PRE 2010 DOCSCity ®f Fridley, Minn.
BUILDING PERMIT N?(jiO:; D7
Date:
Owner: 911" Ad Builder OC
Address Address
LQ IO BUILDING
NO. V
W"I A 1V
'. Ila
Lot Block Addition or Sub-Divist
Comer Lot Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
A DESCRIPTION OF BUILDING
To Used L
nip
eo' I igh
-A Depth t Cu.Ft. 424
/4.old 4 Ft _aV
Front
Prod '4'Jl� Depth geightFt.
Sq- FL-rG Cu'
To be
Type of G?WrQction 'rAQ_-fF5To Completed
7W
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 a11 provisions of
ordinances of the city of Fridley.
A
In consideration of the payment of a fee 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 an 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"LWY time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the condrueflon, hweiintion for whino, phnobing, gas heafte, sower or water. Be sm to soo
the Building Invoctor for separdo pmft for then Items.
Owner's NamF
Address
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
r
No. Street CA Part of Lot
EgLLot Block Addition or Subdivision �C�
19
Corner Lot Inside Lot a/ Setback 15—
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 sed as:.
Front Depth Height
Sq, Ft. Cu. Ft.
r Front ' Depth„ Height C� .
Sq. Ft. ;L Cu. Ft.
Type of Construction Estimated Cost—.�
To be Completed
The undersigned hereby makes'application.for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true
and correct.
� 0"
DATE Z_
SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
"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 $
''I
MECIi. 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. IDR Hot Water ... 8.00 $
Each add. 200 sq. ft. IDR Steam ...................... 2.50 $
Each add. 320 sq. ft. IDR 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 TONAL
1st 3 Fixtures x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,060 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH
FINAL
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.
Fridley,,Nlinn AUG 2 8 I2 19
Kind of Building
Used as Al
To be completed about
oe�
Estimated Cost, $
ew uilding Permit No. Permit No. 6
DESCRIPTION OF WORK
BEATING W -P ' ae},:14e�VWate, Warm Air—No-
Trade Nam Size Nozl—�
Capacity Sq. �Ft. E.D.R ' BTU H.P.
Total Connected Loa 1�+ Kind of Fuel
BURNER — Trade Nam . Size No��
Capacity Sq. Ft. E.D. D" ATU H.P.
GEO. SE® ICK HTG. & AIR-COND. CO
1001 Xenia AV. S.
Minneapolis 16, Minn.
Signe
By Az
4a 2M Business Phone o
(REMARKS—OVER)
Ot 41"(
74ft>9
HEAT LOSS CA-&LATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling RoofE�Or I Kind
V4 --No es-FFT 19— 44 le Y ",
F1.1 I Room 1 Length Width Height F1.1 Room I Length
Windows and. Doors—Crackage and Area Windows and Dooirs—Crackage
I Width I Height No. of I Lineal ft. I Area Wldtb Height No. of L
No.
of parte of 4 n I lights I of crack I sq.-TV1 • M. nf an,
m
/
Coef.1 Btu
Infiltration
I P LN 0
16"1
Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
Infiltration
Glass
Class
Exp. wall
v 74
Btu
Infiltration
Exp. wall
Net exp. wall""a,
t'
I/
Net exp. wall
Int. wall
—F--
131--
s
Int. wall
Ceiling 2-r�
77
776
5
T77
I
1,(
Ceiling
Floor
Net exp. wall
Floor
Total Btu.
Ir
Total Btu.
MINNEAPOLIS. MM.
Insulation
How. Applied
Width Height
and Area
seal ft. Area
crack sq.ft.
Coef. 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
F1.1 �1) /f T -75Z ��Rniiunith width 77
4Room I Length Width Height Fi.v
Windows and Doors--Crackage and Area Windows and Doors—Crackage and Area
Width Height No. of Lineal ft Area Width Height No. of Lineal ft. Area
No. of pane of pe�ne lights of crack sq, f 1,
It-' No. of pane ofpanelights of crack 9, Q. ft.,,,
;'-Ar 6-11fp illlc -Y 0-07
2
Coed Btu
Infiltration Infiltration 7
Glass
Glass
Exp. wall 4?' v a Exp. wall tea'
exp. wall ALL C10-1 7Y 7 7 Net exp. wall
Int.. wall Int. wall
Ceiling CT Ceiling
Floor Floor.
Tm.1 W."
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
7" FM /„� s. Aa/` ""`"Room I Lensith k i ! idth I �71 H e; a h t
Windows= and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
sw
Cqef.j
Btu
Infiltration
t'
I/
Glass
131--
s
Exp. wall id%
Net exp. wall
e
Int. wall
Ceiling
Floor
Total l3fix.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
;NN lal 'fT P
V1 "X
40 )L I
Height Al
Btu
Required sq. ft. E.D.R. or sq. ifis. W.A. Leader area I
Fj.j#?,° ! Room I Length —T —OWidth Q, %'Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lig is of crack- sq. ft.
17
i.
Coet.1 Btu. 1
Infiltration Oer 1 :7
Glass
Exp. wall
Net exp wall I
ILL
Int. wall
Ceiling
Floor
Total Btu. -
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
City of Fridley
Application for Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
I
Iz
y
�
x
gZ
<�z
OEC
J
1.20
(y9
Z
(�90
•
•
N
WATER HTR.
GAS
ELEC.
Base
3.25
$
Water Heater (Up to 200,000 BTU) ......
Z x
2.00
I
New Ground Run Old Bldg. ............
x
/
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$
Additional Fixtures ....................
Ist
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings I
Connected with Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x
$1.50
$
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
Z x
2.00
$ C/
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 A.,�
Dept. of Bldgs. Phone SU 4-7470 /
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 fact
and representations stated in this applicatiofn� are true and correct.
Fridley, Minn. " /'8- / 16 , 19_
Owner
Kind of
Used as
To be a
Estimated Cost, $
Old New. uilding Permit No U Permit No.
Signe
By --
Business Phone No
ROUGH / ' o
FINAL
42 2M
City of Fridley, Minn. N 1089'5,,
BUILDING PERMIT - -
Date: November 18_1970
Owner: — Daniel Murphy guilder Sussel Company_
Address 5600 RQgis. Drive N_ -E- Address 1850 Como Avenue. St. Pau
LOCATION OF BUILDING
No. 5600 street—Regis Drive N.E. ____, Part of Lot
Lot 3 __ Block 4 Addition or Sub -Division Parkview Oaks 1st Addition
Corner Lot ._ Inside Lot — X Setback _____ Sideyard
Sewer Elevation
To be Used as:
Porch
Foundation Elevation
DESCRIPTION OF BUILDING
Front 14.3 Depth 8.4 Height — Sq. Ft. Cu. Ft
— Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction - frame Est. Cost _$42000.00 _, To be Completed March 15, 1971
Stipulations: 1. Maintain present building lines. 2. Investigation and conclusions
by Twin City Testing to be part of stipulation (Attached to Permit)
In consideration of the issuance to me of a permit to c
the proposed work in accordance with the description above
ordinances of the city of Fridley.
I agree to do
provisions of
In consideration of the payment of a fee of $ 24 - 00 / /, permit is hereby granted to Sussel GPAPMIY
J to construct the building or addiVon 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, altE;ration, maintenance, repair and. moving of buildings
within the city ]units and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
�i,4f/-Building Inspector
HUNK MUNICH
NOTICE:
This permit does not cover the construction, InstaWon for wiring, plumbing, gas heating, sewer or water. Be cora to we
the BulMing Inspector for separate permits for these items.
e
..
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: 1D-i-xbJiMJfzr-�+`� BUILDER: Sc
ADDRESS : ,--5-6c:9(:? ZDV. ADDRESS:
NO:. STREET: —(ZC<:G t S FDjz(,
LOT: BLOCK: -V ADDITION:
CORNER LOT: INSIDE LOT:X SETBACK: SIDEYARD:
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: i
®-(�- Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:_ $
To Be Completed: &7 c j/
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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.
SIGNATURE :
(See Reverse Side For Additional/ Information.) /
/
F
� � f
,✓ 4 ' Ct-
I
**AIN
-4.1cRMs, R r sl 40 -
In order to proceed with the proposed addition to the existing
structure located at 5600 Regis Drive as explained in the building permit
number 10,895, I agree to hold the City of Fridley and the Building
Inspection Department blameless for any structural damage to the addition
which might result from the existing structural and soil conditions. This
agreement will be made a part of building permit number 10,895.
MR. DAN MURPHY/
Property Owner o"5600Re Drive
645-3601
TWIG CITY TESTING ono foommino HBOUTORY, Inc.
CHEMICAL & PHYSICAL TESTS • INSPECTIONS • RESEARCH
HOME OFFICE:
662 CROMWELL AVENUE
ST. PAUL, MINN. 66114
BRANCH OFFICES:
BISMARCK, N.D.
MINOT, N.D.
FARGO. N.D.
GRAND FORKS, N.D.
SIOUX FALLS, S.D.
WATERLOO, IOWA
ROCHESTER, MINN.
The Village of Fridley
Building Inspection Department
Fridley, Minnesota 55421
Attention: Mr. Hark Muhich
Gentlemen:
o
CHARLES W. BRITZIUS. P.E.
>a
President
JOHN F. GISLASON. P.E.
o
Executive Vice -President
NORMAN E. HENNING. P.E.
Vice -President Engineering
ALBERT C. HOLLER, F.A.I.C.
Vice -President Chemistry and Metallurgy
CLINTON R. EUE
Secretary Treasurer
December 22, 1970
Re: Daniel J. Murphy Residence
5600 Regia Drive
Fridley, Minnesota
Laboratory No, 9-3004
Mr. David Dahl of The Sussell Company contacted us concerning work which we
performed at the above referenced project. We submitted a report of our work,
dated November 9, 1970, in which we summarized investigative work and provided
some material recommendations to the owner of the structure.
Mr. Dahl related to us the events which transpired since that time. Our report
was received by the Village of Fridley. A permit to build the enclosed dining
room was granted with the stipulation that replacement of the garage floor slab
and recommendations given by our firm be performed at that time. However, the
expenses involved to undertake both the construction and the extensive repair
activities have been found to be beyond the owners means at this time. Therefore,
we were requested to submit an opinion to the Village concerning feasible alternatives.
Our report of November 9, 1969, states that in our opinion the porch area can be
enclosed to form the proposed dining area without the added load adversely affecting
the structural concrete floor slab. We noted irregularities in the present
construction which could, however, affect the existing structure and possibly
any new construction in the building, The most abnormal irregularity is the
subsidence of the garage floor and a separation of the floor -west foundation wall
junction. Here, melting snow from automobiles parked in the garage could drain
down the west foundation wall and freeze, bowing the construction outward elven
farther than already deflected.
The garage floor slab need not be replaced prior to the dining area construction
if some precautions are taken to safeguard the structure from possible future
damage. We recommend that a water stop be positioned in the junctions of the
AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR.
IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL
The Village of Fridley
December 22, 1970
Page 2
garage floor and the north, west and south foundation walls. This water stop
should consist of a rubber membrane securely bonded tv both the floor and the
masonry block walls with an epoxy or equal adhesive. The membrane should
extend outward from the junction along both floor and wall a minimum of 2".
If this corrective work is performed, it is our opinion that the new construction
will not adversely effect the existing building, nor will the existing conditions
adversely effect either the present structure or the proposed addition. We
anticipate that there will be some water ponding in the garage. However, snow
removal from the automobile and sweeping of snow and ice from the garage floor will
minimize this difficulty. Regular maintanence of the water barrier will protect
the construction until the garage can be improved for proper drainage and
release of pressures against the west garage foundation wall.
Very truly yours,
TWIN CITY TESTING AND
ENGINEERING LO ORATORY, INC.
�--�
Brian R. Dobie
Civil
--Engineer
Norman E. Henning, P.E.
Vice -President,
Engineering
BRD:NEH:amc
Copies to:
(1) Mr. Daniel J. Murphy
5600 Regis Drive
Fridley, Minnesota 55421
(1) Mr. David Dahl
The Sussel Company
Laboratory No. 9-3004
Application for Power Plants and Heating. Cooling. Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
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 $
',V s ;_.i V , _- -t
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 ..............
&00
$
2.00
$
5.00
$
5.00
$
2.50
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR 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 $
ALTERATIONS & REPAIRS TOTAL FEE $ % v--&
ROUGH
FINAL
Dept. of Bldgs. Phone SU 4-7470
Location 5600 Renis Drive
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
Fridley, Aflnn /0 % , 1A
Dave Curry
To be completed about
Frame
A
Estimated Cost, $
Old—New.XBuilding Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm AirX-No 1
Trade Na --P ATCO Size No GB 1105-OHB
Capacity.
Total Connected
BURNER — Trade
Capacity.
(REMARKS -OVER)
Sq. Ft. E.D.R 1 ee " 0 0 0 BTU H.P.
68,238 Kind of Fuel Nat".R Gas
Size No
Sq. Ft. E.D.R BTU H.P.
Signed Mill City Heating Co
B tlk / - A -®
y
Business Phone No 544-1501
r
IS I' LOSS_CALM•ATICINS' �bEPARI"MENT Oji �.'g�t� ,f—lt�t�a ¢ � „T
,
�leatlter$trtps _ �l
!f9bYi1-- �ahryrg
I•� _ Room
Windows and Doc
�Yldth He1g0
No. of pane �oqf pan
Ke.,_Sp
fautt� ___ Corastrurt ista Ia(� � � a
Faefer,nce 0i"t. �Wall T*
��� �tu„
No. at
tights
/0 height
e and .area
1 i 1P31Ct°A'} ka i to »Cr i^ � ? aril A!'-
�
L!tiwal ft. Art s .— .__ — — _ _
of crack a.t. ft. K.e'+ft e : v i d n 1 Yt 6 "
I : Coef. Btu
Infiltration /
Glass
F.xp. wail
Net rap, wall
Int. wall 4T
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. header area
+FRoom (Length Width Height
Windows and Boors--Crackkage a"nd Area
Width rislght No. of Lineal ft. Area
No. oY yane of pane If ghto of crack sq. ft.
1' ®� �-
Coef. Btu
Infiltration
Glass
�G
Exp. wall/1,k
'dst exp. wall
: 12—
nt. wall
Veiling 9 x 4
loor
i'otal Btu.
e49uired sq. ft. E I.R• or @a. .-irna. V,.A�L�eader area
_''t',. n�[�. r.• s �f t5a�- tsc�r �&wp f2
1 �^
Claus
�p. wall
Net
_F_locr
Y_Twal D31.1.
—Requtred sa. ft. k.I.l.. or sq. ins. W.A. Lt3der yrs
l•l e b� °� `ts� Rc�ni l I �nter�
W4
Windows zrid
�';
Pci,jht
qt�l
tnlldth
N+r. of pane
ef. Btu
Infiltration ___
Glass
Inff.'tration
Exp. wall
Net exp. wall
Int, wall
Ceiling ® Ar Z
Floor
Total Btu.
�s�'
r
Required sq. ft. E.D.R. or sq. ins. W.A. Leader
area
B b Roem Length Width /
height tv
Windows and DOOrs--Craehase and Area
�1
Width Height Na. of Llneal '!. Area
pane of pane l°igfhis of crack sq. ft.
gNp.of
/0'2
Total Btu.
I : Coef. Btu
Infiltration /
Glass
F.xp. wail
Net rap, wall
Int. wall 4T
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. header area
+FRoom (Length Width Height
Windows and Boors--Crackkage a"nd Area
Width rislght No. of Lineal ft. Area
No. oY yane of pane If ghto of crack sq. ft.
1' ®� �-
Coef. Btu
Infiltration
Glass
�G
Exp. wall/1,k
'dst exp. wall
: 12—
nt. wall
Veiling 9 x 4
loor
i'otal Btu.
e49uired sq. ft. E I.R• or @a. .-irna. V,.A�L�eader area
_''t',. n�[�. r.• s �f t5a�- tsc�r �&wp f2
1 �^
Claus
�p. wall
Net
_F_locr
Y_Twal D31.1.
—Requtred sa. ft. k.I.l.. or sq. ins. W.A. Lt3der yrs
l•l e b� °� `ts� Rc�ni l I �nter�
W4
Windows zrid
�';
Pci,jht
qt�l
tnlldth
N+r. of pane
r4e:gnf
o* pane
Nc. off �L7:3maE f•..
t7t; hty of crack
Area
a+t. ft.
c}
Inff.'tration
j�
ld
Etp, wall
Not exp. wall.� �?
�s�'
r
Int. wall _
Ceiling �_� B
e i
�1
Flocs
Total Btu.
atcquirea rq, ri:. r -U.K. or sq. ins. W.A. Leader area
m �•I Y -A I.,.�-� Ro-oos I Length '2--j Widths
Windows and Doors--C*xc;�age and Are
w/dlh Helghf No. of i.ina:al !t. Area
No. of pane oY Fanolights ot_rack eq. tt.
L- ___1__- Coe£. Btu
Infiltration h
Glass
Exp. wall
Net exp. well
Int. wall
Ceiling
Floor
Total Btu. r�—
Required sat. £t. E.D.R. or sq, ins. W.A. Leader area
MEAT LOSS f°�a9�� 6� �:Tl�`1'�� e DEPAR>'"E'EN-I CF l;'K'>
®fb r4 �4 iii .a e' T$ 4a i% S A, AA
eat leo
kdc,r•-a 1 a �h 0 P �r W i deh { 3 V Height I! � l�a�
V111 h 11,;f-ent SIn.t�am Lt,atail.
it P7 o. a2 o4ese of P Tt 6i ccs !see tt ^2. Yt.
�In��Jt°i8 8n4 , 6ari--�.rti4:i3.��� and Area3
Width Height
No. of t•lneal t4. a1r�.a
No. of pat+e of sire �ighte_��oY crack a•4• ft.
Doorv---Craekage sand Areaa
Width
No. or pane
Height
of pane
No. of
lights
Uses) ft.
of crack
Area
sq. It.
'L ®
30 -3
/42Coef.
Infiltration
�?
Coef. Btu
Infiltration'''
Class
Coef.
Bu
Infiltration
Exp. wall
Glass
Net exp. wall
Int. waU
1�
Exp. walla o
Btas _
Net exp. wall
�
7
Inc. wall
Calaasa
Ceiling 74rx
�I ar
Floor , X9 Bit
c
Total Btu.
Net exp. wall
Int. Mall
Ceiling
Required sq. ft. E.D.R. or sq. ins;. W.A. Leader area I
I M. -jJ R. I 1 meth M k Width 2 ._... Heiaht �
Windows and Boars—CM-6ge and Area
Doorv---Craekage sand Areaa
Width
No. or pane
Height
of pane
No. of
lights
Uses) ft.
of crack
Area
sq. It.
'L ®
30 -3
/42Coef.
Infiltration
�?
Coef. Btu
Infiltration'''
Class
.3.3
3-0 Zja 6_0
Exp. wall
Net exp. wall
Int. waU
Btas _
Infiltraation
r
Calaasa
Exp.wall — x
Net exp. wall
Int. Mall
Ceiling
--
Floor /
%®
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
1 m I Lwi'Y-b u Rnaa.ae I I. nth ) A— Width ® Heimht
®Windows aM
Doorv---Craekage sand Areaa
HatBht ldo. uE Liot 1t.
_oY r^t,na Sagpto .it rack
Width Height No. aE
No. of pane of pane sights
Lineal Et. Area
of crack oq. it.
�§7
'L ®
30 -3
Infiltration
�?
Coef. Btu
Infiltration'''
Class
.3.3
3-0 Zja 6_0
Exp. wall
Net exp. wall
Int. waU
Ceiling
Floor
Ceiling
Tatal 1,4
S
ins . ; _.�. � �4 arty 1
Coef.1 P I a
Infiltration
_Mass Mt
F p. gall X,
Net exp. wall _�—�^-
Int. will
Ceiling
Floor at9�
Total Fath. _ —
Required sq. fa. E.D.R. or sq. ins. TVA- l.,ea&r area
Vrr... i- and Area
No.
�dtdth
of parvo
HatBht ldo. uE Liot 1t.
_oY r^t,na Sagpto .it rack
Area
sq. ft.
�.
Infiltration
�?
rf.MIA
Glass
Exp, wall YX
Net exp. wall
Int. wall
--
Ceiling
r
Floor
Total 13m. - _ —
Required sq. ft. F-D.R_ar rq. ilia. VIA. Uaader area
7�'� 6 $ Floorrl i ler gilt
Windows and Doors--Cra_ckvze and Area
Width HB[silt leo. of LWeal ft. Area
oY Cana of Fano I anithtte� of cescic sq Et.
Coef
Infiltration _ I
Glass
Exp. wall _
Net exp. wall ' ✓�� _.__
Int. wall
Ceiling
!Floor
Total Btu. _-
E r ate. ft. E.M w sq. ices. W.A. Leader arta
t>,.
PERMIT for Power Plants and Heating. Cool-
ing. ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of_ Heating Plants L,� zA dam) to tnsta ltered—repaired
Make ra'e) , m C ;
Oil fired_; Coal fired—, Gap fired ; Cas.Authorization No.
Remarks
j Approved
Permit N° 4878
Fee $ /Q. C8
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.. _ , 192--c)
Owner ,L- �'
Location_Aj_t.cj
Kind of Building
How Occupied •9 ,,
' a
Work to be Commenced—, 19—
To be Completed ,19_
Final Inspection Date '19— 11 Estimated Cost, $
Inspector11 Ol - ew, uilding Permit No.
Permission is hereby granted to 1 to install—erect—use the material and devices described in the
s statement. This permit is granted upon the express condition that the person tow m it is granted, and his agents, employees and workmen, in all the work
and materials used under this permit, and in the operation of the devices herein meet' ned shall conform in all respects to the ordinances of the City of Fridley
ng to or governing the work to be done and the operation of the devices herein named, and to the specifications set for h in the approved application for this
it on file in the office of the Inspector of Buildings.
,Inspector of Buildings
42 3M 11-67 d
January 22, 1971
SUBJECT: Buiding Permit for 5600 Regis Drive
Mr. Nuhich,
This letter is in response to your request. It states my
understanding of your apprehension concerning the building of
a structure onto my existing house. Your apprehensions were
reflected in the conditional issuance of the building permit.
I recognize your concern about the wall cracking. At your
suggestion, I retained the services of the Stain City Testing
Labs Inc. to investigate the cracking. They made an inspection
and submitted a report to me and sent you a copy.
•Several suggestions were made to arrest the cracking and to
effect repairs to existing cracks. I have selected a method
of sealing which has the approval of the testing lab; a caulking
sealant made by the General Electric Company. My contractor,
The Sussel Company, will install the sealant as part of the
construction project.
If this plan meets with your approval, please call the contractor's
representative, Dave Dahl, at 645-03:1 to permit start of the
project. - plu+
MEMO TO: Marvin Brunsell
MEMO FROM: Hank Muhich
MEMO DATE: January 28, 1971
RE: Balthazar Property Progress Report
Four Inspections,& Two Phone Calls
On January 21, 1971 at 1:30 P.M. checked both units on grade floor for
occupancy. Both apparently occupied as barking dog responded to ringing of
door bell in each unit. Checked rear entry of previously occupied basement
apartment. No response: Location of portable milk cooler against storm
door was evidence of no recent use of entry, and possibly no occupancy of
lower unit.
On January 21, 1971 at 4:15 P.M. checked all three units again for
possible return of at least one of the occupants. Again no response.
Additional evidence of vacating of one unit was the presence of only two
of the previous three N.S.P. electric meters. Apparently one recently
removed.
On January 22, 1971 at 10:00 A.M. there was no response again.
On January 23, 1971 at 8:10 A.M. called the Balthazar residence (788-
7241) and there was no answer. Checked reverse directory for any additional
numbers. Found Radloff number to be 788-0183 o- nd called this number. No
answer.
Dialed Balthazar number again. Operator informed me that the phone
had been disconnected and referred me to a different number to contact
(781-7979). This turned out to be the daughter. She informed me that
parents had complied to the agreement and were now in Florida.
On January 25, 1971 at 3:00 P.M. checked all 3 units again. No answer
at any of the units.
HANK MUHICH
Chief Building Inspector
HM/cc
CITY OF FRIDLEY
Effective Date May 1, 1988
.APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL ` RATE TOTAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
18 of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work
20.00 $ °0, L)
10.00 $
10.00 $
10.00 $
$ 10.00 $ ►® •u®
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit 12
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
$
$ .50
$
Job Address SCOOO` I�QQt--, >06X)Q
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. �' 01 , 19SI&
OWNER
KIND OF BUILDING
USED
TO BE COMPLETED ABOUT �A
C)cs
ESTIMATED COST LA _ � 0
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. 4
Trade Name ` !A ciec Size No.
Capacity
Total Connected Load
BURNER - Trade Name
Sq. Ft. EDR BTU HP
Kind of Fuel
Size No.
Capacity Sq. Ft. EDR BTU HP
TT s
Fill out back side for stack verification on replacement furnaces
CITY OF FRIDLEY
Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
ei.ernow.mrw r
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
18 of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work
RATE
TOTAL
$ 20.00
$
$ 10.00
$ ��
$ 10.00
$
$ 10.00
$
$ 10.00
$
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
S
$ .50
Job Address � 6c�v Wd l —DZ I
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. �y /®� / 14 , iJ�
OWNER
KIND OF BUILDINGa�
USED AS
TO BE COMPLETED ABOUT ,P f % A I �CJ�✓
ESTIMATED COST ✓ `�'
OLD - NEW BUILDING PERMIT NO. PERMIT NO. V V1
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name ��-moo% --0— Size No.
Capacity _ Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company /vim
Signed By G
Tel. No.� C�
Fill out back side for stack verification on replacement furnaces
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
I.
Has been carefully examined
Yes ( )
No
2.
Is free from rust or deterioration
Yes ( )
No
3.
Has no foreign objects lodged within
Yes ( )
No
4.
Is securely supported
Yes ( )
No
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company _
Signed By
Da to
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
QRCTnLT'iTTnT.
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
RATE
TOTAL
$ 20.00
$
$ 10.00
$ ®e
$ 10.00
$
$ 10.00
$
$ 10.00
$
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit 2G
MINIMUM FEE FOR ANY HEATING PERMIT IS
PLUS $.50 STATE SURCHARGE
$ .50
Attach stack verification form with.replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Job Address C70 A
Effective Aug. 1, 1981
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. L:/Lr- 1 _, 1900
OWNER �. Q Ws 6d
KIND OF BUILDING��"HH
USED AS
TO BE COMPLETED ABOUT C <�
ESTIMATED COST 4,0 C" ��tt ryy
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name Size Size No.�
Capacity Sq. Ft. EDR BTU 49 HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company
Signed By
Tel. No. zecA -7 —" 1 ?,6
SUBJECT
City of Fridley-,
M
3 0 45
AT THE TOP OF THE TWINS
BUILDING PERMIT'
r
�
ECEIPT
COMMUNITY DEVELOPMENT DIV.
m PROTECTIVE INSPECTION SEC.
3-70r
CITY HALL FRIDLEY 55432
NUMBERREV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
1/26/00
10B ADDRESS 5600 Regis Drive NE
1 LEGAL
LOT NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
4
Parkview Oaks First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Daniel Murphy 5600 Regis Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
First Choice Exteriors 2405 Annapolis Ln N, Plymouth, MN
55441 553-1918
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE N0,
4266
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW 0 ADDITION O ALTERATION REPAIR
0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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 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 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 SE COMPLIED
$13,000
$6.50
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
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fie SC $13.00
K C N RFT"NCE OF N TION
$223.25
�THE
AQ r)�,
PLAN CHECK F
Lice e
TO AL FEE
SC
-1m
0
247.75
SIGNATUREO - CTORORAUTHORIZED AGENT (DATE.
PR P VALID E THIS IS YOUR PERMIT
4reMEN
SL -NSP
DATE
S.GNATURE OF OWNEROF OWNER SUILOER1 iDATEi
NEW [ ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY 612-572-3604,Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1 y�
BUILDING PERMIT APPLICATION („L�
Construction Address:
Legal Description:
Owner Name & Address: D-, t l,_, L A40IIy (-9Atw7.� > Tel. #
Contractor:r rem' MN LICENSE #o
Address: e e/ -S 64We 41 Ze WIV-Tel. # v2"3 �/•S/�
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
Mit: I#1Z
Construction Type: RFEZZ4 0-/' 4�_IA�21416-- Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: / G0 APPLICANT: Tel. # '��3/�
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application
Permit Fee $3e7 Fee Schedule on Reverse Side
Fire Surcharge $ 1-:5,60 .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1100 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 [ ]
Building
BUILDING
$
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
s
DATE
YOUR E- L ADDRESS
N
SITE ADDRESS`P1
•
THIS APPLICANT IS: ❑ O
ER CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS:
CITY
STATE ZIP
PHONE:
CONTRACTORNAME:
A`��'d, C
SUBMIT A COPY OF
p
STATE LICENSE 20.A 6
6 b 3 EXP DATE
YOUR STATE LICENSE
ADDRESS:
CITY
STATE ZIP
WITH APPLICATION
PHONE
FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION
❑ GE/SHED ❑ WINDOWS
E3 BASEMENT FINISH OOF ❑ DRAIN TILE
❑ DECK
❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW
❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes [No
LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ o' §-. ' 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
Q
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev 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 applicatio a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all wor h' equires eview and approval of plans.
L
�SIGNATURE OF APPLICAN " PR1NTNDATE
AM�'`v
$
$
$lC�
Q
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev 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 applicatio a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all wor h' equires eview and approval of plans.
L
�SIGNATURE OF APPLICAN " PR1NTNDATE
AM�'`v