PRE 2010 DOCSS
Village of Fridley, Nflun.
Office of INSPECTOR OF BUILDINGS
Architect '' p Fridley, Minn._ 19
Builders
F° LQCATION OF BUILDING
No. Street: 'a ---Part of Lot
Block Addition or Sub -Division
Front Pepih %-
DEw3CRIPTION OF BUILDING -
Height ' _'"`� Stories Manner of Construction
To be used as ' * To be completed x Ri Estimated
`�
�•.r` ,J u.�e,. �. �.4tt�], �o �T=`�2'�. nk. .t.,:; TM� �'I �. r 5 �'�4�' ;'�-; 4 v,�r
Permit is hereby granted io �'�' ``r''�' to � + ```" �-• F
the building described in the above statement. This permit is granted
upon the express cgndition that the rson to whom it is granted, and his agents, employees and workmen, in all
the work done in, 'laround and upon "said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the 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
e
ordinances.
F� ,+ Spector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consider4tion of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth And according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby] state and say that the facts stated by me and contained in the above permit are
true as therein 0tated.
11
Subscribed and, sworn to before me at Fridley,
day of ,,',;tea x A.D. 19A. -L.
r—
U
yyyyyy d° r„r,
t '
Minnesota,,_
v
L
SUBJECT
PERMIT N
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
.13503
r
ECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
t . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
812-560-3450
910-F15
15/6/76
JOB ADDRESS 4647 = 212 Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
28 & 27
10
Plymouth Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Thomas Manning 4647 - 211 Street 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
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Structure
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
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
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
$300
• 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.
$5.00
PLAN CHECK FEE
TOTALFEE
$5.50
SIGN,A REOFCONTRACTOR ORAUTHO EDAGENT;
WHEN PROPERLY VALIDIDA�T,ED THAIS/IS YOUR PERMIT
(((DATE) %
BLDG INSP DATE
SIGNATU OFOWNER(IFO NERBUILDERI IDATEI
L
APPLICATION FOR RISIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME 3SIP00if-5 BUILDER:
ADDRESS: �f� / �a •7i• ' i� + �r ADDRESS: e
NO:. STREET:
LOT :2 "'.2 BLOCK: �� ADDITION: 1V'07.pu
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. of,
DESCRIPTION OF BUILDING
To Be Used As:
X}01 a Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: iGZ Estimated Cost:
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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: Aao4 SIGNATURE:
0 A99�4&
(See Reverse Side For Additional Information.)
•P�
' SO
F
.I
SUBJECT
EMIT NO.
City of Fridley
23586
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
-RE CFLP---
______ COMMUNITY DEVELOPMENT DIV
I L PROTECTIVE INSPECTION SEC
r
NUMBER
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
171
7/31/95
JOB ADDRESS 4647 2 1/2 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
27,28
10
Plymouth
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Katherine Hofford 4647 2 1/2 Street NE
571-4585
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
R & M Associates 3482 Auger Ave, White Bear Lake, MN 55110
770-9322 4391
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 0 ALTERATION QX REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House, Reroof House (12 Sq) Tear -off, Install 4 windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Windows being
changed in sleeping areas must 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
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
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
$10,000
$5.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE $10.00
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC7rqN OR THE PERFORMANCE OF CONSTRUCTION
$117.00
Fire SIC
PLAN CHECK FEE
TOTALFEE
—
License S 5.
$137.00
SIGNA RE bF CONTRACTOR ORAUTHORIZED AGENT IDATEI
PEEVATED THIS IS YOUR PERMIT
&WHEN
BLD INSP
DATI1F�
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW (( Effective 8/1/95
ADDN (( CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R -I AND R-2
Building Permit Application
Construction Address: 7 �
Legal Description: —
Owner Name & dress: z. c
Tei. #
MN LICENSE #
Contractor: "1` h✓I Ci —
Tel. # %® -73 `L
Address:
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 H Ground Sq. Ft.
OTHER:
Comer Lot [ } Inside Lot [ } Ft. Yd Setback Side Yard Setbacks
Type of Construction: S e d L fi 16on F Estimated Cost:
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft 6 Ft = Ft x $ _ $
DATE -Y- % )' APPLICANT: Tel. #-V—&, "
CITY USE ONLY
Permit Fee
$
f%,
Fee Schedule on Reverse Side
Fire Surcharge
$
l0 , LI O
.001 of Permit Valuation (1/10th%)
State Surcharge
$
S-,00
$.50/$1,000 Valuation
SAC Charge
$
$850 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.0 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ } Not Necessary [ ]
TOTAL
$ 3 CC)
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
r
Stories I' Urir
__.W. rowe .a p12!2�kry{�c�4
Floor 1
Floor 2 _�
`IN100 dvvl ' i,.
-�_`_::h ..
Floor 3 r
Floor 4
r F
PLUMBING FIXTURE RATES:
Effective On August 1, 1995
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
NO. RATE TOTAL
New f=ixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater --Electric
$ 7.00
Water Heater – Gas**
$1040
Gas Range** ; ,
$10.00
Gas Dryer**
$10.010
Back Flow Preventer es LLNo
Reiftspection Fee $42.00/Hr
BALL OTHERS AND/OR REPAIRS AND ALTERATI
State Surcharge .50
TOTAL FEE $ 0
'r
JOB ADDRESS � rc
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.
11
Owner
d
Bulfding Used As
Estimated Cost ���'��c?� PERMIT NO.
y
PLUMBING CQMPANY�,�
SIGNED BY TEL N0. —
Approved B Rough–In Date Final Date 7
MINIMUM FEE FOR ANY PLUMBING GAS PER f,T' IS $20.00
PLUS STATE SURCHARGE
**COMBUSTION AIRSHALL 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,
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
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
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.
TOTAL
JOB ADDRESS
OWNE
Effective On January 1, 2000
BUILDING USED AS
ESTIMATED COST
.���7\C� PERMIT N0. � e�
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heatin Units Circle One (Steam) (Hot Water (Warm Air
$ Trade Name t5r ,� 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
HEATING CO
Signe�. TEL #
Approved By Rough -In Date Final Date l �I ���-
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 X 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 NA No( )
When installing a new venting 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 Tyne 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 ,_e 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: Mescribe)
I 4 =fin CSC,.
4
HEATING CO:
Signed By:\
AZ a'A Date : �tfJj
/ O !�
SUBJECT
PERM
City of Fridley
3 219
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
`y _ _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
®®
r
E � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
��'
763-571-3450
910-F15
10/29/02
JOB ADDRESS 4647 2 1/2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
27,28
10
Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
ate Hofford 4647 2 1/2 Street NE
763-571-4585
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Taskmasters Handyman Service Inc 7411 152 Lane NW, Ramsey, MN 55303 612-363-4538
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20249328
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK ❑
❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Convert window into sliding patio door
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310..9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings. See notations on plan.
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 BO 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
$2,800
$1.40
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISI0 S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$83.25
Fire SC $2.80
STRUCT N OR THEERFOR UCTION
PLAN CHECK
OTAL FEE
�k.NAkCO i6TOAUTHORIZEDAGE
Lic se C 15
00
$92.45
NT iDATE,
HEP
RLY V ATED THIS IS Y^OUR ERMIT
/4/
S,GNATURE OF OWNER,1F OWNER BWLDERi iDATE,
/ O !�
NEW (] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
r.nnstructien Address- q ( Li -? 9./x -54,-e-
Legal Description:
Owner Name & Address: Tel. # 7��
Contractor1---�s MN LICENSE #
Address: "?9/I - /� �e '�°' 05 s��w�e `r OAA -7 Tel: # �/� - ��3 �/ 3-319
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:�5
Construction Type: Estimated Cost: $ P
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: APPLICANT: Sc 0,,-U) J -ns ! Tel. # 0a ^3(13 A52
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.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway.Escrow
Erosion Control
Park Fee
Sewer Main Charge
$
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 [ ]
TOTAL $ e7. STIPULATIONS:
4pkvo
8
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C,.'Ale�, AAAI 55 ya 1
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RIC- res �� , v l/j 5-5-3e--)
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