PRE 2010 DOCSSUBJECT
P . - IT NO.
City of Fridley
® 13330
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 1 i
s
CITY HALL FRIDLEY 55432
� ,'J
NUMBER
REV.
DATE
PAGE OF APPROVED By
"'•� 812-580-3450
910-F15
112/12/75
JOB ADDRESS 6000 - 4th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
14,] j
4
Hyde Park Addition
SHEETO/- 91®(j
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
North Metro Construction Inc. 5203 Central Avenue N.E., Mpls. 55421
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑
X
REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
—IMPORTANT -4
Construct a 36' x 24' and a 20' x 22' Garage
NOTIFY THE FRIDLEY ENGR.
DIVISION REGARDING CURB.
9 CHANGEOFUSEFROM TO
REMOVAL AND REPLACEMENT
AT DRIVEWAL OPENINGS
STIPULATIONS provide a verifying survey before capping.
Provideia hard surface
driveway. Provide sod in the front and side yards.
SOIL TEST MAY BE REQUIRED
SEWER LOCATION: Wye Location is 57' north of the Manhole on 60th Avenue and 4th
Street (centerline on 60th) and 256' south of the Manhole, mid -block on 4th Stree
between 60th and 61st Avenue. 30'' West of the Wye to property line and end of
service.
Wye Elev: 838.15
Top of Footing: 841.15 Minimum
(NOTE: Possible service may not be stubbed to propety line, exa rom
Wye unknown)
N91
6
WATER LOCATION: 1' south of sewer service in same trench. Before digging call local IJ:i?iflPS
SEPERATE PERMITS REQUIRED FOR. WIRING.
TELEPHONE - ELECTRIC -G�;Sr:►c.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
OCCUPA U Y dQft VY
VENTILATING OR AIR CONDITIONING. Wood Frame
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
+440 16,824+4500
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I
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.
13.18
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $26,350
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-
TR $39.45
$325.00
STRUCTION OR THE PERFOR_" OE QF CONS
la r PLAN CHECK FEE
TOTAL FEE
7
$377.63
SIGNATU OF CONTRACTOR ORALLFFjORZEflAGE (DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT
,/SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG )NSP
ATE
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City of Fridley
Appilafflan for Plumhkq Plc'and R nS Pormlt
Dept. of Bldgs. Phone S50-3450 "
DESCRIPTION OF WORK
Number, Kind and Loce:tfon of Fixtures Lotm4iea L��
• Future Cona•ctioa Oponings
• Now Fixture, Old Openings
a.vaa+`sea.iaRa wawa
Saver
Cccspool C]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
N
�
!I
Number Fixtures ................
z
$
Future Fixture Opening ............
Or
$ J!
�
N
z
Catch Basin ....................
WATE4 MN.
$
Water Heater (Up to 99,000 BTU)....
x $3,00
$
New Ground Run Old Bldg.........
x $.3.25
$
Electric Wator iioatar...... ........
Y $2.00
.�
3AS FITTING FEES:
<
7
i
7
•
N
GAS
ELIC.
x $5.00
6
Base
f
%r
2nd
_
3rd
4th
• Future Cona•ctioa Oponings
• Now Fixture, Old Openings
a.vaa+`sea.iaRa wawa
Saver
Cccspool C]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
!I
Number Fixtures ................
- x $2.00
$
Future Fixture Opening ............
-3 X$1.50
$ J!
New Fixture Old Opening.....:....
x $1.50
Catch Basin ....................
x $3.25
$
Water Heater (Up to 99,000 BTU)....
x $3,00
$
New Ground Run Old Bldg.........
x $.3.25
$
Electric Wator iioatar...... ........
Y $2.00
3
3AS FITTING FEES:
NO. RATE TOTAL
Ist 3 Fixtures ............ • • • • • •
x $2.00
$ .
Additional Fixtures ...............
x $ .75
$
Gas Range to 199.000 BTU ..........
x $5.00
6
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 face
and representations stated in this application true and correct
�`ts dleyMi '217 I97.6
Owner
0/9�� G.� � � ` e
Kind of
Used as
To be completed about 06'— /— 76
Estimated Cost,
Old--JgD Building Permit No. Permit
0
Signed P �'
ROUGH
FINAL, .2: / 3 ^ ? .
REPAIRS it ALTERATIONS—Refer to Code .50 State Surcharge
-Description ........................................ $
TOTAL FEE
. 1
Business Phune No���
I
� � '�`:nr-:tT$,. �.. .� �:• ry .'� .,.� r � sem.. Y� �;.8., ....,x.3 �n .z.� ,..,, .,y . t � .• pp ,--�"' �
:'.. :.b \'r.�wv L•1 2 r1s'..�J L N.... v44.J L...� Dwt ...♦ ....
oW 9� ..tj �Nv."•+♦ �' 4L....: tr Y..sw .e/i':� 6V..��.•.. V._._.I ..r k.f'
Crab; 4 ion? EwV".4��ui�-0
GRAVITY W17UM JIM: TOTLL
rurnrce She:l & Davt Fear's ... ... ..... ..$10.03 S
Replacement of 7%.rnact 6.00 $
Repairs & Alterations --up to ;500.00 600
Repzirs do Alterations each add. 2500.00. 300 $
IMCM W11.7 -M Fit
rurrusce Shell & Duct Work to 123,000 BTU
m -z',2 add. 60,000 BTU .
^^ c?zr:art of F urr ace
•& ?:lterztions—up to $500.00
:tzpsirs & Altera lona each add. $500.00
STEAM or HOT VIM= rY I'E
Dap t. of B11;, -s. Mona £-:D-Z;zb
City o? Fridley:
The undersigned hereby makes application for a permit for tie work heretr•
specified. agreeing to. do all work in strict accordance with the City Q:di:-%&acer
and ruling of the Depar :ment of Buildings, and hereby declares that all the fez
and representations stated in this application are true and correct.
as
..$1000 $ ® s
3.W $ Owner
6•00 $ Kind of E
6.00 $
Used as
3.00 $
Furnace Shell. & Lines—to 400 sq. ft. MR Stearn $10.00 $
Furnace Shell & Line --to 840 sq. ft. EDR Hot Water 10.00 $.
Each add 200 sq. ft. EPri Stearn -4.th'1 $
Each add. 320 sq. ft. EDR Hot Water 3.00
OIL BUITINMR—to a gal. per hour 6.03 $.
over 3 gal. per hour ---See Pee Schedule
GpLS B>31tn,ES (up to M9,033 BTU) &C3 $ �
Jaz 1"01,000 BMJ 300 Fee ze-%odula
GALS FITTING FZE3: Nay RATE TOTAL
Ist 3 Fixtures x 2.00 $
Additional Fixture's .75
Gas Range to 14;-0,033 s* 5.00 $ —
State Surcharge .50
AIR :i:C3
FAX TML`a'IM:. Z 12'r—M-f 3330 Fara 9:111:r
A LTZPIJI ; YO?M &s AMURS
nou-013
1f=AL JT -/ 5 "7d
To be completed about._ 4-1-76
Estimated Ccst $ -- 200
Old Building Permit No. Permit No.�®
HF-1kTING or POWER PS.RN°f S am, Hot Water, ' -No
Trade Name Rize Pio-
Capacity ✓...._._ _ Sq. Ft. E.D.R- �eyo ®� � H p
Total Connected Load 3./? Kim of ruet���
BURL M — Trade Name Size Nd
Cap4ci4y SO1. FK. E.D.R BTU IMP -L
192AARO-OV921
f � /
� .,.
'
6 _
Coef.
Btu
�fl /..,�ro wa- -.• d-; .�'. a ��' "'
�•
bass
Windows and Doorar'--Cracksa and Area
1,
I
HEAT LOSS CALCUL
�Y
DEPARTMENT OF B'UILEINGS
V14LAGE
OF BROOKLYN PARK
Weatherstrips
A S H
V.
Int. wall
Construction No. �I
t - rry
r,1 Ag
or
Insulation
Windows Doors
Yes -No Yes
I RGer,
nr
out. Wall tnt� Wall TCed ng Rot3f r ll
_
11�
- -
I.in"� , ,
How Applied
PP
>I -No
--�
if _
Width q Height es°� II ,w F0, >; r .:
koorr, ' Lc hth
'
width Height r
FL1 6, Rc►orn ! Len th
Windows and Df. yrs- Crack�,ge and Area
lVldth diel h;. N -o[ Lancxi�t:. A,-oa':
Na off pane of pane lights' of crack- ev f,,.
Total Btu.
Required sq. ft. E.D.R. or sq. ini. W.A. Leader
Coef.
Btu
Infiltration
Height
-
'ten, I'Length , idth
bass
Windows and Doorar'--Cracksa and Area
1,
u - - - _ _a
�Ind;isa Intl Boo's -Cracks ae awl Area
Exp. wall frit n" d
wiaYh Height
No. or pane o
-�f papa
xo. of .i�tai a: wrea
Ilgea
hta of aQ ft.
.., ��
Net exp. wall
.
Int. wall
Ceiling j Ir
t - rry
r,1 Ag
or
er,'ft.
Floor
Windows and Dors --Cral k-ige and An -a
'-N+. c!..+. I eu �!I. Nrea
Nn par,-'rir p n< I1. tst. ( rack ma. It
i
Coef. Btu
,t- rat_
Infiltion
I _ Np wall' - - -
Net exp.:, 311
Int wall
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ini. W.A. Leader
t,CqUlre(i 3r], lkk t. E.D.P. . _ .ct..in=. W.A.Z.eader area
r'e4 Ron !, L.eng li � �''dth
% F1 • ni „
Height
-
'ten, I'Length , idth
Height �
Windows and Doorar'--Cracksa and Area
1,
u - - - _ _a
�Ind;isa Intl Boo's -Cracks ae awl Area
wiaYh Height
No. or pane o
-�f papa
xo. of .i�tai a: wrea
Ilgea
hta of aQ ft.
.., ��
-
Ca- . of
; �' `t -7-ii-011:
'trte r0f `i,�
�'
t - rry
r,1 Ag
or
er,'ft.
Btu
�
Cosf.
Coef_.
Btu
1_cIt a
AU f ttQA
- . II
•- r �.
CalasJt ^ ^114. <•
� x"t fi
fila~. T
/; ...,�
Exp. wall ; 91" ^a7
!�
Exp. w ltl.
Net exp. wall
Net rata watt
Int. wall
Int. tla'S
Ceiling
—
Floor
Total Btu.
Total sig'
Required sq; ft. E.D.R. or sq. ins W.A. Leader area
s
"_„ _.- '
i Rrd;4q y :L,t' n: ! J..W A: ► [,:der area
fl. A ,a � - k;;m I Lengt : 12. Width li'l
Height
�l , _~ -� _ m t e .til Wi4th �
Height
Windows and Door& --Cracks a and Area
Wtnds:ws and to, I;sge and Area
- Width Height No of - meal ft.. Arta
No. Of pane of Pane lights. of [tack aq. it. -
-
s IdJ 7 -�-H-• al h -fes i i ea` Area
Pana' Ila ZR
_r.
Btu
_ I r ,r ---
_ _ ._ a_
Coef.
Coef.
Btu
Infiltration
�•,
lnft..,aeton
,.
-- _.�.
Glass ii,
.v�
`r '
Glass
Exp. wall' Ji'�
Exp. wall
Net exp. wall.
+
�° �`* I�
Net escpvrt:t
fat. wall-
P----
Int. wall
Ceiling / x >!I/ /„s 1-
%e e9 ;-1
Ceiling
`Floor , •�
�;'
�:'
I
r'Ic ;r _ _ ___
__
Tota
-
firt�l Pf'.
Required sq. ft. E.D.R. or sq. ins: W.A. U.
53-84-9915051 city G4a8-10Y
g pig
Applic�Lfian for b-dl.�rabliLi"� �8� Gas it �'�a4t:� �'aSe :i$
��...�..........._.._.- -.., Dopy. of Sldp�. phone 5:0•3450 ..
DESCMPT101f OF V,'0117-'6000 Z,ocaLl nth Strut NF,
Nu�Ssr, Ki: d nnnd I.*Wk'n of Fixiares. .
• Fu:Ccr: c:s5ra Ci?:,a'.r_�• I —_---- -- sover C]
t Old C>,sn inns CCZ&Pcct 0
PARTIAL RATE SCHEDULE
City of Fridley:.
The undersigned hereby makes application for a permit for the- work hemi
specified, agreeing to do all wont in strict accords ;ce with the Citl O:-dir.:nce
and ruling of the Depar trnent of Euilc°..'nZz, and hereby declares that .01 the fad
• and representations stated in Ltiis app:icat:on are true and correct -
'Fridley, Minn 4-26-76 19._..
Owner North Matrro yonst '
Kind of Building frame
Used as res.
To be completed about 5-3-76
Estimated Cost, $ 0
P•rai2lvo. ��'�
Old --ltd. Building Permit No.
'PL MING F ITU?E RATES:
HO. RATE TOTAL
•
Signed
Number Fixtures ..........
---x5'0.0. $ _
Future Fixture Opening ...... • • • • • •-------
x S1.50
WLltq HU.
Business Phone \o��
few Fixture Old Opening ......•• • • •
x 51.50 8._ :-. ---
Catch Basin ....................
_ _ x 53.25 $
Water Iieater 'Up to 99,000 BTU)
x $300 $ -
ROUGH
•
few Ground Run Old Bldg....:.... __._.__—
x :1.25 S
Voctek Watsr Hoatar.....:....... a
s S? CJ S FINAL ,� r.7
t
ZrJ,S nTTING FEES.
N0. RnTE TOTAL
W3 Fixtures .................. .-----
x $2.03 -
Ad4itJcnal Fixtures .......,...... • ------
x $ .75 $
$5.00 $—•��+-�
Gs R.y:ae to 199.000 BTU........
.50 State Su:.cha 9e
'
FWAIRS tr LLTFP.ATIOHS•--P.afor to Cods
Q.
TOTAL. M 5.50 4. _
83:2
1
IA tall
3 ane
2
3rd
d :!s
• Fu:Ccr: c:s5ra Ci?:,a'.r_�• I —_---- -- sover C]
t Old C>,sn inns CCZ&Pcct 0
PARTIAL RATE SCHEDULE
City of Fridley:.
The undersigned hereby makes application for a permit for the- work hemi
specified, agreeing to do all wont in strict accords ;ce with the Citl O:-dir.:nce
and ruling of the Depar trnent of Euilc°..'nZz, and hereby declares that .01 the fad
• and representations stated in Ltiis app:icat:on are true and correct -
'Fridley, Minn 4-26-76 19._..
Owner North Matrro yonst '
Kind of Building frame
Used as res.
To be completed about 5-3-76
Estimated Cost, $ 0
P•rai2lvo. ��'�
Old --ltd. Building Permit No.
'PL MING F ITU?E RATES:
HO. RATE TOTAL
•
Signed
Number Fixtures ..........
---x5'0.0. $ _
Future Fixture Opening ...... • • • • • •-------
x S1.50
Business Phone \o��
few Fixture Old Opening ......•• • • •
x 51.50 8._ :-. ---
Catch Basin ....................
_ _ x 53.25 $
Water Iieater 'Up to 99,000 BTU)
x $300 $ -
ROUGH
•
few Ground Run Old Bldg....:.... __._.__—
x :1.25 S
Voctek Watsr Hoatar.....:....... a
s S? CJ S FINAL ,� r.7
ZrJ,S nTTING FEES.
N0. RnTE TOTAL
W3 Fixtures .................. .-----
x $2.03 -
Ad4itJcnal Fixtures .......,...... • ------
x $ .75 $
$5.00 $—•��+-�
Gs R.y:ae to 199.000 BTU........
.50 State Su:.cha 9e
'
FWAIRS tr LLTFP.ATIOHS•--P.afor to Cods
Q.
TOTAL. M 5.50 4. _
SUBJECT
RMIT NO.
City of Fridley
®14135
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
' `
REC IPT O.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
6/6/77
JOB ADDRESS 6000 4th Street N.E.
1 LEGAL
LOT NO.
TRACTOR ADDITION SEE ATTACHED
DESCR.
14,15
'15
4
Hyde Park SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Dennis L. Barker 6000 4th Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE, LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Construct a 16' x 40' Swimming Pool (Above Ground) and a deck
9 CHANGE OF USE FROM TO
STIPULATIONS See letter from Environmental Officer dated May 26, 1977
W00"
�
total uR Me
I5110M dlift CI11
•� E
.jLEMONE •ELECTRIC
.EDBY LAN
ItEoUlp
SEPERATE PERMITS REQUIRED FAR WJMN%
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST. OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
& Steel
VENTILATING OR AIR CONDITIONING.
Vinyl
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
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.
$3,000
$1.50
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-
$18.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$19.50
GNATUREOFCONTRACTCRORAUTHORIZEDAG (DATE)WHEN
PRO ERLY VALIDATED THIS IS YOUR PERMIT
`�
I &LA)
G
A) 77
BLDG INSP DATE
SIGNATURE OF OWNEFr0F OWNER BUILDERI (DATE)
6ANII: urtbBYO�R ,
0'" JACK80M
ROM/TUMM UNDRA LAWS OP /TATs OF MM"KMTA
KMN/SO tT CROOMMOR OF OMTY OF MIU MBAPOU9
RAW 08TH 9TRKL"r PA. 4-4681 • � �' � ^� r� �} � k.
i
� � s ��•, h _T c Vir ��' z�� n
i
11111111 > +'4'
or
r 3?
` In
/ 2 59 O s'
SI<>
"aM8V CSRTIVY THAT THR'„A/OVB M/ A TIIUs AND OORR[CT PRAT OF A SURVtY OF
ktt,F� t r;
.t
- *i.: .,
Lots 14 and 15,Block 4,Hyde Park,
Anoka County,Mionesota.
I,
^ `1U1111 ss#IS TNIL-Ath• DAY OF Aujust . a. 1975 °�
Foundation locatisA Jam. 31st,: 1976
23.30-Z4
s1ONMtD
r F. C. J CKSOW. bQ%KO47
OT 1/TRAT#bW'
. a:
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: 4QLL,1L1%�.,�,4PE /r BUILDER:
Address: 4G 1D7r - Vol y"" ��- klof--' Address: -�
Tel. No. -S 7 /- a � � l% � � 11-7mo,
No.: ty
LOT:
CORNER LOT:
Street: ( v`Z S/
BLOCK: _ ADDITION: !f7 l�� A p e
INSIDE LOT: SETBACK: SIDEYARDS:
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:
/�
PC
Front: /{� ��
Depth:
Height: 31
&T ti 1 aC4& j To Vj,,,�quare Feet:
Cubic Feet:
ae j4j'*�
Front: le9
Depth: c;20 •
Height: '� f
Square Feet: Cubic Feet:
f
Type of Construction: �/� s��/Estimated Cost: $
To Be Completed: & - 129 - ! -7 Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side fo• additional information✓
DATE: �� ` SIGNATURE:
Stipulations:
C1 O ELE
6431 UNIVERSITY AVENUE N.E., FRI®LEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
C;e'>°
May 26, 1977
' Mr. Dennis L. Barker
6000 - 4th Street X.E.
Fridley, Mn. 55432
Re: Swimming Pool Construction at 6000 - 4th Street N.E.
Dear Mr. Barker:
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, one (1) skimmer approved by the National Sanitation
Foundation will be provided.
2. As indicated, two (2) inlets of approved design for fresh and/or
repurified water will be provided.
3. The filter and pump shall be approved by the N.S.F. and be of
sufficient capacity to provide a minimum turnover of at least two (2)
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
4. A deck of at least three (3) feet wide, measured from the pool water's
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the
City.
5. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
(c) Self-closing and self -latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
6. An automatic chlorinator should be provided with,a suitable test kit.
7. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
11
Mr.•Dennis L. Barker
6000 - 4th Street N.E.
May 26, 1977 - Page 2
8. All electrical lines must be 10-20 feet or more away from the pool
surface.
9. The pool fill spout must be,air gapped or protected by a vacuum
breaker.
10. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 1' times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450, ext. 170.
Sincerely,
STEVEN J. OLSON
Environmental officer
SJO/mh
0. �
August 8, 1977
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
Mr. Dennis Barker
6000 - 4th Street N.E.
Fridley, Mn. 55432
Re:. Pool Corrections to Comply With Code
Dear Mr. Barker:
An inspection on the pool at 6000 - 4th Street N.E. noted that the pool
wiring is done incorectly. We will expect the corrections to be made
within 10 days and a reinspection called for.
I would suggest having the pool wiring corrected by a master electrician.
If you choose to do it yourself, a $6.00 reinspection charge will be
necessary.
Sincerely,
LEONARD EICHMILLER
Electrical Inspector
LE/mh
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING
PERMIT
P - _
� 3 5 5 8�
Ir
�
COMMUNITY DEVELOPMENT DIV.
r I L PROTECTIVE INSPECTION SEC
I �
CITY HALL FRIDLEY 55432
612-571-3450
RECEIPT NO.
7�0
NUMBER
910415
REV
DATE
7/19/95
PAGE OF
APPROVED BY
JOB ADDRESS 6000 4 Street NE
1 LEGAL
DEscR.
LOT NO.
14,15
BLOCK
4
TRACTOR ADDITION
Hyde Park Addition
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
David Peterson 6000 4 Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Western Remodelers 2520 W Larpenteur Ave, St Paul MN
55113 645-1411
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 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Replacement sleeping room windows must meet the State Egress Code.
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 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. 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
1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,200
$2.60
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O A W THER STATE OR LOCAL LAW REGULATING CON-
TRUCTION; E' EOFORMANCE OF CONSTRUCTION$81.00
Fire SC 20
d,,-"`ry
PLAN CHECK FEE
TOTAL FEE
j
Cit
GN uREOFCONTRACTORORAUTHORIZEDAGENT IDATEI
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
r
BLp INa
4 T
-DATE I
SIGNATURE OF OWNERoF OWNER BUILDERI IDATEI
NEW [ )
ADDN [ ]
ALTER []
CITY OF FRIDLEY -
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: G L L) 0
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1/ 1/95
Tel. #
MN I' S # i
' - Tel. #
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.
Comer Lot [ ] Inside Lot (] Ft. Yd Se ck Side Yard Setbacks
Type of Construction: �'shmated Cost: $
Approx. Completion Date.
(cost 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 ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$850 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 [ ]
CITY OF FRIDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
.AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
$12.00
V
RIND OF BUILDING
4.00
U
Z7r
GRAVITY WARM AIR:
RATE
TOTAL
Job Address J J
Furnace Shell & Duct Work
$12.00
$
$
Replacement of Furnace
Repairs & Alterations -up to $500.00
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Tel. #571-3450
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
GAS BURNER- from 100,000 BTU to 199,999 BTU
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
The undersigned hereby makes application for a permit for the work herein
$12.00 $ specified agreeing to do all work in strict accordance with the City Codes
4.00 $ and rulings of the Department of Buildings, and hereby declares that all the
7.00 $ facts and representations stated in this application are true and correct.
7.00 $ / �p
4.00 $ Fridley, Minn. (O �((� , 19 /7 7
$10.00 $
10.00 $
$10.00 $ 16.00
1st 3 Fixtures x $ 3.00 $
Additional Fixtures x $ 1.00 $
Gas Range to 199,000 BTU x $10.00- $
AIR CONDITIONING $
FAN HEATING SYSTEMS see Fee schedule $
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS $
State Surcharge $ 50
TOTAL FEE $
/Q9, f -
ROUGH INSP.
iJHLe
FINAL INSP.
Date
APPROVAL FOR PERMIT
REINSPECTION FEE
($1o.00)
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO. C�
DESCRIPTION OF FURNACE/BURNER m
HEATING or POWER PLANTS, Steam, Bot Water, Warm Air- No.� 7 S
f%r : y G c7a I", s10,?/�f' l�
Trade N e Size No.
Capacity Sq. Ft. EDR STUD HP
Total Connected Load Kind of Fuel �� S
BURNER - Trade Name' Size No.
Capacity Sq. Ft. EDR BJTU� �' y HP
Company
Signed By Z
Tel. No. 5 7
OWNER KJ
$12.00
$
RIND OF BUILDING
4.00
$
-
7.00
$
USED AS
6.00
$
TO BE COMPLETED ABOUT
(p
$10.00 $
10.00 $
$10.00 $ 16.00
1st 3 Fixtures x $ 3.00 $
Additional Fixtures x $ 1.00 $
Gas Range to 199,000 BTU x $10.00- $
AIR CONDITIONING $
FAN HEATING SYSTEMS see Fee schedule $
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS $
State Surcharge $ 50
TOTAL FEE $
/Q9, f -
ROUGH INSP.
iJHLe
FINAL INSP.
Date
APPROVAL FOR PERMIT
REINSPECTION FEE
($1o.00)
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO. C�
DESCRIPTION OF FURNACE/BURNER m
HEATING or POWER PLANTS, Steam, Bot Water, Warm Air- No.� 7 S
f%r : y G c7a I", s10,?/�f' l�
Trade N e Size No.
Capacity Sq. Ft. EDR STUD HP
Total Connected Load Kind of Fuel �� S
BURNER - Trade Name' Size No.
Capacity Sq. Ft. EDR BJTU� �' y HP
Company
Signed By Z
Tel. No. 5 7
CI7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
December 30, 1998
David Peterson
6000 4th St. NE
Fridley, MN 55432
Re: Construction Without Obtaining a Building Permit
(Reroof/Deck at 6000 4th St. NE)
Dear Mr. Peterson:
According to Section 106.1 of the 1994 Uniform Building Code as
adopted by the .City of Fridley, no building or structure regulated
by this Code shall be erected, constructed, enlarged, altered,
repaired, moved, improved, removed, converted, or demolished unless
a separate permit for each building or structure has first been
obtained from the Building Official.
You have been notified of your need to obtain a building permit and
have failed to comply as of today's date. As a result, a special
investigation fee will now be added to the permit, equal to the
permit fee. The City of Fridley will give you 30 days in which to
comply before turning this matter over to the City Attorney for his
legal consideration.
Please contact me at 572-3603 if you have any questions on this
matter.
Sincerely,
`'
BARRY IES
Building Inspector
BR/bk
01
SUBJECT
RMIT NO.
City of Fridley
28829
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC
r PROTECTIVE
1 , ,
NUMBER
REV
OAT fi
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F 15
1/12/9f
JOB ADDRESS 6000 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
14, 15
4
1 Hyde Park Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
David/Janet Peterson 6000 4 Street NE
571-2299
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 XQ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10' x 8' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on sketch.
WARNING
Before d'9=;in; Csll for
all (I ility lontions
X154-0002
REQUIRED BY LA
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
@@
SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$737
�p .
DOES N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVI O S F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fie SC $.74
STRU TI N R HE PERFORMANCE OF CONSTRUCTION
$29.25
PLAN CHECK FE
L FE0.49
X
I NATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
HE PROPEFPF
VALI(IATUO THIS IS YOUR PERMIT^
SIGNATURE OF OWNERof OWNER BUILDER, IDATEI
Bl G IhSo
r1ATE
01
NEW [ j Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 aq
BUILDING PERMIT APPLICATION
,� 0
ConstructionAddress: €,. L- CSU `=-� �'` Ot
Legal Description:
Owner Name & Address: i_ �fW \A -1- STA kJ ( -r Tel. #
Contractor: / �„ vv.si ""-Q ""4, 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 EMPROVEMENT
LIVING AREA:
Length Width
Height
Sq. Ft.
GARAGE AREA:
Length Width
Height
Sq. Ft.
DECK AREA:
Length 1 ,C) ` Width
c Hgt/Ground � j
Sq. Ft. ZZ
OTHER:
$
IV
.001 of Permit Valuation (1/10th%)
Construction Type:
a
Estimated Cost: $ 62 O O
$.50/$1,000 Valuation
SAC Charge
$
(Fee Schedule on Back)
$1050 per SAC Unit
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Ft x $ = $
DATE: — I — `% f APPLICANT: Tel. # 571
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
C)qc %r
Fee Schedule on Reverse Side
Fire Surcharge
$
IV
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 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
$
STIPULATIONS:
J �
�
r
to
LA
Q
Z
4 60
0
11
FRIDOF
LEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
June 7, 1999
David & Janet Peterson
6000 4 Street NE
Fridley, MN 55432
Re: Deck Corrections at 6000 4 Street NE
Dear Mr & Ms Peterson:
This letter is in response to your request to have the necessary corrections on the
deck mailed to you for your review.
A final inspection was conducted on March 26, 1999 and the following items were
noted which must be corrected before the deck can be finaled;
1. Install guardrail to meet the State Building Code. Existing guardrail is to low
and does not have a grippable handrail. See attached brochure.
2. Increase beam size supporting joists & stairs (double existing) and solid block
beam to footing.
3. Obtain building permit for deck corrections. Original building permit expired
January 12, 1999.
Please contact us for a reinspection when the corrections have been completed.
Any questions can be addressed to myself at 572-3603.
Sincerely,
BARRY MSCH
Building Inspector
BR/mh
ATTACH: 2
.1.
The largest tread width or riser height within any stairway
shall not exceed the smallest by more than 318 Inch.
Headroom
Every stairway shall have a headroom clearance of not less
than 6 feet 8 inches. Such clearance shall be measured
vertically from a plane parallel and tangent to the stairway
tread nosings to the soffit above at all poir ts.
Handrails
The top shall be placed not less than 34 inches nar more
than 38 inches above the nosing of the treads. They shag
be: continuous the full length of the stairs and, except for
private stairways. at least one handrail shall extend not less
than 6 inches beyond the top and bottom risers. Ends shall
OCCUPANT LOAD
LESS THAN 10
(PRNATE STAIRWAY)
6'8" MWg11At IM
HEADROOM
RUN:
9" MINIMUM
RISE 4" MINgKUM
8" MAXIMUM
GUIDELINES:
Stairways
be returned or terminated in newel posts or safety ternbnals.
The handgrips shall be not less than 1.5 Inches nor more
than 2 Inches in cross-sectional dimension or the shape
shall provide an equivalent gripping surface. The handgrip
shall have a smooth surface with no sharp corners.
Stairways less than 44 inches in width or stairways
serving one individual dwelling in Group R, Division 1
or 3 Occupancies, may have one handrail.
2. Private stairways 30 inches or less in height may have
handrails on one side only.
3. Stairways having less than four risers and serving one
individual dwelling unit In Group R, Division 1 or 3, or
Group M Occupancies need not have handrails.
OCCUPANT LOAD
100RMORE
HANDRAIL
6'8" NMdMUM
HEADROOM
34... M' .
RISE: 4" MINIMUM
r MAXIMUM
HANDRAIL DETAILS
Other shapes may be acceptable N they provide equivalent gripping service.
3.5
•1,1 I 1 1 1 1 I 1 1 •+r"
r�B�i _ 1' MAX.'
A 1 r A A B B Alo
_L
A = 1.5" Minimum B n 1.5" to 2"
BEAM
{BEST) .
See Beam and
FooBng Table
NOTES:
• rW sipfbes
In beam must be
over support
All beams of2 or more.
members shall be
imfled together with
2 rows of 16d Nails
at 1600 C.
POST —
3'/a" Minimum
Pin or other
approved
iastener
abO 0 °
e p
CONCRETE
°off;
PIER.4 0:d°o
FOOTING 8 }
Minimum
°v op o
e A0*
00
°ov
a
See Table
for Footing size
MANUFACTURED
BEAM SUPPORT
ALTERNATE ...;
BEAM (BETrER)
POST --►
51h" Minimum
(4X6 or 6X6)
ALTERNATE -►
BEAM (000m
POST --
3'/z" Minimum
42"
Minimum
JOIST, _ DECKING
See Joist 16" or less Span: 1" and 610
Span Table Over 16" Span: 2"
'
LEDGER
',
Same size as joists.
Install Lag Screws
wo
that penetrate
Irl z" Carriage
1Ile minimum into
Bolts with
rim joist or wall
Washers
studs. (Minimum
two 3/e" Lag Screws
every 16")
NOTE.•
Joist hangers must
be correct size for
joist size used
BUILDING ---
_ e
8" Vd'odo
See Table
for Footing Size
One 'AzO
One'/2" Carriage
Bolt with Washer
if 2"X8" or
larger beam.
Two 5/e" Bolts
with Washers
through Manufactured GRADE
Beam Support.
ALTERNATE FOOTING
BACKFILL MATERIAL
WOOD POST
POURED CONCRETE FOOTING
Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Date Rec'd: � oo�
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: OKOWNER OCONTRACTOR
PROPERTY
NAME: J
TENANT
ADDRESS: — CITY r� STATF ►'W ZIP_�2 'L
PHONE: G�
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS: CITY STATE ZIP
LICENSE WITH
PHONE FAX
APPLICATION
PERMIT TYPE
>01INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:L4EW
❑ REPLACEMENT
DETAILED DESCRIPTION OF WORK ►
PER MS 1613.665 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: (INDICATE TOTAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
_
—BATHTUB _ GAS PIPING aEw cn7uC&a4 _, SWIMMING POOL _ WATER SOFTNER ($35)
_ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET BACKFLOW PREV. ($IS)
_ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
_ WATER METER _ OTHER
x
Permit Fee $ % 7N=ber of fixtures $10.00 x $10.00
@
Surcharge 50 ber ofs$15.00 x $15.00 =
TOTAL DUE $ __1_�' ___. mber of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
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 ap cation 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 o work which requires review and approval of plans.
SIGNATURE OF APPLI PRINT NAME -304 PekrJ *j DATE 6 4Y IN.
City of Fridley
]Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977