PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: .4. .. ... ....._. . . .........don
t
Owne : ........... Builder _�:......
Address._...... o. �__ . _ _. _ ___ ._
' Address ---...:. _.".`."."_.,:.._.. s... . _.._.�a..
_, LO9►TIOV OF BUILDING
No.. ,- Street .. r :..... ...._._ : ....:..:....:._:....:._ P Lot ..--......._ �...._.._.._. ......_1..._.....__..._.._.
Lot Block ... ......-.......r... Addition or Sub-Divisin`._:......:_:
Corner Lot .................................... Inside Lot ....._. ............... Setback -._ __.-.................. Sideyard ........... ..._...._...............
Sewer Elevation
Foundation Elevation ......................... ...... ............_-..........._......._...._............._..
DESCRIPTION OF BUILDING
To be Used as:
. : - - -
Front - Depth ``.:.... Height Cu. Ft. •�... �
... Sq. Ft....
:.t �........... rot .._ Depth ........�. Height'�.yle 17
Sq. Ft. p :.. Cu. Ft. _..
Type o Construction -- Est. Cost........ .+.................. To be Completed ....._........_..._............._.
CAU • oN
THIS PERMIT Dr?;�xU�� VR" j.
ION Or Af.'Y i✓1.1 .,k i c tN!j f l
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 $.... 31_...€.._` 'permit is hereby granted to ..... _........... .................... ........._......._..
_.._.___._.........__.W._..._.._..._..._........ to construct the building. or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents,employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limns and this permit may be revoked at any time upon violation f any of the provisions of said
ordinances.
Building Inspector
NOTICE:
.This: permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
.QW4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name ��✓� Builder
Address Address kne>
LOCATION OF BUILDING
6 %
No. _Street KV- s. _Part of Lot
Lot Block Addition or Sub.Div,�.G��r�a�vs
Corner 'Loth ?Inside Lot - Set Back .;4r4 „Side -Yard lL�
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front � ., Depth_____- & , Height
Sq. Ft. /3 ` Cu. Ft.
ff
I I 0 Front - - Depth„,-,�;�;_,���___Height
2
Sq. Ft. / l� Cu, Fto
Type of Construction Estimated Cost_,,�„��
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions statA in this application are true and torr"£?
DATE SIGNATURE
($ aedule of Fee costs can be found on the Reverse Side.)
Application for Power Plants and Heating, Coaling, Ventilation, Refrivwff an and
% Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470
GRAVITY WARM AIR: RATE TOTAL Locatlo `L�-'�
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00
$ City of Fridley:
Repairs &Alterations—u to 500.00 5.00 The undersigned hereby makes application for a permit for the work herein
Alterations—up $ • • • • • • • • • • • • • . • • • $ specified, agreeing to do all work in strict accordance with the City Ordinances
Repairs & Alterations each add. $500.00 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
MECEL WARM AIR dley, annn AUG 12 1960 195—
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $--
each
each add. 60,000 BTU ....................... 2.00 $ Owner 195—
Replacement of Furnace 5.00 $ Kind of Building 195—
Repairs & Alterations—up to $500.00 ................. 5.00 $
Used as
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM To be completed about 41arT a rn 960
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Estimated Cost, $� `
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ w. wilding Permit No.��`n
— ,)Rach add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
DESCRIPTION OF WORE:
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 $ A/
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 IDEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM It
ALTERATIONS & REPAIRS TOTAL FEE $
'REMARKS:
HEATING - er, Warm Air—No
Trade Name
Capacity
Size No
Capacity Sq. Ft. BTU r H.P.
Total Connected Load al'2�0, f0 Z Kind of Fuel
BURNER — Trade Named Size o��
Capacity Sq. Ft. E.D.R ®kp' H.P.
CEO.SE® ICK E 1 tl G. & AIR-COND, CO
® %�`� 1001 Xenia Av. S.
Minneapolis 16, Minn.
Signe
11 POST 1M-12-58 Business Phoz No
% 7 - - ���
Y ,6t Lvz�
D-56 -01EW79
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN.
a
Windows and Doors—Crackage and Area
YZ
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
R D (P l /
J .J e
Coef.1
Coef.1
Coef. Btu
Coef.
Btu
Infiltration
19
ff
Glass
13
&)
Glass
IL?
Exp. wall
%
S'D
d' o
Exp. wall
Net exp. wall
Net exp. wall
'
zQ
Net exp. wall
Int. wall
Floor
Floor
Ceiling '
Int. wall
X/
Floor
Floor
Ceiling
.9
<T10
Floor
Total Btu. �-
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
?,X,,Room I Length / 9 Width e, ? Height �
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
R D (P l /
` o
Coef.1
Coef.1
Coef. Btu
Infiltration
Infiltration
n,
19
F' -_;2-
Glass
Glass
Exp. wall
T
IL?
Exp. wall
Exp. wall
Net exp. wall
sil
Net exp. wall
Net exp. wall
zQ
Int. wall
Int. wall
Floor
Floor
Ceiling '
Ceiling
X/
Floor
Floor
Total Btu. 1,13/1Z /
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Reom l Lenath /-) Width /%' Hei.ht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Height 7
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of panne of pane _ lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1
Coef.1
Coef.
Btu
Infiltration
n,
19
Glass
Glass
Exp. wall
T
IL?
4 -40
Exp. wall
Net exp. wall
sil
Int. wall
Net exp. wall
Ceiling
Ceiling
Int. wall
Floor
Floor
Ceiling
X/
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
L�1 i �! /✓ �,, A. ,,.., t i e....►1, _ wirkl, .=T 14,.ioht '
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of panne of pane _ lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1
Coef.1
Btu
Infiltration
n,
c� dz
Glass
Exp. wall
Exp. wall 3
c
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F7_I R..I Length sF Width „ Height �
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of panne of pane _ lights of crack sq. ft.
Coef.1
Btu
Infiltration
c
n,
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
b D G/1 -
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 Kind
e No 17re-s"TNo 19—
/ Fl.l � e.-., R.. 1 i.enoth 1/ Width ABX Height P" II Fl_I Room I Lensth
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal f . Area
No. of pane ofpane lights of crack sq. ft.
Coef. Btu
Coef
Coef. Btu
Coef.
Btu
Infiltration
Glass
_
5-
Glass
Int. wall
A6 -2d
Exp. wall 9 oY
Floor
Int. wall
Net exp. wall
L3
9
Int. wall
Ceiling * �.�?
4
Floor
Total Btu. I G'y`
Required sq..J ft. E.D.R. or sq. ins. W.A. Leader area {
I/
�;Atb /B 1 NPldIt
77/7
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Coef
Coef. Btu
Infiltration
Glass
-p
Glass
_
5 c� ..-�,
Exp. wall
Int. wall
Net exp. wall
Floor
Int. wall
Ceiling
c z,,
Floor
Total Btu. ,
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 ft. Area
No. of pane of pane lights of crack sq. ft.
MINNEAPOLIS, MINN.
Insulation
How. Applied
Width Height
Windows and Doors—Crackage and Area
Width Height No. ofLineal ft. Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
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 ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. I
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area I
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
SUBJECT
IT NO.
City ®f Fridley
AT THE TOP OF THE TWINS
BUILDING PERMI
f
�
RECEIPT N
COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
I
-"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/5/81
JOB ADDRESS 5164 Rainer Pass. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
4
1 Innsbruck First Add. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
John Exon 5.164 Rainer Pass N.E. Fridley 55432 571-4210
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner
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
❑ NEWJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Add on a 15' X 21' porch and a 15' X 21' deck.
9 CHANGE OF USE FROM TO
STIPULATIONS
Area can not be heated unless it meets the. S.IL C. energy code.
All floor framing to be treated wood.
EPERATE PERMITS REQUIRED FOR IR S,,
HEATING, PLUMBING AND SIGNS- AN��G
HEATING,
Before digging call local utilities
TELEPHONE - ELECTRIC - CRS Etc.
REQUIRED BY IAV'
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood frame
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
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
ISTALLS 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
$11,000.00
$5.50
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.
$66.00
PLAN CHECK FEE
TOTALFEE
��
$16.50
$88.00
SIG UREOF ONTR OR OR AED AGENT (DATE)
WHEN PD THIS IS YOUR PERMIT
�
942(
r
'
Z
BLDG INSP DATE
SIGN REOF OWNER I OWN` BU DERI (DATE) �
CITY OF FRIDLEY
APPLICA'FIOd FOR RESIDENTIAL BUILDING IIEPJ4ITS
(New, Alterations, Additions, or Repairs)
G� Vl �-xo ►'i
OtdtdER: BUILDER: -
nDDRESS:G�J9�/� ��J-S'S ADDRESS:
TEL NO: /-- 4,2-14 TEL NO:
Construction Location
STREET.NO: STREET: S �J• .
LOT: BLOCK: ADDITION:
Corner Lot: Inside Lot: f0 Setback.: Sideyards:
Applicant attach to this form two Certificates of: Survey of lot and
proposed building .location drawn on certificates to scale.
DESCRIPTION OF COFNSTRUCTIONI
Front: Depth: Height:
Square. Feet: -Cubic Feet: ai
Front: Depth: -° Height:
Square -Peet: Peeet: 3t� Cubic Feet:
°�5�71
-,E-- MORS
11-S)e r00 I, S-� , D0��� l ►, 0 0 d
Type of Construction: Estimated Cost: $ lJ
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
Mie 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 trug%and correct-,
- L_ 0/
DATE: .__ � S IGNATU PE
Stipulations
P. 1
-V�X'
Ejitc:
�e
�00
own #o"we
A
SUBJECT
PER .
City of Fridley
®Q7838'
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIP
' `
`y ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
/"'1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
1/9/85
JOB ADDRESS 5164 Rainier Pass: N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
4
4
Mrmebruck 1st Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John J. Exon 5164 Rainier Pass. N.E. 571-4210
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 Ej ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Interior alterations to bath and bedroom area
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS REQUIRED FOR
"VP_"
1i IN &sa o 4 s �'� & u °,:1i a L ..,., L. ' iite"< L_'t j it.?zd F Al"-'
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 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
$12,000
$6•Q0
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-
$92.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$98.50
�IG TURE0 OACTOR UTHORIZEDAGENT IDATEI t•
WHE• P OPERL V LI T D IS IS YOUR PERMIT _
G INSP DATE
'SiGNAUR OF OWN OF OONIER BUILDER) IDATEI
A
NEW [ ]
ADDN. [ ]
ALTER. [
Construction Addr4
Legal Description
Owner Name & Addn
City of Fridley Effective 4/1/84
�R-1 AND R-2
Building Permit Application
Contractor: Tel. #
Address:
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:'
Corner Lot [ ] Inside Lot Ft. Yd.
,SSide Yard Setback
.ettback
Type of Construction: %moi �-- Estimated Cost: $ �� c
Approx. Completion Date:
I
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: /' 6 APPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ dFee Schedule on Reverse Side
Plan Check $25% of Building Permit Fee
State Surcharge $ 64 $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
® Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On March 1, 1996
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas** JZ &p (A e !
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance moa
State Surcharge $ .50
TOTAL FEE $ .'Zc,5.'
JOB ADDRESS i\) F_ 2 P4 iZz
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
and representations stated In this application are true and correct.
®fir 19967
Owner pe . 6) <� 77
Building Used As �S
Estimated Cost PERMIT NO.
PLUMBING COMPANY e A. T64 4 f3 Snt�
SIGNED TEL N0, .2, 6
Approved By Rough—in Date Final Date
MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS $20.00
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
'
SUBJECT
City of Fridley
30857
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
�
R T NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
F
NUMBER
pEv
DATE
PAGE OF
AtsvROVED Br
CITY HALL FRIDLEY 53432
L 612-571-3450
910-F15
4/25/00
JOB ADDRESS 5164 Rainer Pass NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
4
Innsbruck
1st Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Cindy/Ed Anderson 5164 Rainer Pass
NE
586-0877
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
MCR Roofing 829 20 Ave NE, Minneapolis, MN 55418
788-5749 20063096
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
Q
❑ NEW ❑ ADDITION 0 ALTERATION X REPAIR
X
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State
Building Code.
SEPARATE PERMITS ARE REOUIRED 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
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS OF WORK WILL BE COMPLIED
$21185
$1.09
WITH WHETHER SPECIFIED HEREIN T. THE GRANTING OF A PERMIT
�',T"Y
DOES NOT PRESUME GIVE H TO V TE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF A THER AT OR LO REGULATING CON-
$83.25
Fire SC $2.19
TR CTION E ERF0 AN OF C ST ION
PLAN CHECK FEE
TOTAL E
1p
License $5.0
$ 1.53
S-GNAT RE OF CONTRACTOR OR
NROPE Y ALIOA
BLD INSP ZgArE
D IS IS �RIT
C/�r [[L�
S-GNATURE OF OWNER ,,F OWNER BUILDER, tDATEi
I
NEW I ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION -14
Construction Address: 4/
Legal Description:
Owner Name & Address:(, /1v � —<!1Z n Tel. # 646 5:217
Contractor: rYi. C I? �� on fr, ?n7 ci MN LICENSE #,200 G E 0,9
Address: E Q ,� ® y U,� 77 Tel. # ,,� 1.Z 22,F- ,-75' 9
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 WidthHgt/Ground Sq. Ft
OTHER:
Construction Type: i n Q- Estimated Cost: $
Driveway Curb Cut Width Needed: _
DATE: -! APPLICANT:
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Tel. #d/
Call (763) 572-3604 for Permit Fees if mailing in application
Fee Schedule on Reverse Side
$- r .001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$_$1 100 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
R
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
r
CITY OF FRIDLEY INSPECTION DIV.
r
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1999
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance �
State Surcharge $ .50
TOTAL FEE $®,.5/%
JOB ADDRESS / 6 `f 91 A V f L ,1 4o
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
and representations stated in this application are true and correct.
.1999
Owner
V 7
Building Used As
Estimated Cost 70 PERMIT NO.
MR. ROOTER OF ANOKA COUNTY
PLUMBING COMPANY 6250 Industry Ava. N. #11
Ramsey, MN 55303
SIGNED BY 421-6140 TEL N0.
421 -6198 -FAX r .
Approved By Rough—In Date Final Date—��
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
f
OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
October 9, 2000
Cynthia Anderson
5164 Rainer Pass NE
Fridley, MN 55421
Re: Final Inspection at 5164 Rainer Pass NE
Contractor: Mr. Rooter of Anoka Co.
Dear Ms. Anderson:
A plumbing permit was issued on April 8, 1999, for the above noted address,
to install a water softener. According to section 4715.2800 of the State Plumbing
Code, a final inspection shall be conducted on the plumbing authorized by this
permit. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
DN JfNSEN
Buildi Inspector
FAI
SUBJECT
PE
City of Fridley
3 3 7 2 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
' ,
REC O.
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 . ,
NUMBER
REv
DATE
PAGE OF
APPROVED By
..-'-D CITY HALL FRIDLEY 55432
.......
763-571-3450
910-F15
21 / 0 3
7/21/03
JOB ADDRESS 5164 Rainer Pass NE
I LEGAL
LOT NO.
BLOCK
4
TRACT OR ADDITION SEE ATTACHED
Innsbruck, 1st Addition
DESCR.
4
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Cindy & Ed Anderson, 5164 Rainer Pass, Fridley, MN 55421 763-586-0877
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
William Kettle, 938 Dartmouth P1 SE, Mpls, MN 5515 612-379-2047 20214153
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
❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Replace 5 windows.
9 CHANGE OF USE FROM TO
STIPULATIONS
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.
Caulking and flashing for all exterior openings.
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
$8,000.00
$4.00
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-
$153.25
Fire SC $8.00
STRUCTION THE PE FO NCE OF CONSTRUCTION
PLAN CHECK FEE
$5.0 cense
EE
TOY25
$1
SIGNATURE OF CONTRACTOR OR AUTMORiZEO AGE NT (DATE,
PRO ALIOATED HIS IS YOUR P MIT
I-AWH
DG NSP T,A
SIGNATURE OF OWNER OF OWNER BUILDER, �OATE� +'
FAI
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fax
BUILDING PERMIT APPLICATION
C'.nnefn infinn AddrAsm- >' 6 4 1 A7 t f2- PA -5
Legal Description: �F-evo-a'
Owner Name & Address: G� ^' D �'�' E Tel. # %�K 3 37e6 oi�r72
Contractor: W l LL 14 Kf- 17- L, -C- MN LICENSE #
Address: `i��s �/h^°�' ® P-� gr M���,� Tel. # C 1 ),
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Yp
Construction T e: Estimated Cost: $
Driveway Curb Cut Width Needed:
Ft. + 6 Ft =
Ft x $
_ $
DATE: D- I 3-V L APPLICANT:
W1 1-1-0 /ti
40P -E
Tel. # C ] Ol
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 4( too
$
TOTAL $ t—1 'rj- 0
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
City of Fridley
AT THE TOP OF THE TWINS
SUBJECTERMIT
I L D I N G PERMIT
306
`
COMMUNITY DEVELOPMENT DIV.
r 1 ______ � PROTECTIVE INSPECTION SEC.
I �
CITY HALL FRIDLE`1 55432
L J\ 763-571-3450
RECEIPT NO.
NUMBER
910 -FIS
REV
DATE
8/15/03
PAGE OF
APPROVED BY
JOB ADDRESS 5164 Rainer Pass NE
1 LEGAL
DEscR.
LOT NO.
4
BLOCK
4
TRACT OR ADDITION
Innsbruck 1st
Addition
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Cindy & Ed Anderson 5164 Rainer Pass
NE
763-588-0877
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
William Kettle Construction 938 Dartmouth
PI SE, Mpls., MN
55414 612-379-2047
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
20214153
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
�J NEW ❑ ADDITION O ALTERATION
❑ REPAIR
❑ MOVE REMOVE
B DESCRIBE WORK
Remove and ..replace a 277 sf deck
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
YPEOFCONST
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ONING
SO. FT
CU FT.
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. 110
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$@ 3,440
SURTAX
$1.72
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE R LOCAL LAW REGULATING CON-
STRUC ION O HE PERF R AN F CONSTRUCTION
ERMIT FEE
$97.25
SAC CHARGE
Fire SC $3.44
IJ AL.)&®
LAN CHECK FE
L i c e nfi A &e S' $5.0
TO AL FEE
107.41
D SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE,
ENROP VALID
BLD iNSR
D THIS IS YOUR RMIT.r
o E
SIGNATURE OF OWNER dF OWNER BURDERi iDATE,
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fak SNIo.
BUILDING PERMIT APPLICATION
Construction Address: S i b (�/�t N t 'I -
Legal
�A
Legal Description: .Vo k r 06-1/, !d ; rtl< 16-1 ADp(T Io N
Owner Name & Address: Go tib V + iF 6 AA -1b F- fq �50 I`-' Tel. # b" 3 Ll --S ®e6
Contractor. WjL-1-kAMN V<--- MN LICENSE# �G )-0�
Address: "T316' T Mo l 1.46-F 6E Tel. # 6 i, 3 G( ) L� 9
l
PLS Attach to this application, a Certificate of Survey of the
lot, moth the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height rSq. Ft.
DECK AREA: Length Width Hgt/Grou Sq. Ft. 77
OTHER: max
-�;;p J-4z40.-�g44
Construction Type: G� C M Fti I Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE. 5A"&03 APPLICANT: Tel. #
. P�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 9 `7,Q' -s
$ QL(
$
TOTAL $ 107,
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
0
GEORGE E. HOPKINS • Registered Land Surveyor and Civil Engineer
.Phone SO. 1-8856 10701 Nicollet Avenue South
Minneapolis 20, Minn.
PLAT OF SURVEY'
. Scale 1 inch 4C feet
PROPERTY OF 4.
Described as LOT 41 BLOCK. 4, INN55KUCK 15T ADDITION,
I C°T
W
0
o
I' pmt
5' Wilily ea3&c
`'S ! e�:•.i � � rte"
140.41
I
'°°
denotes iron monumen+
�..� ,3 '
r;� eti This survey was made -and a,.Cer-ificae PrcPared for
,:: for the{ showin' boundaries of 4he lol and ulil4y eaiemen+s-
purpose o
' There are no encroachments.
CERTIFICATE OF SURVEY
Nov. 10 y9 I surveyed the propert .desctlbed above and,that the above plat is a correct
I hereby certify that on
representation of said survey. x'
r• r