PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMITNo (6 65 8
Date: __ ..... ��.._.._.._.........._._..._-._....._....�
Owner:
Builde '
Address..._....... ......_. ...._ _...._ _ ..---....-..__._...__.._.._......-_-_ Address __--
s O N OF BUILDING
NO.. � .. Street✓ _ .
Lot ..- f�..d�_ Block _ _ - ...._......_.._.-........ Addition or Sub -Division _
v`
Corner Lot ... .Lir+� _Inside Lot .... _............ ..... _....... _.... Setback _..,�...._-_...4Seyrd
Sewer Elevation ...._..._._.__....... .._..___........................... Foundation Elevation ............. _._............... ...
DESCRIPTION OF BUILDING
jT Upd-Front �� Depth .... Height .�.. Sq. �:Cu. Ft.Front _ _ . De th i ht .�_� p ..i%- g ....-�� Sq. Ft. -{. .. Cu. Ft.
of.. -_ Est.��Cost !L jo.be Completed ..._.......�._ ........_._
Ar
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.
a ,
In consideration of the payment of a fee of $ ..... ___._.., permit is hereby granted to ----
to
o....-- _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 bw1thIn the uildings
ordinances, limits and this permit may be revoked at any time uMnAviolati=jDf any of the provisions of said
1. -d Gddidot-M Building Inspector
NOTICES
This permit does not cover the construction, Installation for wiring, plumbing, gas boating, sewor or water. M sure�Wlo
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
NAME
BUILDER
ADDRESS
ADDRASS./
s
LOCATION OF BUILDING
No. Street ? Part of Lot
Lot/G Block ZVI Addition or Subdivisio
Corner LotInside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To beu as :
..� Front pth Height
01 Sq. Ftj �aT-,-� u. Ft.
Front % Depth-- Height
Sq. Ft.
Cu. Ft.
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 SIGNA �s/�%�✓ vyLi�-'^�"
(schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
q
Z
88
U'
Z
0O
•
F
•
N
WATER HTR.
GAS
ELEC
Base
1st
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings I
Connected with
Sewer ❑
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
�
Number Fixtures ...................... x $1.50 $/4
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ f!
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $Zr 4®,
_ - -r s�-
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
Owner
Kind of
Used as ��evc— /- 4
To be completed about �� ✓� '�
Estimated Cost, $ z�'
Old— ew. uilding Permit No, ® Permit No.
ROUGHT v / / '-4-3-
FINAL
42 '2M
Business Phone
Application for Power Plants and Heating, Cooling, Ventilation, .Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU .... . .................. 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 5.00 $
Repairs .& Alterations each add. $500.00 ....... :...... 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam....... 8.00 $ 0 >
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water ...... ........... 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
W.
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ I�
Additional Fixtures ...............:. x .50 $
Gas Range to 200,000 BTU .......... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $
ROUGH—
OUGH
FINAL—
FINAL
Dept.
Dept. of Bldgs. Phone SII 4-7470
rv/ _ & .
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.
Owner
194=7
Kind of Building
Used as e✓" p�
To be completed about , ® xs—
Estimated Cost, $ J--">
Old a uilding Permit No. Permit No. 11Z 1�clk
DESCRIPTION OF WORK
HEATING or PO R PLANTS— Ste H�Wa�terarmAir—No
Trade Name --t-� Size No
Capacity Sq. Ft. E.D.R BTU H.P.
f 5-0 °f
Total Connected Load • . G% Kind of Fuel
BURNER — Trade Name Size No
I� �'
®
Capacity ®® Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
kjz s ��
HEAT LOSS CALCULATIONS DEPARTMEN OF BUILI?INCS i IOSEVILLE, MINN.
Weatherstrips A.S.H. .E.
Construction No.
Width Height No. of Lineal ft. Ara
No. of pane of pane lights of crack sq. eft.
3v
OP
Guide
Infiltration2W
Glass
Coef. Btu
Infiltration 117
Exp. wall
Net exp. wall
Glass
Exp. wall
Windows
Doors
Refer a
Out. Wall
Int. Wall Ceiling
Roof Floor
Floor
Kind
Yes—No
I Yes—No
19
F1.1 Room I Length Width
Height
Room I Length
Windows and Doors—Crackage and Area -
\Vldth Helght No. of Llneal tt. Area
No. of Dane of Dane lights or craelt sq. ft.
Infiltration
Glass
Exp. wall J
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l 7N) W )ad /—Room I Lenath Width Height
Windows and Doors--Crackage and Area
A7
Width Height No. of Lineal ft. Ara
No. of pane of pane lights of crack sq. eft.
3v
OP
2 2
Infiltration2W
Glass
Coef. Btu
Infiltration 117
Exp. wall
Net exp. wall
Glass
Exp. wall
?a—
Net exp. wall
O -770
Int. wall
Ceiling
Ceiling
Floor
Floor
Q I(a
Total Btu.'
Required sq. ft. E.G.R. or sq. ins. W.A. Leader area
9 Fl.l 1 _ir '' Room I Lenttth Width Height
Windows and Doors—Crackage and Area
�, r
Width Height No. of Lineal ft. Area
No. of pane of pane Itghta of crack eq, ft.
3v
OP
2 2
Infiltration2W
Glass
3
Coef.
low
®,
t
Exp. wall
Net exp. wall
Q
Exp. wall Z
Int. wall
Net exp. wall
Inc. wall
Net cap. wall
Ceiling
Int. wall
Floor
Floor
Floor
Total Btu.
Req
sq. ft. E.D.R. or sq. ins. W.A. Leader area
Insulation
How Applied
Width Height
Windows and Doors—Crackage and Area
/
Wid4He No. of Llneal ft. Area
No. of Dlights ofcrack eq. it.
3v
OP
2 2
Coef. Btu
Infiltration
1o -16 ej
Glass
O
Exp. wall Z
Exp. wall
Net exp. wall
Inc. wall
Net cap. wall
Ceiling
Int. wall
Floor
O
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
A M I AGLArTtl Rnam I Lenath Width Height
W Windows and Doom--Crackage and Area
C3
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
2 2
f. Btu
Infiltration
0
p
Glass
Exp. wall
0
Net cap. wall
Int. wall
Ceiling
Floor
Total Btu. t Zp go
Required sq. ft. E.D. or sq. ins. W.A. Leader area
/ 0 1 U-1 'I hri nnm I I Pnath Width Height
Windows and Doors--Crackage and Area
Width HeightNo. of Lineal ft. Area
No. of pane of Daae lights of crack eq. ft.
2 2
ef. tl�
Infiltration
Glass
0
p
_
Exp. wall
Net exp. wall
Int. wall
Ceiling • p
Floor
0 p
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
//,0-
F f�rkK® Z)1�q, -- Ize0
HEAT LOSS CALCULATIONS - DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
WindowsI Doors Refereme Out. Wall Int. Wall Ceiling Roof Floor
Yes—No Yes—No 19—
I SIJ A . _B / Rnesn I L.enath Width Heistht II Fl.�
Windows and Doors—Crackage and Area
,
WidthHelght No. of Lineal ft. Area
No. or pane of pane Ilgh a of crack sq. ft.
'L CO Z
16 7L.
Coef. Btu
Infiltration
Btu
Glass
Exp. wall
Net exp. wall
p
01 lie
Int. wall
Glass
Ceiling 30
101 pip
Floor
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I Fl.l A. J 7 _ Room I L.enath Width Height
Win ws and Doors—Crackage and Area
9�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
16 7L.
Coef. Btu
Co f.
Btu
Infiltration
D
b
Glass
Net exp. w
166 0
Exp. wall
Floor
Ceiling
Net exp. wall
b
G
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 IIA Room I L.enath Width Height
ROSEVILLE, MINN.
Insulation
Kind How Applied
R.nm I 1 moth Width Height
Windows and Doors—Crackage and Area
9�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration %
U
Glass
Exp. wall
Exp. wall A P1-
Net exp. wall
Int. wall
Net exp. w
Ceiling
d O
Floor
Ceiling
Total Btu. b
Required sq. ft. E.D.R. or sq. ins. WA.Leader area
FI.I Room I Length Width Height
Windows and Doors—Crackage and Area
9�
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
U
Glass
d
Exp. wall A P1-
Net exp. w
fp
Int. wall
Ceiling
Floor
O Total Btu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
m I RMm I 1 moth Width Heisrht
Windows and Doors—Crackage and Area
9�
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
U
Glass
d
Exp. wall L 4
Net exp. wall
Int. wall
Ceiling
Floor
fp
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
C.
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. tt.
Coef. Btu
Infiltration
Glass
_
Exp. wall
Net txp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
V
01
SUBJECT
Po
City of Fridley
19055
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_
CEIPT NO.
�
1 • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 1
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/7/87
JOB ADDRESS
4501 - 3rd Street N.E.
1 LEGAL
LOT NO.
BLOCKTRACT
OR ADDITION
SEE ATTACHED
DESCR.
16,17
I 16
Pl ou: Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jessie De'arlais 4501 - 3rd Street N.E.
572-1563
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
Reside Dwelling
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Steel
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
$6,000
$3.00
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-
$56.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$59.50
ySIGNAT FCONTRACTOR UTHORIZEDAGENT IDATEI
WHEN PROPERLY VA ATED THIS IS YOUR PER IT
lea
SiGNATURE OF OWNER IIF ER UILDE I IDATEI
4
Ajz..e
BLDG INSv
TE
V
01
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address:
Legal Descriptio
s
Owner Name & Address:
Tel. #
Contractor: `� ____— Tel. #
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
Hgt/Ground
Sq.
Ft.
OTHER:
4.�.o
Corner Lot L l
Inside Lot [ ]
Ft. Yd. Setback
Side
Yard
Setback
Type of Construction: Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: ') ".*7— 2_7 APPLICANT: ��� Tel.
CITY USE ONLY
Permit Fee $ s� Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ Q U $•50/$1,000 Valuation
SAC Charge $ $ 525 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary L ] Not Necessary [ ]
TOTAL $ a�9 S�
STIPULATIONS:
SUBJECT
PVRMIT
City of Fridley
1.9569
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_
rp
EIPTNO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
1 ; �
l 1� ��'���,,J CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
--•-
L 612-571-3450
910-F15
6/28/88
JOB ADDRESS 4501 - 3rd Street N.E.
1 LEGAL
LOT N0.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
16,17
16
Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jessie DeJarlais 4501 - 3rd Street N.E.
572-1563
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
AMRE 3700 Annapolis Lane, Mpls., MN
631-0450
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 x❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 161 x 161 Deck Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
1
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
WI H WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1.,750
$.87
DOS NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR SIOE OTHER STATE O LOCAL LAW REGULATIN CON-
ST CTIOERFORM
$41.00
XOFNSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
c z
$41.87
SIGNATUR OFC NTRACTO O AUTHORIZED AGENT (DATE)
WHENPROPERLY VA ATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) 1DATE)
BLDG )NSP
IATE
NEW [ ] City of Fridley Effective 5/1/88
ADDN [ ] R-1 AND R-2
r'
AMER [ ] Building Permit Application
Construction Address: ��� ye�
Legal Description:--. LOT -S n Mo, -W
Owner Name & ress: V f,i.5 ( �� Tel. #
Contractor: id'1 c Tel. # �i -OS�
Address:�C�
Attach to this application, a Certif icate of Survey of the
lot, with the proposoed construction drawn on it to scale.
DESCRIPTION OF IMPROVIIMENP
LIVING AREA: Length Width Height Sg. Ft.
GARAGE AREA- Length Width Height Sq Ft.
DEM AREA: Length l6 Width �� Hgt/Ground Z6 1.4
Sq. Ft.
LEM6:.
Cbrner Lot [ ] Inside Lot [ ] Ft. Yd Setb@Lck V0 Side Yard Setbacks
Type of Construction: -T"44AEstimated Cost:
Approx. Completion Date: / -
Pa L 16 a I a �� �'� ��� Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: 5 5
Width + ' See Back Page
DATE: S APPLICANT: /ATel. # S v
CITY SE ONLY
Permit Fee $ 0030
State Surcharge S
SAC Charge $
Driveway Escrow 5
Park Fee 5
Sewer Main Charge 5
Sl'IFULATIONS:
$ I®
Flee Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC Unit
Alt. "A" or Alt. 'B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
0 0