PRE 2010 DOCSCity of Fridley, Atinn.
BUILDING PERMIT N° 54 4
Date:+'
ot
Owner: ..... Builder V
Address _.._ _ __ _ _ _ _.._ _ Address
),�CATI ' UIL®ING
ATO." Street ;''°._.. _ y'� `rPart oUbt _
Lot _ ._.. —.._ Block_ __ _ Addition or Sub -Division !•.:
Corner Lot TY_.... Inside Lot _ .1"'"" Setback Sideyard
Sewer Elevation, _ .M _ .._ Foundation Elevation
DESCRIPTION OF BUILDING 4
To MUused
Front Depth height Sq. Ftr_ Cu. Ft
Front Depth
Height Sq. Ft.361k Cu. Ft..
Type of ction w . Esta Coe-, .� `� 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 m 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
wit ntthhe city' limits and this permit may be revoked at any time upon..vio of any of the provisions of said
ord
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, Bas heating, sewer or water. Bo sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Address
LOCATION OF BUILDING
No. IS Street Part of Lot
Lot 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:
Sq. Ft. /,Q�-Z Cu. Ft. Q
Front 14 Depth �,4 Height ® Q
5q. Ft. 150 (4 Cu. Ft. �=
00
Type of ConstructionEstimated Cost
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.
DATE / SIGNATURE
J,,
(A Schedul` of Fee Costs can be found on the Reverse Side.)
r
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
P
O
NO. RATE
TOTAL
,„
�L
Z
�n
x}
�4y
Y F
ZZ
$
Z
O
Z
tai_
at`/�
°C
O
3
�aq
m
c�
�Z
Z
z
�a
F
N
WATER HTR.
GAS
ELEG
$ �®
-Ir-.
-_
x 3.25
Q�
GAS FITTING FEES:
N
3 F-
�Q
LL
x $1.50
��
LL C
m
Q S�
(9 Q
G 4a
t9 O
$ —
®
Base
1st
2nd
_
3rd
4th
' Future Connection Openings
I
Connected with
Sewer []
Now Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
x $1.50
$
Future Fixture Opening
x 1.20
$--. a
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
x 2.00
$ �®
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures ..........................
x $1.50
$
a ► Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU .... .........
x 2.00
$ —
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ —u IZ
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, 1Vhnn / a , 191 /
Owner
Kind of Building A_
Used as
To be completed about
Estimated Cost,
Old—New. Building Permit
ROUGH - 1S
FINAL
42 2M 7-59
�I
l Appliccition for Power Plants and Heating, Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone t47,1
GRAVITY WARM AIR: RATE TOTAL Locatio
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
City of Fridley:
Repairs &Alterations—up to $500.00 .............. The undersigned hereby makes application for a permit for the work herein
... 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances
Repairs & Alterations each add. $500.00 ............... and ruling of the Department of Buildings, and hereby declares that all the facts
2.50 $ and representations stated in this applicationare a and correct.
MECH. WARM AIR Fridley, �..s 1g�
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $—i
each add. 60,000 BTU ....................... 2.00 $ Owner 195—
Replacement of Furnace 5.00 $ Kind of Buildin a!t �� 195—
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs &Alterations each add. $500.00 .............. 2.50
$ Used as
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—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 HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
It el 5-b
To be completed about
Estimated Cost, $ -N O—V
AON
Old ew" Building Permit No.
DESCRIPTION OF WORK
HEATING or P team, Hot Water, Warm Air—No
Trade Nam Size No- 21/ 0
Capacity Sq. Ft. E.B. BTU01 H.P.
Total Connected Load Rind of Fuet
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
REMARKS:
11 POST IM -12-58
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE
SCHEDULE
m
PLUMBING FIXTURE RATES:
%
w
RATE
a
New Fixtures
U4
$
7.00
- $
Old Opening, New Fixture
Water
W
N
N
4
S
w
H.
e
m
N
p
S
a w
a
o
h
S
Heater
d
61
.M.
$
7.00
- $
Sump/Receiving Tank
�a
►.
7.00
m
Water Treating Appliance
$
10.00
- $
Mater Heater - Electric
$
.Uo.
u
M
�_
a
[
.ci
a
►CAi
8
:. i
.+ N
N
in
m
10.00
a
U
a
A
2
a
Type
ow
co
w
U"a
?c9
41
ig
3
i
1
1st
2nd
3rd
4th
1R) - Future Connection Opening
Connected with Sewer
(�) - Now Fixture, Old Opening
Yater
RATE
SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$
7.00
- $
Old Opening, New Fixture
$
4.00
- S
Beer Dispenser
S
5.00
- S
Blow Off Basin
S
7.00
- $
Catch Basin
S
7.00
- $
Rain Water Leader
$
7.00
- $
Sump/Receiving Tank
$
7.00
a $
Water Treating Appliance
$
10.00
- $
Mater Heater - Electric
$
7.00
- $
Water Heater - Gas
�_
$
10.00
- $ /aur'
Gas Range
$
10.00
- $
Gas Dryer
S
10.00
- $
Back Flow Preventer Required
( ) Yes (
)
No
Type
S
5.00
- $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
19 of value of Fixture or appliance
State Surcharge 5 .50
REINSPECTION FEE $30.00
TOTAL FEL' $ /(i
Job Addre::s
Effective Uate January 1, 1991
DAHLBERG, HAROLD
132 RICKARD ROAD
FRIDLEY, MN 55432
H 571-8217 W
Building Inspection Div. 6431 University Ave NE
Tel. No. 572-3604 Fridley MN 55432
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.
—311- 9L—
OWNER AJC .C'JY1�� e1
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST ct-) / d
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
ROUGH INSP.
Date
FI:i;.L I:1SP. kq - -
Gate
APikOVAL FOR PEPMIT
Company
Signed U-1
Tel.
'WINN,��ie :l F
827-4,D33 - 027-43
MINIMUM FEE FOR ANY PLUMbl"C/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
01
SUBJECT
NO.
City of Fridley
? 4 3 8 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
Ir
_ COMMUNITY DEVELOPMENT DIV.
r ; PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
' 612-571-3450
910-F15
7/22/96
JOB ADDRESS 132 Rickard Road NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
5
2
Garten's
I
Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Harold Dahlberg 132 Rickard Road NE
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Richard Hastings 6331 Riverview Ter NE,
Fridley 55432
574-9966 4051
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 JJ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house (21 Sq) 2nd Layer
9 CHANGE OF USE FROM
TO
STIPULATIONS
Roofing can be the 2nd layer but
not the 3rd.
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
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
$1,302
$.65
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-
$45.75
Fire SC $1.30
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
` 7 Z T_1&
License SC $5.00
$52.70
SIGNATURE OF CONTRACTOR ORAUTHO ED AGENT DATT)
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
Leo
BLD ,INSP
72 __a
DATE
SIGNATURE OF OWNER 0F OWNER BUILDER$ IDATEI
01
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 132- 'jZ, CkA K D R, -0 ,
Legal Description:
Owner Name & Address: 4A 2a LI) D AA L 6 a k!) Tel. #
Contractor: MN LICENSE #
Address: 6 3 3 f R ` �� � v i � L✓ � i� . 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: --,7 / to i74,- P®A Jr- -�)A lC\ / sa, .'
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Side Yard Setbacks
Estimated Cost: $ l 30'Q
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: z Z G APPLICANT: _10#� Tel. # 5 7 cC
CITY USE ONLY
Permit Fee
$ '��� %S�
Fee Schedule on Reverse Side
Fire Surcharge
$ 1-30
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation.
SAC Charge
$
$900 per SAC Unit
License Surcharge
$ () 0
$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:
3067/9P
CITY OF FR111L.E`f
Aldlllg BUILDING
Received By:
speCt7AnS REsIDENV(AL "PLICATION k,
i3-577,e.3604C U�' FR X,�ly d.
1,E a , %l✓�i YOUR E-MAIL ADDRESS
E ADDRESS
13 APPLICANT 5'. 0 OAR �°R
ROPYR Y o W 74AW:
TENANT TArAMMSS! C1TY
SUBMIT A COPY OF
,OUR STATE MME
WM-I APK ICATION
gROPIr — TXT:
STATE
■ S y '1:1 i by
>ESCRIBE WORKBEING
WING
3 vinyl
3 Alwaimm►
3 Gehar
P5a0sM200pMW03 Ma ONO
31t pORNM 01-M OS -D)` 8 SWE OF
3Pl 4 WG CHANGES &-- - --- . —
V
Fern* Fes
Plan Review
Surcharge
Fire Sine
License Smawte
SAC [urge
Curie Cut Escrow
Trosion Couirol
Park Fee
Sewer Main Charge
Total Oft
EAP DATE
re
LENGTH
WIDTPI.
�TG1iT . FL
O NOUSONLY
RAS�MIIvrR
prn,rnnRt rntr, StiSNiiT:
❑ HOUSE & GARA(M
1.
Egg Flow PIM
o ATT crow GARAGE
O DETACHED GARAGE
2-
3.
PEOPO ed amp bc VWd
List of scrn�tutl
FOR NEW CONS MUCrM INCLUDINo Di e
039f 51
�,rinmorta
1.
& �rr�s stmMrr:
Sias P 'ty sAaotft ft strtut�
and proposal proJw-
❑ Fasaa
I
Tow scb Of OwwxbOu Plm
3.
Eaergl, Calavla 00
.t fur �; • t u . + —
(USMG THE 1,997
FET SCMDULE)
See Back Page for Fee 5cawwe
6510/0of Building Permit Fee um S.50(.0005) time$ the total job valuation - MhLi4a
.001 x Permit Valuation (1/100/0)
$5.00 (Stam Licensed Residential Coaftaors)
$1450 per SAC Unit (Plans to MWCC for detezn ns ion)
ft-I-6$a--_ftx$20-$
$450 Cousetvation Plan Review
Vee Dommminecl by En&aming
Agreement necessary ( ) Won Necessary ( )
M.k. rhecks eavable to: C* of Fridky Attar
TtiiS IS RN APPLICATION FOR A PERMIT' NOT VALID UPTM PROCI
3860
I hereby apply for a buiidnng permit and I acknowledge that tete information above is c unVIete and acxwoM that the work will be in
conformer with the vrdinenees and cedes of the City of Fridley and with the Mimesota Const wiion Codes; that I understated this is not a
permit but only an application ter a permand work is not to stair without a permit; that the work will be in accvsdanee with the approved
plan in ft case of all work wY& rn�uireit r"IbRd fl gzaYai of plains- _ _ _ • - n ,. �.,, P �/ /,V -
SIGNATURE OF