PRE 2010 DOCSArchitee Fridley, Minn., F 19
Builder j
City of Fridley, Mims..
BUILDING PERMIT N® (K3
Date: .__ a?"`__ P.,_ -e"' )_ _._
_.
Owner. Builder A
Address
Address
,.
LOCATIQ OF IsPUILDING
No. Street _ yl' _�:.�.`� _' ._----_ .tel _._ Pari, of .o _. -- _.._.._..._.....
Lot4.t.. _ ,r.�. Block ......_......................... Addition or Sub-Divis3�.i�,..
�►-74
Corner Lot ...... ..............._.._........ Inside Lot .... ......L�^'"'`� .... Setback ....._..:, � : �� ............. Sideyard ....._ �1'.a��:,_. _ _........ _............._.._..._..
Sewer Elevation ....... ... _... _........... _.._--•--•--•--------•------_—.---•----__:.. Foundation Elevation ........ ............. ------- ._...._................... .....
_._..._..._.
DESCRIPTION OF BUILDING
To be Used as
8s`!4 ::1+ Front .. /- Depth _ :..� Height .,:.,._.. Sq. Ft. LV:.1_ Cu. Ft. 6-
....
----.............. _......... ........................... o _...._.. Depth ......... ht Sq. Ft....................... Cu. Ft. ....._.......-- ......
Type of Construction ""� ' ......._ ......- - .. Est. Cost � o - -t .
....... To be Completed ............... _.......... -----------....
THIS F'ERm1T DU -ti f`JOl- AUTHORIZE VIOLAT.
ION OF ANY PP„
SATE LANG COVENANTS AND
BUILDING RESTRICTIONS.
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 $..,........ _...._..__, permit is hereby granted to. .......... _.----.._..._....____- ...........
-•
_ r_ �—W 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 anytime upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE: t
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these Nems.
4
r r..
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name���� Builder
Address ,j I? y e , s �� -� �� Address
LOCATION OF BUILDING
o•
No. Street_ . Part of Lot
Lot Block Addition or Sub.Div.
~' Corner Lot _Inside Lot�Set Back o Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
4 Front %� Depth Height
Sq. Ft. L Cu. Ft.
�—s
Front Depth Height
Sq. Ft. Cu. Ft.
c�
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 representa-
tions stated in this application are true and correct. _
DATE 'R SIGNATURE 44d_'
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley, Minn. _
BUILDING PERMIT N? 5392-
Date: "' ^
t .
Owner: "` "` ' ' Builder
Address Address ;-�--L, I ---
1
LOCATIO YI DING
f
No. 1 Street_ Part of Lot r
Lot _ _Block _ Addition or Sub -?On
Corner Lot Inside Lot"` "IUtback� Sideyard—
Sewer Elevation ____ FoHdation Elevation —
DESCRIPTION OF BUILDING
as: ��
Front L6( Depth Height Sq. /) Cu. F6-1:°s4e
u�� �p� • t, ..::.�.,,� Sq. Ft. Cu. Ft.
Type of Constructio �'�; Est Cos f ___ _ 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.
j AP
In consideration of the payment of a fee of $ �,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 violation of any of the provisions of said
ordinances.
- 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 hems.
4
�D 1,
APPLICATION FOR HEATING OR POWER PLANT ANS,, SPECIAL DEVICE PERMIT
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work 8.00 $
Replacement of Furnace ............................. 4.00 $
Repairs & Alterations—up to $500.00 ..:. ........... 4.00 $
Repairs & Alterations each add. $500.00 ............... 2.00 $--
MECH._
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ........... 8.00 $
each add. 60,000 BTU ........................ 1.00 $
Replacement of Furnace 4.00 $
Repairs & Alterations—up to $500.00 ................. 4.00 $
Repairs & Alterations each add. $500.00 .............. 2.00 $ _
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines --to 400 sq. ft. IDR Steam ......
8.00
$
Furnace Shell & Line --to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.00
$
Each add. 320 sq. ft. EDR Hot Water ..................
.2.00
$
OIL BURNER—to 3 gal. per hour ........................ 4.00 $
over 3 gal. per hours—See Fee Schedule _
GAS BURNER .......................................... 4.00 $
GAS PIPING (Up to 5 Fixtures) .......................... 1.25 $ _
AIR CONDITIONING a
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
• TOTAL FEE $�
REMARKS:
wv-e�
Dept. of Bldgs. Phone
Location
The undersigned hereby ads a lication for e
ersign Y o a p for th�work herein
specified, agreeing to do all work in ct accordance with the Village 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.
a , Minn —, 195—
Owner 195—
Kind of Building R 195—
Used as.
To be completed about —
Estimated Cost, $
Old—New. Building Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No--.-
Trade
ir—No _._
Trace 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. BTU H. P.
Application for Fewer Phu is and Heating. Cooling. Ventilation. RAN-- ion a»d
Air Conditioning Sydem and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIA: RATE TOTAL
Furnace Shell & Duct Work ................ .. $10.00 $
Replacement of Furnace .. &00 $
Repairs & Alterations --up to $500.00 6.00 $�
Repairs & Alterations each add. $500.00 3.00
MECIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ........
each add 60,000 BTU .................... .
Replacement of Furnace .. .. ...
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines -to 400 sq. ft. EDR Steam
Furnace Shell & Line -to 640 sq. ft. EDR Hot Water
Each add. 200 sq. ft. EDR Steam
Each add. 320 sq. ft. EDR Hot Water
OIL BURNER -to 3 gal. per hour
over 3 gal. per hour -See Fee Schedule
GAS BURNER (up to 189,000 BTU) .. . ......
over 189,000 BTU See Fee Schedule
.$10.00 $-
3.W ;
6.00
&00 $
&00 $
$10.00
$. _
10.00
$-
3,00
3.00
6.00 $
5.00 $ -�
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 200 $
Additional Fixtures x .75 $
Gas Range to 199,000 x$ 8.00 $
AIR COR?DITIONWa
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH p� /
FINAL. ✓1 - 2 � ' �(
See Foo Schedule
$
TOTAL FEE
Dept. of Bldq L Phone 560.3480
city of Irddley:
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, Mip6 IC! 19�z
Owner 4ZI -C -1.- ys ti'cZ1 !-ice.^ � ,C
Kind of Building .y
Used as
To be completed about -- —Z'
Estimated Cost,
Old -New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLAN15-Steam, got Water, Warm Air -No
Trade Name Sin Ne -
Capacity Sq. Ft. E.D.R BTU H.p
Total Connected load Kind Of Ft
BURNER - Trade Nam Size No C/3) ,--2
Capacity.
(REMARKS -OVER)
Sq. YL "it -1,1 ,1 d-Zt BTU ISP.
i
r�
Signe
By
Business now No-
[ • a
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
y
Number Fixtures
x
$3.00
m
Future Fixture Opening
ro
$2.00
O
New Fixture, Old Opening
K
O
$
Water
x
$5.00
v
Water Heater - to 99,000 BTU
x
$5.00
N
z
N
q
$
.0
p
w
0
New Ground Run Old Building
Heater
al
m
4J
Electric Water Heater
x
N
$
H
•.i r3
$4
N
rt N
P.
$
Additional Fixtures
x
$1.00
•H
Sa
M a)
O N
m
Q
$10.00
a
••I
N
1
4
x u
r. R
ai
3
$4
0
.c a
0 •^i
N43
e
.0
M
N
U
N
N
W
$ .ilk d
O
O
••i
N
—1 S
0
0
+J
rd
.�
rd U
P
CQ
C1
y
3
A W
t�A
Gam.
U
3
Cro7
a
as
lec
Cn
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
X
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3,00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199 000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$ 0'0
each add. $100.00 or fraction
$2.00
$ .ilk d
State Surcharge
$ .50
��•
TOTAL FEE
$ " `r
REINSPECTION FEE
($10.00)
Job Address
fG/ *AIV Sr7 Al. F
Department of Buildings
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 application are true and correct
Fridley, Mn. , 19
OWNER J� lAf 1 NOled-S OAJ
KIND OF BUILDING FfZ#Q 1E
USED AS
TO BE COMPLETED ABOUT �S4- I// S' i�
ESTIMATED COST ?-'57'0 D . &t
OLD - NEW BUILDING PERMIT NO. PERMIT NO. 904
Company r11or=A(14A.. / L i/0"IS-e/d 6—
Signed By
Tel. No. s _ �Z'P
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
SUBJECT
P
City of Fridley
20938
AT THE TOP OF THE TWINS
BUILDING PERMIT
'r ,
RECEIPT
I COMMUNITY DEVELOPMENT DIV.
`
r � _"; PROTECTIVE INSPECTION SEC.
A/p 9y�
I _ CITY HALL FRIDLEY 55432
11
IL""""'
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
/ I.J 612-571-3450
910-F15
7/12/91
10B ADDRESS 6501 Main Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
23,24
4
LowelVE; Addn. to Fridley SHEET
DESCR.
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Berg 6501 Main Street NE 572-9441
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Salue
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
Reside House (Masonite)
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.
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
$650
$.50
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-
$19.00
Fire SC $.65
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$20.15
SIGN O CONTRACTORORAUTHORIZEDAGENT (DATE)WH
�R PE Y VALIDATED THIS IS YOUR PERMIT
�JE
-- 0
IV BL G INS- DATE
S,GP4qLRE OF OWNER IIF OWNER BUILDERI - IDATEI
NEW [ ] Effective 1,/1/91
ADDN [ ] R-1 AMID R-2
ALTER [ ] Building Permit Application
Cmwtructian Address:
legal Description:
Owner Name & Address: '73-dArl Tel. #
Oantrac.-tor. Tel.
#
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed bion drawn on it to scale.
r �, ct �, - . !moi / • ��u - a
• b'i�•
Corner Lat t -l' Inside Int [ ] Ft. Yd Setback Side Yard Setbacks
Type of Cmwtruckion: 5-d, 0 /�%As�,L,r� Estimated Cost:
Approx. Ccupletion Date: -7- /_S - moi/
Proposed Driveway Width If New Opening Is Desired: Ft. $. $
Width + 6' See Back Page
DATE: -7- 19 - c? / APPr�c�xr: Tel. # S-72-9-0-1/1
Pexmit Fee $ 19
Fire Sur&arge
State Surcharge $ G�
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main C2karge $
s-I'IFJIA ONS:
k
CITY USE QTY
Fee Schedule on Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined byi * *�
Agrement Necessary [ ] Not Necessary [ ]
Building
Inspections
7.63-572-3604
DATE_.�3 _ 0 6
SITE ADDRESS 6,50
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR
0 OWNER )QWNTRACTOR
NAME _
ADDRESS: a kA A i' r) "I CITY,
PHONE �, � 7 � �!S
Permit No.:
Received By:
i
Date Rec'd: f�,
ATEM ZI6:5_e
COMPANY N °A "'°
CONTACT PERS a 39
STATE LICENSE r .ao .. n�� 554 EXP DATE
'STATE ZIP
ADDRESS: 49,2N 2FA_9�Crit
PHONE (763) 754-219U Fax
XYNGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
0 NEW REPLACEMENT 0 ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK 0 -
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor
5-00x.05=
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: OMICATE TOTAL
NUMBER OF EACH BELOW) MODEL: SIZE/BTU
Equipment Installed MFG: SIZEIBTU
MFC,: MODEL:
MFG: MODEL: SIZEBTU
—FIREPLACE
FIREPLACE (GAS) $15.00 . ,—GAS RANGEIOVEN $10.00
X,A/C $25.00 NEW GAS GRILL $10.00
AIR TO AIR EXCHANGEER $IS —FI RL NACE$3(W� D) $35.00 —GAS UNIT HTR $10.00
_BOILER $35.00 — POOL HEATER $35.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTII,ATOR $15.00
_ ..—,_�. f!i-La 4"4Y° i1�i,%iwWfMrr/aY1'I",'f'�•Rc'ACA
`
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ S- C's'C
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $ 9,5 S --C>
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 DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977