PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 4063
Date:'��
Owner: ........... -.............. ................................. ....... _.._...._---- ------------------------- Builder `�......... _ ...._
Address....._......._...._..... _.._._.._---_.._ _..._ . _...__...._......__.._......... Address
LOCATION OFo BUILDING
No.. .. ........ Street ............ Part of Lot ------------
----- ._._..... .._......._._._.....__. �r.�
Lot .......... oZ_z............. Block ....._....... .. .Y .......................... Addition or Sub -Division
vv o o/
Corner Lot .......................... _........ Inside Lot ....................................... Setback'j.'.'5.�.-..i....................... Sideyard ...1 ....-- -d.------•-------------•--•-----.._.......
Sewer Elevation ..... .............. _.............-............._......................_............................. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: ,
- -- - --- .._.... �. Front Depth.v.........d. Height Ft. �®.Q..� Cu. F>" ���------
. -- ... Front� . �:.._ Fla.. Depth.22./...7Q. v/ Height /®...� _vim, Sq. Ft. ..� .7 Cu. Ft.
Type of Construction..................................................... Est. Co�.,9,.._®..®... To be Completed .-............- _... .............
In consideration of the issuance to me of a permit to construct a building described above, I agree to do
the proposed work in accordance with the description above set fro and in com ce with all provisions of
ordinances of the city of Fridley.
............ ..........................� w _ _>._.....s��' J ..... ...................
In consideration of the payment of a fee of $ .. wrap.... permit is hereby granted
_._-_-..._......... -.............. _....... .............. 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. �
D
".�:�...• `�. ._----_-_-- ��'��..----_.. Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
Original
PERMIT for Power Plants and Heating, Cool.
ing, Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. ting Plants U -)n- r ,-, Q— o`, to b ltered—repaired
Make
QTS � , Sixe /00 ;
Oil fired ; Coal fired ; Gas fired � �/ ; Gas Authorization No.
Remarks
Approved
Final Inspection Date , 19_
Inspector
-4-i3 94
Permit N° - -
Fee $ / 4'70 5
%DCS
Office of the Inspector of Buildings
City of Fridley
City of Frid Minn.,
r �
, SMTLV- A -�V$ a W WN Z' MM—W 2N. A MW - � W�
Location 9s� �Cts✓� 1
Kind of Building�n �^-
,
How Occupied
Work to be Commenced—, 19
To be Completed �,19-10
Estimated Cost, $, 9 a!5� 0 0
Old—Building Permit
Permission is hereby granted to �Atea." -+lled #- to install—erect—use the material and devices described in the
above statement. This permit is granted upon the express condigon that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this
permit on file in the office j'ice o f the Inspector of Buildings. l ' ► � �_ / � %'`/,Inspector of Buildings
2M 11-67 v - - - - -
97-8h-416051 CITY OF FRIDLEY
APPLICATION FOR PLJMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$ _^
New Fixture, Old Opening
�
$
Catch Basin
Water
N
o
m
�
100,000 BTU to 199,000 BTU
Sl
EA
r•+�
x $7.00
$
New Ground Run Old Building
x $5.00
$
wU
tP
$
Heater
-0
C
lst 3 fixtures
x $3.00
G
N
x $1.00
X E
Gas Range to 199,000 BTU
x $10.00
C
E d
CL
i%c�
First $100.00
$4
$
each add. $100.00 or fraction
$2.00
4
G 0
C
-•a
4
U
«d
N
$ 8.00
C r
i
4
•'
N
O
"
O
-•i
M
mi
a
4 O
C
14
ro
1j N.
7 M
ill
b
N
N
U
P
M
o�
y
s
4w
N
w
6wa3
0
0
dS
leC
1st
2nd
3rd
4th
(R) - Future Connection OpeningConnected
with Sewer
(•) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$ _^
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5.00
$
Water Heater - to 99,000 BTU
x $5.00
$
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
Electric water Heater
x $5.00
$
GAS FITTING FEES:
lst 3 fixtures
x $3.00
$
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTU
x $10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
REINSPECTION FEE
($10.00)
Job Address 921 Pandora Drive
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 trua and correct
Fridley, Mn. 6-11-79 , 19
OWNER OLSON
KIND OF. BUILDING frame
USED AS res
TO BE COMPLETED ABOUT 6-18-79
ESTIMATED COST 40.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company"`��
Signed By MINNEGASCO
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT e
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
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 N�yx4+ VA -4 �-✓��-
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
$�?
G��� representations stated in this application are true and correct.
(Side Vent - Fill Out Back)
1997
Gas Piping (Needed with new furnace) $ 10.00
$
OWNER C2�`c.I� J c9J� 5�%/'.foi?
Gas Range $ 10.00
$
BUILDING USED AS 4,
Gas Dryer $ 10.00
$
ESTIMATED COST l You . j PERMIT NO. /� CCD
*Air Conditioning -All Sizes $ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
$
No. of Heating Units / Circle One (Steam) (Hot Wate (Warm Air
Trade Name �% �s7Log-,t.) Size No. Nte s
Commercial/Industrial
BTU HP EDR
1.25% of Value of Appliance or Work
$
_ Fuel /UA -t- 4fj,*.r. Total Connected Load
State Surcharge
$
.50 Burner Trade Name Size No.
TOTAL FEE
BTU HP EDR
C�• SZ'
HEATING COMPANY p✓- 1,1 ;lj-
L,/4�K as �
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signed By �C� Tel No. �21_0.PV3
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Approved By 0 Rough -In Date Final Date
*Air Conditioners can not be placed in a side yard without
FILL OUT BACK SIDE F STACK VERIFICATION ON �� 0
written permission from adjoining property owner.
REPLACEMENT FURNA E
Remarks: .
HEATING CO:
Signed By:
Date:
CFHMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the -existing chimney or stack:
1.
Has been carefully examined
Yes (zf 'No (
)
2.
Is free from rust or deterioration
Yes (c--YNo (
)
-3.
Has no foreign objects lodged within
Yes (1 No (
)
Yes (--f 'No (
)
4.
Is securely supported
5.
Meets all current Code requirements for size
Yes No (
)
and total BTU's connected
(-J'
6
Has total heating BTU's of %
All other BTU's 3 Js �z
-ms
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes () No
8.
Has combustion air been provided for water heater
Yes �-fNo (
)
Remarks: .
HEATING CO:
Signed By:
Date:
SUBJECT
City of Fridley
2781�
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RE O.
v _����_ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.c(S-K
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3460
910415
7/24/98
10B ADDRESS 921 Pandora Dr
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
22
3
Brookview Terrace - 2nd
SHEET
2 PROPERTY OWNER MAILADDRES$
ZIP
PHONE
Eric Johnson
571-6992
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Quality Contracting 11380 W. River Rd.
Champlin 55316 427-7733 7053
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 00 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof (18 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
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
SQ. 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. OWLG. 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
$1501
$.75
DOES NOT PRESU E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS 0 ANY OTHEB STATE OR OCAL LAW REGULATING CON-
STRUC 90 R THE MANCE ONSTRUCTION.
$51.25
Fire SC $1.50
PLAN CHECK FEE
TOTAL FEE
Z02A_
License SC $5.00
04
1$58.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT I IDA EI
WHEN PROPERLY DATED THIS IS YOUR PERMIT
LDa NSP
DATE
S,GNATURE OF OWNER qF OWNER BUILDER, IDATEI
NEW [ ]
Effective 1/1/98
ADDN [ ]
CITY OF FRIDLEY
$
ALTER [ ]
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Fire Surcharge
$
BUILDING PERMIT APPLICATION
State Surcharge
$
12-1 fil 41
$.50/$1,000 Valuation
ConstructionAddress:
(� �
Legal Description:
License Surcharge
$
Owner Name & Address:
w C Te kyySeJ
Tel. # 7,/- 69'T?_
Contractor:
r L4®�-�2�-t t`c� MN LICENSE #70,3S_
Alt. "A" or Alt. "B" Above
Erosion Control
$
Address:
ei-
Tel. # �1'2_7- 7 J
$
Attach to this application, a Certificate of Survey of the
Fee Determined by Engineering
Sewer Main Charge
lot, with the proposed construction drawn on it to scale.
Agreement Necessary [ ] Not Necessary [ ]
DESCRIPTION OF EMPROVEMENT
TOTAL
LIVING AREA:
Length Width Height
Sq. Ft.
GARAGE AREA:
Length Width Height
Sq. Ft.
DECK AREA:
Length Width Hgt/Ground
Sq. Ft.
OTHER:
1 / sg
Construction Type: qy t Pry d"`F Estimated Cost: $ i
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: q cil
Tel. 77S 3
STIPULATIONS:
r
CITY USE ONLY
Permit Fee
$
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
$
�� 6&"
$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:
r
k-oj�.qq
3uilding
aspechons
763-572-3604
TM ADVMS
'7iiI.SS APPLICANT IS;
TENANT
SUBMIT A COPY OF
YOM STATE LICENSE
WrrH APPLICATION
PROPERTY TYPE
OF
CITY OF FRIDLEY
1BMDING Permit No
RESIDENTIAL APPLICATION Receivel By: /
CI'T'Y OF FRIDLEY Dae Recd
YOUR F. -MAIL ADDRESS
STATE
■ [ 71 Ip i 1`Y 'I;` ���
■ � �i ■ It 1' C
DESCRIBE WORK BEING DONE;
SIZE
SQUAns 2-0%
GARAGES
PROPOSED SMF--
PROPOSED HEIGHT_
.SWING
O vinyl
17 Aluminum
0 Other,,
wriVDt)WS
IN EXI87l�iG OPENINGS Oyes ONO
OR FOR NEW OPSINGS-DESCRI$E SIZE OF
OPEMNO, CHANGES &
TYFB OF WINDOW TO 13E INSTALLED NLWER OF
VALUATION, INCLUDING THE COST OF I
(USING THE W7 U.S.0 FEE SCMDULE)
)N . OCCUPANCY
O HOUSE & GARAGE
0 ATTACHIID GARAGE
O DETACHED GARAGE
Mffit
0 Trim
0 Fascia
LOCATION OF WINDOWS
CITY STATE-
-.72-
M DATE
%61111,06111M
FEES
Permit Fee
Plana Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Pee
Sewer Main Charge
��F
Ft.
SOMM REMMUNCZ SUBMIL
I. Etsti g Floor Plan
2 Proposed floor pian
3. List of strunftual members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONNS,Mm= SUMM
I. site PlsmJs�evey showing the a stn,cn,res
and proposed project.
2. Two sets of aanstruction Plans
3. Energy CaiOWWOas
$
See Back Page for Fee Schedule
$ ------
65% of Building Permit Fee
S(.0005)
ices the total job valuation—iulun► $.50
x Permit V01Uati0n (1/10%)
$
$5.00 (State Licensed Residential Contractors)
$
$1450 per SAC Unit (Plans to MWCC for determinadon)
$
_ft+68= ftx$20=$
$
$450 Ct>mmyatiion Placa Review
$
Fee Determined by Engineering
$
Agreement necessary ( ) Non Necessary ( )
S 00��
Make cbeeks payable to: City of Fridley Attar
THIS IS AN WPLICATION FOR A PERM T NOT VALID UNTIL PROCE55W
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 Mi wesota Construction Codes; that I understand this is not a
permit but only an application for a and work is not to start without a permit; that the work wUl be in accordance with the approved
plan in the case of ail work wreviewpproval of plans_ D
SIGNATURE OF APPLICANT
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
..........
