PRE 2010 DOCSCity of Fridley, Atinn.
BUILDING No *6-9-3)
Date:'°"'_'`,
Owner: _ _ _ _ udder _.._ __.._ _ _.
Address _ _ _ _ Address —•-••--- ---
LO,CATl j -N OF BUILDING
No. Street _ _ Part,C f, Lot --•.-••-
Lot _ ._ _ ___ Block Addition or Sub -Division —
Corner Lot __ Inside Lot Setback ._._,� Sideyard __. . :
Sewer Elevation _ _ __ _ Foundation Elevation
DESCRIPTION OF BUILDING
To Used
'"" ,.
Front ` Depth - Height _ Sq. Ft. , cu. Ft-
_ _Fio�nt Depth Height r: "r3" Sq. Ft. _ _ Cu. Ft. _
i
Type of ConstructionEst. 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.
P
V
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, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
prdinancm �""0 fi/) "
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, _plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these Items.
a
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDiEY, MINNESOTA
Owner's Name'/Lo
Address -5;v/e----Address
LOCATION OF BUILDING
No. ,4 '3 � � Street/ .f errs ,fJ/c � � Part of Lot �-
Lot Block Addition or Subdivision�r
Corner Lot Inside Lot _ Setback r Side -Yard
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:�LDeptl% Height
Sq. Ft. Ft. 2 S 8 j
FrontDepth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost%�.
r
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all worts 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.
DATE ��� ® SIGNATURE
_ UZI)'
`� f
(A Schedule of Fee Costs can be found on the Reverse Side.) (�
City of Fridley
Application for Plnnrbing and Gas Fitting Perndt
Dept. of Bldgs. Phone SU 4-7470 10DESCRIPTION OF WORK , ,� —.2-1 a O �
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ..................... x $1.50 $ U
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) ...... �L x 2.00 $ 5
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $—/• S c!
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
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 true and correct.
Fridley, Minn. / 19
Owner al-��
Kind of Building
0
Used as
To be completed about
Estimated Cost, $
old -4e3 Building Permit No ''-&—a , —Permit No.�-
Signer' a 'o A L-
By
Business Phone No
ROUGH 6' 11- b I
FINAL
e a 2M 7-59
Zz
'a�
N
pZ
w
iTjZ
O
w
0
Z
2
0U'
.
N
WATER HTR.
GAS
ELEG
�O
LL
N
(gip
U
Q3
U°d
��
O
Base
1st
1
2nd
_
3rd
_
4th
• Future Connection Openings
Connected with Sewer E]
New Fixture, Old Openings
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ..................... x $1.50 $ U
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) ...... �L x 2.00 $ 5
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $—/• S c!
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
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 true and correct.
Fridley, Minn. / 19
Owner al-��
Kind of Building
0
Used as
To be completed about
Estimated Cost, $
old -4e3 Building Permit No ''-&—a , —Permit No.�-
Signer' a 'o A L-
By
Business Phone No
ROUGH 6' 11- b I
FINAL
e a 2M 7-59
�I
I Application for Power Plants and Heating, Cooling, Ventilation. ReFri� cid
Air Conditioning Systems and DeYices
PARTIAL RATE SCHEDULE
&RAVITY WARM AIR:
r
Furnace Shell & Duct Work ..........................
v' 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 add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $ lz
2.00
$
5.00
$
5.00
$
2.50
$
Dept. of Bldgs. Phone SII
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.
Owner
Kind of Building
Used as
STEAM or HOT WATER "SYSTEM To be completed about �I��d� mV 4II lI �� p
Furnace Shell & Lines—to 400�—
sq. ft. EDR Steam ...... 8.00 $ Estimated Cast, $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ......... -� ew - ding Permit No..
............. 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
DESCRIPTION OF WORK
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 DATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
TOTAL FEE
$
;
REMARKS:
195—
195—
195—
HEATING oAft Warm Air—/No
Trade Name Size No -
Capacity—
o Capacity Sq. Ft. E.D.R 'P/"�z A -e -w BTU H.P.
Total Connected Loa Kind of Fuel-
BURNER — Trade Name Size No- 'k
Capacity---✓ Sq. Ft. `BT1T
1001 Xenia Av. S.
Minneapolis 16, Minn.
Sign
By
11 POST IM -12-58 Business Phone0
A 0 f1l Z) &I
HEAT LOSS CALCULATIONS DEPAIRTMENT OF BUILDM VMLAGE OF ST.:.ANISONY, MINK.
Weatherstrips KV.LConstruction No. Insulation
. Guide
►Vi oevs I rs Reference Out. Wall W. Wall Ceiling Roof I FloorKind How Applied
e 19
F1.1 Room I Length ✓ t 1, FU Room I Length Width 66%i6t
Windows and. Doors—Cracknge and Area
400
Width Height Noof --Unoalft. I Area.
No. of pane of pane ilgitte of crack I sq. ft.
O
E,7te'"
Coef. Btu
Infiltration
Glass
see
Exp. wall
Nei exp. wall
Int. wall
14U �5
Ceiling
Net exp. wall
Int. wall
Floor,
:tiling
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI Roo L.e h ° 'dth He' ht
m ngt 1 tg
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of sans of vane lights of crack sq. ft.
Coef. Btu
Glass /"
Exp. wall y
Net exp. wall
Int. wall
Ceiling
FloorY"
rotal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A.. Leader area
AM -00 D-- I 1 __...1. /t t W:a.L'
Windows and Doors—Crackage and Area
lJ
Width Height No. of Lineal ft. Area
Jo. of pane of pane lights of crack sQ. fL
®
E,7te'"
G)AL Btu
infiltration
Masa
Exp.wall
Ceiling
Net exp. wall
Int. wall
Floor
:tiling
Floar
Windows and Doors--Crackage and Area
width Height No. of eat 11,Ataa
No of pane of pane lights of crack s0• ft ✓�( ll
o-02
Infiltration Vii`
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling _
Floor J
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
'FI_I .. ;,.d :Raotn I L.efufth .:� Widths He'titlht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane' of pane lights of, crack sq. iL
j
E,7te'"
f. to
Infiltration
C4lass .
Exp, wall
Net exp. wall
Int. wall
Exp. wall .149
Ceiling
Floor
II It
AW
AR. or sqi his. W.A. Leader area
'2.enn, 11 .'natio /.s.. Width 6. Heisiltt
' dowa and Doors—Crackage 7d Area
Width Height Na of Lineal ft. Area
Na of pane,of pane lights of crack m ft.
--7 :4:4
E,7te'"
CoefBtu
InfiltrationAvt
Glass
S
Exp. wall .149
jr
Net exp. wall
Int. wall
Ceiling SVC
Floor
/
Total Btu. II Total Btu.
Required sq. ft. E.D.R. or, sq. -ins. W.A. -Leader area. INI Required sq. ft.. E.D.R. or sq. ins. W.A. Leader area
SUBJECT
PER
City of Fridley
0 15.3.9 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
N
'
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/13/79
JOB ADDRESS 5521 Regis Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
3
Parkview Oaks 1St Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Walther 5521 Regis Drive N.E. 571-1556
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548
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
8 DESCRIBE WORK
Reroof structure
9 CHANGE OF USE FROM TO
STIPULATIONS
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
I
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$] 500
$. 75
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-
$9.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$9.75
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) , 1
WHEN PROPERLY VALIDATpED THIS IS YOUR PERMIT
_
8 G G)
BLDG )NSP OAFTE
SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE)
CITY OF FRIDLE'Y
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: of e /I H�
ADDRESS: ���� (� D"e_ iV E -
TEL NO:
STREET NO: STREET:
LOT: BLOCK:
BUILDER S: 0'J_
e
ADDRESS:
TEL NO:
Construction Location
ADDITION:
jqbj)ka
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.
DESCRIPTION OF
CONSTRUCTION
Front:
Depth:
Height:
Square. Feet:
Cubic Feet:
Front:
Depth:
Height:
Square - Feet:
Cubic. Feet:
Type of Construction:
Estimated Cost: $
To Be Oompletedt
•
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 true and cor�ect.
DATE: i SIGNATURE:
Stipulations:
C5 o
T 9 41 • • y \
}
SUBJECT
NO.
City of Fridley
2 5 5 7
AT THE TOP OF THE TWINS
BUILDING PERMIT
I _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.®
NUMBER
REV
DATE
PAGE OF
APPROVED By
_"'1 CITY HALL FRIDLEY 55432
�""� 612-571-3450
910-F15
10/8/97
JOB ADDRESS 5521 Regis Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
6
3
Parkview Oaks First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
John Walther 5521 Regis Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Pro Exteriors 3012 Kentucky Ave N, Crystal MN 55427
546-8329 6094
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 Ej REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (20 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
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
$1,668
$.83
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-
$
STRUCTION OR PERFORMANCE OF CON TRUCTIOIJ.
PLAN CHECK FEE
TOTAL -E
Li $5.00
$61.50
SIGN TUBE CO .RACTORORAUTHORIZEDAGENT IDATEt
N P PER LIDATE,#
r
BLDG AXP
IS IS YOUR PERMIT
r /�
v �
DATE
SIGNATURE OF OWNEROF OWNER BUILDERI IDATEI
NEW [ ] Effective i/l/97
ADDN [ ] CITY OF FRIDLEY /1�
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 04.
ConstructionAddress: `j j 1 Pp eg z'e AO d -Q
,9
Legal Description: (%Q V S �
Owner Name & Address: ��� Tel. #
Contractor: MN LICENSE # to
Address: Tel. # 5 w
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: g r9Q �Tcfc7a"
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed.
DATE: O7 APPLICANT: , Tel.
S1 iPULATIONS:
CITY USE. ONLY
Permit Fee
$ y '�7 , 6) 6
Fee Schedule on Reverse Side
Fire Surcharge
$ �°,7
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 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 [ ]
t
TOTAL
$,
S1 iPULATIONS: