PRE 2010 DOCSi •
Village of Fridley, Minn.
BUILDING PERMIT
N° 819 Office of INSPECTOR OF BUILDINGS
Architect
Builder
Z' p 19"`
Fridley, Minn.,
LOCATIO2 OF BUILDING
No. Street- Part oP Lot
Lot ` Block Addition or Sub -Division
t I
DESCRIPTIONOFBUILDING p�
Fro t,--. Depth Height Stories Manner of Construction
To be used ad� tw '- To be completed ' Estimated Cost —L
Permit is hereby granted to . e
the building �'"`" ` 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 in, around 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
ordinances.
C C Inspector of Buildings.
;.r
AGREEMENT AND SWORN STATEMENT
In consideration 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 stated.
Subscribed and sworn to before me at Fridley,
day of A.D. ice'` Y..
Minnesota, this `
J
If' '
ii
�I
i
WELDING PERMT
Village of Fr�,dley, Minn.
l N° 2030
,I
Date ....(k,.A
......
Owner Builder ...... ...........................
Address ... �7.® /�...::.. ��:....... Address
*s LOCATION Off' BUILDING
No.. . !..... Street ..�i, .6', ...... ... Part
.Lot .. *: + :: ?..:. Block :'...... Addition o
Sub -Division ,
.. !
Corner Lot .:...... + ... Inside Lot .. Setb ick idey
DESCRIPTION OF BUILDING
To be Used as:
/ • . .. Front .. Depth . . Height-. .`. Sq.
......... ......... nt ........ " Depth'.... .Tleight .. ... Sq.
Type of Construction'Est. Cost!.. ....`... To be
Lot.......................
T........ ...............
........ Cu. Ft.........
....... Cu. Ft ........
pleted ...........
jl
�I
9 ,I
II P
In consideration of the issuance to me of a'permit to construct the building �1,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 village of Pridley.
.i. ... ..
In consideration of the payment of a fee of . e.60" ... ./. " ....... , » .... .
I�3'm $° a permit is ,hereby granted � to
................ . to construct the building or, addition as described abov�, 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 l respects to ,the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repai�' and moving of buildings with -
In the village limits and this permit may be revoked at any time u n violation c any of the provisions of said
ordinances.
..... r.. .. Cr°'". Building Inspector
NOTICE:
This permit does not oover the construction, Installatlon or alteration for ,iviring,.plumbing, gas heating,
sewer or water:' Be sure to see the Building Inspector,' for separate 'permits foK these Items.
Application for Power Plants and Heating. Cooling. Ventilation, Ref igerand
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE DepA of Bldgs. Phone SU 4-7470
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 $
MECIL 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. EDR 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. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x $1.50
$
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
e
REMARKS:
IL
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 arSArue and correct.
Fridley, Minn— - 195
Owner '�.eE �� s. L�—a 195—
Kind of Building
Used as
195_
To be completed about
Estimated Cost, $ 4e, 6- r, 6D
Old --Building Permit No. =U --C -
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 Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
11 POST IM -12-58
City of Fridley
53-84-5915.51
Application for Plumbing md G= %ting Pemdt
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK Locate 11627 NE • 3 St.
Number, Kind and Location of Fixtures
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 ..............
x $2.00
$
x $1.50
$
x $1.50
$
x $3.25
$
x $3.00
$
z
$
z $2.00
7z
UN'
i
F
N
WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• Future Connection Openings
s New Fixture, Old Openings I
Connected with
Sewer El
Cesspool
El
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 ..............
x $2.00
$
x $1.50
$
x $1.50
$
x $3.25
$
x $3.00
$
x $3.25
$
z $2.00
$
NO. RATE TOTAL
l x $2.00
$ 2.00
x $ .75
$
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ..stall (1) gas lite QQ
.......................................$ 3.
TOTAL FEE $ 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 fact
and representations stated in this application are true and correct.
Fridley, Minn-NOV- 9s 1970 , 19_
Owner Dallas Nelson
Kind of Building frame
Used as residence
To be completed about NOV.13, 1970
Estimated Cost, $10.00
OldgNew. Building Permit N Perot No. o; 7
s
i
-109
By ��ppn�°� ��
Business �x UM POLIS
ROUGH
FINAL_; " 1 ' �
01
SUBJEGT
1 PERMIT
City of Fridley
2 9 219
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`L __�___ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC
�
17 PROTECTIVE
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY MALL FRIDLEY 55132
612-571-3450
910-F15
4/15/99
JOB ADDRESS 4627 3 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
20,21
9
Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Barbara Otremba 4627 3 Street NE
572-8886
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Aspen Roofing & Siding 2735 Cheshire In, Plymouth MN 55447 577-3710
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20158715
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [I REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reroof House & Garage (15 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State
Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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 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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,285
$.64
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-
STRUCT R THE RF NCE OF CONSTRUCTION
s
PLAN CHECK F
TOT L FEE
Lic se SC
$ 00
$49.9
(414A Q76F CO AACTOR ORAUTHORIZEOAGENT I TE.
MEN/PR
VALID THIS IS090A
E�
00,
S-GNATURE OF OVVNERi6 OWNER BUILOERt IOAfE
BlG IS
f)ATE
01
NEW [ ]
NEW[ a ] CITY OF FRIDLEY
ADDNALTER [,j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
11 BUILDING PERMIT APPLICATION
ConstructionAddress :
Effective 1 / 1 /99
Legal Description:
Owner Name & A dress: xz OA44Tel. #—(0 ll
Contractor: ooG/,�1� r 'J�►� �� MN LICENSE #
Address: 7�7 coem(Re- Li'l, Tel.
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:
r—e)to�6tiConstruction Type: QQ o� c -�oo� Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: �% APPLICANT: �u Tel#�y� - x'77- 3 710
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
S 4-19, g.2
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
CITY OF FRIDLEY BUILDING INSPECTION
3431 University Ave NE
=ridley, MN 55432
763-572-36`04 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
0DC7— Ob :31i
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS pl Z1 3'"d f2t n
Fee Total
Owner V'q CAye lm
$35.00 $ 35.00 Building Used As Residence t
$10.00 $ ESTIMATED COST tD_210 . c0 PERMIT NO =
_ - t
$10.00 $ DESCRIPTION OF FURNACE AND BURNER~
$10.00
$25.00
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater, on work less than $500.00
Commercial/Industrial/Institutional
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
$ # of Heating Units 1 Circle One (Steam) (Hot Water) Qrm i
Trade Name -MCP o1MPVi5 Size No.
$ a5%1' BTU _15DC>0 HP EDR
Fuel Natural Gds Total Connected Load
$ Burner Trade Name 2.CPCRCyZ Size No. o� ''b1nS
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
$ and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
$ .50 HEATING CO_ Home Energy Center
$ (.D.50 Signed Tel 0763-476-1990
FAX # 763-476-1143 Date .5-9 -05
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Approved by Rough -in Date Final Date
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. 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. YeSK No
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
YesK 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
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 Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type Fu rr 2 BTU Inputs 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 5 jD
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
ALTERATIONS: (Describe)
1 M nGtMl'Ry GEMEII
200 25TH AVE. N #128
HEATING -C6 pi-vunima_ n911W554A7