PRE 2010 DOCS0♦
City of Fridley, Minn.
BUILDING PERMIT
Date: JULY 14, 1966
X? 8922
Owner: WALLACE SCHMEDEKE Builder CARL HANSON (CMENT CONTRACTOR)
Address 5616 - 4th St. w. E. Address
Fridley, Minnesota 55421
LOCATION OF BUILDING
No. 5 616 street — 4th S t . N. E . —_part of Lot
Lot 6 Block 4 Addition or Sub.Division HANILTONS ADDN. TO MECHANICSVILLE
Corner Lot _ Inside Lot _._. X Setback Sideyard
Sewer Elevation _ _.._ — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
D. Garage Front 24 Depth 24 Height 10 Sq, Ft. 576 Cu. pt. 5,760
Front Depth Leight — Sq. Ft. — Cu. Ft.
Type of Construction Frame Est. Cost —9-1-21-00 -.20 _„ To be Completed
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'#orth and in coos an with ail ons of
ordinances of the city of Fridley. n U /W %�
In consideration of the payment of a Pee of $ 6.00, permit is hereby ranted to WALLACE
SCHMEDEKEto 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 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 adthis permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE
NOTIM
ibis permit don sot eowr the eembumion, 6atailWan hr wi log, plumbing, ger hating, awor or water. Be an to no
the building hupemor for apmes permhe hr thea hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME �'"!�� �. �", '� �� BUMDER
��
ADDRESS ADDRESS
LOCATION OF BUILDING`
STREET '� PART OF L
N0. /t—� `
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE .LOT SETBACK SIDE YARD
SEWER ELEVATION FOUNDATION ELEVATION
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;
Front_ Depth_±,�/Height U
Sq. Ft. Cu. Ft. s5
i U > ` ` �� Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost`.
To be completed
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.
DATE SIGNATURE
(Schedule-of Fee Costs can be found on the Reverse Side),
� J
®d �i"
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices V�Z//
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ...........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00
$
2.00
$
5.00
$
5.00
$
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 $� r>
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
$$-1
ALTERATIONS & REPAIRS
TOTAL FEE
P�(L
ROUGH
FINAL
Dept. of Bldga. Phone BW -33450
Location Q5Z/1/ — `7 - 7•S
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.
19 ��
Owner
Kind of Building
Used as +z�_
To be completed about
Estimated Cost,
Building Permit No.
7
Permit No(df
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 C'!%5�tli✓ &-uW-e-A' Size No —
Capacity ®o Sq. Ft. E.D.R BTU Hp.
(REMARKS -OVER)
42 Business
end H bd
Aira-fl!� g '�'v z s -A Dow1cm
PARTIAL RATE SCHEDULE
GR1!@rI" WARN AIR:
RATE TOTJU..
Furnace Shell & Duct Work ... ...
..... .. $10.00 $
Replacement of )lumace
6.00
Repairs & Alterations—up to $300.00
600 $
Repairs & Alterations each add. $500.00
3 W $
1zC1-L WMW ADI;
F tunace Shell & Duct Work to 120,000 BTU
each add 60.000 BTU . .........
Replacement of Furnace
Repairs & Alterations—up to $300.00
Repairs & Alterations each add. $300.00
STEAM or HOT WA'TE'R SYSTEM
..$10.00
$--f---
3.00
S
6.00
$
6.00
$
3.00
$
Furnace Shell & LInes—to 400 sq. it. F.DR Steam $10.00 $
Furnace Shell & Line ---to 640 sq. ft. EDR flot Water 10.00 $,
Each add 200 sq. ft. EDR Steam xon $
Each add. 320 sq. ft. EDR Hot Water 3.00 $
OIL BURNER—to 3 gal. per hour 6.00 $
over 3 gal, per hour—See Fee Schedule
V
GAS BURNER (up to M.000 BTU)
over 199,E BW See Fee Schedule
GAS FMING FEES: NO RATE TOTAL
-o
1st 3 Fixtures x$ Zoo g
Additional Fixtures x .98
Gas Range Range to 10.00 x$ 6.00 8
COEDMOMMG >(, -�^(® State Surcharge t7,1 50
VEMTMATMG STSTM
ALTER&Trom & REPAM Tom. rM
Dapt. of Bld9s. Phom IMO -UM
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 Ordisnano
and ruling of the Department of Buildings, and hereby declares that all the fac
and representations stated in this application are true and correct.
Owner
Kind of Building • ��
Used as
To be completed about, 7
Estimated Cost~ $
Old ew. Building Permit No. __ Permit No.1-3
HEATING or PO FI.ANI�--Str�ar>a, Not Water, Warm Air—No
Trade Name— piC S1m NO
Capacity—_-- .— Sq. Vt. E.D.R ' co BTU NJ
Total Connected Lomd— --.77 Kind of fte'.
BURNER — TrvAe Nance Siwe No
Capikei Sq. FL E D BTU 7M
v e/ (0
®� — .
4a6aRf—om0t1 �1��� (�
53-811.-879.01
City of Fridley
Appliceicn for.Plumbing and Gas 0j4'.n� Perm!'
Dept. of Bldg*. Phone SED -3454 .
DESCRIPTION 07 WORM 5616 N. E. 4th. Street
Number, Kind and Loce_Ken of Fixtures Locate
r
NO. RATE
TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ...........
x $1.50
$
_.
New Fixture Old Opening..........
x $1.50
wATrq MTR.
Catch Basin ....................
x $3.25
$
Water Heater 'L•p to 99.000 BTU) • • • •
x $3.00
$
I
New Ground Run Old Bldg.......:.
x $3.25
$
Electric avatar Heater ..............
s $2.00
$
IIS FITTING FEES:
NO. RATE
TOTAL
Ist 3 Fixtures ... * ...... * . • • • • • •
x $2.00
Re la
a
an e
x $ .75
$
l
l
5.00
Gas Range to 199.000 BTU ...........
x 55.00
S
Future Connettiaa Op'oaintsI r..�.�...,.......
go-warNew Fixture. Old Openings -- Cccspool 0
PARTIAL RATE SCHEDULE
.CMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ...........
x $1.50
$
_.
New Fixture Old Opening..........
x $1.50
$_-_---.
Catch Basin ....................
x $3.25
$
Water Heater 'L•p to 99.000 BTU) • • • •
x $3.00
$
New Ground Run Old Bldg.......:.
x $3.25
$
Electric avatar Heater ..............
s $2.00
$
IIS FITTING FEES:
NO. RATE
TOTAL
Ist 3 Fixtures ... * ...... * . • • • • • •
x $2.00
$
.
Additional Fixtures ..............
x $ .75
$
l
5.00
Gas Range to 199.000 BTU ...........
x 55.00
S
City of Fridley:
The undersigned hereby makes application for a permit for the Work herei
specified, an eeing 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 4-i5-75 19—
Owner _. A. Wallace
Kind.of Building Frame _
Used as Res.
To be completed about 4-22-75
Estimated Cost. $ 10.00 --
Old—NaW=uilding Permit No P.rmit No.
Signed �"'�'�� "� •
By MINNEGASCQ --
Business Mine No
ROUGH
EPAIRS a ALTERATIONS—Aofat fo Code .50 State Surcharge
.Description ....................................... � .
TOTAL FEE s 5.50
Acres �V-urcharge .50s?
t
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00 $
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement)
Gas Range $ 10.00 $
Gas Dryer $ 10.00 $
*Air Conditioning - All Sizes $ 25.00 $ a S: �0
All Others/Repairs & Alterations (LIST ON BACK)
11yo of Value of Appliance or Work $
Commercial/Industrial
1.25% of Value of Appliance or Work $
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
Effective On January 1, 2000
JOB ADDRESS 5 (o I L 'q T11
$'t . pi • C.
OWNER 1 I m W h e,e'L ► S
BUILDING USED AS 0e Il n G
ESTIMATED COST 19 00 , Od PERMIT NO. / LPC
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
River City Sheet Metal, Inc.
9923 Bluebird St. N.V\VATE rl a I I o0
Coon Rapids, MN 55433
HEATIN%
Signed /, / A
Approved BykJ b Rough -In Date
TEL #
Is. :�7
Final Date 6
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, 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.
Yes () No
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () 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 BTU Input 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
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)
HEATING CO:
Signed By: Date
Building #/qq(5 MECHANICAL Permit N "* -;?0612M
Inspections RESIDENTIAL APPLICATION Received By:
763-57-2-3604 CITY OF FRIDLEY RURAuG - 1
DATE -a-7 -O -7 YOUR E-MAIL ADDRESS
(
SITE ADDRESS 5(014p !"l 54Y f_167 - 'X)G`
THIS APPLICANT IS: ❑ OWNER ]CONTRACTOR
PROPERTY
NAME:/0e_ o
OWNER/
TENANT
t�
F
ADDRESS: SIOI IO 4a' + IO6 CITY cdt Ie 4 STARZIP $ 3
PHONE:
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
CONTACT PERSON: JOANN Z INKEN
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE RITY "COON'-'RAP.IDS sTATEMN ziP55433
APPLICATION
PHONE 763 — 757 -- 6202 FAX 763-757--6701
PERMIT TYPE
aINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
13NEW 9<6LACEMENT 13ALTERATIONMMODEL
DETAILED DESCRIPTION OF WORK-J;�Sdal l Qp„p A-[ _
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (IND �C/1TE TOTAL
NUMBER OF EACH BELOW) � /(
Equipment Installed MFG�� MODEL:-Y������ -01f S1zE/BTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZE/BTU
_A/C $25.00 FIREPLACE (GAS) $15.00 ; ' GAS RANGEIOVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
__
_BOIL' ER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
,...
9 k l 1
al
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00 1 x $25.00 = $ c35. OD
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $�3S • 5D
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.
SIGNATURE OF APPLICANT �• NAME ROGER HOFFHEIN DATE
INE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS /EXISTING HOME ❑ MADE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REOUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
Building
BUILDING
Permit No.-2AQ0 q
Inspections
RESIDENTIAL APPLICATION
Received By(
763-572-3604
CITY OF FRIDLEY
n cq1�
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE 7 ?2 YOUR E-MAIL ADDRESS
SITE ADDRESS S,!(/4
THIS APPLICANT IS:OWNER
❑CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: 474W i 4 _S-,I—,V-P CITY r,
STATL"4/ZIP
PHONE:_ 76.3 -5-,X2-,22J/-5--
572-e22J/-5--CONTRACTOR
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILYNEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GAR.AGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR '❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING HOUSE ONLY
!
NUMBER OF SQUARES,.�� OUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2.
Two sets of construction plans
V11MOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes 17No LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
COTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ (O(4 `/�� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ F .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ Make checks Davable to: Citv of Fridlev Attach
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 permJit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all w rk w 'ctituires review and approval of plans.
L/
SIGNATURE OF APPLICANT PRINT NAME 70 DATE r - -Z( - l