PRE 2010 DOCSCity of Fridley, 1VIi=.
BUILDING PERMIT N°
Date:
Owner: _' _ s�".s+ Builder_ _.._.__. _._._..._..
Address _— -- — —.—
#; L p TION F BUILDING
Part�of Lot.._.... ---
Lot _ _ ` __- Block Addition or Sub -Division;, .`
Corner Lot _ Inside Loi _ _ _._ Setback _ Sideyard
Sewer Elevation , _ Foundation Elevation _
,DESCRIPTION OF BUILDING
Tore U
r
�•� Front Depth � Height . Sq. Ft.�._�.. Cu. Ft��
_ Zol . Depth ... -A ". Height Sq. Ft... Ca, k"t.
Type of C etion 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 $.7 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 timpo of any of the provisions of said
ordinances,
.- Building Inspector
NOTICE:
This pennh does not cover the construction, installation for wiringo plumbing; 'gas beating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Owner's Name Builder i a 4 j
Address Address? L 7 ®
LOCATION OF BUILDING
NO. + / 3 I Street I► EDI e-4-1-4 c _____Part of Lot n�
Lot h Block Addition or Subdivision e- /®dA 4Atg
Corner Lot Inside LotSetback 3 V Side -Yard 1
SEWER. ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
"13 3
To bp used as: /pq,�
All
r
Sq. Ft. I S"® Cu. Ft.
A —�_ Front Depth 2` Height % �
Sq. Ft._ `-Cu. Ft.
To be Completed
ted Cost
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.
DATE SIGNATURE
(A Schedule of Fee Costs can be found on the Revers
BUILDING PERMIT FEE SCFEDUIR
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 existing build-
ing 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 fireproof garage, warehouse,
factory or grain elevator, or for the erection of any fireproof addition, for
similar occupancy, to any existing building shall be at the rate of 01.25 for
each one thousand cubic feet, classified as "fireproof" by Section 502 of the
'NU.nneapolis Building Code,
HOUS Z, S
2.3. For any such permit for the erection of any non -fireproof building other
Vhan 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 nor -fireproof addition, for
similar occupancy, to any existing building or for each such building or addition.
Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical
contents thereof with a minimum of $4.00.
For the purpo^�: 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 for each Five Hundred Dollars ($500.00), or fraction thereof in the
cost of all proposed work.
2.6. In no case shall the fee charged for any permit as set forth in Section 2 be
less than $4.00.
City of Fridley
Application for Plumbing and Cas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
�j
'+
0
yy
��
Z
H
qy
3F
y =O
OLL
x $1.50
iii
V
C
Q'S
�Q
O
Z
C9O
R
6
N
WATER HTR.
GAS
ELEC.
Ba
$ Q
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
Z x $1.50
"d
$
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
1st
J
2nd
_
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLIIMBING FIXTURE RATES:
NO. RATE
TOTAL
#7
Number Fixtures ......................
x $1.50
$-16'
Future Fixture Opening ................
Qt2 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
$ Q
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
Z x $1.50
"d
$
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $
0
Dept. of Bldgs. Phone SII 4-7470
Location 7cf
City of Fridley:
The undersigned hereby makes application for a permit for the work herek
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 faci
and representations stated in this application are true and correct.
�1)*ey, Mann
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $®®�\\ �����
01d Ne. . Building Permit Nom
ROUGH 3 - 3 ® — G 7 --
FINAL
Business Phone
0
Application for Power Plants and Heating, Cooling. Ventilation, .Reftigmation 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 §.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 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
ovet 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 FFE
_
$�
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.
s, Frey, 11tinn �> , 199 Y
Owner
Kind of $adding
m o s
Used as
To be completed about
d -a
Estimated Cost, $
/ Gf e" -r/
Building Permit No. Permit No.
1
DESCRIPTION OF WORK
HEATING or P9WER PLANTS --Steam, Hot Wa r��,
Warm
Trade Name 7 �' -" D Size No 4
Capacity Sq. Ft. E.D.R_ �"�� BTU H.P.
Total Connected Load -,/% 6 ro Kind of Fue
BURNER — Trade Name Size No
Capacity Sq. Ft. EM.R BTU H.P.
(REMARKS—OVER)
S'gne'hAY N. WELTER HEATINGr+C
By 4637 CHICAGO AVE.
MINNEAPOLIS 7, MINNESOTA
Jaz 2M 7-59 Business Phone No
City of Fridley, Mm. 7501
BURDING
M
Date: May 24s 1965
Owner: Walter Sabol Builder nalberg BIiUders Inc.
Address 7371 'e Terrace
Address 7 72 Stinson Blvd. X. E.
LOCATION OF BUILDING
No. 7371 street Tempo Terrace Part of Lot
Lot 2 Block 2 Addition or Sub -Division Melody &norr
Corner Lot . _ inside Lot Setback _ _ Sideyard
Sewer Elevation __ _ Foundation Elevation
To be Used as:
Front
Front
Type of Construction
DESCRIPTION OF BUILDING
Depth Freight Sq. Ft Cu. Ft
Depth Freight Sq. Ft Cu. Ft
— Est Cost $6,- 00 __ To be Completed
Storm Damage , Frame
In consideration of the issuance to me of a permit to construct the building described above I agree to do
tht' proposed work in accordance with the description above set forth in compliance , a'' provisions of
ordinances of the city of Fridley. � „ l B d /d A .
In consideration of the payment of a fee of $ld• , permit is hereby granted
Inc.
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work,
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances
NOTICE:
Ub permit don not sower the sondruetion, huftffiffion for wkbs phmebheg, an heads®, sewer or eider. Be sure to no
the Building hrspeator for separate permits for these BMW
`APPLICATION FOR ING PERMIT
CITY OF PRIMV"Ito LNNESOTA
OWNER ,
LocAnoN OF .!
Lot_ —Block _2. Additions or Subdlvision
Corner Lot Inside Lot Aetb4ck Side Yard
of Lot ,
SEWER ELE'QATIQN FOUNDATION EUVATXON
Applicant attach to thio form, Two. Certificates of Survey of Lot and proposed`bu$ld—
ing location drewn on these Wtificates .
DESCRIPTION OF BUILDING
T* be used as;
ronC Depth Height
9q, Ft. cu. Ft.
front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
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 ®f the Department' -of Buildings, and hereby declares that all the facts and,'
repre *mations stated in this application ar rue and correct
J ` 'chedale .of Fee Costs can be found on the Reverse Side) .
r
s�,�katE�i��;•.
n
BUILDIM PERMIT FEE SC }ME
a
� •
Section 2. The Inspector of Buildings eha2l, befors'i�sa�,i any permit for
the erection of any building or structt;,ure., ,Coe - for any add;,t to any exist-
ing building or structure, or for -any alteratss«or'repaita to any existing
build3,i�g or structure, upon applicatic►ti }erefgr, Vequire the pa nt by the
applicant for such permit of fees `to the amount •herein.- below set •forth -and
in the. manner herein provided to-witt
For any. -such permit for the araptiod-pfany fir44rqsf bufidipg, other. ;.
• a garage# warehouse, factory. az . '' 44V45W. f®r the ex tUn of '
anp •Bice -prof addition,. or`. aim$iarallopanay� -to: any existi}g bud.lci w
shall be at the rate a# 1.4Qfor eanli'pno_tboutand tubi,¢ feet, orfr�n
...thereof, in such cubical contests,''
2.2. For any such permit.. faa ._�be erection of any fire -proof gorage..•rau:a-�--�
ory or grain elevator, or fr •the eraction Of anF f Sao$
for similar occupancy, to any wish'
..ng
ildfug shad.%• •be at .t ie ` '
w fob 'sash one .thousand cubic .feet,$'c�,lassified .As.Pfireprftf"
the- Minaeeap�...g,t�dii�g: Code.�+*�: ..
HOUSES
<; &n.
Forenysuch permit for the erection of any non-firep}rf building otba a garage, warehouse, factory or, grain elevator, or any none-fi f'
addixi�an, for simil,dr occupahcy, to any e#iati builditg - permit $1.:•60 for
each one thousago -cubit. feet..
GAS
2A. For any such permit for the erection of any non -fireproof garage,,
warehouse, factory or grain ei;evator, or for the erection of any -non-ftreproa
additioixr-.4*r -similar' occupancy, to any existing building of for each such
a »ing or addition - ninet
or fiea�tifeet
on thereof, in the cubical contentsfthereof withta minimum ofd cu�irt$4*04L •
For the purpose of computing fees for•building permits, the cubical cov►tentir'•
Of any building or addition to a uniform height throughout."by multiplying t��'•
ground area covered .from a point six (6) inchoO below'the floor line vf_the�,. ,..
basement or cellar to the average heightofthe upper -surface or to -the
average height of the rQo£ surface of the main gable of a•pitbhed roof,
. 2.5 . For repairs or alterations to an exist
• at the rate of 3.00 striuctu a fee shall ,bo v� ••.
$ per each Five Hundred Dollars ($3 6.67-,'M: ,,o-,,. r rac on .
�therebf in the cosi 'of`h11 proposed Work,
2 6.` • xn, no .case ... , . �• ,.. : � x` :.
...�r._ shall the
Sectioa. 2 be less..,.,than_$4,00f ,Dp `
I Ar
SUBJECTI
T NO. .
City of Fridley
26884
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
� PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
---. .�
L 612-571-3450
910415
7/29/98
JOB ADDRESS
7371 Tem o Ter
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2 2
IMelodvManor
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP
PHONE
Ann Sabol
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Four Seasons Roof & Remod.9
-
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 R] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garag e(23Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with 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 BO 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1918
$.96
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONSANY OT TE OR LOCAL LAW REGULATING CON-
STRUCTION OO THE P FORMA E OF CONSTRUCTION.
$62.25
Fire SC $1.92
PLAN CHECK FEE
License 5.00
TOTAL FEE
$70.
NATURE OFCONT ACTOJ/OR AUTHORIZED AGENT
EN P OPERLY A
ATED THI S YOUR PERMIT
c
• BL INSP
f)AT
SIGNATURE OF OWNEROF OWNER BUILOERI IDATEI
I Ar
NEW [ ] Effective 1/1/98
ADDN [ ] ,..CdY,.OF FRIDLEY .
ALTER [ ] SINGLE FAM14IY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
- ... t t •::.v 7R.+u:�.e .��it�r.n+ �+ 8th?�: .. � .ti .;,i afr $:,xy+,'.� 1�a4: AV 7 t.,'.. �L ...
Constructio-nAddress:
Legal Description: ;
Owner Name & Address: 4- —Tel: #4
Contractor: U U ( S eas M,S R o v�Cia ei Rem ode -Le . MN LICENSE #
Address: '7Cl3 d U vi (U eX� 4-4 U f -r %V E F�r i cl I Tel. # %?5- Q ql D
Attach to .this 'application; - a Certificate of Survey of the
lot, with the proposed: construction drawn on it to scale.
DESCRIPTION, OF BIPROVEMENT
LIMING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
. Height
Sq. Ft.
DECD AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER: 62 //0 a Y,0
$ %. 'x.001 hof Permit'Valuation (1/10th%)
SG
Swte Sufzha
Construction Type: Refit tthd�C�lS
yO-�-
Estimated Cost: $
•
t
(Fee Schedule onBack): ;
Driveway Curb Cut Width Needed:
Ft. , + 6 Ft =
Ft x $
_ $
DATE:. �% `% APPLICANT:'
Tel: # ' X96 7440
CITY, USE _O_NLY
Permit Fee
s.
'2 Fee Schedule.on Reverse Side'_
Fire Surcharge
$ %. 'x.001 hof Permit'Valuation (1/10th%)
Swte Sufzha
, $.1;000 Vaivation
SAC Charge .
000 per SAC Unit
t
License Surcharge
� :;-.',Y`.$5.00: (State Licensed Residential Contractors)
Driveway Escrow
$
' „ Alf, "A" or"Alt: "B" Above
sit}�t4�
Erosion Control
$
; 4 )$450.00 Conservation Plan Review
Fee Dete�b� Engineeriuz
Sewer Main Charge -
_Not.
.F t
ljAlu
t k
S IPULAUONS:
f;,
BUILDING PERMITTEE SCHEDULE
The Chief Building Official shall, be 'ord jssuing permits for'the erection'of any building or structure,, or for
any addition to any existing building or structurei'or for any alteration or repair to°any: existing;building or
structure, upon application herefore, require the payment by the applicant for such permit of fees to ahe 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 $25,000
$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 $50,000.
$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 $100,600
$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 1$13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6=:W466"depth; Driveway, .width plus 6 feet times` $15:75.
i f
VERIFICATION OF FOUNDATION w
Permits for.constructionwill be,.ssuet.'a,minimt�m,af.4 hours,from�the tune of app roper
n to,
�+ or p
review of the proposed structur "in "of. the construction site.
A Certificate of Survey of the .lot,. showing the location of the foundation once,.it basit,has been -constructed
will be required before proceeding?with the framing.
C17YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
May 19, 1999 /
l�
Jim Woltering
7341 Tempo Terrace NE
Fridley, MN 55432
Re: Final plumbing inspection at 7341 Tempo Terrace NE
Contractor: Anoka Culligan
Dear Mr. Woltering:
A plumbing permit was issued on May 12, 1998 for the property located at 7341
Tempo Terrace NE for a new water softener. According to Section 30.5(a) of the 1991
Uniform Plumbing Code a final inspection shall be performed on plumbing systems. As
of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, we will expire the permit and any inspections on this installation will
require a new permit.
Any questions can be addressed to myself at (612) 572-3603.
Sincerely,
je�x' /X;/�
Bary iesch
Building Inspector
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Effective On March 1, 1996
Kj
wifrnn ntumtstrt
ter H4IURE5 TO BE INSTALLED
ON EACH FLOOR
$ 7.00
t� ...
Urinal
Beer Dispenser
Shower
Blow Off Basin
W as h
Y :.�?:::::.::>•:.
Drain
•Ct`�1p �`
::E)c11:::>:::
Auto, ...:..:.:.:.:.:::..
Washer ::I.>`
i:?I� ....
Gas ware re
H ate r
Range
9 Gas Elec
S
stories
ori s
$ 7.00
Bam e
se nt
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10;00
Gas Dryer**
$10.00
Floor
Type
$15.00
Floor
Floo 3
r
FoI or 4
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$ 7.00
Old Opening, Now Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
.$7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Applianceo-p_v_a
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10;00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance • C-11 o
State Surcharge $ .50
TOTAL FEE $ 0 _$1D
JOB ADDRESS_
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.
Owner
O
Building Used As_ Au
Estimated Cost PERMIT NO
IRS
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 80 INCHES.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURFS Tn RF INSTAI i Fn nN FA(`N M nnR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_'5491F te, 6W.31E�I? .
New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture $ 4.00 specified agreeing to do all work,in strict accordance with the c# cedes
Beer Dispenser $ 5.00 and fulings of thef�uilding Division, and hereby declares that all the facts
Blow Off Basin $ 7.00 and representations stated in this application are true and correct.
Catch Basin $ 7.00 SABOL, ANN
Rain Water Leader $ 7.00 7371 TEMPO TERRACE 20
Sump/Receiving Tank $ 7,00 FRIDLEY, MN 55432
Water Treating Appliance $10.00 Owner. (763) 784-8988
Water Heater -Electric. $ 7.00
Water Heater - Gas''' -� $10.00 _.Building Used As hE_61D Com,,
G4.r
Range" $10.00
Gas Dryer" $10.00 � Estimated Cost ��._ PERMIT NO.
Back Flaw Preventer Required ( )Yes () No
Type $15.00 _PLUMBING COMPANY
Reinspection Fee $47.00/Hr SIGNED BY j41I TEL N0.
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Picture orAppliance
Approved By Rough -In Date Final Date4MC)�
State Surcharge $ .50
MINIMUM FEE FO ANY PI
PLUMBINGIGAS PERME IS S20.00
TOTAL FEE PLUS SAO SUTE -SUR-CHAEME
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE
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PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_'5491F te, 6W.31E�I? .
New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture $ 4.00 specified agreeing to do all work,in strict accordance with the c# cedes
Beer Dispenser $ 5.00 and fulings of thef�uilding Division, and hereby declares that all the facts
Blow Off Basin $ 7.00 and representations stated in this application are true and correct.
Catch Basin $ 7.00 SABOL, ANN
Rain Water Leader $ 7.00 7371 TEMPO TERRACE 20
Sump/Receiving Tank $ 7,00 FRIDLEY, MN 55432
Water Treating Appliance $10.00 Owner. (763) 784-8988
Water Heater -Electric. $ 7.00
Water Heater - Gas''' -� $10.00 _.Building Used As hE_61D Com,,
G4.r
Range" $10.00
Gas Dryer" $10.00 � Estimated Cost ��._ PERMIT NO.
Back Flaw Preventer Required ( )Yes () No
Type $15.00 _PLUMBING COMPANY
Reinspection Fee $47.00/Hr SIGNED BY j41I TEL N0.
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Picture orAppliance
Approved By Rough -In Date Final Date4MC)�
State Surcharge $ .50
MINIMUM FEE FO ANY PI
PLUMBINGIGAS PERME IS S20.00
TOTAL FEE PLUS SAO SUTE -SUR-CHAEME
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AiR VFRIFICATION
When replacing an existing furance, 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. Yds () No ( )
The venting:Aystem is. plastic/PVC and meets all current codes and manufacturer
specifications.Including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustmotb ahi jt will be sized and insOlie
To meet the current codes and manufacturers specifications. Yes () No ( )
When Installina a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correc'itly after
an appliance,i:has been -removed from the common vent and vented
separately as';per current codes. Yes( )No(
)
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter 'inches
Appliance #1 Vent Connector Height
' ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter., in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By:
Date :
.4
Building
BUILDING Permit NO.*: 0� a73
Inspections
RESIDENTIAL APPLICATION Received By:
763-572-3604
CITY OF FRIDLEY Date Rec'd: A2 —
763-502-4977 FAX
$
EFFECTIVE 8-19-09
DATE � �%L�e1
YOUR E-MAIL ADDRESS GAYFIse QC)1. (On
SITEADDRESS 'q3 I I evV►PC-.' 7\or/'.
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: S c.;rr Se R he r—
TENANT
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
ADDRESS: CITY STATE ZIP
ft + 6 ft = ft x $22 = $
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
$
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY STATE ZIP
.INSURANCE
PHONE FAX
PROPERTY TYPE
"SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
N(Ca1
29 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIREPAIR PLREMODELING
DESCRIBE WORK BEING DONE: Mew 1l,1 -,s e "rR rrrJ
SIZE OF IMPROVEMENT
`
LENGTH 1,91 WIDTH P- i HEIGHT 1 SQ FT ' 6�
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. 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
I. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
WINDOWS pSS�� I r �tnl/1nynQ�
and proposed project.
2. Two sets of construction plans
IN EXISTING OPENINGS Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
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:
SING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $�C�'C� OCCUPANCY TYPE
Permit Fee
$ 91&1s
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due _
$ OS a
Make checks vavable to: Citv of Fridlev Attach StiDulafionS
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 t e 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 plication 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 e I work which requires review and approval of plans.
SIGNATURE OF APPLIC1'. PRINT NAME DATE
X,0
Page 2 - Building Residential Application
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 VALUE
FEES
$1 to $500
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1" $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 1' $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 1" $500,000 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
s
Building
MECHANICAL
Permit No.:�i� --icy
InspectionsRESIDENTIAL
APPLICATION
Received By
763-572-3604
CITY OF FRIDLEY
D'
763-502-4977 FAX
EFFECTIVE 2-19-09
Loq Icy GN4 ';@ Q I•
DATE U YOUR E-MAIL ADDRESS F Vel'Q 0 GUy,
SITE ADDRESS
THIS APPLICANT IS: eab OWNER ❑CONTRACTOR
PROPERTY
NAME:
ADDRESS: JA Oil CITY STATE ZIP
OWNER/
TENANT
11.04
,
c.
PHONE:
CONTRACTOR
COMPANY NAME:
CONTACT PERSON:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: CITY STATE ZIP
APPLICATION
PHONE FAX
INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
PERMIT TYPE
❑ NEW ftEPLACEMENT ❑ ALTERATION/REMODEL
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK ('MiaCe Oed LA ft/1thGe,
FEES-AM BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACRULOW) . , - "
PROVIREMEAT LOSS CALCIS PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
1AjC
MFG: MODEL: SIZE/BTU
$25.00 PLACE (GAS) $15.00 _GAS RANGE/OVEN $1000
_F
AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 GAS GRILL $10 D0
XREPLACE _NEW
BOILER $35.00 $35.00 _GAS UNIT HTR $10 00
_FURNACE
_CHIMNEY LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 : r
_GAS
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Cit F
25 '�✓ x e
r � i
"1.�
;.h. �', �` f .. � Pi : � `� � g '� C �£ C � .v F3 ,r 1 ,R "C.� C _. 3 :. x➢ to , k-. v � �
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 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 York which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME C V2n ���— DATE
APPROVAL INSPECTORS SIGNATURE DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ 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 MN Rule 1346 Sec. 501
3. Venting
a. Gas appliances IFGC ,Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. N1104.4.13
5. Ventilation
a. Per MN Rule Chapter 1322. Sec. 1104
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.