PRE 2010 DOCSDate: - /�
Owner: V:(/,1• i:' rI ice/ .9E.
AddressAddress,
/S 2912
NO. 6359
LOCATIOnxOF BUILDING
No. Street -- Part o Lo
Lot _ Block Addition or Sub-Divisia _ d
Corner Lot _ Inside Lot Setback Sideyard _ �a
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
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
thto construct the building or addition as described above. This t is granted upon
e eupress condition that the person to whom it is granted and his agents, employees an workmen, in all work
done in, around and upon said building, or any Thereof, shall conform in all respects to the ordinance's of 7Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings
cee. city lisnits� permit may be revoked at any time upon violation of aay of the provisions of said
Building Inspector
NOTICE:
Sh ponn1t does not corer the construction, Instdldon for wir(ne, plumbing, on heating, sewer or ranter. Be euro io no
the Building inspector for sopmee pennfls for these items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
a
oe
Owner's Name ild
Address,3,2
LOCATION OF BUILDING
No. Street 4a L Part of Lot
Lot BlockAddition or Subdivision c
Corner Lot Inside Lot Setback Side-Yarda
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. /�,�� Cu. Ft.
Front Depth Height_,_,,,_„r
Sq. Ft. Cu. Ft.
Type.. of Constructions e(,- �� Estimated Cosh
To be Completed
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 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. /
DA S 6 SIGNA°TUR�e
l
(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 $
1 7
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ V/
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 $ d/
GAS FITTING FEES: NO RATE TO AL
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 $
ROUGH
FINAL
Dept. of Bldgs. Phone SU
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.
FEB 15 1963
_ Fridley, Minn 18 —
Owner
Kind of Building
Used as72'
To be completed a t
Estimated Cost, $
eO,4ew. Jhuilding Permit No.� Permit No.
APR 15 1963
OF WORK
HEATING o
Air—NoZ
Trade Nam �%�+®�'
Size N ��2 '7 f/'®
Capacity
Sq. Ft. E..D.R� Ole 10 BTV H.P.
1
Total Connected Load
T ��* �%l�� Kind of Fuel—A.,
BURNER — Trade Name
�� Size No
Capacity
Sq. Ft. E.D.I,/--P BTU H.P.
GEO. SEWW--ICK HTG. & AIR-COND. CO
1001 Xenia Av. S.
Minneapolis 16, Minn.
Signe
By
.OJW4 Z YM
Business Phone
(REMARKS -OVER)
Windows and Doors—Crackage and Area
Width Height No. of Lineal fi. Area
No. oY pa e f ile lights of crack sq. ft.
—7—
s'?
J),36
e
Windows and Doors—Crackage and Arear.
HEAT LOSS CALCULATIONS
DEPARTMENT OF BUILDINGS
MINNEAPOLIS. MINN.
Weatherstrips
S.H.V.E.
A.Guide
Construction No.
Infiltration
Insulation
Windows
I Doors
Reference
Out. Wall Int. Wall I Ceiling I
Roof Floor
Kind How Applied
N—o
(Ye
19— 19—
1
1
L
Fl.1 Room I Length
Width Height il
Int. wall
(WRoam I Length / M, Width fleittlit a
Windows and Doors—Crackage and Area
Width Height No. of Lineal fi. Area
No. oY pa e f ile lights of crack sq. ft.
—7—
s'?
10
Height 46,07
Windows and Doors—Crackage and Arear.
F-1
)v
Coef.
Coef.,
Btu
Infiltration
Infiltration
Glass
?, 1
37,50
Glass
Glass
55 M b
Net exp. wall
14�0 1
ir—ci
Exp. wall �9"
v ,
9 LIZ'
Int. wall
7V
Net exp. wall
Net exp. wall
Ceiling
•
Ceiling
Int. wall
Floor
'.
Floor r
t
I I
Ceiling
IALIG
Floor
I otal Btu. W 0
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I I
; F1.1 i'l, . t- i Room I Length Width r o ijeisr_ht�,_
Windows and boors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of ane of pane lights of crack sq. ft.
s'?
10
Height 46,07
Windows and Doors—Crackage and Arear.
F-1
)v
Coef.
Coef. Btu
Infiltration
Btul�__
Infiltration
Glass
Glass
Exp. wall
�77
Glass
55 M b
Net exp. wall
v ,
9 LIZ'
Int. wall
Z_
Int. wall
Net exp. wall
Ceiling
•
Ceiling
Int. wall.
Floor
'.
Floor r
t
I I
Total 13tu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I F1.1 / 4 Room I Length// Width
Windows and boors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
-7
Btu
Infiltration V? K I 'I
Glass
k-& I
Exp. wall
Net exp. wall e;
Int. wall
Ceiling j, v
Floor
Total 9tu.
Required sq. ft. E.D.R. or sq. ins., W.A. Leader area
Windows and Doors—Crackage and Area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Width Height No f era Lineal Area
No. of pane of pane lights ft. crack SQ. ft.
10
Height 46,07
Windows and Doors—Crackage and Arear.
F-1
)v
Coef.
Btu:!
Coef.
Btul�__
Infiltration
Glass
�77
Glass
Exp. wall
Exp. wall
V'
Z_
Int. wall
Net exp. wall
Ceiling
Int. wall.
'.
Floor r
Ceiling-')
Floor 11,
Total'Stu.
J
Required sq., ft. E.D.R.,, or sq. ins. W.A. Leader area
Room I Length / t,,' Width Heistht
Windows and Doors—Crackage and Area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack SQ. ft.
Width
Room I Length / �,,- -
Height 46,07
Windows and Doors—Crackage and Arear.
Width Height No. of Lineal ft. Area 4"
No. of pa of pane lights of crack sq. ft.
)v
Coef.
Btu:!
Infiltration
Infiltration
Glass
Exp. wall
Net exp. wall
Z_
Int. wall
Ceiling
'.
Floor r
Total Beh.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Width
Room I Length / �,,- -
Height 46,07
Windows and Doors—Crackage and Arear.
Width Height No. of Lineal ft. Area 4"
No. of pa of pane lights of crack sq. ft.
)v
_LCoef.
Btu:'
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
P
Ci+y of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SU 4-7
DESCRIPTION OF WORK Location J V'
Number, Kind and Location of Fixtures
rn
NO. RATE TOTAL
Number Fixtures ....... ..............
Is 10
�
$ 60
Future Fixture Opening ................
x 1.20
c�
New Fixture Old Opening ..............
8o
S
<
U�' $
��
aa'
Z
�O
i
R
•
:v
WATER HTR.
GAS
ELEG
Base
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
/
$ > "
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
1st
TOTAL FEES...
l
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings
Connected with
Sewer (�
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ....... ..............
x $1.50
$ 60
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
$—
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 FEES...
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 application are true and correct.
Fridley, Minn- i�'/^ y 1A-1
Owner
Kind of Building
Used as
To be completed about —
Estimated Cost, $
Old-7�4 ew. uilding Permit
ROUGH
FINAL
42 2ND
Permit
r
a
Business Phone No- � -� �� 'C�l
Original
PERMIT for Power P ants and Heating. Cool-
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be installed—altered—repaired
Make Size �9 ;
Oil fired _ , Coal fired ; Gas fired—Z—; Gas Authorization No.
Remarks
Approved
Final Inspection Date , 19_
Inspector
Y� -� a L/
Permit 10T ° 4783
Fee $ da -®0
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. -6- , 19
Owner LLLA-Ad.off
Location 140
Kind of Building— � -'
How Occupied
Work to be Commenced—, 19—
To be Completed—, 19—
Estimated Cost, $ '9 00.0 d
(gVew, Building Permit Ni
Permission is hereby granted to lA to install—erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications t forth in the approved application for this
permit on file in the office of the Inspector of Buildings. g
�✓ �L ,��! ��� �n..:� ,Inspector of Buildings
42 2M 11-67 v -
its, sop 70 it
xw
-
xw
-
2
�0��� �
�
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Furnace Shell & Duct Work ...........................
$10.00
$
Replacement of Furnace .............................
6.00
$
Repairs & Alterations—up to $500.00 .................
6.00
$
Repairs & Alterations each add. $500.00 ...............
300
$
CH. WARM AYR
Furnace Shell & Duct Work to 120,000 BTU
... I ........ $10.00
$
each add. 60,000 BTU .......................
3.00
$
Replacement of Furnace .............................
6.00
$
Repairs & Alterations—up to $500.00 .................
6.00
$
Repairs & Alterations each add. $500.00 ..............
9.00
$
STEAM or HOT WATER SYSTEM
Furnace Shell & Famines—to 400 sq. ft. FDR Steam .... .$10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $
Each add. 200 sq. ft. EDR Steam ............... :....... &M, $
Each add. 320 sq. ft. EDR Hot Water . ... ........ ... 3.00 $
OIL, BURNER—to 3 gal. per hour ... .:... ... . , ....... 6.00 $
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 199,000 BTI) ................. 800 $
over 199,000 BTU See. Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
Ist 3 Fixtures ..... ................ x$ 100 $
Additional Fixtures x .78 $
Gas Range to 198,000 ........... x$: SAO $
AIR CONDITIONING $
rAN HEATING SYSTEM See Fee scheduis
VENTILATING STST09 i I
ALTERATIONS & REPAIRS TOTAL F=
ROUGH—
. F -t 7-71
Dept. of Bldge. Mom 680 MW
City of Fridley:
v(
The undersigned hereby makes application .for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinancea
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, Affirm
Owner 04.,' -
Kind of Building
Used as
To be completed about ,6- 7
G�
Estimated Cost, $
OiIC-New. Building Permit No. Permit No.�`�-�
DESCRIPTION OF WORK.
HEATING or POWER PLANTS -steam, Hot Water, Warm Air -No -
Trade Name size No
CapaciSq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capadty Sq. FL ED BTU Hip.,
ARIES -OVER'
J
,5 -
City
City of Fridley, MinzI.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
'Date.- Mnat 1,.,1s 1971
e. �•..: u• I. .- IJ• •
I k•I affi
No 1200 Street Regis Lane N.E. Part of Lot
.Lot _Si Block 1 Addition or Sub -Division _-La Addition
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
To be Used as:
Basement Rec. Room Front Depth Height Sq. Ft _ _ Cu. Ft__
Front Depth Height Sq. Ft. _ Cu. Ft.
Type of Construction - FramP Est, Cost _$9,432.()Q _ To be Completed 7111
Ia consideration of the issuance to me of a permit to cons a building described abov I agree to do
the proposed work in accordance with the description above set d in compliance wi a1l provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 15.00 , permit is hereby granted to Mork & Associates
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 buildiags
.Within city limits and this permit may be revoked at any time upon violation of any of the provisions of Acid
nces. r
Inspector
ARF
NCE BET TSL E
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, Bas beating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: /410/412S S i Ut M a fL ► S BUILDER: V h b 2 K t 4GCc ., + 7-C- S, i M C,
ADDRESS: l;Zao g -6►S ADDRESS:_1� G��nlcve.®�j ,4U� • /b,
NO:. /tea STREET: QE-G►S
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT:9 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:.
(5 1 Front: Depth: Height
vn
Square Feet: Z1g0 Cubic Feet: S y o
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: rZA—,vl Estimated Cost: 6C
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.
1 / ��/,`
GATE: SIGNATURE:
(See Reverse Side For Additional Information.)
♦'
1II dI�FIC ei!31 ILL oIVIIVI(�YI(79� �I �IGASTER MTRC.
'Em-
■NrRN 1
Sower
Cesspool (-1
PARTIAL RATE SCHEDULE
F1.UMl3ING FIXTURE RATES:
NO. RATE
T�.
..........
Number Fixtures ................
x $2.00$
Future Fixture Opening ...........
x $1.50 $ _
New Fixture Old Opening ..........
. x $1.50 $
Catch Basin ....................
x $3.25 $
Water Heater :Up to 99,000 BTU) ....
x $3.00 $
New Ground Run Old Bldg. ........
x $3.25 $
Electric Wates Heater ..............
z $2.00 $
GAS FITTING FEES:
NO. RAVE TOTAL
1st 3 Fixtures ..................
x $2.00 $
Additional Fixtures ..................
x $ .75 $
Gas Range to 198,000 BTU.. .
x $5.00 $
REPAIRS & ALTERATI Refer io de
Description .....................
TOTAL FEE $
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 alk the fact
and representations stated in this application are true and correct
Fridley, Minn�°��� fl8,
Owner a -
Kind of Building _=#--� 0
Used as
To be completed about
Estimated Cost, $
®c-,
Old—New. Building Permit
ROUGH
FINAL �'' ®' 0.5—
By
Business
City of Fridley, NUmme _
6431 University Ave. N. t., Minneapolis, Minn. 55432
BUILDING PERMT
Date: May 13, 1971
Owner: Aivars Stumbris Builder SAMe-
Address 1200 Regis Lane N.E. Address same _
•; : . Eel Z e
No. _ 1.-Q 0 ._._.,.. Street — Regis Lane.JLK Part of Lot
Lot _..4 ._ Block _ _ 1 _ --- Addition or Sub -Division L e1andHe ghts
Corner Lot. __..__ . — Inside Lot X _ Setback Sideyard -5i–& 5
Sewer Elevation _ _ Foundation Elevation
To be Used as:
Storage Shed Front 10Depth 10' Height 92" Sq. Ft. Cu. Ft.
Front ._ Depth Height Sq. Ft. Cu. Ft.
Type of Construction ._ Frig Est. Cost—$150.00 To be Completed Aug, 1971
In consideration of the issuance to me of a permit to construct the building described above I agree t4 do
the proposed work in accordance with the description above setAc and in com 'encs with a'il provisions of
Ordinances of the city of Fridley. , "
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to Aitrars S''F,,mb=;i
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
vyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CBARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for whims, plumbing, gas heating, sewer or water. Be sure to s"
the Building inspector for separate permits for these items.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:_ &'L,4R
ADDRESS : /®%®0 ZaA e ADDRESS: �®
NO:. STREET:
LOT:- ':BLOCK: ADDITION: 111XV /%/PO elo�� 6,g 7 $
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Ste_
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:
. Front • Depth: • /(e
P Height: �aze
Square Feet: /_ � Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: o6f fA4.—_- Estimated Cost: 0-0
To Be Completed: . 15P7/
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.
(See Reverse Side For Additional Information.)
SUBJECT
City of Fridley
o 15.83' 30
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• ___ _ COMMUNITY DEVELOPMENT DIV.
z: - e
r PROTECTIVE INSPECTION SEC.
1 � �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/15/80
JOB ADDRESS 1200 Regis Lane N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
1
Lakeland Heights SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Aiva.is Stumbris 1200 Regis Lane N.E. 571-7958
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 MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Install aluminum trim and gutters.- Insulate attic & roof
9 CHANGEOFUSEFROM 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
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
$3,000
$1.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$19.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
A- 0-La
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) )DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
New, Alterations, Additions, or Repairs)
OWNER: Al w VA i S � � u 15
ADDRESS:
TEL NO:
BUILDER: IL
ADDRESS:' —ltIq L
TEL 1.10: 7 �/
Construction Location
STREET NO:
STREET:
JOT:
BLOCK:
ADDITION:
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.
DESCRIPTIO14
OF .CONSTRUCTION
Front:
Depth:
Height: --
Squane. Feei_:
Cubic Feet:
Front:
Depth:
Height:
Square - Feet:
Cubic Feet:
Type of Construction: AlV 17 'r /V% ,,'t- c"7 d / Estimated Cost: $
To Be Completed:
• Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: _ $ $
SEE REyERSE 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
correct-
Stipulations:
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997
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
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work
Commercial/I ndustrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
$ .50
$ 3o. �;D
MINIMUM FEE FOR ANY HEATING/COOLI�ENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Burner Trade Name
BTU
�
HEATING C,U=rcpf
C umbia e
Signed By_I_ Cbl/
Approved By,
Size No.
HP EDR
rAjr CAnditioning
eve, P'r
iglus. MN P41
,t72-0451Tel No.
Rough—In Date Final Date
FILL OUT BACK SIDE FPR STACK VERIFICATION ON
REPLACEMENT FURNACE
JOBADDRESS�'
The undersigned hereby makes application for a permit for the work herein
Rate TOTAL
specified agreeing to do all work in. strict accordance with the City Codes and
$�< <�
rulings of the .Building Division, and hereby declares that all the facts and
$ 30.00
representations stated in this application are true and correct.
$ 10.00 $
1�/f1 �e�r�i c!5$
OWNER "Z4Jf 5*71>
$ 10.00 $
5,1 /� Ilse
BUILDING USED AS " 4�t-i, g
$ 10.00 $
ESTIMATED COST /!9'00 PERMIT N0..
$ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$
No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name� Size No,
BTU 6 HP EDR
$ _
Fuel Total Connected Load
State Surcharge
TOTAL FEE
$ .50
$ 3o. �;D
MINIMUM FEE FOR ANY HEATING/COOLI�ENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Burner Trade Name
BTU
�
HEATING C,U=rcpf
C umbia e
Signed By_I_ Cbl/
Approved By,
Size No.
HP EDR
rAjr CAnditioning
eve, P'r
iglus. MN P41
,t72-0451Tel No.
Rough—In Date Final Date
FILL OUT BACK SIDE FPR STACK VERIFICATION ON
REPLACEMENT FURNACE
Remarks:
HEATING CO:
Signed By:
Date:
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the .existing chimney or
stack:
1.
Has been carefully examined
Yes
O
No
( )
2.
Is free from rust or deterioration
Yes
O
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's connected
Yes {)
No
( )
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes (
)
No
( )
8.
Has combustion air been provided for water heater
Yes (
)
No
( )
Remarks:
HEATING CO:
Signed By:
Date:
City of Fridley
SUBJECT
29495'
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
�(C�
i CITY HALL FRIDLEY 55432
l
NUMBER
REV
DATE
PAGE OF
APPROVED BY
----;"',•�
612-571-3450
910415
5/18/99
JOB ADDRESS 1200 Regis Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DES CR.
4
1
1 Lakeland Heights
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Aivars Stumbris
571-7958
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Midwest Timberoof Co. 1001 E. Cliff Rd. Burnsville MN 55337 808-1149 20147336
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 1 REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (19 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Perms# Inspection Cards
:. will go Mailed
TO NOMeowner To Post
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCYLOAD
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
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1628
$.81
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.
$60.10
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire SC $1.63
PLAN CHECK FEE
TOTAL FEE
Licsnse SC $5.OQ
$67.54
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERL y) LIDATED THIS IS YOUR PERMIT
BL INSP OATS `�
S-GNATURE OF OWNEAOF OWNER BUILDERI IDATEI
01
NEW C i
ADDN
ALTER f l
i_- `• F1'!g1 11 iJF 1 F1 OLE Tri
ConstructionAddress: I
., .
CITY OF FRIDLEY
SINGLE FAMILY AlND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 111,98
mei- I U-1-54
him A6
Legal Description:
Owner Name & Address: l�W QC-9IS Ln •
Contractor: M j 5+ MN LICENSE #
Address:_ {CSR E. Ci i-K--Ro- ;Ile, Mn �5� Tel. #_ O?s— I Hq
Attach to this application, a Certificate of Survey of the
Jot, with the proposed construction drawn on It to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length — Width height _ Sq. Ft.
GARAGE ARRA: Length Width _ — Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
kaA
Construction Type: tiepf Cf � CV-) d, re_ -VDO( Estimated Cost: I q 01:5.
(nee Schedule on Back)
Driveway Curb Cut Width; Needed: Ft. + 6 Ft= Pt x $ $
DATE:.__�5 [qC APPLICANT: '3r'CQ Rnk is Tel. # So � -I ILICI
TOTAL $ . S
. STIPULATIONS:
CITY USE ONLY
/
Permit Fee
-
$ l�®. O
Fee Schedule on Reverse Side
Fire Surcharge
$� %.te3
.001 of Permit Valuation (1110th%)
State Surcharge
$�
$.50/$1.000 Valuation
SAC Charge
$_
$1000 per SAC Unit
License Surcharge
$ s 0-0
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion, Control
$
$450.04 Conservation plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ j
TOTAL $ . S
. STIPULATIONS: