PRE 2010 DOCSCity of Fridley, inn
BUILDING PERMIT N° 5:978
Date:
Owner: . Buildei
Address _ _ _ __.__ _ _ Address
LOST NE B ILDING
No. Street-= - Pa Lot
Lot --.--.Addition or Sub-Divisio
Corner Lot __ _ _ Inside Lot Setback _ Sideyard 0
Sewer Elevation _ _ _ ___ _ _ Foundation Elevation _
DESCRIPTION OF BUILDING
To Used ,
Front ' Depth4 F't.
Height: Sq: " Cu. Ft:'
_ _ o Depth Height _ Sq. Ft.. Cu. Ft.
Type of nstructiog Est. Cost 00 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.
is
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 aVmany n viola of any of the provisions of said
ordinances. n
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to as
the Building Inspector for separate permits for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name 1e V' -"C9- CC, ��x1Builder �r
Address —Address
LOCATION OF BUILDING
No. "1577 ® Street--�=1 � � te"&- Part of. Lot
Lot 14� Block Addition or Subdivision, &"umz Of -A -s- - z5sr
Corner Lot _Inside Lot Setback a r Side -Yard .v/t
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:
P� f-ak-�
c-'�rys�, �lcUr���,r� Front epth v� Height i /
Sq. Ft. Cu. Ft. Z 7-, Z .act 23
4a, Front Depth Z/' Height . Z
Sq. Ft. Cu. Ft.37j
Type of Constructions- Estimated Cost
To be Completed
i
The undersigned hereby makes application for a permit for the work herein specified, 2�
agreeing to do all work in strict accordance with the City Ordinances and ruling of 1z'
the Department of Buildings, and hereby declares that all the facts and representations
stated in this -application are true and correct. _
DATE � r a 2- SIGNATURE / Y?o/O/ e Sdtaj
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK�"' �y ' ✓.S � /�
Number. Kind and Location of Fixtures I'ohon
C
ya_
Z..
S NN
Y Z
Z
w
WATER HTR.
GAS
EEEG
3 0
�,
3
K
3
o�
Base
1st
2nd
_
3rd
_
4th
• Future Connection Openings
Connected with
Sewer
� New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... .... x $1.50 $-7—,,5-0=
Future Fixture Opening .............. x 1.20 $A
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heate:.(Up to 200,000 BTU) ...... x 2.00 $
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 $ /�•
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 17 -'zZ� , 19
/� ,
Owner a/7/ 'JI'D� 0/gyx-
Kind of Building
Used as Z-,? ,
To be completed about /
Estimated Cost, $ a v v r
Old w. uilding Permit
ROUGH Y - Z & - i. —
FINAL
.QMW42 2M 7-59
By
Business P one No
Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
L
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 $J
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water . 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ........................ 5.00 $�
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM A
ALTERATIONS & REPAIRS TOTAL FEE $ z
RfUGH
FINAL
—
i
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.
Kind of Building
Used as
19 —
To be completed about 'OW
Estimated Cost, $
a �a
Permit No. '*'� Y ZZ_ permit No.
DESCRIPTION OF WORK
HEATING c�r-P6
, Warm Air—No A
Trade Nam
Size
Capacity
Sq. Ft. E.D. A ` BTU H.P. ,
Total Connected Loa
0049,Kind of Fuel
BURNER — Trade Nam Size
Capacity
Sq. Ft. E.D.–Me2TU H.P.
®. S*q1r4_1,V1rTG 4 Aeft-CONN. CO
1001 Xen'.a AV. S.
Minneapo;;s 1v, Minn.
(REMARKS -OVER)
kgLW .tom
42 2M Business Phone
A P�'
D•56 i v
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows1(-Ye-s
Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
No No 19—
Fl.l Room l Length - . :R Width /'S,/a Heiizht 11 F1.1
Windows and Doors—Crackage and Area
d�
J
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
�ft.
Jam®
a7,
G �✓�
Coef. Btu
(
Coef.
Btu
Infiltration
Infiltration
e) � 0 o
6-�76?
-9 r
z5�5-o
Glass
-'1,''
r
A1000
Exp. wall
Exp. wall e j` o Y
Exp. wall
Net exp. wall
Net exp. wall
Net exp. wall
�K
P�
Int. wall
Floor /� °� ,s �' a
4av-wa41
e�,
Ceiling
; T
Ceiling
Floor p a
Floor
x &-®
Floor IAL lwl)
4Z
Aq
d 2
Total Btu. le 6 -
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/m] Rnnm l 1.ength Height
Windows and Doors—Crackage and Area
d�
J
Width Height No. of Lineal ft. Area
No. of Dane of pa®®n. lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
�ft.
Jam®
Coef. Btu
Infiltration
Coef.1 Btu
Btu
Infiltration
Infiltration
e) � 0 o
6-�76?
Glass
Glass
Net exp. wall
-'1,''
r
A1000
Exp. wall
1/9
Exp. wall
Net exp. wall
Net exp. wall
-
�K
P�
Int. wall
Floor /� °� ,s �' a
Ceiling
Ceiling
Floor z<
Floor p a
Total Btu. f `
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/F1.1 -al Room ILenrathP��j Width P' Heiaht r�
Windows and Doors—Crackage and Area
d�
J
Width Height No. of Lineal ft. Area
No. of Dane of pa®®n. lights of crack sq. ft.
L� 9
�ft.
Jam®
Coef. Btu
Infiltration
Coef.1 Btu
Infiltration
Glass
Infiltration
e) � 0 o
6-�76?
Glass
Net exp. wall
Glass
65?
Exp, wall
,Y-
1/9
Exp. wall
Net exp. wall
Floor
�K
Int. wall
Floor /� °� ,s �' a
Ceiling
A io
Floor z<
Ceiling
� Total Btu.
Required sq. ft. E.D.R. or sq, ins. W.A. Leader area
MINNEAPOLIS. MILAN.
Insulation
Kind How. Applied
Rnnm I Length l.? e` Width Height P"
Windows and Doors—Crackage and Area
j
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
y Ogry
�ft.
Jam®
Coef. Btu
Infiltration
Infiltration
J
Glass
Infiltration
e) � 0 o
Exp. wall
Net exp. wall
Glass
Int. wall
Net exp. wall,_u"
Ceiling
Exp. wall
Int. wall
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
® P1 _ I *�� Rnnm I Lenath Width /.4 Heiaht f`
Windows and Doors—Crackage and Area
j
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.
Jam®
Coef. Btu
Infiltration
z-�
Btu
Infiltration
Glass
Exp. wall
Glass
Net exp. wall,_u"
Exp. wall
Int. wall
Ceiling
Net exp. wall
Floor /� °� ,s �' a
�
A io
Total Btu. -S'"
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
-,'V1 I .-. �,- . , ,.,..R.,.,... I i .onath ®moi Width Height 91
Windows and Doors—Crackage and Area
j
4e
Width Height No. of Lineal ft. Area
No. of pane of.pane lights of crack sq.
�ft.
Jam®
Coef.1
Btu
Infiltration
Glass
Exp. wall
Net exp. wall
/w/�
'
Int. wall
Ceiling
Floor IAL lwl)
e N ? is9
'i/9�
_ Aja -
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
,914?e,3
City of Fridley, Minn. N° 8639
BUILDING PERMIT
Date: DECEMBER 21, 1965
Owner: EUGENE MC DONOUGH Builder THE SUSSEL COMPANY
Address 5590 Regis Drime Karma Address ? S5.0. Comn" A-; a-mi'm
Fridley, Minnesota 55421 St. Paul, Minnesota
LOCATION OF BUILDING
No. 5590 Street -REGI -s- DRTVE ____ _ ___ Para of Lot
Lot _ 4 __ Block 4 Addition or sub -Division ____ PARmnyll nAuc, 'EIRcm A=TION
Corner Lot Inside Lot -- Setback Sideyard
Sewer Elevation __. w Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
BASEMENT FINISlJ;�ront _ Depth - Height Sq. Ft Cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Est Cost _ _ 2 s .OQU 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 th ail provisions of
ordinances of the city of Fridley. a Q �
In camsideration of the payment of a fee of $ 12.00 , permit is hereby granted toTHESUSSS&
CPM= 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.
ALLEN G. JENSEN Building rnqxwtor
Nonce:
Tido porn h don net never the sandtreafien, hutdhetan hr wkbM phrmhin8, Ba heating, awer or wafer. Be sen to as
As BWMh* hmpeater ler aparafe penaNa for these Nemo.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME<a/� y �� �o �(/®tl�ff BUILDER � �G moo.
ADDRESS��%C� /� c�/� DR!/az-_ ADDRESS /,?Sr
LOCATION OF BUILDING
NO, STREET_, ZE <;; 15 PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE 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:
F&�F Fhr- Front Depth Height
Sq, Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Fit.
Type of Construction FRV f Estimated Cosh
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,
DATE3:pz5_c
(Schedule of Fee Costs can be rouna on me xeverse siae).
PARTIAL RATE -SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
Future Fixture Opening
New Fixture Old Opening
Catch Basin
Water Heater (Up to 99,000 B71D
New Ground Run Old Bldg.
Electric Water Heater
GAS FITTING FEES:
x $2.00
X $1.50
x $1.50
x $3.25
$
x $3.00
$
12
z
J
!2
WATER HTR.
V
0
0 0
P
N
GAS
ELEC
J
2nd
3rd
4th
Yukare Gam Ovsninw
nxtm' Old Openjup
ftwer El
cempool []
PARTIAL RATE -SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
Future Fixture Opening
New Fixture Old Opening
Catch Basin
Water Heater (Up to 99,000 B71D
New Ground Run Old Bldg.
Electric Water Heater
GAS FITTING FEES:
x $2.00
X $1.50
x $1.50
x $3.25
$
x $3.00
$
x $3.25 $
z $2.00 6 -
NO. RATE TOTAL
1st 3 Fixtures .... .... . ........... .. x IMM $_
Additional Fixtures ..... .............. —x$. -M $
Gas Range. to 199,000 BTU ............... — X $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description .................................. . ............ !p_
TOTAL FM $L
City of Fridley:
The undersigned hereby makes application for a permit for the work herd
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn
Owner
Kind of Building —
Used as - � UJ& LU Mr,
To be completed about
Estimated Cost,
Old—New. Building Permit No--- —Permit No.-
Signed C�44
_-Jr 2 er
4�
By- 06 -1
Business Phone leVAO-1—
ROUG*L�
0ri&81 Permit for AUMBING AND GAS PITTING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit.,
DESCRIPTION OF WOGS II
Number, Sind and Location of Fixtures
Connected with
Gas Piping for Openings
Permission is hereby granted czLU do the plumbing and
gas fitting in the building described in the statemkht hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
4z IM—"9.v
N? 5001
053�1 . -/,.f 4:5-9
[pr$"
F15- 6-6
City of Fridley a 1 , .19-Y, y
Owner e
4t:L4�
Location
Kind of Building
d
Used as
To be Completed ,19____
Estimated Cost
Old New. Building Permit No.
0
Date
Inspector of Buildings.
C hl
F p
�r
4
MO
m
m
F
O a
OZSFStories
pa
m
WZOR'
WATER HTR.
GAS
ELEC.
Basement
ist
2nd
3rd
4th
Connected with
Gas Piping for Openings
Permission is hereby granted czLU do the plumbing and
gas fitting in the building described in the statemkht hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
4z IM—"9.v
N? 5001
053�1 . -/,.f 4:5-9
[pr$"
F15- 6-6
City of Fridley a 1 , .19-Y, y
Owner e
4t:L4�
Location
Kind of Building
d
Used as
To be Completed ,19____
Estimated Cost
Old New. Building Permit No.
0
Date
Inspector of Buildings.
SUBJECT
PER
City of Fridley
19921
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
LW. COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
75 ;)9
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE -
PAGE OF
APPROVED BY
L J\ 612-571-3450
910-F15
5/26/89
JOB ADDRESS 5590 Regis Drive N.E.
1 LEGALLOT
NO.
4
BLOCK
4
TRACT OR ADDITION SEE ATTACHED
Parkview Oaks lst Addn.
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Fred Baumgardner 5590 Regis'Drive N.E. 572-9631
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
The American Handyman Cont. Inc. 1202 Hathaway Lane N.E., Fridley 571-2655
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 j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (27 Squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.
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
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
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
$1,350
$.68
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 THE PERFORMANCE OF CONSTRUCTION.
$33.00
PLAN CHECK FEE
TOTALFEE
$33.68
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
VALIDATED HIS IS YOUR PERMIT
,),WH,,ENP,ROPERLY
(�
BLDG INSP ATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
Prepaid Plan Check $ Effective 5/1/88
Estimated Cost $�/ OF FRIDIEY
Receipt # R- �CIAL & 33MUSTRIRL
ding Pemtit Application
Y e�7
Construction Address Zoning
Legal Description
Property O4 rner/Address Fee,)
(J-q" ,, r,-.� ✓ l� to Tel . # r-2,2-76'11
CONTRACMR & ADDRESS `� Tel . #
Architect & Address Reg.#
Engineer & Address Reg.#
TYPE OF WORK [ ] New [ ] Addition W Alteration -Describe F SZ o
7
Applicant Signature s e� �i10 Tel # S�/ , v W Date s
Width
OFC. AREA: Length
WHSE AREA: Length
CGHEM AREA: Length
Height Sq. Ft. # of Stories
Width
Height
Width
Height
Width
Height
Sq. Ft.
Sq. Ft.
Sq. Ft.
Sq. Ft.
x $
Cost/Sq. Ft. =
Valuation
$ )
Sq. Ft.
x $
Cast/Sq. Ft. =
Valuation
$
Sq. Ft.
x $
Cost/Sq. Ft. =
Valuation
$ ) TOTAL VALUE
Building Use . Construction Type Occupancy Group
Air Conditioning []Yes []No Fire Protection Provided []Yes []No
Performance Bond Amount $ See Reverse for Schedule Received []Yes []No
Permit Fee $Js,3 , oo
Plan Check $
State Surcharge $=�
SAC Charge $
Park Fee $
Spec. Assessments $
Driveway Escrow $
mrAw $ 3113. t�S
5
See Fee Schedule on Reverse Side
In E:Kcess of Prepaid Amount - See Reverse Side
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$575 per SAC Unit
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $13.50/foot
� � wM •1.�:=�+MMiU Y �;,ti �;, ;oaf'/�.-7�=���`�
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
Rate TOTAL
po
$ 20.00 $-
$10.00
$10.00 $
$10.00 $
$10.00 $-
$10-00
$10.00 $
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work $
Commercial/Industrial
1 % of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
JOB
19
61,
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 ruling of the Building Division, and hereby dec ares
that all the facts and representations stated in this ap icatio are
true and correct. /� 17 '199L
OWNER J(�rd'4111M qej i -I
BUILDING USED AS t' dell
ESTIMATED COST LOU PERMIT NO. 1%/9111
DESCRIPTION OF FURNACE AND OR BURNER W 41i
No. of Heating its Circle One (Steam) (Hot Water) (Warm Air)
Trade Names Size No. -
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
ROYALTON HEATING & COOLING
HEATING COMPANY 4120 -85TH AVENUE N.
BROOKLYN
Signed By nuinki AII%
Approved By � Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been care ully examined Yes ( ) No ( )
2. Is free from st or d terioration Yes ( ) No ( )
3. Has no rei n bjed s 1 ged within Yes ( ) No ( )
4. Is secu el s pp rted Yes ( ) No ( )
5. Meets all current Code requirements for
size and total BTU's connected Yes ( ) No ( )
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY.
a
Signed By
Date
SUBJECT
P� N
City of Fridley
21873
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
' ,
R
� • _ COMMUNITY DEVELOPMENT DIV.
�: -----
qq
r PROTECTIVE INSPECTION SEC.
1. I/
Q
1 i
NUMBER
REV
DATE
PAGE OF
APPROVED BV
`
CITY HALL FRIDLEY 55432
612-571-3450
910415
5%25/93
JOB ADDRESS 5590 Regis Drive NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
4
Parkview Oaks
First Addition
SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP
PHONE
Fred Baumgardner 5590 Regis Drive NE
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
American Handyman 2835 Central Ave NE M ls. MN 55418
788-2881 3887
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 .0 ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install skylite in kitchen area
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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 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
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1r2Q.0
$e6O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$29.. QO
,Fire SC $1.20
STRUCTION R THE PERFORMANCE DI57CPNSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
&44,License
SC $5,00.
$35.80
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGEN IDATEI
WFiE P RLY i'LID ED THIS IS YOUR PERMIT
BLDG INSP
MATE
SIGNATURE OF OWNER IF OWNER BUILDERI IDATEI
TYPE
OF WORK
M- /,% A/I
BURDM Pyr APPLICATION
.ssl �
Effective 1/1/93
zoning of
I
[ l New [ ] M4on 't-j� Alteration Describe - '�tf x/e 4-60F A &J W
Applicant Signature
hength Width Height Sq. Ft. # of Stories
OFC. AREA: Length idth Height Sq. Ft.
%USE AREA: Length 'Width Height Sq. Ft.
C7TM AREA: Length Width Height Sq. Ft.
VATlQ MCK
Sq. Ft.x $ cost/Sq. Ft. = Valuation $ )
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) 'TOTAL VAIM
Building Use 1AA e Construction Type v`� _ Occupancy Group
Aix Conditioning []Yes []No Fire Protection Provided []Yes []No
Performance Bond Amount $ See Reverse for Schedule Received []Yes
Permit Fee
Plan Check
Fire Surcharge
State Surcharge
$�rUf1
$ �?®
S '6o
SAC $
spec. AsseSSMents $
Driveway EscrowTOM
$
[ ]No
See Fee Schedule on Reverse Side
In Excess of Prepaid Ammmt - See Reverse Side
.001 x Permit Valuation (1/10th o)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$750 per SAC Unit (Plans to NWOC for determination)
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $13.50/foot
1
sue�Ecr
IT NO.
City Of Fridley
33477
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�•
RECEIPT
� COMMUNITY DEVELOPMENT DIV.
- '____
r PROTECTIVE INSPECTION SEC.
I
a� I
1
NUMBER
REV
GATEPAGE
OF
APPROVED BY
i
1 1 CITY HALL FRIOLEY 55432
I1'' 763-571-3450
910-F15
4/29/03
JOB ADDRESS 5590 Regis Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
4
1 Parkview Oaks First Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dave Van Orsow 5590 Regis Drive NE
651-503-7783
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Dave Kraemer Service .6220 167 Ave NW, Ramsey, MN
612-834-1118
d ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20149471
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION JJ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage ( 28 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
' Underlayment must comply with the State
Building Code.
Refund license surcharge collected in error.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
S0. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
1STALLS 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
$31242
$1'62
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NO RESUME TO GtV AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI NS OF ANY OTHE STATE OR LOCAL LAW REGULATING CON-
$97.25
Fire SC $3.24
TR C ION R THE E RMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
�/ p
"7 �/ 0
44__4/$0/$
OO
$102.11
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IOATI,VA6_Od_u#;SP
PROPERLY VALIDATED THIS IS YOUR PERMIT
S-GNATURE OF OWNER,lo OWNER BUILDERi iDATE.
OATS 11
1
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) 571-1287 Fax
BUILDING PERMIT APPLICATION
r:nncfnir_finn Aririrass. 55 q0 1<-c I'S O6_f Ve— 1�b (G!'ec,h
Legal. Description:
Owner Name & Address: CL U f Tel. # &5 I S03 77k-3
Contractor d"LrP1"el- wc-e MN LICENSE# Vie- aU1`t�y�
Address: 6d,90 1 PW fa. . c e� M ti Tel. # Cola 8'3 Lf 11 1 if
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: Lengtj W�idtjh Hgt/Ground Sq. Ft.
OTHER: i1 C� f 3 - %.%- tr—��`CI�, e 6W L 3 �C�!' A,
Construction Type: Estimated Cost: $ g
jil
Driveway Curb Cut Width Needed: F 6 Ft = tx
_ $
DATE: � d? o APPLICANT: �---- Tel. # 60-- 9-31-I / I 1 &'
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
$ o?
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1275 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Curb Cut 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
$ Y
STIPULATIONS-