PRE 2010 DOCSCity of Fridley, 31bm.
BUILDING PERMITN° QR)
Date:
Owner."` "` >' Builder
Address _ _ _ Address
L0 AT F BUILDING
No. y� Streets -9_'/ ss rz _ _ Pam 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.
Depth Height _._ _„ Sq. Ft. _ _ Cu. Ft.
._• 2!,
�.. "r �..
Type of Construction _ Est Cost 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.
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
ordinances. y
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, Bas heating, sower or water. Be sure to we
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name'l�,c�'
Address vA Address
No. 6-Y16-1
LOCATION OF BUILDING
i VL -:—
Lot `,!Block 1-5Addition or Subdi
Corner Lot Inside
of Lot
r
Si iA-Yard /0
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building.
location.
To be used as:
DESCRIPTION OF BUILDING
X
Front'Depth K z e ` Height Ael, l%
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Gu. Ft.
Type of Construction Estimated Cost t�v:�/a
To be Completed
I
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.
DATES d- a -d SIGNATURE
(A Schedule of Fee Costs can be found on the Reve e�Side-)
�
" . . r
City ofiFridley
Application for Plumbing and Gas Fitting Perndt
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures (�o x $1.50 $ • & G
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) ......—�� x 2.00 $__2!Z ' v
New Ground Run Old Bldg. ............ x 3.25 $
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 $
Dept. of Bldgs. Phone SU 4-7470
Locatio e If/ f
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do al1 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 g f 19-L/
P
Owner
Kind of Building -�-�
Used as
To be completed about
Estimated Cost, $
Old -(O. Building Permit No Permit No.
Signed 4e 40�w�
By Ai
ROUGH - - % -7- 1- r
FINAL
.QW42 2M 7-59
Business Phone
�^
Z'
`02
QJz
Oi<
e
z
F
N
WATER HTR.
GAS
ELEG
az
0O
m
Base
1st
2nd
_
3rd
4th
• Future Connection Openings I
Connected with
Sewer
New Fixture. Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures (�o x $1.50 $ • & G
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) ......—�� x 2.00 $__2!Z ' v
New Ground Run Old Bldg. ............ x 3.25 $
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 $
Dept. of Bldgs. Phone SU 4-7470
Locatio e If/ f
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do al1 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 g f 19-L/
P
Owner
Kind of Building -�-�
Used as
To be completed about
Estimated Cost, $
Old -(O. Building Permit No Permit No.
Signed 4e 40�w�
By Ai
ROUGH - - % -7- 1- r
FINAL
.QW42 2M 7-59
Business Phone
a
App' Heating. ' g Ventilation, Refrigeration and
l�cat�on for Power Plants and Heap , C�tm ,
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7M n
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
TOT L
1st 3 Fixtures ......................
x $1.50
$
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ..........
x 2.00
$
AIR CONDITIONING
FAN BEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
wj
REMARKS:
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 true and correct.
Fridle Minn APR A 0 1.,
—, 195—
Owner L` } 195_
Kind of Building 195—
Used as
To be completed about
JUN ® 1961
Estimated Cost, $_ J-7 -
�. —
� ew. uilding Permit No.� !g3
DESCRIPTION OF WORK
HEATING er, Warm Air—No Z
Trade Size
Capacity Sq. Ft. E.D.R 0'0 _BTU H.P.
Total Connected Load 4-44 - 717 Kind of Fuel
BURNER — Trade Name - &--Size No
Capacity Sq. Ft. E.D.R,-1Q' • BTU H.P.
GEO. SE®G? ICI HTG. & AIR-COND. CO
1001 Xenia Av. S.
Minneapolis 16, Minn.
Sign
By
ines
11 POST 1M-12-58 Buss Phone one
.0 F OOVID eom iwJl hd®�'V' O.L'c� / .�+��% y'i`'N✓ iWW�j ��� ,
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS BROOKLYN CENTER, MINN.
Weatherstrips A.S.H.V.E,_ Guide Construction No. Insulation
Windows I , oors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied
es I es II
19—
F1, Room I Lengthj4p 3aVidth eight Fl. Room I Length Width 9 Height .
Windows and Doors—Crackag
and Area
i
l
Width Height . No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Net exp. wall
girdJtAOIX
�!
Int. wall
Coe£ Btu.
Infiltration
Floor
;
Glass
Exp. wall
Net exp. wall
Ceiling .:to d Own. Z. r
Y
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq, ins. W.A. Leader area
Fl. p ® & Room ( Length Width
Windows and Doors—Crackage and Area
V idth Height No. of Lineal ft. Area
No. of�rpaane of pane lights of crackle sq. ft.
Windows and Doors—Crackage and Area
Wldth Height No. of Lineal ft. Area
No. of pane of ppane lights of crack sq. ft.
JCoef.j Btu
Infiltration ./"
Glass
Exp. wall .Y
Net exp. wall
V
Int. wall
Ceiling
Floor
;
Total Btu.
-
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
sight Fl. Room ( Length WidthHeight
Windows and Doors—Crack and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu Coef. Btu
Infiltration' Infiltration ,
Glass , a�"47 Glass '
Exp. wall Exp. wall
Net exp. wall, Net exp. waif-
Int. wall Int. wall
Ceiling Ceiling
Floor .°� Floor ;
Total Btu. Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. Room I Length/
Wid
Windows and Doors—Crackage anct Area
Width Height No. of Lineal ft. Area
No. 01 Dana Of p$ne 111%w of crack ea. EL
Infiltration
Glass
Exp. wall ,e ,
Net exp. wall
Int. wall
Ceiling
Floor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Height F1jP1,V1,uey Rooms I LeneveZewidth
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of vanL. of.pans lights of crack sq. ft.
A4, 5p
oef. Btu. I I I Coef. Btu
Infiltration ,
Eloor�
' ax
mm
Claes
Exp. wall
Net exp. wall`
Int. wall
Ceiling
Floor yA V6
Total Btu.
Required sq. ft. £.D.R. or sq. ins. W.A. Leader area
52-e4-5915°51
City of Fridley
Application for PluniVing and Gas Fitting Porn*
Dept. of Bldgs. Phone SII 4.7470
DESCRIPTION OF WORK Location W1 N E Regis Dr
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ...... .....................
Water Heater (Up to 200,000 BTU) ......
New Ground Run Old Bldg. ............
NO. RATE TOTAL
x $1.50 $
x 1.20 $
x 1.00 $
x 3.25 $
x 2.00 $
x 3.25 $
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 $
Gas Incinertor 1 2.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
City of Fridley:
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 facl
and representations stated in this application are true and correct.
Fridley, Minn -a -°'u^ 19_
Owner Curtis Marzo2le
Kind of Building frame
Used as res
To be completed about 31-16-66
Estimated Cost, $ 10.00
Old—New. Building Permit No Permit No. �T v2 v2
S.
By
Business Phone
ROUGH
FINAL
TOTAL FEE $ 2 •00 QW42
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WATER HTR.
GAS
ELEC.
�9
3� e� �i
u.� U
(�9 Sa
C70
m
Base
In
1 Tne�nerat
r
1st
2nd
3rd
4th
° Future Connection Openings
Connected with
Sewer El
*� New Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ...... .....................
Water Heater (Up to 200,000 BTU) ......
New Ground Run Old Bldg. ............
NO. RATE TOTAL
x $1.50 $
x 1.20 $
x 1.00 $
x 3.25 $
x 2.00 $
x 3.25 $
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 $
Gas Incinertor 1 2.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
City of Fridley:
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 facl
and representations stated in this application are true and correct.
Fridley, Minn -a -°'u^ 19_
Owner Curtis Marzo2le
Kind of Building frame
Used as res
To be completed about 31-16-66
Estimated Cost, $ 10.00
Old—New. Building Permit No Permit No. �T v2 v2
S.
By
Business Phone
ROUGH
FINAL
TOTAL FEE $ 2 •00 QW42
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s72-3604 YAN:
ADDRESS
5551 REGIS DR NE
PIN
243024310083
LEGAL DESC
PARKVIEW OAKS 1ST ADD
LOT 4 BLOCK 3
PERMIT TYPE
BUILDING
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: ROOFING
VALUATION
: $ 2,547.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE.
REROOF HOUSE & GARAGE (22 SQ) TEAR -OFF
STATE LICENSED CONTRACTOR 1
APPLICANT
L J ROOFING
10151 FOLEY BLVD
COON RAPIDS, MN 55448 -
OWNER
OROURKE KEVIN & KATHLEEN
5551 REGIS DR 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 worl
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 or local law
regulating construction or the performance of construction.
Appli Date
L 0/
571-1Lb'/
PERMITO.: 2004-00413
DATE ISSUED: 03/31/2004
BUILDING PERMIT FEE 83.25
FIRE SURCHARGE 2.55
STATE SURCHARGE, VALUE 1.27
LICENSE SURCHARGE 5.00
TOTAL 92.07
PAID WITH CHECK # 6020
JDrt1At11 z rr'xuy111 a 1CP�l,(lJ i n r"L r Vit w V1111 V I. rmrkl 1 rIni'4 LP��7�.1\1DiiL t117 V Y L'..
NEW [ ] CITY OF FRIDLEY � fective 1/1/2004
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: A r v-ve
Legal Description:
Owner Name /& Address: �� �' 1 ^ �' % ��j k) & 19k -e Tel. #
t
Contractor: 'T MN LICENSE # 9c>3
Address: 10 1 s1 (fe k K tak Tet. # ? � 3 - 7(-'? - e rP ?
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: Z. S�
Construction Type: Cf ae- g44-- F -- Estimated Cost: $ 'v0
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 7)3/)0 N APPLICANT: Tel. # 96-3-76-2-1j-17
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
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
STIPULATIONS:
Building
BUILDING
Permit No.: �I L�i
Ins
RESIDENTIAL APPLICATION
,(y;�
Received By:
-,572- 60
763-572-3604
763-502-4977 FAX
CITY OF FRIDLEY
a p
D�`--- %®10
EFFECTIVE 1-1-2010
�; t
DATE �— � / !� (� YOUR E-MAIL DRESS
p-�
A�
SITE ADDRESS _S&51 R W -r P/ • NC „ 1�� i�
5
THIS APPLICANT IS: ❑ OWNER FtONTRACTOR
PROPERTY OWNER/
N
TENANT
ADDRESS.STATE
IP��
PHONE:
CONTRACTOR
NAME: !
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE n
AND CERTIFICATE OF
ADDRESS: 1 ' s Y
CITY TATE IP
INSURANCE
PHONE `- FAX
S�
PROPERTY TYPE
c1i-SING FAMILY/NEw CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
OWS
❑ BASEMENT FINISH Q -ROOF ❑ DRAIN TILE
❑ DECK m& SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR RYMMODELING
DESCRIBE WORK BEING DONE: a f
v
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT z SQ FT f V
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
O&Vinyl 94offt
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum /� RTrim
1. Site Plan/Survey showing the existing structures
❑ Other,//:' V 15 -Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING'OPENINGS QWes ❑No LOCATION OF WINDOWS CO
FOR WINDOWS — PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF i
OPENING CHANGES & 4 0 7- — coj—
MANUFACTURE STICKER ON WINDOW.
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(US G THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $_ � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ 11„4-1 �ti�a See Back Page for Fee Schedule
$_ 65% of Building Permit Fee
$ .001 times the total job valuation
$ /J�G/' .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
R0,40�� Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete 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 applica. ' ermit ork is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all wo hic a es review and approval of plans. 2
SIGNATURE OF APPLICANT PRINT NAME /� mj""' -DATE / 3 ®x>i r
Ir
n.