PRE 2010 DOCSCity ofFridley,„1, i
BUILDING PERMIT
,'p' 1 (::5:8:9
Date: '
• •• aer: Builder
Address Address
No.77' aStreet
Lot .___ _ w Block
Corner Lot
Sewer Elevation
v
Foundation Elevation
DESCRIPTION OF BUILDING
To�� Used 'tA I '�&o
Front _ epth Height Sq. Ft., _.,I- Cu. Ft.
Fr ntpth Height Sq. Ft. Cu. Ft.
Type of traction Est. Cos ”" "' �" To be Completed
In consideration of the issuanceto 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, maizrtenance repair and moving of buildings
within the city limits and this permit may be revoked at any time upon �Fb a of any of the provisions of said
ordinances. ,r-, s h
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for then items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No. , �z Street ti,�.Q. Part of Lot
Lot �j Block TT __ Addition or Su division
Corner Lot Inside Lot_)LSetbark Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of 'Survey of Lot and proposed
building location drawn on these Certificates..
DESCRIPTION OF BUILDING
To b used as:
i
rr.o Front� Depth na Height
Sq. Ft. Cu. Ft.
iq
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction/(,d Estimated Cost
To be Completed
1. / C/ l V
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 representatigls}tated.in this application
are true and correct. / i) // W - C ,_ -(
DATE S , /-T- 6 71' SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
Ciiy of Fridley
Application for Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
_
3d
��
?
�
Y
c�
Z
8�
V
S
<
��
WW
(�9d
0
Z
�0
i
N
WATER HTR.
GAS
EL
Base
1st
2nd
3rd
4th
" Future Connection Openings
e New Fixture, Old Openings
I
Connected with
Sewer �
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures ....... .............. x $1.50
Future Fixture Opening ................ x 1.20
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
TOF'AL
$ 6 .
$
$
$
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... "If x $1.50 $
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU ............... x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................. :..............................
TOTAL FEE $
Dept. of Bldgs. Phone SII 4-7470 C
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 all the fact
and representations stated in this application are true and correct.
dley, Minn ••� 19��
Owner
Kind of Building
Used as
To be completed about
M
Estimated Cost, $
Ol Nev4Building Permit No \"&_er
/Permit No. U
Signe `
By
Business Phone No
ROUGH _
FINAL
OM_42 '2M
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration 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 ..............
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
STEAM or HOT WATER SYSTEM
t�
8.00
$
2.00
$_
5.00
$
5.00
$
2.50
$
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
$
" d 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
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
$
See Fee Schedule
TOTAL FEE $�
Dept. of Bldgs. Phone S 4-747700/
Lomfinn �� 1`1'f l
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 aMtrue and correct.
Fridley,
Owner v
Kind of Building.�!E�✓Y(�?
Used as
To be completed about U / �y� / 6 -�
Estimated Cost, $
Old uilding Permit No.
New Permit No.j�a
DESCRIPTION OF WORK
194_Y
BEATING or PO R PLANTS -Steam, Hot Wa Warm A o
Trade Nam Size No foZ
Capacity Sq. 'Ft. E.D.R B z1�i BTU H.P.
Total Connected Load /P`�' Kind of Fuel �, �' `�"
BURNER — Trade NamP
Size No
Capacity.
(REMARKS -OVER)
a 42 2M
Sq. Ft. E.D.R I BTU H.P.
RAY N.WELTER HEATING,CO.
Signed
463T T.FITGAt,O AVE.
By MINNEAPOLIS 7. MINpN- ES®TA
Business Phone No- k- '.r -
p'd�t a
n s6 s t �a At aC'els1.� r
HEAT LOSS CALCULATIONS DEPARTkIENT OF BUILDINGS" 1VIINNEAPOus. MINN.
A.S.H:V.E, -
Weathers &,",, � Constrl}ction No, : Insulation
Guide
Windows I Doors Reference Out. Wall Int. Miall Ceiling Roof Floor Kind How. Applied
es�—No`'s 9 -e"
R.l __Room I Length J! 'reWidth ) A .0 -Height 5r rt II I F1.1 A - -/ Room I Length /I -z fWidth ,/,, A-leight 7, '
Windows and Doors—Crackage and Area
oom I Length Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal f . Area
No. of pane of pane lights of cracksq. ft.
1 f3 er
Width Height No. of Lineal ft. Area
No. of pane of pane lights of, crack sq. ft.
Coef. Btu
Coef.1 Btu
ICoef.1
Btu
Infiltration
Infiltration
A �
a (0 6
Glass
Exp. wall .7 6.Y
4-6
Glass
0 0
Net exp. wall
Int. wall
Floor 40
act 0
1-112-0
Ceiling f0
Ceiling
+t
11,2 -
Floor
c
&
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
M-1 1q,64- j Room I Lenath a%A PWidth AP 14eight SKQ
Windows and Doors—Crackage and Area
oom I Length Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of panne of pane lights ofcrack sq. ft.
AIJ
Width Height No. of Lineal ft. Area
No. of pane of pane lights of, crack sq. ft.
Coef. Btu
Coef.1 Btu
Infiltration
Coef.
Btu
Infiltration
A �
2 -45
Net exp. wall
Int. wall
4-6
Glass
Ceiling 1,0 6
Floor 40
act 0
Exp. wall
"^
Ceiling
+t
Net exp. wall
Int. wall
c
&
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 'I
F1.1 6red Room I Length d Width'k S Height
Windows and Doors-Crackage and Area
Width I Height No. of Lineal ft. Area
No.
or pane of pane lights of crack sq. ft.
R IA big _ ® 4 1a .. 'a
ICoef.1 Btu
Infiltration
Glass ; - ,T
Exp. wall n,
Net exp. wall a"„8
Int. wall
Ceiling e s
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area %
Windows and Doors—Crackage and Area
oom I Length Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
r n
Width Height No. of Lineal ft. Area
No. of pane of pane lights of, crack sq. ft.
Coef. Btu
Coef.1 Btu
Infiltration
Glass
y
Glass -
Exp. wall
A �
2 -45
Net exp. wall
Int. wall
Int: wall 16 16�s
19n, 17- t
Ceiling 1,0 6
Floor 40
Floor"
"^
Total Btu. 17
Required so. ft. E.D.R. or so. ins. W.A. Leader area /
Fl.l
oom I Length Width
-tietght
Win ows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of, crack sq. ft.
Coef. Btu
Infiltration
Glass
Coef. Btu
Infiltration
Net exp. wall
Glass
Int: wall 16 16�s
Exp. Wall°
Floor 40
Net exp. wall
Int. wall
Ceiling
+t
Floor
c
Total.Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
o M] 4!V l- RMm I I .moth M SMidth
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int: wall 16 16�s
Ceiling
Floor 40
E0
Total. Btu.
Required s9. ft. E.D.R. or sq. ins. W.A. Leader area �`
I
suB.lEcr
PERMIT NO.I
City of Fridley
P,
®�=3019
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY TY DEVELOPMENT DIV.
1
r PROTECTIVE INSPECTION SEC.
1 ,
�6 &j
1 r ,
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
.910-F15
JOB ADDRESS
5164 St. Moritz Drive N.E. Fridley, Minmsota
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION .
SEE ATTACHED
DESCR.
2
4
D ADDITION
SHEET
2 PROPERTY OWNER MAILADDRESS
ROGER LA-MERT
ZIP PHONE
3 CONTRACTOR MAIL. ADDRESS
ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
DRAIN TILING WITEL SUMP AND PUMP
7 CLASS OF WORK
❑ NEW ❑ ADDITION E:k ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
INSTALL DRAIN TILING
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
113
ZONRPIN 1L
tj@ 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
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,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,600.00
.75
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 -
STRUC N OR THE PERFORMANCE OF CONSTRUCTION.
$9.00
/.
PLAN CHECK FEE
TOTAL FEE
$9.75
SIG ATURE OF CONTRACTOR ORAUTHORIZED AGENT (DATE)
WHEN PROPER V IDATED)THIS IS YOUR PERMIT
BLDG. )NSP
JUNE 16, 1975
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
I
APPLICATION FOR RESIDENTIAL., ALTERATION,
OR ADDITION.BUILDING PERMIT
CITY OF 'FRIDLEY, MINNESOTA
OWNER'S NMIE Y::�i �u BUILDER:
ADDRESS: ADDRESS: ~ -/,3_ J !dam "SGC
a
s i A
ILZ
NO: STREET,.--
LOT:
TREET`--LOT: ��
BLOCK:
CORNER LOT: INSIDE LOT: SETBACK:: SIDEYARD:
Applicant attach to this fors Two Certificates -f Survey of Lotand propose'
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth: height:
Square Feet: Cubic.Fdet:
Front: Depth:
Square Feet; Cubic Feet:
Height:
Type of Construction: �Estimated Cost: $ cc
To Be Completed: v % � yej ti
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.
I TE: -.7 C SIGNATURE: G
17
(See reverse Side For Additional Information.)'
CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS 51 i . Igor , �"� I�
RATE SCHEDULE
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 ®ivisicn, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00 $_sM representations stated in this application are true and correct.
(Side Vent — Fill Out Back) _ , = 1996
Gas Piping (Needed with new furnace) $ 10.00 $
OWNER S
Gas Range $10.00 $
BUILDING USED ASd)E�nnl
Gas Dryer $ 10.00 $ ro
— PERMIT NO.—
7
,
ESTIMATED COST �P��i C
*Air Conditioning —All Sizes $ 25.00 $ - o
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK) f
1 % of Value of Appliance or Work $ No. of Heating Units ` Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Lf�1 Size No,
Commercial/Industrial BTU Q HP EDR
1.25% of Value of Appliance or Work $ Fuel Total Connected Load
State Surcharge 50 Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE $.
HEATING CO PANY
MINIMUM SEE FOR ANY HEATIN�COOLING/VENTILATION I
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. �d
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE ItR STACK VERIFICATION ON
3�
written permission from adjoining property owner. REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
�c
CHMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes No ( )
2.
Is free from rust or deterioration
Yes 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
TOTAL BTU's J,
7.
Has a liner been provided for water heater
Yes No ( )
8.
Has combustion air been provided for water heater
Yes No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
�c
N
SUBJECT
P IT
City of Fridley
3 0 0 8 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
-L ------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
f PROTECTIVE
cc�
1 �
=
1 ---1 CITY HALL FRIDLEY 55432
ti.__.11.' '•�
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/20/99
JOB ADDRESS 5164 St. .Moritz Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
2
4
Innsbruck, 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Roger Lambert
571-4910
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Suburban Exteriors 9701 Penn Ave. S Ste 107 Bloomington
55431 881-8232 4289
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 29X REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (31 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 80 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2709
$1.35
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-
T CTION R THE PERFORMANCE OF ONSTRUCTION
83.25.
Fire SC $2.71
PLAN CHECK FEE
TOTAL FEE'
(
License 5.0
2.31
SIG T OFCON'RACTO AUTHORIZED AGENT (DATE,
ENROP
Y ALIO;;
S IS UR PERMIT
BL G INSP
&W
�.
OAIE
SIGNATURE OF OW NER �If OWNER BUILDER. IDAiEI
N
r .
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: J
X5.1 C tl . ry) D'n:
r
Owner Name & Address: IQ Cx V cGe . Tel. # / I L) 10
Contractor: 3 MN LICENSE # 81
Address: o/ "201 2-` aA-140— �/ ®' Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIP'T'ION OF EMPROVEME r
Width
Height
Width
Height
Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: Estimated Cost: $ j_� �f %� z
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: 8 - l q -q 9 APPLICANT: � -. n" Tel. # ? f ' 1 - � P 3 j
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ �J. �S
Fee Schedule on Reverse Side
$
.001 of Permit Valuation (1/10th%)
$
$.50/$1,000 Valuation
$
$1050 per SAC Unit
_
$ _ . _ . - 00
$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 [ ]
$ 9-,2,31
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1998
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
New Fixtures
$ 7.00
'e 99 OLD
Old Opening, New 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
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance o,
• : ADDRESS
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.
Owner
Building Used As Ae'2�& -�
Estimated Cost PERMIT NO.
PLUMBING COMPANY
SIGNED
Approved
0A - I __ �214_
TEL N0. 7�0 Z `VX7
Rough—In Date Final Date //- L/-®�_
State Surcharge $ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $ ot�2•� PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
I
SUBJECT
PERMIT NO.
City of Fridley
3033
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RE NO.
►— COMMUNITY DEVELOPMENT DIV.
_
r PROTECTIVE INSPECTION SEC.1p
q 3(o
1
NUMBER
REV
GATEPAGE
Of
APPROVED BY
� 1 CITY MALL FRIOLEY 55432
763-571-3450
910-F15
9/3/02
JOB ADDRESS 5164 St Moritz Drive NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
4
Innsbruck 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Roger Lambert 5164 St Moritz Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
TJB Homes Inc 9100 Baltimore St NE, Blaine, MN 55434
763-780-2944 1845
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 O ADDITION (i ALTERATION O REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Remodel kitchen
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS
REQUIRED FOR:
UN�SGPLBIASIGNS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$17.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$35,000
DOES NOT PRESUME TO GIVE RITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY O ATE R LOCAL LAW REGULATING CON-
$492.25
Fire SC $35.00
SRUCTIO R FOR NCE F C NSTRUCTION
C - 0 -A-
PLAN CHECK FEE
Licens C $5.0
TOTAL FEE
$/4!9 .75
I -GNATUAE OF CON'RACTOp a ur agEO AGENT (DATEi-
ME PROP ALIDATED HIS IS YOUR PERMIT
$-GNATUQE OF OVVNAS iDATE�
BLjDG rNSP
ATE
I
NEW [ j CITY OF FRIDLEY Effective 1/1/2002
ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER (j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
P VlT"
Construction Address:
Legal Description:
Owner Narr
Contractor.
/ Tel. #
IN LICENSE #S—
Address: '1/00 6a 64!�F- ,LAWN' Tel. # '7—& 3 --7 � Q - A9 V V
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LMNG AREA: LengthWidth L�eight Sq. Ftp
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: 12::, s1n'n A 0 ` �– i -�" ra ,
'j veju-Q ca
Construction Type: PO y' -x__ _ _ _.
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
c C k '776 3
DATE: �2 3 - 02 APPLICANT: Tel. #��
Call (763) 572-3604 for Permit Fees if mailing In application or Fax o 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
$ c�? �5- Fee Schedule on Reverse Side
$ ® .001 of Permit Valuation (1/10th%)
$ 0 aS'O $.50/$1,000 Valuation
$ $1200 per SAC Unit
$ a ®® $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 [ ]
TOTAL $ o STIPULATIONS:
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
Effective On January 1, 2002
JOB ADDRESS . 'C A `C O
OWNERfAk
Rate TOTAL
BUILDING USED AS
$ 30.00 $ It
ESTIMATED COST !k,550 PERMIT NO.
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00 $ Trade Name Size No'
BTU HP EDR
$ 25.00 $ Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
?1.ctej Vkeod V c1-�-Rie o a "4e --&4y
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
*Air Conditioners can not be placed in a side yard without
written permission from; adjoining property owner.
$ 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 C 1: lec^:�
HEATING CO
Sig r d TEL # _)�Ll 0000
FAX # r01
Approved By Rough -In Date Final Date /l �'
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VFNT, VENT CONN TOR AND r.QMR1 IRTION AIR V RIFT ATION
When re la .ing, an existing f_sran , the undersigned hereby verifies that the
venting has been examined and is free from lust, deterioration; obstructions,
and is securely supported and firestopped where required. Yes O No()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes( ) No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing comb ,conn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to install a new comb istien air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When installing a new v _n ingsystam, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
.01 '/ d
Ill
SUBJECT
RMIT NO.
City of Fridley
33998
AT THE TOP OF THE TWINS
BUILDING
PERM
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
5 /6f
NUMBER
REv
DATE
PAGE OF
APPROVED BY
`-__•� � CITY HALL FRIDLEY 55432
L 763-571-3450
910-F15
10/27/03
JOB ADDRESS 5164 St Moritz Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
4
1 Innsbruck
2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Roger Lampert 5164 St Moritz Drive NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Conceptual Design 8485 142 St, Apple Valley, MN 55124
952-431-3393 20070881
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct an 8' x 8' and 7' x 56" Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING -
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
$1,266
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$.61
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-
CON-STRUCTRT
$47.90
Fire $1.22
ERFORMANCE OF CONSTRUCTION
P0
PLAN CHECK FE
TOTA EE
a"1 dut 21 ®3
Lice SC $5.
0
$ 4.73
SIGNATURE OF CON RACTOR OR AUTHORIZED AGENT IDATEI
ENP OPLIDATE
MIS I$Y P MIT
0rZ41�
S,GNATURE OF OWNERoF OWNER BUILDERI IDATEI
BLDG NSR
GATE
.01 '/ d
Ill
[ ] CITY OF FRIDLEY Effective 1/1/2003
NEW
NEW[ ] 6431 University Ave NE, Fridley, MN 55432 (763) 5724604 Bldg Insp
ADDN
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 571-1287 F
BUILDING PERMIT APPLICATION
Construction Address: 56!C� ::2:i-
Legal
:2: Legal Description:
Owner Name & Address: C-R- ZAK P�1" Tel.
Contractor. �bA.e� MN LICENSE #��
Address: �V5� /YAP �??� Tel. # 1a —5�3 s— 3�y?
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 Heiaht
_ Sq. Ft.
Length ® in a
Width I round
Sq. Ft.
DECK AREA:
OTHER:
Construction Type:ost
A�
Oro
Estimated . $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: �'' APPLICANT: t;'1 Tel.
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$ 0 $.50/$1,000 Valuation
$ $1275 per SAC Unit
$ �(� $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 [ ]