PRE 2010 DOCSDate:
Owner,
Addres
City of Fridley, Minn.
BUEMING PERMIT
No
(5::17j)'
uilder
.ddress
LOCATION OF B} ING
No.
_..._ fr _. _. Part of La - -
_ S eet
-L_._
Lot _ .__ Block Addition or Sub -Division._
Corner Lot _ _ Inside Lot d" Setback _ _ Sideyard
Sewer Elevation _ _ _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To Used Vis•
Front Depth _ p Height sq. Ft. Cu. Ft.
_ 5—r"-40
,.P
Front Depth Height -/-40--Sq. Ft. ..� � Cu. Ft.
Typev f Construction Fast. Cost` _ - o be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set. forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee .of $ , permit is hereby granted to.._.....
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
Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
eo
PM XPuilciing Inspector
NOTICE:
This permit does not cover the construction, installation for wiring,: plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these Items.
-- 4
r—
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Owner I shame
Builder
Address Address
< LOCATION OF
No. �/� Streeter^--�'��-� /�.�!o Part of Lot
Lot _ S Block Addition or Subdivision
Corner Lot Inside Lot Setback _ Side-Yard,,��`
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front Depth ght�___
a
147 ron _Pep�
VSq. Ft. `� ® Cu. Ft.
Type of ConstructionEstimated Cos �—
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 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. / ll
(A Schedule of Fee Costs can be found on the Reverse Sid
City of Fridley
Apps cation for Plumbing and Gas Fitting permit
Dept. of Bldgs. Phone SII/j,7
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
. PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
.,
a
x $1.50
$
Future Fixture Opening ................—;f
Z F
1.20
z Z}
N
O
J
O
Z
�U'
•
r
WATER HTR.
Water Heater (Up to 200,000 BTU)
......,Z x
2.00
�
j
a �
3.25
in
3 �
o �
RATES TOT
AL1st
�7 �
Qom+
� �
�U' 4a
O
F
N
GAS
ELEG
rn
;
Gas Range to 200,000 BTU ..............
x
2.00
$
LL
Base
/
1st
2nd
_
3rd
4th
• Future Connection Openings
C°nnected with
Sewer �
New .Fixture, Old Openings
Cesspool El
. PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x $1.50
$
Future Fixture Opening ................—;f
x
1.20
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU)
......,Z x
2.00
$
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
NO.
RATES TOT
AL1st
3 Fixtures ..........................
x
$1.50
�—
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description........ $
.............................
TOTAL FEE
City of Fridley:
The undersigned hereby .makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Blinn / 19=—
Owner -� C�� �� e--xJ 'd�)
Kind of Building _
Used as
To be completed about
Estimated Cost,
Old—New. Building Permit
ROUGH "' - 't.t- - 4
FINAL
d z 2M 749
No. Z6-3 —3 6
Business % one No.
d'
1 Application for Power Plants and Heating. coalin Ventilation '
I� APPI g. g. . Refrtgerction and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
.GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ................. .
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $_
2.00
$
5.00
$
5.00
$
2.50
$
Furnace Shell & Dines—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water ................... 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $_
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN IDEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
REMARKS:
See Fee Schedule ,
TOTAL FEE $
Dept. of Bldgs. Phone
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
l X "w"IN.
im
Kind of
Used as
195—
To be completed about
Estimated Cost, s-
Old—W6 Building Permit No.
DESCRIPTION OF
BEATING or PO team, Hot Water, —No
Trade Nam Size No '2 f
Capacity Sq. Ft. E.D.R.BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name Size No
Capacity. Sq. Ft. EM.R BTU H. P.
a0fooll POST IM -12-58
No_ ZU'4-
SUBJECT
PE
City of Fridley
3 3 2 5 2
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
/
_
r PROTECTIVE INSPECTION SEC.
���..J
E
1
NUMBER
IEEv
DATE
PAGE of
APPROVED BY
I 1 CITY HALL FRIDLEV 55432
' 763-571-3450
910-F15
11/13/02
10B ADDRESS 129 Rickard Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Gartens Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Peter Herlofsky 129 Rickard Road NE
763-574-9130
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Cedar Valley Exteriors 1700 93 Lane NE, Blaine, MN 55449 763-755-2221
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20177285
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (20 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
i Inspection Cub
WillBe Mailed
ro
To Homeowner To, t
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,315
$1.16
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-
$83.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire SC $2.32
PLAN CHECK FEE
TOTAL FEE
Lice e SC $5.00
$91.73
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI
EN PROPERLY VALIDATED THIS IS YOUR PERMIT
INSP PATE
SIGNATURE OF OwNER,IF OWNER BUILDERI IDATE,
JUN -24-1998 11:48 FROM CITY OF FRIDLEY TO 8959962 8.01/04
141✓w t i .........
ADDN [ I �CIT'Y OF FRIDLEY
kLTER [ ] ��� SINGL9 FAMILY AND DUPLEXES R-1 AND R&17Y OF FRIDLEY
�z BUILDING PERMIT APPLICATION 6431 UNIVERSITY AVE. N.E.
(p FRIDLEY, NIN 55432-4384
-onstructionAddress: _ ` C�
zgal Description:
honer Name & Address: Tel. N 57q —1' 1--2')0
:ontractor:� fet'l MN LICENSE 11� f v�
.Address:./ Tel. 1/ -6
Attach to this application, a Certificate of Survey of the
10t, 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: LengthT i th HgVGround Sq. Ft.
DTHER: A `
.onstruction Type: Estimated Cost: $
(Fee Schedule on Back)
)riveway Club Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
)ATE: APPLICANT: Tel.
TOTAL $� ,
;TIPULATIONS:
.,A
110
CITY USE ONLY
'ermit Fee
$ 3: Z'
Fee Schedule on Reverse Side
:ire Surcharge
$
.001 of Permit Valuation (1/10th%)
tate Surcharge
$ /, / �_
$.50/$1,000 Valuation
;AC Charge
$
$1000 per SAC Unit
.icense Surcharge
$
$5.00 (State Licensed Residential Contractors)
)riveway Escrow
$
Alt. "A" or Alt. "B" Above
;rosion Control
$
$450.00 Conservation Plan Review
'ark Fee
$
Fee Determined by Engineering
;ewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $� ,
;TIPULATIONS:
.,A
110
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical -Permit#
Residential Application
City of Fridley
See Back Side For Required Information
Date Y -I %, Cdr Site Address:
The applicant is: (cirlce one)
Owner ontrac
Property Owner:
Address:
City:
State: / Zip:
Phone: 14d
Cell: Fax:
Contractor Information
Company Name:
Contact Person:
ddress:{
Address:—/--
City:
City:
State: Zp:
Phone:
Cell: Fax:
Email:
MN Bond# & Exp Date
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work:
&P
Equipment Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU:
Please check all that apply:
_Fireplace (gas) $15.00 New Gas Grill $10.00
_A/C $25.00
_Fireplace (wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00
_Boiler $35.00
_Gas Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10.00
_Gas Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00
Permit Fee $ 3 (Total from above -Minimum fee $35.00)
Surcharge
0.50
Total Due $
Make check payable to City of Fridley
This is an application for a permit- not valid until processed
I hereby apply for a mechanical 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; that the work will be in accordance with the
approved plan in case of all work which requires review and approval of plans.
Signature of Applicant: /� Date: /SI
Approval Inspector Signature: Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Revised 6/14/2005
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
FROM :City of Fridley
Building
Inspections
763-572-3604
763-502-4977 F
T)ATL:_— -2f U
SrrN ADDRESS ,•—
THUS APPLICANT IS:
OW NE.R/
TENANT
CONTft ACTOR
SUBMIT A COPY OF
YOUR STATE
1,1cENs -, BOND AND
CERTIF]CATE OF
INSURANCt.
PERMIT TYPE
TYPE OF WORK
DETAILED DHSCR'
Eel
PFR MS 1613.665 the I
improvement, installat
Labor cost under $300
FOR PROJEGIS WHF:RC
NUMBP.R OF EACH BFT.
_ BATH SINK/LAV
_ BA: rHTUB
CLOTHES WASHER
DISHWAS HER
FAX NO. :7635711287 Feb. 15 2008 12:55PM P2j
PLUMBING Pe=rmit Nn.. 114. '
RESIDENTIAL APPLICATION pel:eived Tay: ! —
OF PRLDLEY am
Glu--- 200(cCITY
11 AI>DDRI`-SS��
VNER CUNTRAt: I OR
CITY_—
ONL-:
J da: —FX
COMWO40" E
Ifl� X•P DATE_
A•fE L10E'NSF.. #_ — � HATE _.
ATF BOND N _ •— 1'TATh� Z(H _, —
)ORESS: Y —
IONP.—
.y�
SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE - — —
❑ NAW •�• REPi.ACEMENT — — — .— — —• — — —" _
[ON OF WORK _ , l-� l.� — — —. _—. +_ _• —
rmit fee is a minimum of 515.00 or 5%a of the total cost up to Sjoo.00, whichever is greater, for the
ement orn residential fixture, excluding the fixtures. (This should reflect only the cast of labor)
n or replac
x .05:- —, — plus .50 suTcharge
S 15.00, Labor cost between $3oo to S5oo cost of labor _ ,—
OR
BOR EXCEbDY $500, FF.BS' ARE BASED ON E:, E
S10.001'FA FIXTURE:, WHERE NOTED. FIXrURFS: (INDICATE• 'I'UTAL
0. MINIMUM FL -F $ 15.50. - SHOWER _ WATER PIPINO -
-rLOOR DRAINS SHOWER U F'001. WATER SAtTNER (5.i5)
_GAS PIPING(NOV CITY LIC) —WA1'GRC:IAStir ~'-RACKPLOWPRL•V.515)
KrrcH_ LALIN R TR WATER JIEA'n!R ($35) " OTl IEROR RIGATIUN
_ - LAUNDRY 'PRAY WATER METER —
Pe�mitFer $ — __ Number of fixtures (a 510.00 _ x $10.00' $— —•
_
Surcharge ...50 NuFnber of fixtures (r� T 15.00 — x $15.00 S—. _—
r— TAL DUE $ — _, — AR Number of fixtures 533.00 _ X rcharg3 5.00 $
State Surcharge = S�
�IMUM 515.40 — �MINTMliM 5]5.50) Total
•1 -HIS IS AN APPLICATION FOR A PERMIT-N(Tf VALID UNTIL Pft(-X; 5F.0
I h0eby apply for a plumbing pennit and 1 acknowledge that tic information above is complete and accurate; that the work will be in
conformance with the Drdinances and codes of the City of Fridlcy and with the Minnesnta Construction Codas; that I understand this is
not a permit but only n applicati for a permit work is not to start without a permit on site; that the work will be in accordance
with the approved play in the eas Of Il work w i uues review and approval/Aof�flflpiups.
SIGNATURE OF PP _PRINT NAME
l/l. vVl �• DA'11; a
— , DAFT
APPROVED RY,— — — — —
City of Fridley
Building InsPeetions Department
6431 University Avenue NF., Fridley, MN 5 32
763-572-3604
FAX: 763-502-4977