PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 4023
Date: ___. _._.._._..... ...................... _._.._..._....----•------
Owner: ..... ._._ ........ - _ - - ... Builders..._......._..._ .............__.._. _ ._.__ . _ _._
Address Address
LOCATION OFnBUILDING
No/f Street ...'!.._..._... ..AS .............................. Part f Lo
Lot ..... _......... ...... ... Block ............. .`-�<...................... .. Addition or Sub -Division ......._...9W....��
Corner Lot .......................... _........ Inside Lot.. ........................... Setback .. ...__........ Sideyard 1. ...... °r�.... ..................................... ...
Sewer Elevation ............ ......... ..................................................... _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
_7-
........................................
..... ............. Front �-� Depth ��......��7;P Height . :... "Sq. Ft. / Cu. Ft O?Y eo
...._.............._............._......._.............. Front ........................ Depth ...A
.. Heiigght ....................... Sq. Ft. ..... .................. Cu. Ft.......................
Type of Construction............................................................ Est.t....,1/....--�!'o 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 all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $-15r permit is hereby granted
_... _....... _.................. _..... ..- .... ........................ 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. � _
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
Original
PERMIT for Power Plants and Pleating. Cool-
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be installed—altered—repaired
Make a4 to ' ,Size "qc 13 -3 6 - '0' ;
Oil fired—, Coal fired ; Gas fired—; Gas Authorization No
Remarks
Approved
Final Inspection Date , 19-_
, Inspector
Permit N° 4 5 4 2
Fee $ 42 -
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. ` , 19-4
Owner Awtw
Location ��' s `7 —
Kind of Building ®4
How Occupied --
Work to be Commenced 2' -2 -8: 91
To be Completed 7 - ;3 = ,19 �
Estimated Cost, $ 0 G+ -
Old -New, Building Permit
Permission is hereby granted (:�9 to install—erect--use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifigef4ons set ,forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
Inspector of Buildings
42 2M 11-67 V
Effective Date May 1, 1988
CITY OF FRI DLEY ERICKEUN, GARY
APPLICATION FOR PLUMBING�'•{
PLUMBING AND GAS FITTING PERMIT 1.7 �1_-0s4NIISM ryTF,= NSR-n-C-ACnT
32
H 571—CAC-)5
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
OWNER
RIND OF BUILDING
USED AS
Fridley, Mn. , 19
TO BE COMPLETED ABOUT
RATE SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES: NO.
0
TOTAL
Water
PERMIT NO. /`'� 2t j
49
r4
5.00
Cd.mi
$
3 50 .
$
+ug�� 14
a
w
$
1.50
Heater
Signed By
m
Beer Dispenser
$
4.00
JS
x
8-27-A= ® 827-311
3
$
5.00
mC
o
Catch Basin
m
5.00
$
Rain Water Leader
$
5.00
$
ROUGH INSP.
Hydraulic' Valve
$
5.00
3
Date
gg
o
5.00
lec
U)
U
D
00
y
3
a w°
vii
w
U t
r 3
FINAL INSP.
i�
$
5.00
$ f)
Date
-57'eej
Gas Range
$
10.00
$
Gas Dryer
$ 10.00
$
APPROVAL FOR PERMIT
let
Back Flow Preventer Required. . . Yes ( ) No
(
)
Type
$
5.00
$
ALL OTHI:•'S AND/OR REPAIRS AND ALTERATIONS
2nd
P4INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00
1% of Value of Fixture or Appliance
$
PLUS THE $.50 STATE SURCHARGE
State Surcharge
$ .50
Reinspection Fee $
TOTAL FEE
3rd
($15.00)
4th
(R) - Future Connection Opening
Connected with Sewer
(*) - New Fixture, old Opening
Water
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
OWNER
RIND OF BUILDING
USED AS
Fridley, Mn. , 19
TO BE COMPLETED ABOUT
RATE SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERMIT NO. /`'� 2t j
New Fixtures
$
5.00
Future Fixtures
$
3 50 .
$
Company
X777', o9_--50UTH
Old opening, New Fixture
$
1.50
$
Signed By
a r 3
Beer Dispenser
$
4.00
$
Tel. No.
8-27-A= ® 827-311
Blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
ROUGH INSP.
Hydraulic' Valve
$
5.00
$
Date
Sump or Receiving Tank
$
5.00
$
Water Treating Appliance
$
7.00
$
FINAL INSP.
Hot Water Heater
$
5.00
$ f)
Date
-57'eej
Gas Range
$
10.00
$
Gas Dryer
$ 10.00
$
APPROVAL FOR PERMIT
Back Flow Preventer Required. . . Yes ( ) No
(
)
Type
$
5.00
$
ALL OTHI:•'S AND/OR REPAIRS AND ALTERATIONS
P4INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00
1% of Value of Fixture or Appliance
$
PLUS THE $.50 STATE SURCHARGE
State Surcharge
$ .50
Reinspection Fee $
TOTAL FEE
($15.00)
CATY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604. REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS 5817 TENNISON DRIVE NE
BATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00 $ 20.00 representations stated in this application are true and correct.
5-20 ,1993
Gas Piping (Needed with new furnace) $10.00 $
OWNER GARY ERICKSON
Gas Range $ 10.00 $ DWELLING
BUILDING USED AS
Gas Dryer $10.00 $ f
ESTIMATED COST $2800.00 PERMIT NO. ! k2 01!2
*Air Conditioning - Ali Sizes $10.00 $ 10.00
BRYANT 594CNX030 2 1/2 TON "
All Others/Repaim & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $
Com mercial/industrial
1 % of Value of Appliance or Work $
State Surcharge S .50
TOTAL FEE3$ 0.50
MINIMUM FEE FOR ANY HEATING/COOL.ING 1NENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE 50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DESCRIPTION OF FURNACg_AND OR BURNER
No. of Heating Units 1 Circle One (Steam) (Hot Water) (Warm Air)
Trade Name BRYA T Size No. 395CAV042075
BTU 88,000 HP EDR
Fuel NAT GAS Total Connected Load 71,000
Burner Trade Name
BTU
Size No.
HP EDR
HEATING COMPANY BLAINE HEATING, A/C & ELEC INC
562 CEN RAL AVENUE NE ANOKA 55304
Signed By 60. Tel No. 757-6200
Approved By Rough -in Date Final Date
44
,x 4;- -T3
FIL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (j No ( )
2. Is free from rust or deterioration Yes Q) No ( )
3. Has no foreign objects lodged within Yes (V) No ( )
4. Is securely supported Yes () No ( )
5. Meets all current Code requirements for
size and total BTU's connected Yes () No
6. Has total heating BTU's of o c a
All other BTU's y
TOTAL BTU's 2 0
Remarks
List Alterations Being Done:
BLAME HT®, A/C & ELECT. INC.
HEATING COMPANY 13562 CENTRAL AVE. N.E.
AN U N 55304
If
Signed By
Date S
4
HEATING
AIR CONDITIONING
AND ELECTRIC, INC.
HOUSE HEATING TEST RECORD
ADDRESS �f� .- 11 � b� � �� f'h _1,fk'
OCCUPANT y e
HEAT LOSS DATE HTG. INST.
SOLD BY R
Electrical Work By 9 r'
TYPE OF HEAT GA FA d •.. HW STEAM SPACE HTR.
APT. FLOOR CITYA /^l_SUBURB
OWNE�� e - ��—
INSTALLED BY
Gas Line By
UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE i % C- MAKE OF BURNER
Model q Model
Serial Max. BTU Rating
INPUT MAKE OF FURNACE
Model
CONTROLS
Heat Plug
Valve 4 B
Limit 74--e
Limit Setting11
Fan Setting
Pilot Type
Pilot Make
Pilot Model t Smoke Bombes Wiring Ye -5
Pilot Timing Draft Test Tag 1 ":
L. W. Cut Off ' Door Pressure Lighting Inst. \1 a
Pressure a , Percent CO, Date Tested
Input CFH � � Percent 08 Company TestingE— "'¢
Stack Temp. t' Percent CO Name of Tester ®� ` d
y fd
Vent Spee,
KIND OF LINER m`t SIZE NONE
Draft Hood Regulator
Filters Size � a X-2 . 4 1 Number
Chimney Location Inside �® Outside
Chimney Construction �A
Form 235
SUBJECT
PERMIT
City of Fridley��`
219 2 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
1 ,
EIPT NO.
COMMUNITY DEVELOPMENT DIV.
p�
__�_� .� PROTECTIVE INSPECTION SEC.
'
`�
1 �
1
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
,`� 612-571-3450
1 910-F15
6/'22/93
JOB ADDRESS 5817 Tennison Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
2
Parkview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Gary Erickson 5817 Tennison Drive NE 571-0905
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D & D Home Improvemtent 7401 Central Ave NE, Fridley 55432 784-7543 4840
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 REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof .Dw,elling (18 Squares) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with. the State Building Code. Provide
adequate attic ventilation. lhstall smoke detectors. as per UB -C 1210 - adjacent to
all sleeping areas and in basement,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$972
$150
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25. Qla.
Fire SC $.97
STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License- SC $5. 0.0
$31.47
51G TUREOFCONTRACTORORAUTHOR ED AGENT (DATE)
PR ERLY VALIDATED THIS IS YOURPERMIT
BLDG IN DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
MW [ ] Effective 3,/1/91
ADM [ ] R-1 AND R-2
A= [ ] Building Permit Application
Cmwtruction Address:
Legal rWW4
Owner Name &Address: �� _ Tel.
Contractor: D & D Home Improvement, Inc. Tel. # 784-7543
Address: 7401 Central Avenue N.E.', Fridley, MN 55432 State Lic. # 4840
Attach to this application, a oeitificate of Survey of the
lot, with the proposed rristruct,ion drawn on it to scale.
1: -RIPTIM of II+ MEN=
L1VM AMM: Length Width Height sq. Ft.
AMM: length Width Height Sq. Ft.
ME= ATEA: Length Width Hgt/Ground sq. Ft.
Corner Lot Inside Lot Ft. Yd Setback Side Yard Setbacks
Type of Clonstruction: Estimtedoost: q" r"),
If-
dg
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
2DATE: APPLtCANr: Tel, # 784-7543
Permit Fee
$
2 . 00
Fine surcharge
$ , 0, `7
State Surcharge
SAC Qzazge
$
Driveway Escrow
c' C�
Park Fee
$
Sewer Main Charge
$
srz ULMCINs:
L
Free Schedule on Reverse Side
.001 x Permit Valuation (3/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Free Determine by
Necessary [ ] Not Necessary [ ]
71he Chief Building Official shall, before issuing permits for the erection of any
building or structure, or for any addition to any existing building or due, or
for any alteration or repair to any exd.sting building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amomit
herein below set forth and in the manner herein provided to -wit:
$1 to $500 $15 (Minimm Flee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to arra including $1,000,000
$1,000,001 and up $3539.50 for the first $1, 000, 000 plus $2 for each additional
$1,000 or fraction thereof
Etivow LEP SSICN E9C WW
(Concrete Curb Streets only)
Alternate "All: Removal and replacement of aub and gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": Removal and of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
Permits for construction will be issued a minimum of 24 hairs 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, sbowirg the location of the foundation once it has
it has been oons zucted will be requited before prooeedi . with the fraoming.
Community Development Department
PLANNING DIVISION
City of Fridley
DATE: July 8, 1994
TO: File
FROM: Barbara Dacy, Community Development Director
SUBJECT: D and D Contracting Workmanship at 5817 Tennison
Drive N.E.
Gary Erickson, the owner of 5817 Tennison Drive N.E. contacted me
on Thursday, July 7, 1994 at 4:00 p.m. complaining about the
workmanship completed for a re -roof project at his home. He
complained that the flashing around the chimney and the vents
were loose on the roof after the re -roofing was completed.
Further, D and D Contracting did not obtain a building permit
initially for completion of the work, but then followed-up by
obtaining a permit. Mr. Erickson complained that a double fee
was not charged. I reviewed this issue with John Palacio, Chief
Building Official, and he advised me that there were no specific
code issues that the City could use to pursue prosecution/a
citation against D and D Contracting. On re -roof jobs, it is not
required that the flashing and the vents be -addressed.
I advised Mr. Erickson that I would document his complaints and
workmanship concerns about the contractor and keep it on file for
future reference.
BD/dn
M-94-376
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING,. COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed.with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
Rate
TOTAL
$ 30.00
$
$10.00
$
$10.00
$
$10.00
$
$ 25.00
$
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING[COQLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
50
Z)
Effective On March 1, 1996
JOB ADDRESS f % % -� ► dfZ m
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. _
® ,9196
OWNER 6FitrC S®,v'
BUILDING USED AS
ESTIMATED COST I-OV4 °1-v PERMIT NO. '��C2�-
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No,
BTU HP EDR
Fuel Total Connected Load
1p
Burner Trade Name.44`WA( 64o , Size No.
BTU ?sZ avy HP EDR
HEATING COMPANY 0-1-1,deZrUg;4�e;7
Signed BC—
Approved
FILL OUT BACK SIDEVOR
REPLACEMENT FURNACE
Tel No. &3 3—r®s-( Z -
Rough -In Date-P�Final Date
STACK VERIFICATION ON
in
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ( )
8. Has combustion air been provided for water heater Yes () No ( )
Remarks:
List ALTERATIONS Beim Done:
HEATING CO:
Signed By:
Date:
CEMWaY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney
or stack:
1.
Has been carefully examined
Yes ()
No
( )
2.
Is free from rust or deterioration
Yes ()
No
( )
3.
Has no. foreign objects lodged within
Yes ()
No
( )
4.
Is securely supported
Yes
O
No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()
No
( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ( )
8. Has combustion air been provided for water heater Yes () No ( )
Remarks:
List ALTERATIONS Beim Done:
HEATING CO:
Signed By:
Date:
Building
BUILDING
Permit Na ' O ` ,
Inspections
$
RESIDENTTAT, APPLICATION
Received Byr4
763-572-3604
$
CITY OF FRIDLEY
Date , A�
763-502-4977 FAX
$
is .r(
.001 times the total job valuation
Surcharge
EFFECTIVE 7-1-2010
r]• Ilii (p
— L '--" l 0
DATE 10
YOUR E-MAIL ADDRESS
SITE ADDRESS 5719 T6N IVI S O M .(JRI
$5.00 (State Licensed Residential Contractors)
SAC Charge
THIS APPLICANT IS:
❑ OWNER XONTRACTOR
PROPERTY OWNER/
NAME: Ca A AL 2 caL SoN
�M'1
FI b)1� y STATEA 1q
6-"N) SOPbA, NE ZIP
TENANT
ft + 6 ft = ft x $24 = $
ADDRESS: CITY -5—'5-4—:U—
$
PHONE:
CONTRACTOR
NAME: A U ��
STATE LICENSE # !7i 5 ' EXP DATE
t
SUBMIT A COPY OF
YOUR: STATE INCENSE
AND CERTIFICATE OF
ADDRESS: ( I rL CC7TI 1'SIA_A� 1�, STATE VyIP.50
INSURANCE
PHONE — 3 FAX f �fJ ` 3 c� I
PROPERTY TYPE
SINGLE EAMI Y/NEW CONSTRUCTION SIZE
$
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ':WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
VIAINTENANCEMEPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: Lr 1- r-71 �F jQ W 1 N _r>D cc1.5
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
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
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS Wes ❑No LOCA�ION O
M
FOR WINDOWS — PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF AN 1 R t lT
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES & �O rt 19L.E 1duAi6
TYPE OF WINDOW TO BE INSTALLED
Cr.ASE ME 1.I`iSMJMBER OF WINDOWS 1.5
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
to .00
OCCUPANCY TYPE
Permit Fee
$
I G rj . �rj
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
is .r(
.001 times the total job valuation
Surcharge
$
r]• Ilii (p
.0005 x Permit Valuation Minimum $5.00
License Surcharge
$
5 D D
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
n 95.
Make checks payable 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 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 pe tit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case 1 work hic rec ' es review and approval of plans.
SIGNATURE OF APPLIC PRINT NAMETO N ! A lU IeSo N DATE I �% 1 — D
APPROVAL INSPECTOR SIGNATURE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK
A-W-1
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
Dear Mr. Erickson:
5817 Tennison Drive
I am writing this letter in regard to the phone conversation that we
had on March 19, 2001. As I explained to you the City of Fridley
has no control over the cleaning of your service lateral. The sewer
main televising on Tennison for the upcoming street project was
completed to observe any abnormalities in the pipe as well as the
sewer connections. Service connections that were identified to
have large root masses were then televised from the house to
identify where these problems begin. The services that have severe
root problems will be dug up and repaired from the y connection at
the main along with the service lateral to the blvd.
The televising of your service will be necessary to determine if a
problem exists in the blvd. area, if it is determined that a problem
exists from the connection'at the blvd. to the City main line a
repair of this section of pipe will be completed. I should also add
that there are no additional fees for televising the sewer service,
nor the repair of this service. Please call me at 763.572.3565 so
that we can set up an appointment to televise your house service,
this is an excellent opportunity to put an end to your sewer
problems.
Thank -you
Greg D. Kottsick
Sewer Supervisor
City of Fridley