PRE 2010 DOCS1111"IFORMUDIDIMINd
Village of Fridley, Minn. N? 2151
Date /�� '
Owner Builder ..... v .. . ........................
Address
... .�.:... ......... ........... Address ........ .................................
LOCATION OF BUILDING
No.....Q. Street ..:1f......... ...................... `Part of Lot .......................
Lot r. * Block ..... f. :...... Addition or Sub -Division . /�. ?s ;.' ..... ,.
Corner Lot Inside Lot .. ..... Setback Sideyard i�%....�.r. ....:..........
DESCRIPTION OF BUILDING
To be Used as:
.... Front „ ... Depth . . Height Q.' -Or. Sq. Ft......... Cu. F't.........
• . Front ..;-... Depth ....... Height ........ Sq. Ft...... • Cu. Ft,
Type of Constructio �7• Est. Cost � �.� ...... To be Completed '0 ......
In consideration
the proposed work t
ordinances of the vi]
)f the issuance"to me of a permit to construct the building described above, I agree to do
accordance with the ,description above set forth and in 'compliance with all provisions of
age of Fridley,.
consid f the payment of a fee of ,$.: %rr.. , permit is hereby granted to ...' .............
to construct I the building or' audition as described shave. This permi granted upon
the • , express condition that the person to whom it is in all work
e�A granted. and his agents, employees and workmen,
dome "in, around .and upom said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Wnnesoffi ding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits d this permit may be revoked at any time n viola of any of the provision:ofsvdd
'ordinances.
.dingr
NOTICE:
This permit toes not cover the construction, installation -or alteration for wiring; plumbing, gas heating,
sewer or water. ie sure to see the Building inspector for separate permits for these Items:"
PARTIAL RATE SCHEDULE
GRAVITY WART -4 AIR:
Il%=nzce Shell & Duct Work
Replacenwnt of Furnace
P.cpavr & Aitcrat=s-up to $500.00
Repairs & Alterations each add. 4500.00
11iXCIL WARM ABR
Furnace Shell & Duct Worcs to 120,000 BTU
each add. 60,000 BTU
RepLremmt of Furnace
Repairs & Alterations --up to $500.00
Repairs & Alterations each add. $500.00
STEAM or HOT WATER SYSTEMS
Air -, ;'isr.1Azg S -ad DaAcw
19ATS TOTAL
$10.00 $--
6.00 0
600 S-
300
300 $
41000 00 $
3.UU $
6.00 3 d
6.00 $
3.00 $
Furnace Shell & (.fines -to 400 sq. ft FDR Steam
V0.00
$
Furnace Shell do Line --to 640 sq ft. EDR Not Water
1000
S.
Each add 200 sq. ft. EPR Steam
3 on
;
Each add. 320 sq. ft EDR Hot Water
3.00
$
OIL SUPKEP.-to 3 gal per hour
6.00
$
over 3 gal. per hour -See free Schedule
GAS BURNER Cup to 199,000 BTU)
&00
$ -1
over 199,000 MU See Fee Schedule
GAS FITTING FEE3.
NO RATE TOTAL
Ist 3 nxtures
x$ 200
$�!
Additional Fixtures
x .75
Gas Range to 199.0W
x$ 5.00
:
AIR C.OM8T80G
State Surcharge .50
�
PAR H=TMG SYSTEM Seo Fee €Ick
VENTn.ATIRG S"T
ALTERATIONS & REPAEM TOTJ�L I=
$ 1-»
lit. of Bldg& P'hom tw-
L..
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified agrcring to de all work in strict accordance with the City Ordinaacer
and n:ting of the Depai tment of Buildings, and hereby declares that an the facts
and represontatiuns stated in this application are true and correct.
Fridley. M nn
Kind of Building �� c
Used as
To be completed about
Estimated Cost b - /
e (O�
��iNew. Building Permit No. _ _Permit No.
1T017 Or WORK
kFA NT7 G or POWER PLANTS_-Stteizm, Hot Water, Warm �=No-,�
Trade NameiZ'-�,_ Cry -� _ l' gine Pie_
Capacity---. - Sq. Tt. E.D.R- � �� BTU
Total Connected Load `I -ALIZ i_p - ,< Kind of Ftw %l = -
BURNER - TYade Nagine No
Capalci Sq. Ft ED R BYU
(RMAstss-oattm)
sy-
LJ
SUBJECT
PERMIT
City of Fridley
c 183
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIP
i `y COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
`
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/15/86
JOB ADDRESS 5330 - 5th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
11/N 12
14
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Frances V. Rodgers 5330 - 5th Street N.E.
572-8170
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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof structure
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install
ridged galvanized valleys.
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
]
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
$575
$.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.
$15.00
LAN CHECKFEE
TOTALFEE
$15.50
O C NTRAR THORZEDaAGENT IDArEI -
..� DATEDITIS IS YOUR PE/
ITWHEN PROPERLY
e((l
SSIGNATURE
ATURNERtl O LDERI IDATEI
BLDG INtw
qAT
LJ
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address:�,��
Legal Description:
Owner Name & Address: "If//'"'�� �Y i Tel. # ��
15
Contractor: 11 Tel. #
Address:
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:E�D6
5TR
Corner Lot [ ] Inside Lot
Type of Construction: ,, �7®%f�/i�
[ ]] Ft. Yd. Setback
Estimated
Side Yard Setback
Cost: $
Approx. Completion Date:s-
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �3 7J APPLICANT: Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
DOTAL
STIPULATIONS:
$ /'S7 0 0
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
PLUMBING FIXTURE RATES:
APPLICATION FOR PLU
MARK NUMBER OF FIXTURES TO BE
4<> Wash Drrl
_..' Shower .Sink:_: Trav
NO. RATE TOTAL JOB
New Fixtures
$ 7.00
The un
Old Opening, New Fixture
$ 4.00
specifii
Beer Dispenser
$ 5.00
and rul
Blow Off Basin
$ 7.00
and -rel
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Owner
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Buildin
Gas Range**
$10.00
Gas Dryer**
$10.00
Estima
Back Flow Preventer Required ( )Yes () No
Type
$15.00
PLUM I
Reinspection Fee $42.00/Hr S
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
MINII
TOTAL FEE PLUS
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A)
r '
kS FITTING PERMIT
EACH FLOOR
tc I Auto. GaS
srir>< Washer
-
Effective On January 1, 1997
Gas Water Heater
Gas Elec
M_
;eby makes application for a permit for the work herein
No all work in strict accordance with the city codes
iildIng Division, and hereby declares that all the facts
L
stated in this application are true and correct.
—,1998
PERMIT NO. ), 33L 8
y MR. ROOTER OF ANOKA COUNTY
6250 Indusiry Ave. N. #114
Ra►y �IN 55303 .:.
-614
t
421 -6198 -FAX (�
_ Rough—In Date ` r Final DateC��%"=M�d
MINIMUM SIZE 9 SO INCHES.