PRE 2010 DOCSCITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct Work,
Burner
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
HATE TOTAL
$ 20.00 $ �''�. ` u
$ 10.00
$ 10.00 $
.10.00 $
Air Conditioning (all sizes) $ 10.00
All Others/Repairs and Alterations
1% of Value of Appliance or Work $
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $
Reinspection Fee ($15.00) $ kq. 4-u
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCHARGE
Attach stack verification form with replacement furnace permits
Effective Aug. 1, 1961
Job Address (.6%,O o %! i� s� !v
d
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 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 application are true and correct.
Fridley, Minn. �� / ��. 19 t/
OWNER
KIND OF BUILDING _ J� /'+ 'C.0
Ll
USED AS '/X A�
TO BE COMPLETED ABOUT
ESTIMATED COSTnln
OLD NEW BUILDING PERMIT NO. PERMIT NO. C3 l
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air -- No. /
Trade Name e' -'7e'-'7/ n w ,o Size No. C✓/y
CapacitySq. Ft. EDR BTU//HP
LI?
,pyo
Total Connected Iva Kind of Fuel C✓ ��
BURNER - Trade Name P p r8 4-0 Size No. �/ b 62 :3 E
Capacity Sq. Ft. EDR BTU % u e J HP
Company l� f' o ✓Co !/� /flim �i
Signed By ,w
Tel. No.
-t JC JTY OF RI DL0
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION 7710 g4p' 22L DATE
OWNER �„�.4, ADDRESS
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodged within
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Heating BTU �� Q'
All Other BTU
TOTAL
REMARKS t / S l' r
w
by
Address
HEATING PERMIT # Telephone
Fridley City License #
SUBJECT
PER
City of Fridley
18347
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
....... COMMUNITY DEVELOPMENT DIV.
1 y INSPECTION SEC.
r 1 � PROTECTIVE
1 1
=
1 "1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/26/86
JOB ADDRESS
776 Mississippi Stre t N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1 1 1
Ortenstone Terrace
SHEET
2 PROPERTY OWNER MAILADDRES$
ZIP PHONE
Patricia Meisius
571-6279
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Egress Window
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
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 I HAVE READ AND EXAMINED THIS APPLICATION
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$750.00
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$15.00
PLAN CHECK FEE
TOTAL FEE
pe7� d �'m' -
$15.50
ErIGN;;URf OF ONTRACTOR OR AUTHORIZED AGENT (DATE)
C_
W�HN PRO ER LI A E THIS IS YOUR PERMIT
IN"
s G -SIGNATURE
DATE
OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ] City of Fridley Effective 4/1/84
ADM. [ ] 1 R-1 AAD R-2 j
ALTER. [ ] Building Permit.Application
Construction Addri
Legal Description
Owner Name & A( ess : % �" ( ( L / / 5 Tel. # �"%�^ �� 7 1
Contractor: -t'M s Tel. # 2 �
Address: �)--Y- � v _ Qti ate'- .,- —y-, )rc- ----
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
Setback
Type of Construction: 'E% % L4s/12_�2�
Estimated
Cost: $
'7
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT:
CITY USE ONLY
Tel. #
Permit Fee $ .0 y Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 4 ;9-z) $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ —
TOTAL $ JOU Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS•
E'!!� J2/
GEO.SEDGWICK HTG.& AIR COND. CO.
HOUSE HEATING TEST RECORD
ADDRESS
6"�' -r .r -y-T CITY 3 Q
OCCUPANT
OWNER— � •4�
HEAT LOSS—
DATE HTG. INST.
SOLD BY
INSTALLED BY
Electrical Work By
Gas Line By
TYPE OF HEAT
GA FA-�L�-HW_
STEAM— SPACE HTR. UNIT HTR. nTHEIA
GAS DESIGN
CONVERSION
MAKE
MAKE OF BURNER
Model
Model
Serial
Max. BTU Rating
INPUT
MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Heat Plug
Vent Size,
Valve—
KIND OF LINERSIZE— NONE
Limit
Draft Hood -J I t —', Regulator
Limit Setting
Filters Size Number
Fan Setting
Chimney Location Inside = Outside
Pilot Type
Chimney Construction
Pilot Make
Pilot Model
A
Smoke Bomb Wiring
Pilot Timing—,'-,-,-
Draft Test Tag
L.W. Cut Off
Door Pressure Lighting Inst.
Pressure
Percent CO
21 Date Tested
Input CFH
Percent, C2
Company Testing
Stack Temp.
Percent CO
Name of Tester 7)
Form 235
. ,1 1 .11 ,:.. , . 1-1 1 1... 1.1 ............. 1: 1 11. 1 11 1,,.,,,:. 11:,1 1 ;,; . ;,: .c : ; .:...,..,..,., , .. , „oo,., . , , ,., ,.,r ,1,111 .. ,1 111.. ,. . 111,1,., .,., .. , ,. ,.,.,::r,:,.,..... it . , .
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
March 19, 1992
Patricia Neisius
776 Mississippi Street N.E.
Fridley, MN 55432
RE: Property at 776 Mississippi Street N.E.
Dear Ms. Neisius:
Fridley City Code 506.10 (copy enclosed) provides restrictions on
displaying vehicles for sale. Recently I observed a vehicle
displayed for sale at 776 Mississippi Street which is in violation
of the following requirement:
1. The vehicle must be kept on a paved parking area.
It is important that you attempt to sell this vehicle in a manner
consistent with the enclosed ordinance or remove it immediately.
A reinspection will be conducted on or shortly after March 25,
1992, at which time full compliance is expected.
Please feel free to call me at 572-3595 if you have questions or
wish to discuss this further. Thank you for your cooperation.
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -92-72
SUBJECT
City of Fridley
23161
AT THE TOP OF THE TWINS
BUILDING
PERMIT(
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV
�-------
r � PROTECTIVE INSPECTION SEC.
�®
I . �
F ,---1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
1/10/95
JOB ADDRESS 776 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
1 Ortenstone Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Patricia Neisius 776 Mississippi Street NE
571-6279
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
TwinCity Exteriors Co 9060 Zachary Ln N
Ste #108, Maple
Grove 425-4737 2535
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 0. REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,500
$3.75
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
$99.00
Fire SIC 7.50
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$115.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHEN
THIS IS YOUR PERMIT
7LYLIDATED
BLDG INSP
C0
DATE
SIGNATURE OF OWNER)IF OWNER BUILDER) iDATEi
NEW [ ] Effective 3/l/92
ADDN [ ] CITY OF FRIDLEY
ALTER [ j SINGLE FAhMY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Descri
r:.
Owner` Name & Addtresk . I � =J: rel. 7/-� � ��/
Contract
ICENSE # p7SS
Tel. # 6�2 -�(73 Z
Corner Lot (] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction s i Estimated Cost: $ 7 5-o- o
it
ApprOR. COmpl, oa
..J I t
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft a Ft x $ = $
Attach to this application, a Caffm
to of Survey of the
lot,
with the proposed construction
drawn on it to scale.
Fire Surcharge
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:
Driveway Escrow
$
Corner Lot (] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction s i Estimated Cost: $ 7 5-o- o
it
ApprOR. COmpl, oa
..J I t
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft a Ft x $ = $
TY. USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ '7 ®
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , ��
$.501$1,000 Valuation
SAC Charge
$
$700 per SAC Unit
License Surcharge
$ j
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary j ] Not Necessary ( ]
TOTAL
Gt% A(i
STIPULATIONS:
ITN
SUBJECT
City of Fridley
27050'
AT THE TOP OF THE TWINS
BUILDING PERMIT
RE NO.
COMMUNITY DEVELOPMENT DIV.
/�}
_
v
C[s1
��
rPROTECTIVE INSPECTION SEC.
�df{
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
18/7/98
JOB ADDRESS 776 Mississi i St
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Ortenstone
Terrace SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Patricia Neisius
883-5356
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Twin Cit Exteriors 906 ZacharyL
425-4737
ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
2595
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION XX REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Storm dam age repair
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
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
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
$500
$.50
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.
$21.00
Fire SC $.50
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$27.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PJROPERLY LI DATED THIS IS YOUR PERMIT
� 9
BLDGASP r�ATE
_
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
ITN
NEW
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
� a o
ConstructionAddress: / r� %/i� /%% , ,n,�110 r/) i �J / , , (" —
Legal Description:
Owner Name & Address:
Contractor:
Address:'7,
Effective 1/1/97
-7®
X11
Tel. #�Q� _ S
MN LICENSE #
�MLTel. # #A5:4737
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: Length--�—,�� Width
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Estimated Cost: $� "
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:9Tel. #_ �o?S=?�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY
$ /. 0C Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$_ $.50/$1,000 Valuation
$ $950 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 [ ]
Od
TOTAL $
STIPULATIONS: