PRE 2010 DOCSCity of Fridley, Minn.
BUR DING PERMIT
--r
Date: '. �� ..�..........
Owner......................................
Address ......................................
No 3712
Builder 4 ✓J
Address .............................................
LOCA ION OF BUILDING
No. �Gam/ .�
�?.... W W. Street .... ........... ...... Part o Lot ........��... ............... .
Lot ..... ..... Block ..... Ke .......... Addition or Sub -Division /
Corner Lot ............ Inside Lot A......... Setback .�.:�.. Side %O '® �
...... yard ...........................
DESCRIPTION OF BUILDING
To bq Used ., a
r/ o ,r r
.... ... Front ..®�G >pth.��.. �° Height I.l�.:. o Sq. Ft / ®.�.��. Cu. Ft a� ��i, Q
.............. ..... Front ........ Depth .... ../. Height ......... Sq. Ft......... Cu. Ft. ........
Type of Construction ................... Bit Co./�.�.... To be Completed ...................
In consideration of the issuance to me of a permit to construct
the proposed work in accordance with the description above set f
ordinances of the city of Fridley. %�
X, /JJ
buil g desrib d above, I gree to do
and com H=cMerons of
"06� -
In consideration of the payment of a fee of $� ......, permit is hereby ed to ....... ...........
......................... to construct the building or addition as described ab e. 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:
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
PP7
APPLICATION FOR BUILDING PERMIT
CITY OF.FRIDLEY, MINNESOTA
Owners Name ''`'`�� Builder
Address 67ae Z13U. Address _..
—LOCATION OF BUILDING
No. Street Part of 'Lot
Lot ��. Block - U. Addition or Sub. Div. la '
Corner Lot"
.. -Inside Lot Set Back
Applicant attach to this form Certificate of Survey.of Lost and proposed
building location.
DWCRIBTION OF BUILDING
To be us as
Front 6t O Depth Height
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 specifiedp'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 representations stated in this application
are true and corr ct.
Date 3 1 kv. Signature uo-.CA J
(A Schedule of Fee Costs can be found on the Reverse Side)
0
e.-- WA sir IVAr. rZ77
• •
City of Fridley, Minn.
BUILDING PERMIT
N® 6692
Builder
Address
A -P
CA OF
VU
DING . n_7
No. �treet..— Part of Lot
Block — Addition or Subopn
Corner Lot , Inside Lot — �® ZKback ideyard �_ S
Sewer Elevation ___ _ _ �� Fo dation Elevation
DESCRIPTION OF BUILDING
J�e
. FrontAli
Depth 22,0 Height Sq. Ft. A& Cu. Ft. ZT/�
Fro Depth eigh Sq. Ft. Cu. Ft.
Type of Construct—ion—- Est.Cod
_ --'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 and rp ' e with all provisions of
ordinances of the city of Fridley. QP_
In consideration of the payment of a fee of$JF�, 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 and moving
liof buildings
within the city Emits and this permit may be revoked at any tion of of the provisions of said
ordinances.
Building Inspector
• NOTICE:
This permit does not cover the constrectlon, htstallatlon for whing, phnnhing, gas heating, a or water. Be sure to see
the Bn IA* Inspector for separato poradts for thaw items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER ° S NAME:agd
��
BUILDER
vw f c� ivy -
CJe, rm5 T
ADDRESS
G� k g �(j�
ADDRESS
20 y d c,
u e>C la
LOCATION OF BUILDING
No. 8 4 o Street-'-1� � V. � Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot X_ Side Yard
SEWER ELEVATION
FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
t? M a _r" Front`_Depth Height '7
Sq. Ft. , 6 Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
v�
Type of Construction A de'q Estimated Cost /3 % 3
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
�t
(schedule of Fee Costs can be found on the Reverse Side).
a
City of Fridley, Minn. N° 7587
BUILDING PERMIT
•
Date: May 27, i9b5
owner$on Meyer Builder Elmer T. Peterson
Address 5840 6th. Street N. E. Addrm 3435 Eftchanan St. N. E.
LOCATION OF BUILDING
No. 5840 street 6th. Street N. E. Part of Lot
Lot _ _ 4 --- Block Block 6 Addition or Sub -Division lett Pa]mer Addition
Corner Lot — Inside Lot Setback Sideyard
Sewer Elevation ____ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Est, Cost $3 900000 _ To be Completed
• Storm Damage Repair
•
Roof, Shakes, re—decorating
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 ffi pliance with e& provisions of
ordinanc:zs of the city of Fridley.
In consideration of the payment of a fee of 10•QQ, permit is hereby granted to mer T. Peterson
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 p t thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota location, conatructfon, alteration, maintenance, repair and moving of buildings
withinord nthe city limits � this permit may be revoked at any time upon violation of any of the provisions of said
NOTICE
This pwmb don cot cora the conetwcim, in hffldlm for wkhm Pbw"B. Oa hedhi& sewa or water. Be sora to sea
the Bo MMM hupeder for separate Pamih for these h=W
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' G P'/;— ®/e
S NAME BUILDER k�
ADDRESS JT 4® 101 S / Y
LOCATION OF BUILDING
No. �� Street � 64"7, k/,,r,Part of Lot
LOT _BLOCK ADDITION OR SUBDIVISION�or
o
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;
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft.
Type of Constructi
To be c
Cu.
timated
Ft.
Cost�Q
3�j 0,0
i
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).
•
U
0
City of Fridley, Munn.
BUILDING PERMIT
Date: 2 3
Owner: Or Builder
Address Address
No 8396
f L CATI0 1 F BUILDING
No. Street ,.� Part of
Iat �t��-,.ey
Lot _ Block A tion or Sub -Division n _ ��� - - Y'P
Corner Lot _ Inside Lot _ _Leff Setback _ _._ yard
Sewer Elevation Foun on Mevation
DESCRIPTION OF BUILDING
To be as:
_ Front f r Depth 2= Height / Sq. Ft. Cu. Ft. 4VA40
Type of Construction
Depth Height Sq. Ft. Cu. Ft.
Est. Cost ,� 3 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 fo and in compliance with a& provisions of
oxvlinancxs of the city of Fridley. ---7 ^ --7 ,
�b
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 an work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, M unesota ung location, construction, alteration, maintenance, repair and moving of buildings
within the city limits � thin permit may be revoked at any time upon violation of any of the Provisions of said
ordinances.
NOTICE:
lhis pwmb don not emer the condtrucam, kmaWon for wMM phrmbing, gas haring, smer or water. Be acro to an
the Buiiding hopemr for separate permhs fee than Items.
APPLICA`PION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME ®!- �'s�Y�7 ,i ��i/�= BtrtLDER
ADDRESS� 7 �° / �/' ADDRESS
LOCATION OF BUILDING
W x Street 6/, 2 lV ' jrPart of Lot
LOT K ADDITION OR SUBDIVISIONS
Corner Lot, Inside LOT_ Setback t /-/u4,4aide-ya.rd_ 3�
FEWER 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;
Co ��oo 0
Frontf Dept} Height le9
Sq. Ft. -3 jv c Cu. Ft. 3660
'Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction /W C- Estimated Cost 1.3 7J
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.
DA GNATURE��
(Schedule of Fee Costs can be found on the Reverse Side).
E R M
City of Fridley
il 4129SUBJECTr
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
RECEIPT NO.
`L _ ____ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
6/3/77
JOB ADDRESS 5840 - 6th. Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
6
Bennett-Palmer Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dan Klvender 5840 6th Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Miles Garages 4500 Lyndale Avenue North 520-3555
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
xO
8 DESCRIBE WORK
Construct a 12' x 20' Addition onto Garage
8 CHANGE QF USE FROM TO
STIPULATIONS
Ke new and old footings Key g Before digging call Ivice{ uf'dllflg
TELEPHONE — ELECTRIC e GA,_� tf,&
REQUIRED BY LAW
SEPERAn PERMITS REQUIRED FQR WONG,
HEATING, PLOWING AND SIGINS,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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 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.
SUM �`] 776
$.89
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
PERMITFEE 9 0
.60
SAC CHARGE
STRUCTIO OR THE PERFORMANC F CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
3
IgMa ii $10.49
SIGN URE OF CONTRACTOR RAUTHORIZEDAGENT (DOTE)
WHEN P PER^LY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS.
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: a Al%1/�
//e d CZ -6 t-(
aUILDER:
Alit e S
Address: S y�
- � �/` (�% �.
Address : .
e -I S-oe
e v
Tel. No.:
No.:
7#,S7—
Street:
LOT: y
BLOCK: _
ADDITION:��U��T�T—
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
r
DESCRIPTION OF BUILDING
To Be Used As: 1;)e
Awk)0 0A? -fro -Front: / a Depth: R_o Height: 1�
Square Feet: 07 L/0 Cubic Feet: c�qo ()
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: A14 Estimated Cost:
To Be Completed: % Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired b6 $ $
(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 for additional information.
DATE:SIGNATURE:
Stipulations: C)
IST � EMING C0019INce
ENGINEERS AND SURVEYORS
LAND SURVEYING SOILS TESTING
CIVIL 2- MUNICIPAL ENGINEERING LAND PLANNING
6418—SGT" AVENUE N.
MINNEAPOLIS 2T, MINN.
KE 7- BG37
1,66
I*
I
Pi S
.r
f-
1
' IC66
/-sz
r1
a1
D
/-sz
F�
WE HEREBY CERTIFY�THAT TH15 IS A TRUE AND CORRECT REPRESENTATIOM OF A SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF M4Y, THEREON , AND ALL VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON 5AID LAND. MINDER ENGINEcRtNCG CO., INC.
f
r1
F�
WE HEREBY CERTIFY�THAT TH15 IS A TRUE AND CORRECT REPRESENTATIOM OF A SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF M4Y, THEREON , AND ALL VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON 5AID LAND. MINDER ENGINEcRtNCG CO., INC.
f
SUBJECT
N
City of Fridley
FPEMIT
19613
AT THE TOP OF THE TWINS
BUILDING
PERMIT
' '
• _ COMMUNITY DEVELOPMENT DIV.��
r L -____ PROTECTIVE INSPECTION SEC.
I
D�
CITY HALL FRIDLEY 55432
L J\
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/28/88
JOB ADDRESS 5840 - 6th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
4
6
Bennett-Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
R. Costigan 5840 - 6th Street N.E.
572-1076
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E., Mpls. 55418 781-9548
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW IR ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' x 20' Garage Addition
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a hard surface driveway. See notations
on plan.
SEPARATE PERMITS REQUIRED FOR
8eiore digging cap local
WIRING, HEATING, PLUMBING AND SIGNS.
U
TELEPHONE. ELECTRIC.
GAS
aEtc.
ta.
REQUIRED
REQUIRED
BY LAW
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
SQ. 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,750
$2.88
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-
STRU OR THE PERFORMANCE OFC NSTRUCTION.
$81.00
)�
PLAN CHECK FEE
TOTALFEE
.� �/�
$83.88
NATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WH P�RVD
LDG INS
ED THIS IS YOUR PERMIT
/
ATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] City of Fridley Effective 5/1/88
ADDN [ ] R-1 AND R-2 '
ALAR [ ] Building Permit Application
Construction Address:-) 9'ZZ2 A) e
legal Description
Owner Name &
Oontractor: r r' L-
Tel. # `FIR -/a 76
Tel. # Al
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
Length
Length HCl
Length
Width Height
Width 620 Height
Width Hgt/Ground
DE91rBa'.
®OX / SC c
Corner Lot [ ] Inside Lot I ] Ft. Yd
St;. Ft.
Sg. Ft.
Sq. Ft.
Side Yard Setbacks
Type of Construction: Estimated Cost. 5
Approx. Completion Date: -
Aj)I> o7a
7ff7'L
Lrs
cc ,c �17� 2/Z �� /�� %U e -d f%/ � ✓ /� Alt. A Alt.
s yy B
Prop�sed Driveway WidtK If New Opening Is Desir 5
Width + 6' See Back Page
DATE: - 6 APPLICANT: Tel. #
CITY USE CNLY
Permit Flee $ Fee Schedule on Reverse Side
State Surcharge $ 5.50/51,000 Valuation
SAC Charge 5 $550 per SAC Unit
Driveway Escrow 5 Alt. 'A" or Alt. 'B" Above
Park Fee $ Fee Determined by Engineering
Sewer Hain Charge $ ® Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 0? .
3I TPOLP1PICIM: 0
ao 00
q k g 3�
�l.aU
NUNDERF.-iNGiNE Cy CO,.91 TC.
ENGINEERS AND SURVEYORS
SOILS TESTING
L^940 PLA6"Wlme
CIVIL
6418-5479 AVENUE N.
MINNEAPOLIS 2T. MINN.
KE 7- SG37
4r, it (ta A eb tip IF Is 131 1wripN
1044
C ry
01'. 1,4 T7.4E 16 -
.. ........ .
11"
I
WE HERESY CERTIFY /. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF N SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND or -THE LOCATION OF ALL BUILDINGS, Ir- AMY, THEREON , AND ALL VISIBLE EKIONCHMENTS,
IF ANY, FROM OR. ON SAID LAND.
M L tZ t NG CO.,1mc.
lo
.. ........ .
11"
I
WE HERESY CERTIFY /. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF N SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND or -THE LOCATION OF ALL BUILDINGS, Ir- AMY, THEREON , AND ALL VISIBLE EKIONCHMENTS,
IF ANY, FROM OR. ON SAID LAND.
M L tZ t NG CO.,1mc.
IF45
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A$�
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 1998
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR (POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential Rate TOTAL
Fumace Shell and Duct Work, Burner —
Also Replacement Furnace $ 30.00 $
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $10.00 $
Gas Dryer $10.00 $
Air Conditioning — All Sizes $ 25.00 $ ';iS'2/'V
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work $
Commercial/( ndustrial
1.25% of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
JOB ADDRESS 5 /_/0 s/ S/ _-o eV
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.
/,/ 3 ,1998
OWNER (7®S ! s�
BUILDING USED AS�'—
ESTIMATED COST /,gE.00 PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY Sharp—
'
4854 Central Av®. NE
Signed By 6i TBl�fgbts, MN 55421
(,_ (6M 572. 59
Approved BY _ Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE 56R STACK VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
CHE%MY AND STACK VERIFICATION
The undersigned hereby verifies that the existing
chimney or stack:
1. Has been carefully examined
Yes ()
No ( )
2. Is free from rust or deterioration
Yes ()
No ( )
3. Has no foreign objects lodged within
Yes ()
No ( )
4. Is securely supported .
Yes ()
No ( )
5. Meets all current Code requirements for size
and total BTU's connected Yes () No ( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
8. Has combustion air been provided for water heater Yes ( ) No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CITY OF FRIDLEY INSPECTION DIV.
3431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BF INSTAI I Fn ON FAr.H FI 0nR
Effective On Jan 1, 2000
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**
NO. RATE TOTAL
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 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 $ .50
JOB ADDRESS5417€ t- dW01✓ IZ
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 aDDlication are true and correct.
COSTIGAN, R.P.
5840 6TH STREET NORTHEAST
FRIDLEY, MN 55432
Ow (763) 572-1076
Building Used As ;S61m:Ai Cz
&YZ , 2001
o,,
Estimated Cost PERMIT NO. / 3�
PLUMBING COMPANY OF QM PLJJNIb1/J(4
SIGNED BYTEL N0. Z -
Approved Byz Rough -In Date Final Date C •S �� J
.........w... . ter- r v.` r.� ■ r a.vn.c�u�a�a�ira rCR A... J
TOTAL FEE $M•50 PLUS THE 5.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
8
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• •
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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**
NO. RATE TOTAL
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 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 $ .50
JOB ADDRESS5417€ t- dW01✓ IZ
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 aDDlication are true and correct.
COSTIGAN, R.P.
5840 6TH STREET NORTHEAST
FRIDLEY, MN 55432
Ow (763) 572-1076
Building Used As ;S61m:Ai Cz
&YZ , 2001
o,,
Estimated Cost PERMIT NO. / 3�
PLUMBING COMPANY OF QM PLJJNIb1/J(4
SIGNED BYTEL N0. Z -
Approved Byz Rough -In Date Final Date C •S �� J
.........w... . ter- r v.` r.� ■ r a.vn.c�u�a�a�ira rCR A... J
TOTAL FEE $M•50 PLUS THE 5.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, 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 combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No ( )
When required to install a new combustion air, it will be sized and installed
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 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 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 :