PRE 2010 DOCSV
Application for Power Plants and Heating. Cooling, Ventilation, Advigeration 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
.I
Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ G �/
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 $
OIL 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 $ G 0
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $1.50 $ �� C,
Additional Fixtures x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH-
OUGH
FINAL—
FINAL
Location /3 f / /,V/ SS/ 5smoo/ - W
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. G , 19
Owner T j�OogA *
Kind of Building ���T:4
Used as A4-;,,�
To be completed about 1 / !gG Z
Estimated Cost, $
4@W—New. Building Permit No. v Permit No.
DESCRIPTION
DESCRIPTION OF WORK
HEATING a Hot Water, W No
Trade Name i �r I c vif S Size No- g5'n
Capacity Sq. Ft. E.D.R�-5 U BTU H.P.
Total Connected Load 7Z 6f4Aind of Fuel
BURNER —Trade Name /�i�/%4s�- �✓� S Size No
666 Lw
Capacity Sq. Ft. E.D.RTU H.P.
1
(REMARKS—OVER)
By
OQ 4 a 2M 7-59 Business Phone No
City of Fridley, Ninn..
BUILDING PERMIT N° 5 4 2JO'
Date:
Owner: Builder �.
Address Address
LOCA PUOF BUILDING
No. ,XW Street L ___ _ _ _ _ Pari of t
Blo Addition or Sub -Division ,
Corner Lot _ Inside Lot ai Setback ____ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To Used
Front Depth Height Sq. Ft. Cu. Ft.
DepthHei�� Cu. Ft
Type of Constructiono� Est' � o pleted
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 dts of Fridley►.
In consideration of the payment of a fee of $-W-�+""" , 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 Icor whing, plumbing, Bas heating, sewer or water. Be sure to we
the BuNing Inspector for separate permits for these Items,
4
Land Ploanmy
Landsurveyiny 6875-H�
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Sods 7eslriY9
Minneo�o/s 2/,
Ciw/ 6 Alunicipo/ ENGINEERING
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En�ii�eer�n9 -
— EnTneers Sur vey ors sun�lQ 60
ce,wt� Jicate of
e7 fox, ;
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/hereby
cerirry f/ro} &s is o Prue and toriec} represenfotiagFo ¢serve
/otQlion o�'o// bei/drn9S , (hereon y/hC borintiories 'flee abere
4 -,doll
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a �
APPLICATION FOR BUILDING PER11IT
CITY OF FRIDLEY, MINNESOTA
Owner I s Name 1� l c �+ A ��� 1 �® cP �� i Builders F d- �/9 fO® /�� a�!-/OV C .
Address , f e3 g'/ tWi-s 5. S7--, *. Address / V3,2 J,'P'0"V% A16.
LOCATION OF BUILDING
No. Street M i 5,5 -/ s S `XPi S 7 -,OV- G- Part of Lot
Lot Block / Addition or Subdivision - /ZA
Corner Lot _Inside Lot Setback 5�fSide-Yard 19'
SEWER. ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BU31DING
Front 3 - Depth Hein
Sq. Ft./gr 4 a
Front` Depth Aeight
Sq. Ft. Cu. Ft.
Type of ConstructionJi;6'e,y q'0AI&C ,j4Wz-F Estimated Cost
To be Completed 1 ®�- / 9 6 -0-
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. ^
DATE -64 -20 : i 17 4, / SIGNATURE—
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gin RMng Permit
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
go
N
U'
W
O
•
F
•
N
WATER M.
GAS
ELEC.
Base
1st
x
x
x
X
2nd
_
3rd
4th
• Futuro Connection Openings I
New Fixture. Old Openings
Connected with
Sewer
Cesspool `El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................� x $1.50 $ Q ,l 0
Future Fixture Opening ................ x 1.20 $ a0
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Beater (Up to 200,000 BTU) ......�Z x 2.00 $
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... $1.50 -- -
Additional Fixtures x .50 $
Gas Range to 200,000 BTU..............Z x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Dept. of Bldgs. Phone SII 4-7470
Location
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 Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are true and correct.
Fridley, Minn 214CZ1L
Owner
Kind of Building
Used as
To be completed about � .7—
Estimated Cost, $ �� ✓��� O
Old—New. Building Permit NoPermit No.
