PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N°4 6 z
Date:
r
Owner: Builder
Address Address
y ��=: Address
OTION
OF BUILDING
No.�.?..!?`_ _..�!.... Street _- � `f ••e•._.. Q�� !................ ........ _..... Part of Lot ....._ ...........
Block Bl 4
Lot ....._......---.........
...__._ _Addition or Sub -Division -_ .... +�y....5 �_/.� _ 6 f1
Corner Lot .......................... ......... Inside Lot ........... _............... ........... Setback .....�.................. Sideyard ...../......._./-•-... - ...-...
Sewer Elevation ..-.--.-....._---- __---- _..._..._.._............._............__............._....._. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
-_ ryry qq /
!/�� '!'^•'-r•• ... ...... _-- >s'ront ...�/�_.. Depth _,,��..�.._.. Height;l Sq. Ft. �.�...�L% Cu. Ft. fl�.4D0
.... ......... ....._............._......._.............. Front _...- --..._.. Depth .....-.........;.... Height ......---........U. Sq. Ft. ............ _...._ Cu. Ft. _..._......._.....---
A
Type of Construction ...." .......-............ Est. Cos ....- ,1� 4X7.0To be Completed ....._....._... ..........._.
- ---------------
9 �,-�,'.�-•sem---� P�'-
CAUTION
c7
THIS PERMIT
D—,-)-ES--NOT AUTHORIZE VIOLAT-
ION OF ANY PRWA`AND COVENANTS AND
BUILDING RESTRICTIONS.
In consideration of the issuance to me 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 city of Fridley. yy
In consideration of the payment of a fee of $-7- 4. ....... 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 regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violationany of the provisions of said
ordinances. !1 A A I
Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
JI, ;f j J
'� ��
Iq
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Arvid E. Carlson & Son, Inc. Builder Arvid E. Carlson & Son, Inc.
Address 3200 Prance Ave=s South Address 3200 Prance Avenue South
eapolis, nnesota Minneapolis 16, Minnesota,
LOCATION OF BUILDING
No. an—Street rr�y,,,__Part of Lot
Lot 4 Block 2 Addition or Sub,Div,_ Carlson's Summit Manor Annex
Corner Lot' Inside Lot8 Set Backs j5j Side-Yard,4_7�1 -4p
SEWER ELEVATION 81 below basement floor FOUNDATION ELEVATION ,-
Applicant.attach to this form Certificate of Survey of Lot and proposed building
location..
DESCRIPTION OF BUILDING
To be used as:
Apartment Dwellings Front 77 Depth X3_6 fight
Sq. Ft. 2.772 Cu. Ft. 76,000
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Construction P'aze & Brick Veneer Estimated Cost $60,000.00
To be completed november, 1960
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 hat all the facts and representa-
tions stated'in this application are true and cor ect.
DATE May 11, 1960 SIGNATURE
es en
(A Schedule of Fee costs can be found on the Reverse Side.)
. Application for Poorer Plants and Heating. Coding, Ventilation, Refrigendion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs.. Phone SU.4-7470
GRAVITY WARM AIR: RATE TOTJ�L ,
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 $
.each add. 60,000 BTU ..... . .................. 2.00 $
Replacement of Furnace P.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 $
0
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
$ .�
l
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
TOTAL FEE
$ �8
ROUGH
FINAL
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, inn �_, 19
a ...'9
Owner
Kind of Building �-
Used as
To be completed about /�-u�✓�� - / y
Estimated Cost, $ '
Old— e Building Permit No. /-/-/6 o)7— Permit No.
DESCRIPTION OF WORK
HEATING or POPZ.ANTS�team Hot Water Warm Air—No-
Trade Name �/ c �� Size No- e6g�
Capacity 10 Sq. Ft. E.D.R BTU H.P.
Total Connected Load / ? a ® Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
By.
^ 4 z 2M 7_59 Business Phone
�/• LZn.
HEAT LOSS CALCULATIONS DEPARTMENT' OF BUILDINGS MINN p OLIS, MINN.
Weatherstrips A.S Guie ut'ide • Construction No. Insulation
Windows I Doors Reference Out. Wall 1Int.Wall Ceiling I Roof I Floor Kind How Applied
Yes es—No 19
Fl . oom I Length Width Height F1.1 Room I Length Width Height
Wiridows and Doors—Crackage and Area
—
Width Height No. of Lineal ft. Area
No. of one of pane lights of crack sq. ft.
No. of Lineal ft. Area
jig hte of crack sq. ft.
Coef. Btu
Infiltration
D .�
Glass
y2
Exp. wall 't
JCoef.jBtu
Net exp. wall
o
Int. wall
Ceiling
Floor
cR �®
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
1 —,h /-2 WAth / 9 ,Mp;aht 12
Windows and Doors—Crackage and Area
—
Width Height
No. or pane or pane
No. of Lineal ft. Area
jig hte of crack sq. ft.
Coef.1 Btu
Infiltration
D .�
Glass
y2
®1
JCoef.jBtu
Infiltration
Q
Ceiling
V.add - - --- — - -
in ows and Doors—Crackage and Area
—
Width Height No. of Lineal ft. Area
No. of pane of pane Iigto of crack eq. It.
Coef.1 Btu
Infiltration
D .�
Glass
Exp. wall
Net exp. wall
Int. wall
Q
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
rl I A—/- oma._ I1 a ..1. 0 W:a.L A—
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane Iighte of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
11-5—
Ceiling
Floor
cR �®
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
. e .k - g .D.R. or sq. ins. W.A. Leader area
Fl - Room (Length Width IX Height
Windowsboors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane IfBhto of crack oq. ft.
Coef. Btu
Infiltration
Glass
f Exp. wall
Net exp. wall
Int. wall
I'' Ceiling
Floor
Total Btu.
a . .R. or sq. iris. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height I No. of Lineal ft. Area
No. of pane of pane -Iighte of crack eq. ft.
S / l� Coef. Btu
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
11 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
C TIONS DEPARTMENT OF BUILDINGS MINN MINN.
HEAT LOSS CALULA
WeatherstripsA.S.H.V.E, Construction No. Insulation
Guide
Windows Doors Reference Out. Wall jInt.WalI Ceiling Roof Floor Kind How Applied
Yes a No 19_
FI_ .doom I Length / q Width /-,?' Height II FLS Room I Length Width Height
Win ows an
Doors—Crackage
an Area
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. It.
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
�' �C✓ 90V
Coef. Btu
Infiltration /®
Coef.
Coef.1
Coef. Btu
Infiltration
1 34o2/
D
Glass
Glass
Ceiling
6j O
Exp. wall
1-3 a Q
Exp. wall
Net exp. wall
Net exp. wall
/
Int. wall
IQ
Ceiling
Floor
Floor
Ceiling
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
J F1 -1 R , a,/ / Room I Lenath /.4 Width /-9 .Height V1
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of�pane lights of crack eq/. ft.
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. It.
cX.s � PlS D O
�' �C✓ 90V
Coef. Btu
Infiltration /®
Coef.
Coef.1
Btu
Infiltration
1 34o2/
D
//
Glass
Ceiling
Exp. wall
Floor
1-3 a Q
Exp. wall
Net exp. wall
O
Net exp. wall
IQ
Int. wall
Floor
Ceiling
Total Btu.
Floor
O.R. or sq. itis. W.A. Leader area
F1.1
Room I Length Width
Total Btu. I X1,Yz7a
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
J F1 1 -Ps/ Rnnm I I Pnath V Width I!;-- Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of�pane lights of crack eq/. ft.
Width Height No.of Lineal ft. Area
No. of pane of pane IiBhto of crack Bq. ft.
v'
�' �C✓ 90V
Coef. Btu
Infiltration /®
Coef.
Glass
Q
Exp. wall Hl
Net exp. wall
Glass
Int. wall
Ceiling
Exp. wall
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights I of crack sq. ft.
Width Height No.of Lineal ft. Area
No. of pane of pane IiBhto of crack Bq. ft.
v'
�' �C✓ 90V
-Coef.1 Btu
Infiltration
Coef.
Glass
Infiltration
Exp. wall
Net exp. wall
Glass
Int. wall
Ceiling
Exp. wall
Floor
Total Btu.
R90i f .R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No.of Lineal ft. Area
No. of pane of pane IiBhto of crack Bq. ft.
®
Coef.
Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Reqw
Ae99%
O.R. or sq. itis. W.A. Leader area
F1.1
Room I Length Width
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
AS
Coef.
Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
'Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
Ye I e —No 19—
✓l FI L_ :�Rnom I Length Width ®Q' Height II -,P FI.I
Windows a d Doors—Crackage
an Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Heigh[ I No. of Lineal ft. Area
No. of pane of Dane lights of crack sq. ft.
e
Coef Btu
Infiltration
Q
Glass
Coef.
Btu
Infiltration
Glass
Net exp. wall
�%
O
Q
®Q
Exp. wall
Floor
44
Exp. wall
Net exp. wall
/®
11-3,2
Int. wall
Int. wall
Int. wall
Ceiling
Ceiling
�Q
Q
Floor
Q
��
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
-3 F1.1 0 ,,1 . Room I Lenath / -7 Width /,JaHeight
Win ows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
%
® 5
,� ®
Coef Btu
Infiltration
Q
Glass
Btu
Exp. wall
Coef. Btu
Net exp. wall
'46
Int. wall
Glass
Ceiling
Floor
44
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room I Length A7 Width_/' Height
Windows and Doors—Crackage and Area
Width Height
No. of pane of pane
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
%
® 5
,� ®
Coef. Btu
Infiltration
Coef.
Btu
Infiltration
Coef. Btu
Infiltration
'46
Int. wall
Glass
Glass
Floor
44
Exp. wall
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor
Q
��
Floor
Total Btu.
Reouired sq. ft. E.D.R. or sq. ins. W.A. Leader area
//- ei
NNEAPOI , MINN.
Insulation
Kind How Applied
Re%nm I I.enoth Width Heistht
Windows and Doors—Crackage and Area
Width Height
No. of pane of pane
No. of Lineal ft. Area
lights of craaacck sq. ft.
%
® 5
,� ®
Coef. Btu
Infiltration
Glass
Exp. wall
Coef. Btu
Infiltration
Int. wall
Glass
Floor
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Requ' D . or sq. ins. W.A. Leader area
9 m 1 Rnnm I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
%
® 5
,� ®
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Requir D or sq. iris. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack eq. ft.
jArsi I Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. leader area I
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows I—No Doors Reference Out. Wall Int. Wall Ceiling Roof Flol
Yes—No Yes 19—
o CII f- _ 0-11 ---&L 'a W;Ad, / i t.,;ot,r / / II FI I
Windows and Doors—Crackage Cnd Area
Width Height No. of Lineal it Area
No. of pane of pane lights of crack sq. ft.
r"
Coef. Btu
Infiltration
Glass
'
Exp. wall
Net exp. wall
0
Int. wall
Ceiling
Floor
Total Btu. 0
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ Fl.l 1_ .f. ',l Room I Length 19 Width L, Height /G,
Win ows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
� D
Coef. Btu
Infiltration
Glass
'
Exp. wall
Net exp. wall
d D
Int. wall
Ceiling
Floor
Total Btu. —5
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Heistht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
MINNEAP S, MINN.
Insulation
Kind How Applied
Rnnm I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.—
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
ri I Rnnm I I.pnath Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack aq. ft.
Coef. Btu
Infiltration
Glass
Exp, wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. I Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Application for Power Plants and. Heating. Cooling. Ventilation..Reh igeral'ion 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 $
,r
each add. 60,000 BTU ... — .................. 2.00 $ _
Replacement of Furnace §.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. 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 BTL) ....................... 5.00 $�L• `rte
GAS FITTING FEES:
NO RATE
TOTAL
J
1st 3 Fixtures ......................
x $1.50
$--!,
r�
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS 8: REPAIRS
TOTAL FEE
A
fln
ROUGH
FI
w
Dept. of Bldgs. Phone SU_ 4-7470
Location 0�-/,d--0 �
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.
FridjayMinn_ ® , 19
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Permit No. C oZ Permit No.
DESCRIPTION OF WORK
HEATING or PO PLANTS -Ste Hot Water, Warm Air—No
Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Kind of Fuer
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Jaz 2M 7.59
Business Phone
RIO
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
�PERMIT Or
18623 "
PERMIT
r
• ___ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
,,j CITY HALL FRIDLEY 55432
L J\ 612-571-3450
ECEIPT .
NUMBER
910-F15
REV.
DATE
9/2/86
PAGE OF
APPROVED BY
JOB ADDRESS 5200 - 5291 3rd Street N.E.
1 LEGAL
DESCR.
LOT NO.
Varix ]-
BLOCK
Bl. 2 &
TRACT OR ADDITION SEE ATTACHED
1-6, Bl. 1, Carlson's Summit Manor Annex SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bigos Properties
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Twin City STorm Sash Co. 2641 Louisiana Avenue South, Mpls. 55426 927-6534
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Apartments (_8 Buildings)
7 CLASS OF WORK
❑ NEW ❑ ADDITION Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows
9 CHANGE OF USE FROM TO
STIPULATIONS
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
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$ lOO,000
SURTAX
$50.00
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-
TION OR THE PERFORMVOFNSTRUCTION.
$433.00
PLAN CHECK FEE
TOTAL FEE
$483.00
IGNATURE OF CONTRAC RAUTHOR12ED AGENT IDATEI
WHEN PROPERLYALIDATED THIS IS YOUR E MIT
SLOG INSP
(Tnu
ATE
SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI
NEW [ J City of Fridley Effective 4/1/8c,
ADDN. I J R-1 AND R-2
ALTER. I ] Building Permit Application
Construction Address: �c <22 21 ?-ate 5Y �
Legal Description:
Owner Name 6 Address: . Tel. #
Contractor: _ Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IKPROVEMENT
LIVING AREA: Length Width _ Height Sq. Ft.
GARAGE AREA: Length __ Width _ Height Sq. Ft.
DECK AREA: Length Width _ Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ I Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $ IAZ� C700
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: �' APPLICANT: Tel. 4
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ y3 3
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
SUBJECT
- MLT NO..____,
City of Fridley
2 9 5 71` s
AT THE TOP OF THE TWINS
BUILDING PERMIT
-= /
RECEIPT NO,
1 `v ______ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC,
r PROTECTIVE
1 . �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L „ 612-571-3450
910-F15
15/27/99
JOB ADDRESS
5200 3rd Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR.
4
2
1 Carlson's Summit Manor Annex
SHEET
2 PROPERTY OWNER MAIL ADORES$ ZIP
PHONE
Bigos Properties PO Box 26758
938-6320
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
G.W. Cook Construction 3133 Nicollet Ave S M is 55408
822-1326
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Commercial
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ex REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Repair roof - EPDM Rubber Roof System
9 CHANGEOFUSEFROM TO
STIPULATIONS
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 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
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
7900
$3.95
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
$153.25
Fire SC, $7.90
PLAN CHECK FEE
TOTAL FEE
165.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI
WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
C_
+rIA1E
SIGNATURE OF OWNER,IF OWNER BUILDER, IDATEI
A, OZ INSo
Prepaid Plan Check $
Estimated Cost $
Receipt #
Effective 5/10/99
CITY OF FRIDLEY \
R-3, COMMERCIAL & INDUSTRIAL �1
BUILDING PERMIT APPLICATION11
�O
Construction Address Z d O _S9,0 S 1 Zoning
Tragal ("85 0�PL DIGS
Owner & Address 0, 6y66`% S 9 Tel# g3&-- Cb 3 20
coNTRACrOR & ADDRESS 13 x- o t L 2 T- 14-y i S o , Tel# �-Z 1- 13 ?,C
Architect Reg.# Engineer eg.#
BUILDING CONSTRUCTION
TYPE OF WORK [] New [] Addition [] Alteration -Describe
z ►° 0 rti P-0 g &f P_ IZodF S q Stlz v&A .
OFC. AREA: Length Width Height Sq. Ft.
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
APPLICANT Tel # 9A -2-472 Date 5__-.2 -2
VALUATION
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ )
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ ® d---
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) 'ICTAL VALUE
Building Use A P glerwicjo� Construction Type 2000 &oe LJ_ Occupancy Group
Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No
Performance Bond Amount $ See Reverse for Schedule Received [] Yes [] No
Permit Fee
Plan Check
Fire Surcharge
State Surcharge
$ 3 ,
SAC Charge
$
Erosion Control
$
Park Fee
$
Spec. Assessments
$
Driveway Escrow
$ .
TOTAL
$ 11
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/10th a)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1050 per SAC Unit (Plans to MKCC for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $13.50/foot
ATTACH STIPULATIONS
' wproposal
t
CONT RTO BARRY WORKER'S COMP SATlON AND PU LIC LIAB,I Y N5 -Y4�CE ON ABOV RK.
VERBA S NOT B I - LL D O WORK AGREE IEN S
MUST BE SHOWN IN WRITING. ALL ORDERS ACCEPTED BY US WITH THE
UNDERSTANDING THAT WE ARE NOT TO BE HELD LIABILE FOR CAUSES BEHOND
OUR CONTROL. THIS PROPOSAL SUBJECT TO ACCEPTANCE WITHIN 30 DAYS. try%
PER MONTH CHARGED ON ACCOUNTS OVER 30 DAYS. AUT ZED SIGNATURE
We are required by law to provide you With the following notice regarding the rights of rsons furnishing labor and
materials.
(A) Persons or companies furnishing labor or materials for the improvement of real property may enforce a lien upon
the improved land if they are not paid for their contributions, even if such parties have no direct contractual
relationship with the owner.
(B) Minnesota law permits the owner to Withhold from his contractor so much of the contract price as may be
necessary to meet the demands of all other lien claimants, pay directly such liens and deduct the cost thereof from
the contract price, or withhold amounts from his contractor until the expiration of 920 days from the completion of
such improvement unless the contractor furnishes to the owner waivers of claims for mechanics' liens signed by
persons Who furnished any labor or material for the improvement and who provided the owner with timely notice.
I HAVE HEAD THE ABOVE AND ACCEPTED THE TERMS AND CONDITIONS OF THIS CONTRACT.
SIGN URE - DATE
permit Fee ; 35 . Minimwtt: S35.00
Pian Review
Suraharge �• — i.SO on permits leaf than $1,000 .
Total Due S Make Checks Payable to: City of Fridley
7H1;3 t$ APPUCATi0 FOR A P=Mfr— NOT VALID UNTIL PROMSSED'
I hereby s�PIY a P 'g >m I I ft Mat #0 WWMV ott above IS a and aor "W. that the wak wtl be in CW*ff = WVI I�
I harebY aP and codes of Ma City et Fti4lay d VdM the Mu►Me M Conebuchon Co&q that I understand thM is not a pam t but only an applica6an tar a•
permit end work o not b � WW[WA a panni Met the Work will be In somdanae wIM Ma aPPVV*d th► IM Me Case of e4 vrork wMoh requtrea review �
approved of plans.
NAME OF APPUt:ANT 1 DATE
61010TURE OF APP _ __�_.�. �. — "�-•°�•m�'>r3a
-
eu-t UW4mffY AVENVE.W FRIDLEY; MN
(7e3).92-'Seo4
From: City of Fridley To: 7634752566 Page: 212 Date: 7/20/200712:28:38 PM
Building
PLUMBING
Permit No.._?W-1 -0 l �
Inspections
COMMERCIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Recd:
DATE r7 --'1.-i)_0-7 YOUR E-MAIL ADDRESS
SITE ADDRESS���
Y®
TENANT S V 411A _ SUITE NO.
PROPERTY
NAME:
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
NAME:_�_Uw Ol,V
STATE LICE NSE #•-1 t VEXP DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS -W10 Krl n4f� LIAC� ' CITY STATE WN%,ALIP S37qe/
LICENSE WITH
PHONE FAX ._7S- -)_Gt6--
APPLICATION
PERMIT TYPE
❑ INSTITUTIONAL MULTI -FAMILY ❑ SWIMMING POOL
0 TOWNHOUSE O COMMERCIAL/INDUSTRIAL ❑ OTHER
TYPE OF WORK-
ANEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK ( Ua(WA M jac& lees Gy- 44A aA
.1'�t't"iiltli6 Ct�ii?ICAT1<Tt3TAll�Jh��}�'�A.�FI�
_ CLOTHES WASHER _ FLOOR DRAINS RPZ VALVE _ URINAL
—DISHWASHER _ GAS PIPING O BACKFLOW PREY. _ WATER HEATER
—DRINKING FOUNTAIN _ GREASE TRAP _ ROOF DRAINS _ WATER METER
—FAUCET _ K[TCHEN SINK SHOWER WATER PIPING
FLAMMABLE WASTE TANK _ LAUNDRY TRAY _ SLOP SINK WATER SOFTENER
—LAVATORY _ SWIMMING POOL — WATER CLOSET
..........................................
:;::::................................................................................................................................................
Total Job $�� A11 fees are based on valuation, including the cost of labor and materials.
Valuation
Permit Fee $ _3J`�i�U (1.25% of Job Valuation/ Minimum fee: $35)
Surcharge $ _ J� Valuation X.0005
Total Due $ 35�� Make Checks Payable to: City of Fridley
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 and 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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
�:"� DATE -7—ZP-,0
NAME OF APPLICANT —
SIGNATURE OF APPLICANT✓•`
__.. ._.. ....... .. .......:.:..... ..._.. .
(JTE::::S '-A'RATE:FERI T :t1RE:R TJ I3: EC R:BI1l D T EI . ::.:.:7?:.:.... .:'...'......:::.::.:'.:.:.:
City of Fridley Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977