PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERT N? 4365
Date: -
Owner:
Address
Builder,
Address
LOCATION FE BUILDING
No.... Street Part of Lot .......
Lot....................................... Block ..... -....... ..................... ................. Addition or Sub -Division ..... _.............................
Corner Lot ............... ............ ........ Inside Lot ..... _................................ Setback ............................................. Sideyard
Sewer Elevation ..... -........................................... -............................ - .... __.............. Foundation Elevation ............
DESCRIPTION OF BUILDING
To be Used as:
� f w
Front 20.-' V Depth ®_.—V Height ../0. eSq. Ft. Ft.
........................................................... Front ..... _................. Depth ... ............... /Height ....... ............. Sq. Ft....................... Cu. Ft. ..... _.................
Type of Construction .................... _..................................... Est. Cost ....... /.3 Q. �... ........ To be Completed ...... ...................................... ........
In consideration of the issuan I to me of a permit to construct the building described above, I agree to do
the proposed work in accordance ith the descrip�ipn above set fo and in compliance all provisions of
ordinances of the city of ri Y.
(4
rf
In consideration 1Z payment of a fee of $.....'`9. ...... , 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.
APPLICATION FOR BUILDING PERMIT
CITY OF FRTDLEY; 'MINNESOTA _._.. __ ...._
'Owners Name -Builder ' ✓r�_=�
Address /�v / ���.a �- , Adds�ess / �+L)
LOCATION•OF BUILDING.
No. Street Part of -Lot
Lot Block Addition or Sub.Div.
Corner 'Lot Inside Lot Set Back Side -Yard,
SEWER ELEVATION- FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Front ..� Depth Height'
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of
To be completed e
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'' Ordinances and ruling of
the Department of Buildings, and hereby'. declares that all'th6 facts and-
representa-tions stated in this application are true and rrect.
DATE-.% , 'S �� SIGNATURE
(A `Schedule of Fee costs can be found on'the Reverse Side.)
a
9
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector'..of..Biiildings shall, before issuing any permit
for the erection of any buil ing'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.
= he ent-by the applicant for such permit of fees tb tie.7am6unt 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 fireproof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet—or.fraction
— Efiereo, �in such cubical contents.
0
7,. �-`Yor any such permit for the erection of any fireproof garage, ware-
house, factory or:grain-elevator, or for the erection.of-any fireproof.
addi�io`n; f'orr•similar occupancy, to any existing building shall be at the
rate of $1.25' for each one .thousand cubic feet,.. claesi.fie.d....as "fireproof" r`
_by_Se Riori'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 :J
2.4. For any such, permit for the.erection of any non -fireproof garage,
w•ar-ehauee•, factory' -or grain elevator',- or for the erection 6f any"nob;
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
...-m��i--o-f •-$4200 ....._
=--F 6r.__the._pur'pose of computing fees - i'or-- building permits the cubical contents
of any building or addition to a uniform height throughoutby multiplying
the ° gr6 ind"larea covered from a point six (6) inches. below. the floor line of
the babeker!V`or `eeT' ar to the average .height of the upper..,surface or to the
average height of�•the roof surface o 't. he main gable of.a,pitched roof.
2.5. For repairs or alterations to an existing -structure, the fee shall be
at .the-.xate 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.
x ;z
LOT KM
BLOCK ADDRESS jr, VALUATI.,
ADD, TYPE..
=-.,4,��
-
Property Idze
4 14ouSe
COAJ.D u I T—
FJ"44 gf-.4,'k 04r
Alorlr oto wle
11% f- X X 414 5
e r
e4 Z
M 44-ol �
A eiflr-
Front
m es I+
A P k -a. �Q,
cov
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices �J
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell &. Duct Work ........................... $10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ... ........... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam .. .................. 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal. per hour ..... ..................
6.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE
TOTAL
1st 3 Fixtures ..... ................
x$ 2.00
$
Additional Fixtures ................
x .75
$
Gas Range to 199,000 ...........
x$ 5.00
$
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
$
See Fee Schedule
TOTAL FEE
Dept. of BllAdga. Phone 560-3480
Location (D 3 / -� J/2, 13,4-p-,
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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. y
Fridley, Minn Qz.,� 2 19
Owner �J
Kind of Building�---�—
Used as
To be completed about
Estimated Cost, $��
Old—New. Building Permit No. Permit No.id"
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No -7 -
Capacity Sq. Ft. E.D.R BTU �° `°'rr
Total Connected Load Kind of Fuel -
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
(REMARKS—OVER)
Signed
V R
By t `j/� . /✓jsv
as Business Phone No-
City of Fridley
SUBJECT
IP T _
13830
AT THE TOP OF THE TWINS
BUILDING PERMIT
� �
R
-1 COMMUNITY DEVELOPMENT DIV.
i PROTECTIVE INSPECTION SEC.
3
1 . �
CITY HALL FRIDLEY 55432
�---- �'�
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
110/18/76
JOB ADDRESS 6313 Van Buren Street' N..E.
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
j
17 -1� 1p
Florence Park Addition SHEET
-F-PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Sandra Mar9is 6313 Van Buren Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Royal Alum® Products, Inc. 526 6th Avenue North 332-5591
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
SAME
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential
7 CLASS OF WORK
❑ NEW 7 ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Fi.nf:sK off basement to amusement room
9 CHANGEOFUSEFROM TO
STIPULATIONS
1. All styrofoalOnsulation must be covered
PERMITS REQUIRED WONT,
SEP�A�
ATING, PLUMING AND SIGNS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, -HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I ISTALLS
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
$5,000
2.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY THER ,, ATE CAL LREGULATING CON-
30.00
STRUCTION OR P R r E OF CONS U TIO
PLAN CHECK FEE
TOTAL FEE
32.50
SI ATUR�O'R CT RORAUTHORIZEDAGENT (DATE)
HEN P- OP Y VALIDATED HIS ISYQ R PE,MIT
rs
76
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
I BLDG. IN P DATE
011
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER'S NAME : DRA A111+ KG- 15BUILDER: T�-
ADDRESS : 6 5"-�, ADDRESS :
TEL. NO.: 3 -,575-2
NO:. STREET:
LOT: BLOCK:
CORNER LOT:
ADDITION
INSIDE LOT: SETBACK: SIDEXARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used s:
&C� Front:
C' '._5_
Square Feet:
Front:
Depth • /_( U Height:
Cubic Feet:
Depth: Height:
�_T ®c.V
�1
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:
�To Be Completed: -/C/ ? C
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and c are '
DATE: / SIGNATURE:
(See Revers SieVdr Additional Information.)
r'
let
3 z.� �0.
6')060
f=,
'BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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:
14EW CONSTRUCTION: Single Family Homes and Garages: $4.00/1000 cubic feet
PLAN CHECK: 25 percent of building permit fee.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the averages
height of the roof surface of the main gable of a pitched roof.
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.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $7.50.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made -ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
.
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of ary
building
or structure, or for
for any alteration or repair to
any addition to any existing building or structure, or
any existing building or structure, upon application
therefore, require the payment by the applicant for such of fees
herein below set forth and in
permit to the amount
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 "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15-75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation, once.it
has been constructed will be required before proceeding with the framing.
NEW [ ] City of Fridley Effective 4/1/84
ADDN. (] L R-1 AND R-2 j
ALTER. [ 7 Building Permit Application
Construction Addre
Legal Description:
Owner Name
Contractor
1. # 7/ o2W
1. # &onK�2 c.,
Address: /a &03 ////i����l/� %/�C� 9®0 ��/.�.//�!/���P�.�f�f✓� �'� 3 �7 --
LIVING AREA:
GARAGE AREA:
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 Height Sq. Ft.
Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground . Sq. Ft.
OTHER: 4 yo,f,' d6 F& i ,%% X
Corner Lot [ 7 Inside Lot [tj Ft. Yd. Setbackqft_ Side Yard Setback
Type of Construction: ���` Fel Aide Estimated Cost: $
Approx. Completion Date:� L� D
Proposed Driveway Width If New Opening Is Desired:
3coo U
Alt. A Alt B
$ $
See Back Page for Explanation
DATE: �� l�=_ APPLICANT:Tel ._-���re
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
CITY
USE ONLY
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary [ ]
STIPULATIONS• 3 02 VM 3
�+ 1M� r
#%9QAWAo0Aa
SUBJECT
P NO.
City of Fridley
18336
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_
RECEIPT NO.
1 • COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
PROTECTIVE
1
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
r;GE OF
APPROVED BY
612-571-3450
910-F15
3/14/86
/
JOB ADDRESS 6313 Van Buren Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17, 18
6
1 Florence Park Addition to Fridley SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Whitbeck Res. 6313 Van Buren Street N.E.
571-2986
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Schmidall Construction Co. Inc. 13605 Vincent Ave So 890-6770
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
16`x 12` three season porch
9 CHANGE OF USE FROM TO
STIPULATIONS
1. Increase outside beam to (4 - 2x8) or (3 -
2x10) or add post.
2. Post footing must be UR71.7 square feet or 18" round,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
frame
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3,600
$1.80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION$44.50 OR THE PERFORMANCE OF CONSTRUCT N.
PLAN CHECK FEE
TOTAL FEE
- A
13 $57.43
( WH N PRO ER A THIS IS YOUR PE MIT
SIGNATURE OF CONTRACTOR OR AUTHORI DAGENT (DATE) t -
BLDG )NSP
nATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
Ia
SUBJECT
NO.
City of Fridley
26822
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
e ;���
�(/
NUMBER
REV
PAGE OF
APPROVED BY
/'-'I CITY HALL FRIDLEY 55432
�---- t "'j
612-571-3450
910-F15
I jDATE
7/27/98
JOB ADDRESS
6313 Van Buren St
I , LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17,18
6
1 Florence Park Addn. to Fridley
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Vernon Whitbeck571-2986
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
H K Construction SVC 3426 Newton Ave N
Xplg 55412
521-7390 8169
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 0 ADDITION ❑ ALTERATION ® REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (25 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with 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
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
]
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2085
$1.04
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-
STRUC O OR THEj ERFOR OF CONSTRUCTION.
$74.75
Fire SC $2.08
PLAN CHECK FEE
T782.87 L FEE
Licens 5. 0
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
P OP VALIDAT
BLDG SP
THIS IS YOUR PERMIT
PATE
S)GNATURE OF OWNER OF OWNER BUILDER) IDATEI
Ia
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
l7' �
ConstructionAddress: 4., 5 13 0-:?" lU � e
Legal Description:
Owner Name & Address: Tel. #�
Contractor:- (r!� 16" ✓L MN LICENSE #
T ,, /
Address: j �'?-� W 6�'f"a � lk u IV !79'-r ��� �Dl Tel. # ----A :D--) —7.3 ill
LIVING AREA:
GARAGEAREA:
DECK AREA:
[6 119661 '
Construction Type:
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 Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Estimated Cost: $ of 00)
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $
DATE: -' 2--^Z APPLICANT: Tel. # 4'l -D ^L 0
TOTAL
STIPULATIONS:
r
CITY USE ONLY
Permit Fee
$ ? `�%
Fee Schedule on Reverse Side
Fire Surcharge
$ . G
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 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
STIPULATIONS:
r
BUILDING PERMrY` 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 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 $100,000
$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 $1,000,000 $2887.25 for the. fi st15001, -plus $4.25 for each additional
$1,000, or fraption,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 INSPECTION DIViSION
6431 University Ave NE
C:� 6�;�n
Effective On January 1, 2000
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
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
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
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.
JOB ADDRESS Ca -)L-) V a n uu r -c rt N�-) 1 r(ff I—
OWNER_ V e--rYVy-\ b -'k ifte-CK
TOTAL ff
BUILDING USED AS (�� S t Cie. no e--
ESTIMATED COST ��a CPrS'� a �� PERMIT NO. ///-/C?c�
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
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
$4v
representations stated in this application are true and correct.
{ DATE7
HEATING CO
Si d Ck' TEL # 7&3 -SS
d
Approved By Rough -In Date Final Date ��
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 () No
The venting system 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 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
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
CITY OF FRIDLEY INSPECTION DIV.
15431 University Ave NE
Fridley, MN $5432
(763) 572-3604, FAX (763) 571-1207
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
nr iuc,Tn 1 1 cm /111 CAl^LI C1 nt'%O
Effective On Jan 1, 2003
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS (03 ) � v 0('� �0-\re"� St,
New Fixtures
Old Opening, Newr Fixture
Seer Dispenser
Blow Off Basin —m
Catch Basin
Frain Water Leader
$ornpdReceiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas" O
Baas Range" . �.
Gas Dryer"
Back Flow Prevenier Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$1Q.00
$ 7.00
$10.00
$10-00
sio .00
$15.00
The undersigned hereby makes applicatton 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.
W
N
r)
--r
Owner V -e V' V"0(- u e, c.%
®,
Building Used As PCs t L)a -e--
�..._-.. T �
PERMIT NO. lei o
Estimated Cost ! 3 .. 2--
Reinspection Fee $47.00ft
ALL OTHERS ANDJOR REPAIRS AND ALTERATIONS ®®
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE k®.s®$
PLUMBING COMP Y� Poi - P®cyie-V &L'Vi Vi Cy
Ol�(xi/1 TEL N0.
SIGNED EY ---+,-
3
ApprovedBy �ilRough-In Date Final Date
COLOUSTION AIR SHALT. BE PROVIDED PER UMC SECTION 5Q4(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
-o
m
m
N
6Y1•AI\n 19V1q L1
°° ° >-•
Y..MIR-,
.. ♦ yr u V� i w• �ti..r ....� .....4�-
Washx Floor
- ._.
` :
_ -_ _ _
Auto.
°< Gas
q {„ W�ler Heater
Elec
Storues
. .x�
� ':"Urinal
WIShower
. -
Tra Drain
..�: �>
Washer
:.. Range
,.
} Gas
Y
Basement
Y ]e010!>
'<Gafr
fXKFa-
:xbp'SY(�. O��Y�Vp[[
f , XicE l!'i�'J;l-:K. .... '••JXt;
`.�yCL � _' Sp�i>:a.`Y
% 'yy��(- iX. "
X /
)%!'I�:}.'�}��i�-Vyt 3}. . f
FloorOF
%?'_�- Y .
•_ %� �. iY
.•r �M%!'
p%4
Floor 2Ya:';x8
. �
XK'i:.i-1f(%
Y3T'._
XY.S.,'IP XIJCA�F�j1%O?�'lfX
R �,
•. _[�,�,Ot:�...
4
'. XEY%ij[Y
�� �G
xx
YI.YE]t=.:� a
�iVjfKY. )F�.3•�?��.t3
Ftcor 3
l>IFY.LA•.�F�`,...
e.
..�iY L
�4�x�.J,I,F �
l4XiSkY]1:
lF • K :
• ,rn ...
..��0 YC[Y..
�'u;�y:6 "�X,.. �
.::
Y:.:. Y
�� � �• ��g:
FihjCfL�".1•t ..
� �[.x•}.t�T''
-- fJt ..
...-j� Y :
::
bl•S. 'A.•.YO%�..-
. �•
X. �q
#0�y(3�
g
- Y }^%�Y•j}.
I.
Floor 4
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS (03 ) � v 0('� �0-\re"� St,
New Fixtures
Old Opening, Newr Fixture
Seer Dispenser
Blow Off Basin —m
Catch Basin
Frain Water Leader
$ornpdReceiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas" O
Baas Range" . �.
Gas Dryer"
Back Flow Prevenier Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$1Q.00
$ 7.00
$10.00
$10-00
sio .00
$15.00
The undersigned hereby makes applicatton 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.
W
N
r)
--r
Owner V -e V' V"0(- u e, c.%
®,
Building Used As PCs t L)a -e--
�..._-.. T �
PERMIT NO. lei o
Estimated Cost ! 3 .. 2--
Reinspection Fee $47.00ft
ALL OTHERS ANDJOR REPAIRS AND ALTERATIONS ®®
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE k®.s®$
PLUMBING COMP Y� Poi - P®cyie-V &L'Vi Vi Cy
Ol�(xi/1 TEL N0.
SIGNED EY ---+,-
3
ApprovedBy �ilRough-In Date Final Date
COLOUSTION AIR SHALT. BE PROVIDED PER UMC SECTION 5Q4(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
-o
m
m
N