PRE 2010 DOCSN0 23
No./z, —/ - � /
Village of Fridley, Mum.
Office of INSPECTOR OF BUEL DINGS
Fridley, Minn.,
LOCATION OF BUILDING
Block „ Addition or Sub -Division
of
DESCRIPTION SOF BUILDING
v?
Depth Height ' Stories —Manner of Construction—
Front a
s w
To be used as �� Cdr g 14 To be completed 'U = t Estimated Cost `
R�r�' •�°�/x,��''� €v 5
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n
Permit is hereby granted to
the building—described in the above statement. This permit is granted
upon the express coA41tion that the p rson to whom it is granted, and his agents, employees and workmen, in all
the work done in, around and upon aid building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the 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.
r
_Inspector of Buildings.
AGREEMENT AND SWORN STATEMENT
In cohsideraton of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permits I hereby agree to do the proposed work in accordance with the description
above set forth a d according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby sate and say that the facts stated by me and contained in the above permit are
true as therein stated, pft�
Subscribed and I!
�sworn to before me at Fridley, Minnesota, :-this
Y ofE ,�
PERMIT for Power Plants and. Heating, Cool-
ing, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Aeating Plants to be installed—altered—repaired
Make , Size
Oil fired—,- Coal fired—, Gas fired ; Gas Authorization No
Remarks d
Approved
Final Inspection Date , 19._
, Inspector
Permit N° T 4536
Fee $ o
Office of the Inspector of Buildings
City of
Owner
Locatic
Kind o
City of Fridley
How Occupied LeL-e
Work to be Commenced ,19_
To be Completed—, 19—
Estimated Cost, $ 9C7. 0--h
Old -New, Building Permit No.
Permission is hereby granted to C L L'V ^ 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 specifica ' ns set forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
� = Inspector of Buildings
.11�42 2M11-wv
SUBJECT
P IT NO.
City ®f Fridley
26935
AT THE TOP OF THE TWINS
ry
BUILDING
PERMIT
r
`
v
PT NO.
i v �___�_' COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
��� 6
r
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
�'�
L 612-571-3450
910-F15
7/31/98
JOB ADDRESS 7514 Van Buren St
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
14
2
1 Shaffer's Subdivision #1
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Deann & Michael Glomski 7514 Van Buren St780-3985
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION) REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 24 S 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$2001
81-00
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 OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL F
-75
SIGNA RE OF CON7RAC ORA T O IZED AGENT IOATEI
ROPE ALIDATE IS IS U PE M
�-
R9.SP
SIGNATURE OF OWNER Q ER SUILOERI IDATEI
TE
NEW [ ]
ADDN [ l
ALTER
ConstructionAddress :
Legal Description:
Owner Name & Ad
Contractor: MN LICENSE #
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 a�
BUILDING PERMIT APPLICATION ��
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Tel. #
DESCRIPTION OF EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE -AREA: Length Width Height Sq. Ft.
DECK AREA: Le gth Width Hgt/Ground Sq. Ft.
f �—
OTHER: �� ,�� `r i c? 1-1 �� I - -o
Construction Type: ����ttima"ed Cost: $ f
'(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:I ^ APPLICANT: l�'U �, L Tel. #T- ��
0
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
�'? Fee Schedule on Reverse Side
Fire Surcharge
$
0 0 .001 of Permit Valuation (1/10th%)
State Surcharge
$
j. r% $.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
$
0
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 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 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 FR1DLEy INSPECTION DIVi510N
0
'6431 University Ave NE `1
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 - REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCIiEDi1LE
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 Sues
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial./Industrial
1.25% of V@Iue of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State SUrc:harge
TOTAL. FEZ
1 INtWM FEE FOR ANY HEAVING/CQOIN/VC-N 1 1 N
REFRIGERATi N/AIR CQNDIT'IONING PERMIT IS5?5,00
FLUS THE 5.50 STATS 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 May 10, 1999
JOB ADDRESS,�`In t iJcGn b un 6 -1 --
TOTAL
-TOTAL
BUILDING USED AS
ESTIMATED COST -LU PERMIT IVO. L d
.pE� RIPTIfl ® F�RIYACE Ably OR BURS
$
No. of Heating Units Circle One (Stearn) (Hot Water) i
$ Trade Name 9 Size No.
BTU_ ,� HP
Fuel___.
____ Total Connected Load
Burner Tracie Name— - _ Size No.
$�
BTU--- HP EDR _
$ ' The undersigned hereby makes application for a permit for the work hercii
specified agreeing to do all work in strict accordance with the City Codes z
rulings of the Building Division, and hereby declares that all the Yaf t:� and
representations stat€ d Ira tills application are tale and correct,
�I MMY AM STACK VERMCATION
yes (-Y No
( }
The undersigned hereby vermes that the existing chimney or snack:
Yes (,j No
1. Has been carefully examined
Yes (.-�'No
( )
2. Is free from rust or deterioration
Yes No
( )
3, Has no foreign objects ledged within
Yes No
4. Is securely supported
yea (-f No
{ }
S. 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 bew, provided for water heater
yes (-Y No
( }
8. Has combustion air been provided for water heater
Yes (,j No
( )
Remarks:
List ALTERATIONS Being Dore:
HEATING CO:
Signed Ey:
Date: