PRE 2010 DOCSCity ®f Fridley
r AT THE TOP QIP THE TWINS
rL"---'-- COMMUNITY DEVELOPMENT DIV.
1 i PROTECTIVE INSO•ECTION DEPT.
r--- i CITY HALL CRIOLSY 0002
ob Address
7�v ltih Sri ir,S 7-G1%
.G 11/0 5 h2 411? .0
ontracto
_o= builai.ng
.etion Date
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PLUMBING PERMIT APPLICATION
s
aaaress
Use
1 800
Phone
Phone
r
Plumbing Fixture Rates: NO.
RATE
TOTAL
Number Fixtures
x
$2.00
fo04
Future Fixtures .2—
x
$1.50
3a cr
New Fixture -Old Open.
x
$1.50
Catch Bastn
x
$3.25
Vater Heater -99,000 BTU /
x
$3.00
S 't''C'
Ground Run Old Bldg.
x
$3.25
Elec. Water Heater
x
$2.00
Gas Fitting Fees:
1st 3 Fixtures �_
x
$2.00
', C)
Additional Fixtures
x
$ .75
Gas Range -199,000 BTU
x
$5.00
Repairs & Alterations
See
Description:
Code
State Surcharge .50
TOTAL FEE $
The undersigned hereby y 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 declare that
all°the facts and representations stated in this
appli ation are trun`- c����. -
C`�) Ael
iS gnature ' Date
01
SUBJECT
PERM) --
of Fridley
CIr
12063
AT THE TOP OF THE TWINS
P, Iity
BUILDING P E R
M IT.
,
1. COMMUNITY COMMUNITY DEVELOPMENT DIV.
- --�
!L
%
r � PROTECTIVE INSPECTION SEC.
-
�a
1
(!�
I CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�•"' J 612-560-3450
910-F15
3/14/73
JOB ADDRESS
5700 Washin ton Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Tract F
I Registered Land Survey #14
SHEET
;F -PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Iven Dostaler 6358 Willow Lane N.
561-0143
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
Dwelling & Garage
7 CLASS OF WORK
N NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE El REMOVE
8 DESCRIBE WORK
24' x 44' House, Garage 20' x 22'
9 CHANGE OF USE FROM TO
STIPULATIONS
Stipulations: Provide hard surface driveway. Provide a verifying.survey
before capping. $275.00 SAC charge paid.
SEWER LOCATION: 96' South of Manhole. "Y" Elevation: 860.76
Top of Footing: 863.76
SEQERATE PERMITS REQUIRE® FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Frame
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
1640
28,400
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
1 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
$22,644.40
811.32
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-
$53.00
$275.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
p
�< -3'-1Y--!7
$339.32
SIGNATURE OF CONT CTOR OR AUTHOR ED AGENT JDAT .
WHEN PROPERLY V- LIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
BLDG. INSP
DATE
01
APPLICATION FOR RE$11DENTIAL, ALTERATIONS
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ow= I S NME
ADDRESS: ADW=S#
'Rol, 'U0g2 su=1,L2
LOT i AWITIONI..
4ORM LOT: IDE LOT; SETBACKt— SIDEYARD0.
Afftf,v,ant iat"i* to this fo=_Vo Certificates of Surv2X of Lot and proposed
�bulldlxt$ location Ar wa m Vbeve Certificates,
DESCRIPTION OF BUILDING
'To Be UIWA AR --
'A
square Feet; 4 0 ® Cubic Feetj
Frantz Depth Height:
Square deet; Cubic Feet;
We of Constructions Z'
Estimated cost: $
To So "toted; sx
Me undo
rpigned hereby makes applicatiim for.a permit for the work herein
opealfW, agreeing to do all work im stftct accordance with the Ctity of
Mdlay ordUumces, 4a4 xuUP4* *f tke Department. of W44nss, mW 'hereby
doaj,ag*4 tfmt all the facts and representations stated ta this application
age true aa4 correct,
(000 Raverve s1de For Addy onal infortwtion.)
BUILDING PERMIT FEF SCHEDULE
SECTION 2. The inspector of gtaildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
buildft& or structure, or for any alteration or repairs to any existing
Wtldtng 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 wanner herein provided to -,wits
UI FOP -44 BUILDING CODE r Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 a $1.85 for
eAch one thousand cubic feet.
ADDITIONAL INFORMATION
Yor the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covaWed from a point six (6) inches below the floor line of the basement
the +Pjjar to the average heights of the upper surface or to the average
t; of the roof sface of the twain gable of a pitched roof,
low r i43trs or alterations to an existing strurtutreg the fee shall be at the
rate of $3,00 per each five h�mdred dollars ($500,00) or f=ction thereof in
the cast of all proposed work,
lm ao case shall the fee Wsl for 4W permit as set forth in Section 2 be
low than $5.00,
VVRIVICATION OF FOUNDATION
=s Fermtts for construetion will be issued a mimiCmttm of 24 hours from the
tftw sof Application, to allow for proper review of the proposed structure and
of the construction site.
A Certif W SuzVey of the lot, vbwglug the locatim of the foundation, owe it
hag US= 4oWjstMCt04j, will, be required before proceedW with the frames.
I
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) 4ays prior
to the use or gccupa=, y of my atmetare for which a. building permit has been
issued; .and SAW Structure #shall, not he used or occupied until a Certificate
of Oocupmcy has been isev".
�.�.. my.>.�,_ ...— r...,.,..�.8_�.. �c�ai � '....i..�fl' uBc'�i �. �[:�.,�� q: - � F �.��k � s y,,;�,;'�±'• �...._ ,.,....a,„,�_.._ s_...:ix�,.,x.... s,. .,. _._ ._:;� i
i
' GERALO T. Co YNE 1, LOT SURVEYS COMPANY Sp91f!ONA-4o ►RASCN
vA :E t MINN LAND SURVEYORS ' BROOKLYIN PARK. AA14N
ArOISTERED .MMZZ LAWS or STATE Or KINIFESOTA
LICENSED ET ORDINANCE Or CITY OF SKINNEA"LIS
6914 ldahri Ave. N. 533.9922
Minneapuli., Minne4448 SSS
NN%5TR,AL - AiVICIAL , :..'?ntSININC, °NACRE TH,k'Y 30 YEARS Of
Z^"'fRCIAL - TOPOGR.AF1,+IC4 �urbeporg �ertif�tate SAN.^ aLSVCYING fYP-PENCE IN TrIE
CITY LOTS - PLATTING ME40.01it,0 A-1 AREA
Surve-y for:
ry � t.lV
• D'L'N,-Ti IRON ST ►Kh
V
Ali? [ X-C
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O
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5�3 4 �
�• � - i �ostr,d7Tlar,
35.(
rJ I u
'r:IACT F, RE-71STij' i _) iAND SUFi1—Y i+ic. 14,
FILE] Gr' THEhl..slSlc:.�?:: SIF TITL::3,
'-AA CC, :JPiiY , V tNRLSGT-A
AmendeJ to .311cxour. c
We hereby terrify that this is a true and correct represenfis-
+ion of a survey of the boundaries of the above described
land and the location of all buiidings and visible encroach-
ments, if env, frorr said w •
Svr.eved by as fit,.' 4'l day ' et ' 1*71 1
ILI
C
d !
Signed
IAT SURVEYS COMPANY
r.011P ,
Power HeahM CoMmS Vemikdone
Air Comiitioning Syste .and Devices
PARTIAL RATE SCHEDULE '
GRAVITY WARM AIR:
RATE
TOTAI,
Furnace Shell & Duct Work ................ I ..........
$10.00
$
Replacement of Furnace .............................
6.00
$
Repairs & Alterations—up to $500.00 '.................
6.00
' $
Repairs & Alterations each add. $500.00 ...............
3.00
$
WARM AYR
6.00
O
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. it. 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) ...........................
800
$_ f
over 199,000 BTU SeeFee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x$ 2.00
$ '4.00
Additional Fixtures ..................
x .75
$
Gas Range to 199,000 ...........
AIR t.ONDYTIONYNG
FAN HEATING SYSTEM
jSs*'Feo Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE $ f 7e ® 0
ROUGH
Dept. of Skies. Phone 5W-3490
City of Fridley:
The undersigned hereby makes application for a permit for the work hereic
specified, agreeing to do all work in strict accordance with the City Ordinancek
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, 11Rinn-� ,,- i% —
Owner
Kind of Building
Used as ✓�
To be completed about — �—
Estimated Cost, $ ®� /
Old ew 6
Building Permit No. Permit No.
DESCRIPTION OF WORN
HEATING or POWER Hot Water, arm Nom_
Trade Name -L., Size No �'
" ® e //d
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load g�`� a Kind of Fuel
BURNER — Trade Name Size No- AM, 110 15 0
Capacity Sq. Ft. F..D-RBTU HP:
(REMARKS -OYER)
Compliments of North Central Public Service Co., "Your Natural Gas Company"
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS VLWLA
Weatherstrips A.SILV.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int Wall CeilingRoof or FloKind How Applied
No I No 19........ I I I
/° H 1 I Length Width 1 Height / Fl. I ZERoom I Length /'Width / e) Height
Windows and
Doors-Crackage and Area
_
No.
No.
Width
of pane
Height
of pane
No. of Lineal ft.
lights of crack
Area
sq. ft.
Area
sq. ft.
/./-
/e,
�
®
91%
Coef.
Coef.
Btu
Coef.
i Btu
Infiltration
®Ir
Glass �A
Btu
Infiltration
Exp. wall
D
Glass
Net exp. wall Z Fo 5z
X0
3 d 040
f®
Net exp. wall ;2
&4 0
Exp. wall
c
a e e) 6
Floor
Ceiling /51A ><
Int. wall
Net exp. wall
Ceiling G' '�
X,
61
-,�
IF
FlQor
j
Int. wall
17
le 0 f
TotBtu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Ceiling
-
Floor
Floor
i
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ Fl. Room I Length /7
Width -27,0 Height
Win=s and
Doors-Crackage and Area
_
No.
Width
of pane
Height
ofg Pane
No. of
lights
Lineal ft. Area
of crack sq. ft.
Lineal ft.
of crack
Area
sq. ft.
/e,
�
Coef.
Coef.
Btu
Infiltration
®Ir
Glass �A
Btu
Infiltration
Exp. wall
D
+Exp. wall
Net exp. wall Z Fo 5z
X0
3 d 040
Int. wall
Net exp. wall ;2
&4 0
Ceiling
c
a e e) 6
Floor
Ceiling /51A ><
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Z Fl. I /4�
;-Room I Length ZA Widths Height
Windows and Doors-Crackage and Area
No.
Width
of pane
Height
of pan_ a
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Area
sq. ft.
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
/e,
�
Coef.
Btu
Infiltration1,314
®Ir
Glass
Btu
Infiltration
j
D
+Exp. wall
Glass
�'
Net exp. wall
Glass
Net exp. wall ;2
&4 0
Int. wall
c
a e e) 6
Int. wall
Ceiling /51A ><
Int. wall
Ceiling G' '�
�' �-
61
-,�
IF
FlQor
j
Floor
17
le 0 f
TotBtu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu.
Windows and Doors--Crackage and Area
Doors-Crackage and Area
No.
Width
of pane
Height No. of
ofof p ee lights
Lineal ft.
of crack
Area
sq. ft.
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
/e,
�
CoeL
Btu
Infiltration
®Ir
Glass
Btu
Infiltration
j
Exp. wall
'
Glass
�'
Net exp. wall
Glass
Exp. wall
&4 0
Int. wall
c
a e e) 6
Exp. wall
Ceiling /51A ><
Int. wall
Floor
-Z�?e
Ceiling
Total Btu.
j
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
,, F1. 1 sfi Room I Length,/' Width a° Height
Windows and
Doors-Crackage and Area
_
No.
No.
IWidth
of pane
I Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
/e,
�
Coef.
Coef.1
Btu
Infiltration
'
Glass
�'
o
Glass
Exp. wall
es-
c
a e e) 6
Exp. wall
Int. wall
;
Net exp. wall
Ceiling
3�
j
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Ceiling
-
Floor
i
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ FL I-� oom I Length Width Z Height
Windows and
Doors- Crackage and Area
No.
Width
of pane
Height
of pane
No. of
Lights
Lineal ft.
of crack
Area
sq. it.
Coef.
B
Infiltration
'
Glass
Exp. wall
Net exp. wall
Int. wall
;
Ceiling
/ �G
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
SUBJECT
PER O. )
City ®f Fridley
17 7 4 8
AT THE TOP OF THE TWINS
B U I L D I N G P E R M I T
r
�
CEIPT �
f COMMUNITY DEVELOPMENT DIV.
( PROTECTIVE INSPECTION SEC.
z
/ �/ 0
1 CITY HALL FRIDLEY 55432
,.'
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
Oct. 1,
4
JOB ADDRESS 5700 Washington Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
Tract F
I
Registered Land Survey #14 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jim Stilson 5700 Washington Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Dailey Homes 8510 Central Avenue N.E. Blaine 784-3510
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
x
8 DESCRIBE WORK
Construct a 44' x 24' Second Story Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Submit beam design for new beam that supports new floor trusses.
SEPERATE PERMITS REQUIRE[) FOR WIRING, Before digging call local utilli-hes
TELEPHONE - ELECTRIC - GAS - fx.,,
REQUIRED BY LAS'
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
1056
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
$42, 650
$21.33
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$251.50
None
S UOTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
$ 62.88
TOTAL FEE
$335.71
SIG' TUR CONT CTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY V �IDATED THIS IS YOUR PERMIT
BLDG INSP �A E
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
NEW [ ]
City of Fridley Effective 4/1/84
ADDN. [ ] �R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: -5 7 a® C-() a ANLnt ^- ( AA42
Legal Description:
Owner Name & Address:
Contractor•
Address: 1%
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREAJ. Length y
GARAGE AREA: Length
DECK AREA: Length
Tel. ,#
Tel. # ?9q-'6116
Width °� Height Sq. Ft. 105(a
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [,A Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: (l%=c V Estimated Cost: $ _,.
Approx. Completion Date: y, 1
Proposed Driveway Width If New Opening Is Desired:
DATE:
c6y
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
Alt. A Alt B
$ $
See Back Page for Explanation
APPLICANT: Tel. # LE�(-3Q(o
CI Y 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 [ ] Not Necessary [ ]
STIPULATIONS: -.. 1•;. / ,' .._ �' is t
ffiAAj
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 "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.
VS rd
CITY OF FRIDLEY
APPLICATION FOR PLJJMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$
5.00
$ ®.
Future Fixtures
$
3.50
$
Old Opening, New Fixture
M
v
$
Water
di
4.00
0
Blow off Basin
$
5.00
H
.c�
$
�
m
�6pro N
a
w
5
Hydraulic Valve
Heater
34
$
4
$
5.00
�eC
water Treating Appliance
$
7.00
p
O
w
$
5.00
$
o�Nya
m
10.00
$
Gas Dryer
$
O
$
O
�+
Vq4
.gym{
tq
U
b
00
RI
f�l1
3
O W
U,
W
U
lst
%
2nd
3rd
4th
(R) a Future Connection Opening
Connected with Sewer
(*) a New Fixture, old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$
5.00
$ ®.
Future Fixtures
$
3.50
$
Old Opening, New Fixture
$
1.50
$
Beer Dispenser
$
4.00
$
Blow off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic Valve
$
5.00
$
Sump or Receiving Tank
$
5.00
$
water Treating Appliance
$
7.00
$
Hot Water Heater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
li of Value of Fixture or Appliance $
Reins State Surcharge $ .50
Reinspection Fee S -Cn
($15.00) TOTAL FEE $
Ettective Aug. 1, 19dl
Job Address_^-QQ
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. _ --Cb
OWNER _ 6✓i z
KIND OF BUILDING,��gyj��
USED AS eA �5ec17c
TO BE COMPLETED ABOUT ep
ESTIMATED COST
OLD NEW BUILDING PERMIT NO. PEERMINO.
oG
Company it c mac! ®o
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Can Dryer
Air Conditioning (all sizes)
RATE TO'PAL
$ 20.00
$
$ 10.00
$
$ 10.00
$
$ 10.00
$
All Others/Repairs and Alterations
It of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1• of Value of Appliance or Work
$ 10.00 $
G �
S
S
State Surcharge $ .50
TOTAL PLE
Reinspection Fee ($15.00) $
Rough Insp.
Date
Final
Date
Approval for Permit
061-1-2-L
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCHARGE
Attach stack verification fon with replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Effective Aug. 1, 17H1
Job Address
Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432
City of Fridley
Tel. 0571-3450
The undersiqned hereby waked application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulinqs of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
�/
Fridley. Minn.
n r /➢ /f 4
OWNER
RIND OF BUILDINGy moi✓ ��—�
USED AS
TO BE COMPLETED ABOUT
�S oma_
ESTIMATED COST
0OLD ,
OLD NEN BUILDING PERMIT No. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Mater, Norm Air- No.
Trade Name
site No.
Capacity Sq. Ft. EDR BTU NP
Total Connected Load
BURNER - Trade Name
Kind of Fuel
Size No.
Capacity Sq. Ft. EDR BTU HH//PP�
Company
Signed By q
Tel. No.
SUBJECT
City ®f Fridley
27299
AT THE TOP OF THE TWINS
BUILDING
PER MIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
•Io
r PROTECTIVE INSPECTION SEC.
`d ZD
e
NUMBER
REV
DATE
PAGE OF
APPROVED BY
`
CITY HALL FRIDLEY 55432
�j 612-571-3450
910-F15
18/19/98
JOB ADDRESS
im Washin ton Street NE
1 LEGAL
LOT NO. F BLOCK
TRACT OR ADDITION
lRegistered
SEE ATTACHED
oescR.
Tract
Land SurveyNo
SHEET
14
2 PROPERTY OWNER MAIL ADDRESS
JIM SH 1 1son
ZIP PHONE
574-9456
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Town & Country Roofing 7910 12th Ave S Bloomington MN
55425 545-4M
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO,
6 USE OF BUILDING
Residential'
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 2a REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 30 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must Empcomply 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2502
$1.25
DOES NOT PRESUME TO GIVE AUT ITY TO LATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STAT O LOCA AW REGULATING CON-
ST R ION OR THE PERFORMANCE CONS R CTION.
$74.75
Fire SC $2.50
PLAN CHECK FEE
FEE
License
5.0
.50
;4L
SIGN OF CO R CTO ORAUTHORIZED A ENT DATEiN
ROP
VALID T THIS IS Y UR PERMIT
S4NATUREOFOWNER OFOWNER BUiLDERi iDATEi
or Al.
AUG -13-1998
...... t
ADDN j ]
ALTM [ ]
ConsauctionAddre
Legal Descripdm
08:42 FROM CITY OF FRIDLEY TO
CITY OF FRIDLEY
SINGLE FAMMY AND DUPLEXES R-1 AND R-2
BUIMING PERMIT APPLICATION
8589320 P.01/02
r uwuves u V Y6
Owner Name & Address:
Contractor..
Address: `'
LIVING AREA:
GARAGE AREA.-
DECK
REA:DECK AREA:
OTHER:
z Tel. j( I () I -?_) 15 -T14 -9e4 S to
Iii LICENSE # Z
Tel. # (p 12-- S!i S— L1 Z33
Attach to this spplic adqu, a Certificate of Survey of the
lot, with the proposed codon drawn on u to scale.
DESCRVMN OF WROV EENT
Length Width _ Height Sq. Ft.TOW&
Width Height Sq. FL
Length Width Hgt/Ground Sq. FL
3 ® 5*q
Consavacion Type: _ Fstimated Cost; S 5 O
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: ,Ft. + 4 Ft = _Ft x $ =$
DATE:
Permit Fee $ ,-/t' • Fee Schedule on Reverse Side
TeL # C; --Ll '
Fire Samharge $ • 5'® .001 of Permit Valuation (1/lOt %)
State stm:barge $ ! • 5� $-5W$1,000 Valuation
SAC Charge-. $ $1000 per SAC unit
License Sumbarge $ T,00 $5.00 (State Licensed Ramal Contractors)
Driveway Escrow $ Art. 'A" or Alt. "B' Above
Emsion Control $ $450.00 Coamution Plan Review
ParkFee$ Fee Deteumined by Engineering
Sewer Main Charge $ Agreement Necessary ( ] Not Necessary [ ]
roru, s q Z •So
.STIPULATIONS.
m