PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3619
Date: .. :... ..-....... �.........
Owner ....................................... Builder.......... .s .......................
Address ...................................... Address ................. ...........................
LOCATION OF BUILDING
No. 540 0.... Street.. C.�.�........... .. !..f! . ..... ... art of Lot . .. ..............
..
Lot ...®.... Block ............... Addition or Sub -Division!. ..... .....
Corner Lot ............ Inside Lot .,C......... Setback . .. Sideyard ...................
DESCRIPTION OF BUILDING
To be Usect as.
... ..... Front � . .. Depth �� .. Height Sq. Ft. Cu. I't.
.... Front ....®
P ��.:�� 'Depth fir, a� Height �.�.: � sq. Ft. Cu. Ft.4.�.
Type of nstruction ................... 11kt. Cost..4 ( ''.. �—"� To be Completed ..............:... .
In consideration of the issuance to me of a permit to construct the building desribed 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. a
X . ........... 0 Jam' . r:.:$ ............. .
In consideration of the payment of a fee of $ ....., permit is hereby granted to ...................
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
...... Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for vfiT, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE
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
MECFL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00
each add. 60,000 BTU ....................... 2.00
Replacement of Furnace ............................. 5.00
Repairs & Alterations --up to $500.00 ................. 5.00
Repairs & Alterations each add. $500.00 .............. 2.50
STEAM or HOT WATER SYSTEM
Furnace Shell & Linea—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. IDR Hot Water .................. 2.50 $
OIL BURNER to 3 gal. per hour ........................ 5.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00
$�
GAS PIPING (Up to 3 Fixtures) .......................... 1.50
$�
(Add 50c each over 3)
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE
Dept. of Bldgs. Phone SII 4-7470
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�7 true and correct.
Fridley, 195
Owner
.195—
Kind of Building
Used as
To be completed about
Estimated Cost,
Old— w. Building Permit No.
195—
DESCRIPTION OF WORK
HEATING or P to Hot Water, Warm Air—No
Trade Nam �y Size No -'�)y �)
Capacity Sq. Ft. E.DR BTU H.P.
Total Connected Load Kind of Fue]
BURNER — Trade Name Size
Capacity Sq. Ft. E.D.R BTU H.P.
Siga
sy
oOlElo-
11 POST IM -8-58 Business Phone No
City of Fridley, YHnn. N° 8770
BUILDING PERMIT
Date: APRIL 142 1966
Owner: M. W. 14MRS Builder NORTH STAR, BUILDERS
Address 560 Rice Creek Terrace Address 5738 Garfield Avenue South
Fridley, Minnesota 55432 Minneapolis, Minnesota 55419
LOCATION OF BUILDING
No. 560 Street Rice Creek Terrace Part of Lot
Lot — 10 ._ Block 3 Addition or Sub -Division . RICE CREEK TERRACE, PLAT 4
Corner Lot . _ Inside Lot — Setback _ _ Sideyard
Sewer Elevation _.._ Foundation Elevation
To be Used as:
BASEMENT
REMODELING
DESCRIPTION OF BUILDING
Front Depth . _ Height Sq. Ft. C tL Ft.
Front Depth Height ____ _ _ Sq. Ft. _ _ Cu. Ft.
Type of Construction Est. Cost _ 900.00 To be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
thN Proposed work in accordance with the description above set forth and in compliance with ail pr ns of
ordinances of the city of Fridley. l�
In consideration of the payment of a fee of6S • 00 , permit is hereby granted to NORTH STAR
to construct the building or addition as described above. This permit is granted upon
the express condition that the peon 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, alteration, maintenance,
conform in all respects to the ordinances Of
Fridley, Minnesota regarding t constr� revoked mat any, times upon violation of of theand �Proof bvlsion of said
calor an� city limits and this
ALLEN G. JENSEN Building Inspector
NOTICES
rob por o t does not aowr the aonotruWoo, hatalhWon for wlrinB, pWaibInB► ®a hodh2& eewe# or woter. Be wro to me
the Bulldlao Inepoeter for wpmeo ponelts for thea Nona.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NANE,�If�BUILDER_
C
ADDRES S -T�t� o ADDRES.41
LOCATION OF BUILDING -
NO.) STREET PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION y 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
Sq. Ft. Cu. Ft.
Type of Construction �, a stimated Cost q C9
To be completed _ y
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. a
DATE_Uyto,/ SIGNATURE
T
(Schedule of Fee Costs can be found on the Reverse Side).
CITY OF FRIDLEY�
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
m,
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
k
0
$
Water
x
$2.00
$
Q
x
$5.00
$
c 14
Q7
Q
$
y
pa
w
b
Water Softener
Heater
u
u
rA 14
x
Qf
$
E+
•a rt
$4
$
N
ro N
P
1st 3 fixtures
kQ)
$3.00
.i
Q)
rS
$1.00
C
N
'
x
X Aj
C
a
la
C C
U •�
0
U
$5.00
$
each add. $100.00 or fraction
H
U 7:
$
State Surcharge
$ .50
TOTAL FEE
0
C
° u
a
w
3
A w
W
w
rd
U m
3
rd
o
as
lec
Cn
a�
1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 7, C -D
REINSPECTION FEE
($10.00)
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn.
OWNER ► f�'7 lT �/ 6�t
KIND OF BUILDING�A or
USED AS d LJ G -C. C i —6
TO BE COMPLETED ABOUT e�
ESTIMATED COST
OOLD NEW BUILDING PERMIT NO. PERMIT NO.
Company Co
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT �, 7e
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
SUBJECT
MI
City of Fridley
7
08
AT THE TOP OF THE TWINS
BUILDING
P E R M I
_
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
17 J P
1 I
=
1 /"'1 CITY HALL FRIDLEY 55432
'`j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/25/85
JOB ADDRESS 560 Rice Creek Terrace N..E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat
4 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Maurice Meyer 560 Rice Creek Terrace
571--8742
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
D & D Home Improvement, Inc. 7401 Central Avenue N.E.
784-7543
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 C1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof . Dwelling and install aluminin tr9am
9 CHANGE OF USE FROM 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
$3.70
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,400
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-
$68.50
STRUC N OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
�r
�giy
r fi.l
$7.2.20
S76NATUREOFCO RACTOROR HORIZEDAGENT f ( FATE)
WHEN PROPERLY VALP#TED THIS IS YOUR PERMIT
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI -
BLDG INSP
ATE
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: �(f�
Legal Description: 407L Ay i A` 5 A',�L Lhek f£'xne, �/,-
Owner Name & Address: /�'i�It'� 1. /''/- `�� �� Tel . #
Contractor: �f- /ys��%1hy/i'r/r�� —�Tel . #
Address:
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:
DECK AREA:
OTHER:
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Ae-10®� AIR 6 Estimated Cost: $ ��"� .5p
Approx. Completion Date:��`�
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �� APPLICANT: Tel. #7zo`7`Sv_?
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Hain Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
1
SUBJECT
PER
City of Fridley
142
18121
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT .
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 CITY HALL FRIDLEY 55432
1.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
17/19/85
10B ADDRESS 560 Rice Creek Terrace N. E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
10
3
Rice Creek. Terrace Plat 4
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Maurice Meyer 560 Rice Creek Terrace N.E.
571-8742
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Donnelly. Stucco Company 2310 Snelling Avenue South 55404 722-4200
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
Restucco House & Garage
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
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
1 ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1.02
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,040
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$38.50
PLAN CHECK FEE
TOTALFEE
$39.52
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERL VALIDATED THIS IS YOUR PERMIT
BLDG INSP
f1AYA
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] City of Fridley Effective 4/1/84
ADDN., [ 7 R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: 560 P-Lce Cxeek Teirhaee
Legal Description:
Owner Name & Address: Ma -rice Meyer (Same as above) Tel. # ;71-9 U9
Contractor: vonnetty Stucco Company Tel. # 722-4200
Address: 2310 Sne,P.Pina AVPoup onth --
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: Re ,stucco oA hou-se and CaAaae 170i1aad,& --
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: St n Estimated Cost: $ 2,040.00
Approx. Completion Date: 8-1-45
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
.� #
DATE:—7-9-85 APPLICAKTr-'�Tel.
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Plan Check $ rte' 25$ of Building Permit Fee
State Surcharge $ 1*o "%w $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS:
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,
572-3604 REFRIGERATION AND AiR CONDITIONING SYSTEMS AND DEVICES
ist
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 20.00 $
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $ 10,00 $
Gas Dryer $10,00 $
*Air Conditioning — All Sizes $10.00 $
All Others/Repairs & Alterations (LIST QN BACK�y
1% of Value of Appliance or Work S �l��(��� $
Commercial/industrial
1 % of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEAT] big/COOLzINGNENTIL ATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS -T -HE 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.
JOB ADDRESS_<ro® AC-er 1_&WA Oe �
The undersigned hereby mikes 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,
,1993
OWNER
BUILDING USED AS
ESTIMATED.COST rS���� PERMIT NO.�
K :. •l i :ZR01 la► .
No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade NameA-��r— Size No.
BTU ®0 HP EDR
HEATi N
Signed
'AJ VL_
Approved By ® Rough—In Date Final Date
/ k1
FiLL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
I.
Has been carefully examined
Yes
(
)
No
(
)
Z.
Is free from rust or -deterioration
Yes
(
i
No
(
j
3.
Has no foreign objects lodged within
Yes
(
j
No
(
)
4.
Is securely supported
Yes
(
j
No
(
)
S.
Meets all current Code requirements for
size'and total BTU's connected
Yes
(
)
No
(
)
6.
Has total heating BTU's of
All other BTUIs
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
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,
572-3604 REFRIGERATION AND
AIR CONDITIONING
SYSTEMS AND DEVICES
/J
JOB ADDRESS ®-Gc-�
RATE SCHEDUii,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
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00
$
representations stated in this application are true and correct.
(Side Vent — Fill Out Back)
' 994
Gas Piping (Needed with new furnace $ 10.00
$
-'Ga—s—fra-rige $ 10.00
$
OWNER
BUILDING USED AS
Gas Dryer $10.00
$
ESTIMATED COST/ 7 t5y PERMIT NO. L11
*Air Conditioning — All Sizes $10.00
$
DESCRIPTION OF FURNACE AND ORBURNER
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/industrial
BTU HP EDR
1 % of Value of Appliance or Work
$
Fuel Total Coginected Load
State Surcharge
.50
B mer Tr e Nam Size No,
1$ � ' S�
BTU HP EDR
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATIONIAIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HEATING COMPANY
Signed By Tel No. S& 7 `4-
�WRough—In
Approved B Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
CHIMNEY AND STACK YERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes {) No { )
2.
3.
4.
5.
Ei
7.
8.
Is free from rust or deterioration
Has no foreign objects lodged within
Is securely supported
Meets all current Code requirements for size
and total BTU's connected
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Has a liner been provided for water heater
Has combustion air been provided for water heater
Remarks:
HEATING CO:
Signed By:
Date:
Yes () No ( )
Yes (}No{}
Yes () No { }
Yes ()No()
Yes No
Yes () No ( )
CITY OF FRIDLEY INSPECTION DIV. Eftedtive.On January 1, 1995
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT".
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Water.,
Bath
Wash
$7.00
Flooratc Auto.
Gas`a
Beer Dispenser
Gds Mise. ;Water
Heater
Stories Closet Urinal
Tuh' Shower in
I lay
Rain Water Leader
Drain Washer
Sump/Receiving Tank
$7.00
IF p
Gas Elec
Basement
I
1T
0
$10.00
Gas Range
$10.00
Gas Dryer
$10.00
Back Flow Preventer Required )Yes No
11 N
$5.00
Floor
M.E
"
lcla
Floor 2
R!
FTill
lo orS
ii;
!til li.
III
9;I fill.
- i5z, j!
Floor 4
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$7.00
Old Opening, Now Fixture
$4.00
Beer Dispenser
$5.00
Blow Off Basin
$7.00
Catch Basin
$7.00
Rain Water Leader
$7.00
Sump/Receiving Tank
$7.00
Water Treating Appliance
$10.00
Water Heater –Electric
$7.00
Water Heater – Gas
$10.00
Gas Range
$10.00
Gas Dryer
$10.00
Back Flow Preventer Required )Yes No
Type —
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
I% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $_()
JOB ADDRESS C)
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 d-ecfares that all the facts
and representations stated In this application'are true and correct.
1995
Owner
Building Used.As k S-�de. Q e -
Estimated Cost PERMIT NO. 13 9v
(D
PLUMBING COMPANY
SIGNED BY TEL NO. .7 S
Approved By Rough–in Date Final Date
J4r
MINIMUM F ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE -SURCHARGE
SuB.,ECT
PERMIT NO.
City of Fridley
17 8
P, AT THE TOP OF THE TWINS
BUILDING PERMIT
m
Ir
i • _ COMMUNITY DEVELOPMENT DIV
L
PROTECTIVE INSPECTION SEC.
® '
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE of
APPROVED BY
612-571-3450
910-F15
6/16/97
JOB ADDRESS 560 Rice Creek Terrace NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10
3
Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Maurice Meyer 560 Rice Creek Terrace NE 757-4754
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Donnelly & Peterson Inc 12351 Cloud Dr, Blaine MN 55449 757-4754
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
24 Sq.Yds redash; 4 Sq.Yds patching (Stucco)
9 CHANGE OF USE FROM 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
1
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
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$2,100
SXM $1.05
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-
$74.75
Fire SC $2.10
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$77.90
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT I IDATEI
WHEN PROPERLY LI DATED THIS IS YOUR PERMIT
BLDG 1NSP gaTE
SIGNATURE OF OWNER0F OWNER BUiLDERi
'DATEi
NEW [ l
ADDN ( ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: to
Owner Name & Address:
Contractor:
Address:
Effective 1/1/97
Tel. # 2 S 2- C/ Z.5 -
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWROVEMENT
Tel. # ) �% ` %` A5-
LIVING
S
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
OTHER:
Length('
_ 7 � c
A Width , Hgt/Ground J
• yd' S �a s !� L%
Sq. Ft.
Construction Type: (JCC O Ike i /' Estimated Cost: $ �'
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
J
DATE: % % APPLICANTi 1 ��a n 7'-e��t Tel. # 75-7-
C '
5 -7 -
CITY USE ONLY
Permit Fee
$_
Fee Schedule on Reverse Side
Fire Surcharge
$-,)/0
.001 of Permit Valuation (1/10th%)
State Surcharge
$-----/ pS
$.501$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:
/
SUBJECT
P qfMIT N
City of Fridley
2 3 8
AT THE TOP OF THE TWINS
BUILDING PERMIT
� �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
_
` -_
L PROTECTIVE INSPECTION SEC.
1
Cd
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7-10-98
JOB ADDRESS 560 Rice Creek Terrace
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
3
1 Rice Creek Terrace Plat 4
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE.
571-8742
Maurice Meyer
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Citywide Hime Imp, 1005 W Broadway, M is 55411,529-2489. 3013
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
B DESCRIBE WORK
Roof tear-off (27 Sq)House & >i€1;Garage
8 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
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
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
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION Sof
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
�' $ 1 13
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
v
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION,
PLAN CHECK FEE
TO AL FEE
$83.13
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
N P OP V LID THIS IS UR
BLD INSP
FRT��
)ATE
SIGNATURE OF OWNER OF OWNER BUILDER] IDATEI
NEW
ADDN
ALTER
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 8/l/95
Tel.
MN LICENSE #
Address: ' L'u Tel. # _ < -
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:
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: r .� Estimated Cost: $ _
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: F + 6 Ft = Ft x $ = $
DATE: r APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Schedule on Reverse Side
001 of Permit Valuation (1/10th%)
$ , / $.50/$1,000 Valuation
$ $850 per SAC Unit
$ , d� $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering .
$ Agreement Necessary [ ] Not Necessary [ ]
$ 1
I