Signed
ROUGH q- 20 �O
FINAL
Description .........
TOTAL FEE $ ,� / 42 2M
By
Business Phone
53-84-S915.51
City of Fridley
AppocaMoe for Numbbg and Gay Fktbq Pamb
Dept. of Ridge. Phone 9®0-3490
DESCRIPTION OF WORN tim 1391 Mississippi St N E
Number, Kind and Location of Fixtures °"
W
V
NO. RATE TOTAL
Number Fixtures ................
S�
Future Fixture Opening ..... • . • .. •
x $1.50 $--
_New
New Fixture Old Opening ..........
x $1.50 $
Catch Basin ....................
x $3.25 $
3
<
New Ground Run Old Bldg.........
x $3.25 $
�
ub
x $100 $
N
WATEA MTQ.
GAS
ELEC.
Base
x $ .75 $
Gas Range to 199,000 BTU ... ,..........
x $5.00 4
Gas Incinerator
1 5.00
REPAIRS k ALTERATIONS—Refer to Code
Description ............................................. ;
TOTAL FlMs 5.00
1st
Int
'jasl
In
i
er
to
o
ts'
2nd
_
3rd
4th
ruturo Connection Openings I a.vnaMPcsq waao
Saar
* Now Fixture. Old Openings spool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00 $
Future Fixture Opening ..... • . • .. •
x $1.50 $--
_New
New Fixture Old Opening ..........
x $1.50 $
Catch Basin ....................
x $3.25 $
Water Heater (Up to 99,000 BTU) • • • •
x $3.00 $
New Ground Run Old Bldg.........
x $3.25 $
Electric Wates Heater ..............
x $100 $
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ... • • .. • • • • • .. •
x $2.00 $
Additional Fixtures ..................
x $ .75 $
Gas Range to 199,000 BTU ... ,..........
x $5.00 4
Gas Incinerator
1 5.00
REPAIRS k ALTERATIONS—Refer to Code
Description ............................................. ;
TOTAL FlMs 5.00
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the CitF Ordinance
and ruling of the Department of Buildings, and hereby declares that alk the tact
and representations stated in this application are true and correct
Fridley, Minn 7-13-70 19.
R Podvin
Owner
Kind of Building
frame
Used as res
To be completed about 7-18-70
Estimated Cost, $ 10.00
Old—New. Building Permit o. ® rmit
Signed
gy141011AD111
Business PhuVell
o
ii . i
ROUGH
FINAL ' " r 3
ma
i
suBJECT
PER1.�� N0,
City of Fridley13845
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
RO
L
• ______ COMMUNITY DEVELOPMENT DIV.��
r PROTECTIVE INSPECTION SEC.
1 = �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---5 CITY HALL FRIDLEY 55432
IL
L---- �.J 612-560-3450
910-F15
10/27/76
JOB ADDRESS 13.91 Mississippi Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
j
Gena-Rae
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard T. Podvin 1391 Mississippi Street N.E.
3 CONTRACTOR MAILADDRESS
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
❑
X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 241 x 221 x 181 Garage
9 CHANGE OF USE FROM
TO
STIPULATIONS- provide #A= a hard surface driveway. —IMPORTANT-
NOTIFY THE FRIDLEY ENGR.
DIVISION REGARDING CURB
REMOVAL AND REPLACEMENT
AT DRIVE-WAY OPENINGS.
SEPERATE PERMITS REQUIRED FSR WIRING.
HEATING, PLUMBING AND SIGNS.
wDIC
Before digging call 1001 utilities
TELEPHONE=,ELEMIC -GAS Etc.
REQUIRED BY LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
528
6864
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
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
$3,907.20
$1.95
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.
$27.46
PLAN CHECK FEE
TOTAL FEE
$29.41
SIGNATU OFCONTRACTOR ORAU RIZED ENT IDATEI
HEN PR P LY VALID TED THIS IS YOUR PERMIT
1
o
BLDG. INSP DATE
-Sl NATURE OF OWN IIF O NER ILDERI IDA EI
ma
i
CITY OF FRIDLEY
APPLICATION FOR. RESI DENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME : �cy�/20 ;� NOyy1w BUILDER: S%.,nZ
ADDRESS: 5. 57- W.sr ADDRESS: 54,we-
TEL . 140.: 6-71- 2 s g0
NO :. /39/ STREET: A-7�®s s. ZV- OV C.
LOT: 2— BLOCK: ADDITION: Qui . P de -
CORKER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form nco Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DhSCRIPTION OF BUILDING
To Be Used As:
/G
G41a9G.6 Front: 24' Depth: 22-' Height: /8
Square Feet: 5��8 Cubic Feet:
Front:
Depth:
Square Feet; Cubic Feet:
Height:
// v
Type of Construction: �/�sy�E ur4oD Estimated Cost: $ ?SOO=
To Be Completed: 42F,6. 1977 3) q0% Z
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.
DATE: a27 /7 74 SIGNATURE:
(See Reverse Side For Additional Information.)
53-8l'-879001 CITY OF FRIDLEY
APPLICATION FOR PLJMBING AND GAS FITTING PERMIT
Job Address 1391 MTSSTSSTPPT STREET
+ 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. 12-23-76 '19
OWNER DICK PODVIN
KIND OF BUILDING . frame
USED AS TAR
TO BE COMPLETED ABOUT 12-30-76
PARTIAL RATE SCHEDULE
e
ESTIMATED COST 1() -nn
PLUMBING FIXTURE RATES: NO.
�
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Number Fixtures
x
$3.00
x
w
Future Fixture Opening
Water
$2.00
$
Company
New Fixture, Old Opening
x
$2.00
$
Signed By
0
a
$5.00
1�1
w
w
b+
$5.00
Heater
Tel. No.
100,000 BTU to 199,000 BTU
x
$10.00
$
H
t6
ty�
$
N
rd Sa
G)
A.
a
$5.00
$
ROUGH INSP.
i1 d
M
S.'
C
•.1
N
$5.00
X 1J
CC
y
$
N
O
.C'. r
•N
0
N
FINAL INSP.
11
U N
C
$3.00
$
.0
m
•14 o
x
$
18.1
101
N
W
N
.0
.oi
w
m
ro
14
.oi
ro
Q 3
U
N
U
7
CQ
im
N
3
A W
in
W
U
lst
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
Job Address 1391 MTSSTSSTPPT STREET
+ 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. 12-23-76 '19
OWNER DICK PODVIN
KIND OF BUILDING . frame
USED AS TAR
TO BE COMPLETED ABOUT 12-30-76
PARTIAL RATE SCHEDULE
ESTIMATED COST 1() -nn
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
Company
New Fixture, Old Opening
x
$2.00
$
Signed By
Catch Basin
x
$5.00
$
MIWNEGASCO
Water Heater - to 99,000 BTU
x
$5.00
$
Tel. No.
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
ROUGH INSP.
Date
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
FINAL INSP.
Date
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
APPROVAL FOR PERMIT �
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS & ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
State Surcharge $ .50
� "A- Surcharge .500
TOTAL FEE $ 5.00
REINSPECTION FEE
($30.00)
SUBJECTrjt"I
MIT NO.
City of Fridley
9 3 3 2
AT THE TOP OF THE TWINS
BUILDING
_
P E R M I T
r
�
RECEIPT NO.
`COMMUNITY DEVELOPMENT DIV.
L_ -___
r � � PROTECTIVE INSPECTION SEC.
1 �
= "\ CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
2/26/88
JOB ADDRESS 1391 Mississippi. Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
2
1
Gena-Rae Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard Podvin 1391 Mississippi Street N.E.
571-2390
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 'Central Avenue N.E. M ls.
55418 781-9548
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 j1 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Rerooi Dwelling (20 Squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
Roos; can be the 2nd layer but not the 3rd,
Install ridged galvanized
valleys,
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
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
$1,000
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OT R STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PER RMANCE OF CONSTRUCTION.
$17.50
9'
� � � �
PLAN CHECK FEE
TOTAL FEE
�,,..��� 1 F' •
$18.00
SIGNATURE OF CO CTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY
VA ATED THI IS YOUR P
//MIT
� �(O
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
BLDG )NSP
nATE
NEW [ ]
ADDN. [ ]
ALTER. L ]
Construction Address
Legal Description:_
Owner Name & Address
Contractor: �!
Address:���
City of Fridley
R-1 AND R-2
Building Permit Application
y
-�,ss `
�sS,
�S
tG ,� o L)
EA) %,
Effective 14/1/86
Tel. #
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 L [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: �`1 ° 1 U Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: i APPLICANT: ����1 f�-i'• Tel. #
�7 CITY USE ONLY
Permit Fee $ % /- S� Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ Q $•50/$1,000 Valuation
SAC Charge $ $ 3,5Q per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS:
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, 1997
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
Gas Range**
NO. RATE TOTAL JOB ADDRESS
I ._
Gas Dryer** —
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
•
$ .50
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.
Owner
Building Used As__ �LIN\-C'
`"1 1'5- ,1997
Estimated Cost �� Ste® PERMIT NO. /
PLUMBING CO APN
SIGNED BY TEL NO.,S,_L_)
Approved By A,!�:4_ Rough—In Date Final Date
S MINIMUM 1'tt I -PK ANY FLUMbINU/
P�J� PLUS THE $.50 STATE. SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
SUBJECT
P
City of Fridley
2 7 3 9 0
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
NO.
COMMUNITY DEVELOPMENT DIV.
_REGetPf
r PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
PAGE Of
APPROVED By
= CITY HALL FRIDLEY 55432
612-571-3450
910415
1
18/25/98
JOB ADDRESS
1391 Mississi i Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Gena -Rae Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Richard Podvin571-6639
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
$ Owner
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
B DESCRIBE WORK
Reroof kmxxzxxxd izarage 8 S 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
I HEREBY CERTIFY THAT 1 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
667
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.
$26.50
PLAN CHECK FEET
OT F E6
GNA UR OFC TRACTOR OR AUTHORIZED AGENT IDATEI
N P PER LIDAT IS S V R PERMIT
V
BL $P
BATE
SIGNATURE OF OWNER OF OWNER BUILDER[ IDATEI
NEW [ T Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 .r
BUILDING PERMIT APPLICATION P�� 39 0
-�ConstructionAddress: %�'�i i'Y1 sS5 _ ST,�L��
Legal Description:
Owner Name & Address: 'Rt c6Fv2D P®,pv raw Tel. # 7f' <�b 31
}� Contractor: Ji5A--F MN LICENSE #
\Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
KOTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Len Width Hgt/Ground Sq. Ft.
Z
Construction Type: �aF -x'16 e E R5'44'-6""'Estimated Cost: $ ! Co �%
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE:
�'-' x,98
APPLICANT: Tel. # ,; 7�-� `� 1-7
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
0 Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.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:
SUBJECT
City of Fridley
11
3 4 0 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
t
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
73
r
NUMBER
REV
OATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
L •, ` 763-571-3450
910415
12 / 18/03
JOB ADDRESS 1391 Mississippi Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Gena Rae Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Richard Podvin 1391 Mississippi Street NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Robinson Construction Inc 1317 118 Ave SE, Forest Lake, MN
55025 612-502-8840
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20266707
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK ❑
❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR
X
O MOVE O REMOVE
B DESCRIBE WORK
Reroof House (15 S Tear-off' Reroof Garage 12 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Garage
roofing can be the
2nd layer but not the 3rd.
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
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
$2,780
$1
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
•39
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 FOR ANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
Licens SC $5.00
$92.42
SIGNATURE OF. RACTOA UTHOAIZED AGENT IDATE,MEN
PROPERLY VALIDATED THIS IS YOU PER IT
F7 AA
LOG INS
1
MATE
S-GNATURE OF OWNER SIF OWNER BUILDEAj IDATEI
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: °�l VA 1 S4 t% c'm m
Legal Description:
Owner Name & Address: Tel. #
Contractor. �m� insor. Cc9✓�s�r`L��`` MN LICENSE # 20Z1p I.Q707
Adriress- f31-7 A$ Aa_ ST' TomA Wk.— Ole, <79C2-:; Tel. # ( 12- •V '40
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 H1 gt/Ground Sq. Ft. 1�
OTHER: fL ry"� � C�.-� Cn Guth KC 1215, Lam., [`�txe.,- �I-�CIi i ®�F / U�J
)!g- v"
Construction Type-:'-F—c.\r -o-FF -t, f?,- ��F- Estimated Cost: $�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 11 -lis'-off APPLICANT: MiTI & L ncCin Tel. # /n (2 -C-W--479 t,10
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 $ - 2 0"
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 [ ]