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PRE 2010 DOCSis City, of Fridley, Address Address rA.00ATION!tBUI ING No. street Part or Lot Lot _ ___ Block Addition or Sub -Division . ®y --- --- Corner Lot — Inside, Lot �.. �� Setback ___._ Sideyard �®_ ..... -9 ._._.._._.._ Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING J T U Front Depth Height Sq. Ft. Ft. k-e—ve Fron Depth Ht _ Sq. Ft. Cu. Ft. 3-kklP Type of dinStrUCtiOn Fast. 4 P—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 sp forth n ompliance wi all provisions of ordinances oY the city of Fridley. ei In consideration of the payment of a fee of $ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the rsqn to whom it is granted and his agents, employees and workmen, in all work !L, theme city limits and permit may be revoked at any upon viol of aay of the provisions of said NOTICE: lids permit does not Cover the contruction, bntAmen for wiring, plumbing, an heating, sower or water. Be acre to we the Building bqm ter for awarate permit for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNE R'S Z �.4 1 &e& / ADDRESS ADDRESS LOCATION OF BUILDING No. [ Street Part of Lot Lot Block �� Addition or Subdivisipip Corner Lot Inside Lot Setback &%I-/ Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates.of Survey of Lot and proposed build- ing location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed 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 applicatio4-gre true and correct. DATE /U s "' -0- 6 J1 SIGNATIME �/ 7- 2� � (Schedule of Fee Costs can be found on the Reyerse Side). c BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any exist- ing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, 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; 2.1. For any such permit for the erection of any fire -proof building, other than a garage# warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any fire -proof garage, warehouse, :factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, for -similar occupancy, to any existing building or for each such wilding or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00. For the purpose of computing fees for building permits, the cubical contents of any building or addition to a.uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. 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. 2.6. In no case shall the foo-chargad for any permit as set forth in Section 2 be leas than $4.00. Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ................ 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ t OXL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal, per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. �Fridle� Minn_ / 6 /'-i / O ! 6 19 — Owner Kind of Building Used as To be completed about Estimated Cost, $ Permit No. 6 / d Y Permit DESCRIPTION OF WORK HEATINGor WER. PLANTS—Steam,Water, arm Air o Trade NamL�—�ize No 2!Z/ 7-4-- Capacity 4 Sq. Ft. E.D.R BTU A.P. Total Connected Loa Kinof Fuel BURNER — Trade Nam Capacity Sq. Ft. E.D.R" BTU H.P. (REMARKS -OVER) Sign �— By - 42 2M Business P ane N Permit Fee` (¢ yi APPLICATIpN FOR MECHANICAL WARM AIR HEATING PERMIT No.P........................ Date of issuance ....................................................... I96------ Location -•-- '�f le.. glee el' .Minn.,..:. ..... , .. .........--, 1965.- Inspector of Buildings The undersigned hereby makes application for a permit for the installation, alteration or repair of a heating, air conditioning or ventilatin_% system, device, or equipment, as herein specified, agreeing to do all such; work in strict accordance with the City Ord inanees and rulings of the Department of Inspections and the specifications set fort?i in this application as approvedand filed in the Department of Inspections. Lt/7,2r.-4ddress of Owner-- --------- -------------------------------------•. Kind of Building .eGif1 1rr R.r ......... ....... ----......How occupied .......... ........................................................... Work to be started ...... ).A.:...c::1... ................1196 ...... Work to be completed--- ................, 1963. Estimated Cost ,._.t. ? �..... ..............Old — .New Building Permit X0 .......... w ... ...................... DESCRIPTION OF WORK Note: Insert the word install, add, alter, or repair, according to which is to be done. Under "Remarks, ` itemize removals, If any, and alterations to equipment. ............ .................Mechanical Warm Air Heating Plants --Furnaces ........ .......................................................... ... .?.. s ------------------------------------ acity.. a1.1t1✓1.-----...-•--------------------------- Air Conditioning System: Summer -- :Winter — .411 Year;--------------- .................................... ................................... .Make ................................................Capacity------------------- .-------------- --- Osm --------------- -------•------- Ventilating System: Make..-- ..:...... ... .... ............ .........Capacity.-----•.. -------------------- Cfm-------------- -- Remarks.................... ..................... ----•........... ....................... ............. ........................ ..................................................... ... --I firS7.REATMO ------- .---------------- .vry aid YG G L_..I�J� l r�----------•---------•-- ~ 2505 MARSHALL ST -N -L Signed......... ......... ....-------------------------------•-. By------------ / ............. ✓lddress ..... ............... .. _-----... .—................................ Telephone. /.., ----------------•------- ----------------------------------------------------------------------------------------------------- ...................................................................... ...................................................................................................................... . .............. ..... ....... .................. ..................... ................................................................................... D-20 4UjjW3 HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTIONS MINNEA Weatherstrips A.S.H.V.E, Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Yes—No Yes—No 19— F1.1 Room I Length Width Height F1.1 Room I Length Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area pane of pane lights of crack aq. ft. No. of Lineal ft: Area lights of crack sq. ft. iI Coef. Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of pane of pane No. of Lineal ft: Area lights of crack sq. ft. iI Coef. Btu Infiltration Glass Coef. Btu Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FLl Rnnm I Length Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. iI Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader are Height Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Lenath Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int, wall Ceiling Floor -Iota! Utu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D-56 9 HEAVLOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall JInt.WalI I Ceiling I Roof Floor Ye Ye— s d2 N 0 19_ H FLI J l 1. Room I Lenath-1 -i X Width A q ' Heisht d II FI Windows and Doors --C and Area a�ww jL.V11KLAS Width Height No. of pane of pane No. of Lineal ft. Area lights of crack '.. sq, ft. A 6 .Q Coef. Btu R -A® Glass Coef. Btu Infiltration Infiltration Net exp. wall d Glass Infiltration Ceiling 2 Exp. wall Glass Exp. wall Net exp. wall p 73 d 6 Int. wall d! ` Ceiling Int. wall - 4UL RIO Floor Ceiling Q f r Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1 Id 1 F1.I --,T. Room I Lenath • Width 1 a_ Heitrht Windows and Doors—Crackage and Area a�ww jL.V11KLAS Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. lop a acyyua Windows and Doors—Crackage and Area Coef. Btu Infiltration ' Glass Btu Exp. wall Infiltration Net exp. wall d Int. wall Infiltration Ceiling 2 Floor 1 A Total Btu. - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r� —I Pj 10 ��- r t. a�ww jL.V11KLAS w tuut lop a acyyua Windows and Doors—Crackage and Area Coef. Btu Width Height No. of Lineal ft. Area No. of pane of pane lighta of crack sq. ft. Glass Exp. wall a Btu Net exp. wall Infiltration Int. wall Coef. Btu Infiltration Floor /% / - Glass Exp. wall p Exp. wall Net exp. wall ?3" ` Net exp. wall Int. wall Int. wall ell I RIO Ceiling Q f r e d R Floor,, / p� d. Total Btu. Required so. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS, MINN. Insulation Kind How. A plied n I i _ _.l_ e^- IVf:J.L • s LJ -:-L& P.S' Windows and Doors—Crackage ana Area - Width I Height No. ofLineal ft. Area No. of pane of pane light. of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. b Coef. Btu Infiltration Glass Exp. wall a Btu Net exp. wall Infiltration Int. wall Ceiling t, Glass Floor /% / Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r, n i r_ _.L A . VIM -3.1- A IALl-:..t. �� Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. b Coef. Btu Infiltration Infiltration Glass Glass Exp. wall Exp. wall p Net exp. wall Net exp. wall ?3" ` Int. wall Int. wall Ceiling A E r CY lv . Floor. / p� Total Btu. I rl " .�_ ,Required sq. ft. E.D.R. or sq. ins. W.A. Leader area s F1.I P . _® Room I Lenath -- /J,- Width f Height Windows and Doors—Crackage and%Y-ea 4 t Width Height No. of Lineal ft. Area No. of pane of.pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall p Net exp. wall /j 3 Int. wall Ceiling r CY lv Floor II Total Btu. Al Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D•J6 9 t , HEAT -LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H. .E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Ye Yes No 19— F1.1 Z j V Room I Lenath 14 . Width -Y e Height V II 1 Fl Windows and Doors—Crackage and Area Room I Length //S Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. d� J— INV IQ,0 �- Coef. Btu Infiltration a or Glass Coef. Exp. wall Infiltration Net exp. wall A 73 1 ® s.? Int. wall Ceiling . Glass Floor Int. wall Total Btu.�. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room l Length Width Height Windows and Doors—Crackage and Area Room I Length //S Width Height No. of Lineal ft. Area No. ofpane ofpane lights of crac�kp sq. ft. d� J— ZQ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Infiltration Glass o Coef. Exp. wall Infiltration Net exp. wall f Exp. wall Int. wall Ceiling 6, Glass Floor" Int. wall Total Btu. .24,06 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area P F1.1 R, 4 Room I Length ®tea Width ®-I- Height ' Windows and Doors—Crackage and Area Room I Length //S Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ZQ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration o Infiltration Glass Coef. Btu Infiltration Net exp. wall Exp. wall ® ,3 Glass Floor Int. wall o Ceiling Exp. wall �. Floor i q y 11 Ceiling Net exp. wall o Floor Int. wall Ceiling 2. go i e Floor Z ®.;k, Total Btu. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS. MINN. Insulation Kind How. A lied D_-- I r ___.L I� 1Y/:.7aL 9 ,a i-1e:n1,♦ Windows and Doors—Crackage and Area Room I Length //S Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. O (p0 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration o Infiltration Glass 9,6 Exp. wall Coef. Btu Net exp. wall Exp. wall Int. wall Ceiling Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area e L I I R......, I i —1-h ; e -j W"Ith i° 0 Haiol,f ad Windows and Doors—Crackage and Area Room I Length //S Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. kC Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration ?` Glass Coef. Btu Infiltration Glass Exp. wall �y Net exp. wall I 1h Int. wall Net exp. wall Ceiling 1 Floor i q y 11 Total Btu. Required sq. ft. E.D.R. or sq. iiis. W.A. Leader area I F1.1 tkge Room I Length //S Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass a �y Exp. wall Net exp. wall Int. wall Ceiling o Floor Total Btu. l-3 -?V6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I .-- APPLICATION FOR GAS BURNER PERMT Permit No. M ...... L! ....... Location ------------------------------------ -------------------------------------- Donald A. FAckson 'Inspedor of Bullclings: The undersiqnj hereby makes application for a permit for the work herein specified, agreeing 0 do all such work In strict accordance with the City ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations 1! stated in this application are true and correct. Owner... A ..... e I ................... Kind of Building- CJZ�. . .... ...... Used as—4.: ...... . ---------- To be begun about ... J�- J-1 ........................................................ 4-3 To be completed about .... ................................................ 10.. . 6-3 Estimated Cost, ...... .............. .................................................... Old -New Building Application No ................ ...................................................... ElectricalPermit No ............ ...................................................... . ....................... DESCRIPTION OF WORK No. of burners to be Installed ........ .J� ....................................... ..................... altered........... ...................... repaired ........................................................... Conversion..............i.. ............6........... GC98 Vnit.......:........................................ ...... Trade Name .. . .....114 Z ........................................................ Size No ..../1-1� .................Btu Input...... JAOL ............................... Gas supply pipinq to be Installed .......... ;71.4 ................................................................. feet Type of Heating Plants Steam—hot water warm a a-34, Connected load .... 16 . ... Btu. Proposed vent flue size Oia= In Inches) ...... —6 .......................Chimney flue dimen. sions ........................ ............................................... Authorization No—) .... 1p Remarks: (Spear:any removal, or nature of any alterations) ............................................ ................................. ........................................................................................................................... .................................. 4 ..................... ........................................................................ FRA -WS -H -EATING Signed................... : ............... ..... ............ ......................... AND ... SHEET ... METAL ... .... .. .............................. 2505.M.A.RS.H.AL.L ST.N. E. `;7*-*/� ........ ... .. .... .. .... . Inspectedby ....... roved..............................................19........ City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7 DESCRIPTION OF WORK Number, Find and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 6 x $1.50 $ 191. U d Future Fixture Opening ................ x ��(�9 $ <�ig a z C7 w • F • N WATER HTR. GAS ELEC. x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ o Sa �O Base 1st 2nd 3rd 4th • Future Connection Openings Connected with e New Fixture, Old Openings Sewer spool p PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 6 x $1.50 $ 191. U d 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 $ City of Fridley: The undersigned hereby .makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true, and correct. 0 Owner C/ ' f� Kind of Building Used as To be completed about Estimate ost, $ Old Ne ing Permit No , By t— ' -- Business Phone ROUGH—/ G —2, F _ 0 FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ 0 TOTAL FEE $ 42 '2M C) 4?j City of Fridley 53-81�-s-915.51 APPfor Mmbbg and Gas IN" ftrm* Dept. of Bldgs. Phone SBO -3M DESCRIPTION OF WORK 6516 N. E. Stinson Blvd. Number, Kind and Location of Fixtures •�{ �10I i 3a3a ��`i • • WATER NM. at C < 3 �Qj < < -I N GAS ELEG Base I st &11 Dr Fer 1st 2nd 3rd 4th • Futuro Connection Openings w8h + New Fixture. Old Openings - -- Sow" ❑ X001 ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $—_ New Fixture Old Opening .......... x $1.50 $ Catch Basin ..................... x $3.26 $ Water Heater (Up to 99,000 BTU) . • .. x $3.00 $ New Ground Run Old Bldg......... x $325 $ Electric Water Heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......... • ... • a $2.00 $ Additional Fixtures ..., .............. x $ .75 $ Gas Range to 199,000 BTU ...... , ........ x $5.00 $ City of iftdley: The .undersigned hereby makes application for a permit for the, work herei specified, agreeing to do 411 work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that alt the fact and representations stated in this application are true and correct. Fridley,8-22-72 19._ air;nn , Owner John J, Gannon Kind of Building Frame Res. Used as To be completed about 8-29-72 Estimated Cost, $ 10.00 —New. Building Permit No. Permit No. 7 Signe . Z 414 a A? By �anena�e�acsre.rn Business Phone No ROUGH REPAIRS & ALTERATIONB —Refer to Coda Description ....... Instill ,D,ry®r ....:.......... .00 ��'5up4hari a $*50 coo TOTAL, F= S 5.00 (SURCHARGE $_,50) suBIEcr RMI City of Fridley ° y 17 715 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT COMMUNITY DEVELOPMENT DIV. °y PROTECTIVE INSPECTION SEC. �'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/13/84 JOB ADDRESS 6516 Stinson Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 Moore Dake Park First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Gannon 6516 Stinson Boulevard N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Mr. Siding Inc. 10800 Xavis Street N.W., Coon Rapids 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 J] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. AluMinUM 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 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 $2, 600 $1.30 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- $38.50 STRU TION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $39.80 S NATURE OFONiRACT RORAUTHORIZEDAGENT IDATEI WHEN PROPERLY VA ATED THISIIS YOUR PERMIT w I . ( W , 0/// � -.r SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) BLDG IN., - ATE NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: Legal Description: Owner Name & Address: Tel. # Contractor: 6- ✓/J ati Tel . Address: v/ -�� ✓ 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: $%D/ted Estimated Cost: $ 2/06 Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: ` / y ti T. l CITY USE ONLY Permit Fee $ Msw Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ �$425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ ' $® Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 3"). STIPULATIONS: BUILDING PERMIT FEE SCHEDULE 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 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: Total Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additionfLl $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCRCFW (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 once it has been constructed will be required before proceeding with the framing. SUBJECT P It NO. City ®f Fridley 95 � AT THE TOP OF THE TWINS BUILDING PERMIT i � T NO. rry ______ COMMUNITY DEVELOPMENT DIV. SEC r PROTECTIVE INSPECTION 0 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY ' 612-571-3450 910-F15 6/1/99 JOB ADDRESS 6516 Stinson Blvd. 1` LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 1 Moore Lake Park First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Gannon 571-5067 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing & Siding - 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 OX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house 21 112 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 1885 $.94 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- Fine STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE Tr#L FEE Licens C $5. I$Y4.02 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE- HE PR Y VALI 8 G -NSP A THIS IS OUR PER gAtE S-GNA TUBE OF OWNER �Ic OWNER BUILOE R- IDATEI ITY OF FRIDLEY INSPECTION DIVISION Y 431 University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, O1 763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES a Efiective On Januar 1-3S_ZD JOB ADDRESS VC ( ' S"- n St7Y1 1,' Vd RATE SCHEDULE ((�� C:)av-� OWNER c Y�Vlln lel. 0"V-\ c- .esideritial Rate TOTAL e A 1 Furnace Shell and Duct Work, Burner • Also Replacement Furnace 30.00 $ � BUILDING USED AS �JWV tw $ 't 15eco (Side Vent - Fill Out Back) ESTIMATED COST L✓c PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ 0 No. of Heating U 'ts Circle One (Steam) (Hot Water) ( arm r) Gas Dryer $ 10.00 $ Trade Na e Size No. MAC BTU HP EDR ___NTT; rAir Conditioning - All Sizes $ 25.00 $ �eCO FuelTotal Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value o1 Appliance or Work $ BTU HP EDR w ' e:ommercial/Industrial w1.251% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein U_ specified agreeing to do all work in strict accordance with the City Codes an 0 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and �� representations stated in this application are true and correct. U TOTAL FEE $ �� DATE U_ ELAINE HTa. A/C ELECT, INC• 73562 71NIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO CENTRAL Alle ,.., ;EFRICERATION/AIR CONDITIONING PERMIT IS $25.0,0 -LUS THE $.50 STATE SURCHARGE Signed TEL # P� FAX# - d� !EINSPECTION FEE $47.00/Hr Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date �`"®�• iritten permission from adjoining property owner. F! LOUT BAC SIDE' FOR CK VERIFICATION ON REPLACEMENT FURNACE JAN -16-2002 00:32 FROM CITY OF FRIDLEY TO 7575701 P.02i02 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When rn la in- an isfica furanre, 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. The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. 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-GANIA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina ction air is sized and installed to meet the current codes and manufacturer's specifications. When required to installa nem, c®ml, ,Scion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes) No ( ) Yes,No( ) Yes (i No ( ) Yes( -No( ) Yes ( No( ) When inst3flingamelmventingsum, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAPAA 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 'l` No( ) Appliance #1 Type Vk- BTU Input Fan Assisted or Nates 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 M 13562 CENTRAL AVE. N.E. HEATING CO:" MN 55304 / Signed By: �° Date TOTAL P.02 HEATING ni-AIMEAIR CONDITIONING AND ELECTRIC, INC, ADDRESS &J& 5Cgdsbj2 Bid - 1O chS`/R Yl OCCUPANT ® —f HEAT LOSS TE HTG. INST. SOLD BY Electrical Work By TYPE OF HEAT GA FA HW STEAM SPACE HTR. CONTROLS THERMOSTATQ�i Heat Plug Value KIND OF LINER Limit Draft Hood lsv_ th"r- Limit Setdng Filters Size & x Fan Set in Chimney Location Inside Pilot Type Chimney Construction _, �� i(6 Pilot Make Pilot Model Pilot Timing L.W. Cut Off PressuC, Percent CO2 iD Input CFH v Percent 02 Stack Temp.: a Percent COQ �G> ROUSE HEATING TEST RECORD APT. FLOOR CITY SUBURB OWNER INSTALLED BY Gas Line By _ UNIT HTR. OTHER Smoke Bomb Wiring ✓ Draft �/� Test Tag Door Pressure Lighting Inst. Date Tested ®dZ Company Testing Name of Tester Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO Vent Size - T KIND OF LINER SIZE NONE Draft Hood lsv_ th"r- Regulator ///70 X9?j:!'z= Filters Size & x Number I IF Chimney Location Inside Outside Chimney Construction _, �� i(6 Smoke Bomb Wiring ✓ Draft �/� Test Tag Door Pressure Lighting Inst. Date Tested ®dZ Company Testing Name of Tester Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO Building BUILDING $ Permit No.: Inspections $ RESIDENTIAL APPLICATION .001 times the total job valuation Receiv�((� 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY Date Rec av 3 20 &' I q. O "-?- DATE YOUR E-MAIL ADDRESS SITE ADDRESS �� c�o°yea®� ;qlp THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: 70 ADDRESS: CO P/0 �e�� - CITY STA _ TENANT Make checks uavable to: City of Fridley Attach PHONE: 010NC. CONTRACTOR NAME: 7710 C@Mrel Avenue WER P1 STATE LICENSE # Soft Lds P8% ATE SUBMIT A COPY OF n � �I ` �, , STATE ZIP YOUR STATE LICENSE ADDRESS:_ \� CITY WITH APPLICATION P ONE UNC. 4)017"=S Y PROPERTY TYPE GLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS • DRAIN TILE BASEMENT FINISH ❑IDING 13OTHE 13 DECK �t ��71r ❑ SWIMMING POOL lit TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 0,111f r SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum /' ❑Trim 1. Site Plan/Survey showing the existing structures er A ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING UIE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ A &V OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ (;jam .001 times the total job valuation $ L7 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1675 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation. Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks uavable to: City of Fridley Attach 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 o the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application fo a permi d 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 w uir Pep and approval of plans. SIGNATURE OF APPLICANT PRINT NAME �o'Cl��DATE 1 Page 2 - Building Residential Application BUILDING PERART FEE SCHEDULE The Chief Building Official shall, before issuing permiis 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 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: TOTAL VALUE FEES.. $1 to $500 $23.50 (MinununFee zs;$23,,$0 plus Surcharge) fu x,_ � $501 to $2,000 $23,50 for 1 $ 00>plu"5:.'f6-e 6Wi ditional $100 or fraction' to and including $2,000_ $2,001 to $25,000 $69.25 for I s' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for I' $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1- $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for l- $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for-the'l' $500,0110 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1'$ 1,000,000 plus $3.15 for each additional $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977