PRE 2010 DOCSCity oFridley, F , Minn
BUILDING PERMIT N° 4 0 3 0
�
Date:G 7 -.__..-_.._..........___......_.......__._--.�..... ---
Owner: .....- - ......� _.......... Builder ...._....
Address ddress........_............._....._.........._....._.._._....-...-.......-. ........_................._........____ .....
.:........... _..__....._..........
�,_I�QCATION OF BUILDING
%%No. �/. Street _.. - --- .... ..... _. .. ............. Part of Lot ............ ._.....__._._..........
Lot.............f...................... Block ....-. ................... Addition or Sub -Division ... _�
CornerLot .................................... Inside Lot ..................................-.... Setback ............................. __.......... Side y d ..... ....................................... ............................
Sewer Elevation .................... _............. _...... _.... _............. _............. _....................... Foundation Elevation
DESCRIPTION OF BUILDING
To Used as: I OF
.. ...... ...__............ Front 1......... Depth a�..®..7. Height -. ...� Sq. Ft.... . ®. Cu.
..... ............................. _................. . Front ..... _............ .....Depth ...................._.. Height ............... Sq. Ft... . ................. Cu. Ft.
Type of Construction...................................................... Est. C000,0760 ._. 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. - � I% r, 19
In consideration of the payment of a fee of $ .... . .G -'r+
p ........��.'....., permit is hereby granted to. ................................................ ............
........... ... ._...................................... ...._........ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
A
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY MINNESOTA
Owners Name:�-
AdOess $ . • x ' ..Address :..... .
LOCATION OF BUILDING
No. �'� Street.- �� - Paxt of .Lot,
Lot , BIo[ck ��� Addition or Sub.D.
Corner Lot�__Insids Lot. ..Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
ApplirAnt attach , to this form -Certificate of $upvey of Lot arid proposed building
DESCRIPTION OF BUILDING
To be used as: f
f .
Front Depih�a1 P Height
Sq. Ft. Cu. Ft: .
Front Depth height
Sq. Ft. Cu:,Ft.
Type of Construction Estimated,Gost��'
To be completed
The undersigned hereby makes application for a permit for the work hereixio9ecified,
agreeing to do•611 work in..:strict accordance with the City Ordinances and ruling of
the Department of'Bu ldings, dnd•hereby declares that all the facts and represents -
tions stated in this,oplica.tion are true and correct.
DATE �' SIGNATURE
( Schedule of Fee costs can be found on the Reverse Side.)
a
a :
TIB DING
No. Street 0 Par Lot
Lot .. __ Block Z Addition or Sub -Division
Corner Lot Inside Lot Af --' Setback Sideyard
Sewer Elevation ._._ Foundation Elevation
N® 65?6
DESCRIPTION OF BUILDING
To �[T
antDepth eight _ Sq. Ft. Cu. Ft/ -4121
Depth Height Sq. Ft. Cu. Ft
Type of Construction,. _ Est _ To be Completed
i
/1
In consideration of the issuance to me of a permit to construct the building
the proposed work in accordance with the description above se in co
ordinances of the city of Fridley.
In consideration of the payment of a fee of It permit is hereby granted to
I agree to do
provisions of
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 regardin4 location, construction, alt eration, maintenance, repair and moving of buildings
withinordin� the city limits and this permit may be revoked at of any of the P� of said
NOTICE:
''f9►is pornib doer not corer the construcilon, installation for whin®, phrmhing, gar heating, sewer or water. Be are to can
the Building Inapeetor for separate permits for them items.
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PEN14ITS
MEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
. a .
OWNER: Oak Jj,0',d,0� BUILDER:
Address: 3'J ��® Q 4 108/vIlddress:
Tel. No.
No.: Street:
LOT: BLOCY.: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
Square Feet: Cubic Feet:
Front:
Square Feet:
Depth: Height:
Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $/,j $
o _
�a y.-���`'e �/ (SEE REVERSE SIDE OF SHEET)
0/lc) ^1i4E3zVloe-V /�deT?/ ®dam e'K/ST//VG- 2�3/blle
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 correct. See reverse side for additional informa4on.
DATE: e 2C °- 78 SIGNATURE:
0
Stipulations:
City ®f Fridley
SUBJECT
PE NO.
15 975
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
CEIPT
__ COMMUNITY DEVELOPMENT DIV.
' q
/
1 PROTECTIVE INSPECTION SEC.
s-CJ
CITY HALL FRIDLEY 55432
L
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/15/80
JOB ADDRESS 5881 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Donnay's SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bahram Nikrad 5881 West Moore Lake Drive N.E. 574-1733
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 Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Construct a 14' x 38' Deck off back of Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
r
NA
SEPERAE RERjWITSRE UifbF
Fdiheyoe®F'F1T11N
j OCeIV
QU110T�
�tJr + 4N
NS.
etc
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Woo
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED ISNOT 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
$1,000
$.50
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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
-A Ile x
"L
$8.00
S UREOF NTRACTORORA IZ GEN (DATE)
WHEN PROPERLY VAL ATED THIS IS YOUR PERMIT
6 /'SQ
EWOdWNER tIF DER ffl tDATEI
BLD i P D TE
OCAI�) 0 V
CITY OF FRIDLEY ,
APPLICATION FOR RESIDENTIAL BUILDING PEMITS
(New, Alterations, Additions, or Repairs)
OWNER, ' T 2 BUILDER:
ADDRESS:(,ADDRESS:
TEL N0: S:2- j 2 4 TEL 140:
Construction Location
STRUT Pfd; STREET: - ZA"�l - /mss r 4.d �-y�'► m
4
LOT: BLOCK: f ADDITION.:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form tsao Certificates of Survey of lot and
proposed building .location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: ' height:
Square.Feet: Cubic Feet:
Front: Depth: Height:
Square -Peet: Cubic Feet:
Type of Construction: Fo-oo rG Estimated Cost: $y�
xb 3de CDrtpleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SFE REVERSE SIDE OF SHEET .
'lire 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 state
d in this application are true and corre
MTE: /4— R
� i(f (� SIGNATUr:, r
C %W
Stipulations :
I
City ®f Fraley
SUBJECT
P
o- i 6 6 7 3
AT THE TOP OF THE TWINS
BUILDING PERMIT
P
RE
• _ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
CITY HALL FRIDLEY 55432
�! �•�
NUMBER
REV.
DATE
PAGE OF
APP OVED BY
____1l.'
612-571-3450
910-F15
7/12/82
JOB ADDRESS 5881 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Donnay's Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bahram Nikrad 5881 West Moore Lake Drive N.E. 574-1733
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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Est Construct a 5' x 10' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
�%xcl
SEPERA
RER1y�T5 #i �►��� ��g�E`��RIC�`
Ama 01
%iGA
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$275
$.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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
g5.00
PLAN CHECK FEE
TOTALFEE
$15.00
C NTRACTOROR TH E GENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�NATFbt
BLDG INSP DATE-
NERIIF I DRI (DATE)
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDING PERMITS
(Near, Alterations, .Additions, or Repairs)
01114ER: gadram wi
ADDRESS: 599) l moary. -. bo
TEL NO:
QUI LDER :
ADDRESS:,'
TEL 140: C4
Construction Location
• STREET NO: � � STREET: C oQ On VJE
LOT: . BLOCK: I ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: 9-�?4 Depth: �� Height:
r
Square. Feet_ �� Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: Estimated Cost:
4b Be Completed: A' g S
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET .
Mie undersigned hereby masses application for a permit for the uork'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 an_4 correct.
DATE: 7- a Z SIGNATURE:
Stipulations:
P-9�A I .o
�®
6
,J HARVEY A. CARTWRIGHT GT & OLSON
ANOKA COUNTY SURVEYS
HENNEPIN COUNTY SURVEYS NUSURVEYORS
MINNEAPOLIS SURVEYS ,
_ 5410 PALM STREET N W REGIST[REO UNDER LAWS Of STAT[ OF MINNESOTA
6UNS9T 4.7655 LICENSED sY ORDINANCE OF CITY OF MINNEAPOLIS
owH9w FEDERAL 8-8721
326 PLYMOUTH BUILDING
a
INDUSTRIAL - JUDICIAL
■USINESS - TOPOGRAPK)CAL
CITY LOTS - PLATTING
:ierL"y sweet
0
HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA
6urytpor'll certificate
10
— 73 Inv• N 4 7
SCALE: I 30
—y ^- DENOTES
COMBINING THE R•:CORDS 01.
J. E. HILL, CIVIL ENGINEER
96TASLISH9D I*"
C. F. SANDHOFF
CIVIL ENGINEER
ESTASLISH91) 1900
,JAMES NELSON
SURVEYOR
91STA81.I6H90 1022
METROPOLITAN LAND
SURVEYORS, 9STASLISH90 1991
I hc.rsby certify that this is a true and correct representation e. a survey of the
boundrxies of -
Lot 3, Bloc_: 13 Donnlyls Lakoviarl ::=nor, :.noir: Counts, : i-" esot
�; of -,.he location of all buil in,;s, if any, thereon, pnd Ill visible encroachrients, if
� , from or on said i .n;:. : s survayed by me tris .12th day of Juns, 195 }•
1 r>
SION[O �y/Ildpow
SUBJECT
City of Fridley720
--I
;79
AT THE TOP OF THE TWINS
BUILDING PERMIT,/./
r
�
RECEIPT NO.
• _____ COMMUNITY DEVELOPMENT DIV.
V
r PROTECTIVE INSPECTION SEC.
1 � �
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/19/88
JOB ADDRESS 58.81 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
1
Donnay 1 s Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bahram/Jane Nikrad 5881 West Moore Lake Drive N.E. 574-1733
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
Res iden tia 1
7 CLASS OF WORK
❑ NEW J ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 241 x 221 Addition and remove 221 x 141 portion of existing deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan, If addition is a bedroom, it must be provided
with.a,n egress window, I.nstall fire alarms on both levels of dwelling,
%A",'1U1RH1 SEPARATE PERMITS REQUIRE® EQR
Before digging call local Utilities, WIRING, HEATING, PLUMBING AND SIGNS.
TELEPHONE - ELECTRIC - GAS Etc.
REQUIRED BY LAW
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
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$30
X50
$15,48
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
f
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-
$291,00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$306,48
. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
_ WHENA[ PROPERLY LIDATEDDTHIS IS YOdU�R� PERMIT
'Z"�jSIGNATURE
BLDG I DA
-
OF OWNER IIF OWNER BUILDERI (DATE)
MW II
AMT 1
ALTER I I
Construction Andress
Legal Description
City of Fridley
R-1 AMID R-2
Building Permit Application
Effective 5/1/88
Owrer Name Address:_
01� el
Addressw
Attach to this application, a Certif icate of Survey of the
lot, with the proposoed construction drawn on it to scale.
DESCRIPTION OF IMOVFMU
LIVING AREA: Length Width Height Sg. Ft.
GARAGE AREA: Length Width Height Sg. Ft.
DECK AREA: Len Width Hgt/Ground Sq Ft.
onme
Ourner Lot I I Inside Lot Ft. Yd Setback Side Yard Setbacks
Type of Construction: WN Estimated Cost:
Approx. Oompletiam Date; /ti ®,� •(,�
4 •(a3l q•GG1f'* •(tK SO r" ) Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ 5
Width + 6' See Back Page
DM:ZZ--®
-4APPLICANT: Tel. # r
C337 USE ONLY
Permit Free
State Surcharge
SAC Charge
Driveway Escrow
Park Fee
Sewer Main Charge
TOTAL
ST I=:
®F Awr'na,. 13
Ga Pa-Gc)a
Flee Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC Unit
Alt. "A" or Alt. "B" Above
Fie Determined by Engineering
Agreement Necessary I I Hot Necessary I
�9�Z uj w, ffi,, GS
Ls r� A ECS M5 &ja,,jioLz
W. co
Z
V/
HARVEY A. CARTWRIGHT
ANOKA COUNTY SURVEYS
HENNEPIN COUNTY SURVEYS
MINNEAPOLIS SURVEYS
8410 PALM STREET N.W.
SUNSET 4-7655
OWNER
INDUSTRIAL — JUDICIAL
BUSINESS — TOPOGRAPHICAL
CITY LOTS — PLATTING
Henry Sweet
O
a
CMTWMGNT & OLSON
LAND SURVEYORS
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
LICENSED MY ORDINANCE OF CITY OF MINNEAPOLIS
326 PLYMOUTH BUILDING FEDERAL 8-8721
HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA
*urbepor'o tertificate
`73- T) Inv. _do. 20;'.,'."9
SCALE: 1 30'
—y ^- DENOTES
COMBINING THE RECORDS OF
J. E. HILL• Civ IL ENGINEER
ESTABLISHED leve
C. F. SANDHOFF
CIVIL ENGINEER
ESTABLISHED 1006
JAMES NELSON
SURVEYOR
ESTABLISHED 1911
METROPOLITAN LAND
SURVEYORS. ESTABLISHED 1951
f
I acreby certify that this is a true .nj correct rcpres.nt^.tion o= e survey o- the
bound .ries off'
Lot 3, 310c'; 1, Donn :y13 Lakevla-. -nor, ..no::c: Count,,-, :.irnesot`.
and of the location of all buil in,;s, J" -.ny, thereon, :nd all visible encroachiients, i
�21�', ?r0I1 Ow' on S:�ll� �.: Il::• S `.LL VB;jE:wl by : �^. tti'�? S ! �ti: 'Ij 0=.' ulln^, 12159 -'•
`r•
slarocD 1 TWRIGHT AND OLSON a;'
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Effective On January 1, 1991
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
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
JOB ADDRESS .5E5 I i)° Hd 0✓ 1L t a k'-- 9",
The undersigned hereby makes application for a permit for the work
Rate TOTAL herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
$ 20.00 s --216—,O= that all the facts and representations stated in this application are
true and correct. 2 7 ,19RX
$10.00 $ 16 , 0%
OWNER 1?,�o ✓Dart k z-a-ci
$ 10.00 $
BUILDING USED AS O� r� ���v` 5� 6L22t/1 cf:--
$10.00 $
ESTIMATED COST 7 ��• v� PERMIT NO.
*Air Conditioning - All Sizes $10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
Commercial/lndustrial
1 % of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ 30. So
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units ( Circle One (Steam) (Hot Water)arDA1r
Trade Name ka-i oy -.L- Size No.
BTUP EDR
Fuel Le_ + _ 6o c1 Total Connected Load Z� 6.0 y
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY a C �� ���' e ms,
Signed By c Tel No. %94' 5—J G�
Approved By _-0Rough-In Date l a 7 - F(Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
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 ( ) No ( )
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks `
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
y
SUBJECT
City of Fridley
27289
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
R T NO.
COMMUNITY DEVELOPMENT DIV.
v e
PROTECTIVE INSPECTION SEC.
F ,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8,119,198
JOB ADDRESS
5881 West Moore Lake Drive
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Donnas Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Bahram Nikrad574-1733
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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION qx REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house (11 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 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
$917
$•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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$34.75
Fire SC $.92
PLAN CHECK FEE
7ALFEE 6.17
CONTRACTOR O ED ENT IDATEI
EN PR P
Y VALIG#TtD
THIS IS UR PE5KIT
;SI?G"TURE.OF
iGNATUR FO N 11 ERBUILD RI (DATE)
BL
PrATE
y
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: / ffik�Z-MA816 1�14 Z2&
Legal Description:
Owner Name & Address:
Contractor:
�g Tel. # S- 7
MN LICENSE # Q_4 -®pr/..
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft. �--
OTHER: / LA -4L 061`
- Ly, d o . , l/
Construction Type: ^� ,� r j timated Cost: $ 9/7
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: - APPLICANT: Tel. #_��
. STIPULATIONS:
CITY USE ONLY
Permit Fee
2 /
$ � Fee Schedule on Reverse Side
Fire Surcharge
$ 92 .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:
f
CITY OF FRIDLEY INSPEC'1 iON DIV.
6431 University Ave NE
Fridley, MN 55432
763-572-3604
Bas=
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Effective On Jan 1. 2001
s
JJ
✓G APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
>: Wash .� �[ ; :: Floor J±Cam Auto.
..nt Ift-.24111,
: Chnwpr t ✓r Trav i s Drain B i$ > a Washer
NO. RATE
$ 7.00
$ 4.00
$ 5.00
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range"
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
TOTAL
State Surcharge $ .50
TOTAL FEE $ 4;7cl'sz)
JOB ADDRESS S ddl
Heater
Elec
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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Building Used As
Estimated Cost PERMIT NO.
PLUMBING COMPANY
SIGNED BY TEL N0.
452
Approved By Rough -In Date Final Dat
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS S20 00
PLUS THE S 50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
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 Installina a new ventina 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 :
CRITOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
January 18, 2002
Mr. Bahram Nikrad
5881 West Moore Lake Dr NE
Fridley, MN 55432
Re: Final Inspection at 5881 West Moore Lake Dr NE
Contractor: Owner
Dear Mr. Nikrad:
A plumbing permit was issued on April 10, 2001 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final
inspection shall be conducted on the work authorized by this permit. As of this date,
no final inspection has been called for.
The permit fee that was paid covers the inspection to make sure the work was
completed according to the Code. We will keep your permit open for another 30
days and if we do not hear from you within this time to set up the inspection, we will
mark the permit "no inspection called for" and take no further action.
To set up the inspection or to have any questions answered, please contact the
Building Inspection Division at (763) 572-3604.
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