PRE 2010 DOCSBUILDING PERMIT
V . N° 227(1
Village, of Fridley, Minn.,-
� Y
Date• • .. ......
Owner�.�.��. r...... _ '!��.'�.. ..........
Builder ............................
Address /,FIA' . Address ...... .... ........ .
LOCATION OF BUILDING
NO... i! %w...... Street...................:.... Part of Lot .......................
Lot ...... �131ock . Addition or Sub -Division. B ... .. ! 40 • ........ .
Corner Lot .1l+".`.. Inside Lot ....... Setback . Sideyard .. ... ....... .
t
-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. Coat .:I: t�.. .. To be Completed . u' ................
i
In consideration othe issuance to me. of a permit to construct the building described above, I agree to do
the proposed work h t ccordance with the description above set forth and in compliance with all provisions.of
ordinances of the villof Fridley.
.h.....•. .,.............. ..
n c s oration the payment of a fee of $..41% . , permit is hereby. granted to .
to construct the buildingor addition as described above. This permit is granted upon
the express condition t the person to whom -it is granted and his agents, employees and workmen, in all work
done in, around and, ul on said building, or any part thereof, shall conform In all respects to the ordinances of
Fridley, Minnesota r g location, construction, alteration, maintenance; repair and moving of buildings with -
In tl q village limits an I this permit may be revoked at any, time upo;v violation .of any of the provisions of said
ordinahces..
Building Inspector
NOTICE:
This permit d° i not cover the construction, Installation or alteration' for wiring, plumbing, gas heating,
sewer or water. Be inure to seethe Building Inspector for separate permits for these Items.
I
BUILDING PERMIT
Village of Fridley, Minn.
N° 2335
Date..............................
Owner /....... Builder ............................................
{
Address......... ............................. Address .........................................
� CATION y�O, F BUILDING
No. .. .. Street "'''�"j- '. `....*04;. .............. Part of Lot ...... .............
l�Lot ... I�'Block ...
............ ........ .... Addition or Sub-Division�E�Z..... .................
Corner Lot ..... .. Inside Lot ............ Setback ........ ~�
��� Sideyard ��i!....��.............
11
DESCRIPTION OF BUILDING
To be Use as:
..... .... Front . T .. Depth 4 # ... Height /14!...
I,
................... Front ........ Depth /�...... Height .........
Type of Construction: ... t ! 46!11rd .............
Est. Cost
Sq. Ft......... Cu. Ft. ........
Sq. Ft. ........
/�, Cu.
yFt.........
To be Completed "'lay
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 village of Fridley.
..............................A*...................
id��era 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 rearding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon }nolat�on of any of the provisions of said
ordinances. .� 1 / ,/_ % ,n
fir ... V.... f -'': Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Bq. sure to see the Building Inspector for separate permits for these Items.
,
i
City of Fridley, Minn. N° .8 519
BUILDING PERMIT
Date: October UP 1265
Owner: John L. Jensen Builder J. J. Nagengart
Address - 6070 - 6th Street, N --W- Address 5712 Greek V l l evs Edina_
LOCATION OF BUILDING
No. 6Q7i1_ _ Street 6th ftreet R.E. Para of Lot
Lot _.3 _ Block p Addition or Sub.Division . Bonny Addition
Corner Lot _ Inside Lot Setback _ Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
D glli8g Front Depth Height — Sq. Ft. Cu. Ft.
Front Depth Height _ _ Sq. Ft. Cu. Ft.
Type of Construction & Est. Cost _ 1 s 000.00 _ _ To be Completed
Storm Damage
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 sett forth and in compliance with ons of
ord moss of the city of Fridley. A //
In consideration of the payment of a fee of .�?�.CC �`J , permit is hereby granted to .J.,7.1laganoart
to construct the building or addition as described above. This permit is granted upon
the express condition that the peon to whom it is granted and his agents, employs and workmen, in aII work
done in, around and upon said building, or any thereof, shall conform in all respects to the ordinances of
Fridley, Mirmesota rega�n� location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and tb�a permit may be revoked at aqy time upon violation of say of the Provisions of said
ordinances.
NOTICE:
Me permit den net emu the eenstraetien, Irma m for wirl& ph=bW9, on hsdW& sewer or water. Be son to sso
do Bufldh* hmpedw for apm to permits for thea it=s.
OWNER'S
ADDRESS
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
Street Part of Lot
LOT, OCR ADDITION OR SUBDIVISION ff
Corner Lot_L_Inside LOT 10 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.
To be used as;
DESCRIPTION OF BUILDING
Front Depth,_ Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Coastruction,�_�� Estimated Cott si O
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.
SIGNATURE I�
(Schedule of Fee Costs can be found o e Revers Side)
0 Date: Sept. 13, 1967
0
City of Fridley, Minn. N9 9446
BUILDING PERMIT
Owner. John L. Jenson Builder ____Sup s e 1 Co.
Address 6070 6th S t . N. E. Address 1850 Como Ave,
LOCATION OF BUILDING
No. 6 07 0 Street 6th S t . N. E. __ pmt of Lot
Lot — I ___ Block 2 Addition or Sub -Division _— B nnIM A d do
Corner Lot Inside Lot _ Setback --_ Sideyard
Sewer Elevation __ _ _ Foundation Elevation
To be Used as:
Finish Basement Front
Front
Type of Construction
DESCRIPTION OF BUILDING
Depth Height Sq. Ft. Cu. Ft
Depth Height Sq. Ft. Cu. Ft.
r
Est. Cost _ �a _2...QQ4 �To be Completed 7 %1 S �h R
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 aft provisions of
ordinances of the city of Fridley. j 'g
® "
In consideration of the payment of a fee of $ 12.00 , permit is hereby granted to Sussel Co.
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
withinythed e8lota imitsregardingnthislocation, construction, alteration, maintenance, repair and moving of building
city permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE Building Inspector
NOTICE:
This permit does not cover the construction, Installation for whdng, plumbing, gas heating, ewer or water. Be sun to ase
the Building Inspector for separate permits for these Mena.
AMLIC.M.Cli FOR B711ILDIPIG ??E r- IT
CIT OF Fk�i;J:,E?, MINNESOTA
OWNER'S NAME e/®1l �y ®l @ � Ru,.F•DER C� .SSE co
ADDRESS f) 7 lJ ' S f- �9 ADDRESS gs, o
LOCATION OF BUILDING
N0. STREET f ILI /- PART OF LOT
LOTBLOCK ADDITION OR SUBDIVISION 11 o a
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 Ad:
jd,4,,� Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost �G d
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 3 - SIGNATURE
Uo-
yy
(Schedule of Fee Costs can be found on the Revetse Side).
t►
City of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
ate; July 16, 1971
per; _ John Jenson Builder Russel Company
MIR
Address - _6070-6tb Street N.E. Address 1850 Como Avenue, St. Paul
LOCATION OF BUILDING
No. - 6070 Street 6th Street N.E. Part of Lot
Lot 1 Block 2 Addition or Sub -Division M Bonny Addition
Corner Lot inside Lot X Setback __ Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Gnrage Front 24' Depth 22' Height 10' Sq. Ft. 528' Cu. Ft. 5280'
Front Depth Height Sq. Ft. __ Cu. Ft.
Type of Construction Frame Est. Cost _ $2,100.00 To be Completed 90 days
Provide a hard surface drive. Set Garage slab elevation 4" above grade at house on
West side.
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.
----
$1 -15 -State Surcharge ..
In consideration of the payment of a fee of - 10.00 , permit is hereby granted to Sussel Company
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 buildup
V.Itblnnthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said
l �: /1 �n�.e' �✓ ►. L�-� A ay Spector
CLARENCE BELISLE
NOTICE
This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sun to we
the Building Inspector for separate permits for these items.
1e',V .:;I. f nec«
SALES M AN ,` 'i,%k �'�s" - •-
CONTRACT DATE
JOB. ADD-.—�--SS
BLGD. CODE AREA -' d
OR GrY 10E Us. bALYy
CONTRACTOR:' JOB E7" `
SUSSEL UOB r CONTRACT # 300 -
INDICATE THE ITEMS BELOW ON LAYOUT
Cord4iz
'F-- r Kear Z-5-carzings mint:: wiry
�.n. Dr. Offset Alley S.P.L. house
S.L. Location meets y S.S.P.L.
--locks "W?,—L]-BF- Property Lines R.P.L. Gtiaer
indows 1SEasement p -ley
�sare With
Soa Reem. -BY5 `�_ -
-Eaz Mix
. RG•iilJ .�LiG
Permit By
Legal Description
Lot
Blk b
Add'
Value
Type Const. "
f'
CONTRACT # 1
j fi
0
_ ., j
/-RC�c�hrj� hf(t�i
J� .
IL',50 CONwO AVE. ST. PAUL
CALL: 645-0331
SALESMAN
CONTRACT DATE
JOB ADDRESS
FOR OFF/CEUSE ONLY
CONTRACTOR JOB# '^— -
' |ND|CATETHE ITEMS 8ELQWDi\jLAYOUT
_
�Pormitby
/ [] Legal Description —_---_--_�
� �uo
� �� 8|l(
| :1Add'n
[-7 Value
E: Type Consx.
| /
�Square With
/ —
Rods
|�
*asn
�Sod Rmn.'By___________
Mix
— 3,3ug K0.x
ompirig
_ [,�oTamping
2-6zaninyoPoints Only
S.P.L.
S.S]P.L.
R.P.L.
Alley
House
F. Street
Other
CJNDU|T
Dr. Offset
� S.D.Lumtion
— "';ocks
�vVindowo
'
' .
?A��7 OF CONTRACT # ns��
~ / �
`
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: -fc k-, -Ae -L.T'0/U BUILDER: '=�d6 Sj e
ADDRESS: foo iQ 6 "', 1511 kl� ADDRESS: 145-6 bin a A-V_ - --51'
NO:. STREET:
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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: & 4d Lk
._;1 I/ Front • �7 �?_ Depth: /o o Height
Square Feet:__ Cubic Feet: ' vz S
Front: —Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: krO.W� Estimated Cost: $ .71es =`
To Be Completed: ?0 4z I
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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: dcc /0 - 1 ?W SIGNATURE: Cd -
(See Reverse Side For Additional Information.)
f.? los l//"v
A.,
60000 VIOGUNNoto so-ladvilmm"
Hinom mnNHAV HIVE - 6909
MOASAmns QNV U33NION2 11AID
A3-lC3VU8 'H 'S
io
IV
t)
f.? los l//"v
A.,
60000 VIOGUNNoto so-ladvilmm"
Hinom mnNHAV HIVE - 6909
MOASAmns QNV U33NION2 11AID
A3-lC3VU8 'H 'S
CITY OF FRIDLEY
Effective Date January 1, 1991
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE /
RESIDEaTIAL RATE TOTAL Job Address L 070'9 / /J
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $ 20.00 $ Building Inspection Div. 6431 University Ave NE Fridley MN 55432
Tel. No. 572-3604
Gas Piping $ 10.08 $T_
(piping needed with now furnace)
Gas Range $ 10.00 $_� 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
Ga or $ 10.00 $ ' and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
w
•Air Conditionin -.(all sizes) $ 10.00 S a, 19�L
All .Others/Repairs and Alterations '' owtasR
11 of Value of Appliance or Work S :_
KIND of BUILDING
COMMERCIAL/INDUSTRIAL USED AS
It of Value of Appliance or Work $ Ta BE COMPLETED ABOUT
nOLDIM
ATEDCOSTState Surcharge $ .50 . 10(p)NEW BUILDING PERMIT NO. PERMIT NO. a�
TOTAL !SE $
REINSPECTION FEE $30.00: $ ��
DESCRIPTION OF FURNACE BUHAFERDAi,/l
-
Rough Insp. Date HEATINGAr POWER PLANTS, Steam, Not Water,Wallo.
Final Insp. �D r Trade Name�� 11 E9 1 K . Size No. TZO 0 3 ® 5
Date ( capacity Sq. Ft. EDR BTU MD UP -13
Approval for Permit
Total Connected load kind of Fuel
BURNER - Trade Name size No.
Capacity Sq. Ft. EDR BTU NP
MINIMUM FEE FOR ANY BEATING/COOLING/VENTING PERMIT
IS $15.00 PLUS TBE $.50 STATE SURCHARGE
'Aix - Conditioners- can not be placed in side yard wi.thagt;_
written pesmiasion from adjoining neighbor.
company Richmond & Sons Eir, ft ft Signori By 5182 West Broadway
GrYSK MN 55429
Tel. Phon rye
Fill out back side for stack verification on replacement furnaces
CHIM14EY 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
YesNo
( )
3.
Has no foreign objects lodged within
Yes
No ( )
4.
Is securely supported
Yes X 1
No ( )
5.
Meets all current Code requirements for size and
to-tal_.BTU connected
Yes
No ( )
6.
Has Total heating BTU's of
All other BTU's
—7
TOTAL / U
Rema rk s
RI�HMtI��SONS dbal.
Company GOLD0I VALLEY HSG & A1R
Signed By
SEP 5
Date 1 J J
J e -f
suarecr
PE
City of Fridley
2720-_
7 2 0.�-1
AT THE TOP OF THE TWINS
P,NO.
BUILDING P E R M I T
1
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r ;
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/17198
JOB ADDRESS
6070 6th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Bonn
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jenson
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Darr Brent Construction 12601 Able Circle
NE Blaine MN 55434 862-3574 20134193
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Rk REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 20 S Tear -off
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
ZONING
MOT.
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
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
1668
$.83
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 O�R�THE OF CONSTRUCTION.
54.00
Fire SC $1.67
PERFORMANCE
1�i �/I/�- � f 7—C� �
PLAN CHECK FEE
TOTAL F E
�✓'V \
License 5.00
6 0
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
N P OPER[ IOAT I$ IS V UR PERMIT
i
BLD INSP PATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW' [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY 1
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 070 6A 54 fU E
Legal Description:
Owner Name & Address: J e h 5 o h Tel. #
Contractor: B J - f "t b a V' Ca 1,15 fl- U CMN LICENSE #
Address: W01 Able 6, c % IrE Cy j q Tel. #- j�j � r64 35 7�
Attach to this application, a Certificate of Surve of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width
GARAGE AREA: Length Width
DECK AREA: Length Width
OTHER:
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
Construction Type: A e ' Q oo F Estimated Cost: $ / 6 8
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: �-17- 1g' APPLICANT: &-evf bOrr Tel. # bJ W 357y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ 5^ 14• 00 Fee Schedule on Reverse Side
$ (-, 7 .001 of Permit Valuation (1/10th%)
$ 3 $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ 5`, OO $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 [ ]
g /S
SUBJECT -
PE -.
City of Fridley
31734
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
�1 -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
572-3604
/71171/r
PROTECTIVE
i "'�•� CITY HALL FRIDLEY 55432
NUMBED
pEv
DATE
PAGE OF
APPROVED By
---•�
l 612-571-3450
910-F15
4/9/01
JOB ADDRESS 6070 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
1 Bonny Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Barry/Eleanor Jensen 6070 6 Street NE 763-571-6211
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55416
952-933-6300
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION J REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Caulk
and flash all exterior openings.
Permit inspection Cards
Will Be (Nailed
To Homomer To Post,
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
$3.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,502
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-
$139.25
Fir,r SC $6.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TO L FEE
City i ense
49.00
SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT MATE(
EN O VALID THIS IS
R P OR IT
S-GNATURE OF OWNER.IF OWNER BUILDER. IDATEI
g p (NSF'
FIAfE
NEW [ ] Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name, & Address: E IUD r Tel. # 26? -S7/ -6Q
Contractor.G w MN LICENSE # G2
2
Address: Tel. # q .�
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:
Rep cCte-cmc , -" "C:, � C> -&.Construction Type:UJ'G/S Estimated Cost: $ <;50a
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$
DATE: �` S , Ol APPLICANT: / �� Tel. #
CITY USE ONLY.:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (763) 572-3604 for Permit Fees if mailing in application
$ 21 Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$ M $1100 per SAC Unit
$ i 'Licensed -Residential Contractors)
$ Alt. "A" or Alt. T" Above
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
(((( ov
TOTAL $ �I i
STIPULATIONS:r% j"jl�'
47--�o /7`17 l-! c • �G/c,�•�s�---
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK N11MRFR ()F FIXTI IPPR Trl RF INICTeI I PrI nni Genu r1 nnc
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES:
NO. RATE
New Fixtures �7
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas"*_
$10.00
Gas Range"*
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes ( ) No
Type
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
TOTAL JOB ADDRESS_ 3417£- +S dWL)SF_ ®l D
State Surcharge 5_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.
5/0 102' , 20
Owner C-16ndi \Jef [ — &070 &'-- (9'.. �jf
Building Used As �;S611)sm Cz
Estimated Cost PERMIT NO.
1
PLUMBING COMPANY
SIGNED BY TEL NO. 6I0" 8Z7 '1(9
Approved By Rough -in Date Final Date
TOTAL FEE $141550 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
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When reviacing 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 O No ( )
The venting"system is plastic/PVC and meets all current codes and manufacturer
specifications :including sizing, length, number of elbows and termination.
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.
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
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(. )
Yes ( ) No ( )
Yes ( ) No ( )
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 It Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By:
Date :