PRE 2010 DOCSCity of Fridley
SUBJECT
C?7�
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
�����
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
8/22/77
JOB ADDRESS 6390 Starlite Boulevard N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
4
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
Lill -Son Builders Inc. 8535 Central Avenue
784-6012
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
QA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 26' x 40' Dwelling and a 22' x 22' Garage
S,PEM'M P` MITS R QUWD FOR WIRING,
9 CHANGE OF USE FROM HEATING, PLUMBING .
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. Provide city with copy of
truss design before capping.
SEWER LOCATION: (Approx. 8.5' Deep in Street) 36' South
of Manhole (Inv. 837.02)
WYE ELEV: 836.75 TOP OF FOOTING: 840.25 Minimurn
WATER LOCATION: 19' South of Sewer Service, 55' South of Manhole
DRIVEWAY DEPRESSION COST: N/A
/p
ARNI
THE CITY OF FRIDW OW NOT GUARANTEE
�i
ACCURACY OF tmtmr IOCATIpNS AND jI�vATlcr,�..
Bef6ie digging calf local Utilities
THIS DATA IS FOR INFORM JR014 pURPOSES ONLY AND
TELEPHONE - CLi:Ci�,l� � Gr;v Etc.
PERSONS U W40 ri' &40U.,D VERIFY THE INFOWATION
REQUIRED BY LAW
ON THE Sn
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
1100 + 484
26,360 Total
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.
$33,120
$16.56
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$105.44.
$375.00
ST R THE PERFORMANCE OFC STRUCTION.
PLAN CHECK FEE
TOTAL FEE
S266.36
$523.36
IGNATUREOFCONTRACTORORAUTHORIZEDAGE (DATt)
WHEN PROPERLY VALIDAT D THIS IS YOUR PERMIT
E
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BLDG. INSP
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V DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
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CERTIFICATE O SURVEY
FOR: /
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THE
Pim Or' FIR4MV 009-S N ,T GUARANTEE THE
OF "UN 1IOC ` KJti iS AND ELEVATIONS.
DATA IS FOR RNMRMAwN PURPOSES ONLY AKIn
WAR h
881010 digging call local utilities
tPHONE -ELECTRIC - GAS Etc.
REQUIRED 13Y SAW
-•-..wb1d.j�wvaeq� nu Qr"wUw. ,` 1r- ' Yl AMbV�C' � �9this is a true and correct representation of a survey of File No.
ON THE SITE. the boundaries of the above described land and of the location of all buildings,
DEMARS - GABRIEL if any, thereon, and all visible encroachments, if any, from or on said land. /2-1 a -I-
LAND SURVEYORS, INC. As survey d Wme this — y of G� � f9-77 Book — Page
3030 Harbor Lane No. ' ;^/
Plymouth MN 55441 0^
Phone: (612) 559-0908 VScale
Minn. Reg. o. �OCOt'�- �"4a
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ON THE SITE. the boundaries of the above described land and of the location of all buildings,
DEMARS - GABRIEL if any, thereon, and all visible encroachments, if any, from or on said land. /2-1 a -I-
LAND SURVEYORS, INC. As survey d Wme this — y of G� � f9-77 Book — Page
3030 Harbor Lane No. ' ;^/
Plymouth MN 55441 0^
Phone: (612) 559-0908 VScale
Minn. Reg. o. �OCOt'�- �"4a
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I hereby certify that this plan,
specification, or report was prepared
by me or under my direct supervision
and that I am a duly Registered Pro-
fessional Engineerun.1er the laws of
e State of is Inn soca.
Date _ 17 - 77 Reg. No T G 2-
151S*
SCALE -3/111- je-Dp
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CLAAY412 113th. St. ENG, FOR- `i'RUSS MFG.
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I hereby certify that this plan,
specification, or report was prepared
by me or under my direct supervision
and that I am a duly Registered Pro-
fessional Engineerun.1er the laws of
e State of is Inn soca.
Date _ 17 - 77 Reg. No T G 2-
151S*
SCALE -3/111- je-Dp
CLARY CORPORATION DESCRIPTJQN- Sr - I SSOK- 9 PA*: i
CLAAY412 113th. St. ENG, FOR- `i'RUSS MFG.
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S MISS Mr K tut (U.N.)
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I hereby certify that this plan,
specification, or report was prepared
by me or under my direct supervision
and that I am a duly -Registered Pro-
fessional Engineer under the laws of
the State of Min esota.
Q
Date 7-94- 7 G Reg. No / D 2
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the State of Min esota.
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i
• CITY OF FRIDLEY AA II
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
N
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWPdER: BUILDER: 04 4 A,!p / S
Address: i�L er�e� Address : ��
Tel. No. -7 CV -6 0Z 2
No. d Street: s-zA6,4 19 0
• LOT: BLOCK: ADDITIONS"�� i✓�idiG ��G �� �.���
CORNER I,OT: INSIDE LOT: SETBACK: 3 7 - SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Used As:
'n Front: �� Depth: �� Height: o�
//®j ®?® �Q20
Square Feet: -140Cubic Feet:
(° A P( Front:
Square Feet: ( Cubic Feet:
X02 + Depth:
V Height: 161
-Ypee) —
Type of Construction: )`XA A Estimated Cost: $
To Be Completed: Alt. A Alt. B
r
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side additional information.
DATE: r7sf
Stipulations:°
a sa
BUILDING PERMIT FEE SCi{FDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or for any addition to any existing building'or structure,
or for any alteration or.repairs to any existing building or structure, upon application
therefore, require the payment by .the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x $11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $15.40
ADDITIONAL INFORMATION.
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIF_I_CATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a buildbng'permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
0 . .
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
>.
m
Qj x
A
$077 0
o
x
k
N
New Fixture, Old Opening
Water
m
�5
104
x
y
$
H
b
$5.00
100,000 BTU to 199,000 BTU
to W
$10.00
Wo
Water Softener
Heater
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
x
$
GAS FITTING FEES:
1st 3 fixtures
R�m7�
'$3.00
$
i
v W
$1.00
C
Gas Range to 199,000 BTU
x
A
G3
REPAIRS 4 ALTERATIONS
g
0
.0i
First $100.00
$5.00
each add. $100.00 or fraction
O
O
State Surcharge
1
N
TOTAL FEE
$�
11 N
N
.apCt
U
M
w
§
am
w
o
3W
0
a
c
o
as
lec
f
lst
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, old opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
Qj x
$3.00
$077 0
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
$ S o
100,000 BTU to 199,000 BTU
_L
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
I x
'$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS 4 ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$�
REINSPECTION FEE
($10.00) .
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 0 �� , 19-2
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST'
OLD UILDING PERMIT NO. PERMIT NO. �J
:.i
Company t�
Signed BY
Tel. No. �� `� U$—
ROUGH
ROUGH INSP.
Date
FINALINSP. l �✓ ' � s
A Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLu3 $.50 STATE SURCHARGE
CITY OF FRIDLEY
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 SCHEDULE
7.000
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
C/j 390
GRAVITY WARM AIR:
RATE
TOTAL
Job Address
Furnace Shell & Duct Work
$12.00
7.00
$
$
each addn. 50,000 BTU
Replacement of Furnace
7.00
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
$10.00
$
Tel. #571-3450
MECHANICAL WARM AIR:
ROUGH INSP. REINSPECTION FEE
Date ($10.00)
FINAL INSP.
Date
APPROVAL FOR PERMIT e
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
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.
OWNER
KIND C
USED 2
Fridley, Minn. 2 — 11�. 19e7p
TU BE CUDWIASTW "UU-4;
ESTIMATEDCOST
OLD(fILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWERS6& PLANTS, Steam, Hot Water, Warm Air- No. �
ER
Trade Name / 12 fjYj..-@a Size No.
Capacity Sq. Ft. EDR BTU HP
Total Connected Load �� �'� Kind of Fuel
BURNER - Trade Name, Size No.
Capacity Sq. Ft. EDR BTU HP
Company J3�
Signed By
Tel. No. -' alb .11
Furnace Shell & Duct Work to 100,000 BTU
.
$12.00
$
' 0
each add. 50,000 BTU
Replacement of Furnace
7.000
$
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
STEAM OR HOT WATER SYSTEM:
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
$ /0.00
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
3 o U.
lst 3 Fixtures x$
3.00
$
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEMS See Fee Schedule
$
VENTILATING SYSTEMS
$
ALTERATIONS & REPAIRS
$
State Surcharge
$ .50
TOTAL FEE
$ o) • .�
ROUGH INSP. REINSPECTION FEE
Date ($10.00)
FINAL INSP.
Date
APPROVAL FOR PERMIT e
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
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.
OWNER
KIND C
USED 2
Fridley, Minn. 2 — 11�. 19e7p
TU BE CUDWIASTW "UU-4;
ESTIMATEDCOST
OLD(fILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWERS6& PLANTS, Steam, Hot Water, Warm Air- No. �
ER
Trade Name / 12 fjYj..-@a Size No.
Capacity Sq. Ft. EDR BTU HP
Total Connected Load �� �'� Kind of Fuel
BURNER - Trade Name, Size No.
Capacity Sq. Ft. EDR BTU HP
Company J3�
Signed By
Tel. No. -' alb .11
d f/r
7,' 7
6'��
f
Y
dr;
r
F d�
d �
P
May 25, 1978
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Michael J. Larson
6390 Starlite Boulevard
Fridley, MN 55432
Dear Mr. Larson:
TELEPHONE ( 612)571-3450
I have reivewed your letter of May 22, 1978 regarding the easement
that adjoins your property in which you ask for my comments.
A few weeks ago, you called in to our offices and through a verbal
check with some of the staff, you were told that no vacation request
has come into our offices.
This is still the case. A vacation request would be initiated through
the Planning Division, after being requested by the property owner,
for consideration by the Planning Commission. Upon their recommendation,
there would have to be a public hearing before the City Council. For
each of these meetings, a notice would be sent to.the affected property
owners. Therefore, you would have received official notification
through the mail, plus a legal notice is published in our official
newspaper, the "Fridley Sun". After the public hearing, an ordinance
has to be passed to accomplish this vacation, which requires two
readings at least one week apart. After the two readings, the adopted
ordinance is then published in the "Fridley Sun", at which time it
becomes law.
As you can see, a vacation procedure is a rather lengthy process, and
there are specific legal steps which must be taken. You would have
received legal notification, provided you were an adjacent property
owner, and thereby affected by the request, and are the owner of the
property.
If you have any questions, please feel free to call our offices.
Yours very truly,
Richard N. Sobiech, P.E.
Public Works Director
RNS/jm
t (►
6390 Starlite Boulevard
Fridley, Minnesota 55432
May 22, 1978
Mr. Dick Sobieck
City of Fridley
6431 University Avenue N. E.
Fridley, Minnesota 55432
Dear Mr. Sobieck:
It has come to my attention that there are actions underway to vacate
the easement that adjoins my property at 6390 Starlite Boulevard on
the north side.
Although the easement adjoins and is not a part of my property descrip-
tion, do I have any right to challenge these actions?
Ron Lilliencrantz of White Oak Realty (who sold me the 6390 Starlite
property) and Robert Lee of Robert Lee Realty (an agent for said property)
both told me that no homes would ever .be built oVer.tl'Le easement.
In purchasing the property, I felt the combination of the easement plus
the planting zone provided by Burlington Northern was another reason
justifying the purchase.
Since moving to Fridley, I have found that the easement is used daily by
many people as is evidenced by the pathway worn through the Burlington
Northern property.
I would appreciate your comments.
MTL: sg
Sincerely,
Michael T. Larson
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
Lill -Son Builders
8535 Central Avenue N.E.
Blaine, Mn. 55432
Re: Final Inspection at 6390 Starlite Boulevard N.E.
Dear Sirs:
TELEPHONE ( 612)571-3450
A final inspection was made on December 28, 1977 of the above address
and the following itens were noted which must be completed before the
structure can be finaled out;
1. Provide a handrail to the basement by January 4, 1978.
2. Provide sod in the front and side yards by July 18, 1978.
We will expect the above items to be completed by the scheduled dates
when reinspections will be conducted to determine compliance. If you
have any questions on these items, please contact me at 571-3450.
Sincerely,
J� -'4
'01
RON HOLDEN
Building Inspector
RH/mh
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
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
Water Heater - Gas**
Effective On March 1, 1996
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
th..
Wash pt(trk Floor
>01:i:: Auto.
;C��;�:€:>�>�:: Gas
<Ms��<> Water Heater
ater
:.:.:
<•:; Tray
Urinal : ... ...D ::.<. Washer .Ran erain :
as Elec
NO. RATE TOTAL
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 _0-0
$10.00
$10.00
JOB ADDRESS-5"r-
The
DDRESS 5s r
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.
JS ,L�_L1ia , 1996
ner STEW
FiT -�� EaRRC(
5390 .m iN_ +T BOULEVARD
Building Use( FR I DLE,' M-1 55432
R 571-2550 W 962-6301
Estimated Cost �%1h� PERMIT NO.
Type $15.00 PLUMBING
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance 4
State Surcharge
TOTAL FEE
SIGNED BY
Approved By
$ .50
TEL N0. 6Z7 -q0 -?
Rough -In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
$,2,50 PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES.
.r.
SUBJECT
"P�ERIk:i'YRTa®<@
City of Fridley
2545 1
AT THE TOP OF THE TWINS
BUILDING PE
MIT
r
COMMUNITY DEVELOPMENT DIV.
REC+Fr1T NO.
r i PROTECTIVE INSPECTION SEC.
1 � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/2/97
JOB ADDRESS 6390 Starlite Boulevard NE
t LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
4
Sylvan Hills Plat 3
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Brad Stewart 6390 Starlite Blvd NE
571-2550
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
MidweTAst Siding & Roofing 18979 Gladstone Blvd, Maple Grove MN 55311 416-4804
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20010277
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION? REPAIR
❑ MOVE ❑ REMOVE
I
8 DESCRIBE WORK
Reroof House (23 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
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
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,918
$.96
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$
STRUCTION OR THE PERFORMANCE OFdCONSTRUCTION.
1W j 1", .5,@ Q ` --
PLAN CHECK FEE
License SC $5.00
TOTAL FEE
$70.13
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT MATE I
WHEN PROPERLY WDATED THIS IS YOUR PERMIT
LL Qbgp
DATE
S.GNATURE OF OWNERoF OWNER BUILDERiIDATEi
.r.
NEW [ ] Effective 1/1/97
ADDN [ ] CITY' OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R -i AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: L.9 D S B 1 La
Legal Description:
Owner Name & Address: Brad- `)4 cp n r-� Tel. # 5 71 - d�
Contractor: M l MN LICENSE # aOO 1" O
Address: 1 & D -OC Tel. # )LD
Attach to this application, a Certificate of Survey ofW n S s 3 l I
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: �C� �1 i',t ).�� I j C9
Construction Type:- -ntnr Estimated Cost: $ 5(9 DO
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft.' + 6 Ft = Ft x $ _ $
DATE: l �"� APPLICANT: (� Tel. # 0 q l
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%)
$.50/$1,000 Valuation
$950 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 [ ]
(W1110ING PERMIT FEE SCHEDULF-
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any cxisting building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including 525,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including 550,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus'6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation ,Tice it has it has been cons41-uC":1."'!
_, + b:_- rcquire(l before with the frtmin,,.
®3769
CITY OF FRIDLEI(INSPECTION DIV. Effective On January 1, 1997
6431 University Ave NE
Fridley, MN 55432. APPLICATION FOR POWER,PLANTS,AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING.SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
$ 30.00
(Side Vent Fill .0t -A .Oack)
Gas Piping (Needed with new1urnace)
Gas Range
$10.00
Gas Dryer
$10.00
*Air Conditioning- — All Slies
$ 25.00
$
All Others/Repairs & Alterations (UST ON SACK)
1 % of Value of Appliance or Work
$
Com me rcial ji nd ustrlal
1.25% of Value of Appliance or Work
$ .....
State Surcharge -.80
TOTAL FEE
MINIMUM FEE FOR ANY HgLTING/G00LIN0NENT'ILATION
REEF IGERATIONLAIR 00NDITIONING PERMIT IS $26.00
PLUS THE $,50 STATS .SURCHAfiG�
REINSPECTION FEE $42.001Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
J013 ADDRESS 3 /'6' 5 )_olt't L f 1 61 vd,
r
r
The undersigned hereby makes application for a permit for. the work herein r
Specified agreeing to do all work In strict aocondanee with the City Codes and
Mngs of the Building Division: and hereby declares that all the facts and
w
representations stated In this application are true and correct,:
dD 17d .1f�97
OWNER. �.-- --- �t bole
BUILDING USED AS
i
ESTIMATED COST 500, PERMITNO.-
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle Ono (Steam) (Hot Water) arm a
Trade Name . Le Size No, 623 - a!/,, 7 -
BTU _�, �7s HP EDR
Fuel.. W'& -T" Total•Connected Load,
Burner Trade Name Size No.
BTU HP EDA .
HEAVINGCOMPANY ` � ,�'4 60'dd.
0
Tel No.
.Signed By '"�������
Approved By Rough --in Date Final Date
FILL OUT DACK SIDE FO STACK VERIFICATION ON
REPLACEMENT FURNACE
v
JUN --18-1997 16:e3 CITY OF FR I DLEY
b
612 571 1287 P.02i02
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(k} off. sa;� �4 io; �ap�nd uaaq aeg -L .
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30. S�IIjA-9urtwq imeq seH 9
{) 014 V) sad, pm=oa. small Inc" pue
am -104 swxmm. dw apoo =aura n8 E3=jq •S
{)
TOTPL P.02
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pMwddns Alwn as sl -y'.
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taqued pa poZ slag go U4=o; ou, an •£.. .
(}
off :() sad
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ort, "E } sa�.,w• ..
-.... `papa iaexa a .=oq seg Y
30 •*V VW=J.UZA /.q=q p*^= _pvn oql
'°AiOI.MI3LZ IZA
30VISAW ARNKEH
TOTPL P.02
11OUSE HEATING TL••:;T KLLUM)
ADDRESs_G` 5 �{- 6tv�Q APT. MOR CITYF;JI'CISUBUnn_�N
OCCUPANT OIMER 4/.44 -
HEAT LOSS DATE 11TG . INST. / Z0 `7 c
SOLD BY. , _S L, 111STALLED BY
circ:cric:a�
Work Dy S peri- Gas Line By. s
TYPE OF HEAT: CA FA)� 11W STEAM ShCE JITR. UNIT 11TR.- OTHER
CAS DESIGN
MJIKL OF. BURNER
e>,? 3 - �l3 — 7S! Model
Scrial 5-97'76-- 3 3 0717 Max. BTU Rating
INPUT 7s O®o MAKE OF FUMMACE
Model
CONTROLS
T11EIt�w� i.�j ,Qitcat Plug Vent
Valva L"j '` KIND
Z .
CONVERSION
,/, G /r 9
OF LINER SIZE NONE
Limit Draft Hood Rcrulator
°, Zsx � Number
Limit Setting, 200D Filters; Size /�r�
Fan Setting ���✓'^ Chimney Location: 'Inside Outside _
Pilot Type_ Chi=cy Construction
Pilot Make
Pilot Model Smoke Bomb Wiring ��
?110 t Timing 2 sec- Draf t Tea t Tar
L.li.• Cut Off Door Pressure _ Lirhtinr Inst.
Prcasure 3 S u -c Percent CO2 � Date Tented
Input CFF{ Percent O. Codipany Tcati.nr
Stack Temp. Percent CO Hame of Taster
UMDING
E•���RESIDENTUL APPLICATION
'. FP"LEY
aim=
GARAM
03 A.. d'
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CMUACHWO,
MoFammour
EMmil
pp
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