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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 6203 Date: '� `�.► "` +.. Owner: _ �'• %+�. _ guilder Address Address LOCATI R&RUILDING No. Street Part ofAt Lot ��+i_�� _ Block ZAddition or Sub -Division . Corner Lot — 7nsi Lot _ Setback �.� Sideyard Sewer Elevation _ _ - _ Foundation Elevation DESCRIPTION OF BUILDING Tod,/ UsedL G Front Depth Height Sq. Ft.. Cu. F't�l ZZ XA '�pth RnightSq. Ft. Cu. Ft. Type of ConstructionEst. Cost CA W _'_'wY'o be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do tht, proposed work in accordance with the description above set forth and in compliance with all provisions of ordineaoes 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, constru on, 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 A �A 0 NOTICE: Ibis permit does sof cover the construction, h atalistion for willow piu"teo, eas heog , sewer or crater. Be am to coo the Building Inspestor for separate peradts for these items. Owner's Name Address 61�, APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. &Zs1,6 Street -.Cd ° , part of Lot Lot 91— Block /6 Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION 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 Depth a V Height Sq, Ft. Cu. Ft. �- Front /0e"' Depth �?.fll 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��}�+�' `� ' //rot' SIGNATURE '`��al (Schedule of Fee Costs can be found on the Reverse Side). Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ............... MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each ado. 60,000 BTU ....................... Replacement of Furnace ................ Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM RATE TOTAL 8.00 $ 5.00 5.00 $ 2.50 $ h.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ 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 $ off-, t GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .......... ........... x $1.50 $ 1 Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ ,AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule $ _ TOTAL FEE SP Dept. of Bldgs. Phone SU 4-774470 Location 4.5A– zeea;.e�� pid 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- Owner ,4(P Kind of Used as To be cc Estimated Cost, $ O1dBuilding Permit No. Permit No.� ' DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name Size 105<1_zzls Capacity. Sq. Ft. E.D.R. A®V/� BTU H.P. Total Connected Load 34 WL Kind of Fuel BURNER — Trade Name r Size No- Capacity Sq. Ft. E.D.R/4e�0!9!a BTU H.P. (REMARKS -OVER) SUUU SU IIIUJINIG & SHEET METAL' 8419 CEMER ER DRIVE N. E. Signed MINNEAPOLIS 21 MINN. By M404.42 2M Business Phone No- sa 4-,01,00 HEAT .LOSS'CALCULATIONS. DEPARTMENT OF .BUILDINGS MINN. Wbathetstrips A Construction No. Insulation Guide wiredows Doors Reference Out. Walt Int. Wall Ceiling Roof Floor Kind ow A plied - :No Room I Lenitth/-V,- Width /i ! Heiifht SP, Il OFFI.I 0 Ronin I I-onifth �. �.vvemdth t> > Height.P � Windows A Doors—Crackage and Area Width i Height No. of No. of paneof.PUMP lights Lineal ft. Area of crask eq. ft. Width Height No. of Lineal ft. Area No. or pane of pane lights of crack $4. ft.ki so t""' K&(e hpe3 AP, 0` Infiltration r - Glass Coef. Btu Infiltration Infiltration Int. wall �'',�, O Glass ® -'2,3Z� 33®0 Exp. wall st Int. wall Net exp. wall Ceiling 10-6,0 Int.. wall .� Floor Ceiling y�® Floor Total Btu.. Required sq, ft. E.D.R. or sq. ins. W.A. Leader area '�v oom I Length 2/ � Width 12/ Height ff Windows and Doors—Crackage and Area Width i Height No. of No. of paneof.PUMP lights Lineal ft. Area of crask eq. ft. so Coef. Btu Infiltration r - Glass Exp. wall Coef.1 Btu Infiltration Int. wall �'',�, O Glass Exp. wall -'2,3Z� 'Net exp. wallp Z Int. wall Ceiling .� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.) Room I Lenirth. /`.31 Width ,/ I Height- A,/ Windows and Doors—Cratckage and. Area Width Height No. of Lineal ft.. Area No. of pane of pane lights of crack eq. ft. 2 . atS Coef. Btu Infiltration r - Glass Exp. wall Net exp. wall Int. wall Ceiling �1 Floor Total Btu. ' Required sq. ft. E.D.M. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane, lights of crack sq. ft. 7-2?, ICoef.1 Btu Infiltration > 1•L Glass Exp. wall Net tip. wall Int. wall Ceiling Floor Q�^ Total Btu. �j r :Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Y F1.1 :F, Room I Length /'Zt Width,0/ Height 3? Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Ares. No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Z Glass F O Exp. wall Net exp. wall Int. wall Ceiling AV Q�^ Floor Total Btu. Required sq, ft. E.D.R. or sq. iris. W.A. Leader area FL+ Rotrm I Length / Width7,-, Height / Windows and Doors—Crackage and Area Width, Height No. of Lineal ft.Area No. of pans of bane itghte of crack w. tt Btu I Infiltration Glass 'cp Exp. wall Net exp. wall 'Int. wap Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley AppliaMm for Pkmbbg and C7= RM" Pandt Dept. of Bldgn. Phone 560-UW �J DESCRIPTION OF WORK Number. Kind and LocaBion of PUtu"s • �••tl PARTIAL RATE SCHEDULE PLUMBING FIXTURE A LTES. NO. RATE TOTAL Number Fixtures ................ x 62.00 6 Future Fixture Opening .... :...... x 61.50 i New Fixture Old Opening .......... x 61.50 6 Catch Basin ..... ....... a ®. a .. x 63.25 i Water Heater 'Up to 99,000 BTU) ®. • • x $3.00 6 New Ground Reagin Old Bldg......... x 63.25 $ Electric Water Heater .............. a $zoo $ GAS FITTING FEES. NO. RATE TOTAL let 3 Fixtures ............ • • • . x $2.00 6 Additional Fixtures .... o .......... x $.76 6 Gas Range to 199,000 BTU .. ,......... x 65.00 6 State Surcharge $ .50 REPAIRS ALTERATIONS—Raga¢ to Coda _ 1.& Description e o a o o. a ... e.. s o. o o.. m w... e e ...... . .... o .... TOTAL FEE - City of Fridley: The undersigned hereby makes application for a permit for the work herei: speeified, agreeing to do all work in strict accordance with the City Ordinance and nzling of the Department of Buildings, and hereby declares that all the fact and representations stated in this appliefito n are true and correct Fridley. I9z ?i Owner l.¢, ... Kind ® uilding Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. /v ROUGH_ FINAL Signed By Business Phone No A G R E E M E N T This is an agreement between the City of Fridley and James L. Anderson that the well being drilled on his property, legally des- cribed as Lot 6, Block 2, Don's Second Addition, the same being 6516 Pierce Street N.E., Fridley, will be used as a sprinkling system and will never be connected in any way to the City of Fridley water system. Da 12, 1972 City of Fridley ,6-3-8h-116051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLIDSING FIXTURE RATES: N0. RATE .N', =.be= Futures cc^.1ture Fixture Opening New Fixture, Old Opening Catch Basin :rater :eater - to 99,000 BTU 100,.000 B:J to 199,000 BTU Water Softener New Ground Ran Old Building Electric grater Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas RZInge to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $3.00 x $2.00 X $2.00 x U.o X $5.00 x o x $7.00 it $5.00 water $5.00 o� e. w e m q +�+ b 1t w w Heater O .4 si O .-1- q C C Cf E 0 Y 1, U N N .0 C Q U140 pa O U C. ••a i� L` N •.i :3O O L 71 1! N. N N a G �a�y [II N 3 a 4. La W U11 a s � �N�pp 8 O a3 �lec 'S= r r i (R) - Future Connection Opening Connected with Sewer (*3 - New. Fixture, old Opening Water PARTIAL RATE SCHEDULE PLIDSING FIXTURE RATES: N0. RATE .N', =.be= Futures cc^.1ture Fixture Opening New Fixture, Old Opening Catch Basin :rater :eater - to 99,000 BTU 100,.000 B:J to 199,000 BTU Water Softener New Ground Ran Old Building Electric grater Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas RZInge to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $3.00 x $2.00 X $2.00 x $5.00 X $5.00 x $10.00 x $7.00 X $5.00 X $5.00 x $3.00 X $1.00 X $10.00 State Surcharge TOTAL FEE REINSPECTION FEE 010.00) $5.00 $2.00 TOTAL S Job Address 6516 NE tierce 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 roprosontations statod in this application are true and correct Fridley, Mn. 3-16-81 19 OWNER L ANN KIND OF BUILDING frame USED AS TO BE COMPLETED ABOUT 3-23-81 ESTIMATED COST — 50.00 ��j OLD - NEW BUILDING PERMIT NO. PERMIT NO. 8sz Company Signed -By - -. � v .W" MIMMEGASCO Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT -42f OcCL MINIMUM FEE FOR ANY PLUM9ZNG PERMIT IS $7.50 PLUS $.50 STATE SUpMMRGE 1� SUBJECT 11 NV. of Fridley 25209 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir?ity � COMMUNITY DEVELOPMENT DIV. v 1 r PROTECTIVE INSPECTION SEC sJ NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 1.j 612-571-3450 910415 6/23/97 JOB ADDRESS 6516 Pierce Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 Don's 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE J. Chappa 6516 Pierce Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO PTL Contracting 2526 N Ferry St, Anoka, MN 55303 323-7400 5294 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 O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (24 Sq) Tear -off; Soffit & Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Ventilation must meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 1 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 $3,060 $1.53 WITH WH ER SPECIFIED HER OR NOT. THE GRANTING OF A PERMIT DOES N T P ESUTO GIV A HORITY TO VIOLATE OR CANCEL THE pEgM1T FEE SAC CHARGE PROW ONS OF ANY HE ST TE OR LOCAL LAW REGULATING CON- @87�2r) ``PP F re SC $3.06 STRU ION OR THE P FO NCE OF CONSTRUCTION. PLAN CHECK FEE T T L FEE Licen SC $1.00 $96.84 SIGNATOR OF CHORIZEDAGENT IDATEI E PA�VAD "' BG ASF THIS IS UR PERMIT �� DATE S)GNATURE OF OWNERIIF OWNE R BUILDER) IDATEI 1� NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PE)WIIT APPLICATION ConstructionAddress: Legal Description: Owner t Contract Address: Effective 1 / 1 /97 ,619,6 OPROJEN - ir�lmvljrl _ Tel. # M/N--LICENSE # �S- Tel. # 32- 3 ^% z r of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Sq. Ft. Sq. Ft. Sq. Ft. Construction Type- Estimated Cost: $ (Fee Schedule on Back)--- Driveway ack)—Driveway Curb Cut Width Needed: —Ft /+) 6 Ft = x $ _ $ DATE: V — j 1 `% APPLICANT•— Tel. # 3 CITY USE ONLY Permit Fee $r Fee Schedule on Reverse Side Fire Surcharge $ _ f % .001 of Permit Valuation (1/10th%) State Surcharge $ /, S j $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ S. &V $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 $ ��. o ( STIPULATIONS: WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well anti Boring WELL AND BORING SEALING RECORD sealing No Minnesota Unique jNeti No. Minnesota Slatotes, Chapter 1031 - or W -series No.- .:-. n.em. elms xna gown) H 71 County Name ppg��g �M'r.]`$i:�At�,^1•< AIR Township Name Township No. Range No. Section No. Fraction (sm. -t. Ig.) Date Sealed Date Well or Bori ,g Constructed Numerical Street Address or Fire Number and City of Well or Bonng Location Depth Before Sealing ft. Original Depth _ °y n. Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section gridwAh'X'. location, showing property lines, roads, and buildings. N Single Aquifer ❑ Multiaquifer Estimated WELL/BORINGMeasured IkWaterSupply Well ❑ Monit. Well ❑ Env. Bore Hole C1 Other 70 ft�l i below El above land surface YJ a� " '+ ""?"" E CASING TYPE(S) --�- ---- -;-- ---I-- Steel ❑ Plastic ❑ Tile ❑ Other IIS lhmlts --�- -'-- -i - --i CASING(S) Diameter Depth Set in ov I•size hole? Annular space initially grouted? ll SJ�a �t�--trrdle �1 ,p!�' in. from 0 to 7 ft. Yes No ❑Yes C]No [I Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME JERRY & JUDY CHAPPA in. from to k. ❑ Yes li ❑ No ❑ Yes ❑ No ❑ Unknown Property owner's mailing address if different than well location address indicated above. STREWSCREEWOPENHOLE UK 6516 PTFW(!EFR-MM Y, $5432 Screen from 97 to k. Open Hole from to ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑ Chegk Valve(s) ❑ Debris ❑ Fill Type of Obstructions (Describe). o Obstruction N.. WEt?LL OWNER'S NAME AM Wall owner's mailirtg,address M different than property owner's address indicated above. - . Obstructions removed?- ❑ Yes ❑ No Describe PUMP Type J Ij Removed ❑ Not Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO FORMATION If not known, indicateeedmefe{llormetkm log from nearby well or boring. ` METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS; OR CASING AND BORE HOLE: ❑ No Annular Space Exists ❑ Annular space grouted with tremie pipe El taring Perforation/Removal �I - in. from to ft. ❑ Perforated ❑ Removed tn. from to ft. ❑ Perforated ❑ Removed Type of perforator CLAY RAY 6C 10- ; ^" PE ° /0 1',rEi 1 ❑ Other i GROUTING MATERIAL(S) (One bag of cement d 04 Ibs„ o0e bag .of bentonite a 50 lbs.) 90 4 Grouting Material from to fl yards bags from row_ ft. yards bags from to ft.yards bags it— from to n. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS GWLO" FRO a 6537 CENTRAL AVE Other unsealed and unused well or boring on property? ❑ Yes No How many? MLEVEL IN A ML f 45' LICENSED OR REGISTERED CONTRACTOR CERTIFICATION DATE WATM LVJE:L T ; 2/29/40 This well or bortng was sealed In accordance with Minnesota Rules, Ohapter 4725. The Womlation contairred In this repot Is a 14" true to the best of my knowledge. E,Hb RENNER fi IRMS, 71015 A an"ciar awne� Name Lkense a Registration No. tiELEUr Regulations - - 5/4 / Auftrized Rep According to MN State I - 1*;1 ' E-M/KEV1K HOPPE LOCAL Ci3PY H Name at Per" SeaftWetlorBoft