PRE 2010 DOCSCity ®f Fridley, e 11Ta 9919
BUILDING PERMIT
Date:
Owner: Kenneth G. Ziemer Bider Gorco Construction. Co
Address --47-01.,-2md.. Street X -R. Address ,3384 Brno ow St. T.rm-i a Park
LOCATION OF BUILDING
No. 4701 Street .._..2nr9 Stree+_N.F.--- Part Of Lot
Lot _ 16-17 __ Block 6 Addition or Sub -Division — j=o a.th .-
Corner Lot — Inside Lot X Setback Sideyard
Sewer Elevation -- Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front — 22 Depth �4 Height 12? Sq. Ft. 528 Cu. Ft 6336
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction __ Rhe ____ _ _ . Est. Cost r80�__ ___ To be Completed 10--4-6,9
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 rth and In co pliance with all ovisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 0.00 _ , permit is hereby granted to_ _eco Const Co
to construct the building or addition as described above. pen B C thol
R,fi& rc tt gran 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 apon violation of any of the provisions of said
ordinances.
Official
Building
John Breher
NOTICE: ,
'This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sore to see
the Building Inspector for separata permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNE6 IS NANE e �11_ �"%u.eZ BUILDER /tea
ADDRESS At &, ADDRESS 33 S Y
LOCATION OF BUILDING
NO o 41 o I STR � r` )V -Z
LOT—/ ` ` /`7 BLOCK C® -AADDITION OR SUBDIVISION? A6 (i L C H
COR'M LOT INSIDE LOT / SETBACK SIDEYARD
SEVM ELEVATION TOP OF FOOTING 4y4e4, ,
Applicant attach to this form Tv.Fo Certifioates of Survey of Lot and
proposed building location dray -i on theso Certificates.
DESCRIP"'+ ON CI' BUILDING
To B Used As.-
r
Front Depth Height
Square feet Cubic Feet
6 3
Front Depth Height
Square feet Cubic Feat
Type of Construction Estimated Cost
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 and representations stated in
this application are true and correct. _
DATE - % (° SIGNATURE %oma- CvxdJ, dab
(Schedule of Fee Costs can be found on the Reverse Side
L� �. � 41�
-OLD GARAGE []
PROMISED: ASAP EXCAVATE ❑ JOB NO. 8741
'NAME: Kenneth G. Ziemer DATE: 8-19-68
' ! ADDRESS: 470i 2nd St,. N.E. ZONE. Fridley
i
fSALESMAN: Serrell CARPENTERS:
N , CEMENT MAN: Cl"'`:
DETACHED ATTACHED
E Pi Pr ( 22 x 24
DRIVE-IN DOOR: 1X7 ICU
SERVICE DOOR: Yes
E
SLAB & APRON: Yes 1
0
• U CONTRACTOR'S REPORT
q S DATE RECEIVED:
DATE SLAB POURED:
DATE RETURNED:
S
SPECIAL NOTES: SLAB HEIGHT:
YES NO LUMBER ORDERED:
REINFORCE SLAB: X CARPENTERS:
REINFORCE DRIVEWAY: X COMPLETED:
$60®771.8 ADDITIONAL INFORMATION
tel._ Install Conduit Hole_-_ask-_fox-.conduit_.pipe. !
2. Note that prop lino is p2wk possibly l°
beyond fence. I
3. (I)
� jj
i
GORCO CONSTRUCTION COMPANY
r!
i
' e
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER Mt- a'r\ vs , 0!:s%Ne—V + r
SITE ADDRESS L1701 ,� `� , J +E� -Tv=a 1e!z
CONTRACTOR K--1 yoAf DATE PHONE r
Determine working square footage of each.
1. Total exposed wall area qh%' sq. ft. x .17 = 1 76—®,65
2. Total roof/ceiling area ...... 4 sq. ft. x .05 = I L3
Total exposed wall area above floor = 2 4 Q
a. Total wall window area ...........................
b. Total door area ..............................
c. Total sliding glass door area ...................
d. Total fireplace wall area........ ........................ --
e. Total wall framing area (average10%)............. 940
f. Total net wall area above floor ................. &125
g. Total rim joist area ............................ /05
^'
Total exposed foundation area =
h. Total foundation window area .....................
i. Toal net foundation area above grade ............
Determine "U" value of each wall segment.
a. / X "U"
b. X "U"
c. X „u„ _ -
X 11ii _ _ _
e. 2410 X llull , All —--ALL119
f. 1025.6 X e,u„ 0 7
g. V X uUII
h. X fluff�=_�--_ - e -
i T-=_ X fluff
3.....................................Total = 1s 7W I
If item #3 is the same as, or less than item f1, you have met the intent
of SBC 6006(c)2.
Total exposed roof/ceiling area =,
J. Total skylight area... ..........................
k. Total roof/ceiling framing area (average 10%)... J2,
1. Total net insulated roof/ceiling area...........
Determine "U° value for each roof/ceiling segment.
j.
X 11u11 c
k• 68j4X 1111
X (lull ®® I 'Rq' 6
4...................................Total = o
11 7
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6.006(c)l.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. /4®®!0-' + 2. J-91, 2 = 19IVI"?
3. 1 //®A 1,? + 4. 3 3051 = I-qS' O?1
0 0
SUBJECT
MIT NO.
City of Fridley
® 13730
AT THE TOP OF THE TWINS
BUILDING PERMIT
'
r
�
REC
COMMUNITY DEVELOPMENT DIV.
INSPECTION
k3l(10
r PROTECTIVE SEC.
1 . ,
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
8/31/76
JOB ADDRESS 4701 - 2nd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
16,17
6
Plymouth Addition SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Robert Sankey 4701 - 2nd Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Panelcraft of Minnesota 3615 East Lake Street
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 24' x 28'6" house addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Subject to an on site inspection and verification of house being
within Code as to all R-1 setbacks.
WARNW""��
r
� � �
,Mix, MOT R F= NBC.
REQUIRED by LAW
iD
e,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood, 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
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
686
6860
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$8,500
$4.25
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-
$39.22
STRUCTIOTHE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$43.47
.91�„A
SIGNATURE)FCONTRA O OR AUTHORIZED AGENT ATE)
WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
BLDG )NSP DAT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
0 0
Vi i r ur rmLuccr
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDITION, OR REPAIR BUILDING PERMIT
OWNER'S NAM:Bnber-jr Sct h�e v BUILDER: 0.x1 vco °� o4 t l' Ate_
ADDRESS: Y70I doot S L AIL E ADDRESS: 34, l5 ,E j—,* ke- Sf
NO: r�Q STREET: °� ® ��/�,c���
LOT: �� BLOCK: �0 ADDITION: A- w'nou n/
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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:
nt:
. 21V/
Depth:
.2 T 6
Height: l
Square Feets(09, �,�Cubi.c Feet: (0866 r --
Front: Depth: Height:
Square Feet;
Cubic Feet:
Type of Construction: S62 t(4 Estimated Cost: $ ,?46","
To Be Completed: 9/
j&
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.
DATE ://_ SIGNATURE:
(See Reverse Side For Additional Information.)
y
d ^
City ®f Fridley
SUBJECT P.
AT THE TOP OF THE TWINS
BUILDING P [DAA I
r
�
L R' Y'
RECEIP
`L -------- COMMUNITY DEVELOPMENT DIV.
INSPECTION
%
r PROTECTIVE SEC.
----i � CITY HALL F.RIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
L 612-571-3450
910-F15
9/7/83
JOB ADDRESS 4701 -- 2nd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
16-.17
6
1 Plymouth. Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Sankey 4701 - 2nd Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Viking Inc. 6311 Wayzata Boulevard 541-0893
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 l4' x 20" Addition to Dwelling
9 CHANGE QF USE FROM TO
StIPULATIONS
Install smoke detectors on all levels. Provide combustion air.
'FOR
G SEPERATE PERMIT; REQVIRED WIRD
Bes®re digging call local HEAVING. Pl(�MBINC ANO �ICNS.
TELEPHONE. ELECtaIC
. �� �fc.
REC�UIRED BY LAW
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
I
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
$11,10.0
$55.5.555
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$92.50
STR TION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
i -
$23.13
$121.18
SIGNATURE OF CONTRACTOR OR AUTH AGENT (DATE)
WHEN POUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER tlF OWNER BUILDER) (DATE)
A
CITY OF FRIDLEY
Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDING PEMITS
(New, Alterations, Additions, or Repairs)
OVINER: 'BUILDER:
ADDRESS: V7®l ADDRESS:
TEL NO: TEL 110: �,�/ d
Construction Location
STREET NO: -el -2o STREET: ;;/fid
LOT: ��� �� °� BLOCK: ADDITION:
Corner Lot: _ I e**' Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOR OF CONSTPUCTION
Front: Depth: l� / Height:
Square feet: cc—® Cubic Feet:
Front: ' Depth: Height:
Square Feet: Cubic Feet: _
Type of Construction: ���� Estimated Cost: $ ®�6
410 Be Oor,ipleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE F.EVF.RSE SIDE OF SHEET
1Sie undersigned hereby ma);es application for a permit for the ♦:.,ork 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.
UWE: �7" 2-,' jZ2_ SIG
Stimulations:
'Ind
01
susIEcr
P NO.
City of Fridley
17401
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
ECEIPT NO.
�
COMMUNITY DEVELOPMENT DIV.
SEC.
`/
r PROTECTIVE INSPECTION
7 5F'7
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
.6 612-571-3450
910-F15
11/19/84
/ /
JOB ADDRESS 4701 - 2nd Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
16,17
6
Plymouth Addition SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Robert Sankey 4701 - 2nd Street N.E. 572-8914
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Northwestern Builders 7400 Cedar Avenue South 866-0600
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential.
7 CLASS OF, WORK
❑ NEW ❑ ADDITION ALTERATION ElREPAIR ❑ MOVE ElREMOVE
X❑
8 DESCRIBE WORK
Finish off Addition that was started under Permit #17,231
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.
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
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
$8,000 $4.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$68.50
PLAN CHECK FEE TOTALFEE
$72..
§14NA�TURREOFCONTRACTOR ORAUTHORIZED AGENT (DATE)
WH PROPS L AL AT:DjjIS IS YOUR PERMIT
,
bAAX
- BLDG INSP BATE
SIGNATUREO NER OWNER BUILDER) (DATE)
'Ind
01
CITY OF FRIDLEY
. Effective Aug. 1, 1981
APPLIGITIM FOR RESIDENTIAL BUILD11M PL'Pv9ITS
(new, Alterations, Additions, or Repairs
O�SNER: r ad ►� BUILDER: ,�),����w-fZ-3_ VJ-L/ -
ADDRESS: �f 7� i � P nL, .� ADDRESS: "2 �i°G�Z,% �L� �-� -e—
TEL
eTEL R0: 492 1 TEL 110: -K�6 A
Construction Location
STR=T NO: ..J.. STREET: A J � t=
LOT: (°Z� BLOCK: ADDITION: � C� 071
Corner Lot: �L_ Inside Lotti Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
N DESCRIPTIOR OF CONSTRUCTION
Front: Depth: Height:
Square Feet:300 Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Teet:
WC)OD p �
"aype of Construction. � Estimated Cost:
7b Be Mr. pleted: 2 ! —�'i
Alt. A Al t. B
Proposed Driveway Width If New Opening Is Desired: $ S
SEL PiVF.R,L' SIDE OF SHEET .
91ie undersigned hereby makes application for a permit fcr the vork herein specified,
agreeing to do .all work in strict accordance with the City of rridley Ordinances and
rulings of the Delvirtment of Buildings, and hereby declares that all the facts and
representations stated in this application arm true and correct.
D.`TE: SI6NRTum
Stipulations:
s
City
®f Fridley
AT THE TOP OF THE TWINS
P
TRACT OR ADDITION
COMMUNITY DEVELOPMENT DIV.
r
PROTECTIVE INSPECTION SEC
0 � �
16,17
I = �•"t
CITY HALL FRIDLEY 54432
NO. DWLG. UNITS
612-571-3450
JOB ADDRESS 4701 2 Street NE
BUILDING PERMIT
NUMBER REV DATE PAGE OF
910-F15 5/30/01
EFfIMIT NO.
31859
RECEIPT NO.
/9r
1PPROVEO By
1
LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
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
DESCR.
16,17
6
Plymouth Addition
NO. DWLG. UNITS
OFFSTREET PARKING
SHEET
2
PROPERTY OWNER
MAIL ADDRESS
ZIP
PHONE
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL HE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
@
$4',954
Robert Sankey
4701 2 Street NE
PERMIT FEE
763-421-2264
3
CONTRACTOR
MAIL ADDRESS
ZIP
PHONE
LICENSE NO
Reliant Energy
Minnegasco/Banner Roofing 2305
Snelling Ave.S,
Mpls.,
MN 55404
4
ARCHITECT OR DESIGNER
MAIL ADDRESS
ZIP
PHONE
LICENSE NO
612-721-2000
20169856
5
ENGINEER
MAIL ADDRESS
ZIP
PHONE
LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Sq) Tear -off
9 CHANGE OF USE FROM
STIPULATIONS
Underlayment must comply with the State Building Code.
Permit InsPacts®n Cards
III Be Mailed
To Hemmner To Post
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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ZONING
SQ. FT
CU FT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL HE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
@
$4',954
$1.07
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
$83.25
FlAe SC $2.15
Lic se C $ 0 $91.47
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI HE P LY VA ID TED THIS IS YOUR PERA
SIGNATURE OF OWNER .IF OWNER 13u4DERI IDATE, - Bt INSP - gAtE
NEW [ ]
ADDN [ J
ALTER []
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 000
0• Bldg In
Legal Description:
Owner Name & AddressJ40beO Sofleu— 5 Tel. # -7tp3 – U3 I m J3Lot-,(
Contractor. L Enemij m1finfau ICENSE # dOl 0 4510
Address: a 30 `Z�i Tel. # 1010 A" 0000
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 Wdth Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt(Ground Sq. Ft
Construction Type: lew-am Estimated Cost: $ 4gSq
-o
Driveway Curb Cut Width Needed: Ft + 6LFt x $ _ $DATE: ''� � APPLICANT:Gj Tel. 4)
CITY USE ONLY - Call (612) 572-3604 for Permit Fees If mailing In application
Permit Fee $ '�• c� a Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ A . 01 $.50/$1,000 Valuation
SAC Charge $_$1 100 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 / r Not Necessary [ ]
TOTAL $ / '07
STIPULATIONS: ����!
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 200(
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE JOB ADDRESSd arn4 S� QV , t
Residential Rate
TOTAL
OWNER e 6Z'C J Arid
Furnace Shell and Duct Work, Burner -
BUILDING USED AS pi C,:,
Also Replacement Furnace $ 30.00
$
(Side Vent - Fill Out Back)
ESTIMATED COST 00 PERMIT NO.�!'(
Gas Piping (Needed with new furnace, �w $ 10.00
_.Z
but not replacement) IjAl �''�'�
Gas Range 6t�t�b`�'�'R"� $ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
Gas Dryer $ 10.00
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
*Air Conditioning - All Sizes $ 25.00
$
BTU HP EDR
Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No.
1% of Value of Appliance or Work
$
BTU HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work
$
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
State Surcharge
$ .50
rulings of the Building Division, and hereby declares that all the facts and
TOTAL FEE
$ � S � S D
representations stated in this application are true and correct.
River City Sheet Metal, Inc. DATE \O 0 1
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
HEATIN 98 Bluebird St N.W.
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
OOn Rapids, MN 65433
PLUS THE $.50 STATE SURCHARGE
Signed %3- 754-2199 TEL #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
Approved By Rough -In Date Final Date
written permission from adjoining property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
PLUMBING
RESIDENTIAL APPLICATION
City Of Fridley
I .Ulf eJl
WROI l•,
Received By
Date Reaeivo
NOTE: IF PROPERTY IS NOT OWNERIOCCUPIED- A UCENSIED CONTRACTOR MUST OBTAIN THE PERMIT.
(DATE //' _'�- YOUR E-MAIL ADDRESS
SITE ADDRESS r
THE APPLICANT IS: (CIRCLE ONE) OWNER CO
PROPERTY OWNERf
TENANT
CITY
PHONE
0
NAMIE A990 Main St- N F_, SiYite 32 LICENSE#
CONTRACTOR ADDRESS 1=-ridley,- N 55432
CITY
PHONE # (763)754--2199 Fax(7o-
1
I.. PERMIT` TYPE ! SWGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORT( I ❑ NEW
DETAILED DESCRIPTION OF WORK
REPLACEMENT
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINKIlAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB OAS PIPING (Need City License) SwiMu NG POOL WATER SOFrRM ($SM
CLOTHES WASHER KITCIeN SINK � WATER CLOSET BACKFLOW PREY. ($15)
AU
DISHWASHER LNDRY TRAY p WATER HTR (536► FOR IRRIGATION
WATER METER OTHER
Permit Fee $ _ 3 MINNAUM: $15.00 or S% of cost of the Improvement -whichever is
Plan Review S greater on work less than $300
Surcharge $ .50
TOTAL DUE $ _15"92 v Make checks payable to: City of Fridley
I -His is AN APPLICATION FOR A PERMIT- NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing pamit and I acknowledge that the information above Is comptete and accurate: that the work veli be In =far mance with
the ordinances and codes of the Cllr of Fridley and with the PAnnesota Construction Codes: that I understand this is not a permit but only an
application for a pamhit and work Is not to start without a permit that the work grill be in accordance with the approved plan in the Case of at work which
requires review end approval of plans.
NAME OF APPUCANr_r IS 0 DATE /J-3-0
Please type or p int
SIGNATURE OF APPLICANT
TOTAL P.01
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit# 6;zo
Residential Application
City of Fridley
See Back Side For Required Information
Date bS Site Address e — AM Stevo!ff'f
The applicant is: (cirice one) Owner Contractor
Property Owner:
Addre ;
City: State: Ak Zip:
Phone: 3 4 P Cell: Fax:
Contractor Informatioiver City Sheet Metal, Inc.
Company Name:
Contact Person: 829U M—a—In—WIT.E.,bite 39
Address: TrIdley, MN 55432
City: gW) 7 -2 9 Rte s Zip:
Phone: Cell: Fax:
Email: MN Bond# & Exp Date
Type of Work (circle one): New lace Alteration/Remodel
Detailed escription of work:
a
Equipment Installed: MFG: Model: Size/BTU:
MFG: alb Model O4.10-7-6 _ Size/BTU:
MFG: Model: Size/BTU:
Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00
,4/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00 Umace $35.00 _Pool Heater $35.00
_Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10.00 _Gas Piping $10.00
Duct Work $10.00 Gas Range/Oven $10.00
Permit Fee $ 0 (Total from above -Minimum fee $35.00)
Surcharge $ 0.50
Total Due $ Make check payable to City of Fridley
This is an application for a permit- not valid until processed
I hereby apply for a mechanical 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 case of all work which requires review and approval of plans.
Signature of Applicant: e4l� VrA Date://—
Approval
ate: —Approval Inspector Signature: Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Revised 6/14/2005