PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N°(4, 68 4
Date:.__
Owner: A"-:trClc Builder
.a
Address Address ......_....... ..........
LOMAT ON OF BUILDING
No. .%'. ... StreetPart_of
Lot .... ...!4�_ .. ....... Block ..... v ...... .............._.. y 1 w .• ..... _
Addition or Su -Divis n -
Corner Lot ............. ...... Inside Lot ..:.._..._........ _................. SetbaSideyard ._. _..___ _.... ........
SewerElevation ............. ............................................................ .................. ... _. Foundation Elevation _ ................. ._............._._.._......_..........._................ ......._..._..
J f - V i G' AY-
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.:......._ ............._...y permit is hereby granted to. ..................... ......................
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violatiof any of the provisions of said
ordinances.? f' t
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas, heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
4
I
DESCRIPTION
OF BUILDING
TZ Used a�:
:[_r
�G..+../1'
Front.._:. Depth L '..
Height ..t._.. Sq. Fti��..:�-C.�'.
Cu.
............ ............ ................................
Type of Construction
Front ..................... Depth .................... _..
Est. Cost.....:..:...:...:......_�:...,�.....
'ght .................. --- Sq. Ft. ......................
t9".:.",C""i°o be Completed •---._............._..
Cu. Ft. ......................
............................
J f - V i G' AY-
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.:......._ ............._...y permit is hereby granted to. ..................... ......................
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violatiof any of the provisions of said
ordinances.? f' t
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas, heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
4
I
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners
Address es / ` Srll 1 /l)J0k_ Address �` ®/
,y
LOCATION OF BUILDING
No.�, Street ,'aPart of Lot �Or
c
Lot -d Block Addition or Sub.Div.
Corner Lot ,�, Inside Lot_,_ Set Back �yS""�� Side -Yard �`S
SEWER ELEVATION FOUNDATION ELEVATION_
Applicant -attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING -
To be used as if-If
CIV C
7' HeightZ;
�s 4 Front Depth , �a :.._
Sq. Ft. ° Cu. Ft.
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions'stated in this application are true and correct.
DATE
SIGNATURE
„®� ,
(A Schedule of Fee costs can be found on the Reverse Side.)
0 0
w e r
City of Fridley, Minn..
PUHDING PERMIT
Date:
.{ r
Owner: _s Builder
Or
Address — Address
N° 5216
61 OF BUILDING
No. ��4 -J) � t - d Part of Lpt r . -----
Lot ;Z __`"'Blo& 1.�__ Addition or Su
Corner Lot —__ Inside Lot - ..rback V Sideyard
Sewer Elevation
DESCRIPTION OF BUILDING
Tp<b U�qd as:
Front Depth Height Sq. Ft.
Front _ Depth Helg — Sq. Ft.
Type of Construction _ Est. Cost To be Completed _
Cu. Ft.
Cu. Ft.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _ _ • I
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heattng, sewer or water. Be sure to as
the Building Inspector for separate permits for these Items.
APPLICATION ' BUILDING PER)W
CITY OF FRIDLEY, MINNESOTA
i
Owner 19 (T "4 t
A -
Address Address_
OF BUILDING
No.
of Lot
Lot Block Addition or Subdivision
Corner Lot _ _ Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To sed as:
1�4r Front_ZDepth Height to
Sq. Ft. Ole Cu. Ft.
Front Depth Height
Sq. Ft. Gu. Ft.
Type of Construction timated Cost -
5 a
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that a;4 the its and representations
stated int s application are true and correct.
DATE — / — 4-�-' / SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.) Jrc-4a'y�
C�
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City of Fridley, Minn.
BUILDING PERMIT
Date: June 23, 1969
Owner: Warren Osborne Builder
Address 7541 University Ave. N. E. Address
Same
Same
N° 103®4
LOCATION OF BUILDING
No. 5 6 01 Street 5th S t . N. E. ____ part of Lot
Lot 16 & 17Block 2 _ Addition or Sub -Division _ Hamilton's Addn. of Mechanicsville
Corner Lot _ X— Inside Lot — Setback —_ Sideyard
Sewer Elevation ____ 847.94 _ 850.%3 Approx .
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
DwellingFront 57' 6" Dept 40'121 Height -- Sq. Ft. 1432 Cu. Ft 28,64
Gage Front 231 Depth 28 Height 10' Sq Ft, 591 Cu. Ft. 5910
Type of Construction _ _ Frame Est. Cost $28,000.00 ^ To be Completed
SEWER LOCATION 50' North of Manhole
WATER LOCATION 41' North of Manhole
In consideration of the issuance to me of a permit to cons the uil ' g described above I agree to do
the proposed work in accordance with the description above r pliance with ail provisions of
ordinances of the city of Fridley. U
00_ Sewer Connection Charge
In consideration of the payment of a fee of $ 52.00 , permit is hereby granted to Warren Osborne
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 -4'IA4--
within the
city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ch
• NOTICE:
M permit does not cover the construction, Intl ation for Wiring, Plumbing, on heating, sewer or wafer. Be sure to no
the Building Inspector for separate permits for thews Noma.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME _ (� .'�> BUILDER-���.✓x�f-�`-��G,.
ADDRESS ADDRESS
LOCATION OF BUILDING
NO. STREET
LOT BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDEYARD
SEWER ELEVATION TOP OF FOOTING
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:
) p �
z
hC Front -� ®Depth rJ%,� ef
Square feet Cubic Feet 2 S 6 Y D l
61!C1 "Y q Front 2-1 Depth Height �d
T
Square feet`J �� Cubic Feet U
Type of Construction Estimated Cost
P �.,
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.)
2Crl�
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1 y3 vC)7,,
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3�
a-�O
r a, 9 �P
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Oris !
PERMIT for Power tants and Heating. Cool=
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of_ ! Heating Plants Linto be installed tered—repaired
Make
Oil fired ; Coal ftred , Gas fired ; Gas Authorization No.
Remarks
Approved by
Final Inspection
wWm
,19
Inspector
Permit N° 4546
Fee $ aZ5
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. -9 Y , 19-6-1
Owner ZLs I
Location
Kind of Building
How Occupied
Work to be Commenced ,19
To be Completed ,194,7
Estimated Cost,
Old -New, Building Permit No.! 0'_ 3 0 4
Permission is hereby granted to ' / �'t to install—erect—use the material and devices described in the
above statement. This permit is granted upon the expres condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein nam d, and to the specific ns set forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
Inspector of Buildings
42 2M 11-67 V
N° 498'7
Original Permit for IrLUMBING AND GAS FRTING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for I FP it
,� o-0
inspection shall be phoned in to the plumbing Inspector, 550-3450 giving number of this permit., Fee
DESCRIPTION OF WORK II
Number, Bind and Location of Fixtures /1
.Stories
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WATER HTR.
6A8
ELEC.
Basement
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2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
Permission is hereby granted to do the plumbing and
gas fitting in the building described in the statement here attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
142 IM -6.65-V
City of Fridley rr -
Owner
Location '5(C6I G�
Kind of Building
Used as
To be Completed-
Estimated
ompleted
Estimated Cost $ / 7 e -a • &=;o
Old -New. Building Permit No. - 4
Date g - (r1
Inspector of Buildings.
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures
Future Fixture Opening
New Fixture Old Opening
NO. RATE TOTAL
9 x $2.00 $ o-0
x $1.50 $ -3 ."
x $1.50 $
Catch Basin x $3.25 $
Water Heater (Up to 99,000 BTU) x $3.00 $
New Ground Run Old Bldg. x $3.26 $
Electric Water Heater a $2.00 S.
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ..... ....... x $2.00 $ 19 .'--0
Additional Fixtures ..... x $ .,m $
Gas Range to 195,000 BTU . ............ x $5.00 $
REPAIRS & ALTERATIONS -Refer to Code
Description .... .... ....................... ...........#
TOTAL FEE $ & �'
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 fact
and representations stated in this application are true and correct.
Fridley, Minn / lg
Owner '6�
Kind of Building
Used as
To be completed about
Q�
Estimated Cost, $®�+
Old—New. Building Permit No. / e -,l _. P it o.� 7
Signed
By- —
Business Phone No �G7
ROUGH
FINAL / - �7
ii
ZQ
sN
WATER HTR.
GAS
ELEC.
Base-
lst
>
-
-
—
-
--
-
--
—
2nd
-
3rd
4th
_
ryatnre COnneC:on Openings Connected with — -- --
# Now Fixture, Old OpeningsBawer ❑
I
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures
Future Fixture Opening
New Fixture Old Opening
NO. RATE TOTAL
9 x $2.00 $ o-0
x $1.50 $ -3 ."
x $1.50 $
Catch Basin x $3.25 $
Water Heater (Up to 99,000 BTU) x $3.00 $
New Ground Run Old Bldg. x $3.26 $
Electric Water Heater a $2.00 S.
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ..... ....... x $2.00 $ 19 .'--0
Additional Fixtures ..... x $ .,m $
Gas Range to 195,000 BTU . ............ x $5.00 $
REPAIRS & ALTERATIONS -Refer to Code
Description .... .... ....................... ...........#
TOTAL FEE $ & �'
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 fact
and representations stated in this application are true and correct.
Fridley, Minn / lg
Owner '6�
Kind of Building
Used as
To be completed about
Q�
Estimated Cost, $®�+
Old—New. Building Permit No. / e -,l _. P it o.� 7
Signed
By- —
Business Phone No �G7
ROUGH
FINAL / - �7
o
SUBJECTPERMI
O.
City of Fridley
18796
AT THE TOP OF THE TWINS
BUILDING
PERMIT
R EIPT N
Ir?
• COMMUNITY DEVELOPMENT DIV.
►y_------
f � � PROTECTIVE INSPECTION SEC.
9350 0
iCITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
2/17/87
JOB ADDRESS 5601 - 5th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
16,17
2
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Susan Ecklund 5601 - 5th Street N.E.
571-3519
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Panelcraft Inc. 3118 Snelling Avenue So., M ls. 55406 721-6628
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 IR ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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
$3,250
$1.62
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
D ES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
I V IONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$44.50
ST CTION OR THE PER OR C OF CONSTRUCTION.
'
PLAN CHECK FEE
TOTALFEE
$46.12
E OF CONTRACTOR OR AUTHORIZED AGENT .)DATE) .�
WHEN PROPE
V LIDATED THIS IS YOUR PERM TT
BLDG )NSP
�TE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. Building Permit Application
Construction Addr,
Legal Description
Owner Name & Ad i
Contractor: L
Address:
Tel. #
7, -- 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:
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: rs/.f Estimated Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
r
DATE:
/� �� APPLICANT: Tel.
` CITY USE ONLY
Permit Fee $ 44 Ste- Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 46 $.50/$1,000 Valuation
SAC Charge $ $525 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ �o
STIPULATIONS:
10
Z
SuBjECY
T NO`.'
City of Fridley
d731358,
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC
p�
Z114
r PROTECTIVE
' 1 I CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED Br
612-571-3450
910-F15
9/1/00
JOB ADDRESS 5601 5 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16,17
2
Hamilton's Addn to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeff/Becky Eull 5601 5 Street NE
571-3866
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
B DESCRIBE WORK
Reroof House & Garage (35 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. 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 OWLG. 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
@3,579
$1.79
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
W
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
W
PLAN CHECK EE
OTAL FEE
t
Ifl
$102.62
SIGNA R OF CO •RACTOR A ORiZEDAGENT iDATE,
H P O
Y VALIDA ED THIS I OUR PERMIT
.G E OF OWNER OF OWNER BUiLDER, iOATE
--KIM NSP I
DATE
Z
NEW Il
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
Effective 1/1/2000
(763) 572-3604 Bldg Insp�
O
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: �. � r ®r
02'.'or-
Construction
Construction Type: Estimated Cost: $ 3599
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:. APPLICANT: Tel. # S71- -Tee&
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ 3,,_80 .001 of Permit Valuation (1/10th%)
State Surcharge $ 1, 9 $.50/$1,000 Valuation
SAC Charge $ $1100 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 $ 10.2, 6.
STIPULATIONS:
Building
BUILDING
(USING THE 199
Permit No.44I b-D214
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
$
CITY OF FRIDLEY
Date Rec'd: fb
763-502-X479777 FAX
$
65% of Building Permit Fee
Fire Surcharge
$
EFFECTIVE 7-1-2010
.001 times the total job valuation
Surcharge
-%-10
S4
de�Z �� ��� ��s...
o
DATE 12,
YOUR E-MAIL ADDRESS
• �-'
SITE ADDRESS 6* 0
c
/ JJ 04-
$
THIS APPLICANT IS:
PiDWNER ❑CONTRACTOR
Curb Cut Escrow
PROPERTY OWNER/
NAME: Q hi �B tom/
ft + 6 ft = ft x $24 = $
_CITY
�p�Q
STATEI%IP_�
TENANTADDRESS:
$450 Conservation Plan Review
•��
PHONE:
$
CONTRACTOR
NAME:
Sewer Main Charge
SUBMIT A COPY OF
Agreement necessary ( ) Non Necessary ( )
YOUR STATE LICENSE
STATE LICENSE #
EXP DA
AND CERTIFICATE OF
ADDRESS:
CITY STATE ZIP
INSURANCE
PHONE
FAX
PROPERTY TYPE
• !rSINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
eMINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: +/�1/
n / -
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
11 HOUSE & GARAGE
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
I . Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS Nes ❑No LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
2
TYPE OF WINDOW TO BE INSTALLED T NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDIN THE COST OF LABR TERIALS:
(USING THE 199
U.B.0 CHEQW)
TOTAL JOB VALUATION $
dP &V
CCUPANCY TYPE
Permit Fee
$
` •a,
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
o
.001 times the total job valuation
Surcharge
$
060
.0005 x Permit Valuation Minimum $5.00
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
p (p �Z- a
Make checks payable to: Citv of Fridlev Attach Stipulations
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 theordinances d codes f the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application a and rk is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of a w view and approval of p _s. - - VIK / a
SIGNATURE OF APPLICANT PRINTNAME AIGni41ONi ATE 12-!g--10
APPROVAL INSPECTOR SIGN URE
---
FO ODE
_
-
BLD Inspector
--
0
d
Building
PLUMBING
P
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'dz
763-502-4977 FAX
IEFFECTIVE 7-1-2010
r /0
DATE 2_1- YOUR E-MAIL ADDRESS
SITE ADDRESS 5 6 O I 5 7' ST- N16-
THIS APPLICANT IS: 0 OWNER WCONTRACTOR
PROPERTY
NAME: �ri `��••�tlJ W IN C J-4— O bleL1467
OWNER/
ADDRESS: CITY STATE ZIP
TENANT
PHONE:
CONTRACTOR
NAME: <�-►?TACC- -MTOEvs ?t. v V 3 r n 6-1 INC-
SUBMIT ACOPY OF
STATE LICENSE #?Ak �, 16'7- FM EXP DATE I Z- N - 201 O
YOUR STATE
t
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
ADDRESS: If 57(f ROY 65 PE CITY 6&r �3errta STATE�ZIP 168//
INSURANCE
PHONE_ 763-y/3`60k,4 FAX
O
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
0 NEW 1r REPLACEMENT
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK RRPC.E 3 5i6ec TdvceT5 . 3 -W- Le-1— a- 3 LAV. I kif.
Mod'57 3ftEP1'iL7r 71-umbinka '13 TH -M NCiJ (A.I1r, cn Le-55 Wn 2'
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAV DRAINS 2-SHOWER WATER PIPING
_FLOOR
BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35)
_ _
CLOTHES WASHER KITCHEN SINK T WATER CLOSET _ BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
<-�, i i _ °F M .Y•ti 'v� ��.i"'i: l S }. .�. g 73 1y.� k } �3 : Y^' X�:. s� j : 9 tG +D } 'Ci ii� h
i � S A'^ #u"A 3$"3 S'S 2''n � F S &' � �fi 1£�F�✓"f� � '� i .��' �'� 4j i}
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes4theity of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for ad work is not to start without a permit on site; that the work will be in accordance
with the approved plan in t all rrequires review and approve Qf pl�nG
SIGNATURE OF OF APPLICANT PRINT NAME /�/ DATE /O
APPROVAL INSPECTORS SIGNATU
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
MECHANICAL
Permit No.: lip -OM I
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
763-502-4977 FAX
EFFECTIVE 1-1-2011
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR
PROPERTY12
NAME: ®� "
OWNER/
ADDRESS: 'S O/ S /�� CITY � '�STATZ�' ZIP �T5
TENANT
��t
PHONE/ 7—�
CONTRACTOR
COMPANY NAME:
SUBMIT A COPY OF
CONTACT PERSON: /ylr%e alv/
STATE LICENSE # EXP DATE l //
YOUR STATE
LICENSE WITH
ADDRESS: -?7U CITY x,141, STATl?-*✓ZIP /
APPLICATION
-SZ '
PHONE (moi FAX
PERMIT TYPE
fa &NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW ❑ REPLACEMENT LTERATION/REMODEL
DETAILED DESCRIPTION OF WORK willr4i / S
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 RANGE/OVEN $10.00
_GAS
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GAS GRILL $10.00
_NEW
BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
� OHIMNEY LINER $10.00 _GAS DRYER $10.00 ,PUOL HEATER $35.00
EDUCT WORK $10.00 GAS PIPING $10.00 6�VENTILATOR $15.00
yFF t ' e
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ld tv •, he a, �.5 '.� � �i
, _ e. _ a .a .,o -i
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a buildin rmit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with th�� mances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but Drily an applic ion for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in twie work which requiresand approval of p/yfi,l
SIGNATURE OF APPLIC PRINT NAME /v DATE
APPROVAL INSPECTORS SIGNATURE DATE
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 ❑ MAKE-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 MN Rule 1346 Sec. 501
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. NI 104.4.13
5. Ventilation
a. Per MN Rule Chapter 1322. Sec. 1104
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.