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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: Oct 17 1967 Owner: _ John Gorman Builder Address Address Dalberg Blders .3 T 6 &/-_!5_ N9 9513 1121 80th Ave. N. E. LOCATION OF BUILDING No. 1611 Street _ Onondaga _ Part of Lot Lot — 9 --- Block 1 — Addition or Sub -Division .__..__Dalberg Terrace Corner Lot —_ Inside Lot X Setback 35' _ _ _ Sideyard _ Sewer Elevation --890.5 Top of Footing DESCRIPTION OF BUILDING To be Used as: 441 Dwelling Front _ _ Depth 26 t Height _20'_ Sq. Ft. 1 018 Cu. Ft. 2 0.36 0 Front Depth _ _ Height _ Sq. Ft. _ _ Cu. Ft. Type of Construction Frame Est. Cost _ $13,5 00 -.-To be Completed SEWER LOCATION -135' from Lakeside Manhole In consideration of the issuance to me of a permit to construct the building described aboveAI agree to do the proposed work in accordance with the description above set fo andIni—n compli a with provisions of ordinances of the city of Fridley. �'l $100.00 Sewer Connection Charge In consideration of the payment of a fee of $__3l . �QQ , permit is hereby granted to..._. Dalberg Blders 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. B- CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, Gutallation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. n .r APPLICATION FOR BUILDING PEW11T CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS ADDRESS cz LOCATION OF BUILDING STREET 1- PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD &�6 SEWER BLEVATI:ON',* FOUNDATIOIN ELEVATTONff 13 - Applicant attach to thig forma Two Corti icates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used Ad: ­% *. . DESCRIPTIQ17 Or, BUILDING Front—666L Depth ,2:,. Height T Sq. Ft. jej 9 —F Cu. t. C —Frol'it—_—Depth Height Sq. Ft. Cu. Ft. 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. DATE SIGNATURE j 4 g (Schedule of Fee Costs can be found on the Reverse Side). /00 sP 6 yIV City of Fridley % Application for Plumbing and Cv= Fitting Perndt Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location Z 'r"l sly PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $4* $ , 0 © q?. e a Future Fixture Opening ................ x iag $ ` /' 'r-4 New Fixture Old Opening .............. x UW $ 1-6-0 Catch Basin ...... ~` k ; 3.25 $ Water Heater (Up toA0 0 oBTU) ...... 7 `a ; 8 $ New QGround RunOldOldBldg �.�............ x 3.25 $ G(II.LiJ 7,u /w�/�wldw,^" - 4- 040 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................z x $**W- $ ,1, ® 0 C7 ,B o Additional Fixtures .................... >99, oo0 Gas Range to i BTU .............. REPAIRS & ALTERATIONS—Refer to Code X RM $ ,S•oo 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 1190 Owner Kind of Building Used as ` To be completed about Estimated Cost, $ �a I Old -4 a uilding Permit No 3 Permit No. T 7 Signed -.1 By Business Phone ROUGH FINAL Description................................................$ TOTAL FEE , ®o 42 _ It Y<' i� gZaiZ o 3 U' i �d itO • F • N WATER HTR. GAS ELEG Base 1st 2nd 3rd 4th • Future Connection Openings I I New Fixture, Old Openings J Connected with Sewer Cesspool ,El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $4* $ , 0 © q?. e a Future Fixture Opening ................ x iag $ ` /' 'r-4 New Fixture Old Opening .............. x UW $ 1-6-0 Catch Basin ...... ~` k ; 3.25 $ Water Heater (Up toA0 0 oBTU) ...... 7 `a ; 8 $ New QGround RunOldOldBldg �.�............ x 3.25 $ G(II.LiJ 7,u /w�/�wldw,^" - 4- 040 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................z x $**W- $ ,1, ® 0 C7 ,B o Additional Fixtures .................... >99, oo0 Gas Range to i BTU .............. REPAIRS & ALTERATIONS—Refer to Code X RM $ ,S•oo 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 1190 Owner Kind of Building Used as ` To be completed about Estimated Cost, $ �a I Old -4 a uilding Permit No 3 Permit No. T 7 Signed -.1 By Business Phone ROUGH FINAL Description................................................$ TOTAL FEE , ®o 42 . U. Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems 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 AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ l� ' 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 ..................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ • v v over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE $17-,00 Dept. of Bldgs. Phone 560-3480 City of Fridley: The undersigned hereby makes application for a permit for the work hereiL 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. Owner -4-' Kind of Building Used as To be completed about Fridley, Minn_ /Z — 196 Estimated Cost, $ ( �� - Old ew. Building Permit No. Permit No. --511411f DESCRIPTION OF WORK HEATING orPOWE PLANTS—Steam, Hot Water, Warm Air—No ' /7 Trade Name--�`¢ ,,.,J Size No. /� p�- Capacity Sq. Ft. E.D.R BTU i)'4d H.P, Total Connected Load j) V,� � % Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed SUBURBAN AIR CONDMON1U O 0419 CENTER DRIVE - By --MINNEAPOLIS. MINNE—M C4110.42 Business Phone No City of Fridley SUBJECT R Q, 13869 .11 AT THE TOP OF THE TWINS PERMIT BUILDING ECEIPT NO. L------ r ` COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 . � "1 CITY HALL FRIDLEY 55432 NUMBER REV. 111/12/76 DATEPAGE P OF APPROVED BY 612-560-3450 910-F15 JOB ADDRESS 1611 Onondaga Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 9 1 Dahlberg terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Gorman 1611 Onondaga Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Miles Garage 4500 Lyndale Avenue North 521-3555 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 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 construct 22 x 24 garage 9 CHANGE OF USE FROM TO STIPULATIONS 1. Provide agreement from Closest neighbor (received 11112/76) 2. Provide a hard surface drive Q �j NTS ..1MP�RTA ENR. REQUIRED F f1 N Ck fR10LEY , Irl 1"S Rj)ITAG C� ENT SEPERI�TE PERMITS ®V�VR� A ROP�NEGPI INGS. HF,pT1NG, PEU3ING© SIG)!' SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 2Xn 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 528 5,280 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING '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. $3,907.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- 1.12 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 23.07 `, SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) H P RLY VALIDATED THIS ISYOURERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER'S NAME: 46 BUILDER: ADDRESS ; (aC 1010 ® 0 A- Cr I-%- ADDRESS : 4,>GU C � tl�v TEL. NO. : NO:. STREET: IU V3 A & A - LOT: BLOCK: ADDITION: CORNER LOT: 9 INSIDE LOT: SETBACK: SIMARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To a Used As: Front: ! Depth: t Height: Square Feet :!5 `� Cubic Feet: Front: Depth: Height: /ar Square Feet; Cubic Feet: Type of Construction: ZEstimated Cost: .*To Be Completed: G`� -3 F,0 7, Za The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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: �' �/ t v ^ 7 • . SIGNATURE (See Reverse Side For Additional i a� 2 - Information.) Information.) SLAB LOCATION AND BUILDIN6.•PEBAIIT SLIP Name�0/17i2/// Address r Home City or Pillage /l%�� i% Phone 7�l ��O Work Home Home Phone Days Evenings Salesman Gurage Size �2x2y Countour of Lot Gradual Steep At Garage Site Flat Slope Slope Permit to be obtained by: Miles Y Customer Permit No. Lot No. Block No.—��---- Addition Lot Size /S /r IL,C / STREET .ST I I N � I . ml ly a, ,�, 1 w El �o� ��' l eAk, • .T IO I o . . iz� "4 a - El ,i ❑ Check here if alley ❑ Paved ❑ Not Paved Width ❑ Office Copy ❑ Cement Copy 4 AGREEMENT J I,L owner of the property located at /& have no objection to the V� City allowing the construction of a �, _ to be located atzthout the required certificate of survey that the City ordinarily requires for all new construction. Signatu )ze, / -� Address Date ,� �,,- 7" - �- - r-- 7 ;?::: -e - � � � � - tness q -, I 7 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 Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION RIFRIGERATION/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, 2000 JOB ADDRESS 11! I I b n1 nda Ott KL& OWNER_ TOTAL BUILDING USED AS di ESTIMATED COST t sbc)•M PERMIT NO. /V5 0 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) ( arm A' $ Trade Name Size No. U"?� BTU U HP EDR $ Fuel KA • I^� - Total Connected Load 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 3-2-01 BLA I E I-ITG, A/C ELECT., INN, 13 2 CENTRAL AVE, .E. HEATIN 0 0 Signed TEL # � 3'� — Approved By Rough -in Date Final Date �® 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 plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes P(� No ( The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers 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 (�7No ( ) When required to install a new combustion air, it will be si_ed and installed To meet the current codes and manufacturer's specifications. Yesp 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 X 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 b/No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type d �G�C P _ BTU Input 1 oj0,610 Fan Assisted or Nat 6-t 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) ifnb�fku H BLAINS HM A/C I ENTRAL. AVE.N-E. 13562 HEATING CO: ANOKA, MN 55-M4 Signed By: A Date : O� MIA INE HEATING AIR CONDITIONING AND ELECTRIC, INC. ADDRESS- OCCUPANT, DDRESSOCCUPANT HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work Byy TYPE OF HEAT GA FA-4,.-4—STEAM 0 SPACE HTR. GAS DESIGN MAKE Model ? 6 Serial INPUT / CONTROLS THERMOSTAT qS� ��' Heat Plu Value Limit 3 �GII`e Limit Setting Fan Setting. Pilot Type Pilot Make Pilot Model Pilot Timin L.W. Cut Off Pressure Percent CO2 �7r Input CFH Percent 02 Stack Temp. f1140' Percent CO, HOUSE HEATING TEST RECORD l r I8(44 -t APT. FLOOR CITY Pv SUBURB OWNER / G. INSTALLED BY Gas Line By UNIT HTR. OTHER CONVERSION h Vent Size KIND OF LINER A SIZE NONE Draft Hood Regulator Filters Size / 6;r 11trJCT Number Chimney Location Inside /Outside Chimney Construction Smoke Bomb Wiring Draft Test Tag Door Pressure Lighting Inst. Date Tested Company Testing Name of Tester Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO Building $101-15 BUILDING $ Permit No.: Inspections Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 SAC Charge $ Curb Cut Escrow $ Erosion Control $ CITY OF FRIDLEY Dat ( � el' �q 763-502-4977 FAX $ Total Due $ , EFFECTIVE 1-1-09 DATE 1- 1 iy d 1 YOUR E-MAIL ,-/ 1A/DDRESS SITE ADDRESS -�� Q h on 4,1!n Ot Cr 1 d t e t.( � $�� y -L THIS APPLICANT IS: ❑ OWNER�KCONTRACTOR PROPERTY OWNER/ NAME; � 0 ,n TENANT ADDRESS: / & 57-1 / CITY > f / P StJ STATEM,1ZIP� _ PHONE: 6 5_1 9'8 3— Q ig1 CONTRACTOR NAME; i a aI,,. O V% SUBMIT A COPY OF YOUR STATE LICENSE , ` STATE LICENSE # Z04 30 Co "1 � EXP DATE 3 -3 1 - d 9 AND CERTIFICATE OF I ADDRESS: /89�. 9 / 1` i tJ tO` �l CITY. _Kia ®�� STATEXIn ZIP 55-30 .3; INSURANCE PHONE 6,/ 2- - - 2 S(e FAX PROPERTY TYPE /NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES__L__ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH )8 ROOF ❑ DRAIN TILE ❑ DECK KSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: /ee s^ o a e -" SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING❑ HOUSE ONLY NUMBER OF SQUARES HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: KDETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SUDING FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia 45, C � � 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 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 q97 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ = I OCCUPANCY TYPE Permit Fee $101-15 Plan Review $ Fire Surcharge $ Surcharge $ i4al License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ , See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2000 per SAC Unit (Plans to MWCC for determination) -ft +6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Citv of Fridlev Attach 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 on site; that the work will be in accordance with the approved plan in the case of all work w uutireweview and approval of plans. �% l q SIGNATURE OF APPLICANT (� PRINT NAME ��+ R �` ✓, DATE - leo 0 /