PRE 2010 DOCS0 4WS0
BUILDING PERMIT
Village of Fridley, Minn. N° 2 R I R
Date//�l �1 C
/'._ .DQ.7:�. Z `1 ......................
Owner 4 ��r.. ..... Builder !'.......................
Address ... ��iO!m° ..�{.,�? . ��'`. f' .... Address .........................................
LOCATION OF BUILDING
No. ...... !9. Street. ........................ Part of Lot .......................
Lot ..... /.6....... Block ... L .......... Addition or Sub -Division Z.. ,%ee
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ..........................
DESCRIPTION OF BUILDING
To be Used as:
93
;a; .... Front NJ ftp ! `Q Depth Height .... Sq. Ft. Ac 746, Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........
Type of Construction.... Est. cost �,�.. ............ To be Completed k !e�?�?*.
In consideration of the issuance to we 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 village of Fridley.
.t .................................................
co ideration of the payment of a fee of $.��, permit is hereby granted to .... .
.Or_~construct the building or addition as described above. This permit is granted upon
e 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 buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. A., J. _,
!DV4Z%r*4'11*'.rK........ Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
City of Fridley, Minn.
WELDING PERMIT N° 3078
Date: ... �. .................
Owner. .......... .uilder 4.. ...✓.�
Address ...................................... Address ....
LOCATION OF BUILDING
No.�� ' street. �:1:......�.. s :.:............. Part of Lot ...... .......... . .
Lot ... �.(,...... Block ..K ............ Addition or Sub -Division .. ... .. '. a�o
Corner Lot ............ Inside Lot ...` Setback Sideyard .......................
DESCRIPTION OF BUILDING
To be Used as:
.. Front ... Depth Height ........ Sq. Ft. 04 . Cu. Ft. ........
................ Fro t ........ Depth ... Height ........ Sq. Ft. ........ Cu. Ft.
® c�
Type of Construction Est. Cost../.4Z!.4+.°...� ..... To be Completed a
a
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in m ii with all provisions of
ordinances of the city of Fridley.
...... . ... ................... ...
In consideration of the payment of a fee of $...., 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, orany part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
..a✓%� e% .. _ n -A _
NOTICE: V
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
y
879.01
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone 560-3480
DESCRIPTION OF WORK 5069 N.E. 3 Street
Number, Kind and Location of Fixtures Location
e
K
x 1.20
$
x 1.00
$
x 3.25
Y
x 2.00
K
8��0
fV.,Z
$
ZWATER
F
N
HTR.
GAS
ELEC.
m+�
rill
;
j
in�
c�
5
Base
1st
Inst
11
1
2nd
3rd
4th
_
• Future Connection Openings
Connected with
I
Bower
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin .... . .....................
Water Heater (Up to 200,000 BTU) ......
New Ground Run Old Bldg. ............
GAS FITTING FEES:
x $1.50
$
x 1.20
$
x 1.00
$
x 3.25
$
x 2.00
$
x 3.25
$
NO. RATE TOTAL
1st 3 Fixtures ....... .................. x $1.50 $
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $ �$ ."
REPAIRS & ALTERATIONS—Refer to Code
Description .... .................. ........................$
T
. d•t4
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, ATinn JUN 141961 19_
Owner W • Or
Kind of Building Fr SMe
Used as Residence
To be completed about JUN 191%7
Estimated Cost, $ 10.00
Old-XTew. Building Permit No Permit No.
Signe MINNEAPOLIS GAS Co.
Business Phone No
ROUGH
FINAL
SUBJE&
City of Fridley2
7WNO.
8Ir
13i
AT THE TOP OF THE TWINS
BUILDING
PERMIT
O
_ COMMUNITY DEVELOPMENT DIV.
��: -----
INSPECTION SEC.
r � � PROTECTIVE
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
9/29/98
JOB ADDRESS
5069 3rd Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
4
1 Carlson's Summit Manor So.
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dean Hoskins
572-8688
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
James A. Bazoff 632 Monroe St Anoka MN 55303
760-4611
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 O ADDITION ❑ ALTERATION gx REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 35 s Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 80 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
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
$2999.50
$1.50
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 STRUCTION
$74.75Fire
SC 3.00
PLAN CHECK FEE
TOTAL FEE
[se
SC $5,
00 A 1
$84.25
SIG TUBE OF CONTRACTOR ORA EO AGENT D iE�
WHEN PROPERLY
BLD INSP
IOAT THIS IS YO R PERMIT
i �E!
rIAiE
S.GNATURE OF OVVNERIIF OWNER BUILDERI IDATEI I
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FANIILY AND DUPLEXES R-1 AND R-2----- - -
BUILDING PERMIT APPLICATION
ConstructionAddress: —50670/ 3 �-� S -f-- AJF
l�
Legal Description:
Owner Name &Address: Tel. #
Contractor: Mq ln'E 5` � /�%�j-�O d�� MN LICENSE # 2c) j
Address: (o 3,1 A GA! /to i� 5 i" ✓riG[ A IVA,) 5S -5'a3 Tel. # aO —��
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: O - -- �g 4� 15'
Construction Type: 2 P /P� Estimated Cost:
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: Tel. #
CITY USE ONL
$0
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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 an
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
TOTAL FEE �
representations stated in this application are true and correct.
$�
DATE 16) 3/ o 3
C l�
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION TING CO E� gj
REFRIGERATION/AIR CONDITIONING PERMIT IS.$25.00
PLUS THE $.50 STATE SURCHARGE Signed TEL #
FAX #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date -b 0�
written permission from adjoining property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
���^�
NO`a1C'n5 lilYective January 1, 2003
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
FAX (763) 571-1287
JOB ADDRESS
RATE SCHEDULE
IC
OWNER D gI-V7 Ism S;
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
Ov
BUILDING USED AS e� 1
Also Replacement Furnace A2
$ 30.00
$ �-
,
(Side Vent - Fill Out Back)
ESTIMATED COSTPERMIT N0.�`'
Gas Piping (Needed with new furnace,
$ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00
$'
No. of Heating Units Circle One (Steam) (Hot Water) Warm Air
Gas Dryer
$ 10.00.
$
Trade Name boss,. Size No.
BTU ` 0,cxA) HP EDR
*Air Conditioning - All Sizes
$ 25.00
$
Fuel AAeC, 4 Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name Size No.
1% of Value of Appliance or Work
$
BTU HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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 an
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
TOTAL FEE �
representations stated in this application are true and correct.
$�
DATE 16) 3/ o 3
C l�
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION TING CO E� gj
REFRIGERATION/AIR CONDITIONING PERMIT IS.$25.00
PLUS THE $.50 STATE SURCHARGE Signed TEL #
FAX #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date -b 0�
written permission from adjoining property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
rO■eMON VENT VFNT r-QNNFCTQR AND C)MMISTIM AIR VERIFICATION
When mala _i n an Yistinn furance, the undersigned hereby verges that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes O� No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes (%A 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 avichnn r_nmeLntinn air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to install a now r-nme Ioban alri it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes
,a No( )
When jpgftljnn a now venting nplem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA -LAMA Category I Central Furnace
draft
Yes No( )
Venting Tables for fan assisted and natural appliances.
90
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.
Vent
Yes) No( )
Information
ArnoliT�,y and Si7AtCnmmnn Vent and _nnnectnr
Appliance #1 Type BTU Input c4u an As ' r Nat
Appliance #2 Type 4&Mer BTU Input 2bco k9h Assisted
�,rAppfiance #3 Type water /l�1-S BTU Inputlev6 (a r Fan Assisted
Na
Total Appliances a Total Btu Input 2 2& u0
Common Vent Type c-,)/ 131- 13 Vent Height 4-' Diameter
inches
Appliance #1 Vent Connector Height _.L -ft Length —1 -ft Diameter in Type is
Appliance #2 Vent Connector Height --Z---ft Length __a_ft Diameter_ a in Type 13
�.x Appliance #3 Vent Connector Height _L_ft Length ft Diameter L+ in Type C-
HEATING
HEATING CO: d� /
Signed By: Date : �® /3�C®
3