PRE 2010 DOCSN° 8�14
•
Mage ®f FrItHey, Minm
BUILDING PERMW
(Mee of INSPEMO$ OF BUMDINGS
Fridley, Minn
b
LOCATIO �O,FF BUILDING
A � '_ Part of Lo*
81ock Addition or Bub -Division
DESCRIPTION 0? BUILDING
Dep t/ Height StoriesL'tA! Manner of C; tion
To be used as To be completed ° Estimated COAZ O.-
Permit is hereby FSted to
the building—�`�"` described in the above statement. This permit is granted
upon the express candition that the person to whom it is granted, and his" agents,employees and workmen, in all
the work done in,3round. and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Ridley, Minn., regarding the construction, alteration, maintenence, repair and moving of buildings
within the city ts, and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Inspector of Buildings.
In consider
the above perm
above set forth
sworn, I hereby
true as therein i
day
AGREEMENT AND- SWORN STATEMENT
tion of the issue and delivery to me by the Inspector, of Buildings of Fridley of
I hereby agree to do the proposed work in accordance with the description
end according to the provisions of the ordinances of Fridley, and, being first duly
state and say that the facts stated by me and contained in the above permit are
fated.
sworn before me at Fridle Minnea
n► to y� r,n+a
A _D. 19r=-"-��, c '
j,
CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
,lob Address 4880 - 3rd Street N. E.
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
4.00
$
$
Fridley, Minn. October 6, 19 76
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM:
OWNER L. A. Schnell
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING Frame
each addn. 50,000 BTU
4.00
$
Dwelling
Boiler only up to 100,000 BTU
7.00
$
USED AS
each addn. 50,000 BTU
6.00
$
November 6 1976
TO BE COMPLETED ABOUT �
OIL BURNER- to 3 gal. per hour
$10.00
$
$1, 648.40
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00
$ 10.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures 1
Additional Fixtures
Gas Range to 199,000 BTU
AIR CONDITIONING
FA'Q HEATING SYSTEX4S
x $ 3.00 $-3.00
x $ 1.00 $
x $10.00 $
VENTILATING SYSTEMS—`See Fee Schedule
ALTERATIONS & REPAIRS s
Lennox Air Conditioner State Surcharge
Model HS9-261 - 2 Tons TOTAL FEE
800 ffm
ROUGH INSP. REINSPECTION FEE _
Date ($10.00)
FINAL INSP. A - 2 - ? 5"'
Date
APPROVAL FOR PERMIT r
O.S-
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, UK , Warm Air- No.
$ 10.00 Trade Name Lennox Size No. G110.3-110
S
$ Capacity Sq. Ft. EDR 110, w"M�MVS
TU HP
$ .50 Total Connected Load Kind of Fuel nNa�tura l Gas
$ 30—`L BURNER - Trade Name Lennox Size No. GllQ3-110
Capacity Sq. Ft. EDR 110, 000 BTU HP
Company Kleve Heating & Air Cond. Inc.
Signed By
Tel. No. 941-4
SUBJECT
City of Fridley
29551
AT THE TOP OF THE TWINS
BUILDING
PERMIT
• ____ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
, //
r PROTECTIVE
,'; CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L „ 612-571-3450
914415
5/25/99
JOB ADDRESS 4880 3 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1,2
2
Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Sam Schmel 4880 3 Street NE
572-8892
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Lloyd's Home Improvements Inc 1012 42 1/2 Ave NE, Columbia Heights, MN 55421
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
788-5602 1798
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION KI REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House & Garage (23 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
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 OWLG. 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
$1,971
$.98
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-
Fire SC $1.97
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$69.25
PLAN CHECK FEE
TOT FEE
( <��
Lice
$5.
$77.20
SIGNATURE OFCON•RACTO ORAUTN EDAGENT IDATEi
EN R P
VALID T THIS IS YOUR EEgMIT��
SIGNATURE OF OWNER,IF OWNER BUILDERI iDATEI
BLOC INSP
T1AiE
NEW
ADDN
ALTER
ConstructionAddress :
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
4880 - 3RD. ST.. NE
Effective 1/1/99
Legal Description:
Owner Name & Address: SAM SCHMEL 4880 - 3RD. ST, NE Tel. # 612-572-8892
Contractor: LLOYDS HOME IMPROVEMENTS, INGe MN LICENSE # 0001798
Address: 012-42 11� AVE.. NE., COU MBIA HEIGHTS, MN. 55421-3159 Tel. # 612-788-5602
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: 23 sq,*
Construction Type: Tear off & reroof house & garage Estimated Cost: $ [ / 7
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: MAY 25, 1999 APPLICANT:! Tel. # 612-788-5602
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ S
Fee Schedule on Reverse Side
Fire Surcharge
$ %
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$ 9 CO)
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ 0
$5.00 (State Licensed Residential Contractors) t .
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 [ J
TOTAL
$ C
STIPULATIONS:
Building
--- -- -
)I. (o0 See Back Page for Fee Schedule
BUILDING
Permit No `
Inspections .
Fire Surcharge
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$
CITY OF FRIDLEY
Datod�R 9 200$
763-502-4977 FAX
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
EFFECTIVE 1-1-08
ft + 6 ft = ft x $21 =$
5S
E-MAIL ADDRESS
DATE
YOUR
SITE ADDRESS �-f�$C �L �"� N� F2;y1Py, n�►n/664Z1
THIS APPLICANT IS: IJOWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: —1 ►1
ADDRESS: LLS -Lo 3(o wr pig CITY i'2iD/�3' STATE I `Af ZIP S3Yp/
TENANT
$
PHONE: (01 z - z24- i.0z? b
NAME:
ADDRESS: CITY STATE—ZIP-
TATEZIPSUBMIT
CONTRACTOR
SUBMITA COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
VSINGLE FAMILY/NEW CONSTRUCTION SIZE 116V
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED 0 WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
.L , `,. <....lk3�,�
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIREPAIR (A REMODELING
DESCRIBE WORK BEING DONE: .2 lAk1MC"ri- W ,KCJOLAg CNIF-165 A 9-ftfi Pay tr.+i ee f S �i7l�e Ss
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
L Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS. & PORCHES SUBMIT:
❑ Vinyl
❑Soffit
I. Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project.
❑ Other
❑ Fascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes PNo LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE
SIZE QF 40ftmg v#J
N S�9F-mpr kWvSt
OPENING CHANGES &
2 S�tJ cE1v.a ,��„r
9h�1
TYPE OF WINDOW TO BE INSTALLEI]i^ C�-►�anl� NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, 1NULUDINU THEA UUP i Ur LARVA AivL iviA i Zr"FLLo;
(USING THE 1997 UBC FEE SCHEDULE)
. T Two X71 T TT 1 TT/lAT @ "1 __ -.� nf'd-1TPAN1-V TVPF.
L V l AL V V L ♦ A
Permit Fee $
--- -- -
)I. (o0 See Back Page for Fee Schedule
Plan Review
$
/9. Zy 65% of Building Permit Fee
Fire Surcharge
$
.'70 .001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
60 # Oq Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for -a -building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley
with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the wo
wi a in accordance wit th plan in the case of all work which requires revs w and approval of plans.
SIGNATURE OF APP C NT
PRINT NAME �Ar% 01 be.,// DATE l
DATE 4_ W
APPROVED BY
.L , `,. <....lk3�,�
L'J
99
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