PRE 2010 DOCS52-84-s915-51
City of Fridley
Application for Plumbing and Gxn Rtti•ng Permit
Dept. of Bldgs. Phone 560-3480
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
v2
$
X $1.50
$
X $1.50
$
x $3.25
$
x $3.00
Z
`j Z_
O5 S
,�
33U'
Z
�p
x $2.00
N
WATER HTR.
GAS
ELEC.
Base
1st
�-
2nd
3rd
4th
• Future Connection Openings
o New Fixture, Old Openings I
Connected with
Sower
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... ...... .......
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ...... ....................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg . ............
Electric Water Heater
GAS FITTING FEES:
1st 3 Fixtures ....................... ..
Additional Fixtures ....................
Gas Range to 199,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
x $2.00
$
X $1.50
$
X $1.50
$
x $3.25
$
x $3.00
$
x $3.25
$
a $2.00
$
NO. RATE TOTAL
x $2.00
$
x$.75
�-
$
.00
x $5.00
$
Description ................................................$
TOTAL FEE $ 1.00
i
Location 6131 Starlight Blvd
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 facl
and representations stated in this application are true and correct.
Fridley, Anna 10-30-67 19_
Owner
haul Hu mnick
Kind of Building frame
Used as res
To be completed about 0-5-67
Estimated Cost, $ 10000
Old—New. Building Permit No Permit No.
•
S gn
By
Business Phone No
ROUGH
FINAL
42
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
Furnace Shell & Duct Work to 100,000 BTU
.AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDUI E
4.00
$
Replaceaent of Furnace
GRAVITY WARM AIR:
RATE
TOTAL
c /
Job Address /i� �31 cJ%�Cc lr�1/1 �e_,
Ft:rnace Shell & Duct Work
$12.00
$
,
Replacement of Furnace
Repairs & Alterations -up to $500.00
7.00
7.00
$
$
Department of Buildings
Repairs S Alterations each add. $500.00
4.00
$
City of Fridley ,
Tel. #571-3450
MECHANICAL WARM AIR:
rn L INSP.
Date
APPROVAL FOR PER*iIT l
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, Minn. C ® 1�
OWNER dP L✓ CJI�I / C_
KIND OF BUILDING Alk,
USED AS //e eel
TO BE COMPLETED ABOUT�/R�(�,
ESTIMATED COST �(
OLD - NEW BUILDING PER14IT NO. PERMIT NO. / ,•��
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. f
Trade Name Size No.
Capacity Sq. Ft. EDR STU e_Y - HP
Total Connected Load Kind of Fuel
BURNER - Trade Name' Size No.
Lo 9c
Capacity Eq. Ft. EDR BTU a. �HP
RAY N. WE�LTERHEHEATM CO.
Company +46@7 Qhieelse; Ave,
Signed By MinneopoI14 MinneW a 55407
14 /1
� g1ej ,? /, . • Tel. No. � `(
taNIKUK FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.SO STATE SURCHARGE
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
each add. 50,000 BTU
4.00
$
Replaceaent of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
srA.If OR HOT WATER SYSIDI:
Boiler & Lines up to 100,000 BTU
$12.00
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
each addn. 50,000 BTU
6.00
$
OIL_ BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 100,000 BTU to 199.999 BTU
$10.00
SU.,Kl_
(over 199,999 BTU see Fee Schedule)
S
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$ is
Additional Fixtures x
$ 1.00
S
Gas Range to 199,000 BTU x
$10.00•
$
AIR CONDITIONI`G
$
FAN HEATING SYSTEMS See Fee Schedule
$
VENTILATING SYSTEMS
$
ALTERATIONS $ REPAIRS
$
State Surcharge
$ .50
TOTAL FEE
$ e
BOUGH L\SP. REYNSPECTION FEE
Date 1($10.00)
rn L INSP.
Date
APPROVAL FOR PER*iIT l
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, Minn. C ® 1�
OWNER dP L✓ CJI�I / C_
KIND OF BUILDING Alk,
USED AS //e eel
TO BE COMPLETED ABOUT�/R�(�,
ESTIMATED COST �(
OLD - NEW BUILDING PER14IT NO. PERMIT NO. / ,•��
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. f
Trade Name Size No.
Capacity Sq. Ft. EDR STU e_Y - HP
Total Connected Load Kind of Fuel
BURNER - Trade Name' Size No.
Lo 9c
Capacity Eq. Ft. EDR BTU a. �HP
RAY N. WE�LTERHEHEATM CO.
Company +46@7 Qhieelse; Ave,
Signed By MinneopoI14 MinneW a 55407
14 /1
� g1ej ,? /, . • Tel. No. � `(
taNIKUK FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.SO STATE SURCHARGE
0
TO, John Flora Message
- Date august 2, 1985 Speed
From NASIM QURESHI, CITY MANAGER'S OFFICE
Subject Citizen Selling out of House
SM 24-85
We brought a memo to the City Council saying that it would be
a violation of the City Code to sell out of this house. We should
be sending this citizen a response on this also.
Wilson Jones Company
17,
To: Nasim Qureshi
Signed
From: Jim Robinson
Thank you, -
NMQ/ms
Dated, 8/6/85
Rosemary Humnick has been informed that she can not sell consignment goods
out of her home, as it is in violation of City Code.
JR:jmo
August 6, 1985
Rosemary Humnick
6131 Starlite Boulevard
Fridley, MN 55432
Dear Ms. Humni ck :
Upon reviewal of your request to sell consignment goods out of your home it
has been determined that this Would be in violation of the City Code (see
attached). Chapter 205.03.36 states that no over-the-counter retail sales
are allowed as part of a home occupation.
If you should have any questions please contact me at 571-3450.
Sincerely,
James L. Robinson
Planning Coordinator
JLR/ dm
C-85-201
J
SUBJECT
PE
City ®f Fridley
2 210
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
9
r ' PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
PAGE Of
BY
i CITY HALL FRIDLEY 55432
J 612-571-345.0
910-F15
9/15/93
JAPPROVED
JOB ADDRESS 6131 Starlite Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
15
2
Sylvan Hills Plat 2 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Paul Humnick 6131 Starlite Blvd NE 571-3626
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sante
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 ❑ ALTERATIONCx7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House C15 Squarest Tear--off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with.the State Building Code. Provide
adequate attic ventilation. Provide smoke detectors as per UBC
1210 adjacent to all sleeping areas and in Basement.
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
$810
$, 50_
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.
$23.00
Fire SC $.81
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$24.31
SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT
WH Q ERL LIDATID THIS IS YOUR PER IIT
,4q(DATE)
OC LDG INS P DATE (4//
SiG�..N1LlA'`T"UR�E O�F�O'W�N"HR IIF OW BUILDERI IDATEI
J
NEW [ l
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
4/.3 /-
Effective 5/26/93
Legal Description:c
Owner Name & Address: �` � ��' /� l _ Tel. -z 6
Contractor: G MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length . Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Side Yard Setbacks
Estimated Cost: $ < /U `&
(Cost on Back)
Ft x $
=$
A
DATE: f�� l �-� APPLICANT: %� Tel. #
Permit Fee
$
Fire Surcharge
$ !
State Surcharge
$ S�
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary j ]
STIPULATIONS:
Building
BUILDING
Permit Fee
PerniitNoAAN.
Inspections
Plan Review
RESIDENTIAL APPLICATION
Received
763-572-3604
$ t
CITY OF FRIDLEY
Surcharge
D '
763-502-4977 FAX
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
EFFECTIVE i-1-2010
$
ft + 6 ft = ft x $24 = $
*� �q
DATE !.► � (p
YOi3R9AII, SS
$450 Conservation Plan Review
Park Fee
�i��rvi
SITE ADORES
Sewer Main Charge
$
Agreement necessary ( )Non Necessary ( )
Total Due
$
THIS APPLICANT IS:
PO<& 13CONTRACTOR
PROPERTY OWNER/
NAME:
ADDRESS: CITY
STA ZIP
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
ADDRESS:
CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
0 SINGLE FAMILY/NEW CONSTRUCTION SIZE
0 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
0 ADDITION 0 GARAGE/SHED O W.iNDOWS
0 BASEMENT FINISH lF 0 DRAIN TILE
O DECK 0 SIDING 0 OTHER
0 SWIMMING POOL
TYPE OF WORK:
0 NEW HOME CONSTRUCTION 0 ADDITION
I iTENANCEMEPAiR 0 REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING0 HOUSE ONLY
BASEMENT REMODELING SUBMIT-,
NUMBER OF SQUARES Iq
0 HOUSE & GARAGE
L Existing Floor. Plan
GARAGES
0 ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
0 DETACHED GARAGE
3. Inst of st udmal meanlcs to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS_ & PORCHES SUBMIT:
0 Vinyl
OSoffit
1. Sitc Plan/Survey showing the misting structures
0 Aluminum
❑ Trim
and proposed project.
0 Other
0 Fascia
2. Two sets of cunsinwtion plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS
FOR WINDOWS —PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS
L S,
(USING THE 1997 U B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
OCCUPANCY TYrJL
Permit Fee
$ i :
See Back Page for Fee Schedule
Plan Review
$
655/o of Building Permit Fee
Fire Surcharge
$ t
.001 times the total job valuation
Surcharge
$ 1
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( )Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridle Attach ations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the h i nnesota Construction Codes; that I understand this is .not a
permit but only an application for a permit and work is not to start without a permit on site, that the work will be in accordance with the
approved plan in the case of w ik whid� re9tiire ecu and approval of plans. 'b /�
�/
SIGNATURE OF APPLICANT Tf�ov` PRINT NAME 1� DATE
PLEASE NOTE SEPARATE PERMITS ARE REQUIRED FOR PLUi1lBRiG, ELECTRICAL AND MECHANICAL WORK