PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 3293
/
Date: �.�� �.................... I
Owner ....................................... Builder .........:..............`:":�®'l'�'® .
Address ...................................... Address .............................................
LOCATION OF BUILDING
No. �` . Street .. .. ........................... Part 94 Lot ......... . .............. ...
Lot .. ...... Block .... ........... Addition or Sub -Division .. ... �%!` .. . .
Corner Lot ............ Inside Lot .....t� ... Setback ..lf.L.�r...... Sideyard .. ...... -?. �� :........
DESCRIPTION OF BUILDING
To be Used as:
.�. ... Front 1. Depth .. Height .... .. Sq. Ft.Cu. Ft. ?�q./ %
.................... ont ........ Depth ........ Height ...... Sq. Ft. ........ /'Gu. Ft.........
Type of Construction ...... ............ Bast. Cost. /4.A9 . ��... To be Completed . 4s.. ......
A
In consideration of the issuance to me of a permit to construct the building desribed I agree to do
the proposed work in accordance with the description above set forth and in complianWthrovisions o!
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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
'i
t
. .. .....:f . Building. Inspector
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 separate permits for these Items.
City of Fridley, Minn.
BUILDING PERMIT o
N. x`4'716
Date: ..:.. _`� .. . ` .:_ ._.5 ....... _ _ . _ _ ...._......_...._..
Owner:....
Builder ....._Address Address .1_.__.. _.._.._ _ ._...
_ ....._....... ...__.._..
LO
CAOF BUILDING
No. �... Street _... ..:.. � _. Part Lot
Lot s `..::.....---... --... - Block ....._..... ............................... Ad o r b-DivIsi
Corner Lot ...................... :............ Inside Lot ............. ............... _............. Sidevs
Sewer Elevation
DESCRIPTION OF BUILDING
To U ed
. ,..... ..... ----44A.-t._ Front/ -,6..." ...... Depth ...;rG.. Height -.. Sq. Ft. Cu.
r ~-----•............. F t .... _................ Depth .._:.:.... Height :.... Sq. Ft..:.. ..:.......... Cu. Ft. _..._......... - -
-
Type of Construction .red. Est. 6 To be Completed . ............ .
� � r-' E LA Z ".t;`rlLt4'NT'AIND
_T -_;N�.
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.
4 - -------- _.....
__._..
In consideration of the payment of a fee of $41 ... _.................., 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, re and moving of buildings
within the city limits and this permit may be revoked at any tim on,rJvi ation of y of the provisions of said
ordinances. / !r i�
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, Bas heating, sewer or water. Be sure to see
the Building inspector for separate permits for these Mems.
df
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name Builder
Address `�5� p - ' '� e° Address
LOCATION OF BUILDING
No. ,. j-"6 Street s� ZK' Part of Lot
Lot 3 Block Addition or Sub.Div.
korner Lot Inside Lot -v, Set Back - Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
Tobe used as:
Front /&/ JjP- Depth k Height „_
Sq. Ft. ���� _Cu. Ft. -,-,L
. C,
Front Depth Height
Sq. Ft. Cu, Ft.`
Type of Construction _ir���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 correit.i
DATE �01 ,� a SIGNATURE ��
(A Schedule of Fee costs can be found on the Reverse Side.)
C
•
n
L J
Date:
July 14, 1965
f
City of Fridley, Minn.
BUILDING PERMIT
Builder
Receipt No. 29272
DON BUILDERS, INC.
Address 5956 - 5th Stneet N.E• Address 1052 Osborne Road
Fridley, Minnesota
No 8206
LOCATION OF BUILDING
No. 5956 street 5th STREET N.E. Part of Lot
Lot __ _ 3 _ Block 2 Addition or Sub -Division . Bennett Palmer Addition
Corner Lot Inside Lot Setback
Sideyard
Sewer Elevation Foundation Elevation
To be Used as:
Type of Construction
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft.
Est. Cost $10 * 000.00 _ To be Completed
REPAIRS DUE TO STORM DAMAGE
Cu. Ft.
Cu. Ft.
In consideration of the issuance to me of a permit tothe building described above I agree to do
the proposed work in accordance with the description above t fo and in compliance with a'll provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of 5 0-0 permit is hereby granted to STM BEEF=
the to construct the building or addition as described above. This permit is granted upon
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 location, construction, alteration, maintenance, repair and moving of build�gg
wig city limitsr� permit may be revoked at any time upon violation of aay of the provisions of said
ALLEN G. JENSEN Building Inspector
NOTICE:
Thb pamb don net sewn the cendresdon, bdaffadw for whim& phmbbB, an hadn& sewer or wdar. Be sun fa sa
the Building ingn sr for sopmft permhs for dh hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER
ADDRESS ADDRESS
LOCATION OF BUILDING
N0. STREET PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
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;
A__) A F ont Dept HeightNjW,
�..
Sq. Ft. Cu. Ft.
Depth Height
Sq. Ft.. Cu. Ft.
Type of Construction✓ Estimated Cost � b �
v C-1
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).
Bax
1st
and
3rd
4th
53-84-s-915.51
Chy of Fd&y
for Maem
Dart. of Bldgs. Phos•
aIMPTION OF WORKr,,,,_,,,r 5956 NE 5th St.
Number. rJ" Gerd I.•sadva d 11MIUM
iblmm cemecdm Openings
New 7t"n Old Opoetugs
PARTIAL RATE SCHEDULE
warm Mei.
Gas ne.
TUM RATES-
PLUMINGNumber �
N06 RATE TOTAL
............. �.._`
x x2.00 $
Fixture Opening ...........
x $1.80 =_..
New Fixture Olaf Opening ..........
x $1.80 = .
Catch Basin ....................
x $3.25 $
Water Heater 'Up to 09.000 BTU) . • . •
x $3.00 i
New Ground Run Old Bldg.........
x $3.Nr f
Electric Water Untep ..............
s $200 $
GAS Mir XG PEES;
NO. HATE TOTAL
lot Fixtures •••••••••••••• •. •• 1
x$200 $ 2-00
Additional Fixtures ...............
x $ .7b =
Lias lunge to 1911.000 NM ............
x I&00 $
State Surcharge
$_.50_
REPAIRS A ALTEHATIOAb—Rdas Ls Coda
Install (1) Gas Grill
_
3 00
Y�Fd ■pLLen e . a ....... w. s w . ........-... i..... w..... I...
TOTAL IZE 6 5.50
CIV of Fldley:
The undersigned hereby makes application for a permit for tAe work herein
specit 4 agreeing to do an work in strict accordance with the City Ordinam
and ruling of the Department of Buildings, and hereby declares that all the fact`
and representations stated in this apple are true 51973 and correct
Fridley, man i 10.
Owner Margaret J. Seefela
Kind of Building Frame
Used as Res.
To be completed about -6/10/73
loitimated Cost. $ 10.00
OldX New. Building Permit No. p
ermit N d
Sic r G •
By �
Business Phune No
Filth•
6�A,UC HEATING HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND ELECTRIC. INC.
//
� �(Q � A
ADDRESS
APT. FLOOR
CITY SUBURB
OCCUPANT
OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY
INSTALLED BY
Electrical Work By
Gas Una By
TYPE OF HEAT GA FA HW STEAM_ SPACE HTR._
UNIT HTR. OTHER
GAS DESIGN
CONVERSION
MAKE
MAKE OF BURNER
Model e�`�oS&
Modal
Serial
Max. BTU Rating
INPUT 600
MAKE OF FURNACE
Model
L 'J CONTROLS
!/
7—
THERMOSTAT % ^(J r Heat Plug
Vent Size
Valve"��
KIND OF LINER
SIZE NONE
Limit
Draft Hood
Regulator
Limit Setting L e—
Filters Size
Number
s
Fan Setting
Chimney Location Inside
Outside
Pllot Type
Chimney Construction
Pilot Make
Pilot Model
Smoke Bomb
Wiring
Pilot Timing 1p Q
Draft
Test Tag
L. W. Cut Off
Door Pressure
Lighting Inst.
Pressure 13. Ic Percent CO,
Date Tested 2
0
Input CFH Percent O,
Company Testing
StackTamp. , Percent CO
Name of Tester
Form 235
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1. 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS 9f5to 5 '"► S� A �
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work
Residential Rate TOTAL
herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Bumer -
city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace $ 20.00 $ 60 ( . 00
that all the facts and representations stated in this application are 01
true and correct.
Gas Piping (Needed with new furnace) $10.00 $
OWNER
Gas Range $ 10.00 $
BUILDING USED AS
Gas Dryer $10.00 $
ESTIMATED COST A4 PERMIT NO. Z'I o
"Air Conditioning - All Sizes / $ 10.00 $_A_."_
CLQ 5�95FCn �D a7
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
No. of Heating U its Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
CommerciaUlndustrial
BTU HP EDR
1 % of Value of Appliance or Work $
Fuel Total Connected Load
State Surcharge $ .50_
Bumer Trade Name Size No.
BTU HP EDR
TOTAL FEE $13® .
HEATING COMPANY/ rte, Ath I �4- Cly
Q
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION/3
24v-e n� °�
'—'-Tel
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
Signed By L 1..M. Tel No.
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
Approved Bk;o—: Rough-In Date Final Date
"Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
SUBJECT
,
City of Fridley
26790
2 6 7 9 0
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
1 ,
RE
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED
CITY HALL FRIDLEY 55432
612-571-3450
910415
7/23/98
JOB ADDRESS
5956 5th St NE
t LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
2
Bennett Palmer Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP
PHONE
Margret Seefeld
571-7320
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO-
--- D.L. Builders 1166 14th Av SE M is 55414 378-0950
20096711
"W 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 M REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 23 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIREO 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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1918.20
$.96
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-
RUCTION OR THE PERFORMANCE OF CONSTRUCTION.
62.25
/+
Fire SC $1.92
PLAN CHECK FEE
TOTAL FEE
7' Z3'4
License SC
5.0
70.13
SIGNAT CONTRACTORORAUTHORIZEDAGENT IDATEI
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
2LU
DATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
1� a6-1
ConstructionAddress: 5,�54 5+` ST i - 6
Legal Description:
Owner Name & Address: MAM &eyrr sge ass Ic9 Tel. # 571— 73 Z O
Contractor: h. U. lu:,lau& MN LICENSE # 2M9(p71
Address: 1(6t, tel' 4,J SF. Tel. # 318 — 0-15 o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE -AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: R.1 Estimated Cost. Oa
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $
DATE:3L01 APPLICANT: Tel. #7���5a
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ C2,21-
$ Z,��
$
$
Park Fee $
Fee Schedule on Reverse Side
.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
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley. MN 55432
572-3604
Ia ?3,9S
//2� �o /'
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Effecdve On January 1. 1997
MARK NUMBER
OF FIXTURES TO BE 114b IALLW UN tAGrt rLUUn
Water Bath
Closet Urinal Tub Shower
SinkJ;WashDrink. Floor Catch Auto. Gas Gas Misc, Water Heater
ay Fount. Drain Basin Washer Appi. Range Fiat..:: Gas Elec
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
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�S�s�`
Gas Range"
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
JOB ADDRESS -f715_4
$ 7.00 The undersigned hereby makes application for a permit for the work herein
$ 4.00 specified agreeing to do all work in strict accordance with the city codes
$ 5.00 and rulings of the Building Division, and hereby declares that all the facts
$ 7.00 and representations stated in this application are true and correct.
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Picture or Appliance
State Surcharge 1Z .0
Owner
Building Used As I
Estimated Cost PERMIT NO.
PLUMBING COMPANY." O4GvT '� 0"'��'��
SIGNEZE
NO.
Am
Approved By Rough -In Date Final Date
utwimim FEE FOR ;ANY PLUMBING/GAS PERMIT IS 20.00
Mk
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2003
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**
Gas Dryer**
Back Flow Preventer Required ( )Yes () Nc
Type
NO. RATE
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
TOTAL JOB ADD
50
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.
Owner /
Building Used As
Estimated Cost
PLUMBING COMPANY
PERMIT NO. i f
SIGNED BYg� PSL L N0.
Approved By Rough -In Date Final Date ! D3
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
,20D
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When rala -ing an exacting Mrance, 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 manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( No( )
The existing _emb jstinn air is sized and installed to meet the current codes
and manufacturers specifications. Yes( ) No( )
When required to install a new nnmhustinn air, it will be sized and installed
to meet the current codes and manufacturers specifications. Yes () No ( )
When installing a new venting eyc _m, 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 #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
HEATING CO:
Signed By: Date: