PRE 2010 DOCSi '4
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City of Fridley, Minn.
BUILDING PERMIT
Date:.... . ..� ....................
Owner .......................................
0
N® 3572
Builder ........ ....�.. .... .... .... .!. .
Address ...................................... Address .............................................
LOCATION OF BUILDING
C� �
No.
®709.! Street ........... '........ Part of Lot ...... .. ...................
Lot .. ✓.. ..... Block ... �........... Addition or Sub -Division � &... 40. ...........
... Inside Lot . X......... Setback 33.7 ...O . r Sideyard 4. `1. .
Corner Lot ......... ..............
DESCRIPTION OF BUILDING
To be Used
�g H �g
.... Front ��4� Depth 4?0 Height . �j�. ?�. , Sq. Ft. /10.6. ¢C Cu. Ft. ;?. / 7 $ry
.................... Front ........ Depth .. Height ........ Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... Bst. Com. . —?) 0 6.--3 . To be Completed ...................
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 fo and in ompliance th pro ons of
ordinances of the city of Fridley.
...... ............ .............. .....
In consideration of the payment of a fee of $........., permit is hereby;Zed 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
�.. .. a.. 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 teparate permits for these Items
E
City of Fridley, Minn.
BUILDING PERMIT
Date: —J= 2s 1965
Owner: Paul Bakken
Builder
Carsten E. Emerson
N° '7631
V--QK-z-;`--5
Adm 5909 Uh, Street N. F-. Adder 25,39 37th Lve• So.,Mp s.;
LOCATION OF BUILDING
No. 5909 street 4th. Street N. E. part of Lot
Lot 12 Block 2 Addition or Sub -Division Bennett Palmer
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft Cu. Ft
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Fat Cost ,10Q.* 00 _ To be Completed
Storm damage repair
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 forth and in com ce with a'll provisions of
ordinances of the city of Fridley.
0
In consideration of the payment of a fee of $ 10-00 , permit is hereby granted toCarsten E. borson
the express to construct the building or addition as described above. This permit is granted upon
condition that the peon 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 aII respects to the ordinances of
:yncm
wlorditdty limits permit may be revoked at auy time upon violation of any of the provisions of said
Allen Jensen Building Mmspector
NOTICE:
'mss puede don sot deer tho coestrudtlon, hnt& Wiae for v rhe& plun"N, on hen&& sewer or weer. Be airs to ses
tho BWMko Impeder for apntlo permfb for thea Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER (i/L 6
ADDRESS .� �. ADDRESS��''�—'4
LOCATION OF'BUILDING
No. Street Part of Lot
LOT �. BLOCK ADDITION OR SUBDIVISION
Corner Lot �Inside LOT Setback Sida-;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: 0
Front Depth Height
Sq. Ft. Cu. Ft.
Front: Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Costo AUZ '06
To be completed
The undersigned hereby.makes application for a permit for the work herein specified,
agreeing to do all work in stiict'accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that.all the facts
:aad representations stated in this application are. -true and correct.
DATE_ �� SIGNATURE
T
(Sch�//edd�J\ule of Fee Costs can be found on the Reverse Side). I-
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
2gCy
ADDRESS-- ® y 14`�Si ADDREss�� c�--Ze �'
LOCATION OF BUILDING
No._ �%(� �% Street 1 - Part of ho
LOT / a BLOCK ADDITION. OR SUBDIVISION i
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^'' Eeight
Sq. Ft. /,� / Cu. Ft.
Front Depth Height
.Sq. Ft. Cu. Ftl.
Type of Construction Estimated' 'dost4,/9��,�
To be completed
The undersigned hereby makes application -fora permit for the work herein specified,
agreeing 'to do all work in strict accordance with.the City.of'Fridley Ordinances
and rulifgi` of - the Department of 'Buildings, and hereby declares that. -all the facts
and representations stated in this application.are true and correct.-
SIGNATURE
orrect.SIGNATURE
(Schedule of Fee Costs can'$e.found on the Reverse Side). ��
SUBJECTg3rr-MMIT
NO. .
City of Fridley
23056,
AT THE TOP OF THE TWINS
BUILDING
PERMIT
-
RECEIPT NO.
Jr?
� • ______ COMMUNITY DEVELOPMENT DIV
L PROTECTIVE INSPECTION SEC
t1d7
r i
7 TT
NUMBER
REV
DATEPAGE
OF
APPROVED BY
/--'1 CITY HALL FRIDLEY 55432
�---' 1'' 612-571-3450
910-F15
10/31/94
JOB ADDRESS 5909 4 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
12
2
Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Paul Bakken 5909 4 Street NE
571-1623
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Demars Construction 8401 166 Cir NW Ramsey 55303
441-7084 6614
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 N REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House 12 SO Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
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
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
$.50
WITH WHETHER SPECIFIED H EIN OR NO THE GRANTING OF A PERMIT
$900
DOES NOT PRESUME TO GJ , AUYHORi TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
E O OCAL LAW REGULATING CON-
PROVISIONS O A&ORM
STRUCTION T E F STRUCTIOV
23.00
Fire SC $.90
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$29.40
SIGN ATURE OF CON; TOR OR UTMORiZED AGENT iD TES
WHEN PROPE194Y
VALIDATED THIS IS YOUR
01
13LOA iNSP
1PERMIT
MATE
SIGNATURE OF OWNERUF OWNER BUILDER) iDATEi
NEW [ ] Effective 1/1/94
ADDN { ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2c�7�
Building Permit Application /
ConstcuctionAddress:
Legal Description:
Owner Name & Address: TOL v I C t Tel. #
Contractor: "�- 5 SMN LICENSE # (�
Address: S D I— 16 64-- e r (_ "_ Tel. # Y y/ 7 d<:? 4
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: � t oo TPS - Estimated Cost:. $
Approx. Completion Date:/
(Cost on Back).
Driveway Cut Width Needed: Ft. t — Ft
DATE: APPLICANT: Tel. # ► -,7 c"
Permit Fee
$
023 � 0 0
CITY USE ONLY
Fee Schedule on Reverse Side
Fire Surcharge
$
..001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$800 per SAC Unit
License Surcharge
$
_
0 (
$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 $ c2c)• /6
STIPULATIONS:
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed In a side yard without
written permission from adjoining property owner.
HEATING COMPANY 'St• 1'1lu._�1e S` Tef IMSt6'r�C
Signed By� S ` � Tel No. -1g 4-5 34)
Approved By Rough—In Date Final Date G/
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1,199tt
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND
AIR CONDITIONING
SYSTEMS AND DEVICES
SCHEDULE
JOB ADDRESS Uq S�Y e f
RATE
The undersigned hereby makes application for a permit for the work herein
Residential Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 20.00
$ D0
representations stated In this application are true and correct.
(Side Vent — Fill Out Back)
Gas Piping
L2 /-) L _ x.444
(Needed with new furnace) $10.00
$
OWNER
Gas Range $10.00
$
BUILDING USED AS
Gas Dryer $ 10.00
$
ESTIMATED COST c DU • y0 PERMIT NO.
*Air Conditioning — All Sizes $10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repaim & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water)ani Air))
Name d Size No.&WTO 5
Commercial/Industrial
BTU `%S1 UUO• HP EDR
1% of Value of Appliance or Work
$
Fuel D-, Total Connected Load
State Surcharge
$�50
Bumer Trade Name Size No.
o
BTU HP EDR
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed In a side yard without
written permission from adjoining property owner.
HEATING COMPANY 'St• 1'1lu._�1e S` Tef IMSt6'r�C
Signed By� S ` � Tel No. -1g 4-5 34)
Approved By Rough—In Date Final Date G/
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
�• i��v a�•� �� v �, it �- a ��� � ii��- � �,
1. Has been carefully examined
Yes ()
No ( )
2. Is free from rust or deterioration
Yes ()
No ( )
3. Has no foreign objects lodged within
Yes ()
No { )
4. Is securely supported
Yes ()
No ( )
5.
6
Meets all current Code requirements for size
and total BTU's connected
Has total heating BTU's of
Yes ()No()
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( }
8. Has combustion air been provided for water heater Yes ( ) No ( )
Remarks:
lit TERATIONS &ft DQ=
HEATING CO:
signed By:
Date:
01
sueJEcr
E
City of Fridley
�39
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
1 i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
�"""A �'j 612-571-3450
910-F15
7/28/97
JOB ADDRESS 5909 4 STREET NE
1 LEGAL
LOT N0.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
12
2
Bennett Palmer SHEET
I
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Carrie Bakken 5909 4 Street NE'
571-1623
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW h,O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 142 sf Handicap Ramp
9 CHANGE OF USE FROM
TO
STIPULATIONS See notations on plan.
Before MON cell for
ali utility W'ti +ons
454-000"2
REQUIRED 13Y LAW
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 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
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
$600
$.50
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 OTHER STATE OR LOCAL LAW REGULATING CON-
$23.75
Fire SC $.60
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$24.85
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY (DATED THIS IS YOUR PERMIT
,�14
BLDG SP 0 E
S,GNATURE OF OWNER OF OWNER BUILDER) IDATEI
01
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 5
Legal Description: Lo 4 -
N
M
4
Effective 1/1/97
9111:!4
ds3//o
- 16'k,
Owner Name & Address: PO. u Tel. #
Contractor: 0&,)A.),f RNMN LICENSE #
Address:
13
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Me r Ram a
Construction Type:
�j ���,�
�'��
Estimated Cost: $
(.Fee Schedule on Back)
Driveway Curb Cut
Width Needed:
Ft. + 6 Ft = Ft. x $ _ $
DATE: 7 X - V
APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
$3
%S
Fee Schedule on Reverse Side
Fire Surcharge
$
60
.001 of Permit Valuation (1/10th%)
State Surcharge
$
, S Z)
$.50/$1,000 Valuation
SAC Charge
$
$950 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
$`�.
�S
STIM ! LATYONS:
12
4F.
op
2,Y
.............. .
L6
SUBJECT(?_&IWHTNO.3'-
City of Fridley
26503
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�af CE PT
COMMUNITY DEVELOPMENT DIV.
h�
______
r 1 - PROTECTIVE INSPECTION SEC.
v
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
7/8/98
JOB ADDRESS 5909 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
12
2
1 Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Paul Bakken 5909 4 Street NE
571-1623
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
X
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 Sq) Tear -off; Replace Siding on two Ends of House
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Call for
inspection of building wrap before covering.
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 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 1 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
$2 251
$1 12
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 OTHER STATE OR LOCAL LAW REGULATING CON-
$
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$83.12
SIG0FCONTRACTORORAUTHORIZEDAGENT (DATE)
HEN PROPERLY LIDATED THIS IS YOUR PERMI
/J
_
NAT OF WNER F Q N E - TEI
BLDG INSP
/ )ATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION®.�
ConstructionAddress:IT:Va r, C 7-rN
Legal Description:
Owner Name & AddressTel. #
Contractor: MN LICENSE #
Address:. Tel. , 5 71�-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
T bv
Construction Type: Estimated Cost:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: - APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ S . oo
$
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
S
Sq. Ft.
Sq. Ft.
Sq. Ft.
s- a n2 F)b5'
(Fee Schedule on Back)
Ft x $ = $
CITY USE ONLY
Fee Schedule on Reverse Side
l'7Si
Tel. #ll-��
.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 [ J
CITY OF FRIDLEY INSPECTION DIV. YPOM
Effective On January 1. 1997
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Water Bath
Stories Closet Urinal Tub Shower Sink
Wash Drink. Floor Catch Auto. 'Gas Gas I Misc.. Water Heater
Tray Fount Drain Basin Washer 1Ap I. Range Fimt :. Gas Elec
Basement
Floor 1
Floor 2
Floor 3
!Floor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range
NO. RATE TOTAL
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
Gas Dryer" $10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
JOB ADDRESS
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 Building Division, and hereby declares that all the facts
and representations stated in this application are we and correct.
4111-2 , 1991f
Owner V•. al-
Building Used As
Estimated Cost ,��o •� PERMIT NO.
PLUMBING COMPANY
Reinspection Fee $42.00/Hr SIGNED
TEL N0..S"�S/-
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ki
1.5% of Value of Fixture or Appliance
Approved By Rough -In Date Final Oate��
State Surcharge $ .50
------ 'Q lAA AA
-- ..,.M.-IIAn0±G
J!10
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000
A431 University Ave NE dv
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES V�
JOB ADDRESS (_�q0?
RATE SCHEDULE/
OWNER _ Vuzllfir 7
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner - BUILDING USED AS
Also Replacement Furnace $ 30.00 $
'(-13,1,(Side Vent - Fill Out Back) ESTIMATED COST �l. �_ PERMIT NO.—
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 $ 1 $ Trade Name Size No.
BTU HP EDR
*Air Conditioning - All Sizes $ 25.00 $ 0 �.y1 Fuel 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
representations stated in this application are true and correct.
TOTAL FEE $�
DATE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING C9W8Mq
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 40AWIMMAW N. #1 "
PLUS THE $.50 STATE SURCHARGE Signe JPLYMOUrk MNspM74 44 -76 — l Q%gU
REINSPECTION FEE $47.00/Hr '
11
*Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date,
141
written permission from adjoining property owner. _
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 manufacturers specifications. This does
include AGA -LAMA 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 manufacturers specifications. Yes( ) No( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturers 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 manufacturers
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 ;'Type
Appliance #2 Vent Connector Height ft Length ft Diameter4ni-Type
��",!
Appliance #3 Vent Connector Height ft Length ft Diameter to Type
ALTERATIONS: (Describe) ,
HEATING CO:
Signed By:
Date
v
RIGHT -J LOAD AND EQUIPMENT SUMMARY
`H Entire House
Home Energy Center
15200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143
® • • •
For: Daniels
5909 4th St. NE, Fridley, MN
Notes:
Weather: Minneapolis -St. Paul, MN, US
Winter Design Conditions Summer Design Conditions
Outside db -16 OF Outside db 97 OF
Inside db 70 OF Inside db 75 OF
Design TD 86 OF Design TD 22 OF
Daily range M
Relative humidity 50 %
Moisture difference 43 gr/Ib
Heating Summary
Building heat loss 30084 Btuh
Ventilation air 0 cfm
Ventilation air loss 0 Btuh
Design heat load 30084 Btuh
Infiltration
Method Simplified
Construction quality Average
Fireplaces 0
Sensible Cooling Equipment Load Sizing
Structure
Heating Cooling
Area (ft2)
960 960
Volume (ft')
7680 7680
Air changes/hour
1.0 0.5
Equiv. AVF (cfm)
128 64
Heating Equipment
Summary
Make
1.02
Trade
Total sens. equip. load
Sensible Cooling Equipment Load Sizing
Structure
16913
Btuh
Ventilation
0
Btuh
Design temperature swing
3.0
OF
Use mfg. data
n
Btuh
Rate/swing multiplier
1.02
Latent cooling
Total sens. equip. load
17251
Btuh
Latent Cooling Equipment Load Sizing
Internal gains
1380
Btuh
Ventilation
0
Btuh
Infiltration
1892
Btuh
Total latent equip. load
3272
Btuh
Total equipment load 20522 Btuh
Make
Trade
Cooling Equipment Summary
Efficiency
80.0 AFUE
Efficiency 0.0 EER
Heating input
0
Btuh
Sensible cooling
0
Btuh
Heating output
0
Btuh
Latent cooling
0
Btuh
Heating temp rise
0
OF
Total cooling
0
Btuh
Actual heating fan
809
cfm
Actual cooling fan
809
cfm
Heating air flow factor
0.027
cfm/Btuh
Cooling air flow factor
0.048
cfm/Btuh
Space thermostat
Load sensible heat ratio
84
%
Printout
certified by ACCA to meet all requirements of Manual J 7th Ed.
- wrjCjhtsoft
Right -Suite ResidentialTm 5.0.28 RSR20001
2000 -May -15 11:23:04
i4C� C:\My Documents\Wrightsoft HVACVoad1.rsr
Page 1
RIGHT -J WORKSHEET
Entire House
Home Energy Center
15200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143
Printout certified by ACCA to meet all requirements of Manual J 7th Ed.
AWY79h7t501rt Right -Suite Residential- 5.0.28 RSR20001 2000 -May -15 11:23:04
k CAMy Documents\Wrightsoft HVAC\load1.rsr Page 1
MANUAL J: 7th Ed.
1
Name of room
Entire House
Daniels
2
Length of exposed wall
128.0 ft
128.0 ft
3
Room dimensions
40.0 x 24.0 ft
4
Ceiings Condit. Option
8.0 ftl d
8.0 ft heat/cool
TYPE OF
CST
HTM
Area
Load (Btuh)
Area
Load (Btuh)
Area
Area
EXPOSURE
NO.
Htg Clg
(ft2)
Htg Clg
(ftl
Htg Clg
Htg Clg
Htg Clg
5
Gross
a 12D
6.9
2.0
1024
"*'
"'"'
1024
Exposed
b
0.0
0.0
0
'"'"
*"*
0
walls and
c
0.0
0.0
0
'"*'
""
0
partitions
d
0.0
0.0
0
*"'"
****
0
e
0.0
0.0
0
....
.:..
0
....
....
....
..«*
...*
:...
f
0.0
0.0
0
""
*"'
0
6
Windows and
a 2A
40.8
*`
157
6413
"'
157
6413
glass doors
b
0.0
"
0
0
'"""
0
0
Heating
c
0.0
`*
0
0
"*'
0
0
*"
'
d
0.0
**
0
0
****
0
0
e
0.0
'"
0
0
****
0
0
f
1 0.01
01
0
"'*'
0
0
7
Windows and
North
23.6
16
"**
378
16
"'*
378
glass doors
NE/NW
0.0
0
`**'
0
0
""""
0�
Cooling
E/W
57.6
117
"""
6739
117
****
6739
SE/SW
0.0
0
""
0
0
**''
0
*'*"
�..
South
33.6
24
****
806
24
'"""
806
Horz
0.0
0
""'
0
0
**'*
0
8
Other doors
a 10F
27.5
8.2
42
1156
344
42
1156
344
b
0.0
0.0
0
0
0
0
0
0
c
0.0
0.0
01
0
0
0
0
0
9
Net
a 12D
6.9
2.0
825
5676
1690
825
5676
1690
exposed
b
0.0
0.0
0
0
0
0
0
0
walls and
c
0.0
0.0
0
0
0
0
0
0
partitions
d
0.0
0.0
0
0
0
0
0
0
e
0.0
0.0
0
0
0
0
0
0
f
0.0
0.0
0
0
0
0
0
0
10
Ceilings
a 16G
2.8
1.3
960
2724
1204
960
2724
1204
b
0.0
0.0
0
0
0
0
0
0
c
0.0
0.0
0
0
0
0
0
0
d
0.0
0.0
0
0
0
0
0
0
e
0.0
0.0
0
0
0
0
0
0
f
0.0
0.0
0
0
0
0
0
0
11
Floors
a 21A
2.1
0.0
960
1981
0
960
1981
0
(Note: room
b
0.0
0.0
0
0
0
0
0
0
perimeter
c
0.0
0.0
0
0
0
0
0
0
is displ.
d
0.0
0.0
0
0
0
0
0
0
for slab
a
0.0
0.0
0
0
0
0
0
0
floors)
f
0.0
0.0
0
0
0
0
0
0
12
Infiltration a
1 61.0
7.8
199
12133
1552
199
12133
1552
13
Subtotal loss=6+8..+11+12
*"*"
30084
"*""
****
30084
Less extemal heating
"'"
0
***'
""
0
Less transfer
*"'
0
'***
`*""
0
14
Duct loss
0%
0
""'
0%
0
15
Total loss = 13+14
****
30084
""
"***
30084
16
Int. gains: People @ 300
6
-
1800
6
****
1800
Appl. @ 1200
2
**'*
2400
2
-
2400
17
Subtot RSH gain=7+8..+12+16
*"'
"*'
16913
`*"*
-
16913
Less external cooling
'*"
'""
0
***'
*'*
0
Less transfer
****
" ""
0
*'*'
*""`
0
18
Duct gain
0%
'***
0
0%
**"*
0
o/
*"'
°/
19
Total RSH gain=(17+18)*PLF
1.00
-
16913
1.00
'""
16913
20
Air required (cfm)
809
8091
8091
809
Printout certified by ACCA to meet all requirements of Manual J 7th Ed.
AWY79h7t501rt Right -Suite Residential- 5.0.28 RSR20001 2000 -May -15 11:23:04
k CAMy Documents\Wrightsoft HVAC\load1.rsr Page 1
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
August 9, 2000
Mr. Mark Daniels
5909 4 St NE
Fridley, MN 55432
Re: Final Inspection at 5909 4 St NE
Contractor: Home Energy Center, Mr. Rooter and Previous Owner
Dear Mr. Daniels:
A mechanical permit was issued on May 15, 2000 for an air conditioning unit, a
plumbing permit was issued April 20, 1999 for a water heater and corrections on
the reroof need to be inspected. Final inspections on these projects are required
by code and as of this date no inspections have been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
77)
SUBJECT
PE R
City of Fridley
3 2 6 0 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
RECEIPT NO.
• DIY.
COMMUNITY DEVELOPMENTINSPECTION
LV ____
r PROTECTIVE INSPECTION SEC.
��
1 �
NUMBER
REV
OATfi
PAGE OF
APPROVED BY
=
1 "9 CITY HALL FRIDLEY 55432
IL"""�'
�'' 612-571-3450
910 -FIS
5/16/02
JOB ADDRESS 5909 4 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17,18
10
1 Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mark Daniels 5905 4 Street NE
763-571-3477
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
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION j] REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace front steps
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
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
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
$500
•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 CONSTRUCTION
PLAN CHECK F
TOTAL FEE
4.50
S1GNnTURE OF CO RACTO AUTHORIZED NT �DATE�
41b4,4' 41
EN ROP
Y ALIDATED HIS IS YOUR P IT
Sa RE OwNE of OWNER BU t iE�
Bl0 NSP
gAtE
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 02 4TH 7- /16'
Description:
Legal tion:
9 P
"7`` Owner Name & Address: A Alit 0AMtLS - itagrN S! AIC Tel. # '71?- 5'71 —217
Contractor. MN LICENSE #
Address: Tel. #
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: ra E:g rW(,pA r-6AI r
Construction Type: RFtnoue, an�lffle1j,41rz 4W4 G� u -rEstimated Cost: $ �Lo, oo
JAI ro ;rW;
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
�( DATE: I ® Z APPLICANT: �i (� � Tel. # 76 3-- 5-7/- 3 � 7 Z
`Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
$ oc��.
Fee Schedule on Reverse Side
Fire Surcharge
$ S -b
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1200 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 [ J
TOTAL
$ �� . ��
STIPULATIONS:
I�
I�
it a
,ft -AN AP OVED
so, Bitc To! MILD
IN$P tTIONCTOR-
' >
I I j
,t
w 1 —1a—e-EW4 11D ---w4
11L.VV I11
1
ADDN
ALTER I )
Constructim Address: c%
Owner Name & Address:
%.l1T ur" rmi A-mT �200J/ r. YJ1.,VJ4
CITY OF FRIDL.EY f� Effectlw vlr2ow
6431 University Ave NE, Fridley, MN 55432 (763) 5722604 Bldg leap
SINGLE FAMILY ANt) DUPLEXES R-1 AND R.2 (783) 57942.87 Fax
BUILDING PERMIT APPLICATION
Affach to this s •• 1.• w. • •
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height � Sq. Ft.
GARAGE AREA: Length Width Height, Sq. Ft.
DECK AREA; Length Wide HgVGround " Sq. Ft,
OTHER:
Construction TYPOlUaL*IkAffl� IM uthh/mssted Cost: $ � 0
DrMN81y Curb Cut Width Needed•Ft. + 6 Ft = _Ft x $ '
_ $
DATA APPLICANT; Tel. E
Call (763) 672-604 for Permit Fees It mailing In application. Fax to 763.6714287 if using credit card and we wiq call
You for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
Ucense Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Und
$5.00 (State Licensed Residential Contractors)
Alt °A" or Aft. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Necessary [ I Not Necessary [ )
STIPULATIONS:
OCT -18-2004 10:00AM FAX: ID:POMERLEAU PAINTING PAGE:001 R=100%