PRE 2010 DOCSCity 1Fridley,nns
BUEMING PERMIT t' '
�� ,... (� ��.�BuilderI1iF
Address CZ Address
L= OF U L ING
Street sPart of Lot
Lot Block Addition or Sub -Di ons
Corner Lot _ Inside Lot Setback ---� .Sideyard
Sewer Elevation 30 77 Elevation S= 3 :3. a1 2
r
'roil 4 r^ Fu iT / J19 d8
DESCRIPTION OF BUILDING
?�e
Fron Depth Height Ine Sq. Cu. Ft WX
Fro t Depth Height w� Sq. Ft. cu. Ft.
Type of Construction _ Est. o be Completed
In consideration of the issuance to me of a permit to construct ilding d above, I agree to do
the proposed work in accordance with the description above set fo�;a'L in plian with all provisions of
ordbiannces of the city of Fridley.
i�
In consideration of the payment of a fee of $9� , permit is herby 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
w� � city limits and this permit may be revoked at any tim!u vio g� of any of the provisions of said
NOTICE:
Ible permit does not sorer the construction, haftWon for wiring, plumbing, gu headog, wwor or water. Be sure to see
the Building Impeetor for separate permits for those items.
e
Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
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 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ ® Oro
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 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
$10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
... 10.00
$
Each add. 200 sq. ft. EDR Steam ......................
3.00
$
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 BTU) .......................
5.00
$
C-00
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE
TOTAL
® 6
1st 3 Fixtures .....4
................
x$ 2.00
$
Additional Fixtures .................
x .75
$
Gas Range to 199,000 ...........
x$ 5.00
$
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
$
See Fee Schedule
$
TOTAL FEE $ / C9 6
Dept. of Bldgs. Phone 560-3450 (�
Location 45f �
City of Fridley:
The undersigned hereby makes application for a permit for the work hereiz
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn 19
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Ole—New. Building Permit No. Permit No.
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No �,
Trade NamP Lit- Size N�S�/✓�y-6 -lad
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load f F ®� d Kind of Fuel_ &L•-
BURNER — Trade Name— Size No /a® O
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
r
5915.51 —
City ®f Fridley
pig an
Dept. of Bldgm. Phone SM -34M
DESCRIPTION OF WORK
Number, Kind and Localion of Fixtures
res
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Lea". 551 Rice CrAek Bld.
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, m.nNoy. 12, 1969 19_
Owner R. C Gerri.tsen
Kind of Building frame
Used as residence
To be completed about-NOV* 17, 1969
Estimated Cost, $ 10.00
O1dX-New. Building Permit No Permit No.
Number Fixtures ...... .. ...........
x $200
$
Signe _
Future Fixture Opening .... ...........
x $1.50
$
B�
New Fixture Old Opening ......... ....
x $1.50
$
B . ess Phone No
WATER HTR.
x $3.25
$
L
orC
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg. . ..... ....
x $3M
$ ROUGE
:
Electric Water Heater
: $2.00
$
GAB FITTING :
R
M
GAS
EIEC.
Base
Additional Fixtures ............ ,.......
x $ .?5
$
Lias Range to 199,000 BTU ..............
x $5.00
$
install (1) gas lite
5.00
let
2nd
-
3rd
— –
4th
P-MIUM Connection openings lung—clodw9Slr
❑
NOW Fizhm, Old OpeningsI SewerCesspool
'm
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Lea". 551 Rice CrAek Bld.
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, m.nNoy. 12, 1969 19_
Owner R. C Gerri.tsen
Kind of Building frame
Used as residence
To be completed about-NOV* 17, 1969
Estimated Cost, $ 10.00
O1dX-New. Building Permit No Permit No.
Number Fixtures ...... .. ...........
x $200
$
Signe _
Future Fixture Opening .... ...........
x $1.50
$
B�
New Fixture Old Opening ......... ....
x $1.50
$
B . ess Phone No
Catch Basin ... ... ... – – ..
x $3.25
$
L
orC
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg. . ..... ....
x $3M
$ ROUGE
:
Electric Water Heater
: $2.00
$
GAB FITTING :
NO. RATE TOTAL ��
lot 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ............ ,.......
x $ .?5
$
Lias Range to 199,000 BTU ..............
x $5.00
$
install (1) gas lite
5.00
ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $--5 --00
CITY OF FRIDLEY INSPECTION DIV, Effective On January 1;1993
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
672-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
_ o
JOB ADDRESS_ S/
Residential
Furnace Shelf and Duct Work, Burner –
Also Replacement Furnace
Gas Piping (Needed with new furnace)
y�
Gas Range
Gas Dryer
*Air Conditioning -• Ali Sizes
All Others/Repairs & AReratlons (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
11% of Value of Appliance or Work
I -if �P / –
The undersigned hereby makes application for a permit for the work herein
Rate TOTAL specified agreeing to do all work in strict accordance wlth'the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
$ 20.00 $ representations stated in this application are true and correct,
lad 0
$•x°0'0 $ / s
OWNER
$10.00 $ .
BUILDING USED AS
$10,00 $ j
ESTIMATED COST l G' PERMIT NO.•
$10,00 $
DESCRIPTION OF FURNACE AN_12 08 BURNER
State Surcharge
TOTAL FEE
,50
��5 6
MINIMUM FEE FOR ANY HEATING/COOL,INGNENTILATION
REFRIGERATIONIAIR CONDITIONING PERMIT IS 115.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner,
C ) _#40406" r)
Trade Named Size No. efloQ,a29c
BTU HP EDR
Fuel �( Total Connected Load
Bu er Tradeame tflzo No,
BTU HP EDR
HEATING COMPAI Y
Signed By Tel No. S 3 7�/
Approved ByG-4-j—Rough–In Date Final Date'--` 3
FILL OUT BACK SIDE FOR STACK VERIFICATION' ON
REPLACEMENT FURNACE
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
.1.
Has been carefully examined
Yes
(
)
No
(
)
2..
Is free from rust or deterioration
Yes
(
)
No
(
j
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
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
NEW [ ] Effective 1 / 1 /97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 U
BUILDING PERMIT APPLICATION
ConstructionAddress: y j ( R i' ce rnu & v r) N . L .
Legal Description:
Owner Name & Address: e �- �� } �N� Tel. #
Contractor:
Address:
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
\� J
riveway Curb Cut Width Needed: ,W- Ft. + 6 Ft = oZ' Ft x $ 13, SO = $ O 31o.
- r
DATE; S ( ZZ APPLICANT:-_ Tel. #
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
-$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
wr 4--rw 2r'7vry
-Lop
14
I
a
sue"""
City of Fridley
5� T O THE TWINS
• _____ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� CITY HALL FRIDLEY 55432
L 612-571-3450
BUILDING
PERMIT
2
2 822
—REtVIPT
NUMBER
910-F15
REV
GATE
AT13 98
vAGE OF
APPROVED By
JOB ADDRESS 551 Rice Creek Blvd NE
1 LEGAL
DESCR.
LOT NO.
3
BLOCK
2
TRACT OR ADDITION
1 Holiday Hills
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dan & Ann Hagen
571-2058
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Bo's Construction 2218 22nd Ave S M is MN 55404 709-5037 0
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 1c REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (24 S) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT
CU FT.
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
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
VALUATION
SURTAX
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2056
$1.03
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
STRUCTION OR HE PERFOR NCE OF CONSTRUCTION
$74.75
ire 2.06
PLAN CHECK FEE
TOTAL EE
Li S
d84
SIGNE O N'RA OA Op A RIZED AGENT IDATE�
EN ROP
LI ATE I IS YOUR PERMIT
_
S,GNATUAE Of OWNERnf OWNER BU4.DERt iDATEi
BLO& INS P
GATE
a
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�"" &�p
ConstructionAddress: � I 41C cy6e �lv�J /V 0
Legal Description:
Owner Name & Address: _Oar Av, Pa��rr1 Tel. # �7/— , (o S8
Contractor: `SMN LICENSE
Address: tea( �� e 4, l< 1 t" -559 -r Tel. # ' -7dq--T03 -7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:/
Construction Type: Lzerbyol Estimated Cost: $ c:P b
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ '07 e S
Fee Schedule on Reverse Side
Fire Surcharge
$ A. b G
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 6 3
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 5.06
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
�'
TOTAL
$
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": -Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
ITY OF FRIDLEY INSPECTION DIV.
.31 University Ave NE
idley, MN 55432
63) 572-3604, FAX (763) 571-1287
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
? , , - � M- Lem �yv; - Anm a
1 011% � 12"
.UMBING FIXTURE RATES: NO. RATE TOTAL
.w Fixtures
d Opening, New Fixture
:er Dispenser
ow Off Basin
itch Basin
ain Water Leafier
amp/Receiving Tank
ater Treating Appliance
titer Heater -Electric
10ater Heate - Gas'*
as Range"`
as Dryer"
tick Flow Preventer Required { )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00 O
$10.00
$10.00
$15.00
:inspection Fee $50.00IHr
_L OTHERS AND/OR REPAIRS AND ALTERATIONS 00
1.25% of Value of Fixture or Appliance 3 ccs —
J013 ADDRESS, 5`51 /9 - C',r�E8 � r1
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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE: 1 Q- , 20 _0&
OWNER �C�i d� 1 �� anm
BUILDING USED AS
ESTIMATED COST j PE=RMIT NO.
PLUMBING COMPANY �� 1 � '� Lk
SIGNED Bl'' TEL N0.
Approved By Rough -In Date Final Data
State Surcharge $ . 50
TOTAL FEE $.a.5 , 50
OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN S300
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE