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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N°12 3 Date: Za 91-01 Owner: Builder Awddrx A '.► Address Address %, LOCATI F ILDING No. - %6 Street Part t — — Lot _.._ ___ Block Addition or Sub -Division . Corner Lot _ Inside Lot Setback -_ Sideyard Sewer Elevation Foupdation Elevation DESCRIPTION OF BUILDING Front *— Depth Height At Am Sq. Ft/4"Cu. Ft it Depth eight Sq. Ft. ! Cu. Ft. of ction Fit. Costo be Completed Type / p 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. 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 -an y part thereof, shall conform in all respects to'the ordinances of Fridley, Minnesota regarding location, constructCon, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any upon vii , f any of the provisions of said ordinances. ! � Building Inspector NOTICE: %b penult doss not corer the condructbn, bst&Won for vrtrhro, phudbg, •a hendes, sorer or vnMr. Be arra to we the Wdh* luspedor for »paraft perm6e for thea home. 1® M Owner's'Name APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Address a aZ&0Z��. Address LOCATION f OF BUILDING No fr lo, streetPart of Lot Lot Block__Addition or Subdivision04:2�a 4Q - Corner Lot 'lbside 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 Height Sq. Ft. Cu. Ft. Front Depth Height • C Ft Sq. It, u. 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. � .-I^` r, DATE 7SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Permit D DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin ...... x 3.25 Water Heater (Up to 200,000 BTU) ...... 7_ x 2.00 New Ground Run Old Bldg. x 3.25 TOTAL $ /d.:5— d $ "Z ,0 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 $ REPAIRS & ALTERATIONS—Refer to Code Description .....................................$ / TOTAL FEE $ W 0 ept. of Bldgs. Phone SII 44470 City of Fridley: k � 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. Kind of Building I4elL�i% Used as To be completed about Estimated Cost, Old—New. Building Permit No 6P Permit N ROUGH w FINAL - Business Phone IS in � O � (I � 9 00 0 p F N WATER HTR. GAS ELEG Base 1st 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin ...... x 3.25 Water Heater (Up to 200,000 BTU) ...... 7_ x 2.00 New Ground Run Old Bldg. x 3.25 TOTAL $ /d.:5— d $ "Z ,0 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 $ REPAIRS & ALTERATIONS—Refer to Code Description .....................................$ / TOTAL FEE $ W 0 ept. of Bldgs. Phone SII 44470 City of Fridley: k � 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. Kind of Building I4elL�i% Used as To be completed about Estimated Cost, Old—New. Building Permit No 6P Permit N ROUGH w FINAL - Business Phone Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 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 $ 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 VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE $ 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 tWe and correct. Owner _ Kind of Used as To be co Fridley, Minn_r�—, 19 Estimated Cost, $ O1d-4�Building Permit No. l Permit No. _2 DESCRIPTION OF WORK HEATING or PO team, Hot Water, Warm Air—No� Trade Nam -'n Size No�l®� Capacity Sq. Ft. E.D.R� BTU H.P. Total Connected Loa Kind of Fuel BURNER — Trade Nam Size Noee� 'O;F!) Capacity Sq. AE.D.R' BTU H.P. (REMARKS -OVER) SUBURBAN HEATING & SHEET METAL 8419 CENTER DRIVE N. E. Signe By ,<W42 2M Business Phone No- D46 j HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation t Guide Windows Doors 11 Reference I Out. Wall Int. Wall Ceiling Roof Floor I Kind- Jlow Auolied Vo 1 o y Room Length 9/ ;P idth /,("Height :P II ` Fl.l O,q ,./ Windows asid Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2-0 6'® Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. i 6 / ,@ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. V Coef. Btu Coef.1 Btu Infiltration Coef.1 Glass Infiltration Glass Exp. wall ?moi -� p Net exp. wall �j o Ap �p O Int. wall ,eq Int. wall Net exp. wall Ceiling p Ceiling Int. wall Floor Floor Ceiling total Btu. 21 O Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl -1 Room I Lenath///i s Width Heiaht 91 Windows and Doors—Crackage and Area ooID If engffl ywill Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2-0 6'® O Ma a- M Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. V Coef. Btu Infiltration Q O Coef.1 Glass Infiltration Exp. wall ?moi Exp. wall Glass Floor �j Net exp. wall Exp. wall j ,eq Int. wall Net exp. wall Floor p Ceiling Int. wall Floor Ceiling 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / — 1 .. . rt. — ooID If engffl ywill yr rielgnr 2r, 14 Windows and Doors—Crackage and Area Ma a- M Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. V Btu Infiltration Q O Coef.1 Btu Infiltration Exp. wall ?moi kklp Glass Floor �j yir Exp. wall Ceiling Net exp. wall Floor p Int. wall ®V Ceiling Floor I btal Btu. ft. E.D.R. or sq. ins. WA. Leader area Room I Lenath / 4,/- Width/ 19�, Heiaht-4-Pl/ Windows and Doors—Crackage and Area - --- Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack aq. ft Width Height No. of Lineal ft. Area No. of panne of pane lights of crack sq. ft. Z O16 Ma a- M Coef. Btu Coef. Btu Infiltration Q O Glass p 60 Glass Exp. wall kklp Net exp. wall Floor O Int. wall Net exp. wall Ceiling Int. wall Floor Total Btu. a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ZA rl i 0,......11 ......k tee, ._ W:.1.1. .0. r u_:..t,. 0 - - ----- -- �- - --- Windows and Doors--Crackage and Area - --- Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack aq. ft Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ® s0 Ma a- M Coef. Btu Infiltration ® Coef. Btu Infiltration Exp. wall ® 60 Glass Int. wall kklp Exp. wall Floor Net exp. wall A0 Int. wall Ceiling ®V Floor Total Btu. Required sq. ft. ED.R. or sq. ins. W.A. Leader area I O / M I 0...._ 11......1, /,-// W.At . Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. ofpane of pane lights of crack aq. ft tri es'® Coef. Btu Infiltration ® a Glass ggj, 10 Exp. wall Net exp. wall Int. wall Ceiling O Floor 1 otal Btu. Required sq. ft. MR. or so. ins. WA. Leader area SUBJECT PERMIT PERMIT City of Fridley 155365 AT THE TOP OF THE TWINS BUILDING P E R M I T t • COMMUNITY DEVELOPMENT DIV. �: ------ PROTECTIVE INSPECTION SEC. r � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7 JOB ADDRESS 6565 Pierce Street N.E. 1 LEGAL LOT NO. BLOCK TR ACT OR ADDITION SEE ATTACHED DESCR. 1 1 Don's 2nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE David Phillips 6565 Pierce Street N.E. 571-2923 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 X 8 DESCRIBE WORK Construct addition to gamge (71 x 261 9 CHANGE OF USE FROM TO STIPULATIONS Variance approved 6/12/78. Use 2 x 6 rafters. SEPERATE PERMITS REQUIRED F, oR WIRIW.' HEATING,. PLUMBING AI10.IiVS. .. WARNING Before Illong CO keel uti IN$ RIEWt* - ELECTRIC • GAS ETC. REQUIRED BY LAW 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 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,300 $.65 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. $7.50 PLAN CHECK FEE TOTAL FEE $4 15 GNAT RE OF CONT TOR A o ENT (DATE) WHEN ROPERL V D T IS YOUR PERMIT LLMLr� BLQrINSP GATE SIGNA URE OF OWNER IIF OWNTR BUILDER) ID TEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) ADDRESS: �— BUILDER: C''�`n"�1 ADDRESS: TEL NO: Construction Location STREET NO: �S .5 STREET: LOT: BLOCK: �^ ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIO14 OF CONSTRUCTION C'pgf -1-- A �JZA(-e_ Front: r7 Depth: Height: Squane Feet: v Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: x c_,_(SWcn 4 Estimated Cost: $ '" To Be Oompleted: 7 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 applicatiR are true and correct. DATE:, Stipulations: U� p L1 SIGNATURE: SUBJECT PERMI City of Fridley O - 499 AT THE TOP OF THE TWINS PU M E D I A %� D[ D� A I T BUILDING Ir D v I v V r C R'v, I REC _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. p CITY HALL FRIDLEY 55432 L J` NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/22/84 JOB ADDRESS 6565 Pierce Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 1 Don Is 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Erwin Bergland 6565 Pierce Street N.E. 571-0293 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Diamond Construction 2501 Blaisdell South, Mpls- 55404 872-8150 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 §I ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 18' x 14' Addition to the back of dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING. PLUMBING AND SIGNS. WARNING) Before digging call local utilifia TELEPHONE - ELECTRIC - GAS Etc.. REQUIRED BY LAW 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 60 DAYS, OR IF CONSTRUCTION R-1 252 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 $6,750 $3.38 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE P OVISIONS OF ANY OTHER STATE OR LOCA GULATING CON- $62.50 None S CTION OR THE PERFORMANCE OF CON RUCTION. t PLAN CHECK FEE TOTAL FEE --2 _tZtWHEN $81.51 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PROPERLY LIDATED IS YOUR PERMIT I )HIS L ' BLDG INSP I DAT SIGNATURE OF OWNERIIF OWNER BUILDER) )DATE) NEW [ ] City of Fridley Effective 4/1/84 ADDN. �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: /� �.5 S-77 Legal Description: 1-t9 /- �� ® �� A6m ADO Owner Name &Address: 6e/z/��J�f[� '_ Tel. #,e✓"/-®a'f�s' Contractor: Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. r D AL E U F s�( 6,4e -e/ DESCRIPTION OF IMPROVEMENT LIVING AREA: Length / Width 141 Height_ Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: 1//2 t�:>&jg:7 Estimated Cost: $ � �— Approx. Completion Date: 60 43 Alt. (0, ri ab Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: Tel.'�(�� CITY USE ONLY Permit Fee $ (0 Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ J .3 $.50/$1,000 Valuation SAC Charge $ 000000 $425 per SAC Unit Park Fee $ 'MMMMMM Fee Determined by Engineering Sewer Main Charge $ —00 - V sWAgreement Necessary [ ] Not NecessaryTOTAL $ STIPULATIONS: F SUBJECT P City of Fridley 27 6 89, AT THE TOP OF THE TWINS BUILDING PERMIT Ir o COMMUNITY DEVELOPMENT DIV. ` r PROTECTIVE INSPECTION SEC. 1 � � �J NUMBER REV DATE 9/10/98 PAGE OF APPROVED By CITY HALL FRIDLEY 55432 ".j 612-571-3450 910-F15 JOB ADDRESS 6565 Pierce St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 1 Don's 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ery & Sue Berglund 571-0293 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO PTL Contracting 2526 N Ferry St Anoka 553323-7400 5294 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 ❑ ADDITION ❑ ALTERATION a REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (33S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 SO. 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 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 $], 946. 1.4100 $ 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- $74.75 Fire SC $2.83 STRUCTION OR THE FORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOT EE /® License SC $5. $83.99 SI ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDA I � L N ROP VALID E HIS IS UR//PE(RMI � /�/) ! 6/ V SIGNATURE OF OWNER OF OWNER SUILDERI IDATEI BLD INSP BATE NEW [ ] Effective 8/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 �j� Building Permit Application I J P d4 2 `76 9' Construction Address: /�we� Legal Description: Owner Name & Address: t/ ,�� Tel. # LJ�%! 412 Contractor: . �' �ti ,f _ MN LICENSE # 2 9 L/ Address:Tel. #�� `7L,lUo 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: �? S'yti'5�. -76 e d _ Comer Lot [ ] Inside Lot [ ] F Yd tback Side Yard Setbacks 00 Type of Construction: U, P Estimated Cost: $ 2 _ Approx. Completion Date: Driveway Curb Cut Width Needed: _ DATE: APPLICANT: (Cost on Back) Ft. + 6 Ft = Ft x $ Tel. # STIPULATIONS: 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 $ $850 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: C 011 SUBJECT PER City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 3 0 7 5 3 r RECEIPT NO. 16. COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. � 1 . � NUMBER REV DATE PAGE OF APPROVED BY l w ; CITY HALL FRIDLEY 55432 --•_ •� L „ 612-571-3450 910415 3/21/00 JOB ADDRESS 6565 Pierce Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 1 IDon's 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Erwin Berglund 6565 Pierce Street NE 571-0293 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 1 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House; install 6 replacement windows 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OFC NST. 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 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 $4,000 $2.00 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- FlAe SC $4.00 STRUCTION OR THE PERFORMANC OF CONSTRUCTION97.25 __? PLAN CHECK FEEL L FEE a ,-I A/' 103.25 OW -CON -ORO AUTHORi ED AGE iDA HE PRO VALI THIS�YOURERMIT !, S� nli 04NOWN WL Rg IDAT i NSP PATE 011 NEW [I ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Effective 1/1/2000 (763) 572-3604 Bldg Insp �P3��s3 Owner Name & A dress: r ter/ � Tel. # Contractor: MN LICENSE # Address: Tel. # 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 J Width Hgt/Grou-ndSq. Ft / OTHER: �J i d i v� A 9L �a r�D�� h, ,0�.0 i��iiiroZV",'75 Construction Type: Estimated Cost: $�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ZlAeoDDAPPL NT: Tel. # F7VZZ�3 CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application Permit Fee $ - Fee Schedule on Reverse Side Fire Surcharge $ L& 0 .001 of Permit Valuation (1/10th%) State Surcharge $ 2,00 $.50/$1,000 Valuation SAC Charge $ $1100 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: EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT N .: 2004-01558 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/08/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6565 PIERCE ST NE PIN : 133024240051 LEGAL DESC : DONS 2ND ADD : LOT 12 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL GAS PIPING FOR FIREPLACE. # A/C UNITS 0 VALUE OF APPL OR WORK 200 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 200 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 15.00 0.00 FIRESIDE HEARTH & HOME 225 COUNTY RD 81 GAS RANGE FEE 0.00 OSSEO, MN 55369 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 607807 0.50 15.50 OWNER BERGLUND ERWIN R & SUZANNE 6565 PIERCE ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state o local law reguMor the performance of cons cti jc*n App 7 ::_Dat Bldg Insp D to EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas PipinikNew Fupace, Fireplace,) _tDfl— } Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 61565' / i per./ e e N Fee Total Owner 1�5r v 4- e d 'r !q 1 cL $35.00 $ Building Used As ReS`'lCkgonCa,e-- $10.00 $ ESTIMATED COST 4622aROW PERMIT NO $10.00 $ $10.00 $ $25.00 $ Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name %uacl rct lea r &— Size No. BTU 20. V-Z� HP EDR Fuel hi 6. Total Connected Load f;"^e p)a e (51 %G%uS (ice e_ 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 $ and rulings of the Building Division, and hereby declares that all the facts *Air Conditioners can not be placed in side yard without written approval ,from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE SeRe r �- -L- 0 05 -Seo Min • Y57,34,9 and representations stated in this application are true and correct. AMO Freese &aaH" FAX # Date / /`7L® e Approv Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 ( ) No ( ) The undersigned also verifies that the replacement unit 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 ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () 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 ( ) 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 ( ) No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat 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) HEATING CO: Signed By: Date : Building MECHANICAL Permit No.:' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY c°x4111 1 200 DATE- 14- YOUR E-MAIL ADDRESS SITE ADDRESS 66%-5— Pj ", . THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: �G N ADDRESS: f/CITY STATE�ZIPJ3Vt TENANT N TET PHONE: CONTRACTOR COMPANY NAME: G� SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # � AXP DATE !�i y LICENSE WITH ADDRESS: M S"/ & d iY//i�. �� CITY 1a t a e, STATI ZIP APPLICATION PHONE 763 FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT XALTERATION/REMODEL DETAILED DESCRIPTION OF WORK RIC" n/ e w PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU _A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR 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 XGAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fix .00 x $35.00 = $ Surcharge = $ .50 :6G7 '�'-� Total = $ THIS IS AN APPLICATION FOR APERMIT-NOT V ID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above ' p ete 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; that the work will be in accordance with the approved plan in the case of all work which requires re d approval of plans. P 6/1-k—k—DATE—L-1® " SIGNATURE OF APPLICANT PRINT NAME—VA// PLEASE NOTE/PARATE PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977