PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT NT° 3848
Date: .....!........./...............
Owner ....................................... Builder ... .......
Address ...................................... Address .............................................
LOCATION OF BUILDING
No. . ZL. Street .. -kg .. . ............. Part of Lot ....... .
Lot .. ..... Block .................. Addition or Sub -Division ?... .
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ...........................
DESCRIPTION OF BUILDING
To be Used as:
. ..... Front ........ Depth ........ Height ........ Sq. Ft......... cu. Ft.........
.... Front "7.7.:'�.� Depth 07 Height /.f " Sq. Ft. 16 cu. Ftp2oo.. (,*.Y'
Type of Cons ction ................... Est. Cost. . �.� �% .... To be' Completed
In consideration of the issuance to me of a permit to construct the building desribed 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.
....4.. .....�: .....................
In consideration of the payment of a fee of o.�—, 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 with-
in 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 or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building InspebBor,fo*. separate permits for these Items.
City of Fridley, Minn..
BUILDING PERAUT
Date:
Owner:;
Address Address
r
PING
No. StreetPart of Lot
Lot _ _ __ Block Addition or Sub- --.- -.
Corner Lot Inside Lot af+ aback `. Sideyard
Sewer Elevation — Fartndation Elevation
DESCRIPTION OF BUILDING
°_ . ?' Front Depth Height _ Sq. Ft., :�Cu. Ft.,; --"4/ :
From�-AdAstDepth ,C He ght Sq. Ft. Cu. Ft.
Type of Construction Cost + t'�`""'"'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 carnS3eral3on 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
glthin the city ]units and this permit may be revoked at any time upon violatio'n� of any of the provisions of said
ordinances. ,.�� i
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to am
the Building btspector for separate permits for these Rome.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLE'
Owner's Name aAV Build,
Address
LOCATIO F BUILDING
No, Street Part of Lot
Lot Block Addition or vision
Corner Lot Inside Lot a aback Side -Yard
SEWER.
ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To b sed s: ` /)
Frontepth Height f°e� _
Sq. Ft. �� Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
PU
Type of Constructio 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. r,
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley, Minn.
BURRING PERMIT
Date: dune 16, 1965
Owner: Charles Amundson
Address 751 Mississippi St.
Builder
D.M. Noyes
N° '7908
LOCATION OF BUILDING
No. 751 street Mississippi St. put of Lot
Lot _ 3 Clover Leaf Addition
Corner Lot --
Sewer Elevation
To be Used as:
Block
Inside Lot
Addition or Sub -Division
_. Setback
Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft.
Type of Construction Est. Cost 169570 To be Completed
Rebuild storm damage
Cu. Ft.
Cu. Ft.
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�setfand in compliance with 21 provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 10.0 , permit is hereby granted to D.M. Noyes
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 oP
Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings
within the city ]imits� permit may be revoked at any time upon violation of any of the provisions of said
ordinanoas.
Alen Jensen
Building Inspector
NOTICE:
7hb pamb don not wwr tha condmatim, hntdlation for whkig, phnobteg, an hntiag, Www or wabr. Be sun to snn
do ft0iog kwedw tar aparata pwm& far then hum
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
0W=R' S NAME
�i`�d�2
��S
��✓� �� � BUILDER
ADDRESS_
7_5Z
'r ° ADBRESS 6
/r
LOCATION OF BUILDING
Part of Lot-' .
LOT KADDITION OR SUBDIVISION
Corner Lot Inside 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.
DESCRIPTION OF BUILDING
To be used as:
..� r
Front Depth,- 4 Height
Sq. Ft. 'c7 Cu, Ft.�^d
Front Depth- Height
SQ. Ft. `ry Cu. Ft. `s
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 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.
DATEA/'
(Schedule of Fee Costs can be found on the Reverse Side).
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
April 28, 1992
Dennis and Cathleen Swanson
751 Mississippi Street N.E.
Fridley, MN 55432
RE: First Notice of Noncompliance at 751 Mississippi Street N.E.
Dear Mr. and Mrs. Swanson:
The City of Fridley has established a City Code for the purpose of
promoting a pleasant and attractive suburban environment. A recent
inspection of the property at 751 Mississippi Street N.E. revealed
that not all Code requirements are presently being met. Listed
below is an item which does not comply with the City Code:
1. Discontinue
front yard.
the side or
outside.storage
(Fridley City
rear yard.)
Y�
of utility trailer located in the
Code does permit such storage in
Your prompt attention in correcting this situation would greatly
assist us in helping make Fridley a better place to live. An
inspection will be conducted on•or about May 11, 1992, to determine
compliance.
If you have questions or would like to discuss this, please contact
me at 572-3595. Thank you for your cooperation!
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -92-153
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
JOB ADDRESS 7//-5Z
The undersigned hereby makes application for a permit for the work
Rate TOTAL herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
$ 20.00 $ ,x O, e(-' that all the facts and representations stated in this app)ication are
true and correct. r S ,199
$10.00
OWNER
$ 10.00 $ -�
BUILDING USED AS 3-
$10.00
-
$10.00 $
ESTIMATED COST CO PERMIT NO.
$10.00
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1 % of Value of Appliance or Work
State Surcharge
TOTAL FEE
$ No. of Heating Units Circle One (Steam) (Hot Water)arm Air
Trade Name Size No.
BTU _% /,. GG'U HP EDR
$ Fuel Total Connected Load
$ .50_
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Burner Trade Name Size No.
EE��
BTU Vr , .fIR CMID1 I�Ni�dGR-.
_.' UXE i. PEET
MIN;f 'EAFOLI3, VA 5MO-2998
HEATING COMPANY PHONE 824-2868 _
�i�
Signed By ®T_ Tel No.
Approved By�7 Rough -In Date Final Date-'�C--93
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes ( )
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5. Meets all current Code requirements for
size and total BTU's connected
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
signed By
Date
Yes ( ) No ( )
LOAD CALCULATION WORKSHEET
SQ. FEET HTM BTU'S
WINDOWS & DOORS 1-7 `i X Biro
1.2 X W= INFILTRATION 2.1q. S X
GROSS EXPOSED WALL 1099
RUNNING FEET
WALL HEIGHT
GROSS WALL /vas
NET EXPOSED WALL O S x
WINDOWS DOORS
EXPOSED CEILING /° 7 x
EXPOSED FLOOR `o'7,-_ X
1f'r G b �• °� o
TOTAL BTLI'S '1 f FLOORS • CEILING
WINDOWS
SINGLE = 90
NORMAL = 50
WALLS
CEILINGS
FLOORS
TRIPLE = 40
0-1" =
19
0-3" = 10
BELOW GRADE = 5
2-3" =
12
4-7" = 10 •
CRAWL SPACE = 8
INFILTRATION
4-5" =
9
8-10" = 6
OVER GARAGE = 18
LOOSE = 30
6-7' =
7
12-14" = 4
TIGHT = 20
18 0
ti
7 zo b.zt b 1�
w w
�.. w
A w — y ~ —
i 8 13. c I)- s -7 -) Z
w 7
w 7
410 W. LAKE ST. 1072 PAYN E AVE.
MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101.3892
612/824-2656 LVENATINGANDAIRCONDITIONING:*3 612/772-2449
iSm,injr n' TW, Cities Since 1930'
ORSAT TEST RECORD
ADDRESS 75-/ m /_<r✓S-T"
OCCUPANT k � � OWNER '� -A
DATE HTG. INST. h INSTALLED BY plo
GAS LINE BY
TYPE OF HEAT: GA FA_ /� HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE MA-KE,0F BURNER
MODELMODE
SERIAL 362 0?�o MAX.
INPUT _ Ay p -D . MAKE
CONTROLS
MODEL
BTU
OF FURNACE
THERMOSTAT -// I, O HEAT PLUG VENT SIZE �" ry<
VALVEKIND OF LINER SIZE NONE
LIMIT %.��,�DRAFT HOOD REGULATOR
LIMIT SETTING f 70� CHIMNEY CONSTRUCTION
FAN SETTING DRAFT jta-R,� TEST TAG WU L_trvC
PILOT TYPE LIGHTING INST. 1ACS1, -r
PILOT MAKE
PILOT MODEL
PILOT TIMING JAL
PRESSURE '�,'r PERCENT
INPUT CFH_14 LQ,oc>oPERCENT
STACK TEMP. PERCENT
CO2 (�a DATE TESTED .:` 2-
0 0��--
CO NAME OF TESTER
SUBJECT
PER
City of Fridley
7
� � 9
AT THE TOP OF THE TWINS
BUILDING
PERMITC
r
� • COMMUNITY DEVELOPMENT DIV.
j - ------
r PROTECTIVE INSPECTION SEC.
3NO.
I
1 i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
10/24/94
JOB ADDRESS 751 Mississippi St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR. 1
3
1
Clover Leaf Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dennis/Kathy Swanson 751 Mississippi St NE
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Northstar Home Improvement 6121 Excelsior Blvd
St Louis
Park 929-1888 5336
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
Reside Dwelling; soffit & fascia
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
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$13,850
6.93
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION OF ANY OTHER TATE OR LO AW REGULATING CON-
STR1JCTI O HE PERFOR N OF C STRU TION
$153.00
Fire SIC 13.85
PLAN CHECK FEE
TOTAL FEE
l42A �
License SC $5.00
$178.78
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPS Y VALIDATED THIS IS�YYOOURR PERMIT
I
{ /."=��
SIGNATURE OF OWNER,,F OWNER BUILDER) IDATEI
_
tIWUG )NSP
GATE
NEW [ ] Effective 1/1/94
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
17s-/
ConstructionAddress• S i SS S P I Si eJ 0�
Legal Description: /,J Erj U ir.9 `1 ( w P -N S c - (' a
Owner Name & Address: C ti V-A-n-��A S w 3 Tel. #
Contractor: ti)o OL 4 -ST & Q-, MN LICENSE #
Address: (, Z i L e `S (ML Kyi) "�:T C c%a c s 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:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $�d > C;
_ Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + t = t = $
DATE: IL APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ /6-J, C7o
$
Fee Schedule on Reverse Side
..001 of Permit Valuation (1/10th%) .
$.50/$1,000 Valuation
$800 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 ( ]
61
01
SUBJECT
P
City of Fridley
2 5 0 018
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
NUMBER
REv
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
4/28/97
JOB ADDRESS 751 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
3
1
Clover Leaf Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Dennis Swanson 751 Mississippi St NE
572-9608
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 j1 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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
1
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
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
$2,145
$1.07
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-
$74.75
Fire SC $2.14
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
$77.96
NATURE%OF CONTRACTO ' R�AUUTHOO IZZEEDAGENTq IDATEI
WHEN PROPERLY VAofI ATED THIS IS YOUR PERMIT
_
BLDG INSD
-
DATE
S4NATUR§e OWKIR 0F OWNER BUILDERI IDATEI
61
01
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
r
ConstructionAddress:
Legal Description:
Effective 1/1/97
4p c6t�—
Owner Name &Address: Tel. # S �o? —,96 O
Contractor: MN LICENSE #
Address:
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
GARAGE AREA: Length Width Height
DECK AREA: Le idth Hgt/Ground _
OTHER: DCS 1
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Xe aJ �x�%' Estimated Cost: $ '� / 4�;✓
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
r�
DATE: APPLICANT: Tel. #
STIPULATIONS:
r
CITY USE ONLY
Permit Fee
$ �
Fee Schedule on Reverse Side
Fire Surcharge
$ /
.001 of Permit Valuation (1/10th%)
State Surcharge
$ / . D
$.50/$1,000 Valuation
SAC Charge
$
$950 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
$ 22 �2
STIPULATIONS:
r
sue.iECT
MIT NO.
City of Fridley
2 9 2 8 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i rr
`v ___��_ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
=
1 I CITY HALL FRIDLEY 55432
,'j
NUMBER
REV
DATEPAGE
OF
APPROVED BY
612-571-3450
910415
4/23/99
JOB ADDRESS 751 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Clover Leaf Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Swanson 751 Mississippi Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
P K Siding 1804 McAndrews Rd W, Burnsville, MN 55337 435-1986 CITY
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
8 DESCRIBE WORK
Reside House & Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Call for building wrap inspection before
covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIREO 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
1
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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,200
$2.10
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-
TRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$99.75
Fir SC $4.20
e
PLAN CHECK F
TOTA EE
06.05
S�GN4 TUNE O�CON'RACTQR Op AUTMOR�ZED AGENT iOATE,
EN RO
I HI$I$
BLO NSP
JPTT
r
TE
S,GNATURE OF OWNEROF OWNER BUILDER. tOATE,
NEW [ ] Effective 1 / 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
���')8 7
ConstructionAddress: 7 S / /YI , X55 r' S' S 7`
Legal Description:
Owner Name & Address: jQ e Y),n, `S S W 4 n S d Tel. #
Contractor: r ��. MN LICENSE #
f 8'o YZw s P..1c j T /� 1-4 35
Address: - o Y1 6 07 -05 V"
' /I � Tel. # o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF BIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: P ,e- 5" 1-1 z No '. s -- A T ELS -It—
Construction Type: V n v I Estimated Cost: $
(Fee Schedule on Back)
Ft x $ = $
cf'�) 6 -D
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: 55 APPLICANT: ��,�. l e , �� S 5 SS Tel. # N.3S- r 9 kb
Permit Fee $ 19ZC21
�s
Fire Surcharge $ LI'2 O
State Surcharge $
SAC Charge $
License Surcharge $ -u
Driveway Escrow $
Erosion Control $
Park Fee $
Sewer Main Charge $
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
TOTAL
STIPULATIONS:
/ y�- 6 _S-
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential Rate
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace, $ 10.00
but of replacement)
Gas Range 1-b,- '\ t--svt c 10.00
Gas Dryer $ 10.00
*Air Conditioning - All Sizes $ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/ Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2001
JOB ADDRESS �� Mks 5 �SS\ PPS ��-����� M�
OWNERS-'-)iN,s Sw�� Som .
TOTAL
BUILDING USED AS Q -F -S p��c
ESTIMATED COST (:;,Scp PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
$ .50
Burner Trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE -!::�\ -1\ - o%
HEATING CO k % Cx= - S
Signed`5 � 5�Dc�.
Approved By'Rough-In Date
TEL # s4 (o oSCYJ
I,— - J 11�D�
Final Date
BACK SIDE MUSTS BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes ( ) No ( )
The venting system is plastiGPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes ( ) No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No ( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes ( ) No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :