PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N? 2923
57
Date G ��..�.�l................. �'
Owner.. �......... . ..... Builder ..� ... .......... .............
c �a
Address .® /... °.........� .............. Address ®. ........... . ate`. t .
LOCATION OF BUILDING
b
No. �p,�f Part of Lot ....' ............. .
.. .. Street .. .. .... ...........
Lot ... /0 ........ Block ... /........... Addition or Sub -Division &.14k
.. .
� � r
Corner Lot ............ Inside Lot ...... ^. Setback ....�:. #r Sideyard
_ ";.
DESCRIPTION OF BUILDING
To be Used as:
✓�/
• Front .. Depth. height Sq. Ft. �� (. �;. J Cu. Ft.
to
Front ®� Depth e fi� .. Height .... Sq. Ft.Cu. Ft........ .
Type of Constructi Est. Cost . , .... • , To be Completed ...
�,4RAN 1W.Wffl
PIP1
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 village of Fridley.
X.. ....... .. ......
In consideration of the payment of a fee of $. ,%.15ermit is hereby granted to ..� ..
...................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of -y of the provisions of said
ordinances. �7
R d" �'i - • • ..IN ..�' /I.FS f � • � .R�LUll�lls lOjJGli
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, p ng, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these i ems.
SUBJECT
PE712958
City of Fridley
1
®
AT THE TOP OF THE TWINS
BUILDINGPERMIT
r
RECEI .
`L ______ COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC.
�
CITY HALL FRIDLEY 55432
`-_--
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
A `,
L J` 612-560-3450
910-F15
5/22/75
JOB ADDRESS 201 Rice Creek Terrace N.E.
1 LEGAL
LOT N0. BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
lO 1
Rice Creek Plaza South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Richard A. Kroger 201 Rice Creek Terrace N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N07
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION EX REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Fire Repair
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
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.
$6,000
3.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE'GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-.
$36.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$39.00
RAI;TORO UTiORIZEDAGENT (DATE)
AT THIS
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT A
k,,�-�-___S_1G_P;7kT/URFCO
/f
SIGNA RE OF OWNER IIF O N R BUIL 1 IOATEI
BLDG INSP DATE ✓ - -
APPLICATION FOR RESIDENTIAL., ALTERATION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME�,a?-d , BUILDER
ADDRESS: to DRESS:
NO:. �.��/ STREET:
LOT: BLOCK: / ADDITION: iL C`�c`� .'%L -)e/-) 'So
�iJPJiV'
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:
1— I Front:
Depth: Height:
Square Feet: Cubic.Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $ 6,066
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.
DATE: SIGNATURE -
(See Aeverse Side For Additional Information.)'
6 Z( !C)o
City of Fridlay
• Applicrition fc7 Plumbing c.d Gaz M'S'ag Permit
Dept. of Bldga. Phone M-3450
DESCRIPTION OF V1011
Numbaer. Kind and LoccS;en o4 Fixtures LocsR�
O
1`<
z
~
i
1?
x
r
<
Yt1
"z
g
u=
O
V
V
i
V
R
N
WATER HTR.
GAS
ELM
.�
°
°�
<
s
Bate
I
Ist
tad
_
3rd
4h
• Future Conncc! ca Opoaings
Conroctod with
Cl?Sous
eSo-war
Fixture, Old Openings
Ce2.pool C]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ — x $2.00 $
Future Fixture Opening ........... x $1.50 $—_.
New Fixture Old Opening.......... x $1.50 $___
Catch Basin .................... x $3.25 $
Water Ilea ter 'Up to 99.000 BTU).... x 53.00 $
New Ground Run Old Bldg.......:. x $.3.25 $
E!octric Water Haatar...... ........ s $2.00 $
;AS FITTING FEES: NO. RAT TOTAL
1st 3 Fixtures ............ • . x $2.00 $ .
Additional Fixtures ................ x $ .75 $
Gas Range to 199.000 BTU ........... x $5.00 8
PXPArRS do ALTERATIONS—Rater to Code
City of Fridley:
The undersigned hereby makes application for a permit for the- work herei
specified, a., reeing to do all work in strict accordance with the Cit' Cr•dinance
and ruling of the Department of Builci:ngs, and hereby declares that all the fact
and representations stated in this appL'caSion are true and correct
Fridley, Minn
Owner T
Kind of Building -
Used as
Y
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.
r
Signed
By
Business Phone No�� �—
ROUGg
FINAL
.50 State Surcharge
Description.........................................5
TOTAL I= EF: $ —
AP�;i
PIlcan for Pl;� I�-9 C d GOS .4d* r- 43 a iS
Dept. of Bldas• Phone
DESCRIPTION O? VIOIZ
NuinL r. Y.ird and Locr2 on of Fixtures
• Furi a Cor :oti'.:a Opocinrs
e Xsvr Fi:-turs. Old Oponings
PARTIAL RATE SCHEDULE
Savaz
Cc=pool
PLUMBING FIXTURE RATES:
.
3
Number Fixtures ................
1
yy
3
M
� x $1.50 $—L_,�
New Fixture Old Operting..... :....
u<
7
3
j
V U
H
V
?
N.
WATER NTR.
GAS
[LE G
Bare
15t 3 Fixtures ...............
x $2.00 $ .
,Additional Fixtures.................
x $ .75 $
Gas Range to 19.9.000 BTU ...........
x $5.00 $
1st
3:d
• Furi a Cor :oti'.:a Opocinrs
e Xsvr Fi:-turs. Old Oponings
PARTIAL RATE SCHEDULE
Savaz
Cc=pool
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00 S
Future Fixture Opening ........ • •••
x 51.50 S _.
� x $1.50 $—L_,�
New Fixture Old Operting..... :....
Catch Basin ....................
x $3.25 S
Water Heater 'Up to 99,000 BTU).. • •
_'X S3•00 $
New Ground Run Old Bldg.
x $3.25 S
E'lectAc Flatar Hsatsr..............
a $2.00 $
ZAS FITTING FEES:
NO. RATE TOTAL
15t 3 Fixtures ...............
x $2.00 $ .
,Additional Fixtures.................
x $ .75 $
Gas Range to 19.9.000 BTU ...........
x $5.00 $
�� ;c 42_ C/'
City of Fridley:
The undersigned hereby makes application for a permit for the work here!
specified, agreeing to do all work 1n strict accordance with the City O:dira tee
and ruling of the Department of Build:aps, and hereby declares that all Lhe fact
and representations stated in this app::cation are true and correct
Fridley, 9riaa -7-23 19��
Owner ' At
Kind of Building h^c1 �E_
Used as ' r—_ I I L r-
To be completed
Estimated Cost, $ 20E
Old—New. Building Permit A'o. Peron No.
By _.
Business Phone NO `7 2
ROUGH °
FINAL C Z I— ® C •
P.rPAIBS & ALTERATIONS—Rater to Code .50 State Surcharge
.Description ...... ° . s ..... • ...... • . ° °... .. • °.....° ..$���-
TOTAL FEY• +�_
p'':.:r..�� ..,c•2+. e,.� `�^'r9 z�.-ti.•.e .,-. t: *i .4 �,,.-. w� C�.�^ ��_ ...,� �"^ .^.+.,e.�°s,... ,,� ;'. ^' ._ fF3 `6'^.—F'-.�... «.,.��.
_:p +:.ami-; ... y'.,rd is k.. s. ..:.j t �i .....,.., .... i.:.s.«i ut n�a. ..ea a..•ry� 't�y„•`•L.,,; �.'s..a .ia U ....L.. e.. .r..�s ., s'd� a,:i :_ e., �_ �P°i v...J �.me..8 .�
' ,C'V„S� � wvr:�,r:JE+ViirJrr � Oia���iD��a6iJa er:ti: Ltb'S.i 4J itvti;t.,y
GRAVITY W.XnM JIM: WHIM 'ti0°;1IM
Fumzce she:I a Dvurt Work ... ...
Replacerrerit of F'°t:rnarx �=
Repairs & Alterations --up to $�500.00 600 $
Repairs & Alterations each add. 1500.00 300 �
MECE°L W R:"2M Ate%
Furnace Shell & Duct Work to 220,05:0 BTU ..$10 OD • §
ea -ch add. W.V.0 BTU . ......... 3M $
s�n°-lac-_=,ent of rurnace 5.00
& Alterations --up to ;500.00 6.00 $
il-;;afrs & lteratio-..s each add. $500.00 3.fJ $
STEAM or HOT WATER Z-YZTZA'
Furnace -Shell & Lines --to 400 sq. ft. T_'.DR Steam
$10.00
$
Furnace Shell & Line --to C40 sq. ft. EDR Hot Water
20.00
$,
Each add 200 sq. h. EDR Steam
xm
$
Each add. 320 sq. ft. EDR Hot Water
3.00.
$
OIL BUIRN R—to 3 gal, per hcur
6.00
over 3 gal. per hour --See Fee Schedule
G.F-S BUrl-WER (up to ID903 BTU)
U-3
ov�<- 2 r3,dJt2 Bs' M See rea Etch'xdula
GAS 3P23°TI2LG
:oda RATE TOTAL
Ist 3 Fixtures
X$ 200
S
Additional F9 ;tures
x ,73
Gas Range to 1€D=0
sw U*
$ —
State Surcharge
.50
l.,Y. 1 i rl , L: iii G .moi Z X.,4
-17 _Is—
TOw&L F�
-tr
� 7TH
p
lit. of B? lgz. pho w &M-123
City of Frridley:
The undersigned hereby makes application for a permit for the work herein
specified. agreeing to do all work in strict accordance with the City Or�e:
and ruling of the Department of Buildings, and hereby deck res that a1I tko fad
and representations stated in this appiicatiot3 are true and corracL
Fridley. Mr an
i r d7 / _
Kind of Building
To be completed about. Ac
Estimated Cost, $ _- :2.
fl
Old --New. Building Permit No. Permit No.
iir.RTING or POWER igY.AIMS,--.Stam, Hot Fater arrn -No
/` i
Trade Ivamy Cr/ e Size No
Capacity._._. — Sq. "F t. L.D.R Bru a Hmp
Total Connected Load Xf-d of lust
BUMMER — Tra& IlaSize Xo
Cap&city sq. FL EM Rgk"u7
Md NEGASDO
53-84-S-915.51
City of Fridley r
Applice,lan for Plumbing C'Md GOSi'��yt�:� Pbt -
Dept. of Bldgs. Phone 360-3450
DESCRIPTION OF x:011;: 201 N. F. Rice Creek Terrace
Number, Kind and Loce2?en of Fixtures R" i
rutwo eozzac:iza Oponinga
SmTros
Naw Fixture, Old Opqaings Ccrzpool
PARTIAL RATE SCHEDULE
;UMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
—x$2.00
$
Future Fixture Opening ............
x $1.50
$ -•
New Fixture Old Opening..........
x $1.50
N
Catcti Basin ....................
x $3.25
WATER MTA.
�
x $3.00
$
New Ground Run Old Bldg....:. • :.
x ".25
$
Electric Water Hoat.er...... ....... .
s $2.00
V$
9
N
GAS ELfC
n
•3
a
S .
d
.+ ��
Gas Range to 199.000 BTU ...........
. . x35.00
5
.-2
t
I
ns
all G s ri
171
tti
z
A
rutwo eozzac:iza Oponinga
SmTros
Naw Fixture, Old Opqaings Ccrzpool
PARTIAL RATE SCHEDULE
;UMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
—x$2.00
$
Future Fixture Opening ............
x $1.50
$ -•
New Fixture Old Opening..........
x $1.50
Catcti Basin ....................
x $3.25
$
Water Heater 'Up to 99.000 BTU) ....
x $3.00
$
New Ground Run Old Bldg....:. • :.
x ".25
$
Electric Water Hoat.er...... ....... .
s $2.00
$
'AS FITTING FEES:
NO. RATE TOTAL
1st3Fixtures ......••••••••••••
x$2.00
$ .
Additional Fixtures ..............
x $ .75
$
Gas Range to 199.000 BTU ...........
. . x35.00
5
City o1 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 Or•diranet
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 5-8-75 15..._
Owner Ouintena Freeberg
Kind of Building Frame -
Used as
Res.
To be completed about . 5-15-75
Estimated Cost, $ 16.o0
Old--XUWXBuilding Permit No. Permit No.
Signed
By MINNEGASCQ --
Business Phone No
ROUGH
FINAL i 1 7- _-_Z
ZPAIRS & ALTERATIONS—Rafor to Code .50 Sate Surcharge
Description .......Install• Gas• Urill .......... 5.00
• TOTAL FEE $--- '
€z s— A'" Surdlarge :fir
City of Fridley
SUBJECT
13413
AT THiE TOP OF THE TWINS
BUILDING PERM1T
�`
i
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
= "1 CITY HALL FRIDLEY 55432
IL
i"" e ,�� 612-560-3450
910-F15
3/24/76
JOB ADDRESS 201 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
1
Rice Creek Plaza South
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Richard Kriker 201 Rice Creek Terrace N.E.
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Aladdin Pools 4738 42nd Avenue North
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 ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Constructla in ground pool
9 CHANGE QF USE FROM TO
STIPULATIONS As per Health Inspector's letter to be sent.
REQUIRED FOR
SIEPERATE p-ERMITS
SIG
P�,U�A�I�6G A�iD
tjEATI3G,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Concrete
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SQ. 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
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.
$4200
2.10
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR 1-041- LAW REGULATING CON-
$27.00
STRUCTION OR THE PEA FORMANCE OF CO RUCTI
PLAN CHECK FEE
TOTA FEE
�G G
$29.10
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG. INSP DATE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT , A ATE)
-. SIGNATURE OF. OWNER pF OWNER BUILDER) (DATE)
e
- •��tj•Lll./fit 1V1V 1•VJC 1C1:JI Ij-LA I dJ\L., nua".%A .....,.,
OR AUDITION.BUILDING PERMIT
•' MINNESOTA
CITY OF FRIDLEY, ;
•
I
011MER' S NAI.it: Al C r,rb 7T i� BUILDER; dclJ Li d L_ 5
• C e, L�p pY ,ADDRESS : %n
a
ADDRESS: p?o 1 - !11 leg,
•
• TREET:
STREET:-
c
{
•
z u
�-� °
/ •ADDITION:
LOT: l® BLOCK: -ADDITION:
mt
CORNER LOT: INSIDE LOT : SETBACK: -- SIDEYAI'.D :
k
Applicant attach to this fora. n -7o Certificates. �f Survey -of Lot and.proposed
building location di -Awn on those Certificates.
DESCRIPTION' OF BUILDING
�{
e
' To Be Used As:
r
Front: Depth: Height: /�Wy
. - Squa:ce feet: Cubic.Feet:
Front:' Depth: Height:
_
Square Feet; Cubic Feet:
Type of Construction; v Z'? � Estimated Cost: yrs C�c� a
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.
• DATE: � SIGNATURE
•(See reverse Side For Additional Information.)'
•,�, U 0
,b MEL
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE March 25, 1976
Aladdin Pools
4738 -42nd Avenue North
Minneapolis, Mn.
Re: swimming Pool at 201 Rice Creek Terrace X.E.
Dear Sirs:
560.3454
or. ` 3
FRIDLEY, MINNESOTA 55432
This letter is to reiterate our conversation -of March 24, 1976 and to make
clear this departments requirements for the swimming pool construction at
the above address.
l� As discussed, two (2) skimmers approved by the National Sanitation
,j . Foundation will be provided.
2 �-As discussed, three (3) inlets of approved design for fresh arid/or
repurified water will be provided.
3�7'- As discussed, a main drain of approved construction will be provided.
4. The filter and pump shall be approved by the N.S.F< and be of sufficient
capacity to provide a minimum turnover of at least two (2) times in
24 hours. This department recommends a turnover rate of 6-6 hours.
5. A deck, a minimum of 3 feet wide and sloped away from the pool, must
be provided around the entire perimeter of the pool.
6. 'The diving area will be acceptable provided there is no overhead
obstruction.
7. A fence or other suitable barrier, a minimum of fou:: (4) feet high,
;,j,�,, hat affords no external hand or foot holds and which is impenetrable
by toddlers, must be provided around the entire perimeter of the pool.
All gates and other accesses shall be equipped with self-closing and 5
latchiTrT devices which are capable of being locked.
8. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
10:J All electrical lines must be 10-20 feet or more away from the pool
P surface.
11�!-The pool fill spout must be air gapped or protected by a vacumn breaker.
12,1 Suitable safety equipment to include but not limited to a ring buoy
and rope that is 132 times the pool diameter, and shepards crook pole
must be provided and maintained with the pool at all times.
e
„Aladdin Pools
March.25, 1976
. �.
Furthermore;, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved.contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450, ext. 170.
Sincerely,
STEVEN J. OLSEM
Environmental Officer
SJO/mh
CC: Mr. Richard Kroker
201 Rice Creek Terrace N.E.
b
Page 2
cilli
Ajlplicc5lion for Pluxrbn r9 ar:, -11S 4ib'i$i-41•9 Peral:•11
------ Dept. of Bldgs. Phone=x•3480
D£SCRIPTIOIi OF WoMr. LOC2ti
Numb4r. Kind and Locr,ion of Fixtures
• FuaWe Cc::ui. a C$4r r_r
Na%r 1 m!uro. Old 074nirsa
PARTIAL RATE SICHIEDULE
50 -War 0
C< ---pool p
City of Fridley:.
The undersigned hereby makes application for a permit for t1he• work herei
specified, a6reeing to do all t? O ^
work in strict accordance with the Ci:dir-%ce
and ruling of the Department of Buildings; and hereby declares that a3I the fact
and representations stated in this applicatiofl are true and correct, .
rridlee_ Minn �5 ^ 2 7F p )% 19-
Owner [' ,
1 -
Kind of Bti1d'ng
Used asTo be completed about —/h, % Cf %f, --- -
Estimated Cost.
Old ---New. Building Permit No. permit No.
UMBING FIXT'Jl?E RATES:
ITO. RATE
TOTAL
Sig:ted - e--
Nurn,ber FixtureS .... o ...........
e� QO g
% $2
�.s
wATER NTrt.
o !`<
a
By
5.��1
d
Iz
g3�t
o
5<
7
u
7�7
<
z
r N
cAs nEG
•�
-
Wzter Beater 'Up to 99,000 BTU?. • • •
x $3 00 $
ROUGH —
Ground Run Old Bldg....:....
_ x ;3.25 5-----
.%
iloctric Water Hoatzr..............
s $?.W $
p
QRS FITTING Flus:
NO. R; T7Z
TOTAL
° -
x $2.W $
Ist 3 Fixtures .................. ---
�- -
AdditicnaI Fixtures ................
B3S2
.
Gas R3.nge to 199.000 BTU ...........
x $5.04 L
'Surcharge
.50 State
XLTERATIOIi3—P.afmr to Code
TOTAL gT�.E S
1•:
3:d_
• FuaWe Cc::ui. a C$4r r_r
Na%r 1 m!uro. Old 074nirsa
PARTIAL RATE SICHIEDULE
50 -War 0
C< ---pool p
City of Fridley:.
The undersigned hereby makes application for a permit for t1he• work herei
specified, a6reeing to do all t? O ^
work in strict accordance with the Ci:dir-%ce
and ruling of the Department of Buildings; and hereby declares that a3I the fact
and representations stated in this applicatiofl are true and correct, .
rridlee_ Minn �5 ^ 2 7F p )% 19-
Owner [' ,
1 -
Kind of Bti1d'ng
Used asTo be completed about —/h, % Cf %f, --- -
Estimated Cost.
Old ---New. Building Permit No. permit No.
UMBING FIXT'Jl?E RATES:
ITO. RATE
TOTAL
Sig:ted - e--
Nurn,ber FixtureS .... o ...........
e� QO g
% $2
�.s
Future Fixture Opening ... • • • • • • • •
x $1.50 $ •
_.
By
Busincss Phone
New Fixture Old Opening... • .: • • • •
x $1.50 $_.___
Catch Basin .................. a .
x $3.25
•�
-
Wzter Beater 'Up to 99,000 BTU?. • • •
x $3 00 $
ROUGH —
Ground Run Old Bldg....:....
_ x ;3.25 5-----
.%
iloctric Water Hoatzr..............
s $?.W $
p
QRS FITTING Flus:
NO. R; T7Z
TOTAL
° -
x $2.W $
Ist 3 Fixtures .................. ---
�- -
AdditicnaI Fixtures ................
x 5 .75 $
.
Gas R3.nge to 199.000 BTU ...........
x $5.04 L
'Surcharge
.50 State
XLTERATIOIi3—P.afmr to Code
TOTAL gT�.E S
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN SS432
572-3£04
Effective On August 1, 1995
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS r -20I x.
New Fixtures
Old Opening, New Fbdure
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater --Electric
Water Heater — Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10:00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or:Appliance
State Surcharge
TOTAL FEE
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,
1995
Owner GrZ tir C25 X r
Building Used As ?el-- s / ,dr ti r
Estimated Cost PERMIT NO.
PLUMBING COMPANY_ /`Z D 0 >4 L 4)og
SIGNED BY � TEL N0. C% CI' Sal
Approved Bya/2 Rough—in Date Final Date
.50
Tt vv mw••wy,t
$ a0,.o PLUS THE $ SQSTATE SURCHARGE
**COMBUSTION AIR -SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
r
p �!
LEE
OUR
- I e!k s��'(���j
1 1-1.14i 'F�.!i.
P
����{pI i�
K
• • �t
��
� 1�.���'9P�!��L�illi�!���i�l ;�
:: i
� i ,
� A ��..4ii�`
-
�-�..: 9��::}=' i�ih,� •P�p�:,: i:n;y
or
sa:_E 'x .: �:!„f1.
;' Hide
p
y,
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS r -20I x.
New Fixtures
Old Opening, New Fbdure
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater --Electric
Water Heater — Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10:00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or:Appliance
State Surcharge
TOTAL FEE
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,
1995
Owner GrZ tir C25 X r
Building Used As ?el-- s / ,dr ti r
Estimated Cost PERMIT NO.
PLUMBING COMPANY_ /`Z D 0 >4 L 4)og
SIGNED BY � TEL N0. C% CI' Sal
Approved Bya/2 Rough—in Date Final Date
.50
Tt vv mw••wy,t
$ a0,.o PLUS THE $ SQSTATE SURCHARGE
**COMBUSTION AIR -SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHE!2=
Effective On August 1, 1995
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,'. 1 - - — —
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS Z C 76 g6
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner –
Also Replacement Furnace $ 30.00 $30-00
(Side Vent – Fill Out Back)
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $10.00 $
Gas Dryer $10.00 $
*Air Conditioning – All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work
Commercialli ndustrial
1.25% of Value of Appliance or Work
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.
41 / Z `7 ,1995
OWNER P%� o/ C tA'A 7;?
BUILDING USED AS
ESTIMATED COST '42� C'O
PERMIT NO.
$ 25.00 $
DESCRIPTION OF FUEWACE AND OR BURNER
State Surcharge
TOTAL FEE
$ No. of-Heatin Units Circle Ocie (Steam) (Hot Water) (Warm Air)
Trade Name C )OX) -1 Size No. W_T003/V i® �®
BTU 909W® AP4 HP EDR
$ Fuel •7" Total Connected Load
Burner Trade Name Size No.
BTU ' _HP EDR
0050
MINIMUM FEE FOR'ANY HEATING/COOLINGNENTILATION
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.
HEATING COMPANY`��COA
Signed By eC� Tel No. _0& (o
Approved By Rough–In Dete Final Date
FILL OUT BACK SIDE OR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND SICK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes (-J'No
(
)
2.
Is free from rust or deterioration
Yes (t. -f 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 0
TOTAL BTU's 0
7. Has a liner been provided for water heater Yes () No
8. Has combustion air been provid forcrr heater Yes () No
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
1-0 13c) 17r
'�} n HOUSE HEATING TL••:;T KLLUKU
ADDRESS_ CN Cre-ec<.T-e/—APT.FLOOR CITYffld(� UBUnn_.._..N
OCCUPANT 3ernym v U y �(Aw n1jwre
HEAT LOSS DATE 11TC. INST.
SOLD BY�d11p ��_— INSTALLED BY�----
ciacczicaa, Mork By JffieGJ/5L1 Cas Linc By. U� �
TYPE OF HEAT: CA FA411W STEAM ShCE 11TR. UNIT 11TR.- OTHER
CAS DESICH CONVERSION
HA};fi bp,� I�'D�C Ca�M�hlB-�2 IT eri�'� MAKE OF. BURNER
_ A 300"/C/ —�Io - j- 1,�%/��o
Serial Sf39� 7-c, 3• Z 3 3 Max. BTU Rating
XNPUT-4t@!e 4D,00c) M• .E OF FURNACE
Model
CONTROLS
Q y4
TIIERJ t0:, i., vV Heat Plug Vent Size
Valva L") � KIND OF LINEA SIZE NONE _._.
Limit 210 Draft Hood Rcrulator
Limit Setting, Filters;
Fan Setting ��- Chimney
Pilot Type Chimney
Pilot Make
T—
Size L���Sx f Number_,_
Location: 'Inside Outsidc
Construction
Pilot model Smoke Bomb Wiring
?110 t aiming q,47 = Draft Tes t Tag VViAY51i
L.W. Cut Off Door Preanure LiEhtinE Inst.
Pressure -5(V f�Percent CO2 Date Tented
Input CFNQDIda) Percent 0� Company Tcatinr 18AP,0111 _
Tq�
Stack Temp. f � 10 Percent CO llama of Tester �l�t%pad�S
Building
AND MATERIALS:
BUILDING
Permit No.: F I
Inspections
TOTAL JOB
RESIDENTIAL APPLICATION
OCCUPANCY TYPE
Received By:
763-572-3604
.mss
CITY OF FRIDLEY
Plan Review
Date Rec'd:
DATE ?✓ S—
YOUR E-MAIL ADDRESS 1 1' �'� I� Maa3+ �f 9 ` "✓G ��
SITE ADDRESS 40 i t2i
ce C �e e k Te,c r��e
THIS APPLICANT IS:
❑ OWNER _VCONTRACTOR
$
PROPERTY OWNER/
NAME: Ter4`4n �rwAroa�sc�
License Surcharge
ADDRESS: Ata l Ra �e C c�Rkk '1'eM®•� e CITY
TATEA"ZIP -S
TENANT
SAC Charge
PHONE:
CONTRACTOR
NAME:
$
/
STATE LICENSE # oic� a o -I �30'�=`+� EXP DATE V&00
ft + 6 ft = ft x $20 = $
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 241 It 1 SaLf L-� r N L..' CITY i g&VKS
.... STATE►"ZIP.'5S-W1
WITH APPLICATION
PHONE Cola- FAX
PROPERTY TYPE
)TZSINGLE FAMILY/NEW CONSTRUCTION SIZE
$
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
Total Due
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
Make checks payable to: City of Fridley Attach Stipulations
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR >JtEMODELING
DESCRIBE WORK BEING DONE: K'Vc�
SIZE OF IMPROVEMENT LENGTH /5" y al WIDTH "1 a 11
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.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
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 THE 1997
U.B.0 FEE SCHEDULE)
TOTAL JOB
VALUATION $ 10. OgDO
OCCUPANCY TYPE
Permit Fee
$
.mss
See Back Page for Fee Schedule
Plan Review
$
/
65% of Building Permit Fee
Surcharge
$
(.0005) times the total job valuation – Minimum $.50
Fire Surcharge
$
lei>,e®
.001 x Permit Valuation (1/10%)
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
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 fo 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 work whrpUires Ie and approva ans.
SIGNATURE OF APPLICANT T NAME & d ��LAJ t JI —Si Ci DATE g,13/® �—
CITY OF FRIDLEY MOVING [ ] DEMO k] PERMIT APPLICATION
64 31.0nii,ersity Ave NE
Fridley MN 55432 RECI) SEP 2 8 2007
(763) 572-3604 FAX (763) 571-1287 1M) 1- 0f 1 ---
Job Address:
Legal Description:
Owner & Address: l dam- J 1 K7 Tel. #-76S 'S -7? -8(92 -
Contractor:
7L.8(9ZContractor: Z-(DS'T-. 0" PcAs r 1A (. Tel. #
Address: . ---1A - State License # SvO5'-1- & �0
DESCRIPTION OF BUILDING
HOUSE: Length
Width
Height
Sq. Ft.
Cu. Ft.
GARAGE:Length
Width
Height
Sq. Ft.
Cu. Ft.
OTHER: Length
2— Width
Height �%
Sq. Ft.
Cu. Ft.
Estimated Cost
$_0/Lj-Z�D. 06
Approx.
Completion
Date l - 30 -
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL
BEFORE
Moving Route: /-1 w —10
�'1✓kf 'i`� lei ��. C Q 7� i
APPROVALS) REQUIRED PRIOR TO I
F
0
Bldg Official
Engineering
Fire Marshal
Conditions
Conditions
❑ Water Bill Paid: Yes[ ] or Collect[$
]Signature
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict
accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the
property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application
are true and correct.
ALL DEMOLITON DEBRIS INCLUDINGFOUN�AION& SLAB, SHALL BE REMOVED FROM SITE.
9
Date
Mo Wrecking
Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25
Accessory building into Fridley ... $ 42.00 For structures which would be impractical to
Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost
Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00
or fraction.
PERMIT FEE: ' ZPO o OD MINIMUM $2 .
Office Use Only: A-) 1 SAC -D form pled I Effective 3/29/07
�i� a 1 J �� J r✓ / �� c L�
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 " APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 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,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
Effective On January 1, 2002
$ 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 an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE %®
HEATING COr6`�Ie-
��� .
Signed TEL #
FAX # /I
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
rt> IW AJ _42526f
Approved ByAa— Rough -In Date Final Date < < NN_
JOB ADDRESS 020/
sc �ng_
OWNER
TOTAL
BUILDING USED ASs•`�
ESTIMATED COST
PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units
Circle One
(Steam) (Hot Water) (Warm Air)
$
Trade Name - e-10
Size No.
'
BTU ,_24�.
HP
EDR
$
Fuel
Total Connected Load
Burner Trade Name
Size No.
$
BTU
HP
EDR
$ 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 an
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE %®
HEATING COr6`�Ie-
��� .
Signed TEL #
FAX # /I
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
rt> IW AJ _42526f
Approved ByAa— Rough -In Date Final Date < < NN_