PRE 2010 DOCSE
City of Fridley, Minn. 0
BUILDING PERMIT N® 6694
Date:
Owner: Builder_ --•—.—
Address _ _ Address
I .UILDING
No. �! `� StreetI:Yz. x _ P t
Lot° Block Addition or S
Corner Lot — Inside Lot eetback 'Side, _ r�
Sewer Elevation — ]' dation Elevation
DESCRIPTION OF BUILDING
T - '�
Front Depth Height _ _ Sq. Ft Ft
n Depth Height ___ �_ Sq. Ft _ __ Cu. Ft
Type of Construction� PA— Est To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set/p and in comp ce with all provisions of
ordinances of the city of Fridley. % n , �,�,
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
Bone 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 erepmr and moving of buildings
within the city limits and this permit may be revoked at anytime upon v� on of of the provisions of said
ordinances. /T
NOTICE:
1h@ permit does not cover the construction, Installation for wirlog, ph rAbing, gas hotting, at/,, or water. Be sure to we
the Building Inspector for separate permits for these Items.
City of Fridley, Minn.
BUILDING PERMIT
•
Date: _ Sept. 3, 1969
•
•
Owner: Rpbert L, Olson Builder
Same
Address _ 5614 5th ,Street N. E. Address Same
LOCATION OF BUILDING
No. 5614 Stmt _ 5th St. N. E. Part of Lot
Lot 7 & 8 --Block 2 Addition or Sub -Division . Hamil ton n s Addn .
Corner Lot _ — Inside Lot x Setback --_ Sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Addn . Living Arehont _ 12' 6 "Dep h 261
Type of Construction
Front Depth
Wood Frame Est cost
N° 10389
to Mechanicsville
Height 20i Sq, Ft. 325 Cu. Ft. 50
Height Sq. Ft. Cu. Ft.
$3,290 _ To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 10.00 permit is hereby granted to Robert L. Olson
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, Mizmesota regarding location, construction, alteration, maintenance, repair and. moving of buildings
within the dty limits and this permit may be revoked at any time upon violation of any of the P�� of said
ordinances.
Building Inspector
rlar Be! fale
NOTICE:
This porndt does not cover tits construction, installation for wldng, plumbing, gas heating, sewer or water. Be suns to see
the Building laspeetor for separate permits for these Nems.
APPLICATION FOR BUILDING PERMIT
CITY OF o
OWNER i /" -� ��.0 _ BUILDER
ADDRESS
LOCATION OF BUILDING
NO. I'y STREET
LOT -4 BLOCK o2 ADDITION OR SUBDIVISION
CORNER. LOT INSIDE LOT 1,-' 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:
ont /,71 Depth Heighta,-& a
Square feet 326- Cubic Feet
Front Depth
Height
Square feet Cubic Feet
Type of Construction VevZ4 >� Estimated Cost 39fe) 0�0
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. ^ _ - n ,
DATE SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
9
E • Y
0
V
y
SUBJECT
Ci_t_ y of Fridley
1
29P7T
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEI N2O.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
o
NUMBER
REv
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
%j612-571-3450
910415
6/21/99
JOB ADDRESS 5614 5th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
7� 8
3
Hamilton's Addition to Mechanicsville
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Karen Trimble Mark Velandra572-8509
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 19X REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (28 Sq) Tear -off; Soffit and fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building 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
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
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
$27(17
0 $1.37
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
$87.37
nET
SIGNATURE F(CONN)TRA/aCCTORORR1THORiZEOAG T iE�
WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
BLO �NS�
gatE
SIGNATURE OF N R,1F0 N RBUILDER, IOAT
r .
NEW[ ]
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: _-64 7` ,s 7—
Legal Description:
Owner Name & Address:
—9 /D L sly M x)
Tel. # _!� 7P '9� SQ
Contractor: Yylw5£ L F ' MN LICENSE #
Address: 56r S /V E �G�/•� £� /%f/v- 57S'9f,3 2 Tel. # S7;2 --
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
Length -= Width eight _Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
ZED®:8-17We
Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: IX W _b, (/ G J Tel.
CITY USE ONLY
d
Permit Fee $ CS 3,4_ Fee Schedule on Reverse Side
Fire Surcharge $ �� � .001 of Permit Valuation (1/10th%)
State Surcharge $ 1,3f $.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:
S 8%..3%
CITY OF FRIDLEY PERMIT NO.: 2004-02146
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED:
11/19/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 5614 5 ST NE
PIN : 233024310034
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
0
# NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS
1
# GAS DRYERS 0 # GAS RANGES
0
# OF NEW FIXTURES 0 # WATER TRMT APPLIANCES
0
APPLICANT
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
0.00
0.00
TRIMBLE KAREN M
5614 5TH ST NE
WATER TREATMENT APPLIANCE
0.00
FRIDLEY, MN 55432
WATER HEATER - ELEC
0.00
GAS RANGE FEE
0.00
GAS DRYER FEE
0.00
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
WATER HEATER - GAS
0.00
0.50
15.00
OWNER
TRIMBLE KAREN M
5614 5TH ST NE
TOTAL
15.50
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisi/nf any other state or local law
regulating construction or thformance of construction.
Applicant Date
Bldg Insp / D/
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT J
(763) 572-3604, FAX (763) 571-1287 s
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$10.00
Old Opening, New Fixture
$10.00
Beer Dispenser
$10.00
Blow Off Basin
$10.00
Catch Basin
$10.00
Rain Water Leader
$10.00
Sump/Receiving Tank
$10.00
Water Treating Appliance
$35.00
Water Heater -Electric
$35.00
Water Heater - Gas**
Gas Range**
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS /sem
1.25% of Value of Fixture or Appliance
State Surcharge $ .50
JOB ADDRESS 5&// 5-) 4 A( r
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 true and correct.
DATE: 0/ I q
OWNER J�f-yl -7-Te em �
BUILDING USED AS 'e
ESTIMATED COST 0O PERMIT NO.
PLUMBING COMPANY
20 O L/
SIGNED BY _�] ?Az— Lh TEL N0.7 (3 - 5-72 -SSU %
Approved By
Rough -In Date
Final Date
TOTAL FEE ter. s6 OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
"PROVIDE COMMON VENT INFO ON BACK SIDE
i
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT,' VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
BTU Input
venting has been examined and is free from rust, deterioration, obstructions,
Appliance #2 Type
and is securely supported and firestopped where required.
Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
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specifications including sizing, length, number of elbows and terminatidn.
Yes () No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
Vent Height
include AGA-GAMA Category I Central Furnace Venting Tables for fan
Appliance #1 Vent Connector Height
assisted and natural draft appliances.
Yes () No ( )
T�e existing combustion air is sized and installed to meet the current codes
ft Length
and manufacturer's specifications.
Yes ( ) No( )
When required to install a new combustion air, it will be sized and inotalled
ft Diameter in Type
to meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's;
specifications. This does include AGA-GAMA Category I Central Fumice
Venting Tables for fan assisted and natural draft appliances.
Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :