PRE 2010 DOCSCity of Fridley, Minns
BOIDING PERMIT . N? 59=74
l
r
Owner:,
. Builder
f
.rcAddress
L9CATIO F I ING
No. Street Part o Lot A—
Lot Block'" Addition or Sufi-Divisio
Corner Lot - Inside Lot _ iof� Setback ideyard
Sewer Elevation — _ Foundation Elevation
DESCRIPTION OF BUILDING
T Used �'
Font &6pth Height Ane Sq. Ft. , Cu. Ft...
nt � Depth Upight E Sq. Ft. Cu. Ft.
of etion Est.. a To be Com leted
Type !
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 $044-* permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
e 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. ..-► /11*1%
r
NOTICE:
This permit does not cover the Construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to see
the Building inspector for separate permits for these items.
wiz("IX3-z�
r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner `s Name ,fC /a`400 6-759S� a Builder
Address Address
ION OF
No. 1 Street, Part of Lot
Lot Block �- Addition or Subdivisions,/V
Corner Lot Inside Lot Setback5Side-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:
k
Front �2 � Depth T3eight
� Sq. Ft. Cu. Ft.
4a," L ��E+, Front3 .3 Depth—Height_��
V `
Sq. Ft. b Cu. Ft. (�
Type of Construction 7��ds� 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 of Fridley Ordinances and ruling of the Department of Build-
ings, and hereby declares that all the.facts and representations
stated in this application are true and correct.
DATE 1 SIGNATURE ~
(Schedule of Fee Costs can be found on the Reverse Side).
. r a
City of Fridley
Application for Plumbing and Gas Fitting Perndt
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
x $RATE$ TOTAL
Number Fixtures �Qc Sd
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 .......................... — x $1.50 $ l�
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................. U
i
TOTAL FEE $
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do 411 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,
196?
Owner Tk&IJ�M'
Kind of Building
Used as
1j
0
WATER HTR.
GAS
ELEG
(�90
R
N
m
Base
`
1st
2nd
_
3rd
4th
• Future Connection Openings
Connected withI Sewer
New Fixture, Old Openings
Cesspool E]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
x $RATE$ TOTAL
Number Fixtures �Qc Sd
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 .......................... — x $1.50 $ l�
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................. U
i
TOTAL FEE $
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do 411 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,
196?
Owner Tk&IJ�M'
Kind of Building
Used as
To be completed about
Estimated Cost,
Old—New. Building Permit
Business
ROUGH " /
FINAL
4z 2M 7-59
��"', MAP
Application for Power Plants and.. Healing, Cooling, Ventilation, Refrigeralion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept• of Bldgs. Phone SII. 4-7470
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 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ........................ 2.00 $
Replacement of Furnace ............................. .§.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 $
9IL 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:
1st 3 Fixtures ......................
Additional Fixtures .................
Gas Range to 200,000 BTU ...........
AIR CONDITIONING
FAN DATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
NO RATE TOTAL
_ x $1.50 $
_ x .50 $
_ x 2.00 $
See Fee Schedule
TOTAL FEE $teaLo_
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 `� 194r*P�
Owner a ®-,�
Kind of Building
Used as LEL
To be completed about
Estimated Cost, $
Old—New. Building Permit No.
Permit No. Cl),-/,
DESCRIPTION OF WORK
HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No.
Trade Name Size No
Capacity_ <��1 Sq. Ft. E.D.R ,��'/ BTU .fit; ® H.P.
Total Connected Load Rind of Fuel kdA qg-S2
BURNER — Trade Name L6 -2A-0 Size No
Capacity.
\\ (REMARKS -OVER)
Sq. Ft. E.D.R BTU H.P.
Signer' d7"
By 2
4z 2M 7-59 Business Phone No.
HEAT 1�SS, CALCULATIONS ''.�' >., F - r; ° ; r BURMAN COMPANY
Weatherstrips, G Contraction No. Insulation
Windows Doors Reference I'Out.Wall Int. Wall I Ceiling 1 Roof Floor Kind How Applied
Yes—No I Yes—NO 11 19—
F1.1 Room Lenlrth 2e Width Height i II —IFU f- .rq .n4 Room I Length Width Height `
Windows and Doors—Crackage and Area
F
Width Height No. of Lineal ft. Area
No. of Dano of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
hh (
Y 9
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Coef. Btu
Infiltration
<
Infiltration
,
Glass
, tets
Glass
Glass
Exp. wau
e "i"
r F,
Exp. Wall
Net exp. wall
Cx y,
a
W.A. Leader area
Int. wall
Net exp. wall
Floor
Int. wall
Int. wall
Ceil.
3r
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W:A. Leader area
Fl.l 6 Room I Length Width , ` ",_'' Heittht P"
Windows and Doors—Crackage and Area
19 a -
Width Height No. ofLineal ft. Area
No. of pane of pane lights of crack sq. tt.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
r Height
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Coef.1
Btu
Infiltration
Infiltration
b-11 AV tv 3
7 777,
, tets
Glass
Glass
Coed Btu
e "i"
77;
Exp. Wall
° ` :f F ` r'
Cx y,
a
W.A. Leader area
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Floor
Floor
Ceil•
p
Art' • ",
Total Btu. I i ;. - r
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Y Fl.1 x, ?;; - .� '"A') Room I Length i P Width ,i 6 Heiaht
Windows and Doors—Crackage and
O
Required sq. ft. E.D.R. or sq. his. W.A. Leader area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
r Height
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Net exp.* wall
Coef.
Btu
Infiltration
b-11 AV tv 3
7 777,
Floor
r'
Glass
Coed Btu
e "i"
77;
%sf
Exp. wall p!"
"
a
W.A. Leader area
ii
Net exp. wall
Int. wall
Floor
Ceil•
p
Art' • ",
,r
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors–Crackage and Area
O
Required sq. ft. E.D.R. or sq. his. W.A. Leader area
'Width Height Na of Lineal ft. Area
No. of pane of pane lights of crack sq; ft.
r Height
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Net exp.* wall
Coef.
Btu
Infiltration'
b-11 AV tv 3
Floor
r'
Glass
Coed Btu
77;
%sf
Eap. wall
"
a
W.A. Leader area
ii
Net exp. wall
Int. wall
Floor
Ca.
^�o e,41
Total Btu. I f A
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 : 7, Room l Length d >_ Width Height ^'
Windows and Doors—Crackage and Area
1 `,..®, ra
Required sq. ft. E.D.R. or sq. his. W.A. Leader area
Width Height No. of Lineal ft. Area
No. otpane of pane Lights of crack sq. ft.
r Height
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Net exp.* wall
Coef.
Btu
Int. wall
b-11 AV tv 3
Floor
Class
Class
Coed Btu
Total Btu.-
Exp. wall
"
a
W.A. Leader area
ii
Net exp. wall
Int. wall
Floor
Cell.
^�o e,41
Total Btu.
1 `,..®, ra
Required sq. ft. E.D.R. or sq. his. W.A. Leader area
IF 0,,iv Room I Length -( 1. Width
r Height
Windows and Doors—Cmckage and Area
�a>'
Width Height No. of Lineal ft. Area
Na of pane of,pane lights of Crack sq. tt.
Net exp.* wall
Int. wall
b-11 AV tv 3
Floor
Coed Btu
Infiltration63.X:
Glass
�' <-� � ee
A
�.
Exp. wall v 'L ' s 71
��ay
Net exp.* wall
Int. wall
Floor
Cd:
Total Btu.-
"
Required sq. ft. E.D.R., or sq. in.
W.A. Leader area
ii
HEAT LOSS CALCULATIONS i; v� I BURMAN COMPANY
'XI
Weatherseips, A-SJi-V4 Guide conar"n No. Insulation
Windows Doors Reference * Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
—Yes—No I Yea --No 11 19— 1
F1.1 0`�)A'T W Room I Lenirth
Width A= Heistht
Windows and Doors—Cracksge and Area
e 1
Height
Width Height No. of Lineal ft. Area
NO. of pane of pane lights of crack SQ: ft.
5 tj
Width Height No. of Lineal ft. Area
NO. of Dane of pane lighta Of Crack SQ. M
Coef.1 Btu
Infiltration
Coef.j
Btu
Inliltration
Mtrati6n
Net exp. wall
Glass
Int. wall
;p
,Exp. wall
-z"
Net exp. will
Net exp. wall
Int. will
/2.
'7,;� 0
Int. wall
v's
Ca.
Floor
Ceil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
1
,D rl.1 7
ik, y Room iLength f zWidth
e 1
Height
Windows and Doors—Crackage and Area
5 tj
Width Height No. of Lineal ft. Area
NO. of Dane of pane lighta Of Crack SQ. M
Coef.1 Btu
Infiltration
Coef.
Btu
Mtrati6n
Net exp. wall
Glass
Int. wall
Exp. wall
-z"
Net exp. will
Int. will
Floor tID
v's
Ca.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI -1 Rnnm I Lenoth Width Height
Windows and Doors—Cmekage and Area
Width Height No. of Lineal ft. Area
No. of pane OtMe lights of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Floor
Ceg;
Total Btu.
Required sq. ft. EDIL,'or ia. ins. W.A. Leader area -A
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1998
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
New Fixtures
3
$ 7.00 a(' W
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes
() No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
JOB ADDRESS CQ 102- Mt t C. 5Lkn ) P, (i 6_
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
1998
Owner � t d
Building Used As �$ t -�O�ci
Estimated Cost
,� 0(j PERMIT NO.�j0
PLUMBING COMPANY
SIGNED BY TEL N0. \5 -7t -'*J7
r
Approved By Rough—In Date Final Date
State Surcharge $ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $� PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
%� a
SUBJECT
O.
City of Fridley
25873
AT THE TOP OF THE TWINS
BUILDING
PERMIT
t
NO.
� �•RECEIPT
i -- -------COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
/��
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
3/26/98
JOB ADDRESS 212 MERCURY DRIVE NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
2
Sylvan Hills Plat 4
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce Falink 212 Mercury Drive NE
571-8651
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 j] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remodel basement bathroom
9 CHANGE OF USE FROM TO
STIPULATIONS
AR4TE pERA#[TS
RE
1!?1�fG,. H'�Tl1yG, �
FOR
PLU"g�N�
AND SIGN
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
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
$1.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,500
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-
$74.75
Fire SC $2.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
FEE
TL
8.50
RACT�O.RpRAUTHORIZEDAGENT ((DAT
SIGNATURECONTRACTOR
o''
EN ROP
VALID T
CHIS IS YOUR PERMIT
;7--x' GJIjr'7�
SIGNATURE OF OWNER OF OWNER BUILDER] 1 ATE]
.' BLOOr INSP
MATE
%� a
NEW [ ]
Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 3
BUILDING PERMIT APPLICATION O
d� I -�
ConstructionAddress: o'Z,? of Z�; r� A9 -
Legal Description:
Owner Name & Address: s'�)
Contractor:
Address:
Tel.# 571
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft. (�
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Yl, Estimated Cost: $ C�-S- y -
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: - �46 98 APPLICANT: c�-z, Tel. # 'x'71- VkJ-1
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge
$ /.2
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway 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:
SUBJEOT
PERMIT NO.
City of Fridley
&1=�T(1F THE TWINS
BUILDING
PERMIT
5■ _((.-___ COMMUNITY DEVELOPMENT DIV.
i VL
j PROTECTIVE INSPECTION SEC.
1
i --_•� 11 CITY HALL FRIDLEY 55432
L 612-571-3450
RECEIPT ��
NUMBER
910-FlS
REv
DATEPAGE
11 30 98
OF
APPROVED BY
JOB ADDRESS
212 Mercur Drive
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
2
ISylvan
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce Falink971-0651
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
New Haven Const.Co. 4208 83rd Ave N Brooklyn—Pk
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 :c REPAIR ❑ MOVE ❑ REMOVE
❑ NEW ❑ ADDITION O ALTERATION
8 DESCRIBE WORK
Reroof house and garage (20 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
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
ZONING
SQ. FT
CU FT
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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
VALUATION
SURTAX
WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT
1714
$.86
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
PERMIT FEE
SAC CHARGE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$56.75
d
Fing SC $1.71
PLAN CHECK FEE
TVOT EE
6.32
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN R
V LIDTHIS HIS IS O R R IT
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
INS
MATE
PPov 3a 9B 11:03a Kerr i
NEW
566-7183
ADDN [ ]
ALTER CITY OF MDLEY
] S NGLE FAMILY AND DUPLEXES R-1 AND R.2
BUILDING PERMIT APPLICATION
p.5
A4
)b
Effective 1/1/98
CottstructionAddress: e
Legal Description:
OwnCr Name & Address: v C- 6: oz' -7,4 L /A.4
Contractor. IV64 v �GL /� _ Tel. # S-7 / - fxoS/
�� &'C40,i o MN LICENSE # ;64) 7 7 `�sv
Address: V A0 ,� g&q! c Are r-64,
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWPROVEMENT
LIVING AREA: Length Width
Height Sq. Ft.
GARAGE AREA: U
ASth Width Height Sq. Ft.
DECK AREA: Length Width
OTHER: Hot/Ground Sq. Ft.
Construction Type: G am, ' -, E-fz,0
Driveway Curb Cut Width Needed: Ft. + b Ft
`Estimated Cost: $ *AD `SQ
(Fee Schedule on Back)
- —Ft x $ = $
DATE: //-9�3 APPLICANT: kms_
Tel.
STIPULATIONS:
zo/To"d EBTL99S
n I
CITY USEONLY
permit Fee
$ Jam•%✓`
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$L—"6%0---
$.50/$1,000 Valuation
SAC Charge
$ /
$1QD0 per SAC Unit
License Surcharge
$ aid _$5.00
(State Licensed Residential Contractors)
Driveway Escrow
Erosion Control
$
$
Alt. "A" or Alt. "B" Above
Park Fee
$450.OU Conservation Plan Review
Sewer Main Charge
$
$
Fee Determined by Engineering
_
Agreement Necessary (] Not Necessary [ ]
TOTAL
$
STIPULATIONS:
zo/To"d EBTL99S
n I
SUBJECT
City of Fridley
r321 �2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
h
�
®
NUMBERREV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910415
9/19/01
JOB ADDRESS 212 Mercury Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
2
Sylvan Hills Plat 4
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP
PHONE
Bruce Falink 212 Mercury Drive NE
763-571-0651
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
JJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 19' x 19' Detached Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
S0. 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
@
$4,151
$2.08
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-
$111.25
Fire SC $4.15
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK F E
TOTAL FEE
117.48
SIGN TIRE OF CON- ACTOR OR AUTHORIZED AGENT IDATEP
HE PROP
VALID THIS YOUR P MIT
Si 4 TUBE 0'OW NER ,6 OWNER BUILDERi IDATE�
B G iNSP
QATE
NEW [ l Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: --L M-64� cet AV7 � P, tvE
Legal Description:
Owner Name & Address:rIttCk Pr L , i✓ r Tel. # !� (/3 A-71 r VT/
Contractor: _I 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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length % 9 'Width r O Hgt/Ground j Sq. Ft. °2 `7Ci' V P/
OTHER: 1-,(�A)q--ri� rl
s- 1 c/�S�- 0�
Construction Type: / 0 FA (`Z J Estimated Cost: $ J.Q V V - V b
Driveway Curb Cut Width Needed: Ft. + 5 Ft = Ft x $ =$
DATE: V / APPLICANT: aut L/, Jr Tel. # 7 J'7 f PW -1
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$1, Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$ Q, 09 $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
lip
01
su6jECT I
PO. 1
City of Fridley
22 3 8
AT THE TOP OF THE TWINS
?
BUILDING PERMIT
r
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
V PROTECTIVE INSPECTION SEC.
672-
r
CITY HALL FRIDLEY 55432
NUMBEn
REV
DATE
PAGE OF
APPROVED By
L 612-571-3450
910-F15
10/11/01
JOB ADDRESS 212 Mercury Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
2
Sylvan Bills Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bruce Falink/Deb Dahl 212 Mercury Drive NE 763-571-0651
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Minnesota Rusco Inc 5558 Smetana Dr Minnetonka MN 55343 952-935-9669 2173
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 O ADDITION O ALTERATION C REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace 10 Windows Within Existing Openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all exterior openings.
Permit Inspection Carus
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
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
$14,213
$7.10
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
Licen C $5.
7$TALFEE
277.56
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi
HE PRO VA 10 ED THIS IS YOUR PERMIT
%
IN QATE
S,GNATURE OF OWNER dF OWNER BWLOERI IOATEI
01
Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: ��Y ��►J�JI �i� `J �'���
Legal Description: '�)F
Owner Name & Address: 51)k�L a lX S` Tel. #
Contractor: ` M bwo l i e MN LICENSE # 73 q
Address: 55. ll�C, C( 65313 Tel. # q6a X 35 9�& /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP iION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: Aid -au 6/) (1d) CUZ/xoto U* "'416bAt r .0N'oL 5
Construction Type: Estimated Cost: $ "I
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: APPLICANT: OUja-,t=� Tel. # qj�? I3j 9(aO
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (612) 572-3604 for Permit Fees If mailing in application
$ A51 - A5 Fee Schedule on Reverse Side
$ IJ -i oa l .001 of Permit Valuation (1/10th%)
$ T ID $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ 5 Q D $5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ `--b
STIPULATIONS: j/������i�' ,`..j�5 j., •
To Whom it may concern:
We agree to allowing Bruce Falink widen his driveway to the dimensions as stated below. We
understand that it is closer then 3 feet to the property line, but we do not feel that is an issue.
Widen feet to the east and feet to the west.
David and Margie Schley
22atMercury Dr Ne
Fridley, Mn 55432 Q�
Bruce Falink
212 Mercury Dr NE
Fridley, Mn 55432
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
'Construction Address:
PR
Effective 1/1 /2003
(763) 572-3604 Bldg Insp
(763) 5714287 Fax
Legal Description:
Owner Name & Address: Tel. #. 7W S-71 0 LF/
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 Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $
y \1"' —
Driveway Curb Cut Width Needed: Ft. + 6 Ft = _- Ft x $
\ / � �+^�� Tel. # .�% f � �/.�I
x DATE: rO APPLICAN r�
/ 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.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
PERMIiT NO.: 2004 -00372, -
DATE ISSUED: 03/22/20048 )413
572-3604 FAX: (763) 571-1287 IL'
ADDRESS : 212 MERCURY DR NE
PIN : 143024320034
LEGAL DESC : SYLVAN HILLS PLAT 4
: LOT 8 BLOCK 2
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOW/DOOR REPL
VALUATION : $ 2,654.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317
OF THE 2000 INTERNATIONAL RESIDENTIAL CODE.
CAULK AND FLASH ALL EXTERIOR OPENINGS.
REPLACE TWO KITCHEN WINDOWS WITHIN EXISTING OPENINGS
STATE LICENSED CONTRACTOR 1
APPLICANT
MINNESOTA RUSCO INC (2173)
5558 SMETANA DR
MINNETONKA, MN 55343-9003
(952)935-9669
OWNER
FALINK BRUCE ROBERT
212 MERCURY DR 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 worl
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
regu cons�uction or the performance of construction.
Annlicant // II Date
Bldg
BUILDING PERMIT FEE 83.25
FIRE SURCHARGE 2.65
STATE SURCHARGE, VALUE 1.33
LICENSE SURCHARGE 5.00
TOTAL 92.23
PAID WITH CHECK # 28929
Permit inspection Cards
Will Be Matted
To Homeowner To Post
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW [ ] CITY OF FRIDLEY
ADDN [ J 6431 University Ave NE, Fridley, MN 55432
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: j
Owner Name & Address:
Effective 1/1/2003
(763) 572-3604 Bldg Insp
(763) 571-1287 Fax
Contractor: L/V,2/i� WU) MN LICENSE # ol/ iJ
Address: 5555 _5/YLQ,�Q,/tA, t-1%%�%l�Ze� 5533 Tel. # g5Z - 935' QI& 9
Attach to this application, a Certificate of Survey of t
�� 9�Z • 9.�s' • 9s�y
lot, with the proposed construction drawn on it to scale.
L�
DESCRIPTION OF IMPROVEMENT goo
LIVING AREA:
GARAGE AREA:
DECK AREA:
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Vyidth Hgt/Ground Sq. Ft.
OTHER: f L& Or XA/ WQ u r i U I - v I�.. -
Construction Type: A Estimated Cost: $__4
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: -31/ -7104 APPLICANT: Tel. #
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
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $ &
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%) Tj
$.50/$1,700 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Building
BUILDING
Permit No.: ®®ss
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE A V ,, Q :avo YOUR E-MAILgA�DDRESS ��'P_�/V1 t'M n C�
_�y� .
SITE ADDRESS ,
Pn C X A p�2� 1\)2
THIS APPLICANT IS:
T_ti����
Ig;OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
ADDRESS: 3PV 1 Pit CSM CITY ��32� f' C.�
STATi�$IP
TENANT
PHONE: �al �LZ
CONTRACTOR
NAME: A)
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE—ZIP—
TATEZIPWITH
WITHAPPLICATION
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGUSHED ❑ WINDOWS
BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
DECK O 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
❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
GARAGES
❑ 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.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3.
Energy Calculations
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:
(USING 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ G OCCUPANCY TYPE
Permit Fee $ , �® See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ a (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $0 .001 x Permit Valuation (1/10%)
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ , Make checks payable to: City of Fridley Attach Stipulations
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 andork ' of to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which r0. ''X're roval of plans.
SIGNATURE OF APPLICANT c_'
I""