PRE 2010 DOCS�J
Mage of Fridley, Minn.
BUILDING PERM"
N? 799 Office of INSPECTOR OF BUILDINGS
Owner �'7.t ar,r r�, r ..
Architect Fridley, Minn.,'
Builder
1 j LOCATION OF BUILDING
No. Street �LPp� Part of Lot
Lot -� { ` � BloAddition or Sub -Division -
DESCRIPTION OF BUILDING
Front , .,t � - Depth `` Height Stories �' Manner of Construction
e r� _ `? To be com leted" _ Estimated Cost
To be used as complet
Permit is hereby granted toc.
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.
a__« Inspector of Buildings.
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,
t z�
A
day of .D. 19
Minnesota, this
susdEcr
PERM IT
-City of Fridley
11 2418
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
16 ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 . �
CITY HALL ' FRIDLEY 55432
NUMBER REV. DATE
PAGE OF APPROVED BY
A r %.J 612-560-3450
910-F15 7/27/77
JOB ADDRESS 4727 - 3rd Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
20,21
8
Plymouth Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Harley Peltz 4727 - 3rd 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 Cl. ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14' x 14' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide galvanized ridged valleys on roof.
WARNING
SEPERATE PERMITS REQUIRED FOR WIRBNGe
leforo dijging call luc,..l .,,r,;_.,,.l.
HEATING. PLUMBING AND SIGNS.-
TELEPHONE ELECTRIC • GAS
-
REQUIRED BY LAY
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
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
196
2352
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,500
S2,75
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.
$9.40
NONE
PLAN CHECK FEE
TOTALFEE
I S14.50
SIGN TUREOFCONTRACTOROR THOR(ZE AGENT (DATE)
WHEN PROP RLYQV�ALIIDA�TED THIS IS YOUR PERMIT
BLDG )NSP
DATE
SIGNATUR F OWNER II WNER B I (DATE)
Ll 1 Y UI 1 R11JLL-Y
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTE=RATION', ADDITIONS,, OR REPAIRS)
>�
Address:'`i /►'�
BUILDER: 54,.#
Address:
Tel. No.:
No.:
Street:
LOT:
BLOCK:
ADDITIOi1: /V),O (4
CORNER LOT:
INSIDE
LOT: eK_
SETBACK: SIDEYARDS:
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:
Ac(siArlG A) Front: /f ;A7 Depth:
Square Feet: �_ C
Front: Depth:
Square Feet:
% �e* Height:
bic Feet:
Height:
Cubic Feet:
Type of Construction: A6®dc� Estimated Cost: $ 7j
To Be Completed: f /V') rP /y- Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: SIGNATURE: r
Stipulations:
ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
PLANNING: AND INSPE,1'TICNNd DETIAPTMENT
CITY OP FRILLEY, MINNESOTA
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFiCiAL can determine that submitted plans comply with the ENERGY CONSERVATION
DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to 7assure construction is per appAro eed plans.
JOB LOCATION:
OWNER/CONTRACTOR:
ADDRESS: �5A'dn PHONE:
A. Determine the Total Exposed Wall Area as follows:
1. Total wall window area
2. Total door area
3. Total sliding glass door area Jte t
4. Total fireplace wall area .2
5. Total wall framing area(average 10%)
6. Total net wall area above floor(average 90%)
7. Total rim joist area
Subtotal: Total exposed wall area above floor
8. Total foundation window area
9. Total net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 =
C. Determine the Total Exposed Roof/Ceiling Area as follows:
10. Total skylight area
11. Total roof/ceiling framing area (10%)
12. Total net insulated roof/ceiling area
GRAND TOTAL EXPOSED ROOF/CEILING AREA
D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 =
Item I
Item II
E. Determines the "U"
value
of each segment
(1-9) and multiply by the area as
f ui _i_("
w' , .
2..
_
X
of U of
3 .
3 Cal
Y
„u„
4.
X
"[J"
5.
X
flull
X
-,U,-
8.
X
"U"
9.
x
fluff
T
= •`/
ADD 1-9
FOR TOTAL PALL SEGMENTS
= ITEM III
F. Determine the "U"
value
of each segment
(10-12) and multiply by the area as
follows:
10.
X
"U"
_
11.
X
"U"
_
12.
X
"U"
_
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State Building Code 6006 (c) 1.
I. Add Item I + Item II =
J. Add Item III + Item IV =
K. If the sum of Items III and IV are less than Items I and II, you have met the
intent of the Code for total envelope system.
The undersigned, as applicant for a building permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate; and hereby
presents the information with required plans in support of the building permit
application.
UZ
DATE:
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SUBJECT
City of Fridley
1.6 5.18
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
rp
RE N0.
COMMUNITY DEVELOPMENT DIV.
1
r PROTECTIVE INSPECTION SEC.
Ir I
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/9/82
JOB ADDRESS 4727 - 3rd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
20,21
8
Plymouth Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Harley Peltz 4727 - 3rd Street N.E. 572-8910
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Norsk Concrete Construction 7401 Central Avenue N.E. 786-1910
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
Lower. Crawl Space Area
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
$1,400
$.70
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$23.50
PLAN CHECK FEE
TOTALFEE
$24.20
SIGNATURE OF CONTRACTOR UTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR P RMIT
BLDG INSP GAIE
SIGNATURE OF OWNER IIF OWNER BUILDER) MATE)
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New. Alterations, Additions, or Repairs)
01114ER: 7��1�-� O� BUILDER: ay, '�
ly
ADDRESS: �7,P 7 ,3't ADDRESS: 7y�l
TEL NO: , LZ ;t - 9/ TEL NO:
Construction Location
• STREET NO: 7 STREET: 3
LOT: Q , �2 / BLOCK: $r ADDITION:
7
Corner Lot: Inside Lot: ` Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
�Lw.) Front:
�-e-Q- au� Square . Feet:
Depth: Height:
Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: �� Estimated Cost: $ ,/���0. �d
Zb Be Cbrapleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSPE SIDE OF SHEET .
Tile 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.
DA72: /✓I�.P �S9— SIGNATUEE:
Stipulations:
'U
0K
��. '�o
r
C
NORSK CONCRETE CONSTRUCTION, INC.
' 7401 CENTRAL AVE. N.E. MINNEAPOLIS, MINNESOTA 55432
PHONE 786-1910
7 7 3,�
qo'
IAJOo. VIv
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PERMIT
C�A
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e
p
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a
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LfA,
IA
m�Y
vii
e
C
3
d+ a
41
A W
3
W
�p
W
O
w
yC� +�i
U p�
v
1 x
3
w
w
u
m
a
C�
mj
b
Water
Heater
as
lec
5.00
l
$
5.00
I
$
5.00
$
I
5.00
S
$
7.00
$
e $
5.00
$
$
1st
$
$ 10.00
$
2nd
3rd
4th
(R) = Future Connection Opening
(*) = New Fixture, Old Opening
Connected with Sewer
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
NO.
RATE
TOTAL
$
5.00
G
$
3.50
$
$
1.50
$
S
4.00
S
$
5.00
$
$
5.00
$
$
5.00
$
$
5.00
$
$
5.00
S
$
7.00
$
e $
5.00
$
$
10.00
$
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
$ .50
S
bttective Aug. 1, 1981
Job Address L?k 1,---� % — 3 C • /v zf--
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn.
OWNER 9. ),c -L G L_..
Q
KIND OF BUILDING ci(L-
G
,,{
USED AS l � C— C�
c ems
TO BE COMPLETED ABOUT
ESTIMATED COST
OL6- NEW BUILDING PERMIT NO.
PERMIT NO.
Company.
Signed By
Tel. No.
J ;7
ROUGH INSP.
Date
FINAL INSP. & '/J v
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
SUBJECT
City of Fridley
31576
AT THE TOP OF THE TWINS
BUILDING PERMIT
Ir i
I.. COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC
1
i CITY MALL FRIDLEY 55131
NUMBER
REV
DATE
PAGE OF APPROVED B
612-571-3450
910415
11/27/00
JOB ADDRESS MUM 4727 3rd Street N.E.
T LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1 20 & 21
I 8
I Plymouth
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Jeff Jansen 4727 3rd Street Fridley, MN 55421
763-574-0198
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Knutson Roofing & Siding, 9307 HIllside Dr., Champlin, MN 55316 323-9238 2501
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Dwelling
7 CLASS OF WORK �gL
❑ NEW ❑ ADDITION ❑ ALTERATION L7 REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Re -roofing
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
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
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
$2,787.00
$ .97
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 OXffiER STATE OR LOCAL LAW REGULATING CON -
$69.25
Fire SC $1.94
STRUCTION R E P FORMANCE OF CONSTRUCTION
It
PLAN CHECK
TOTA FEE
OX
Licen$ .00
T.16
SIGNATU OF CO TOR OR AUTHORIZED AGENT 4 TEI
E FPR P VALID
TE THIS IS YOUR PERMIT
BLQt IVSD
f)AiE
S,GNATURE OF OWNS R, IF OWNER BUILDERI 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
Construction Address: L/ 7 Z% 3r"/
s tiL=
Legal Description:
Owner Name & Address: S e� S� nTel. #
Contractor: I -/ n14 2�,I I��� ,ln c, et 5, :,/,A r::j MN LICENSE# Z 5 -01
Tel.# 5Z�5-51z3S-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
5�iL
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $ z 7 9 %
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 11127Zr v APPLICANT: �;4 CIl G, Sin Tel. # -5
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ 9. Fee Schedule on Reverse Side
Fire Surcharge $ �/ .001 of Permit Valuation (1/10th%)
State Surcharge $ , q% $.50/$1,000 Valuation
SAC Charge $ ®® $1100 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 [ ] Not Necessary [ ]
TOTAL $ -77, /
STIPULATIONS: