PRE 2010 DOCS�
SUBJECT
PE
City ®f Fraley
:
o- i s o 6 s
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
ECEIPT N
• COMMUNITY DEVELOPMENT DIV.
e®
r PROTECTIVE INSPECTION SEC.
1 ; �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/17/81
JOB ADDRESS 6320 Squire Drive N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
]
3
Harris Lake Estates SHEET
I
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ron Ackerman 6320 Squire Drive N.E. 571-9702
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Custom Pools 701 E. Excelsior Avenue, Hopkins, M 933-2255
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
X
8 DESCRIBE WORK
Construct a 181-x 43' In -ground Swiming Pool (8' deeps
9 CHANGE OF USE FROM TO
STIPULATIONS See stipulations on letter dated March 17, 1981 by Environmental
Officer. .114
local u-tiiibe
be#ore di Gall
Et
TELEPHONE m �fC7Ri l S
IZE,-WIRED By LAY
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.
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
$8,000
$4.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$48.00
STRUCTIQ,N R THE PERFO NCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
f P"
$52.00
SIGNATURE OF CONTRACTOR OR AUTH RIZED AGE (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
6ATE
SIGNATURE OF OWNER IIFOWNER BUILDERI (DATE)
CITY CF rRIDLEY
APPLICATION FOR RESIUi NTIAL BUILDING PERlrITS
(Now, Alterations, Additions, or Repairs)
OWNER: &I tv
ADDRESS: G Lr
TEL NO:
STRUT NO: G%
LOT: A
STREET:
BUILDER : '1-7(/S
ADDRESS:
TEL NO: cl'2
Construction Location
G
BLOCK: ADDITION: _ Z,
Corner
Corner Lot: Inside Lot: Setback.-. Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square.Feet.- Cubic Feet:
Front:
Depth: Height:
Square- Feet: Cubic Feet:
r+-�'► v G vvi ,VJ
Type of Construction: S L . t ✓+'l v"� 1 —P
To Be Cbripleted: /3 c7 / -
Proposed Driveway Width If New Opening Is Desired:
Estimated Cost: $ dQ
Alt. A Alt. B
SEE REVERSE SIDE OF SHEET
Me• under signed 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
repro sont�Iti.ans stated in this applicatio are true and correct.
DTE IGN2ITU I'.k:
S :
Stipulations:
X04
qxo
S� C)o .
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432
d
March 17, 1981
rh
,f
f.
Custom Pools
701 E. Excelsior Avenue
Hopkins, rMT 55343
TELEPHONE ( 612)671-3450
Re: Swimming Pool Construction at -6320 Squire Drive N.E.
Dear Sirs:
This letter is to make clear this department's requirements for the swimming
pool construction at the above address.
1. As indicated, two (2) skimmers approved by the National Sanitation
Foundation will be provided.
2. As indicated, four (4) inlets of approved de-ign for fresh and/or
repurified water will be provided.
3. As indicated, 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 - 8 hours.
5. Adeck of at least three (3) feet wide, measured from the pool waters
edge, shall be provided which extends completely.around all private,
residential pools. Above ground private residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the City.
6. The diving area will be acceptable provided there is no overhead
obstruction.
7. Fencing or other effective means including but not limited to walls
or.buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
(c) Self-closing and self -latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
r
Custom Pools
March 17, 1981
Re: 6320 Squire Drive N.E.
Page 2
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. All overhead electrical lines must be a minimum of 10 feethorizontally
from the pool surface and 18 feet straight line distance from the
waters edge.
11. The pool fill spout must be protected by a vacuum breaker or air -gapped.
12. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 11i times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
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.
Sincerely,
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
CC: Mr. Ron Ackerman
6320 Squire Drive N.E.
Fridley, MN 55432
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• 24" CLEARANCE AIR RELIEF AND
ABOVE FILTER PRESSURE GAUGE
'A' FILTER
DIAMETER
V
27" MAX. WIDTH
DIALATROL VALVE � OF - 100 BAGS
� OF !'J° 20
TO WASTE � SILICA SAND
1 34"
---- DRAIN
0
/ o
15°° 1 1/2" POOL RETURN
IPUMP SUCTION
r.mum tm9 19RUAl arumA9m
STRUCTURAL FOAM SKID cm!o: I
NATIONAL
werl>•u7a
SELECTION CHART
CATALOG
NUMBER
MODEL
NUMBER
FILTER AREA
(SQ. FT.)
PUMP
N.P.
RATE S0, FT. TURNOVER CAPACITIES
B
C
15 gpm 20 gpm HOUR
6 HRS. 8 HRS. 10 HRS. A
24735-216
HRSD-16
1.4
1/2
21 1260
7,560 10,030 12,600
1 16"
8,880 11,840 14,800
33"
1 3/4
28 1480
24740-221
HRSD-20
2.2
3/4
33 1980
11,880 15,840 19,800
20"
15,840 21,120 26,400
37"
2
44 2640
24741-224
HRSD-24
.1
1
47 2820
15,9 28,200
-----24"
21,600 23,800 ,000
41"
2 1/2
247 24
1 1/2
60 3600
GENERAL NOTES:
The filter tanks and pump a unitrol valve are approved
1. F1 Orirates shown are cased on 15 and 20 G.P.N.
per sq. ft. by the ;Iational Sanitation Foundation.
of filter area. Hotaevor, rates may vary from
10 to 20 G.P.%
per sq. ft. as desired.
These filters are covered by the following patents:
Australia Pat. No. 275,346; Canada Pat. No. 722,018;
Met MTA isme8eNTe 7Ne u7esr IUNlwtrmc
Great Sri tain Pat. No. 934,997; rlexieo Pat. No. 79,797;
Ai�mw. To US �7�s I""L IN
oATIells AND PeenuvnNo 7Hr w7eAw,
Assure xo uAenm IM9 Ile use
South Africa Pat. No. 1100/65.
• •
SWI.MQUIP
a—
VERTICAL HI -RATE (SKID UNIT)
3301 Oilmen Road. EI Monte, Calif. 91732
HRSD SERIES W / D I A LA T R 0 L VA LV E
1121 Huff Road. N.W. Atlanta, Georgia 30319
2639 Walnut Hill Lane. Suite 129, Dallas, Texas 75229
c COPYRIGHT 1972, SWIMOUIP, DIVISION OF WEIL-McLAIN COMPANY, INC.
wre p®
JUNE 1973
nsasnNo
NUNN.
.PINKat IN Y. i A
SPECIFICATIONS:
FILTER PLANT
The HRSO filter plant specified under this section shall be of
the pressure sand, III -RATE type manufactured by Swimquip,
Inc. The filter plant shall be a product of a company regularly
engaged in manufacture of water filtration equipment with a
minimum of ten years' experience in manufacturing filtration
equipment for public swimming pools.
The filter plant shall consist of a filtering unit, face piping,
cast iron dialatrol valve, injection molded hydraulic dis-
tribution system and lower collection manifold, gauges, XL
Series, cast iron recirculating pump and pump strainer, all of
which shall be manufactured and assembled on a structural foam
skid by Swimquip, Inc.
The filter plant shall be designed and valved to permit reverse
flow backwashing with Swimquip's dialatrol valve.
(1) FILTER AREA
The filter plant shall have a total effective area of
square feet.
When operated at 15/2U GPM per square foot of filtering area,
this filter plant will have a capacity of filtering
gallons in hours and minutes.
(2) FILTER TANK
The filter tank shall be in diameter and shall be
constructed of type 304 stain ess steel with a minimum side
shell and head thickness of lE gauge (16" and 20" diameter),
16 gauge (24" diameter). Tank to be reversed electropolished.
All piping shall be through the side of the filter unit in order
that the lid may be freely removed without any piping disassembly.
The filter tank shall be supported by means of a structural
foam skid.
The filter tank shall be designed for a 200 pound minimum
bursting pressure and tested,at 75 psi in accordance with the
(NSF) National Sanitation Foundation requirements.
(3) FILTER PiEDIA
The filter media shall be a hard, uniformly graded silica material,
commonly referred to as Crystal Grade filter sand. There should
be no limestone or clay present. Crystal Grade R20 filter sand
must have an effective size of .45mm and a uniformity
(4) FACE PIPING
All piping required for the operation of the filter plant shall be
included. Piping shall consist of cast iron dialatrol valve
connected by S.S. band clamps. The operation of the filter and
backwash cycle may be accomplished by the simple manipulation
of the valve handle. The dialatrol filter control valve shall
be fully ported with positive sealing gasket and rotary plug.
The dialatrol valve shall be connected to the tank with
band clamps for easy removal. The filter shall be con-
nected to the pump by means of a stainless steel connector.
(5) RECIRCULATING PUMP AND PULP STRAINER
The pumping unit shall consist of a self -priming single suction
centrifugal pump of the built -together type. The pump volute
and seal plate shall be manufactured of cast iron especially cast
to produce smooth surfaces for water passage.
A cast iron pump strainer shall be an integral part of the pump
assembly. The strainer lid shall be cast iron and secured with
manganese bronze "T" head bolts. The seal between the cover
and the strainer pot shall be effected by mans of an 0 -Ring
gasket. The strainer baskets shall be molded of hi -temperature,
hi -impact styrene with integral lead ballast.
The pump impeller shall be an integral bronze casting of the
semi -enclosed type, attached to the motor shaft. A stainless
steel shaft seal of the mechanical type shall be provided with
ceramic seat and carbon wear ring.
A NEMA C faced motor with a drip proof enclosure shall be
bolted to the pump volute. The motor shall be of the capacitor
type with silver faced centrifugally operated disconnect switch-
ing, and shall be fitted with a thermal overload -protection of
the self -resetting type and a stainless steel shaft.
The motor shall be single phase, 60 cycle horse-
power for service on 110 or 220 volt electric_suppTy.
The pump and motor unit shall be designed for self -locating
assembly, ease of maintenance, inspection and service without
the use of special tools and without the need to disturb piping.
The HRSD filter plant as outlined herein shall be Swimquip
No.
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City of Fridley
SUBJECT
jPERM
05'75
r
AT THE TOP OF THE ?WINS
BUILDING PERMIT
r
`
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
6/9/76
JOB ADDRESS
6320 Squire Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
l
3
Harris: Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Brickner Builders 6245 Ben More Drive 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 NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK j] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 461,x 25' dwelling and a 26' x 22' garage
9 CHANGE OF j§WRPATE
HEATING, PLLM161G AND SUM,
STIPULATIONS
NOTIFY THE FRIDL.EY ENGR.
Provide a hard surface driveway. (,DIVISION REGARDING CURB
Provide a verifying survey before capping REMOVAL AND REPLACEMEN1I!
Provide sod in the front and side yards AT DRIVEWAY OPENINGS.
Provide City with copy of truss design
SEWER SERVICE: (Approx. 10' Deep) 72' South of Manhole (S. Inv. 877.63
WYE ELEV: 882.63"
TOP OF FOOTING: 885.63 (Minimum)
WATER SERVICE: Tied to stop box (89' South of Sanitary Manhole, 66' North of
THE Ci11- OF MON . DOES NOT GVA a%tary Manhole) WARM
ACCURACY OF UTILptY LOCATE; AND ELEVATIONS. Before digging call local Iltiii# a
TWS DATA IS FOR INFORMATION PUPAMS ONLY AND EPHONE ELEC tIC- ft
USING R 8HOUJ D► VWY THE INFORMATION
TYPE OF CONST.
U LAIWAD
OReWReD
SEPA A I ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
frame
VENTILATING OR AIR CONDITIONING.
wood
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
R-1
547 7,800 + 5470
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
1390 +
ANY TIME AFTER WORK IS COMMENCED.
IVO. DWLG. UNITS
OFFSTREET PARKING
'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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$41,720.00
20.86
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 E PERFORMANC O CONSTRUCTION.
61.55
350.00
�
PLAN CHECK FEE
TOTALFEE
"., ,p �
$432.41
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT - (DATE)
HEN PROP F1.Y VALI ATE THIS IS YOUR PERMIT
BLDG INSP
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
APPLICATION POR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PL•RMIT
CITY OF FRIDLEY, MINNESOTA
iI
OWNER'S , NAME : —BUILDER:
.ADDRESS : % C_ it� i.�%ADDRESS:
j'
NO:-... 3 STREET •
LOT:- / LOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
T Used As: e
Front • "/6 Depth: CO Height: /
Square Feet: 40240 Cubic Feet: ,92 f® 6
Front: 1.7-6 Depth: Height: /
Square Feet; Cubic Feet: e
Type of Construction: Estimated Estimated Cost:
To Be Completed: '70.
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 :
(S Reverse Side i'or Additional Information.)
Land Planning (•O"Fj0 6875 Highway No, 65 N, I"
Land Surveying l • (` /+ Minneapolis,
Sails Testing �/�gri
/1('('T (j1(7 •/ %�` .
Minn. 55432
Civil $ngineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Area Code 612
—
Certificate of Survey for► 1 =' = -ONS � �•
CAUTION
I'M$" sVw ,
00 NOT PUM " pU" /req►.
THING IN TNS AIWA jay
PROVAL OF TI# GTM OI*
95.72
1 AJ
Lit
how-.
ides 10 �
B _ 4
BC1rlfaye�/��� Etc,
L ^/
1EGUMED 8Y /0-7- i Z �l \J C-;- Scale.,. 11RG1s 1V���
'L4
125.00
R f RNT.— Y Pp ! N= NOT W • iPWT- E" JJO
Wwwoll
REMOVAL AND REGARDING CURD ���5 Yq* D SNM MW 11� WORMA�I
AT D1NyEWAY OpEtEPU �E�
OATH IFORSO10
PS THE
S US9NG �t� �T®�l Pv �YIUVATI®d�S.
AND
LOT BLOCK 31
RMIM5 LESTATE S
Anoka Cuu,11y
I hereby certify that this is a true and correct refiresen►ution of a survey of the boundaries of the above
described land, and of the location of all build,ngy* thereon unci olf visible encroachments, if any, from or on
said land. As surveyed by me this day of ,; ,t - A p 1G
c DENOTES IRON MONUMENT SUBURBAN ENGINEERING, INC.
ti-
Engineers Surveyors
-- - DE1VDiES DPAWE � UTILITY ;WMENT b �'.
6)f -F
702 � �a�; H Of /9%/r/ 7613)
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gz 4,3
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601
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5,0
Main Office 571.6066
I� UBURBAN 6875 Highway No. 65 N. E.
��� N®INEERINGi Minneapolis, Minnesota 55432
INC. _ -_ _.
n South Office 890-6510
j I I Civil, Municipal & Environmental Engineering 1101 Cliff Road
rLand Surveying • Land Planning • Soil Testing Burnsville, Minnesota 55337
June 14, 1976
Mr. Tom Brickner
Brickner Construction Co.
6245 Ben More Drive
Fridley, Minnesota 55432
Re: Harris Lake Estates
Lot 1 Block 3
Dear Mr. Brickner:
At your request on 7 June 1976, we drilled two (2) hand
auger holes on the above captioned lot. The soils encountered
were visually identified by our Technician at the time of the
boring. The footing excavation appeared to be.into natural
sand to the boring depth of 5 feet.
Prior to pouring the concrete footings, we took a density
test within the forms of the south side footing. It appeared
there was 2 to 6 inches of fill in this area below bottom of
footing grade. The density test indicated 90% modified Proctor
density.
Based on the above, it is our opinion the site is adequate
for single family development.
Sincerely,
SUBURBAN ENGINEERING, INC.
PJM/jp PPeter/.Molinaro,
Project Engineer
cc: Dave Harris
City of Fridley
Ruheri Minden Reg. Eng. E. A. Rathbun, Reg. Suru. Wm. E. Price, Reg. Eng. Gary R. Harris, Reg. Sura.
Wm, E. Jensen. Reg. Eng. Wm. K. Meyer, Reg. Eng. /I William Rogers, Reg. Sura.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures !I 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
TOTAL FEE
REINSPECTION FEE
($10-00)
TOTAL
$
$
$
$
$ .50
P1w. .
g� 305
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. 192
OWNER S/S�
--vim
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
4:
Company / v�
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. g - 13 - ! C -
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
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1st
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
1
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE
Number Fixtures !I 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
TOTAL FEE
REINSPECTION FEE
($10-00)
TOTAL
$
$
$
$
$ .50
P1w. .
g� 305
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. 192
OWNER S/S�
--vim
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
4:
Company / v�
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. g - 13 - ! C -
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
132
w
GRAVITY WARM AIR:
RATE
TOTAL
Job Address
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
I?
Fridley, Minn. p `
Repairs & Alterations each add. $500.00
4.00
$_
STEAM OR HOT WATER SYSTEM:
OWNER �/e/�&z/ eex
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING 4 -A" -d
each addn. 50,000 BTU
4.00
$
o�""®p
/'oC�-
Boiler only up to 100,000 BTU
7.00
$
USED AS eve
each addn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST /�®
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ /4
OLD NEW B ILDING PERMIT NO. PERMIT NO..
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
g _
$�
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. 14ydiq
AIR CONDITIONING �Af7.9 ' i/�.lJd � /0-00
FAN HEATING SYSTEMS %k/r' MC4
See Fee Schedule '77
$
$
Trade Name��� -G.�� Size No. �.�P /26 &PU2
VENTILATING SYSTEMS
$
�y�
Capacity o � 03 Sq. Ft. EDR BTU HP
3
ALTERATIONS $ REPAIRS
$
—�
State Surcharge
$ .50
Total Connected Load Kind of Fuel
TOTAL FEE
$
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Date ($10.00)
I%
l�✓ e `�
FINAL INSP. 7
Company
Date
i
Signed By
APPROVAL FOR PERMIT
y/
Tel. No.�-
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
91 -8L
.h16o5i
LIIT ur rnlULCY
• APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
f
'
PLUMBING FIXTURE RATES: NO.
14
tpgg
.�
TOTAL
h%=Iier Fixtures
x
$3.00
.r
Future Fixture Opening •
oe+
$2.00
Water
Heater
•.ri.
y
$2.00
$
Catch Basin
x
$5.00
$
Nater Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 1990000 BTU
if
$10.00
$
Water Softener
x
$7.90
%v
New Ground -Ran Old Building �
x
$5.00
$
Electric Water Heater - �-
x
$5.00
$ .�
GAS FITTING FEES: ,
1st 3 fixtures _,_
as
lec
$
Additional Fixtures
$1.00
$
.Gas Range to 199,000 BTU ,_
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
-p
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTION FEE
($10.00)
1st
i
2nd
13rd
4 th
L
I
J
(R) - Future Connection Opening
Connected with Sewer
(•) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
'
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
h%=Iier Fixtures
x
$3.00
$•o_
Future Fixture Opening •
x
$2.00
$ _,-
row Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Nater Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 1990000 BTU
x
$10.00
$
Water Softener
x
$7.90
$
New Ground -Ran Old Building �
x
$5.00
$
Electric Water Heater - �-
x
$5.00
$ .�
GAS FITTING FEES: ,
1st 3 fixtures _,_
x
$3.00
$
Additional Fixtures
$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
$
REINSPECTION FEE
($10.00)
Job Address 6320 -. SQUIRE DRIVE NE �
Department of Buildings
City of Fridley
Tel. 5571-3450
The undersigned hereby makes application for permit for the work her
specified agreeing -to do all work in strict accordance with the City Codi
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and co�
Fridley, Mn. 4-15-77
OWNER ROMD ACKERMAN
KIND OF BUILDING frame
USED AS res®
TO 8E COMPLETED ABOUT
ESTIMATED COST 10,00
OLD - NEW BUILDING PERMIT NO. PEWT NO.
+C.
Company
Signed ey
We NO.
SLOUGH INSP.
Date
FINAL INSP. .
Date
APPROVAL FOR PERMIT .
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
Class "A" Surcharge .500
Nowt
rITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PEWIT
PARTIAL RATE SCHEDULE
of
c'LU.MBING FIXTURE RATES: NO.
N
TOTAL
q
x
U
$
X
m
$2.00
Water
!.ew Fixture, Old Opening
x
$2.00
$
Catch Basin
x
,s
$
:rater Heater - to 99,000 BTU
N
r3 $a
W
-00,000 B_J to 199,000 BTU
'�S
$10.00
Heater
Water Softener
x
$7.00
$
New Ground Run Old Building
H
..t
Y 1
$4
a
Wo
A G
5 11
$
N
4'
lst 3 fixtures _
x
$3.00
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
N
N
N
,
y .cul
,at
I
i
I
'
ti :_.
I
(3) = FLtare Connection Opening
Connected with Sewer
( ) _ Naw Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
c'LU.MBING FIXTURE RATES: NO.
RATE
TOTAL
.. -Wer Fixtures
x
$3.00
$
cF*4 .:re Fixture Opening
x
$2.00
S
!.ew Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
:rater Heater - to 99,000 BTU
x
$5.00
-00,000 B_J to 199,000 BTU
x
$10.00
�"
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric hater Heater
x
$5.00
$
G,AS FITTING FEES:
lst 3 fixtures _
x
$3.00
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
State Surcharge
TOTAL FLE
REINSPEC:.ION FEE
(y).0. "))
$5.00 $
$2.00 $
$ .50
S
/3, s
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 t:.at all
the. facts and representations stated in this application are true and ecrrect
Fridley, Mn. 3 - 2 B , 19 Y/
OWNER 01^'
=13 OF
USED AS
TO BE COMPLETED ABOUT / � d
ESTIMATED COST ®, p f)
OLD - NEW BUILDING PEPUVIT NO. PER: -IIT NO. �s
Company
Signed By
LaAm—
Tel. No. i
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PFALMIT Y
MINIMUM FEE FOR ANY PLUMBING PZP,MIT IS $7.50 pLus $.50 STATE SURCr1;=
SUBJECT
P
City of Fridley
21456'
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
r �
s-'-1 CITY HALL FRIDLEY 55432
NUMBER
REV. JDATE
FPAGE OF
APPROVED BY
612-571-3450
910-F15
7/24/92
JOB ADDRESS 6320 Squire Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
3
Harris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ron Ackerman 6320 Squire Drive NE 571-9702
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Gary Jansick. 6480 Squire Drive NE Fridley 55432 574-9679 203
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 O REMOVE
8 DESCRIBE WORK
Construct a 121-x 12t Deck
9 CHANGEQFUSEFROM TO
STIPULATIONS
See notations on plan WARNING
Before digging call for
all utility:watlona
-OM .
REQUIRED BY LAW
SEPARATE PERMITS REQUIRED FOR
illfill4ING, HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1106
$.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$29,00
Fire SC $1.11.
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$35.66
SIGNATOR FCONTRACTORORAUTMORIZEDAGENT (DATE)
ATED THIS IS YOUR PERMIT
WH N P OPVLYZY
G INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IOATEi
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: � al re 4r.
Effective 3/1/92
Legal Description: L o r /, 6 l,-) �_ e 3, ES e-�7S
Owner Name & Address: i' o n Tel. # 5'7/- 9Pe =-
Contractor: ate^y �Q n 6116 k MN LICENSE # D o o-, a 3f�
Address: (P V,?® a G[! �'°� _ E ' �ro� !`a -y Tel. #
Atraach 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 /4L Width /o2 Hgt/Ground , Sq. Ft.
OTHER: co
Comer Lot [x] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: J re 4- C. -ed& r Estimates Cost: $
Approx. Completion Date: gete.
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ = $
DATE: APPLICANT: `%� Tel. #.-F7 K P4 7)f
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
2 /, tOo
Fee Schedule on Reverse Side
Fire Surcharge
$ It /
.001 of Permit Valuation (1/10th%)
State Surcharge
$
�S
$.50/$1,000 Valuation
SAC Charge
$
$700 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ j Not Necessary [
TOTAL
STIPULATIONS:
DECK FOR AKERMANS AT 6320 SQUIRE DRIVE 571-9702
"VIw-
NDERSON DR
PICA -UP CONST. WASTES DAILY
STORE IN AN APPROVED MANNER
ALL REFJIS,E..EK %
12x 12 DECK WITH STAIRS AND RAILING
RAIL 36" HIGHT MIN
OPEN L. OUT,51 DE.
I(
This Plan Must
Be Maintained And
AcCessible On 4ye
Construction Site
SUBJECT
P
City of. Fridley
7 2 p g
AT THE TOP OF THE TWINS
BUILDING
E R M I T
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
4/ia
r i
ICH
NUMBER
REV
DATE
PAGE OF
APPROVED BY
`-_•_/"','� CITY HALL FRIDLEY 55432
L •+` 612-571-3450 -
910-F15
8/17/98
JOB ADDRESS
6320 Sq uire Drive NE
1 LEGAL
LOT NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
3
1 Harris Lake Estates
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ron Ackerman
571-9702
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
B & B Roofing Service 6760 Madison St Fridley MN 55432 571-0248 9042
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 50 REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof xxd house and garage (28 S) Tear -off
9 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
1 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 W HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,335
1.17
DOE NOT PRESUME TO GIVEAUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR ISIO OF ANY OTHE TATE OR CAL AW REGULATING CON-
ST UCT N OR THE PERF MANC O ON CTION.
474.75
Fire SC $2.34
PLAN CHECK FEE
TOTAL FEE
License $5.00
$8;126
SIGNATUR06F CONTRACTOR OR AUTHORIZED AGENT (DATEI
P PER
BLD )NSP
ALIDA D T S IS YQUR PERMIT
nATE
SIGNATURE OF OWNER I)F OWNER BUILDER) IDATEI
NEW a [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ®�
BUILDING PERMIT APPLICATION
ConstructionAddress: (��� U %� 1� 2
Legal Description: SSS l (0 Ye % / ��
Owner Name & Address: k0 /1L ,/ Ze-k Tel. # JAZ/e-- 5�719(57--
Contractor: 66 e/D MN LICENSE #
Address: e�, 7e',';C 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:
Construction Typec�f(F- �l11A Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. 6 Ft = Ft x $ _ $
DATE: S /% APPLICANT: Tel. #5 -7f
CITY USE ONLY
Permit Fee 75 " Fee Schedule on Reverse Side
Fire Surcharge $ . 3 "-/ .001 of Permit Valuation (1/10th%)
State Surcharge $ ) • / $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ s^. d U $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 $ C6 -21
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002
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
JOB ADDRESS _'55 ew ;.-.e— g2,—
RATE SCHEDULE
OWNER
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
TOTAL
BUILDING USED AS�s�e�`
$t0 PERMIT NO. 15
ESTIMATED COST �-7.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heatin Units_ Circle One (Steam) (Hot Water) (Warm Air)
$ Trade NameSize No.
BTU_ HP _;?_7 EDR
$ Fuel /V Total Connected Load
Burner Trade Name Size No._
$ BTU HP ED
$ 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 CO, Alb � --����
Signed
FAX #
*Air Conditioners can not be placed in a side yard without Approved
written permission from adjoining property owner. � a
ee // FILL OUT BACK
r
nnx- � ��• �
�5� ML/ Sam&q
Rough -In Date
TEL #���—��r
Final Date _R1124_//0A
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
1.251yo of Value of Appliance or Work
Effective On January 1, 2002
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.
$ .50
$ S?1 D
g Go ;2c( P/
C.�5_5e®� /VAi S�_Z
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE /..I- - neo
HEATING CO l ."ed
Signed TEL #3�-�33-�
FAX #
Approved B i44
pp y Rough -In Date Final Dat
JOB ADDRESS_d
OWNER ?O -n
�
Rate
TOTAL
/
BUILDING USED AS
$30.00
$
ESTIMATED COST
PERMIT NO. _/
$ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00
$
No. of Heating Units
1 Circe One (Steam) (Hot Water) (Warm Air)
$ 10.00
$
Trade Name
Size No.
,56
BTU _` ocV
HP :ft EDR
$ 25.00
$
Fuel
Total Co nected Load
Burner Trade Name
Size No.
$
BTU
HP EDR
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.
$ .50
$ S?1 D
g Go ;2c( P/
C.�5_5e®� /VAi S�_Z
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE /..I- - neo
HEATING CO l ."ed
Signed TEL #3�-�33-�
FAX #
Approved B i44
pp y Rough -In Date Final Dat
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX: (763) 571-1287
ADDRESS : 6320 SQUIRE DR NE
PIN : 133024410046
LEGAL DESC : HARRIS LAKE ESTATES
: LOT 1 BLOCK 3
PERMIT TYPE : HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-00858
DATE ISSUED: 06/08/2004
VALUATION : $ 1,600.00
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL AIR CONDITIONER.
# A/C UNITS 1 # FURNACES 0
# GAS DRYERS 0 # GAS RANGES 0
APPLICANT
RIVER CITY SHEET METAL
9928 BLUEBIRD ST NW
COON RAPIDS, MN 55433-
(763) 754-2199
1 A/� ,
ACKERMAN RONALD A & KARLA K
6320 SQUIRE DR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Bldg Insp.
HEATING PERMIT MINIMUM FEE 0.00
FURNACE SHELL/DUCT WORK 0.00
GAS PIPING FEE 10.00
GAS RANGE FEE 0.00
GAS DRYER FEE 0.00
AIR CONDITIONING FEE 25.00
STATE SURCHARGE, MECH FLAT 0.50
TOTAL 35.50
PAID WITH CHECK # 13253
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Sj t4 Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Fee Total
$35.00 $
$10.00 $
$10.00 $
Gas Dryer $10.00 $
*_Air Conditioning - AllSizes $25.00 $ x5 a
ez'® 3''1XR'q 3�0 z
All Other Repairs or Alterations (Liston -Back)
1% of Value of Appliance or Work $
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater
Commercial/Industrial/institutional
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
JOB ADDRESS Z�3--Zlg> SA U.I g e
Owner JR'qr)a L J Ac -x er mcLrr
Building Used As /1 cS,'CL e•�'t,c� �..�
ESTIMATED COST I6®0. PERMIT NO �t �
DESCRIPTION OF FURNACE AND BURNER
# of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU _ HP EDR
Fuel
Burner Trade Name
BTU
Total Connected Load
HP
Size No.
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
$ and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
$ .5z
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
HEATINGq�ef City Sheet Metal, Inc.
9928 bluebird N.W.
Signed Coon Rapids, NIN 55433 Tel #
-754-2199
FAX # Date D4�d/�/S of
Approved by Rough -in Date Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () 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 combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, 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 Type and Size/Common Vent and Vent Connector Information
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
CITY OF FRIDLEY PERMIT NO.: 2004-00879 (�
6431 UNIVERSITY AVENUE NE g�-
FRIDLEY, MN 55432 DATE ISSUED: 06/10/2004
63) 572-36U4 k'AX: (763) 571-1287
ADDRESS : 6320 SQUIRE DR NE
PIN : 133024410046
LEGAL DESC : HARRIS LAKE ESTATES
: LOT 1 BLOCK 3
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. CONNECT AIR
CONDITIONER.
# INSPECTIONS 1
APPLICANT
DEPENDABLE ELECTRIC INC
2619 COON RAPIDS BLVD NW
COON RAPIDS, MN 55433
CII'.'/►1 �i7
ACKERMAN RONALD A & KARLA K
6320 SQUIRE DR NE
FRIDLEY, MN 55432
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 28506
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
CC) 0V6 s "Mom
t2Effective April 1, 2004
APPLICATION .FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTAI I FD nN FArH Fi nr)P
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
NO. RATE
Water Heater - Gas** �
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes O No
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
Type $15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
TOTAL JOBADDRES Dt t1 G7
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
arid rulings of the Building Division, and hereby declares that all the facts
and. -representations stated in this application are true and correct.
DATE: 20
OWNER Q(DnQ W A c..Ker ryNa n
BUILDING USED AS @Ls Ld en -h o,
ESTIMATED COSTA 10. C)o PERMIT NO.
PLUMBING COMPANY
SIGNED BY TEL N0.v� -365 340
State Surcharge $
TOTAL FEE
Approved By
Rough -In Date
Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $16.00 or 5% OF COST
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
3C5 •5 0 CY
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMIT
COMMON VENT., VENT CONNECTOR AND COMBUStIOMAIR VI`QIFICATION
When replacina an existing fOrnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () 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 dues
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA -LAMA 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 O No( )
Appliance Type and Size/Common Vent and Vent Connector Information
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
x631572-3604 FAX: (763) 571-1287
ADDRESS 6320 SQUIRE DR NE
PIN : 133024410046
LEGAL DESC HARRIS LAKE ESTATES
LOT 1 BLOCK 3
PERMIT TYPE BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
VALUATION : $ 6,000.00
PERM
�_-�--_._..__ ice.
NO.: 2004-00928
DATE ISSUED: 06/17/2004
NOTE: PER R703,2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN
APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE
MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE.
APPLICANT
ACKERMAN RONALD A & KARLA K
6320 SQUIRE DR NE
FRIDLEY, MN 55432
OWNER
ACKERMAN RONALD A & KARLA K
6320 SQUIRE DR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or qmpel the provisions of any other state or local law
regucc strucliy n ormance of construcool.
♦ _ d`
Bldg
BUILDING PERMIT FEE 125.25
FIRE SURCHARGE 6.00
STATE SURCHARGE, VALUE 3.00
TOTAL 134.25
PAID WITH CHECK # 19868
SEPARATE PERMITS REQUIRED FOR WORK GTHER THAN DESCRIBED ABOVE.
Coq -co 9,71-o'? e'*�- 333?
NEW [ ] CITY OF FRIDLEY Effective 4/1/2004
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
V-rl06C-7
Legal Description:
Owner Name & Address: V-/ Rzl'4� wk Tel. # -1 &3 — %`71' F 7 d z
Contractor: c c:�LF MN LICENSE.#
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
, Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
U Yw,AL c 01 Al G
d'
Construction Type: V I V At- Estimated Cost: $
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: (7 (O'Lf APPLICANTgo--O� Tel. # ?(P 32 -
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
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ %3 a C21
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ J Not Necessary [ J
STIPULATIONS:
L� J