PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N sos
Date: :.,P'
001,71
Owner: _ Builder —
Address Address
LOCAT ILDINC
No. Street a %W. 6 OFF, Part OfAt _
Lot _ Block Addition or Sub•Divislon,
Corner Lot _ Inside Lot — Setbacks — Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To Us
Front Depth Height Sq. Ft
Depth eight Sq. Ft. Cu. Ft.
Type Construction Fant. ---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 compliance' with all provisions of
ordinances of the city of Fridley. y�
In consideration of the payment of a fee of
permit is hereby granted to
to construct the building or addition as described above. This t 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 re to the ordinances of
Fridley, 1Viinnesota regarding location, construction, .alteration, maintenance, _ moving of buildings
within the city limit$ and this permit may be revoked at anyviolation o aay of the provisions of said
ordinanc:eB.
Building Inspector
NOTICE:
Me peneit does not corer the construcHoe, hutagaHon for whip, phnobleg, ges heaHag, sewer or crater. Be sore to see
the BWMbg hupector for separate perm6s for these honor
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name � e [���Builder
Address f0 I�o�s� .= Address
LOCATION Oy BUILDING
No. Street Part of Lot
Lot Block / Addition or 'Subdivision 0V_W_ _4
Corner`Lot Inside Lo t_,?!!�_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 Height
Sq, Ft. Cu. Ft.
Front' 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
(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: RATE TOTAL
Furnace Shell & Duct Work ........................... 8.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ e ®'8
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
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
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...........� x $1.50 $
Additional Fixtures x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE SID
ROUGH
FINAL
—
Dept. of Bldgs. Phone SU 4-7470
R
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 t;ue and correct.
Fridley,
Owner '�9- '&'&A,
Kind of Building
Used as
To be completed about
196 �
Estimated Cost, $
Old-dQ Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or PO team, Hot Water,WNo
Trade Name
P Size No��
Capacity. Sq. Ft. E.D. BTU H.P.
Total Connected Load Kind of Fuel -
BURNER — Trade Nam Size No
Capacity Sq. Ft. E.D.R BTU H.P.
U D��6� �9 TING & Sff[T METRh
SUB
8419 CENTER DRIVE N. E.
Signed
MINNEAPOLIS 21, MINT,
By
42 2M Business Phone No-
(REMARKS -OVER)
IM6...az
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E, Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
—No I No 19.4O y
Fl. Room Length®� Width / / Height / Fl.�
Windows And Doors—Crackage and Area
Width Height oorsNo. of Lineal t . Area '
No. i of pane o[ pane lights of crack se. ft.
Coef. Btu
Infiltration
Glass y
Exp. wall
Net exp. wall
Int. wall
Ceiling ®/� ®,p
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
m I l .on&th -1 % / W;& th av, 14eist,► s? 0
Windows and D : - rackage and Area
l 54
Width Height No. of Lineal ft. Area
No. of pane of pane llghts of crack sq. ft.
!— 2'r 0 L.
v
Z/wo/ol
/
Net exp. wall
Coef. Btu
Infiltration
Btu
Glass
Z
Exp. wall
Glass
Net exp. wall
,J
Int. wall
Ceiling
Floor
v ,®
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
7.,7,-:7'
A-1Room I Length/ -3 / Width /)/ Heiuht a /
Windows and Doors—Crackage and Area
l 54
Width Height No. of Lineal ft. Area
No. of patine of pane llghts of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
?r f Y
o�
Net exp. wall
Coef. Btu
Coef.
Btu
Infiltration _3
p'dfQ
Net exp. wall
Glass
Int. wall
,J
Exp. wall
Floor
Net exp. wall
�
/ 3
Int. wall
Ceiling
Floor
lbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /�p
>i
FRIDLEY, MINNS
Insulation
t?....... it .w..l1. O� fi/' .Afk / %1 Fdaint.r 0 /
v
endows and Doors—Crackage and Area
l 54
Width Height No. of Lineal ft. Area
No. of patine of pane llghts of crack sq. ft.
O
Exp. wall
Net exp. wall
Coef. Btu
Infiltration
Glass
Exp. wall
p'dfQ
Net exp. wall
Int. wall
,J
Ceiling
Floor
Height
Total Btu. Iy
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length / Width / Height'/
Windows and Doors—Crackage and Area
Width Height No. of Lineal rt. Area
No. of Wane of Wena Il`hts of crack ec. ft.
Infiltration I,-xe
l 54
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
p'dfQ
Floor
Total Btu.
,J
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
OC
Room I Length / Width /
Height
Windows and Doors—Crackaite and Area
LI
Coef. Btu
Infiltration p
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling 2.
Floor
Total Btu. y
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Ing
SUBJECT
PE
City of Fridley
, 14383
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
ECEIPT NO.
►y ______ COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
�
�9�
1
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
._•-� �
L , 812-580-3450
910-F15
9/22/77
JOB ADDRESS 6533 Pierce Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
10
1
Don's 2nd Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Alvin Berg 6533 Pierce Street N.E., Fridley
571-0028
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Same
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
❑ NEW Ej ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 81 x 26' Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS Provide a hard surface driveway. Addition side yard setback must be
at least * feet. Release signed by neighbor.
�2
SEPERATE PERMIT.4 . REQUTAD FOR- WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Wood Frame
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. 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
N
AND ORDINANCES TYPE OF WORK WILL BEWITH
$1,505
$.75
EING REINIOR NOT. THE GRANTING OF AOPERMIDT
WHETHER SPECIFIED
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-
$8.32
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$9.07
SIGVfUREOFFC/ONTRACTOR AUTHORIZED AGENT (DATE)
WHEN PROPERLY
VALIDATED THIS IS YOUR PERMIT
BLDG. INSP
o�
DATE OF
SIGNATURE OF OWNE IIF OW ERI RBU (DATE)
Ing
OWNER:
Address
No..
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING
(NEW, ALTERATIONS, ADDITION.
Street:
BUILDER:
Address:
Tel. No..
PEMI TS
LOT: 1®
BLOCK:
�_ ADDITION:
�-7&
CORNER LOT:
INSIDE
LOT: �7 SETBACK:
SIDEYARDS:
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:
f
ront:X 9 Depth: Height: /
Square Feet: Cubic Feet:
/. Front: Depth: Height:
Square Feet: Cubic Feet: 14, b
Type of Construction:/8-a Estimated Cost: $�®�
To Be Completed:�y� ��,� ��/ ��s���" Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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 tru and correct. See reverse side r additiona formation.
r
DAT��% SIGNATURE:
Stipulations:? �/ n
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AGREEMENT
I,
owner of the property
r
located at have no objection to the
City allowing the construction of a to be
located at 3-3&-.-Je�—S&/AFNithout the required
certificate of survey that the City ordinarily requires for all new
construction.
Signature
/V L
Address
-Z61
4 �z zz
Date
fitness
I
SUBJECT
M NO.
IT
City of Fridley
27249
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r ,
�
NO.
COMMUNITY DEVELOPMENT DIV.
v
r PROTECTIVE INSPECTION SEC.
o
1 . i
NUMBER
REV
DATE
PAGE OF
APP11bVED BY
CITY HALL FRIDLEY 55432
�.__.1`•� ,•�
612-571-3450
910-F15
18/18/98
10B ADDRESS
6533 Pierce Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
1
1 Don's 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ruth Ber Sharla Blischok
571-0028
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
PTL Contractiniz 2393-7400
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
ElNEW ❑ ADDITION ❑ ALTERATION Ek REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (26 Sq) Tear -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 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
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
$2168
$1.08
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 TH ERFORMANCE OF CONSTRUCTION
$74.75
Fire SC $2.16
PLAN CHECK FEE
TOTAL FEE
Licens 5.00
$821A9
SIG/ ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI1rf-EYNrOPE
111,ALI DATE QoOgIS IS YOUR P MIT 01
B G )NSP
L
GATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
I
NEW [ J Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 9
BUILDING PERMIT APPLICATION
ConstructionAddress: (053 3 P1 erC, S
Legal Description:
Owner Name & Address: / ,�� �% /� l SC�io% Tel. #
Contractor: TL NI` 7-1/2�. MN LICENSE # :5 R I Li
Address: 2 E,2(o 4J. "t- s- -,A., k %'ly 5s --3o Tel. # ?23 =-7 CtOD
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
Height
Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
D. Wsated
Alt. "A" or Alt. "B" Above
Construction Type:
5
Cost: $
$
(Fee
Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x
$
= $
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
$ `i ` S
Fee Schedule on Reverse Side
Fire Surcharge
$/
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /,Q5,
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$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: