PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
� N. '7184
Date: y
Owner:" Builder
•
•
Address Address
_ LO TION OF BUILDING
No. r6 Street -- Part t
Lot _ Block Ze Addition or Sub -Division .
Corner Lot — Inside Lot �- Setback v® r _ Sideyard
Sewer Elevation _Z��, Z4� ._ _ Mnktion Elevation
DESCRIPTION OF BUILDING
T Used . r
Front Depth Height J-0 Sq. Ft. cu. Ft.
' t _ Depth Height Z O Sq. Ft. Sa Cu. Ft. '-Tv
Type of &instruction 6 Est. 1j:5 1I23� ?& be Completed
In consideration of the issuance to me of a permit to copReb��� �%I �to do
the proposed work in accordance with the description above se ons of
ordinances of the city of Fridley.
In consideration of the payment of a fee of V'23 —_� , 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 location, construction, alteration, maintenauce, repair and moving of buildings
within the city limits and permit mayberevoked at any time upon violation of any of the provisions of said
ordinances. _
NOTICE:
This permit does not cover the construction, Installation for whhng, plumbing, gas heating, sewer or wafer. Be vera to see
the Building hisactor for separate permits for these Hems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNERS NAME �6641_� BUILDER
ADDRESS ADDRESS
LOCATION OF UUiLDING
No. Street -:3 /1-Q J 0- Part of Lot
Lot —vg Block Addition or Subdivision_ �--�,
Corner Lot Inside Lot__4_Setbadk 3 S Side Yard
SETTER ELEVATION
FOUNDATION ELEVATION
/0
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. 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 S
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plumbing and &n fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
I
0Op!!
C
Estimated Cost, $
Z
PLIIMBING FIXTURE RATES:
Z
Z
m
J
Z
(�SuS
ZZ
Z
�U' 0
F
N
WATER HTR.
GAS
ELEc
Base
$
Business Phon J ..
Catch Basin .... .....................
x 3.25
$
Water Heater (Up to 200,000 BTL) ......
x 2.00
$
New Ground Run Old Bldg. ...........
x 3.25
$
ROUGH
FINAL
1st
NO. RATE TOTAL
1st 3 Fixtures ..........................
%
$ /, :ri9
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
2nd
3rd
4th
• Future Connection Openings
+x New Fixture, Old Openings
I
Connected with
Sewer �
Cesspool
Dept. of Bldgs. Phone SII 4-7470i� N. ,/�
Location — E S h J . I1
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do an work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct. �j
Mi
Fridley, nn T —// r� 19—T
Owner Cen l_.frl'12 .QTY
Kind of Buildingyck//ten �
Used as P") P, /J
To be completed about
PARTIAL RATE
SCHEDULE
Estimated Cost, $
°� /
Old New Building Permit No b Permit No ."--�
PLIIMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
$
Signe
Future Fixture Opening ................
x 1.20
$
By
New Fixture Old Opening ..............
x 1.00
$
Business Phon J ..
Catch Basin .... .....................
x 3.25
$
Water Heater (Up to 200,000 BTL) ......
x 2.00
$
New Ground Run Old Bldg. ...........
x 3.25
$
ROUGH
FINAL
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
-roe
x $1.50
$ /, :ri9
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE •'S 42
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 $ S _ 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
$
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. IDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal. per hour .......................
5.00
$
t . over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) .......................
5.00
$
5.00
GAS FITTING FEES:
NO RATE
TOTAL
1st 3 Fixtures ......................
x $1.50
$
1.50
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
Dept. of Bldgs. Phone SII 4-7470
Location 4575 - 3rd St.
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 9-9 19 64
Owner Remco Construction Company
Kind of Building Frame
Used as Residence
To be completed about 10-9-64
Estimated Cost,
Old—New. Building Permit No.
Permit No. I�
OF WORK
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No 1
Trade Name Westinhouse Size No GUa-100
Capacity Sq. Ft. E.D.R loom BTU H.P.
Total Connected Load40_-125 Kind of FueL GAS
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU A.P.
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $ Signe FRED VOGT & G®'
ALTERATIONS & REPAIRS TOTAL FEE $ 14.50
By 3260 Gorham Ave. o qtr 9-6762
ROUGH -Sf- Louis Park 26, Minnesota
42 2M Business Phone No
FINAL
(REMARKS—OVER)
SUBJECT
-
City of Fridley
31010
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
17
r � � PROTECTIVE
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910 -FIS
6/2/00
JOB ADDRESS 4575 3 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
27,28
16
1 Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Don Yeager 4575 3rd Street NE
998-1481
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside front of house
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires
that a weather
resistive barrier be placed over exterior sheathing to
protect the interior
wall covering. Exceptions for this provision would be
if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering
unless the manufacturer
states this in their application guidelines. Call for
inspection of wrap
before covering.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
$1,200
$.60
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-
C $1.20
STRUCTION THE PERFORMANCE OF CONSTRUCTION
$44,85
Fire
PLAN CHECK FEE
TOTALPE
-
i�-�
/
$4 .65
IGNA UAE O� N•RACTOR OR AUTHORIZED AGENT tDATE.
EN 15ROPVALIDAT D MIS IS Y WA PE R.MIT as.�
/
NAT AE --NEA .-f OWNER BUILOER, iD
BLD iNSP
4L�1
MATE
NEW [ ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION l J
Construction Address. •� `7 67 S7 -
Legal Description:
Owner Name & Address: Is s.o 'mow-,. _a r s� S' $ ^a �a Tel. #
Contractor: 6 -ail Al A-41- I MN LICENSE _
Address:, (� — Tel. # �� - l frg_l CG f Z ")
e -
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 Widthgt/Ground Sq. Ft
OTHER: -2S t a.vcA a� 4 ®—/c.C�i'��
Construction Type: Estimated Cost: $ ®o
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: A 04 APPLICANT: 4, Tel. # ? "OT
/
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in applicationj�
Permit Fee $�^ Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $
Driveway Escrow
Erosion Control
Park Fee
$5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
$ 9& , 4_,-5'
CITY OF FRIDLEY PERMITO.: 2004-01351
6431 UNIVERSITY AVENUE NE___)
FRIDLEY, MN 55432 DATE ISSUED: 08/17/2004 '
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 4575 3 ST NE
PIN : 263024330084
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL A FURNACE (WARM AIR, RUUD, 60,000 BTUS) AND AN AIR CONDITIONER.
# A/C UNITS 1 # FURNACES
1
# GAS DRYERS 0 # GAS RANGES
0
VALUE (FOR MINIMUM CALC) 4700
APPLICANT
HEATING PERMIT MINIMUM FEE
FURNACE SHELL/DUCT WORK
0.00
35.00
CENTERPOINT ENERGY/MINNEGASCO
13562 CENTRAL AVE NE
GAS RANGE FEE
0.00
ANOKA, MN 55304-
GAS DRYER FEE
0.00
AIR CONDITIONING FEE
25.00
STATE SURCHARGE, MECH FLAT
0.50
TOTAL
PAID WITH CHECK # 5954
60.50
OWNER
GERVING CHRISTOPHER D
4575 3RD ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
re lating construction or the performance of construction.
Applicant Dat
I
Bldg Ins i D4
SEPARATE PERMITS RE U1RED FOR WORK OTHER THAN DESCRIBED ABOVE.
;ITY OF FRIDLEY BUILDING INSPECTION
8 4 4 4 2 Effective 4/1/2004
M
9 3431 University Ave NE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
9=rldley, MN 55432
L
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
763-5T23604 FAX 763-571-1287
S)
JOB ADDRESS L4 6, 5 3 S E -
D
RATE SCHEDULE Fee Total//11
br Ce a y -V i
Residential
Owner
Furnace Shell and Duct Work, Burner &
3 -5 -CO
Building Used
also Replacement Furnace $35.00 $
ESTIMATED CPERMIT NO
Gas Piping (New Furnace, Fireplace, Insert) $10.00 $
Gas Range $10.00 $
DESCRIPTION OF FURNACE AND BURNER
Gas Dryer $10.00 $
# of Heating Units Circle One (Steam) (Hot W ter) (Warm Air)
%L%uv d V QI R k - 61.00 No.
Trade Name
*Air Conditioning -All Sizes $25.00 $ 26- CO
BTU 60.000 HP EDR
1'i u o a h P6 fY1 C 0 aLLI --TA z-
Fuel Nom• Qk a -s Total Connected Load
All Other Repairs or Alterations (List on Back)
Size No.
r 1% of Value of Appliance or Work $
Burner Trade Name
EDR
a Minimum Fee $15.00 for Residential or 5% of cast of
BTU HP
Y Improvement whichever is greater on work less than $300.00
.
The undersigned hereby makes application for a permit for the work herein
5 Commercial/industrial/institutional
specified agreeing to do all work in strict aocordance with the City Codes
1.25% of Value of Appliance or Work (List on Back) $
and rulings of the Building Division, and hereby declares that all the facts
Minimum Fee $35.00 for Commercial/industrial/institutional
and representations stated in this application are true and correct.
CENTERPOINT ENERGY MINNEGASCO
Y State Surcharge $ .50
HEATING CO 13562 CENTRAL AVE NE BLAINS, MN 55304
1 TOTAL FEE $
Signed Te! ,g763-757-6202
v
REINSPECTION FEE $50.00/HOUR
FAX # - - Date
*Air Conditioners can not be placed in side yard without written approval
rm from adjoining property owner - copy to City
r
ry
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Approved by Rough -in Date Final Date
Ee ' d ldlol
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, 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 (y). 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 (1 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 installing a new venting system, the undersigned hereby verifies that
R is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA -LAMA 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 t -LAA - BTU Input L 10, 61k"' Fan Assisted or Nat f r4 yL°�a
Appliance #2 Type tA, ke4,t- BTU Input --'e' !aFan Assisted or Nat T
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances �. Total Btu Input
Common Vent Type at Vent Height i Diameter inches
Appliance #1 Vent Connector Height ft Length ,eft Diameter _:in Type P ✓e -
Appliance #2 Vent Connector Height _eft Length c ft Diameter 4Z "-in Type C
Appliance 93 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe) 1�- Zf3e t OR.4v�-��--
Y/L�L
1.
_ L/ f r n-ul
CENTERPOINT ENERGY MINNEGASCO
HEATING CO: 13562 CENT AVE NE BLAINE, MN 55304
z
Signed By: Date
J
FRIFG1 ' A rn)' 1.Sb 01 A91Q 1 NA AO ,ll 1 O WON -1 SP : T T b002—LE—Ncki
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 VAX: (763) 571-1287
PERMIT NO.: 200401352
DATE ISSUED: 08/17/2004 z
ADDRESS : 4575 3 ST NE
PIN : 263024330084
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A FURNACE AND
AN AIR CONDITIONER.
# INSPECTIONS 1
APPLICANT
CENTERPOINT ENERGY/MINNEGASCO
13562 CENTRAL AVE NE
ANOKA, MN 55304 -
OWNER
GERVING CHRISTOPHER D
4575 3RD ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 5954
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.