PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT IT N® 4 3 9 9
Date: ........... R_7_... 6-7
Owner:-------•................................_...............--•---......_.._-------•-_-_---_------._....------- Builder -
Address
Address
��jj vv77 LOCATION OF BUILDING
No: Street -- _-- .-- .. .... ....... Part of1XIot ...... ...... __..._......._. _.._ .
Lot -.............. �................ Block....-.....:�.................... .......... Addition or Sub -Division .........
�J
Corner Lot .................................... Inside Lot ...... ............................ Setback . _ .. -F_ ..._... ideyard Z-0:4!�?..... ........................ ........ .....
-
Sewer Elevation ..... -.............. -............. -............. - ............................ -....................... Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
!� e4 L_r
.. .51 e.. Front .../_... Depth `. Height / 10 It Sq. Ft. /GCu. Ft. -111,.Z. j/
..._../
............................................................ Front ........---............. Depth .... Height ........................ Sq. Ft. ..... _................. Cu. Ft.........................
Type of Construction .................... ....... ................................ Est. C 6st.l.. .. ®.--' ...... To be Completed .............................................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
-.1k--------------------- -___ _--- -_-_--_-._.._...._.._._.._-..._.... - --- ___...__...._....
In consideration of the payment of a fee of $...R .. ............. permit is hereby granted to ----- ----------------------------- _------------- _-------
__.-...._............................. ........_........ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the pp .sions of said
ordinances. / '_
Building Inspector
dr.
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 these items.
4
e �/
City of Fridley ;�
Application for Piambing and Gas Pitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x $1.50
It
Future Fixture Opening ................
Z
tri Z
O =
C9
Z
Catch Basin ............................
WATER HTR.
GAs
ELEC
x 2.00
$
New Ground Run Old Bldg . ............
Z
N
�4a
3�
zp
$m
u} J
F
N
o2
u.o
a3
0<
0
Base
1st
2nd
3rd
4th
` Future Connection Openings
Connected with
New Fixture, Old Openings I
Sewer E]
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x $1.50
It
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
$
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
x $1.50 $�
x .50 $
x 2.00 $
Description................................................$
TOTALfo
FEET
.N
Dept. of Bldgs. Phone SII 4-74 0
Z -4 _ _ U.1 ,I
City of Fridley: 6-1�
61, 7
y
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 applica are true and correct.
Fridley, 19-!&
Owner -06a Oa -✓� • '19—
Kind
9Kind of Building , 19—
Used as ,
To be completed about
1
Estimated Cost, $
Old ew Building Permit No -
Sign
By
Business Phone No
Connection Permit No . .......................................................
1960
Water
n r �® IJ
Sewer
Deposit r
iT 1-9,60
PR o
Al
.0113�.11 IM -8-58
City of Fridley, Minn..
BUILDING 15��)
Dates
Owner: X,Builder
a
Address _ _. _ _ _ Address --- .–
LO I " Off , L G
07 11*11A
fi
No. Street _ Part o , t
Lot Block Addition or Sub -Divi 'on
Corner Lot - __ _ Inside Lot _. dMack ideyard ---%;o
Sewer Elevation F dation Elevation
DESCRIPTION .OF BUILDING
To Us1, .)
°. Front _ Depth x Height _ Sq. k't. Cu. Ft.
07 IIt Depth —�H ht �OJ_ _ Sq. Ft. Cu. Ft.
Type of Construction . Est. Cost �.,.:..•To be Completed
In consideration of the issuance to me of a permit to construct the.building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.�� , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
e express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon viola4of any of the provisions of said
ordinances. .01°6*.. _ ,,
r 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 these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEYs M:[NNESOTA
Owners Name IQJ IAN_.� - / 1 /buil der, �� _ 1 k k t
.+,-77- ' R ;� � ,Address 9 7a / 4 v
Address P.
LOCATION OF BUILDING
No.
Street '� _ art of Lot � i
Loot. Block . Addition or Suub.Div. ®��e
Corner Lot,_,_, Inside Lot � Set Back Side -Yard
SEM ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used ass
Front Ds
Sq. Ft. Cu. Ft.
Front Aepth Height
Sq. Ft.
Estimated
Type O.£ construction OU A. i ,f> �..L........,�..._.,,.....r.�._..
To be
The undersigned hereby makes application for a permit for the work herein apecifieds
agreeing to do all work in striet accordance with the City Ordinances and ruling of
the.Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE ; " r'� ®,;.�' SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
6300 Starlight Blvd.
Fri.dl ey t MN 55432
June 7, 1982
Mr. Ronald D. Sherve
Ass't. Superintendent/Administration
Burlington Northern
Northtown General Office Building
80 44th Avenue N.E.
Minneapolis, MN 55421
Dear Mr. Sherve:
If you will remember the first week in May you attended a neighborhood
meeting at the City Offices in Fridley regarding cutting of trees on BN
property, directly behind our properties, by NSP. Mayor Nee spoke to you
regarding a letter I had written to him, and you and I did discus's the
matter briefly that evening. Another copy'of that letter is attached.
This is to direct to you the attached list of engine numbers, dates and times
that trains were sitting for any length of time behind our homes, although
onlythose instances when engine numbers could be determined are shown.
Obviously, there are no night hours shown, and since we have also been gone
from home a considerable amount of time over the past few weeks, this is not
a'true representation of the number of times this happens. There are many
more occurences, night and day, which are not reflected; howevert this will
give you some idea.
As you can see, this is an on-going problem and when one cannot even sit out-
doors and enjoy the peace and quiet of your own backyard because of engines
sitting directly adjacent to your yard for long periods of times, engines
running loudly, then we do believe it is to the point that requires attention
and our only hope is that you can help to find a solution.
Thank you, Mr. Sherve, for your consideration and help in this most annoying
and disturbing situation, and we will anti'ci'pate hearing from you just as soon
as possible.
Since ely,
Mrs. Norris ( ris E.) Knutson
cc: Mayor William J. Nee
City of Fridley
Encl. - List
Copy of letter dated 4/30/82
DATE
ENGINE #
STOP TIME
LEAVE
TIME
5/8/82
77927
10:40
A.M.
11:30
A.M.
8000
8148
5/8/82
8056
4:35
P.M.
6:30
P.M.
Sinn., 5/9/82
1810
;5:05
P.M.
5:50
P.M.
6505
6:00
P.M.
7:00
P.M.
6350
6635
5/10/82
7100
6:40
A.M.
7:30
A.M.
6351
6370
5/11/82
6923
11:55
A.M.
?
5/13/82
6923
7:15
P.M.
8:10
P.M.
2026
6049
6709
5/15/82
6919
8:10
A.M.
10:10
A.M.
6317
1414
6115
5/15/82
7919
11:35
A.M.
12:15
P.M.
7922
5526
5/15/82
6397
5:20
P.M.
5:45 P.M.
6.124
143
552
166
5/15/82
2105
5:55
P.M.
6:30
P.M.
2003
1405
5/16/82
5398
11:30
A.M.
1:05
P.M.
6804
7927
5/19/82
6321
8:00
A.M.
?
6824
6023
5/20/82
6825
11:25
A.M.
11:50.
A.M.
6923
1545
5/20/82
1858
4:30
P.M.
5:31
P.M.
2034
6763
Page 2
DATE
ENGINE #
STOP TIME
LEAVE
TIME
5/22/82
6809
10:30
A.M.
10:45
P.M.
6475
6425
8161
5/22/82
7856 (?)
5:15
P.M.
or earlier 5:55 P.M.
2001
7861
6/2/82
? (couldn't see)
11:45
P.M.
12:30
A.M.
6/5/82
6831
11:30
A.M.
12:10
P.M.
6828
8175
6731
6/5/82
6925
5:50
P.M.
6:30
P.M.
6321
1915
7100
445
6/6/82
8011
11:25
A.M.
?
6/6/82
8087
5:15
P.M.
5:45
P.M.
8067
6542
6626
We were out of town Memorial Day weekend, but our next door neighbor, Jan Christenson
(phone 571-6944) said it was really bad and she had called the control tower to
complain a number of times. I do not have any specific information on times for that
weekend, however.
c
Doris Kn tson
6300 Starlight Boulevard N.E.
Fridley, Minnesota 55432
April 30, 1982
The Honorable William J. Nee
Mayor of the City.of Fridley
6431 University Avenue N.E.
Fridley, Minnesota 55432
Dear Mr. Mayor:
On the morning of Thursday, April 29, you visited Starlight Boulevard to view
the results of the cutting of oak trees and other varieties of trees, bushes,
and other growth by NSP on the railroad and homeowner sides of the fence to the
rear of our properties. At that time I brought to your attention another related
problem with which we, as homeowners, must deal, and you suggested that I write
to you about it.
As you could see, the growth that was cut down had provided us with a perfect
buffer between our properties and the railroad. We could not even see the trains
in the summer irOLI the Sack of our jard, it was so t;iick. Beyond that, since the
computerized system of routing trains into the Northtown Railyards went into effect
not that long ago, a computer housing was installed by the railroad just behind our
properties, thus establishing, for whatever reason, a stopping point directly behind
our homes. Engines (trains) will stop there with engines running (also refrigerator
cars), sometimes for hours at a time, night and day. There have been many, many
sleepless nights by the writer, a great deal of frustration, some anger, and a feeling
of futility in trying to either put up with it or change it. This was discussed
briefly just recently with Jim Verstrate (sp?) of Public Relations/Burlington
Northern, and he is the first person I've spoken to with BN who seems willing to
cooperate. As I mentioned to him, we consider ourselves to be the norm, working
d,
as and tryins to sleep nights, ani that our homes cover only about a three block
stretch, so it seems that perhaps something could be done to establish another
stopping point for these trains behind industrial areas close by. This situation
has always been a problem to a certain degree, but I want to emphasize that it has
become much more serious and consistent over the last couple of years, perhaps a
little longer. We bought our home 17 years ago, making the decision then that we
could and would learn to live with the railroad behind us, but it has now become
far more to deal with than the normal traffic.
We are asking your help to perhaps arrange and/or participate in a meeting with
Burlington Northern to negotiate some kind of amicable solution to this problem.
Thank you very much for your consideration of this matter and for whatever help
you can give us. The writer has obtained the signatures of most of the homeowners
on Starlight Boulevard bordering the railroad (see attached) to substantiate the
significance of this problem.
Since ely,
d�C.d
Mrs. Norris E. (oris) Knutson
cc: Mr. Edward L. Hamernik, Councilman
Telephone: 571-2932(Home)
572-1350 (Office)
�1
,te,
C,-31,0 a;�z- tr 4-
f /r
t
� r 1
ell
le
2 Y,�
SUBJECT
PE _.
City of Fridley
2 2 0 3)
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEV 55432
IL'"'"
NUMBER
REV
DATE
PAGE OF
APPROVED BY
'.J 612-571-3450
910415
JOB ADDRESS 6300 Starlite Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Norris Knutson 6.300 Starlite Blvd NE
571-2932
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
❑ NEW ❑ ADDITION ❑ ALTERATION lJ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (15 Squares.) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS Roo:'ing can be the 2nd layer but not the 3rd.,
Install adequate attic
ventilation, Provide smoke dete.ctors as per UBC 1210 adjacent
to all sleeping areas
and basement,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
$660
$.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-
$ 1.9.00
Fire SC $.66
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$20,16
Si JA URE OF CO -RAC.TOR0 AUTHORIZED AGENT DATE)
e
A �e�-2-7
WHEN P
BLDG NSP
nLY V
TED THIS IS YOU PER IT
FATE
SNATURED NOWNER BUILDER) (DATE
NEW [ I Effective 5/26/93
ADDN [ J CITY OF FRIDLEY 4-3oo
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: S 3 o 0 -SlnlLI- /GH 7' \C-�
Legal Description: ,� e? 7 % yl- Z4 /y zv A A T 3
Y
Owner Name & Address: lVo ter, -15 /6n1 LA -7 =s� o 1,1 Tel. # S- - z 32—
Contractor:
z
Contractor:
Address:
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 0"ROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width HoGround Sq. Ft.
OTHER: - - �a s ' `d 1-f
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: _
Ft. Yd Setback Side Yard Setbacks
Estimated Cost:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: APPLICANT -
(Cost on Back)
Ft x $
Permit Fee
$
/ % eO
Fee Schedule on Reverse Side
Fire Surcharge
$
. 4a%
.001 of Permit Valuation (1/10th%)
State Surcharge
$
C
$.50/$1,000 Valuation
SAC Charge
$
$750 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$_
Alt. "A" or Alt. "B" Above
Erosion Control
$
Conservation Plan Review $450.00
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$C
'
STIPULATIONS:
. . .
=$
Tel. # 6-7/-Zza2
SUBJECT
ER
City ®f Fridley
6 7 12
AT THE TOP OF THE TWINS
BUILDING PEI
T
r
O
� COMMUNITY DEVELOPMENT DIV.
I° -; PROTECTIVE INSPECTION SEC.
1
�!! B6
r
o ,
r/
NUMBER
REV
DAVE
PAGE OF
APPROVED BY
-'I CITY HALL FRIDLEY 55432
612-571-3450
990-F15
7/21J98
10B ADDRESS
6300 Starlite Blvd
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
S lvan Hills s Plat 3
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP
PHONE
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Tabor & Sons Inc 2716 S789-1902-
20014248
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
Reroof house and garage 24 S ear -off
9 CHANGEOFUSEFROM
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 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
1 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
$2001
$1.00
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-
Fire SC $2.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$74.75
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$82.75
SIGNATURE OFC NTRACTOR OR AUTHORIZED AGENT ,DATE,
WHEN PROPERLY V
ATED THIS IS YOUR PEspR�M.IT��7/���
- 1
BLDG SP
DATE
_
SIGNATURE OF OWNEROF OWNER BUILDERi ,DATE,
NEW [ l
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 43o
Effective 1/1/98
Legal Description:
Owner Name & Address: o Q L6 /3, Tel.
Contractor: , MN LICENSE #. ®a/ tl %;91
Address: 3 7/ 4 S 3 ®3 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGEAREA: Length
DECK AREA: Length
OTHER: AV,,
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
Width Hgt/Gro d
Sq. Ft.
Sq. Ft.
Sq. Ft.
r
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: 4 a., Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ /-/ �., Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ - U $.50/$1,000 Valuation
$ $1000 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 [ ]
$
,
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
0 CITY OF FRIDLEY
eM 6_1 hou
DATE j' �' 0-7 YOUR E-MAIL ADDRESS
SITE ADDRESS C) c'.) y r i r- SUA !1®lE
THIS APPLICANT IS: ❑ OWNER JVCONTRACTOR
PROPERTY
NAME: -�S®
OWNER/
ADDRESS:: ®O G�`� Z,\41 CITY �� a d'�xI STATEMi zip SS�E3
TENANT
PHONE: -I - 6-5-1 ® - �� 3
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
CONTACT PERSON: JOANN 7 INKEN
SUBMIT A COPY OF
STATE LICENSE # EXP DATE
YOUR STATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON,'RAP.IDS sTATEMN zIP55433
APPLICATION
PHONE 763 — 757 -- 6202 FAX 763--757--6701
PERMIT TYPE
9fWGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW EX -PT -PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: u tr. MODEL: ul S1ZE/BTU 1 5 , O 0®
MFG: MODEL: Lk L -o2, SIZE/BTU a --off
MFG: MODEL: SIZE/BTU
$25.00 FIREPLACE (GAS) $15.00 ; ' GAS RANGEIOVEN $10.00
_AIR. TO AIR EXCHANGEER $15 —FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_ BOILER $35.00 e� URNACE $35.00 GAS UNIT HTR $10.00
_
_CiIDVII4EY LINER $10.00 _GAS DRYER $10.00 - POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
ff
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 -1 x $25.00 = $ a,3.0D
Number of fixtures @ $35.00 t x $35.00 = $ :3S ,
State Surcharge = $ .50
Total = $ SO
THIS IS AN APPLICATION FOR A PERMTT-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 Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
® eA. �' e'
SIGNATURE OF APPLICANT mTNAME ROGER HOFFHEIN DATE 0
City of Fridley
Building Inspections' Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
ce-
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
0 NEW HOMES/ADDITIONS EXISTING HOME 0 MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.