�iDR BTU HP
Total Connected Load 7 0 Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft: EDR BTU HP
A /& L11
Company rITM
Signed By 441
�y
Tel. No. ."t
n•Ot � `- '� "" �!t :tib ��:G� �
Sys+/ rDEPAR7�►IEPT'
(iV1T 0
VsaAl
theratrips Guide'
Windows 1 Loon
Refereatx Out.Wal1,' Iat WEU Wing
u
- . F`l.(" - Roon;; 1,•ctiPt1► ';'W,dth�. }ieyrht ••• �,
'i>irindows anti Uoer,�rackavc taad Area
wtean KoKpt No. of , j,laa&1
et -.paws
f
Oif �
Coef. Btu
Infiltration
Glaze
Exp. wall
Net a :p. wallInt. wall -
Ceiling
Floor
Total Btu �.. -
Required aq.ot:sq y�sYQ,A• Ltadcr.area �;;,
F1.1 Roorii.Legtttl► W,dtkt Height`.y
'Windows and-Iyoor:-=racitaRc and' Asea,
wletD 'h+Kat '_Ac ot` Lmaal it. <' Ana '
of Crack
OF ' iNSPE&ION
hto.'
Roof F6w Kind
r ,Window. and Door"—Cracksefe, aad Area
.
w/a McMral Ice: d', I It. �►t+a
'� Ne. et Vew el ws ' gtra/e' at Mt p. [l.
l
9
I
lnbleratioa
Cott. Btv
Class
Coef. Btu
Esp. wall
Chas+
:Kct Tip. wall
Ezp. wall
lot. wall
( 9
Ceiling
Int. wall
Hoot ... f
Cei{idg
and.Dotitt=-Craclta�ge as '�liea
� ,,
� •
wleltl Mallkl No. of Ltesal lL Xraa..'.
Ne. el paws - of V&es ltYkla e! erect[' K- it.
l
9
I
I
COCO Btu
Coef. Btu
Infiltration
Chas+
Glast I
Ezp. wall
Exp. wall
( 9
Net ezp. waU !
Int wall I I —
Cci{ing
Floor
Total Btu.
y Reouired sg.-ft:1~D.R.^ or sig. iaa. T+'.iF+. Leafier area -=•- - • --` ; t
6
Totil Btu.
Required sq. ft: E.D.R. or sq. ins. WA Leadcr area
Fl.l Room I Length Width iielttut
Windows Cad Doors---Cracicage and Area
—
wtr. Netrkt M. of I LIN*el it. Ara&
Na. ( of Vane or p&m I nsala at crekk sc. M
9
�)
COCO Btu
Btu—
• Inbltration
Chas+
CUSS
Ezp. wall
Net exp. wall
Int. wall
•Ceiling
Cei{idg
Floor
Foot
Total Btu `' . -
Regwred aG. ft. E.D.R. or'sgAis. WA. Leader area
Width lielghl
i Windows and Doors Zrac6re anti Area
—
WIGLN etral Nes rdNie /L A"&
tie. orVane et taut i `alwbw - at Crack 04. 11.
�)
COCO Btu
lAlt;atlon
Chas+
Ezp. wall
Net exp. wall
Int. wall
Cei{idg
Floor
I
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 ,
Furnace Shell'and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
RATE TOTAL
$ 20.00
$ 10.00
$ 10.00
Gas Dryer $ 10.00
W�jIN1 � a a'1
• Air Conditio ng (all sizes)
All Others/Repairs and Alterations
li of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
10 of Value of Appliance or Work
$ 10.00
State Surcharge
F1�
Reinspection Fee ($15.00)
Rough Insp.
�j Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SU9CHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
n
S
S
Job Address .S L It C. M 4 g e r h o A && . Dr.
Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432
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 applicatQio are true and correct.
Fridley, Minn. O Z G , 19
OWNER rJdire viLC S w" L e r
KIND OF BUILDING 9
USED AS
$ TO BE COMPLETED ABOUT
$ .50
10
ESTIMATED COST love / / J
OLD )NEW BUILDING PERMIT N0. PERMIT NO. ( ®� < �✓
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size No. ,
Capacity Sq. Ft. EDR
Total Connected Load
BTU HP
Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company Ag,ll `w OU, b9� ATIMG & COOLING
4120.351n Avenue N•
Signed By ,,._e. coni KAAA9
Tel. No.
424-8333
Fill out back side for stack verification on replacement furnaces
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
I.
'Has .been_ carefully examined
Yes (,)
-No
2.
Is free from.rust or terioration
Yes ( )
No
3.
Has no foreign obje is 1 d within
Yes ( )
No
4.
Is securely suppor a
Yes ()
No
5.
Meets all curr t Co equi ements for size and
total BTU conne d
Yes ( )
No
6.
Has Total heating TU's o
All other BTU's
TOTAL
Rema rk s
Company.
Signed By
Da to
-
SUBJECT
P
City of Fridley
30911
AT THE TOP OF THE TWINS
BUILDING PERMIT
f
�
R NO.
T
CEIP T
`.: ----- COMMUNITY DEVELOPMENT DIV.
� SEC.
^�
r � PROTECTIVE INSPECTION
1, A
CITY HALL FRIDLEY 55432
NUMBER
REv
DATE
PAGE OF
-OPROVED Br
L 612-571-3450
910415
5/8/00
10B ADDRESS 5246 Matterhorn Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DescR.
4
5
I Innsbruck 1st Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Florence Swanberg 5246 Matterhorn Drive NE
571-2192
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Tacheny Roofing & Siding Inc 49 S Owasso Blvd, Little Canada, MN 55117
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
484-1466 7596
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW 0 ADDITION O ALTERATION REPAIR
0 MOVE 0 REMOVE
B DESCRIBE WORK
Reroof House (18 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED VV.ITHIN 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. OWLG. 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
$.79
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,573
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-
STRUCTION OR THE PERFORMANCE
OF CONSTRUCTION
PLAN CHECK FEE
TOTAL EE
A
LicenseS $5.00
$R4.41
SIGNATURE OF CONTRACTOR OR AUTMO EO AGENT FDATEI,
N ROPER V (DATED
BLO (NSP'
IS IS Y PFI IT
fly/
f1AfE�
S-GNATURE OF OWNEROF OWNER BUILDER. &DATE-
FROM : Tacheny Roofing Inc PHONE NO. : 482 8377 May. 05 2000 02:11PM P2
NEW
ADDN () CITY OF FRIDLEY Effective 1/1/2000
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 572604 Bldg lrfsp
BUILDING PERMIT APPLICATION C fig
Construction Address: 6
Legal Description:
Owner Name & Address: F401? Ill t'E SW MBEI? Tel. —6^71 — .1
Contractor:/40—#6A1W kd'O&/j9 4' 9 .Ne, MN LICENSE# 759
Address: 1149 so . UGC ks "� ,al�LII� � � o A,Ui4��l 41A) -Tel. # lcS/-- Y04-IV46,6
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
STIPULATIONS:
DES..CRIPTION OF I,MPROVEME14T.
LIVING AREA:
Length Width Height Sq. Ft.
GARAGE AREA:
Length Width �; Height_ Sq. Ft.
DECK AREA:
Length Width Hgt/Ground Sq. Ft.
OTHER:
-- Fe-- m oAx / R ,,,j'(,�
Construction Type:
Estimated Cost:
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: --5'-5-00 -5'-5-•0D APPLICANT: __D ®/V %/�C/��,R,1 L� Tel. #
CITY USE ONLY -
Call (763) 572.3604 for Permit Fees if mailing in application
Permit Fee
$ Fee Schedule on Reverse Side
Fire Surcharge
$ .001 of Permit Valuation (1/10th%)
State Surcharge
$ $.50/$1,000 Valuation
SAC Charge
$ $1100 per SAC Unit
License Surcharge
$ 0 $5.00 (State Licensed Residential Contractors)
Driveway Escrow
$ Alt. "A" or Alt. 'B" Above
Erasion Control
$ $450.00 Conservation Plan Review
Park Fee
$ Fee Determined by Engineering
Sewer Main Charge
$ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
l Lit
$ •
STIPULATIONS: