PRE 2010 DOCSCity of Fridley, Mims
BUILDING PERMIT
Date:
Owner: °' Builder
Address _ _ _ Address
N°5332
�WCATI®tx OP BUILDING
No. y Ft` SfreeAt _ _ _._ I?afto Lot
Lot _ Block _ Addition or Sub -Di 'on
Corner Lot _ _ _ __ _ Inside Lot _ aback Sideyard
Sewer Elevation ___ ____,____ oundation II
Fevation
DESCRIPTION OF BUILDING
}AA -As_ Front ` Depth . Height Sq. W Cu. Ft
Fro" Depth Height _ Sq. Ft. Cu. Ft.
Type of Constructi �-�t .....__ Est. _ To be Completed _
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of. $� , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
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, shad 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. _ --1 R , � "=
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sureto an
the Building Inspector for separate permits for these hems.
4
AKVIU E.UARLbUN U !,'JUN INC.
3200 FRANCE AVE. SO.
3rd.
4WA441
N.E.
80.6d 75 75 ss
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CLEARVIEW STREET
APPLICATION FOR BU31DING PES
CITY OF FRIDiEY, MINNESOTA
Owner I s Name K au Builder
Address '5C' `i - (� � LAN Address `� � � -�i ft 9'�,
LOCATION OF BUILDING
No. Street Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback Side -Yard
SEM ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used
iIp& 4 go .-- , Front Denth A-)
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft.
Type of
To be Completed _ --5;
Cu. Ft.
ted Cost 1�
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 -
(A Schedule of Fee Costs can be found on the Reverse Side.)
BUILDING PERMIT FEE SCHEDUIE
Section 2. The Inspector of Buildings shall, before issuipg 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�buitding 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 vanner herein
provided to -wits
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 existingbuilding 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 $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 building or addition.
Ninety Cents for each one thousand cubic feet.or fraction thereof, in the cubical
contents thereof with a minimum of $1.00.
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 for each Five Hu�idr�,d Dollars ($500.00), or fraction thereof in the
cost of all proposedJwbrk.
2.6. In no case shall the fee charged for 'any permit as set forth in Section 2 be
less than $4.00.
MEMO FROM:
RICHARD N.• SOBIECH
Public Works Director
SUBJECT:
0
lV
MEMO NO. RV 35 REPORT BY: 9125175
.DATE 9/12/75
Dumping Oil into Catchbasin on Topper Lane
Make reports, w/background
material as complete as poss-
ible. Make interim report if
necessary.
. Action completed, no
further review needed
[) Further action necessary
[] See attached letter
[] Interim report
COMMENTS:.
I have codtacted Mr. Raymond Smith by telephone.
He admitted'to dumping.oil into our storm sewer,
but he was not aware that he was doing anything wrong.
He stated that it would not happen again.
I am sending him a letter, enclosing the State Regula-
tions about dumping material into the storm sewers.
DATE: 9-15-75 SIGNATURE !?&"
RALPH V LKKAN J
Supt. of Public Works
E[
See attached
REMARKS:.
The Pollution Control Agency (Mr. Jakes 296-7361)
called & indicated.he had received a complaint
on a Raymond Smith, .5972 Topper Lane dumping oil
Review & take appro-
in the catchbasin at the intersection of.Topper
priate action
Lane & Horizon Drive. It is the policy of the
LU
PCA not to get involved in local complaints,
[..Review
& comment
therefore, they are requesting the City to
contact the gentleman and indicate to him that
°-
❑
.Note & discuss with me
_ oil is not to be disposed of in the sewer system.
C)
Perhaps you may want to contact him personally
'-
Work with
& follow up with a letter or you may want to
involve Steve Olson, at any rate it is our
3
[�
Rush, immediate action
storm sewer system & we should assure that
desired
contaminants are not disposed of in such a
manner.
Thanks for your help.
Make reports, w/background
material as complete as poss-
ible. Make interim report if
necessary.
. Action completed, no
further review needed
[) Further action necessary
[] See attached letter
[] Interim report
COMMENTS:.
I have codtacted Mr. Raymond Smith by telephone.
He admitted'to dumping.oil into our storm sewer,
but he was not aware that he was doing anything wrong.
He stated that it would not happen again.
I am sending him a letter, enclosing the State Regula-
tions about dumping material into the storm sewers.
DATE: 9-15-75 SIGNATURE !?&"
RALPH V LKKAN J
Supt. of Public Works
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
m
RATE
TOTAL
D.
m
$
ro
x $2.00
v
New Fixture, Old Opening
43
0
Catch Basin
Water
$
'01N
Water Heater - to 99,000 BTU
x $5.00.
Hca
ro
m
A
m
m sa
W
�'
x $5.00
$
Heater
�+
sew
m
a
1st 3 fixtures
x $3,00
u
Additional Fixtures
x $1.00
xaffi
lGas Range to 199,000 BTU
x $10.00
o
W
N
bu
O
to
3
Qw
M
N
U
lec
is
2n
3r
4
()
Future Connection Opening
Connected with Sewer
()
New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
ILUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5.00
$
'01N
Water Heater - to 99,000 BTU
x $5.00.
$
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
Electric Water Heater
x $5.00
$
.S FITTING FEES:
1st 3 fixtures
x $3,00
$
Additional Fixtures
x $1.00
$
lGas Range to 199,000 BTU
x $10.00
$
RS $ ALTERATIONS
t $100.00 $5.00 $
add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE Z a
REINSPECTION FEE
($10.00)
Job Address ® ��n/-�
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. �, 1997
OWNER
KIND OF
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD NEW BUILDING
PERMIT NO.
PERMIT NO.
Company
'01N
Signed By�
Tel. No.
J .9 P - �-�
ROUGH INSP.
Date
FINAL INSP. 4 - 1 7 -
Date
APPROVAL FOR PERMIT ,
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
SUBJECT
PERMIT NO.
City ®f Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
2 5 7 8
r
COMMUNITY DEVELOPMENT DIV.
R T N.Q
r PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
J "'J 612-571-3450
910-F15
5/31/94
JOB ADDRESS 5072 Topper Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
19
5
1 Carlson's Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Peffer 5072 Topper Lane NE 571-7858
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 26' x 16' Deck Addition
9 CHANGEQFUSEFROM TO
STIPULATIONS
See notations on plan. Provide smoke detectors adjacent to all
sleeping areas and in basement.
110
YwARNING
Before digging 0611 %t
all utility locations
454.0002
REQ UIRED BY LAW
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
$1.61
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,228.16
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC $3.23
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$63.00
PLAN CHECK FEE
TOTALFEE
67 _4
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WH p Y VALI ATE D IS YOUR PERMIT„
BLOC INS DATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW Effective 1/ 1 /94
ADDN CITY OF FRIDLEY i 1.
ALTER (J SINGLE FAMILY AND DUPLEXES R -I AND R -Z
Building Permit Application
Construction Address: --
Legal Description:
Owner Name & Address: 04P:710 Tel. # 7
Contractor: MN LICENSE #
Address: Tel. #
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 . 2-4'e Width 1— Hgt/Ground J ` Sq. Ft.
OTHER:
Comer Lot [ ] Inside Lot M Ft. Yd 'Setback ISide Yard Setbacks
Type of Construction: fit% od 0 Estimated Cost: $ Z; az
r
Approx. Completion Date: 6 -- /S- %-'/
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft 17
=A Ft x_ $ _ $
DATE: APPLICANT: ` Tel. # f- 7
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ r
.001 of Permit Valuation (1/ 10th%)
State Surcharge
$ 9
$.50/$1,000 Valuation
SAC Charge
$
$800 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt_ "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary (] Not Necessary [ ]
%
TOTAL
$ e�
STIPULATIONS:Zh6, bedmewt4
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 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for fust $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for fust $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for fust $25,000 pias $6.50 for each additional $1;000
or fraction thereof, to. and including $50,000
$50,001 to $100,000 $414.50 for, fust $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 fust $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 and including $1,000,000
$1,000,001 and up $3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50_
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
114
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A 1'��
;ITY OF FRIDLEY INSPECTION DIVISION
A31 University Ave NE
ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
'63.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Zesldential
Furnace Shell and Duct Work, Burner
Also Replacement Furnace
(Side Vent • Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
'Air Conditioning - All Sizes
Effective On January 1, 2001
All Others/Repairs & Alterations (LIST ON BACK)
10/0 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/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/I-ir
'Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
$ S0
Burner Trade Name Size No.
BTU tip EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations slated in this application are true and correct.
DATE
BLO.AINE
ENTRAL AVE. E.
HEATING CO _ ANO
Signed ' ` , TEL N (P�71rl�lADOD,
s
Approved By4 Rough -In Date Final Date
BACK SIDE MUSTIBE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
JOB ADDRESS�OWNER
Rate
TOTAL
BUILDING USED AS
S$30.00
$30.00
$30-,0-0
-
ESTIMATED COST®� ' 0-0
PERMIT N0.
$10.00
$
DESCRIPTION OF FURNACE
AND OR SURNtR
$ 10.00
$
No. of Heating Un'ts Circle One
(Steam) ' (Hot Watdr) ( r)�
$ 10.00
$
Trade Name--- c (�
Size No. 31�- VQSG07
_
BTU (Y -Cy 0 HP
EDR
$ 25.00
$ 0-0
Fuel Aj- (h , Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
10/0 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/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/I-ir
'Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
$ S0
Burner Trade Name Size No.
BTU tip EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations slated in this application are true and correct.
DATE
BLO.AINE
ENTRAL AVE. E.
HEATING CO _ ANO
Signed ' ` , TEL N (P�71rl�lADOD,
s
Approved By4 Rough -In Date Final Date
BACK SIDE MUSTIBE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
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. Ye4 No { )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes X 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 -LAMA Category l 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 combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes No( j
When installing 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 -LAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. YesNo ( )
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 ( No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input `. O l}-OFan 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 Diameterin Type®
Appliance #3 Vent Connector Height ft Lengthft Diameter in Type
ALTERATIONS: (Describe)
BLAINE HTO. A/C ELECT., INC.
13582 VENTRAL AVE. N.E.
HEATING CO: ANOKA. MN 553tt4
y
Signed By: eh. Date:
HEATING
AIR CONDITIONING
wSIMAMMINE AND ELECTRIC, INC.
ADDRESS ,
OCCUPANT
HEAT LOSS DATE HTG. INST.
SOLD BY
Electrical Work By
111LO 'p—
TYPE OF HEAT GA FA—Y—HW STEAM SPACE HTR.
GAS DESIGN
CONTROLS
Heat Plug
Limit
Fan !
Pilot Make.
Pilot Model
Pilot Timint
L.W. Cut Off
Pressure / ® Percent CO2 Z42
Input CFH6!(e Percent 02
Stack Temp. _���,�/ Percent CO
HOUSE HEATING TEST RECORD
APT. FLOOR CITY � SUBURB
OWNER
A64 -1
INSTALLED BY
Gas Line By L000l
UNIT HTR. OTHER
C��IIL��3r�1iJ
Vent Size
KIND OF LINER SIZE NONE
Dmft Hood 471WIJ Regulator
Filters Size �� Veg <Y Number %
Chimney Location Inside 0 tside
Chimney Construction �!®
Smoke Bomb Wiring Af
Draft Test Tag
Door Pressure Lighting Inst
,e
Date Tested
Company Testing
Name of Tester
Pressure Percent CO2
Input CFH Percent 02
Stack Temp. Percent CO