PRE 2010 DOCSCity ®f Fridley, Minn.. U°
BUILDING PERMIT . 1094
Date: Februga 10, 1971
Owners Roger Larson Builder Donco Builders, Inc.
Address 1052 Osborne Road N.E. Address Same _
No. 170 Street Rice Creek Terrace N.E. ____ part of Lot
Lot — 1 _ Block 2 Addition or Sub -Division . Rice Creek Plaza South Addn.
Corner Lot —_X _ _ Inside Lot -- Setback -- Sideyard
SMWElevation 834-80' — FEBMURUMPAWn 837.80'
Wye Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 26 1 Depth 40 Height 20' Sq. Ft. 1040' Cu. Ft 20,800'
Garage Front 26' Depth 22 Height 10' Sq. Ft, 572' Cu. Ft. 5720'
Type of Construction Fxame Fit, Cost _j"8 000 _ To be Completed May: 1971
Verify basement location by survey. Hardsurface Drive. Provide 2nd print.
E SEWER LOCATION: 73' E. of Manhole WATER LOCATION: KI 63' E. of Manhole
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 rth and in comp with all provisions of
ordinances of the city of Fridley. y
In consideration of the payment of a fee of - 510 - permit is hereby granted to Donco Builders, Inc.
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, Mizmesota 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.
��L •�%//..�.L E� Building Inspector
HANK MUNICH
NOTICE:
lbb permit don not cover the construction, installation for wiring, plumbing, gas heating, rower or water. Be sure to we
the Building Inspector for separate permits for these Kenn,
s _
l
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S WAME:2 13UILDER:
�r
ADDRESS:—/0
4-�? 0,404z-,,�� ADDRESS: -
NO:. STREET
LOT: BLOCK:_
CORNER LOT: INSIDE LOT: 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:
Front:_ Depth: Height: �Z /
Square FeM- D Cubic Feet:
Front:Depth / Height: / 0 �
Square Feet; Cubic Feet:-�
Type of Construction:
Typ ����� , Estimated Cost: �
To Be Completed:
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.
DATE: SIGNATURE: P
(See Reverse Side For Additional Information.)
--JA
-731
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City of Fridley
Appllicallon for ftmbbg and Gass M"11" Faimb
Dept. of B1dge. Phone 960-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location f,
�¢tj, t �j y��j7( e •
PARTIAL RATE SCHEDULE
PLUMSING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $ /0 O 0
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 $ -3-06
New Ground Run Old Bldg......... x $3.25 $
Electric Wates heater ............. z $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures x $2.00 $---!!•-o
Additional Fixtures .................. x $ .76 $
Gas Range to 199.000 BTU ................ x $5.00 $
REPAIRS & ALTERATIONS—Rotor to Code
Description ............................................... $
TOTAL FEE $ 19,5
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 aA the fact
and representations stated in this application are true and correct.
Fridley, Minn o� 197-1
Owner
Kind of Building
Used as
To be completed about 30 - 7
Estimated Cost, $
Old—New. Building Permit No. Permit No.�
Business Phone No
ROUGH _
FINAL s ��
WATER MTA.
GAS ELEC
oa
Base
I
1st
2nd
3rd
4th
• Future Connection Openings
COQ with
* Now Fixture. Old Openings
n
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMSING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $ /0 O 0
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 $ -3-06
New Ground Run Old Bldg......... x $3.25 $
Electric Wates heater ............. z $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures x $2.00 $---!!•-o
Additional Fixtures .................. x $ .76 $
Gas Range to 199.000 BTU ................ x $5.00 $
REPAIRS & ALTERATIONS—Rotor to Code
Description ............................................... $
TOTAL FEE $ 19,5
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 aA the fact
and representations stated in this application are true and correct.
Fridley, Minn o� 197-1
Owner
Kind of Building
Used as
To be completed about 30 - 7
Estimated Cost, $
Old—New. Building Permit No. Permit No.�
Business Phone No
ROUGH _
FINAL s ��
GRAVITY WARM AIR: RATE TOTAL
Furnace Shen & Duct Work ...........................$10.00 $
Replacement of 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $ —
Repairs & Alterations each add. $500.00. 3.00 $
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each acid, 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 ... . ...... I ..... 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 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 2.00 $
Additional Fixtures 'x .75 $
Gas Range to 199,000 ........... g$ 566 $
AIR CO>�DI1`IONIIIG !�
FAN HEATING SYSTEM See Fee $cis
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE $�L_L�_
3 - 7/
11 1
Dept. of Mdga. Phone
City of Fridley:
The undersigned hereby makes application for a permit for the work hereic
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-
Diad of
Used as
To be completed about
Estimated Cost,
OI New Building Permit No.
Permit No. /
C
DESCRIPTION OFWORK
HEATING or POWER team, Hot Water, Warm Air—No-2--
Tirade
ir—No 'Trade Nam Size No -/10
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load 7 _ 6 Kind of rue
BURNER — Trade Name Size No -
Capacity Sq. Ft. E.D.R BTU H.P:
(REMARKS -OVER)
SUURBAN AIR CONDITIOIuma.
Signed 841.9 cFIuTRR DRAM
MINNEAPOLIS,@ MINNZSOTk 65433
By
Business Phone Nn
CITY GF FRIDL EY INSPECTION DIV. Effective On January 1, 1993
6431 University Ave NE
Fridley, MN SW2, APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, �
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS -1'7 D ZA�.
RATE §CHEDI&E
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
FurnaC&Jbkl and Duct Work, Burner — a0 rulings of the Building Division, and hereby declares that all the facts and
Als epla arca mac $ 20.00 %,O i representations stated in this application are true and
`
Gas Piping (Needed with new fumace) $10.00 $ G�
Gas Range
OWNER U
$ 10.00 $
BUILDING USED AS G:7
s 10.00
ESTIMATED COST-
PLUS
OST
PERMIT NO.77
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be piaced in a side yard without
written permission from adjoining property owner.
f
, e
HEATING COMPANY'
Signed By
Date
� 1
t ,�s
�tc::t, L.VJJ �.na.�.vc.at�tJtvJ---«tlL3�lCl.y=hHtVtll,lVtV`trViyt!"Hlyt -- J'111VlVCft1'UU3,MIN1VES0TA
tVeatherstrips I A.S.11.UE Consttuetion No. Insulation --
_ Guide
Windows Unors Refet•enc@ Out. Woll, Int. Wall Ceiling Roof Floor Kind flow Applied
Yes -No Yes -,No- 1g _ _--- - _ .
~Rooml Length Width f-Idi ht M. Room Length Width_ __ t{eight.
Windows and Doors - Cracka a and Area Windows and Doors -Cracka a and Area
No. Width Ifeight No. of Lineal ft. Area. ¢'�—-"-
/ rtf No. Width Height No. of Lineal ft. Arca.
of pane of pane lights of crack sq.ft. -rpA f or pane of pane lights of mck sq. ft.
14V ed
- 1� r 0 .
l
_. J_. J_:12 1__11
lnrlt►atinn
� �ihcg
F -p, wall,-
Net
all_-[et exp. Nall
lilt. wall
Cail. or floor
Toml nttt.
Requited sq -ft. E.D.R. or sq. ins. W.A. Leader oft
Windows and Doors. Cracka_ a Ind Ared
- No. 1 Width Itelght No. of I Lineal k Atei.
I of pane of pane lights of crsek I tq.ft.
fnfill.MliRn _
exp, wall_._
Viet exp. wall
lilt. will
1-61. or floor I
Void Bbl.
i ,- hilted sq. ft. R.D.R. or sq. ins. W.A. Ledder area
•._..i�u...Ya u�tu L/VVt i -
l im rsa
G anu mea
tin.
j
WMth I Itelght
of pane of pane
No. of
light§
Lineal ft. Area.
of etack sq.ft.
infiltration
t MissNr
F x p. wall
. tet exp. wall
lilt. wall
Nr
.rA-_-or floor fi15SU
,,,..► ata.
+irtcu ,+l.ft. F.D.R. or sq. ins. W.A. Leader ared
Infiltration _
Glass
Exp. wall _
Net exp. wall
Int. wall
Ceil. or floor
Total Bin.
i
E.D.R. or sq. ins. W.A. Leader area II
Room Length _Width_ height -
vtnuuws and Doors - Cracka a and ArEa _
Ne. Width f Leight rNo. of I i_ine.i W Area
or pane of prate light3 or II crack II sq. R.
Coef. Btu --
Cmf. Dtu
infiltration —
Class
Exp. wall — --_ --- - - -:
Net exp. wall
int. wall
Cell. or floor
TOW Biu.-
ttequited sq.ft. E.D.R. or sq. ins. W.A. Leader men 1 —,
G
W
hLJ— Room.�entrth.___ Width Neit!ht
Indows and Doors - Crack nee and Afeaj______..'_.'__
No. WidthT height Nn. r[ Lineal tt. I Are,. I
of panel) of parte I lights of crack I sq.ft.
I I I I(:oef. Btu
Infiltration --- -
tllass------•
I;xp. wall — - -
Net ekp. wall _^
lilt. wall - --
Cell. or floor J
Total Btu.
Required sq.ft. E.D.R. or sq. ins. W.A. Leader area
Building
$
BUILDING
See Back Page for Fee Schedule
Plan Review
Permit No _29!P1 - 0 _-�
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
$
`mss , 00
Received By: i�A
763-572-3604
$
CITY OF FRIDLEY
.0005 x Permit Valuation Minimum $.50
License Surcharge
Date Rec'd: '_:�_ —
763-502-4977 FAX
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
EFFECTIVE 1-1-09
ft + 6 ft = ft x $21 =$
Erosion Control
DATE 1d YOUR E-MAIL ADDRESS
$450 Conservation Plan Review
SITE ADDRESS
$
Fee Determined by Engineering
THIS APPLICANT IS:
❑ OWNER ONTRACTOR
Agreement necessary ( ) Non Necessary ( )
PROPERTY OWNER/
NAME:
,° �'
Make checks vavable to: Citv of Fridlev Attach Stiuulations
TENANT
C
ADDRESS: I`GiTYSTATE
74'►zIP
PHONE: —
i
CONTRACTOR
NAME:�G
SUBMIT A COPY
YOUR STATE LICENSE
STATE LICENSE # Z3 � v EXP DAT
AND CERTIFICATE OF
ADDRESS: %
CITY
STAT A ZIP
INSURANCE
PHObIE FAX
— 3 -3G — a -
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED IMINDOWS
❑ BASEMENT FINISH❑ROOF [I DRAIN TILE
❑ DECK +CSSI \DING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
®1IAINTENAN PAIR I 9 ❑ REMODELING
DESCRIBE WORK BEING DONE: / a�
SIZE OF IMPROVEMENTILI'
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
3�
/
FOR NEW CONSTRUCTION INCLUDING DECKS,
y
.
M It
ADDITIONS.
& PORCHES SUBMIT:
❑ Aluminum
inum
�o
C9'frim
1.
Site Plan/Survey showing the existing structures
❑ Other
ascia
and proposed project.
WINDOWS
2.
3.
Two sets of construction plans
Energy
IN
IN EXISTING OPENINGS es
❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED v ( NUMBER OF WINDOWS o� G
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ le 3C_a OCCUPANCY TYPE
Permit Fee
$
i , :25'
See Back Page for Fee Schedule
Plan Review
$
/'
65% of Building Permit Fee
Fire Surcharge
$
`mss , 00
.001 times the total job valuation
Surcharge
$
(0t,00
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
'&
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
,° �'
Make checks vavable to: Citv of Fridlev Attach Stiuulations
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 application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.(J Q� �� ) �j
SIGNATURE OF APPLICANT PRINT NAME : f / /�-[ X2 V DATE �� /