TOTAL P.01
PLUMBING
PermItNumbw
RESIDENTIAL APPLICATION
City Of Fridley
Date Received
NOTE: IF PROPERTY IS NOT OWNERIOCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERmIT.
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS 1
THE APPLICANT 1S: (CIRCLE ONE) OWNERCONTRACTOR
NAME
PROPERTY OWNER/
TENANT
ADDRESS �/ a
CITY STATErfl LJZIP ,L 2
PRONES
NAME LICENSE#
•ern-rr
CONTRACTOR
verUmbing CO
ADDRESS tITY
--0- 1Ytsiln S't. iV.
CITY ZIP
PHONE # n %& MN ��FAXdj
W) '04- 199 Fax 63
PERMIT TYPE
SINGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORK
❑ NEW REPLACEMENT'
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACIIj
BATH SIIKMV FLOOR DRAINS SHOWER WATEii PIPING
BATHTUB GAS PIPING (Need Miy tioww) SwlMM1NG POOL WATER SOIs MER ($SR
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY ,WATER HSR (> FOR IRRIGATION
WATER MFMR OTHER
Permit Fees $ MINIMUM: $18.00 or 5% of cost of the Improvement-whichever is
Plan Review $ greater on work less than $300
Surcharge $ 50
TOTAL DUE $ Make checks payable.to: City of Fridley
THIS IS AN APPLICATION FORA PERMIT- NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I admowledge that the inbmaticn above Is complete and accurate: that Ift work VAR be in catfonmance with
the ordinances and codes of the City of Fridley and with the PAnnesota Construction Codes, that I understand this is not a permit but only an
application for a permit and wdfk is not to start without a penntt; that the wait wilt be in accordance with the approved plan in the case of all work whirl►
requires review and approval of plana.
NAME OFAPFUCANi b'(.��
(16ZDATE
Please type or yt`—
SIGNATURE OF APPLICANT
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
..........
TOTAL P.01
Building
PLUMBING
Permit N1 X13 '
Inspections
RESIDENTIAL APPLICATION
Received By:
763 -572 -
CITY OF FRIDLEY
atWMD AP 200
763-502-44977977 FAX
EFFECTIVE 2-19-09
DATE - L - YOUR E—MM/AIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER ONTRACTOR
PROPERTY
NAME:
OWNER/
TENANT
ADDRESS: STATE;4'
PHONE: (p >
e „Z - 1 6 L/ "
CONTRACTOR
NAME:
OF
SUBMITOUR
STATE LI NSE # D 1p
TATE
.3 (n EXP DATE
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
ADDRESS: -74o �j
CITY STATE.2h IP`�
INSURANCE
p/
PHONE `7CP - 7l� la ", I FAX
�
PERMIT TYPE
KSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW CEPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
_ BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING
_BATHTUB _GAS PIPING (NEED CITY LIC) _SWIMMING POOL [WATER SOFTNE
_CLOTHES WASHER _KITCHEN SINK _ WATER CLOSET BACKFLOW PREV. )
_ DISHWASHER — LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
3�
{ ��.-'+'%.. �,. 3 f3 S�i 'z 3'." a'wia ;y •!'''� S- C' 1i 3T.3''agE
-4 --" '€ �r , . ' F roa
.H2
'�� Y� '•k,'. # � §� `^F$, m"l- r } 4� eiz ".a -0 � �i �'S 3".. � ( i+,
��� L°e tS � � }I ii'a L )� � k *s� l„ v'i � 1 1 Y P �Yi i ! �- � � � �` *o' (y ✓H � �d �*
i vtN y € yp
� �' � 3`' S F F a'.�
�
'� •,3- y�'i . -t� � � �
4 b °i'� W 2 �� L � A � �fi.Y �' a �'�Z" 'tf {+-+.Ey�`� 2
N
z
d
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 which requires review and approval of plans.
-
SIGNATURE OF APPLICANT RINT NAME �� /�r�/j� 6'� f/S DATE
FIN M RX It
KPI Met 1qN=
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977