PRE 2010 DOCSCity of Fridley,
BI TIDING PERMIT
Date: --- '
w
Owner: oder'
Address _ _ Address
LOCA, OSI OF111W2
1
to;
No. � ``Street irb, I .Lot -
Lot Block _, `' _.__ Addition or Sub -Division :....��_
Corner Lot _ _ Inside Lot _40e Setback.,-- .r..... Sideyard
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth _ Height ' Sq. Ft. Aaro&L Ft
-- Depth Height Sq. Ft. Cu. F
Type o 'Construction Est. Cos " _ T 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, 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.
4
Owner ` s
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Address Address
OF BUILDING
No. � Street I C -� �_ ., Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot ®� Setback,. �-:3' Side-Ya^d
SEWER ELEVATION FOUNDATION ELEVATI.OK
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
DESCRIPTION OF BUILDING
To b used as:
LLEI�__Front .5Depth �°� Height J— 6
sq. Ft. -41 L �7' „ cu. Ft.
Front__' T Depth /'
eight .
S Ft .� cu. Ft.
d
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 ruling of the Department of Build-
ings, and hereby declares that all the facts and representations
stated in this application are true and correct.
- ogle
DATES61
SIGNATURE
Cly
(Schedule of Fee Costs can be found on the Reverse Side).
BUILDING PERMIT FEB 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 existing 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
odic feet, or fraction thereof, in such cubical contents,,
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 1Qfireproof" by Section 502 of the Minneapolis Building. Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof build-
ing other than a garage, warehouse, factory or grain elevator, or any
non-kireproof 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 $4.00.
For the purpose of computing fees for building permits the cubical con-
tents 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 fee charged for any permit as set forth in
Section 2 be less tr $4.00.
Application for Power Plants and Heating.Ging, Ventilation. Refrigeration and
Air Conditioning Systems and Deviates
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
... 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
$
OIL 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 $ 5.00
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ....... x $1.50 $ 1.50
! Additional Fixtures ............
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ 14.50
ROUGH
FINAL
Dept. of Bldgs. Phone SII 4-7470
Location 6280 Van Buren N. E•
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.
Fridley, 10-26 19 61
Kind of Building Fmame
Used as Residence
To be completed about 1126-61
Estimated Cost, $ 450.00
Old—,,Jiew. Building Permit No. Permit No. /
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Westingaouse Size No GUE"7 5
Capacity Sq. Ft. E.D.R BTU 75M H.P.
Total Connected Load 45v815 Kind of Fuel Oars
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Signed F IUM VOLT & CC).
HUMS A AOR COMMIUMNS
By 6530 Wesf Lake
.
>
St. ouis Parts, Minnesota
42 2M 7-59 Business Phone o
y dpD
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN.
S.I I. .
Weatherstrips A.Guide Construction No. Insulation
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes— o I Yes— 19_
/ FV / i iJ Room I Length „D n Width / 44 Height 11 FI.I , _ A Room I Length Width /rte Heiaht .40".•
Windows and Doors—Crackage
and Area
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 or pane lights of rack sq. ft.
13 4�1 t— (:yjU
`Wy
oil i
Coef.
Btu
Infiltration
Coef. Btu
_ Infiltration
Glass
Coef. Btu
:.
Glass
(
tZip
Net exp. wall 6�
_ Exp. wall
LZ 2,,,
Net exp. wall
Int. wall
Net exp. wall77
Int. wall
Ceiling
.— r
yr
Ceiling
Floor
1p .2- S' L
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F1.1 Room I Length Width
Win,dows and Doors--Crackage and Area
Width Height No. or Lineal ft. Area
No. of pane of pane lights o rack eq. ft.
s4i
t r
Coef.
5M
Infiltration
_Glass Ir ELI
_Exp. wall °
Net exp. wall
Int. wall
_Ceiling
Floor 17ro
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
i Fl.j . ,�P— -77 Room I Length -' 7 Width / ✓ Heiaht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
No. of Lineal ft. Area
lights of crack sq. ft.
Area
sq. ft.
Coef.
Btu
Infiltration
o
9,2
Glass
Coef. Btu
Infiltration
Exp. wall r..
(
tZip
Net exp. wall 6�
Int. wall
—Ceiling
Net exp. wall
Int. wall
.— r
Ceiling
F loot ,r
�7
sial Btu.
„ r
Required sq. ft. E.D.R. or sq. ins. W.A. Leader
Windows and Doors—Crackage and Area
Width Height
No. of Dane of pane
No. of Lineal ft. Area
lights of crack sq. ft.
Area
sq. ft.
Coef. Btu
Infiltration
(
tZip
Glass
Exp. wall I
Glass
Net exp. wall
Int. wall
Exp. wall _
Ceiling
Net exp. wall
Inc. wall_
Floor
/
Total Btu.
Requi7ed sq. ft. E.D.R. or sq. ins. W.A. Leader area
f Fl.► r' Room I Length Width
Windows and Doors--Crackage and Area
fV dth Hht No. of Lineal ft. Area
No. of pane of Daelgno lights of crack sqft.
s
/ / Height f " -
Infiltration ' $ /,Owl ?
Glass -
Exp. wall 2- 7,0
Net exp. wall
Int. wall
r
Ceiling ( u
Floor , w
Total Btu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
0 F1.1 jodRoom I Length Width 4" Height rY
Windows and Doors--Crackage and Area
Width Height
No. of pane of pane
No. of Lineal ft.
;,Shia of crack
Area
sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall _
Net exp. wall
Inc. wall_
Ceiling
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
raaYtrrtlai
City of Fridley
Application for Plumbing and Gas Fitting Pennit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK �f
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
12
Number Fixtures ......................
x $1.50
$� `,,°
Future Fixture Opening ................-x
1.20
$ Irj
New Fixture Old Opening ..............
x 1.00
01 Z
+
F
$
N
WATER HTR.
GAS
ELEG
$ a Cj
3
7
$
GAS FITTING FEES:
N
3h
DLL
$ z ^�
LLO
GD
3
U''d
O�
t�0
Base
/
f
1st
2nd
3rd
4th
• Future Connection Openings
Connected with
Sewer El
* New Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
6
Number Fixtures ......................
x $1.50
$� `,,°
Future Fixture Opening ................-x
1.20
$ Irj
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU)
...... ✓ x 2.00
$ a Cj
New Ground Run Old Bldg. ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................--�
x $1.50
$ z ^�
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEEC��
City of Fridley:
The undersigned hereby .makes application for a permit for the work herel
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.
Fridley, Minn. z o /� / 19_
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $ L
01 New. B ' ding Permit No \
_s
ROUGH
FINAL
42 2M
By-d,q-
Business
i
Permit No. A / C%
CP
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
.AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
MECHANICAL WARM AIR:
Furnace Shell & Duct.Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSMI:
RATE
TOTAL
$12.00
$
7.00
$
7.00
$
4.00
$
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
$12.00 $ specified agreeing to do all work in strict accordance with the City Codes
4.00 $ and rulings of the Department of Buildings, and hereby declares that all the
7.00 $ facts and representations stated in this application are true and correct.
7.00 $
4.00 $ FFrrid/�ley, �Mi/nnnp. , 19
28
OWNER B C_ II n A (Z�: N T A A_ rT
ROUGH INSP.
FINAL INSP.
REINSPECTION FEE
Date ($10.00)
uaLe
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY HEATING PERMIT. IS $7.50 PLUS $.50 STATE SURCHARGE
KIND OF
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST -PI L_L_JLJ.t
OOLD
NEW BUILDING PERMIT NO.
PERMIT NO.
I DESCRIPTION OF FURNACE((/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, �1Tarm hir- No.
Trade Name S6Lbf4a Size No.
l�ka
Qj
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Compan�Wjl W If
Signed By
Tel. No.
Boiler & Lines up to 100,000 BTU
$12.00
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
each addn. 50,000 BTU
6.00
$
OIL
BURNER- to 3 gal. per hour
$10:00
$
each add. 3 gal. per hour
10.00
$
GAS
BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$
(over 199,999 BTU see Fee Schedule)
$
GAS
FITTING FEES:
lst 3 Fixtures
x $ 3.00
$
Additional Fixtures
x $ 1.00
$
9,000 BTU
x $10.00•
$
AIR
�NGSYSTEMS
FAQ
$
c e
VENTILATING SYSTEMS
e
$
ALTERATIONS $ REPAIRS
$
State Surcharge
$50
TOTAL FEE
$�
ROUGH INSP.
FINAL INSP.
REINSPECTION FEE
Date ($10.00)
uaLe
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY HEATING PERMIT. IS $7.50 PLUS $.50 STATE SURCHARGE
KIND OF
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST -PI L_L_JLJ.t
OOLD
NEW BUILDING PERMIT NO.
PERMIT NO.
I DESCRIPTION OF FURNACE((/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, �1Tarm hir- No.
Trade Name S6Lbf4a Size No.
l�ka
Qj
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Compan�Wjl W If
Signed By
Tel. No.
RMIT NO.
19143
SUBJECT
P
City of Fridley
_
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1-9 Z,
C -9Z,
/"--1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/1/87
JOB ADDRESS 6280 Van Buren Street N.E..
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1.
Irene Henry Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bob Sotherland 6280 Van Buren Street N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Northwestern Co. 546 W. Main Street Anoka MN 55303 566--3505
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 16' x 14" Garage AIddi.tion
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
WARMIG
Before digging call local
!!lines
ELEPNONE
SEPARATE pERMIfiS
- ELECii;1C - CA$ 6r.
WIRING, HEATING, PL' �UIREa' FOR
REQUIRED By LA VV
IVG AIS® SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOME,§, 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
$1.61
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,2116
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 -
TR CTION OR THE PERFO ANC_ E OF CO, TRUCTION.
$44.50
PLAN CHECK FEE
TOTAL FEE
il
I�W
$46.11
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
"WHEN PROPERLY
DATED T IS IS YOUR PERMIT
IAl
BLDG INSP
DAT
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
RMIT NO.
19143
NEW [ ]
ADDN. [ ]
ALTER. [ ]
Construction Address:
City of Fridley
�R-1 AND R-2
Building Permit Application
Effective 4/1/86
Legal Description:
Owner Name & Address., ��' Tel. # 521- ! 7 J;tl
Contractor: >' 11�s'/ "1 �� 5 �� C29 Tel. # 566-3!5 5
Address• 5 � � 'e�a'^/7
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width
Length Width
Length Width
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot C)(] Ft. Yd. Setback Side Yard Setback
Type of Construction: bt✓� jo C Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: l APPLICANT: T P Tel. # 5-�/.. 15�
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
`� CITY USE ONLY
$'7 J� Fee Schedule on Reverse Side
$ r 25% of Building Permit Fee
$ lr�ol $.50/$1,000 Valuation
$ $ 525 per SAC Unit
$ Fee Determined by Engineering
$
Agreement Necessary [ ] Not Necessary [ ]
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
additional $1,000 or fraction thereof, to and
including $50,000.
$50,001.00 to $100,000.00 $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 ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
Alternate "BTM: 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.
NUNDERFANGiNEMING COogllqco
ENGINEERS AND SURVEYORS
LANo GURVEVING SOILS TESTING
CIVIL d. MUNICIPAL ENGINEERING LANO PLANNING
6418 -SGT" AVENUE N.
MINNEAPOLIS 2T. MINN.
KE 7- SG37
9E?
L
130.15
GA=
IOC3
21► 5.5 1J.3
101.5—`
9a6 Scale. �'=30'
x
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Assume+ Verkieo'1 DXum
Uevckklor,4 Shown
alre ProposeA
U -r 2., B to cY 1, 1 RF -Ns "E�4R� AIDD\-r � ()1a
WE KER 5Y CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATIOW OF A SURYEY OF THE BOUNDARIES OF THE
LWO ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS,
IF wN,r, f, ROM OR ON S►UO LAND. MI•RDER ENGINEERING CO., INC.
t9 �1a5 ��T"owY cc _ , �ULY _ AO.M161 ENGIMEER AND SuRv%yoms
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0
0 € 35
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1999
9a6 Scale. �'=30'
x
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Assume+ Verkieo'1 DXum
Uevckklor,4 Shown
alre ProposeA
U -r 2., B to cY 1, 1 RF -Ns "E�4R� AIDD\-r � ()1a
WE KER 5Y CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATIOW OF A SURYEY OF THE BOUNDARIES OF THE
LWO ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS,
IF wN,r, f, ROM OR ON S►UO LAND. MI•RDER ENGINEERING CO., INC.
t9 �1a5 ��T"owY cc _ , �ULY _ AO.M161 ENGIMEER AND SuRv%yoms
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SUBJECT
PER '��¢�•
City of Fridley5
358
AT THE TOP OF THE TWINS
BUILDING
PERMIT
1f �
• COMMUNITY DEVELOPMENT DIV
PROTECTIVE INSPECTION SEC.
fffJ
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
7/31/95
JOB ADDRESS 6280 Van Buren Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Irene Henry Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mary Sutherland 6280 Van Buren Street NE
571-7932
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Steven R Lee Co 9465 Irving Ave N, Brooklyn Park MN 55444 424-1198 5758
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 O ALTERATION] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (25 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
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
ISTALLS I 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
$.93
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,875
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-
$43.00
Fire SC $1.86
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$50.79
IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY
BLDG NSP
LIDATED THIS IS YOUR PERMIT
O E
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW j j Effective 8/l/95
ADDN (i CITY OF FRIDLEY
ALTER O SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: ?(D e " , 'r T -
Legal Description:
Owner Name & Address: /�1 �y T� R �- 1 Tel.
Contractor: J'�'�-✓Q ,�_ Z- _ MN LICENSE # -5-,7 .r 4e
Address: ��.�J,%e 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 Width Hgt/Ground Sq. Ft.
OTHER: : A- .� �� v2 l' �'� < :2
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks 199 S
Type of Construction: Estimated Cost:
Approx. Completion Date: - / - 'YJ-
(Cost
Y1(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: 7--7)- q-)-APPLICANT-Tel.
CITY USE ONLY
Permit Fee
$ _ C
Fee Schedule on Reverse Side
Fire Surcharge
$ % ,
.001 of Permit Valuation (1/10th%)
State Surcharge
$ '�
$.50/$1,000 Valuation
SAC Charge
$
$850 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 [ J Not Necessary [ ]
TOTAL
$ Sc' `
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 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 fust $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,00
$50,001 to $100,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,0
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
CITY OF FRIDLEY I ItCT.ION DIViSION
6431 University.Ave NES
Fridley, MN 55432 APPLICATION FOR POWER PLANTS SAND HEATING, COOLING, VENTILATION,
763.572.3604REFRIiGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE --,SCHEDULE
JOB ADDRESS_ 61)-<10 ,l ,
Residential
Rate
Furnace Shell and Duct Work, Burner -
Q
Also Replacement Furnace
$ 30.00
(Side Vent - Fill :but Back)
Gas Piping -(Needed with -new furnace,
$ 10.00
but not replacement)
Gas Range
$ 10.00
Gas Dryer
$ 10.00
*Air Conditioning.- All Sizes
$ 25.00
All Others/Repairs & .Alterations (LIST ON BACK)
Trade Name �°p� o„o,� Size No. X93'
1% of Value of Appliance or Work
BTU 66 von' HP EDR
Fuel Total Connected
Commercial/Industrial ...
toad:
1.25% of Value of Appliance or Work
Burner Trade Name Size No.
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/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2001
DATE
HEATING CO D A�
Signed TEL #
Approved By Rough -In Date Final Date
BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTIO 'AIR VERIFICATION
JOB ADDRESS_ 61)-<10 ,l ,
:
OWNER
TOTAL
Q
BUILDING USED AS di�rr
$
ESTIMATED COST /9q0, OU PERMIT.NO.
DESCRIPTION OF FURNACE AND OR BURNER
No.:of Heating Units l Circle One (Steam) (Hot Water (Warm Air
$
Trade Name �°p� o„o,� Size No. X93'
$
BTU 66 von' HP EDR
Fuel Total Connected
toad:
Burner Trade Name Size No.
$
BTU HP 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
$ 50
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ 30,
DATE
HEATING CO D A�
Signed TEL #
Approved By Rough -In Date Final Date
BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTIO '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. Yes- O No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes O 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 combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
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-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 correctly after
an appliance has been removed from the common vent -and vented
Yes No
separately as per current codes: O f )
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 :
C.CIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
January 11, 2002
Ms. Mary Sutherland
6280 Van Buren St NE
Fridley, MN 55432
Re: Final Inspection at 6280 Van Buren St NE
Contractor: Standard Heating & Air Conditioning
Dear Ms. Sutherland:
A mechanical permit was issued on May 16, 2001 to install a furnace at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date, no inspection has
been called for.
The permit fee that was paid covers the inspection to make sure the work was
completed according to the Codes. We will keep your permit open for another 30
days and if we do not hear from you within this time to set up the inspection, we will
mark the permit "no inspection called for" and take no further action.
To set up the inspection or to have any questions answered, please contact the
Building Inspection Division at (763) 572-3604.
Sincerely,
DJ/mh
Building
BUILDING Permit No::
InspectionsRESIDENTIAL
APPLICATION Received By. -
763-572-3604
See Back Page for Fee Schedule
CITY OF FRIDLEY Date
763-502-4977 FAX.
65% of Building Permit Fee
Fire Surcharge
EFFECTIVE 8-19-09
DATE C? `Z Z _vC (
Y Y�
YOUR E-MAIL ADDRESS 5eNl IA,�S Q 0. ®L' c:0 �
SITE ADDRESS &2;W
'" _
+,1 LIIZL � S�T• 4 lt7 ;�_( fxL VO^( 57-3-�t 3 2..
THIS APPLICANT IS:
KOWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: Co z&-0 L) -AJ 73kr4-. s i . &1 CITY- L a STATE4'UZIP Sou 32
Curb Cut Escrow
PHONE: �Co a X02^dUp
CONTRACTOR
NAME:
SUBMIT A COPY OF
$450 Conservation Plan Review
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE a000
Make checks uavable to: Citv of Fridlev Attach Stipulations
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED KWINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK )iTSIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIRE.PPAIR 'REMODELING
DESCRIBE WORK BEING DONE: J_�9t/_4I n
5(®/lj�
Y.�DIa"eMger O� �✓ t:Jan',')0 %S
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
Gil Trim
1. Site Plan/Survey showing the existing structures
XOther �
91 Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS j4Yes
❑No LOCATION OF V JINDOWS `
FOR WINDOWS — PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF S ((6S
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
'TYPE
•11 —7
L
OF WINDOW TO BE INSTALLED
V 1 tJ NUMBER OF WINDOWS 0
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
000
OCCUPANCY TYPE
Permit Fee
$ `
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 00,
.001 times the total job valuation
Surcharge
$ 0o
.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
$ s`I'
Make checks uavable to: Citv of Fridlev Attach Stipulations
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 on site; that the work will be in accordance with the
approved plan in the case of all ork wh h requires review and approval of pl s. ,, ((_- ry
SIGNATURE OF APPLICeNIC PRINT NAME - LI -r— DATE —1 " Z Z Y��
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 V $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