PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
SY
Date . �� �......."...... ..............
Owner .. ....... /.i Builder
Addre .. a Address
No. �... Street .. ...
Lot ......6 ....... Block ... .... Add
Corner Lot ............ Inside Lot ............
OF BUILDING
N9 2992 %
j
............. Part of Lot .......................
on or Sub -Division .. ...... .. .e�.. Pe.4
o
Setback . ...... Sideyard . ... ...... .
DESCRIPTION OF BUILDING
To be Used as:
.. ..Front . J, . !... Depth .`'a. Height A��-W
+................... ont ........ Depth ....... eight ........
Type of Constructio ....... Est Cost ...
Sq. Ft./ O Cu. Ft. ........
Sq. Ft......... Cu. Ft.........
To be Completed ... �.'`
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
yei4�-•-�:�. %� .. , . �... .. 'E®:::.meg.....—... �-�-.__.
In consideration of the payment of a fee of $/� ��rmit 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 with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, piLAI
:r or water. Be sure to see the Building Inspector for separate permits for these items.
gas heating,
- I I
on
,
W
I
City of Fridley, Minn.
BUILDING PERMIT N° 4 017
.e
Date: ...._.._...__......_..._......�.._�__......_..____�....___._--.--•
Owner: ----------- -...... -................. -._........ _...... ........ _......... _ ...... _... ..................... Builder .:....................
Address.............. .... _............... _......... -._._._...._....-..........._..__. --- Address V
66 L CATION OF BUIL ING
No.Street _......... _-... ... _...... .. Of
,�..... Part of Lot
Lot .... ............... Block ............. ...... _ ............. _................. Addition or Sub -Division ................
Corner Lot . -.Y ............... _........ Inside Lot ...................................... Setback ....._.........----•-------- .............. Sideyard
Sewer Elevation ..... .......................... __.._..._...._......._...._............._............._........ Foundation Elevation . ................
DESCRIPTION OF BUILDING
To be Used as:
_..-..........
.........Depth .: HeightQ.....--J Sq. Ft.®. Cu. Ft. ..d..
.... ............... _............._......._..-----....... Front ..... ............. ._.. Depth ....................... Height .......................- Sq. Ft. .................... .. Cu. Ft. ................... ...
Type of Construction ........................... ... ................... ......... Est. Cost.... . ... ... To be Completed ....._..--------------------------------- --
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of . the city of Fridley.
In consideration of the payment of a fee of $........., permit is hereby granted to. .... ..................... .......-............._......._..
...... ........................... .........._...................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these Items.
a
It
D.T.
Propc._ty I.,-:i°ie
N
I
Lot Block V Au
t dition or Sub.Div.
Corner Lot--K.Inside.. Lot Set. Back. Side -Yard
SEWER'EMATIQN. FOUNDATION ELEVATION:.
Applicant attadh .;to this .form •'Certifica*te df Survey of Lot acid proposed building
location.
DESCRIPTION OF BUILDING
To be used as"*.*";** -.",1
r JJ.Front Depth:1 Height
K
Sq. Ft. i . Cu. Ft. c:
�' ` Front /0.1' : Depth / Height .
Sq. Ft. ` D Cu., Ft:
Type of Construction Estimated.Cast
To be
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all,the facts and representa-
tions stated in this application are true and72�r
DATE 11,E v- I T .Cel 4Y SIGNATURE/' . ��.
Schedule of Fee costs can be found on the Reverse Side.)
o .: : _7
1VfW W-1-1
N® '7652
owner: LOM QUMTM Builder Cjdality K mess Inc.
Address ,6$ Wmh1patgn . St. N. B. Address 3701 Fremont Ave. leo.
LOCATION OF BUILDING
No 6800 Street Washington St • N. B • Part of Lot -�
Lot 6 Block 2 Addition or Sub -Division nee Creek Terrace, Plat 4
Corner Lot Inside Lot Setback Side -yard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft Cu. Ft
Front Depth Height Sq. Ft Cu. Ft.
Type of Construction Est Cost �- X303.00 To be Completed
Storm Damage Repair
In consideration of the Issuance to me of a permit to construct the building described above I agree to do
pos%df work or inaccordance with the description above s forth and In nplim7 with aft provisions of
i 1 �a
in consideration of the payment of a fee of $ 10• —, permit is hereby granted to QUAUty Home$,
c. 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
Fddley, Minnesotameming location, construction, alteration, maintenance, repair and moving of buildings
wiord ncesn the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
Men Jensen Building Inspector
NOTICE:
Ub permit don net eoner the eondruetiem, hmialbtiom for wiring, plumbing, gn heWn& saw" or wrier. Be sure to me
the Building kqm tar for separate pwm ft for thea Mm&
�Y
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME_ John Christie+ BUILDER Ouality H6mes, Tnag,
ADDRESS 6800 IV Washington ADDRESS 3701 Fremont Ave. No.
LOCATION OF BUILDING
.No. Street ( Part of Lot
LOT BLOCK ADDITION OR SUBDIVISI01� �-�-
.Corner Lotinside LOT Setback Side -Yard,' -
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be'used as:
DESCRIPTION OF BUILDING
Front Depth Height
Sq, Ft. Cu. Ft.
Front ' �_._ Depth Height
Sq, Ft. Cu. Ft.
Type of Construction 'Nstimated Cost $13,303.00
To be .completed
REPAIRS DUE TO TORNADO
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 Depariient of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
Replace garage
New house from cap
" , y . M
City of Fridley, M=.
6431 University Ave. N. E., Minneapolis, Minn. 55432 --'
BUHDING PERMIT
Date: September 28, 1972
Owner: �John R. Cox Builder Same
Address _ 6800 Washington St N;E; , Address Same
LOCATION OF BUILDING
6800 Washington Street N;E;
No. �__ Street �_ _ Part of Lot
Lot _. 6 _ Block . _ 2 Addition or Sub -Division _ Rice Creek Terrace
Corner Lot --A— Inside Lot Setback Sideyard
Sewer Elevation , Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Family Room _ Front 10' Depth 18' Height 8' Sq. Ft. Cu. F't.
Front . _ Depth Height Sq. Ft., — Cu. Ft.
Type of Construction Wood Esti Cost 450.00 To be Completed 1-30-73
Stipulation: Provide one hour fire wall & door between garage and converted
patio.
In consideration of the issuance to me of a permit to construct the building described above I agree tp do
the proposed work in accordance with the description above set forth and in compliance provisions of
ordinances of the city of Fridley. -'1
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to _,7nbn R rnx,
to construct the building or addition as described above. This permit is granted uponi
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 orft4nees of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiag�
withinordinathecity limits and this permit may be revoked at any time upon violation of any of the provisions of saad
(22—
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sage to we
the Building Inspector for separate permits for these items.
n
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PgIT
CITY OF FRIDLEY, MINNESOTA,
OW= LS NAME: �j� � � CO BUILDER:
ADDRESS: ADDRESS:
n
NO : STREET °e
LOT
BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEXARDB
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 As:
Front: ®� Depth: Height:_
Square Feet: Cubic Feet:
Front: —Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:
To Be Completed: t5po —
The undersigned hereby makes application for a permit for the.w9rk herein
specified, agreeing to do all work in sttict accordance with the Citi' 99
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this applig4tian
are true and correct.
DATE: SIGNATURE:
(See Reverse Side For Additional Information.)
1
m
SUBJECT
RM_IT N
City of .Fridley
19O359
AT THE TOP OF THE TWINS
BUILDINGPERMIT
r
RECEIPT NO.
• __ COMMUNITY DEVELOPMENT DIV.
r PROTECTVE INSPECTION SEC.
----I CITY HALL FRIDLEY 55432
i
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---_
L 612-571-3450
910-F15
3/28/88
JOB ADDRESS 6800 Washington Street N.E.
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
2
Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
R. Stephen Boswell 6800 Washington Street N.E. 574-0343
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.
8 USE OF BUILDING
maml Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION IR REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be the 2nd layer but not the 3rd. Install ridged galvanized
valleys.
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
SQ. 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
l
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
$1,100
$.55WITH
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 COW
$19.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$19.55
SIGNAT REOF CO TRACTO AUTHORIZED AGENT (DAT$
A����� ^
�df/
WHEN PROPERLY V ATED THIS IS YOUR PERMIT
�_
o��Ck
SIGNATURE OWNER IIF OWNER BUILDERI IDATE�
LDG INSP DATE
m
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] fR-1 AND R -2I
ALTER. [ ] Building Permit Application
Construction Addre
Legal Description:
Owner Name & Address:
'`•
e�l��
APPLICANT:
�Q�`�(
Tel.
#57 Y-03
CITY
T
Permit Fee
Contractor:
Fee Schedule on Reverse Side
Plan Check
$
Tel.
#
Address:
Attach to this application, a Certificate of Survey of the
lot., with the proposed construction drawn on it to scale.
LIVING.AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [�a Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $ FVz
Approx. Completion Date: (f` N S //L -)v
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
�►I��G�aY,P' Tel.
DATE:
APPLICANT:
CITY
USE ONLY
Permit Fee
$ 19,-00
Fee Schedule on Reverse Side
Plan Check
$
25$ of Building Permit Fee
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$ 5,50 per SAC Unit
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary
TOTAL $ [ ]
STIPULATIONS:
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
•.�
V~1
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w
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9
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S
S.
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U W
U
m�
w
uq�
M
a.
U
d
°
a
14
ON
+Aldtei
Heater
as
lec
S
Blow Oft Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic Valve
S
5.00
$
Sump or Receiving Tank
1st
5.00
$
Water Treating Appliance
$
7.00
$
Hot Water Heater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
2nd
Back Flow Preventer Required.
Yes ( ) No (
)
Type
S
5.00
S
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1t of Value of Fixture or
Appliance
S
State Surcharge
3rd
Reinspection Fee $
($15.00)
TOTAL FEE
4th
(R) - Future Connection Opening
Connected with Sewer
(•) - 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
S
4.00
S
Blow Oft Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Water Leader
$
5.00
$
Hydraulic Valve
S
5.00
$
Sump or Receiving Tank
S
5.00
$
Water Treating Appliance
$
7.00
$
Hot Water Heater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
Back Flow Preventer Required.
Yes ( ) No (
)
Type
S
5.00
S
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1t of Value of Fixture or
Appliance
S
State Surcharge
S .50
Reinspection Fee $
($15.00)
TOTAL FEE
Effective May 1, 1990.
Job Address � �� I -A )'NU "z �f L a
Department of Buildings
City of Fridley
Tel. 1571-3450
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. 10 19 '50
OWNER
KIND OF BUILDING kl) C001 j�7,r c%l—P s
USED ASU rQ 161 Pf f_�%�YV14
TO BE COMPLETED ABOUT I ®/J / 5
ESTIMATED COST j Q D
OLD - NEW BUILDING PERMIT NO. PERMIT NO. ` �"1
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00
FLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY
Effective Date May 1. 1988
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Job Address �0'q
Furnace Shell and Duct Work,
0
Burner (Also replacement furnace) $
20.00
GZ6,6
$
Department of Buildings, 6431 University Ave. N.E., Fridley, HN 55432
City of Fridley
Gas Piping $
10.00
$
Tel. #571-3450
(piping needed with new furnace)
Gas Range $
10.00
$
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
Gas Dryer $
10.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
• Air Conditioning (all sizes) $
10.00
$ 1�'Q�
Minn. DCT- I 19�
All Others/Repairs and Alterations
1 pFridley,
OWNER gQ-rO l .iYeJFc.�lm
It of Value of Appliance or Work
S
KIND OF BUILDING Ep`Axq
COMMERCIAL/INDUSTRIAL
USED AS h e 9artA C
It of Value of Appliance or Work
$
TO BE COMPLETED ABOUT
ESTIMATED COST .1 I ® n
State Surcharge
S .50
1�
OLD - NEW BUILDING PERMIT N0. PERMIT NO. G
TOTAL FEE
$
Reinspection Fee ($15.00)
S®
Rough Insp.
Date c�
Final Insp. ,��q- -:3- — s
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 -
PLUS $.50 STATE SURCHARGE
*kir Conditioners can not be placed in side yard without
written permission fres adjoining neighbor.
V / DESCRIPTION OF FURNACE/BU !y
/IHEATING or POWER PLANTS, Steam, Hot Wate Warm Air- p
b Trade Name L ►ax - a-1 +lc£ Size No.7
Capacity 4y ®® Sq. Ft. EDR BTU DEQ HP ff`�
Total Connected load Kind of Fuel NAT (,AZ
hURNER - Trade Name Size ND.
Capacity Sq. Ft. EDR BTU HP
Company 9
r �/
Signed By iff"k -- -rilk/� `(
Tel. No.
Fill out back side for stack verification on replacement furnaces
CHIM14EY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has
been carefully examined
Yes (,)
No ( )
2.
Is
free from rust or deterioration
Yes ( )
No ( )
3.
Has
no foreign objects lodged within
Yes ( )
No ( )
4.
Is
securely supported
Yes ( )
No ( )
5. Meets all current Code requirements for size and
total BTU connected Yes ( ) No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
Company _
Signed By
Da to
J
SUBJECT
P
City of Fridley
21932
AT THE TOP OF THE TWINS
BUILDING PERMIT
i �
RECEIPT NO.
i ._____; COMMUNITY DEVELOPMENT DIV.
a„b5-0
r PROTECTIVE INSPECTION SEC.
1 i
CITY HALL FRIDLEv 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
6/25/93
JOB ADDRESS 6800 Washington St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6
2
Rice Creek Terrace Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
R. Stephen Boswell 680.0. Washington St NE 574-•0343
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Finish. basement family room
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS" SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3x000
$1.550
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$54.00
Eire SC $3600.
PLAN CHECK FEE
TOTAL FEE
JI
$58.50
S.G ATUREOFCONTRACT RORAUTHORIZEDAGENT MATEI
WHEN P O Y VA ATED THIS IS YOUR PERMIT
BLO SP GATE
SiGNATU E OF OWNER OF OWNER BUILDER) IDATEI
J
NEW j ] Effective 5/26/93
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND'DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: (r) �Q o W f f #L d x;12 J -r N E
Legal Description:
Owner Name & Address: L4 CW - Ec" T" C t Tel. #��
Contractor: ,j' A-mE MN LICENSE #
LIVING 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
GARAGE AREA.: Length
Tei. #
Width Height Sq. Ft.
.:��
Width Height Sq. Ft.
DECK AREA: length Width Hgt/Ground Sq. Ft.
OTHER: _F i t1.59 O F r FA -011__^y
Corner Lot "— inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $• 3, o o
Approx. Completion Date: 14.1
Driveway Garb Cut Width Needed: Ft. + 6 Ft =
(Cost on Back)
Rx $ _ $
DATE: -L APPLICANT: Tel. # <@ 7 `1- b 3 �-i 3
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ , D O Fee Schedule on Reverse Side
$ � , 00 .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $750 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ Conservation Plan Review $450.00
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ �� �� STIPULATIONS:
0, J
�
o
75.
v
Y
r
01/
r
r
CITY OF FRiDLEY INSPECTION DIV,
Effective On January 1;1993
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER
PLANTS AND HEATING, COOLING, VENTILATION,
512-3604 REFRIGERATION AND
AiR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS ®U
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shelf and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00
$
representations stated in this application are true and cor�eot.
Gas Piping (Needed with new furnace) $10,00
$
OWNER
Gas Range $10.00
$
BUILDING USED ASF.Sr/,�'y�
Gas Dryer $10,00
$
�
ESTIMATED COS T�� �'� PERMIT NO.`
*Air Conditioning — Alt Sizes $10,00
$
•
DESCRIPTION OF FURNACE AND OR DUMB
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$ 0.0
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
Commercial/industrial
BTU HP EDR
1% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
$ ,50
Burner Trade Name Size No.
BTU HP EDR
TOTAL FEE
5`®
$ /<;5-70
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS 915.00
PLUS THE $,60 STATE SURCHARGE
REINSPECTION FEE $30.00
HEATING COMP
Signed
Approved By
Tel No,��/�S
Hough—In Date Final Date
*Air Conditioners can not be placed In a side yard without
written permission from adjoining property owner, FiLL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
Remarks
List Alterations Being Done•
HEATING COMPAN'.
Signed By
Date
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
.1.
Has been carefully examined
Yes
(
)
No
(
)
2.
Is free from rust or deterioration
Yes
(
)
No
(
)
3.
-,Has no foreign objects lodged within
Yes
(
)
No
(
)
4.'
Is securely supported
Yes
(
)
No
(
)
5.
Meets all current Code requirements for
size and total BTU's connected
Yes
(
j
No
(
)
6.
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done•
HEATING COMPAN'.
Signed By
Date
SUBJECT
City of Fridley
8
a1P
AT THE TOP OF THE TWINS
BUILDING
PERM I
`�
NO.
fr __��__ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
��
:
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55132
' 763-571-3450
910-F18
10/18/02
10B ADDRESS 6800 Washington Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
2
Rice Creek Terrace Plat 4
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Steve Boswell 6800 Washington Street NE
763-574-0343
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Install egress window; existing opening must be lenghtened toward floor
Replace one window within existing opening
9 CHANGEOFUSEFROM TO
STIPULATIONS
Window to meet the State Egress 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
1
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
$500
$ •50
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-
Fire SC $
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$23.50
.50
PLAN CHECK F
TOTAL FEE
Al
I 24.50
I N T RE OF CONTRACTOR OR AUT jRiZEO AGENT iDATE,
N ROP
ALIO TE THIS IS YAOUR RMIT
X_ D L
"
(! L
SSG Tu OF Ow E i1F WNER UIT DATE)
BLDG
T
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572.3604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �'-9Q (n) A I [9 IbN C-1 11 ik
Legal Description:
Owner Name & Address: � � � Y Al t \ -k
Contractor. 'S AM 1P— MN LICENSE #
Address: QkQQ ]AA )M1,3,1W'Tel. #
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 . Height Sq. Ft
Length Width Height Sq. Ft
,th Width
^ �Hpgt/GrouAnd n Sq.
nFt
E� \-�c C- IrJIM 'iJIIIAIC IAN I\ 0 'PLAI,/1 iA1I�a<Y na-T
Construction Type: UA,VC Estimated Cost: $ 5D C)
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: 2 u-?— APPLICANT: Tel.#
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
s
of
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by'Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
Building
BUILDING
Permit No. 0 _ co Ij
Inspections
RESIDENTIAL APPLICATION
Received By: n
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE v " 6 7 YOUR E- ADDRES
SITE ADDRESS D
THIS APPLICANT IS:
❑ OWNER ONTRACTOR
PROPERTY OWNER/
NAME:
ADDRESS: O10(�
STATE*r_5 155
TENANT
PHONE:
���'"'��ll
CONTRACTOR
NAME:
p•g
STATE LICENSE # f 6 EXP DATE
SUBN41T A COPY OF
YOUR STATE LICENSE
ADDRESS: - CITY
TE ZIP ]"
W rM APPLICATION
/
PH NE b ('7 FAX 4l "
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT 'TYPE
❑ ADDITION ❑ GARAGE/SHED momMOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: IJ•RWW MI&Ar- I I",
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
I .
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING-
❑ Vinyl
Qp � �
❑Soffit ��,t (tWl
FOR NEW CONSTRUCTION INCLUDING DECKS.
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim•
I .
Site Plan/Survey showing the existing structures
11 Other
❑ Fascia
and proposed project
WRN'boWS
2.
Two sets of construction plans
IN EXISTING OPENINGS []Yes ❑No LOCATION OF WDLgV a, A "t
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASEL) ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S .. A GIS - A f) nrriTpANVV grvpF k' 0 A*,
Permit Fee �'�.� ��'6 S See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ �� 6-3 $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ 71 Agreement necessary ( ) Non Necessary ( )
11 Total Due $ 4) Make checks payable to: City of Fridley Attach Stiuulations
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; that the work will be in accordance with the approved
plan in the case of all work ch req ' esr view a d approval of plans. ` /' �•� J� h�' - N
SIGNATURE OF APPLICANT �C PRINT NAMO (� � � � T - l - { 1 A ^ I17�aJ l� t S -n p
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
J NEW HOMES/ADDITIONS , <EXISTING HOME LJ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW 11OMES
4. Heat loss & cooling loan per room
a. Required on new Construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.