PRE 2010 DOCSBUILDING PERMIT
Tillage of Fridley, Minn.
Date,'...r .......J
Owner .�'�'+&% Builder ;�F�'�^'ye °tom►
Address
2021
Address.................. �,......................
LOCATION OF BUILDING
No. Street Part of Lot .................... .
.�% - .
Lot ...... R.f....... Block ...1b .......... Addition or Sub -Division ' 42�w.......
Corner Lot ............ Inside Lot ..jo,,/....:. Setback�� . Sideyard fit . .
DESCRIPTION OF BUILDING
To be Used as:
Front p�� �!+ DepthHeight r .... Sq. Ft.Cu. Ft.
.................... Front ........ Depth ........ Height ......... Sq. Ft...., ... Cu. Ft.........
Type of Construction .. .. Est Cost.. � .... To be Compleed ...................
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i .
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In consideration of the issuance to me of a permit to construct the building describ d 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 village of Fridley.
............................ ......................
In conjideration of the payment of a fee of $. .; permit is hereby granted to .,..y�4,
We*�.. ..... to construct the builditr ad dition' as described above.. Thi si erxmt is on
ess coalition that the person to whom it is granted and his' agents, employees d workmen, in all work
done in, around and upon said building, or any ,part thereof, shall conform in all resp ec to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and loving of buildings with-
in the village limits and this permit may be revoked at any time upon violation�of any of the provisions of said
ordinances.
4.
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
0- 0
... Building Inspector
gas heating,
City. of Fridley, Minn..
BURDING PERMIT N? ,,
59,
/1� gyBuilder
p/
Address Address
LOCATION LpING
I Z'No. Street -A 0a'` Part A#
Lot ._ : _ Block Addition or Bub -Di n
Corner Lot
Sewer Elevation _ _ Fo tion Elevation
DESCRIPTION OF BUILDING,,,,".
To U '
Front pepth Leight Sq. Ft. Cu. Ft.
Depth 1Teight- Sq. Ft. r " Cu. Ft.
6
Type of Vnstruction F o 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 a'll provisions of
ordinances of the city of Fridley.
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, alteratio�WXY2!94
maintenance, and moving of buildings
within the city limits and this permit may be revoked at any of the Proviatona of said
ordinances
NOTICE
Tide permit don not eovar i6e, eonstmcdoe, h ah0aden for Whine, pWmbing, on hosting, sower or %i ftr. Be sure to as
the MIA* Inspaetor for apsrata Permits for flus tt�s.
�Ipi¢Se Spa�rX s 440A -4 �pi�Mo�f' A1,11c-,AL-11)6iU `CV/LMS r
Application for Pewer Plays and Heating, Cooling, Vm lation, Rafrigen�alioR and
Air Conditioning System and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ... .. $10.00 $
Replacement of Furnace ... ..... ..... 6.00 $
Repairs & Alterations—up to $500.00 6.00 $__
Repairs & Alterations each add. $500.00 3.00
MECH. WARM AIA
Furnace Shell & Duct Work to 120,000 BTU ...... . $10.00 $__
each add. 60,000 BTU .................... 3.00 =
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 3,00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00 $_
Each add. 200 sq. ft. EDR Steam
8.(1(1 -
Each add. 320 sq. ft. EDR Hot Water
3,00 $--
OIL BURNER—to 3 gal. per hour
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 189,000 BTU)
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
1st 3 Fixtures
Additional Fixtures
Gas Range to 198,000
AIR - I
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL 9 - ;Z 3 -9 y
6.00 $--
&00 -_
&00 $
NO RATE TOTAL
- x$ 2.00 $
- x .7a $
-2$5.00 $
WiLL-1
See Fee Schedule
$
TOTAL FEE
(SURCHARGE $ _,50)
Dept. of Bldgs. Phone 860.3490
City of Fridley:
I
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,
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $ G
Old—New. Building Permit No. Permit No.
DESCREMON OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size Ne
Capacity Sq. Ft. E.D.R BTU H.P
Total Connected Load Mnd of Fuet
BURNER — Trade Na.ne Size No
Capaci Sq. Ft. EMD R- BTU NP
(REMARKS-OYER)
SUBJECT
PErD6
City of Fridley
_
o0
'9AT
THE TOP OF THE WNS
BUILDING PERMIT
r
L
-110
RECEI .
1 ; COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i
,-� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
----
L 612-571-3450
910-F15
9/30/88
JOB ADDRESS 6320 Monroe Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
6
Christie Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Maxine Mondloh 6320 Monroe Street N.E.
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 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install ridged
00002KIK galvanized
valleys.
On all new roof$ or tear -offs and replacement roofs,
State Code rsgpjYes that ^2 laydrs of 15 lb. felt,
mopped to , be installed W a point Z4 Inches
',or
up fr n e c yr wall 46,the use sof 6tber
approved : laymen,. emb.*
�I
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
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
$850
$� rj0
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PAN CHECK FEE
TOTALFEE
$21.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY V
ATEDTHIS IS YOUR PERMIT
y
7
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
BLDG INSP
OAT
NEW [ ] City of Fridley Effective 5/1/88
ADDN [) R-1 AMID R-2
ALTER [ ] Building Permit Application
Construction Address: LoJ .JV / / l0 e /V &--
Legal
Legal Description. e % /k-1 6 [ _
Owner Name &Address: ®/T" Tel. #
Cbntr actor : ��� �� Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
J: UA c •' 1,' 1'' • 5 I�
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
ODrner Lot [ ] InsideL [ )h Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost:
Approx. Completion Date:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ S
Width + 6' See Back Page
DATE:-
Arr�I�xr.
Peaoit Flee S / 0 y
State Surcharge S SCJ
SAC Charge 5
Driveway Escrow 5
Park Flee 5
Sewer Dain Charge 5
TOTAL,
CITY USE ONLY
Tel. # Z72
Flee Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC Unit
Alt. "A" or Alt. 'B" Above
Flee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
-4`
Building
MECHANICAL
Permit No..
R!
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
OF FRIDLEY
D q
763-502-497x77 FAX
EFFECTIVE 2-19-09
�=
DATE` YOUR &IVjAIL ADDRESS
SITE ADDRESS �Cl� �-- ��C
��'
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: - - ,
Z2 a
OWNER/
ADDRESS: C�,3�� �� 0-��r1Lf�i .S" CrrY STATE
TENANT
—CONTRACTOR
PHONE:
COMPANY NAME:
SUBMIT A COPY OF
CONTACT PERSON:
STATE LICENSE # 7402 W9*Mft A
YOUR STATE
LICENSE WITH
_�
ADDRESS: bM �6e' MNC STATE ZIP
APPLICATION
PHONE FAX
PERMT TYPE
f `G E FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW LACEMENT ❑ ALTERATION/REMODEL
'
DET ED DISC ON OF WORK/ .�, /
" —kms
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASBRAE HANDBOOK
Equipment Installed MFG: Ce- MODEL:, SIZFIBTU 1;! 40
MFG: r`�s/� MODEL: '9'% SIZE/BTU
MFG: MODEL: SIZE/BTUC
$25.00 FIREPLACE (GAS) $15.00 GAS RANG&OVEN $10.00
*A.IR
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 _POOL HEATER $35.00
_DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00
Number of fixtures @ $10.00 x $10.00 = $
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures 35.00 x $35.00 =
State Surcharge = $��"
FEE $35.50Total = $ Cs�'
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 c s of Ci of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an ap ca on f r a d work Is of to start without a permit; that the work will be in accordance with the
approved plan in the case all h review and pproval of plans.
XDATE
SIGNATURE OF APPLIC PRINT NAME
APPROVAL INSPECTORS SIG ATURE DATE
PLEASE NOTE: SE ARATE PPMTMM REQLTIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
L`�Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977