PRE 2010 DOCSCity of Fridley, 9804
BURDING PERMIT
PAt 1— f n1"r-W. a•°:
owner: Dr. J. Riley Builder Rodney Billman Inc.
Address Address 151Bi— ..Lake Road
LOCATION OF BUILDING
No. 15J2-- Street Wj r mPrP l)r; vP _ _ Part of Lot
Lot Block ____ Addition or Sub -Division __ Inns Gk rlth-A rl -n
Corner Lot _ - Inside Lot — X Setback 32 --- Sideyard
Sewer Elevation 9-91-21 _ 994.2-1 U Q ox.
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dw,- lin- g Front 51 Depth20176 Height S S. L • Sq. Ft. 1970 Cu. Ft.
Front Depth Leight Sq. Ft. Cu. Ft.
Type of Construction Frame Est Cost ^ $33,000.00 TobeCompleted Sept. 30, 1968
SEWER LOCATION - 3' W. of M.H.
WATER LOCATION - 7' E. of MN.H.
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 apA in compliance with ;& provisions of
ordinances of the city of Fridley.
$100.00 Sewer Connection Char
In consideration of the payment of a fee of $ 63.00 , permit is hereby granted to Rodney
�_ 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 ordinance's 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
NOTICE:
This permit does not cover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to we
the Building inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY ; OF FRIDLEY,. MINNESOTA .
OWNER'S NAME . o BUTIME
ADDRESS ry ADDRESS�1'.�
LOCATION` OF BLtLDING
N0.„STREE
T'
LO'C�r ”— LOCK- „ ADDITION OR. SU.BDIVISION 4r
71
CORNER LUT INSIDE LOT � SETBACK gib: SIDEYARD;'�,�
SEWER ELEVATION TOP OF FOOTING
Applicant attach, to this-; form .Two Certificates of Survey. of . X of and proposed
building location drawn on theseCettificat
y _ DESCRIPTION OF BUILDING.
To Be Used As
Front�Depth. B eight
Square feet AZi b �c. i` et
Front Depth aeigltt
Square feet Cubic Feet
Type of Construction _ :Estimated Gost3
To Be Completed
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 nd representations stated in this pplication
are true and
correct,
-
DATE _ SIGNAT ✓C� �
(S edule of F,de Costs can be found on the v_ se Side).
�( C -ell i'.
Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldge. Phone 560-3450
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... $10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ie—
each
a—each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
$10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
... 10.00
$
Each add. 200 sq. ft. EDR Steam ......................
3.00
$
Each add. 320 sq. ft. EDR Hot Water ..................
3.00
$
OIL BURNER—to 3 gal. per hour ........................
6.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x$ 2.00
$ 21—
'—Additional
AdditionalFixtures ................
x .75
$
Gas Range to 199,000 1 ......... I
x$ 5.00
$
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
$
TOTAL FEE $�_
Location J ;f) L?— W R ,.A5!!� AMM.
City of Fridley:
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 representations stated in this application are true and correct.
Fridley, Minn- 1 ®1 19
Owner
Kind of Building
Used as 14 q5
To be completed about
Estimated Cost, $ %i az.�
Old—New. Building Permit No. qvo� Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R. BTU H.P,
Total Connected Load a '2.0 Kind of Fuel
BURNER — Trade Name '5�'A = Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
City of Fridley
Application for Plumbing and Gas Kitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK rr/I
Kind and Location of Fixtures Location—
Number,/ ' a
y
$
X $1.50
$
— x $1.50
,ti
3� �2
N
p z
LLa
N Ej
�O ,Sj� .�
a z
S� <3 �U'd
w
C9
�O
?
z
01
�U' O
•
F
•
N
WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• Future Connection Openings
+x New Fixture, Old Openings I
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg . ............
Electric Water Heater
GAS FITTING FEES:
1st 3 Fixtures ....................... —
Additional Fixtures ...................
Gas Range to 199,000 BTU ..............
REPAIRS & ALTERATIONS --Refer to Code
x $2.00
$
X $1.50
$
— x $1.50
$
x $3.25
$
— x $3.00
$
— x $3.25
$
_ a $2.00
$
NO. RATE TOTAL
x $2.00 $—
x $ .75
x$.75 $
x $5.00 $
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are true and correct.
Fridley, Mnn 9' � -7 19
Owner a xis
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No Pe it No. �l
Signe
By
Business Phone No =& 5
ROUGH
FINAL j ® Al- 7 -�-
Description ............................. .... .. .........
TOTAL FEE $ `� az
City of Fridley
Application for Plumbing and Cas Fitting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK '91 - � Z
Number, Kind and Location of Fixtures Location—.
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x $2.00
$ 3c) . O c
Future Fixture Opening ................
8
Z
Q=
x $1.50
WATER
•
Z
+
HTR.
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
%
x $3.00
$G
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
s $2.00
$
q,
NO.
0o R
N
GAS
EIEC
oto
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
Base
1st
2nd
2
3rd
4th
° Future Connection Openings
Connected with
New Fixture, Old Openings
I
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
x $2.00
$ 3c) . O c
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
%
x $3.00
$G
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
s $2.00
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
%''
x $2.00
oto
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE ��
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are true and correct.
Fridley, Minn "' 19_
Owner
Kind of Building vv#`--qQs
Used as /
To be completed about .t►
Estimated Cost, $
Old-7Te . Building Permit No Permit No.
�,`1 Signe K
By
Business Phone No 14- ��✓�
ROUGH
FINAL
City of Fridley, .Mian.. N9 10269
BUILDING PERMIT
Date: June 6, 1969
Owner: Dr. Riley Builder Pools, Inc.
Address 1512 Windeme a Dr ye Address 229 West 60th St.
LOCATION OF BUILDING
No. 1512 Street Windemere Part of Lot
Lot __ Block Addition or Sub -Division
Corner Lot . Inside Lot — Setback --- Sideyard
Sewer Elevation __ __ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
swimmiug Pool Front 40 ► Depth 21 Height 81911
►9►► Sq. Ft. 640 CU. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _$5x.000.00 __ To be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
ordi aO twork he city of Fridley with the description above set forth and in compliance with a'll p ons of
In consideration of the payment of a fee of $-0;0.x__, permit is hereby granted to Pools, Inc .
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.
NOTICE:
fids permit don not cover the construction, installation for wiring, plumbing, gas heating, sower or water. Be sore to as
the Building inspector for separate permits for them bean.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLFIY9 MINNESOTA
L
OW.NM t
BUILDER g
r �
ADDRESS �� 11' 1
LOCATION OF BUILDING
NO. 1,;Zia T STRERT
LOT BLOCK ADDITION OR SUBDIVISION
CORNER -LOT INSIDE LOT SETBACK SIDEYARD•„., _
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To.pe'Used A®: a -7!' T147
Front Depth Height
Square feet ` Cubic Feet7i d
Front Depth
Height
Square feet Cubic Feet
Type of ConstructionEstimated Cost
To Be Completed
1671,
The undersigned hereby makes application for a permit for the world
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.
DATE 0 SIGNATURE �� �/ �✓��•
.(Schedule of Fee Costs can be found on the Reverse Side.)
0000"-
- '! rlol AO
a
e
June 5, 1969
Pool's, Incorporated
229 Nest 64th Street
Minneapolis, Minnesota 55419
Gentlemen:
_ A review has been made by me of the private pool for Dr. John D. Riley.,
1512 Windemere Drive.
The following items should be given attention;
1. An overhead line(not identified on plan) is noted about five feet from the
edge of the pool grater on the shallow end. This is quite close if it is an
electric line.
2. Fresh make-up water supply must:, be connected to the City water.
3. The distance between the center -�of the tip of the diving board and the side
of the pool is six feet. This distance should be about seven feet.
®4. What about a handrail on the shallow"end?
5. The main electric service line is about twelve feet from the edge of the
water. We like to see at least fifteen to twenty feet between the tato.
6. Why not separate the two skimmers to a. common manifold since the piping
will be about the sada? We will not however, require such separation on
private pools.
7. Provide adequate control valving on inlets since you have one inlet line.
6. Skimmers,"' -filter, pump and chlorinator shall be N.S.P. approved.
9. The general specifications indicate that a fence is or will be provided.
The fence''is not noted on the plot plan but a fence will be required.
Generally, the plans and specifications appear quite satisfactory
especially since it is a private swimming pool. Please contact me if there
are any questions.
Sincerely,
. y Fridley Board of Health
HARVEY J. MGPHEE
Public Health Sanitarian
EJM/mh
CC: Building Inspector
Plumbing Inspector
Ori& to
PERMIT for Power Plants and Heating, Cool-
ing, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No.o fjHeating Plants to be installed—altered—repaired
Make s s , Size- _�iV7ZL 7 3 6 ;
Oil fired ; Coal fired—, Gas fired; Gas Authorization
Remarks
Approved by.
Final Inspection Date , 19._
Inspector
Permit N° 4526
Fee $ 6-�
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.6k-At�a`t, 19-61
Owner
Location
Kind of Building
How Occupied
Work to be Commenced 4 � / ,19_k5�.
To be Completed a -7 ,19
Estimated Cost, $__Z ' 0-3)
Old -New, Building Permit No.
Permission is hereby granted 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 sfecifications set forth in the approved application for this
permit on file in the office of the Inspector of Buildings. % L —c" / r ���
/'b , Inspector of Buildings
42 2M 11-67 V
s-
City of Fridley, Minn. 0 9 9
BUILDING PERMIT
Date: April 29, 1971
Oar: John D. Riley Builder Same
Address 1512 Windemere Dr. Address Same
No. 1512 Street Windemere _ —, part of Lot
Lot — 9 _ Block 3 Addition or Sub -Division .— Innalru th
Corner Lot Inside Lot — X Setback ____ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: Pa Y f f e ®ass t�� le
Recreation Room)Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _y 000 _ To -be Completed 711171
In consideration of the issuance to me of a permit to construct thel builoing described above, I agree to do
the proposed work in accordance with the description above set forth compliance with all provisions of
ordinances of the city of Fridley. 19 .'
In consideration of the payment of a fee of $_ 18 - 00 , permit is hereby granted to John n R j 1 P.
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 andmoving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
li
nnr7inannna
NOTICE:
'fids permit does not cover the construction, installation for wiring, phnnbing, gas headag, sower or water. Be sure to we
the BuibUng inspector for separate permits for these ham
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: D- �LLAPY
BUILDER
ADDRESS: Tj Z--- W ADDRESS:
NO :. 1 S STREET:
LOT:- BLOCK • ADDITION •
CORNER LOT: INSIDE LOT: L/ SETBACK:_SIDEYARD: z-1-
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:
G� x�ont: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:_
Type of Construction: : _ Estimated
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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.
DATE:' V 'd?- ` �- / S IGNATIMP
(See Reverse Side For Additional Informat.)
A
U d
City of Fridley ' J"
Application for Ph g mid G=
Dept. of Bldga. Phone SOD -3450
DESCRIPTION OF WORK LOOM= % 5�/� �, � �/ -X-,/
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $ ® C)
Future Fixture Opening ............ x $1.50 $
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater :Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water Beater .............. : $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ...... • ..... • • • x $2.00 $
Additional Fixtures .................. x $ .75 $
Gas Range to 199,000 BTU.. . x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................ A
TOTAL FEE Sd
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do $11 work in strict accordance with the Ci4y Ovdiwnce
and ruling of the Department of Buildings. and hereby declares that all the fact
and representations stated in this application are true and correct
Owner
Kind of
Used as
To be a
Estimat.E
Old—New. Building Permit No. _Permit No.�j// 51?
Signe C/r
ROUGH
iIF11lIa Si'c3®°' %�
By
Business Phone No -5 37 - 7
01
MMUMMMMMMIN
I
ME
MEN
NNEMENEENNIN
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $ ® C)
Future Fixture Opening ............ x $1.50 $
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater :Up to 99,000 BTU) .... x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water Beater .............. : $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ...... • ..... • • • x $2.00 $
Additional Fixtures .................. x $ .75 $
Gas Range to 199,000 BTU.. . x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................ A
TOTAL FEE Sd
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do $11 work in strict accordance with the Ci4y Ovdiwnce
and ruling of the Department of Buildings. and hereby declares that all the fact
and representations stated in this application are true and correct
Owner
Kind of
Used as
To be a
Estimat.E
Old—New. Building Permit No. _Permit No.�j// 51?
Signe C/r
ROUGH
iIF11lIa Si'c3®°' %�
By
Business Phone No -5 37 - 7
01
SUBJECT
PERMIT NO.
City of Fridley
®13044
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
6-23-75
JOB ADDRESS
JOHN & JOSEPHINE RILEY, 1512 WINDEMERE
DRIVE. N.E.
1 LEGAL
LOT NO.
BLOCKT
TRAC OR ADDITION
SEE ATTACHED
DESCR.
9
3
INNSBRUCK, 5TH. ADDITION SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
JOHN & JOSEPHINE RUEY 1512 WINDEMERE
DRIVE N.E.
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
RESIDENCE
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
NEW ASPHALT ROOF
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ASPHALT
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.iDWLG. 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
$1,200
7
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.
$9.00
PLAN CHECK FEE
TOTAL FEE
9.75
S ATUREOFCONTRACTOR ORA ORIZEDAGENT (DATE)
VALIDATE THIS IS YOUR PERMIT
�WHENOPE
JUNE 23.1975
DATE
GNATU OF OWNER (IF OW ER B ILDER IDATEI
-APPLICATION FOR RESIDE IAL.'RATION,
, ALTL;'
Olt ADDITION. BUILDING PERPIIT
CITY OF F}:IDLI Y, MINNESOTA
OWNER'S Nmlc"IE : S4e nA 1*Vj BUILDER:
ADDRESS:j5)ol I'V)6(eme_re. J])r',ueAADDhESS:
110:. ! S I STREET:
LOT: BLOCK
COT.iNE]", LOT ; IPS IDE LOT: SETBACK: SIDEYAi,D
Applicant attach to this form Tc -7o Certificates of Sitryey .of Lot. and.propose ' _.
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth: Height:
Square Feet: Cubic.Feet:
o
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Mc,� to Estimated Cost: $ )aoo ` O°
e
To Be Completed: T'L t M 1 1� 7
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 ruiings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: SIGNATURE ,
(See Reverse Side For Additional. Information.
tz1_
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares
_�that all the facts and re resentations stated in this a lication are
Als Replacement Furnace $ 20.00 $ P PP
true and correct. /v2/w � ,1991
Gas Piping (Needed with new furnace) $ 10.00 $
OWNER
q�A�
Gas Range $ 10.00 $
BUILDING SED AS
Gas Dryer $ 10.00 $ , , G
ESTIMATED COST PERMIT NO. Z �r t�
*Air Conditioning -All Sizes $ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $ 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
i
State Surcharge $ .50_ Burner Trade Name Size No.
TOTAL FEE $ Z
--nBTU HP EDR
1::1c;ond &Sons Elec.. Inc. dba r
t7 Sons Elec., Inc. dba
C- 'scn d' ".1. N,c R, A!r Cd ^,Iden valiey 11th. & Air Cd
HEATING C <.
' _ devay
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION ; ` Crystal, Mil 55429
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed B)v Tel No. 515-2000
PLUS THE $.50 STATE SURCHARGE %f
qv
REINSPECTION FEE $30.00 App�ved Rough -In Date Final Date 141
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 �✓ j (,� �-
REPLACEMENT FURNACE 14
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
( a
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 ( s� No ( )
6. Has total heating BTU's of �Du�
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
CITY OF FRIDLEY INSPECTION DIV:
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
ARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Wash r ':<< Floor: < Auto.
tih` > r.[ti.l........t. h....
Urinal Tial;;;:: Showerri:k;«:: Tra I`oun#»:> Drain Bann:>::>< Washer
.. Y ......... I ..................
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
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
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $_
JOB ADDRESS.
Effective On March 1, 1996
Gas JVf C
Water Heater
a
Ran a .
Gas Elec
The undersigned hefeby makes application for a perm it 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.
T3 , 1996
Owner ULWA S� 7 / m
�(
Building Used As --- W
Estimated Cost PERMIT NO. f /,s
PLUMBING COMPANY. &AAL st
SIGNED BY TEL N0.
Approved By /� K Rough—In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT I
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
JOB ADDRESS 1/ 1 4- FV l r IV"
OWNER M
Rate TOTAL
BUILDING USED AS
$ 30.00 $ 2�®®
ESTIMATED COST
$ 10.00 $
$ 10.00
_Gas Dryer .00
*Air Conditioning - All Sizes �/" VI v/ $ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2002
cL
PERMIT N0. G�
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
$ 50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE JUN 13 2002
HEATING CO Rie..w Boos EI -F -r- INC.
DBA: GOLDEN VALLEY H70- & AER
Signed 5162 WEST BROAD^ t L #
CRYSTAL, MN 5542
FAX # (.763) 535-200®
Approved By4 Rough -In Date Final Date
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VENT, VENT CONNECTOR ANn COMM IRTION AIR V RIFT ATION
When rel�.a -ing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from Oast, 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 manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The existing nnmhustinn air is sized and installed to meet the current codes
and manufacturers specifications. Yes( ) No( )
When required to install a naw cnmhustinn air, it will be sized and installed
to meet the current codes and manufacturers specifications. Yes O No ( )
When enc aIle g a new ranting system,, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
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 #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
HEATING CO:
Signed By: Date :