PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
Date
.";..�..
i
Owner...........'. ..'� c t� Builder ....................
Address . PIN.... N.... �... :. 4 ddress
2146
...................t.....................
,LOCATION OF BUILDING
No. ..�k...... Street .: ! F. .... ......... Pat of Lot .............
Lot .....IIP ....... Block ....fit'.......... Addition or Sub -Division .A.Z. ......... ....................
Corner Lot ............ Inside Lot ...... Setback ,1*,i .. Sideyard ,`................
DESCRIPTION OF BUILDING
To be Used as:
• r' � ... Front :', ! V' ' Depth tom` ..Height Sq. Ft.... .. Cu. Ft........ .
..................... Front ........ Depth ........ Height ......... Sq. Ft.... .. Cu. Ft........ .
Type of Construction . :ftf�: '.. Est. Cost . �+!'?4 ► .......... To be Complet ....................
In consideration of the issuance to me of a permit to construct the building describeo above, I agree to do
the proposed work in accordance with the description above set forth and in compliance1with all provisions of
ordinances of the village of Fridley. 11
.. .....................
........
considers of the payment of a fee of $.. , permit is hereby granted to ` "y
•. •+!s:�! ............. 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 an 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 mc ving of buildings with-
in the village limits and this permit may revoked at any time 'Ypo1j violation of any of the provisions of said
ordinances. Af Z
NOTICE:
This permit does not cover the construction, installation or alteration for wiring,
sewer or water. Be sure to see the Building Inspector for separate permits for these
. (D
'1� .. Building Inspector
Ing, gas heating,
City of Fridley, Minn.
BUILDING PERMIT N° 4 0 81
_®.9
Date: .-•--- .... ...-------••-----•-----•----_....--•---------_......�...•�•-•__..........._............................
Owner:�..._.........._.... ...-..... Builder .._ ... - ..... _ --- _..
Address........................... ... _.............---.............. _._._......._......... _............... Address ..---..................---•----- -
LOCATION OF BUILDING
No. 43.®0 Street ..._-........... .................. __......................... _.............. Part oft ................... ..... --------...._. .._. ..__.._......._...
Lot ...... .................... Block ..... _.. ��---.------------------- ... Addition or Sub -Division .. _....... ......... - ......_..---•---- ...
Corner Lot ....X ........................ Inside Lot ............ .... ..................... Setback ..... _............. ............... ........ Sideyard
Sewer Elevation ................................................. -............. _...................................... Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as:
P S i ei f �.
e� 1 ..... Front A�...-..�—Depth �l.--.-0 Height /®. . Sq. Ft. _`,�. Cu. Ft.
_.............._...................................... Front ........................ Depth ....... ............. .. Height
��...��............ Sq. Ft. ..... - ............... - Cu. Ft. ---................. ...
Type of Construction.............................•........................ Est. Cost._......�......° . ..... 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 ompliance wi all ovision of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $--.Y" .......... 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. /
------------- ... -----
- .....Q...- -- ------------
..... _ Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to so
a
the Building Inspector for separate permits for these items.
City of Fridley, Minn.
BUILDING PERMIT
Date. July 19, 1965
Harold Boeck
Owner. 6300 Monroe St. N.E.� Builder
Address Address
6300
No.
Lot 10
Street
N? 8225
Sjolander Sonstruction
2246 Johnson St. N.E.
LOCATION OF BUILDING
Monroe St. N.E. p of Lot
Block 6
Addition or Sub -Division Christie
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
To be Used as:
Type of Construction
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft. Cu. Ft.
Est. Cost _ 10,500 To be Completed
Rebuild to original - sborm dwage
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 omn fiance with aft provisions of
ordinances of the city of Fridley.
10
10.00 sJolander.Construction
In consideration of the payment of a fee of $ , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
wiord nthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said
NOTICE:
1W pormh den net corer the censlruction, insls0atton for wbieg, plumbing, gn besting, sewer or water. Be ams to see
As Betiding laapeder for sopmes permits for these hems.
.10
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME ���� BUILDER
ADDRESS Z_7e',0 � ADDRESSS�
LOCATION OF BUILDING
NO. 7e Z_'9 STREET �.l7v����e PART OF LOT
LOT. ,,/� BLOCK ADDITION OR SUBDIVISION �, a
CORNER LOT'�e_INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
a
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;
Front '��.� /d DepthHeight
Sq. Ft.®6 % Cu. Ft.
Front / -' Depth___�2 4-rHeight
Sq. Ft. Cu. Ft.
Type of Construction /!2 Estimated Cost
To be completed
F
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 7— 1SIGNATURE
(Schedule of Fee Costs can be found on the Reverseide).
City of Fridley, Minn. 9 914
BUILDING PERMIT
owner: _ 11axold Boeck Builder Same
Address _ 30 Monroe N.E. Address Same _
LOCATION OF BUILDING
No. _..6.3M Street - Monroe N.E. ____ part of Lot
Lot I Q __ Block ______6_ --Addition or Sub -Division .._._.. Chri gti P
Corner Lot — X Inside Lot _ Setback _.—_ Sideyard __
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
_2308W ("Casa-eFront 20 Depth 24 Height —J2— Sq. Ft. 480 cu. Ft. 5760
— Front Depth _ _ Height — Sq. Ft. Cu. Ft.
Type of Construction Frame �t Cost `1 , 000. _ To be Completed October, 1968
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 comp)iance, with provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Harold G. Boeck
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
John Breher Official
NOTICE:
This penn(t does not cover the construction, heollation for wiring, phumbine, gas heating, sewer or water. Be arra to we
the Building inspector for separate permits for these tone.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
.r ,
OWNEh S NAME �° 3,, d r® BUILDER
ADDRESS 1/b3 ® GAY! /'0 "e ADDRESS,/r,
LOCATION OF BUILDING
No 06 3e 0 STREET
LOT / d BLOCK (, ADDITION OR SUBDIVISIO?i dr, S �-e e
COR -'ER. LOT V-, I?k!SIDE LOT SETBACK SIDE -YARD
SEWER ELFTATION TOP OF FOOTING
Applicant attach to this form T-wo Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
DESCRIFT"iON OF BUILDING
To Be Used As
(��4 i f e Front :2 0 Depth Height l -''--
Square feet LIP Cubic Feet .5- 2 G o
Front
Depth
Square beet L -O Cubic Feat
Height
Type of ConstructionEstimated Cost /oma 1p. a
To Be Completed �c /%' O
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 repreoertation.s stated in
this application are true and correct.
DATE - 6 SIGNATURE�-� "
(Schedule of Fee Costs can be found ori the Reverse Sideo)
at(t11oA7
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On August 1, 1995
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION•AND AIR CONDITIONING SYSTEMS AND DEVICES �J
JOB ADDRESS 6 3Od _72r� o `�
Residential
Furnace Shell and Duct Work, Bumer —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
,r
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
;The undersigned hereby makes application for a permit for the work herein
Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
o�
rulings of the Building Division, and hereby declares that all the facts and
$ 30.00.• $ 3� �" representations stated In this application are true and correct.
—'{—L24, ,1995
$10,00 $ /
OWNER
$10.00 $
BUILDING USED AS r
$10.00 $ uv r
ESTIMATED COST l� f%� PERMIT NO.
$ 25,()0: $
DESCRIPTION OF FURNACE AND OR BURNER
t;
$ No. of.Heating Units,_ Circle One (Steam) (Hot Water) m r
Trada.,Name Size No.NT cSsUo v o
BTU / 00) ® ve) HP EDR
$� Fuels a ^Total Connected Load
State Surcharge x,50
TOTAL FEE Od ;6-6
MINIMUM FEE FOR ANY HEATINGICOOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Bumer•Trade Name Size No,
BTU' ' HP EDR
HEATING COMPANY
Signed By Tel No. -7
Approved By Rough—In Date Final Date
FILL OUT BACK SIDE OR 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.
U securely supported
Yes Q4
No ( )
S.
Meets all current Code requirements for size
and total BTU's connect"
Yes (�
No ( )
.6
Has total heating BTU's of O 0
All other BTU'sU�
TOTAL BTU's C `f U J O o
7.
Has a liner been provided for wager heater
Yes ()6
No ( )
8.
Has combustion air been provided for water heater
Yes (y)
No ( )
Remarks:
HEATING CO:
Signed By:
Date:
Ig -1/-q
suBJEtT
LW
I2
City of Fridley
8 067
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
�
RECE
COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
4,540
CITY HALL FRIDLEY 55432
NUMBERDATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F157RE
10/1/98
JOB ADDRESS 6300 Monroe Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
6
Christie Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Ron & Kelly Franck
571-6467
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Murphy Bros. Bldg. 1613 93rd Ln. Blaine MN 55449
780-3262
3416
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
O NEW ❑ ADDITION ❑ ALTERATION 30 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (25 S Tar -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
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
2142
$1.07
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 bR TPIE PERFORMANCE OF CONSTRUCTION
$74.75
Fire SC $2.14
IV '
PLAN CHECK FEE
L FEE
Lice SC
5. 0
;82.96
SIGN#UOF CON'RA TORORAUTNORIZEO AGENT I TEI
E PRO,
E Y VALI AT
� HIS IS YOUR PERMIT
S.GNATURE OF OINNER,IF OWNER BUILDER, (DATE,
B OG INS
-
MATE
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress :
Legal Description:
Owner Name & Address:
Contractor: 1"Vall
Address: I LP I.1,i o►` t
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT, APPLICATION
Effective 1/1/98
Tel. # 0 7/ — 7
MN LICENSE # ';,�74IIP
Tel. # -7bD' '� I—
Attach to this application, a Ce ificate of Survey of the
lot, with the proposed construc ion drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height a Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft._
DECK AREA: Length W,iiddth% Hgt/Ground Sq. Ft.
OTHER: 1�',fJUbC `�F � �: 77C 'C/
Construction Type: V'
Driveway Curb Cut Width Needed: Ft. + 6 Ft = _
DATE: ®D APPLICANT:1Mr��►��
;timated Cost:
(Fee Schedule'.= Back)
Ft x $ _ $
%cMIKA u� Tel. # 100 '-M
TOTAL $ • 2
STIPULATIONS:
Permit Fee
$ �-J
Fee Schedule on
Reverse Side
Fire Surcharge
$ • /
-.001 of Permit Valuation
(1/10th%)
State Surcharge
$ , U
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ DU
$5.00 (State Licensed
Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt.
"B" Above
Erosion Control
$
$450.00 Conserv tion Plan Review
Park Fee
$
Fee Determined
y Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ J
TOTAL $ • 2
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS h
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct.
(Side Vent — Fill Out Back) ,199
Gas Piping (Needed with new furnace) $10.00
OWNER.ViA- 1VNJA
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (UST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
$10.00 $
$10.00 $
$ 25.00 $2�5t)o
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 $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
BUILDING USED AS Q\),VS&'CK
ESTIMATED COST AVIV PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name o
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name
BTU HP
AlC - u f VwAozi
HEATING COMPANY `Qa\«V-_01
Signed By
Size No.
EDR
?14CVA1-
Tel No -((a)
Approved By/Q Rough—In Date Final Date ,2474.r
FILLOUT BACK SIDE FR STACK VERIFICATION ON
REPLACEMENT FURNACE
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
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
Yes ()
No
( )
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes ()
No
( )
8.
Has combustion air been provided for water heater
Yes ()
No
( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
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 RF INSTALLFD ON FACH FLOOR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES: NO. RATE TOTAL - JOB ADDRESS 541YIE It', 6L413 IEe—
New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture ' $ 4.00 specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser. $ 5.00 and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin $ 7.00 and representations stated in this application are true and correct.
Catch Basin $ 7.00
Rain Water Leader $ 7.00 FRANCK, KELLY �/� 20
Sump/Receiving Tank $ 7.00 6300 MONROE STREET NORTHEAST
FRIDLEY, MN 55432
Water Treating Appliance $10.00 (763) 571-6467
Water Heater -Electric $ 7.00
Water Heater - Gas** �_ $10.00 Building Used As�ra1f? fit.
Gas Range'`* $10.00
Gas Dryer** $10.00 Estimated Cost PERMIT NO.
Back Flow Preventer Required ( )Yes () No ....�tttt1111
Type $15.00 PLUMBING COMPANYO t '=m l'ZU tV1L�t Al C, f18
Reinspection Fee $47.00/Hr SIGNED BY. TEL N0. Z.. Z 0
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved By Rough -In Date Final Date -6 7 o
State Surcharge $ .50
MINIMUM FEE FOI# ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $20.50 PLUS THE S:50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE
P27 "M
IE
MM
PLUMBING FIXTURE RATES: NO. RATE TOTAL - JOB ADDRESS 541YIE It', 6L413 IEe—
New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture ' $ 4.00 specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser. $ 5.00 and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin $ 7.00 and representations stated in this application are true and correct.
Catch Basin $ 7.00
Rain Water Leader $ 7.00 FRANCK, KELLY �/� 20
Sump/Receiving Tank $ 7.00 6300 MONROE STREET NORTHEAST
FRIDLEY, MN 55432
Water Treating Appliance $10.00 (763) 571-6467
Water Heater -Electric $ 7.00
Water Heater - Gas** �_ $10.00 Building Used As�ra1f? fit.
Gas Range'`* $10.00
Gas Dryer** $10.00 Estimated Cost PERMIT NO.
Back Flow Preventer Required ( )Yes () No ....�tttt1111
Type $15.00 PLUMBING COMPANYO t '=m l'ZU tV1L�t Al C, f18
Reinspection Fee $47.00/Hr SIGNED BY. TEL N0. Z.. Z 0
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved By Rough -In Date Final Date -6 7 o
State Surcharge $ .50
MINIMUM FEE FOI# ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $20.50 PLUS THE S:50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE
CITY OF FRIDLEY INSPECTION DIV.
5431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NLJMRFR OF FIXTI IRFG Tr) RF IAICTAI I Rn nM 1=err1..1 GI nnv
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 54NC ite, ata�l�l r✓ f'` � %��
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**
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
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the citycodes
and rulings of the P,uilding Division, and hereby declares that all the facts
.and representations stated in this application are true and correct.
5-123 , 2002 -
Owner rGti1(11'� C31�\
Building Used As ��'61'tii1U cz
Estimated Cost PERMIT NO.
PLUMBING COMPANY Oi ,=m u) /i _ 'n
Reinspection Fee $47.00/Hr SIGNED BY ���� TEL N0. /Z-8Z7_`�03
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS �
1.5% of Value of Fixture or.Appliance
Approved By Rough -In Date Final Date
State Surcharge $ .50
.-.MINIMUM FEE R ANY PLUMBINGLGAS PERMIT IS S20,00
TOTAL FEE $20•520 PLUS THE S.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
Vim M am
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 54NC ite, ata�l�l r✓ f'` � %��
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**
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
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the citycodes
and rulings of the P,uilding Division, and hereby declares that all the facts
.and representations stated in this application are true and correct.
5-123 , 2002 -
Owner rGti1(11'� C31�\
Building Used As ��'61'tii1U cz
Estimated Cost PERMIT NO.
PLUMBING COMPANY Oi ,=m u) /i _ 'n
Reinspection Fee $47.00/Hr SIGNED BY ���� TEL N0. /Z-8Z7_`�03
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS �
1.5% of Value of Fixture or.Appliance
Approved By Rough -In Date Final Date
State Surcharge $ .50
.-.MINIMUM FEE R ANY PLUMBINGLGAS PERMIT IS S20,00
TOTAL FEE $20•520 PLUS THE S.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
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 O No( )
The venting: system is, plastic/PVC 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 :
3uilding BUILDING Permit No : -O44
Inspections RESIDENTIAL APPLICATION Received By:
163-572-3604 CITY OF FRIDLEY Date Rec'd: vim,
)ATE �� ��
®�
YOUR E-MAIL ADDRESS b �F ar' •r RAN
WEE a L G P-0
)(AN OO -Co [\A CA u- 1.01 C)ZL V
;ITE ADDRESS
& 30 G
dee► C ^l 0 q g-1 r� i R I D LG M ,yI 5 S d j?
.
PHONE: n 1 5 "T 2 r �,b �s ®n9�Fs'
'HIS APPLICANT IS: DOWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: r' fFH RA I O Ib U-S'R
See Back Page for Fee Schedule
Plan Review '
ADDRESS: 0 D IA C rs ?. of S"Ir. M
CITY I P LIF 1
STATEM 0Z PS 5 4 3 `-
TENANT
001 times the total job valuation
PHONE: n 1 5 "T 2 r �,b �s ®n9�Fs'
14 `L5 % v CA ; 0
G F 1-W
CONTRACTOR
NAME: 5 S LF
$5.00 (State Licensed Residential Contractors)
SAC Charge
STATE LICENSE # EXP DATE
$1550 per SAC Unit (Plans to MWCC for determination)
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
$
Fee Determined by Engineering
PROPERTY TYPE
® SINGLE FAMILY/NEW CONSTRUCTION
SIZE
Total Due
$
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
1; A A F WG '1"p p t e►1 rs U S P fA G G
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
® OTHER
60m\j c RSto nl
❑ DECK ❑ SIDING
❑ SWARMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE!REPAIR ® REMODELING
DESCRIBE WORK BEING DONE: A''�Ac-1a5P' LARAK-, twowI�,NTG;0 TO &-i\rl-ir SPAeF
SIZE OF IMPROVEMENT LENGTH V& F • WIDTH 14 FT- HEIGHT 9 r--"-- Sq. Ft. 2 5 0
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
' 4\fL. �Zb's6MF'14r
❑Soffit
❑ Trim
❑ Fascia
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ®No LOCATION OF WINDOWS _
OR FOR NEW OPENINGS -DESCRIBE SIZE OF H >b Ae S W r S I D �,
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 THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ S-000-00 OCCUPANCY TYPE
Permit Fee -'
$ W,
See Back Page for Fee Schedule
Plan Review '
$ 221 j
65% of Building Permit Fee
Fire Surcharge
$ , ao
001 times the total job valuation
Surcharge ,
$ 0.
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 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 fora nermit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work 'c r esi �v and approval of plans.
SIGNATURE OF APPLICANT �l PRINT NAMEa ��Ad ON f (^E' DATE g
�'2
I 162218
t
INSPECTION REPORT
CITY OF FRIDLEY MINNESOTA
(763) 572-3604
ADDRESS
OWNER
BUILDER
DATE
REPORT
C21W AV
If no corrections are listed above, approval is hereby given to proceeds. You will be in
violation of the ordinance if you do not call for the proper inspections and make
corrections as called for.
I
160284
INSPECTION REPORT
CITY OF FRIDLEY MINNESOTA
OWNER
BUILDER
INSPECTION REPORT
DATE REPORT
If no corrections are listed above, approval is hereby given to proceeds. You will be in
violation of the ordinance if you do not call for the proper inspections and make
corrections as called for.
Building MECHANICAL=RWAUC'
Inspections RESIDENTIAL APPLICATI
7.63-572-3604 CITY OF FRIDLEY
DATE �(2K� e� YOUR S-MAII.ADDRESS -1 g:pP_ jtAN WS tLr Va yAW BO • GcM
STTE ADDRESS
THIS APPLICANT IS: AOWNER DCONTRACTOR
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
NAME: JEEE P'A n4 W e i LC fZ
ADDRESS: b s O 0 110 o N R 0 E ST P CITY P (t-1 n t_Q STATE M r1 ZIP 55 y 32
PHONE: 763 -2.S8- 4930
COMPANY NAME:
CONTACT PERSON:
STATE LICENSE # EXP DATE
CITY STATE ZIP
ADDRESS:
PHONE
)(SINGLE FAMILY C TWO FAMILY
XNEW O REPLACEMENT
FAX
O TOWNHOUSE
O ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK Ka 11 A %� g o o trr- 022 T11 G E v " t i en i B R o v t, U TN r- AR 1 C Yb
l �iltAv s Ac.� sP�1? OF 2 `` pv�r- 17 q 11, Z p'T-AL V6,4T5 ltj ril9uj Ltv71,Jl,--s".Le.
gk11
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. ('Phis should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor _x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERENOTID. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) MODEL: SIZEIBTU
Equipment Installed MFG: SIZE/BTU
MFG: MODEL: SIZE/BTU MODEL:
A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGF/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 _,GAS DRYER $10.00 PCNL HEATER $35.00
DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00
�r''.�'�• . - J?Viia:r�
Permit Fee $ —15. 0 b Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $_ 1 S •50 Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
THIS IS AN APPLICATION FOR A PERMIT NOT vALTD 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 ordin s and codes of a City of Fridley and with the Minnesota -Construction Codes; that I understand this is
not a permit but only an app on for pe it and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case o or i re uires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME .I Iv F O�W lr I �-�'S L DATE
M.
City of Fridley
Building Inspections Department .
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIMSTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propanel7FGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction ]MC 1346.0312
5. Ventilation .
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air. calculations
Building MECHANICAL Permit No.: 7- S7a
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY DatcQi:�u 8 20
DATE a YOUR E-MAIL ADDRESS
SPIE ADDRESS
THIS APPLICANT IS: O OWNER CONTRACTOR
PROPERTY
NAME:
OWNER/
TENANT
ADDRESS:-1
DDRESS:CITY STATE ZIP
PHONE: 1
AM
CONTRACTOR
COMPANY NAME:
P
SUBMIT A COPY OF
CONTACT PERSON: ka
3 +
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WTI13
ADDRESS: — e CITY'I'&I STATEM ZIP S
APPLICATION
PHONE 703 -,SZA_ - (74 FAX
PERr4H TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
d NEW 0 REPLACEMENT )ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZE/BTU
_A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 _GAS DRYER $10.00 FOOL HEATER $35.00
DUCT WORK $10.00
_GAS PIPING $10.00 VENTILATOR $15.00
Permit Fee $ Number of fixtures @ $ t 0.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $ d i
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case o two w requires review d approval of plans. a
SIGNATURE OF APPLICANTff it; PRINT NAME I . DATE -n-0-7
F
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977