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PRE 2010 DOCSCity of Fridley, Mi BUILDING PERMIT N° 5358 Date: Owner: Address Address 6�71L!T' 0 OF BUILDING,. No. Street Part qUot Lot_.__ $lpek Addition or Sub-Divisio� Corner Lot __ Inside Lot Setback Sideyard r Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T Front Depth _ Height jZiQ_ Sq. Ft. �r Cu.. Ft. � — Fr Depth + Height Sq. Ft. Cu. Ft. Type of Constructice Fat. Cos o 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 $_���, 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 ofbuildings within the city limits and this permit may be revoked at anytune upon violation of any of the provisions of said ordinances. .mowk� .-n el Building Inspector NOTICE: We permit does not cover the construction, installation for wiring, plumbing, gas heating, Sewer or water. Be sure to we the Building Inspector for separate permits for thus Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDIEY, IOTA Otiner I s Name e m r 1 t � ct h /2S®!yl Builder Address a�� 7 / %� fJ -I" .. Address es ;c LOCATION OF BUILDING No. 5 �' 7 / Street l 5' T Part of Lot /?e z„j- Lot / D Block Addition or Subdivision R., " h, / r-- J ! % Corner Lot _Inside Lot Setback / Y Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot andproposed building location. DESCRIPTION OF BUILDING To be used as: r Front a .--7- Depth 1 Height ____Z!�. , __,,,_ Sq. Ft. S.2- S" Cu. Ft. 6 ;?3 G ' Front Depth Height Sq. Ft. Cu. Ft. Type of Construction /" ra ver e- 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 representations stated in this application are true and correct. DATE = SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) 0 • .. 4^ CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $ .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE 7.00 7.00 $_ Repairs & Alterations each add. $500.00 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Job Address ©Of Replacement of Furnace 7.00 $ Boiler only up to 100,000 BTU Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 7.00 4.00 $ $ Department of Buildings ' City of Fridley MECHANICAL WARM AIR: OIL BURNER- to 3 gal. per hour $10.00 Tel. #571-3450 Furnace Shell & Duct Work to 100,000 BTU $12.00 $ eadd. 50,000 BTU 4.00 $ �laceme t of Furnace Repairs & Alterat ons -up to $500.00 7.00 7.00 $_ Repairs & Alterations each add. $500.00 4.00 $ $ STFA61 OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each adds. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (.over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ J60* Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ Z/�2'" �'L CONDITIONING �%"SeFee FAN HEA SYSTEMS (hedule $ /().DC) VENTILATING SYSTEMS$ $ ALTERATIONS $ REPAIRS S $ State Surcharge $ .50 TOTAL FEE $- ROUGH INSP. REINSPECTION FEE Date 010.00) FINAL INSP. Date APPROVAL FOR PERMIT /� MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHAr GE .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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. / Fridley, Minn. (7{.. niVh1 Z'74 , 19 OWNER (:X7 /7 hi & 71(N IIV f KIND OF BUILDING V tLLiLdd L17 — USED AS TO BE COMPLETED ABOUT %L Ao -tiL P. ESTIMATED COST (OLDS- NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER %PLANTS, /Steam, Hot Water, Warm Ai No. � Trade NameNNN111 nn('�/]_/]zmj Size No. Capacity/ Sq. Ft. EDR BTU/4MHP Total Connected Load Kind of Fuel BURNER - Trade Name' Size No. Capacity Sq. Ft. EDR BTU _ HP /^ Company / v • •6;�HiL�-- Signed By RICO%;,QK0 S'SC%, s n-Ec;TRIC co. 2 t •ST 'ROA:)V.AY ;Pel. No. Q°RStA742� �nr9 �Sar:9_ i CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION;,, 7 A DATE OWNER ADDRESS���'� The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. No foreign objects are lodged within 4. That it is securely supported 5. That it meets all current Code requirements for size and total BTU connected b. Total Heat i nq BTU All Other BTU REMARKS //oi. 'WIM r SIGNED.,, Licensee �y GOLDEN VALLEY AIR CON DITIUIING Address 5112 WLST UTDAD',-VA; Telephone HEATING PERMIT Fridley City License # AIA6 0 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS JS 7� Cts' sf New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4A0 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated In this application are true and correct. Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas i Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 Ip.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Applidnce State Surcharge TOTAL FEE - 15 , 1993 Owner La" Glial d t - Building Used As Estimated Cost R. PERMIT NO. PLUMBING COMPANY %-Ill -s 6ual j ��� '✓1� �] �� SIGNED BY (7;, i �TEL N0. 535— 4 R 7.7 Approved By IRr Rough—In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 $ PLUS THE $.50 STATE SURCHARGE City of Fridley("2 AT THE TOP OF THE TWINS SUBJECTT BUILDING PERMIT N 67 7 6 r 1 i VCOMMUNITY DEVELOPMENT DIV. V ������, r PROTECTIVE INSPECTION SEC. 1 . � i ---_� -I,� CITY HALL FRIDLEY 55432 L 612-571-3450 C/^J [;UM-BERREV 910-F15 DATE 7/23/98 PAGE OF APPROVED BY JOB ADDRESS 5871 6th St NE 1 LEGAL DESCR. LOT NO. 10 BLOCK 6 TRACTOR ADDITION Bonn Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pat Cleland 571-4609 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Roofing 1 416-4804 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20010277 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION M REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof(18Sq) Tear -off House; Garage (8 Sq) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 HAV EA ND EX ED THIS APPLICATION ] STALLS GARAGES ANDKNOW THE SME TO E AND FIRE C ALL PROVISIONS OF LAWS AND ORDINANC 10 RNI G THIS T PEO WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETH SNE FIED EREIN O NO THE GRANTING OF A PERMIT 1794 .90 DOES NOT P ESff TO IVE AUT OR TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION OF Y E CAL LAW REGULATING CON- T E FO C OF ONSTRUCTION. $56.75 Fire SC $1.79 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$64.44 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN PROPERLY VA ATED THIS IS YOUR PERMIT I X; Z� BLDG I SP //- . 7, r)ATE S,GNATUREOFOWNER IIFOWNER BUILDERI IDATEI 01 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: (- / Owner Name & Address: �I T C / /a 5 S . �! Tel. # Contractor: Lctuj-C-S�-- 2MN LICENSE # 26 0 1O 2 - Address: Address: g C Tel. # ��(9 90 �z Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. _ GARAGEAREA: Length Width Height Sq. Ft. _ DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 2 c' l Construction Type: "'n Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: '7- e3- �Y APPLICANT: Tel. # 419 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: r s� CITY USE ONLY 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 Agreement Necessary [ ] Not Necessary [ ] Building MECHANICAL Permit No.: --i Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY MIM 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 1.1-q- 0 1 YOUR E-MAIL ADDRESS SITE ADDRESS S 9 71 0 f THIS APPLICANT IS: ❑ OWNER ')tCONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: 11 C.:/ a- ( 0 - ADDRESS: Tf 2/ & trtb (;k i.! E CITY F STATE dt' ZIRSS 41 -1 - PHONE: -16,1 4 j i - -T 3 k 6 COMPANY NAME: fC CONTACT PERSON: a- 16 o--\ STATE LICENSEE # EXP DATE _ ADDRESS: /10 % ® �%P- « 94 -&-t -CITY Pal Ot STATE�ZIP�SII)-i- PHONE -7 4,1S ?Sy 01 q 0) FAX Wf SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW 16 REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK�— FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FI(TURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: — MODEL: 126 TQC t) L. I' tj jA � s SIZE/BTU C,0, 00 MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 TFIREPLACE ! FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 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 the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. g SIGNATURE OF APPLICANT Q �� o PRINT NAME CI 1 t� (/( 1P k7=? DATE 1 ' �� - V City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977