PRE 2010 DOCSCity of Fridley, Minn.
BUR DING PERMIT N® 3672
Date:.. -.. ... . ........
OwnerBuilder, ............ .
........................................
Address ...................................... Address .............................................
jj.
LOCATION OF BUILDING
No. .6.11 ... Street .....�.:'�'��G:/.. e./'l�.�lrr�....... Part of Lot ...... ..... ...
Lot ...,l ... Block ..., .... Addition or Sub -Division _
......... ..... ......
Corner Lot ............ Inside, Lot ...X ...... Setback .. .� ide . ..�
yard ....... ..........
DESCRIPTION OF BUILDING
To Us
r� b
. ........... .... Front ..'�/O: PP Depth Height Sq. Ft. ! : k 0. Cu. Ft. /do.C;r1®
.................... Front ........ Depth ........ Height .. ..... Sq. F't........... Cu. Ft.........
Type of Construction ................... Bat. Cost.. AX -010F To be leted ...................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed. work in accordance with the description above set forth= -
.....................................
with provisions of
ordinances of the city of Fridley. y
A............
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.
® Building Inspector
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.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA.
Owners Name [�• Builder-
Address ��' (f�y�ei._.� Address
L'9CATION OF BUILDING
No l4ZZL Street Part of Lot -
Lot Block Addition or Sufi. Div.
Corner Lot Inside Lot Set Back.
Applicant attach to this form Certificate of Survey of Lot and proposed
building location.
DESCRIPTION -OF BUILDING
To be ue61 as
✓�� Front Depthight
Sq. Ft. �' Cu. Ft.
Front ^;+Depth eight
Sq. Ft. Cu. Ft.
Type of Construction 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 aiid'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)
.A
City of Fridley, Minn.
BUILDING PERMIT
Date:
Owner:
Address
N° 5359
Builder '0414�� X26
� --
Address — —.
LO . T'! �UILDING
No. Street �! _____ Part of Lot
Lot __ _ _ _ Block Addition Oro on
Corner Lot .- Inside Lot SS!lback Sideyard
Sewer Elevation 1nd044on Elevation —
DESCRIPTION OF BUILDING
/ .. . 'r' Front Depth Height Sq. Ft. Cu. ra93
r Frgak Depth Height Sq. Ft. Cu. Ft.
Type ofConstructio��-� Fit. Cost __ 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 $;_ , permit is hereby granted to—
to
o
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 anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any y pon yiSlatfon any of the Provisions of said
ordinances.
NOTICE:.
This `permit does not cover the construction, Installation for whine, plumbing, gas heating, sewer or water. Be sure to so
the Building lospector for separate permits for these items.
4 0
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder,
Address
LOCATION OF BUILDING
No., % C Street r Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
�Front_Depth Height
Sq. Ft. _Cu. Ft._
Front Depth Height
Type of
To be Completed'
Sq. Ft. Cu. Ft.
Cost�C
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.
SIGNATURZ_ '
(A Schedule of Fee Costs can be found on the Reverse Side.)
•
•
Date:
owner'.
May 26, 1965
Elmer Martin
City of Fridley, .Minn.
BUILDING PERMIT
Builder Robert F. Norberg
Address 6111 6-th. Street No E. Address 3924 Utah Aye! No.
No. 6111 Street
Lot 18 _ Block
N° '7565
LOCATION OF BUILDING
6th. Street N. E. part of Lot
1 Addition or Sub -Division Uplands, 2nd • Addition
Corner Lot , Inside Lot Setback Sideyard
Sewer ]Elevation Foundation Mevation
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 IL 5,000.00 To be Completed
Storm Damage Repair: Restore Home and Garage to Original Condition
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 a'll 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 F. Norberg
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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
ibb permit don not effer dw construction, hwalb elan for wiring, plumbing, on beating, nww or wafer. Be urs to an
tbo Building leepntor for separals pnwib for then liens.
C, -2� P, e-1.? 7
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MIIJNESOTA
OWNER'S. NAME�'� � � ��
�' ` � � ec .1
� S1+� y d rf o-
! _ 104' &
ADDRESS_
-BUILDER,
ee , 4 ,,ADDRESS
9�2�
��1 dre/.-c /(/a.
LOCATION OF BUILDING
No. Street ?p ✓ Part of Lots_
LOTBLOCK _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 :�C3yi� 9 �j' c �d �i-r`y �1� . / C° - d l�
Front Dept'Height
Sq. Ft. Cu. Ft.
Front Depth Height,
Sq. Ft. `Cu. Ft.
Type of Construction Estimated Cost 5,-6.6.0-00
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 Departmient'of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE S 9
IGNATURE
(Schedule of Fee Costs can be found on the'Reverse Side)'.
City of Fridley
Application for Plumbing and Gas Ming Permit 53-84-s915.51
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK Location 6111 NE 6 `'t.
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $2.00
$
Future Fixture Opening ................
x $1.50
Y
New Fixture Old Opening ..............
8 Z
Z
Catch Basin ............................
x $3.25
W
a
(�90
,
F
•
N
WATER HTR.
GAS
ELEC
Base
a $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... ...................
2 x $2.00
$ 2.00
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
install (1) gas grill &
(1) lite
6.00
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $2.00
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg . ............
x $3.25
$
Electric Water Heater
a $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... ...................
2 x $2.00
$ 2.00
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
install (1) gas grill &
(1) lite
6.00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ 8.00
City of Fridley.
The undersigned hereby .makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn. JUne 29, 1970 , 19—
Owner Elmer Martin
Kind of Building frame
Used as residence
To be completed about JULY 3, 1970
Estimated Cost, $ 20.00
Oldg New. Building Permit
ROUGH
Permit No.
42
• 53-8L -9915051•
Alarlic:aifion fQV �'lui:r a 3 a ��n�e
v ��;�1�� r::i?
'
Dopt. of Bldg%. Phono 8.10.3450
• 6111
6• . STREET NE
DESCBIPTION OF V10111t Lo=d
XL.d,d Lnd Lccr:!on of Fixtures
_ City of Fridley:
' " 0 e WATf� Mra.
�• = t $ SIM : ° 7 = 7: r w ws nse. The undersigned hereby makes appUcation for a Permit for the• vont
in is S 3 M : : o �w 3 s u 1 o : �u $ specified, a� eeing to do aU work in strict accordarct wit
h the Cit? ori
---1 hereby declares that SA th
B3.,'1� I •• o ec r
3:d
- Cc:.as.•
• FL :::s Co:: c:i.c� CiT:c!r.;. 5,aar
r maw F7sturs. Old Cr}s.Is:gs Cc:spool
PARTIAL RATE SCHEDULE
and ruling of the D�:pa: tr"•ent of 13uI1...agr.
• and represcr ztIons stated is -his applicatsos are true ar.d O.rect• ,
rzidley. Man
8-30-76
_ Owner RTIId
IMM -43111C FIXTURE RATES:
N0. ' RATE TOTAL
x $2.00•
S r- --
Number Fixtures ...... • • • • • • • • • • �.-----
Future Fixture Fixture Opening • • • • • ••• • • • • -----
x $1.50
s ,
few Fixture Old OyrninY• ••• • • •'• • • •--•--�•--
x 31.50
S_. -:----
x $3.25
$
Catch Basin ....................
.....
Water Beater 11:1)to fr3.000 BTU).. • • ---
x . e 3.00
S
• 1:'sew Ground Run Old Bldg.:... • • ----
e
x .1.2 5
S
El•ctew W& r 1:•aW. 0.0
a 53.00
S
1AS FITTING FEES:
N0. Rn::: TOTAL
E -
1st3Fixtures •••••••••••••••'•' -------x$2.00
x + .75
S -
&dalUznal Fixtures ................ •---•------
ou Raa;e to 10.= BTU ...........
x $5.00
b-•
Kind of Building frame
Uscd as res.
To be completed about 9-4-76
Eslirnated Cost. $ �•
�
Old --New. Bulldnng Permit Na. P.mit h'o.
Sizncd ,
By-
Businvu Mir. ,
ROUGH.
FINAL -`3—! - %
.So State Surcha ge '
P..r.?<1R3 be XL:i;RATIONS—P.afer fo code __.......
' TOTAL MS-•- 5— 5--
A
CITY OF FRIDLEY
Effective Date May 1. 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Furnace Shell and Duct Work,
00
Burner (Also replacement furnace)
$
20.00
$
Gas Piping
$
10.00
S
(piping needed with new furnace)
Gas Range
$
10.00
$
Gas Dryer
S
10.00
S
Air Conditioning (all sizes) $ 10.00 $
All Others/Repairs and Alterations
It of Value of Appliance or Work $
COMMERCIAL/INDUSTRIAL
li of Value of Appliance or Work
State Surcharge
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 -
PLUS $.50 STATE SU9CHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
$
Job Address _(,, e ZIG-4 rh 51- A), L ---
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 decla as that all the
facts and representations stated in this application are t -' and correct.
OWNER
KIND OF
USED AS
FXidley, Minn. _ t//—/ I / , 19 la
TO BE COMPLETED ABOUT
ESTIMATED COST / as G
OLD - NEW BUILDING PERMIT NO. PERMIT NO. / 04 90
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANT
S, ,S✓tfeam, Not Water, Warm Air- No.
Trade Name S /A"'7— Size No. 7 '
Capacity Sq. Ft.
EDR BTU HP
u7
Total Connected Load 7 f f Z-- Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
ROYAL—TO M0 6 UUMW—
company F. 4120 - 88th AV040 N,
riruumyll r 9, MN 55443
signed By 424.8333
Tel. No. /
,
Fill out back side for stack verification on replacement furnaces
r
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack`;
Remarks l S 1 L v 0 K( N L-
1. 'Has. .been. carefully examinedNo ( )
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 connected Yes (� No ( )
6. Has Total heating BTU's of -1
Company
Signed By _
Date
�
All other BTU's
TOTAL
Company
Signed By _
Date
Int.
r loor
Total Btu.
Windows
_
Coef. Btts
r 'CilaM
loadatioA
wan
�:
j Net espy wan
w
Intlwallwa
Ceiling';
Floor
,......��
jRaitpitedaq.:ids."NA''.Leiie3+er:;•rt�i_
L
t Fl.� •_,. '. Odfll Io00gt11 -:l Width . H4bt .�w.w.
]
`WMdows 'and DOOaeliage and" Arei'i
width.. Ressr'I.a - N.. *I IL
rii .•! NM at Orwa NrYudyysndY 't•a. tt. -
Wrt. Btu
Iofileraeioa
Clea
cp. wanIn i
Nee e5cp. wean � ! �
Inc. wall
Ceiling °Z
Floor 8LI
i Tate! Btu.
Required, sq.' ft.
fl. Rooal'�Lan*tb Wldti�-. Height
p Wiaelows ,and Ds--Gra4tlae aa�d proa ''
{ width M•�saa,"-- !Iu K? i�l !t. w•••
�, }Id, .:':. ' ttf Mrw et �N"<;. .. •.nfYu df bri1Y ,�{. tt.
I
h
j
Coef.. Btu
In6ltratiob
Giau
ESP. wan
Net erp. wall r
Int, will
j Ceiling
hour
Required K'- ' ft. E•O.R or sq.'iaa."QrA.l,eadei arta .
Int.
r loor
Total Btu.
Windows
Y
CAMf.
1n61eratioa
Glaze
Fap. wall
Net exp. wan
r
Int. wan
Ceiling i
Floor
'Tow gtw
Itmuired sq. ft. E.DR or sq. itis. WA Leader area —
F.eoat I Length Width a �r"
Windows and: Doom—Ciraeltage had Area
i
ldlh ►IM► C Ma at Lind . wrea
Nw of Ow" of a. light at _"k eq - 411.
loadatioA
�:
Hoo► Aw�ie�!
w
Exp.`wan
Net.' - wall
�i
wl�
fiet�itt
Aram
Floor
r.
M M. tl.
C�aef.
1
Leader area
rdeh��
Y
CAMf.
1n61eratioa
Glaze
Fap. wall
Net exp. wan
r
Int. wan
Ceiling i
Floor
'Tow gtw
Itmuired sq. ft. E.DR or sq. itis. WA Leader area —
F.eoat I Length Width a �r"
Windows and: Doom—Ciraeltage had Area
i
ldlh ►IM► C Ma at Lind . wrea
Nw of Ow" of a. light at _"k eq - 411.
Inblt:atiaa
Glasa
Exp.`wan
Net.' - wall
+tat: wan .
Colin;
Floor
7ot�l;;�Btu.
Raquirtd aq. ft. E.D.R. or sq. inn. WA Leader area
—*1__3..
_GAS DESIGN
MAKE ��'�� �` _ MAKE OF BURNER _
Model 1 VU 612 07 : d: , ,Q,2 Model
Serial !a 3� <,y f a�-2 Max. BTU Rating
INPUT 7 S,�,�2aU MAKE OF FURNACE
Model
CONVERSION
SUBURB
�y CONTROLS
�'�
�' /
,
HOUSE
HEATING TEST RECORD
6, Z
Vent Size
7/7
'fr cam`
ADDRESS
Limit M B
a
APT. FLOOR CITY
OCCUOANT .l,r
, L
<,e,4 n�,
- v�
OWNER
H@RAT LOSS
DATE HTG. INST.
Pilot Type Lkc
SOLD BY
Chimney Construction C 4.5-5 G�
INSTALLED BY
Electrical Work By
Pilot Model
Gas Line By
TYPE OF HEAT
GA
FA HW
STEAM SPACE HTR. UNIT HTR. OTHER
_GAS DESIGN
MAKE ��'�� �` _ MAKE OF BURNER _
Model 1 VU 612 07 : d: , ,Q,2 Model
Serial !a 3� <,y f a�-2 Max. BTU Rating
INPUT 7 S,�,�2aU MAKE OF FURNACE
Model
CONVERSION
SUBURB
�y CONTROLS
�'�
�' /
,
THERMOSTAT
Heat Plug
Vent Size
Valve 6��� �`
KIND OF LINER Y-1 ® SIZE eNONE
Limit M B
Draft Hood® Regularor
Limit Setting ��
Filters Size /A Plumber
Fan Setting
Chimney Location Inside Outside
Pilot Type Lkc
Chimney Construction C 4.5-5 G�
Pilot Make
Pilot Model
Smoke Bomb Wiring
Pilot Timing _
Draft 0 Test Tag
L.W. Cut Off
Door Pressure Lighting Inst.
Pressure �' �_
Percent CO2
pJ
Date Tested �/ �J ��
Input CFH
Percent 02
r -�
_
Company Testing
Stack Temp. —Percent
CO
Name of Tester ----
Form 235
01
SUBJECT
PEfR
City of Fridley
36 7AT
THE TOP OF THE TWINS
BUILDING PERMITRT
NO.
_ COMMUNITY DEVELOPMENT DIV.
tr PROTECTIVE INSPECTION SEC.
�J
-I O
r s
�1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
�""� 41 1'j 612-571-3450
910-F15
6/1/92
JOB ADDRESS 6111 6th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
18
1
Uplands 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Cameron J. 011ila 6111 6th Street NE 572-8975
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO,
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' x 61 Garage Addition (Enclose screen porch only)
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations. on plan
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING. THIS TYPE OF WORK WILL BE COMPLIED
$400
$' SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SACCHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$15.00
Fire SC $.40 .
PLAN CHECK FEE
TOTAL FEE
$15.90
SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT (DATE)
WHEN P OP LY THIS IS YOUR PERMIT
UID�A
j9DG iNSP DATE
SiGNATUREOF OWNERIIF OWNER BUILDERi IDATEI
01
NEW [ ] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER [x] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: `' 'Ple
(5
Legal Description: d eWg e Zo / /�' B/ cG P ��► �N �4�- Ooh
Owner Name & Address:�'a�,�.-oma �T ���� Tel. # �7�
Contractor:
FX- -'A�
MN LICENSE #
Tel. #
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 �D , Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: z!�� c /o s,,f 4 Estimated Cost: $
Approx. Completion Date:
Driveway Curb Cut Width Needed:
DATE: r- ��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park Fee
Ft. + 6 Ft =
Ft x $
(Cost on Back)
APPLICANT: v lam- Tel. #
T1--11 a
l¢,-zs 401.
$ 45,4 aO
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
1S�I'1'TJsS g:
DATE
PORCHES
YEAR BUILT
CLASS
FRONT
SIDE
BACK
OPEN
CREENED
GLAZED
FOUNDATION
FLOOR
EXTERIOR
ROOF
INTERIOR
YARD, IMP, YEMENTS
DRIVEWAY
CQ Mcg. r o%
I
5c ree — As --c%
UMd« s4..,c
and en
at �a rR9G
i
W/'// lie c olc4ff
Scree,* P,,f.A
L"// A�✓
/4/1-// & �P� »� AQP T�, s' G✓a //
all d/
a hoc% tr�a
Ex / sfl� 9
16
clt
CJ(,SIJJ
fmf
Fk.cE�� OI.r
- - G.e•fe
Aj�
T
Jr/,Xc /e u doo •, ,E/ 5;..ie /u •� do �-
�0D00
i.
5'cree n
W It
4e Owi r,y
°e ty 1
SUBJECT -
PE
City of Fridley
283
AT THE TOP OF THE TWINS
?
BUILDING
PERMIT (
Ir
_Px4elPT-W, .
' • ____ COMMUNITY DEVELOPMENT DIV.
------
r � v �
PROTECTIVE INSPECTION SEC
,®&
.
�
Vf
1 �
NUMBER
REV
OATS
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
10/20/98
JOB ADDRESS 6111 6th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
18
1
I Upland 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Cameron 011ila
972-89749
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Brian Claypool Const. 810 112th Ave NW Coon Rapidg 55449
759-4RQ3
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
O NEW O ADDITION O ALTERATION QX REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and garage (26 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED 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]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
$2228
$1.11
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
$74.75
JFire
JC $2.23
P0.1 \�PLAN
p s �D ��� 9�
CHECK FEE
Licens SC
5.
TOTAL E
.09
SIGNATURE OF CONTAACTOA OR 4UTMORI2E0 AGENT IDATEI
EN OP
PER
E I$ IS YOUR RM
OF OWNEAOF OWNER SUILDERI IDATEI
'00001S,GNATURE BlD INSP
�lAft
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: CAM , n N o 4 l 1-4 Tel. # Y 7 � ? 9 ,? S
Contractor: '�� [ [/{yon L ti f t • MN LICENSE # 9 0 ( 7 ?
Address: �'� 11 a {� �j✓R - ^' C 4/?,f,- INA, A f Tel. #
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
GARAGE AREA: Length Width
DECK AREA: Length Width
OTHER: ft r/Z o a,F (4,1,- f t
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: P /7 ' a n- 9�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee,
Sewer Main Charge
TOTAL
STIPULATIONS:
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
tin CvARA6n —
Estimated Cost: $
(Fee Schedule on Back)
Ft x $ _ $
APPLICANT: Tel. #
r$ &J.
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 [ ]
���o
7S's - yea 3
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 57171287
Effective On Jan 1, 2003
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT M
.-.v . . &amrm err r1v-r1 mr-0 Tn QC IAICTAI 1 Fn r)N FACH FLOOR
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
NO. RATE TOTAL
IN
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00 Z.106
$ 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
TOTAL FEE $ �•s�
JOB ADDRESS 4 111 6 It' _T" N ar FE l' 921 N !V
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.
el AO , 2010-3
Owner
Building Used
Estimated Cost 2 PERMIT NO. 0
PLUMBING COMPANY
SIGNED 13% "ten TEL NO. f ? .971
Approved By Rough -In Date Final Date
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
::.;::::;
IVVNMM
IVUIVIDCM
%JF
F1n 1 v1'%w
Wash
Iv v.- ........���-.
:.: # ;::::::<:>::::>::
_•
Floor;
- — --- -
- -- -
Au to.
:Os:::>::>::>::::: Gas �.<:::>::::>>::
Water Heater
:::.::.::<:>::>
-
T'Iri�<�>:
Shower
• ::.::>:::::<:::
��#;.:<:::>
Tra
:.:. : ;:::::::>::
Dram
:: >:;:>:
Washer;#
e «:»
Ran t::>::.:::::
Gas Elec
Stories
::<:>::>
::::.
Urinal
:�#�#i<::.::.:::
ent
Basement em
:>:
Floor 1
Flo
Floor r2
Floor or 3
Floor 4
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
NO. RATE TOTAL
IN
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00 Z.106
$ 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
TOTAL FEE $ �•s�
JOB ADDRESS 4 111 6 It' _T" N ar FE l' 921 N !V
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.
el AO , 2010-3
Owner
Building Used
Estimated Cost 2 PERMIT NO. 0
PLUMBING COMPANY
SIGNED 13% "ten TEL NO. f ? .971
Approved By Rough -In Date Final Date
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
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
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 plastictPVC 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 axis ung cnmhustien air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to ins all a now rnmhuktinn airTit will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When installing a new venteng SySteml, 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 #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:
suBjEcr
City of Fridley
33352
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO1.
_---_- COMMUNITY DEVELOPMENT DIV.
r f PROTECTIVE INSPECTION SEC.
f �
CITY MALL FRIOLEV 55132NUMBER
REV
GATE
PAGE OF
APPROVED BY
763-571-3450
910-F15
2/26/03
JOB ADDRESS 6111 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
18
1
Upland 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Giles McConville 6111 6 Street NE
763-571-4571
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
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 Ek ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
S DESCRIBE WORK
Construct a 15' x 28' Living Area Addition
and a 9' x 12' Solar Collector Addition
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
a Ill if 'gft
WARIV b
SEPARATE PERMITS
Before digging
REQUIRED FOR:
SII f®r
eUtility ,®tet'®"�
WIRING HEATING
®o�
PLUMBING AND SIGNS
Ear E BYLAW
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
1 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
$ 35,000
$17.50
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
TOTALFEE
_
$544.75
IGNATU OF CON'RACTOP OR AUTMORIZE ENT IDATEI
W PROPERLY VALIDATED THIS IS YOUR ERMiT
S�GNA7URE OF WNERiIi OWNERS ILDERI I AiEI
L G INS T!A All
xrz
7.5:
Ic-I 18 b1cc-J.-. it
UPLAND 2rid ADDITIO!,
SC',ALEi 1*=15'
1 D I tl
I J. t-'- •,'_.;'1._....I'',•....!
.. ........
►!t _�
f.
P.
I've -41--
T tB F
'I ", . j Iif-
T R E A T 1:7—r -
E j 2'f'
at f -
W 11 DC -1W
F!, --,DE LPIE
2Xl(---,l RIM JOISTS.
SILL
12" BI—OCK. If' -1 C"C"L-IRSE
—4
Fo L/LA a lk-o-rj
N4iNDERFNGDm .. NG CO.,INC.
ENGINEERS AND SURVEYORS
L^No SUMVEVINS SOILS TESTING
CIVIL 8i. MUNICIPAL ENOINEEMING LANO PLANNING
6418-567" AVENUE N.
MINNEAPOLIS TT, MILAN.
KE -t- 3637
/1/o, r' � R&A T Y CC'.
At
SCa/e : / 3411)
910C�r Z — UPLAND 2�D ✓d'rrla.y
N
WE HEREBY CERTIFY THAT THIS IS A TRUE ANO CORRECT REPR95ENTATION OF A SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SND LAND. M I PJb E R ENGINEERING CO., INC.
DATED THIS DNY OF A.O.Iij 2?
ENGINEERS ANO �SURv@YOBS
r
'b
I rrsn
SCa/e : / 3411)
910C�r Z — UPLAND 2�D ✓d'rrla.y
N
WE HEREBY CERTIFY THAT THIS IS A TRUE ANO CORRECT REPR95ENTATION OF A SURVEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SND LAND. M I PJb E R ENGINEERING CO., INC.
DATED THIS DNY OF A.O.Iij 2?
ENGINEERS ANO �SURv@YOBS
r
ENERGY
ORK SHE E
SQ FT
CEILING
15X28
420
U=.033
NORTH W
LL
15*8
120
SOUTH W
LL
15*9
135
EAST WAL
28*9
262
517 TOTAL
U=.037
DOOR
WINDOW
WINDOW
4
4
6'8"X36
1.75X4.17
1.75X5.17
20
29.19
36.19
U= .33
.02 cFm/sgft
WINDOW
41.83X1.0
% openina
7.32
92.7 TOTAL
17.93%
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: _
Owner Name & Addre
Tel. #763 �5_71-1S7%
Contractor - MN LICENSE #
Address:
Tel. #
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 e)- Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width f Hgt/Ground / Sq. Ft.
OTHER: q /2—
Construction
2—
Construction Type: LU del J FAIIASL Estimated Cost: $ 03 S o 0 e)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: ;_7 Z6 APPLICANT:�� Tel. # %vim
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$
itLj s_-
$ 3-,�7. 66-
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]
,dna ���-
All Others/Repairs & Alterations (LIST ON BACK) _
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
Burner Trade Name Size No._
BTU HP ED
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEATING CO
DATE
TEL # 7( 3 -5-7 l q 71
FAX #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved ByA Rough -In Date Final Date
written permission from adjoining property owner.
Effective January 1, 2003
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432 APPLICATION
FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
FAX (763) 571-1287
� � �i � S'>7--
JOB ADDRESS /UE
RATE SCHEDULE
OWNER
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS
Also Replacement Furnace
(Side Vent - Fill Out Back)
$ 30.00
$
ESTIMATED COST �C� PERMIT NO.
Gas Piping (Needed with new furnace,
$ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Gas Dryer
$ 10.00
$
Trade Name Size No.
BTU HP EDR
*Air Conditioning -. All Sizes
$ 25.00
$
Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK) _
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
Burner Trade Name Size No._
BTU HP ED
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEATING CO
DATE
TEL # 7( 3 -5-7 l q 71
FAX #
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without Approved ByA Rough -In Date Final Date
written permission from adjoining property owner.
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
CnMMnN VENT_ VFKIT MKIKECTOR AND C -MRI ISTIC)N AIR VFRIFICATIr1N
When ro la _innan�tino Mran _p, 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 (1 No ( )
The venting system is plasticlPVC 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. I Yes () No ( )
The avin inn rnmhtisfinn air is sized and installed to meet the current codes
and manufacturer's specifications. . Yes () No ( )
When required to iniatall anew cnmbiistinn airy it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When jpstallinn a new venting sygam, 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 #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 M
HEATING CO:
Signed By: Date:
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
763) 572-3604 FAX: (763) 571-1287
ADDRESS
: 6111 6TH ST NE
PIN
: 143024340051
LEGAL DESC
: UPLAND 2ND ADD
LOT 18 BLOCK 1
PERMIT TYPE
HEATING
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE
ADDITION/ALTERATION
PERMIT NO.: 2004-00304
DATE ISSUED: 03/08/2004
VALUATION
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A
INSTALL A FURNACE (WARM AIR, RHEEM, 75,000 BTU) AND AN AIR CONDITIONER
# A/C UNITS 1 VALUE OF APPL OR WORK
# FURNACES
# GAS RANGES
APPLICANT
RICCAR CORP
2387 STATION PARKWAY
ANDOVER, MN 55304
(763)754-4000
OWNER
HAMED FAWAZ A
6111 6TH ST NE
FRIDLEY, MN 55432
1 # GAS DRYERS
0
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 wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate ancel a provisions of any other state or local law
regulating c tion or the performance of construction.
Applicant Date
Bldg Inspt \ K�/e Date.
HEATING PERMIT MINIMUM FEE
FURNACE SHELL/DUCT WORK
GAS PIPING FEE
GAS RANGE FEE
GAS DRYER FEE
AIR CONDITIONING FEE
HEATING REPAIRS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WITH CHECK # 50335
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
0
0
0.00
30.00
10.00
0.00
0.00
25.00
0.00
0.50
65.50
Effective On January 1:, 2001
:ITY OFFRI SPI 10fi1 Qlvi'sim.
X451 Uniarere ,. 1
;:; AP 140, FOR POiI�EPNT3>pI►TIIAIG,#Nt;,11EITiIATi1i,
ridley.►91N
ilei I E 1T1t91 t A , �1 t+g�1+G 'ST`STIEII AND `DEVlCES-
163-572-36104'
JOB ADDI,1ES
t
OWER
Residi0y ;' , ' Rite
�al<
Fumy _ 6�urnex
TOTAL
BUDDING USED OSS
�-1
Also R:plan EWace. 3000
ESTIMATED +DOSTPERMIT.NO.
Side para 4iII +Ry,
" -.
.
Gas Prping T1s d new #urraace, $10:00
p ESCRIPT�+f OF IaiRNAE ASI Olin:BURIi
bij� tfot repYacemeht)
Gas j nge 10.00
—
No: of ating Ur�its Cicle One (Stem) (Hot Water) 4iiR)
H
f
$10.00
�-
Trade N��nae(/►'"�C(/��0.Q..1�1 Size No'. q
--
Gas �i°yer
-=r-----
b =
BTU "1 Hli - EDR
'
*Air �hd�tibmnR AI! :�zes 25;00
$
Fuel Total Connected Load
Others/RO airs &Alterat-iofis ON BACK)
Burner 'Tradene NarSize No.
Hp EDR
All _-LIST
Valor -f Appliance or Work
BTU ;
ComrercialIIirlustria
$ '
Thi undersigned hereby makes application for a permit for the work herein
1.25% of Villus of Ap is nce or Mork
so Me, agreeing to do all,work 'in stria accordance with tht: City Codes an
State Surcharge
50
rulings 11I the tuildi6g<Division,:and hereby declares that all the facts and
represertbons stated in this application are'true and corr`.ect.
s TOTAL FEE
$
DATE .
[1111N1I1�RJNl FEE F i A 11f HIEJATING/C+flt)IINO%'VENTILATION
HEATING
HEf J.i ERAT1�Q�i Oje.�oftjTIONIN0 PERMIT IS $25.00
,
TEL # M
Sign ' � -
PLUS THE $.50 5TATE `5tlRCHARGE
REINSPECTION :FEE'$47:00%Hr
*Air Conditioners :can not be;.placed in a side yard without
Approved By Rough -In Date Final Date
written permission from adjoining property owner.
BACK SIDE MUST BE FILLED 1N ON VENT SIZE, VENT CONNECTORS
I
AND COMBUSTION AIR VERIFICATION
ffies
that the
jK6 ndersidbed! yen
MInG 8 "" " . - 1. n obstructions,
Whellored a "'.. ! - - - f ons,
I *,eegom rust d'.
verging ties been eksmined
d'
andis secure 'O, securely supported where reiuire.
4411nanufacturer
fls plastid. Pvt �meets all current a
Th Venting syst"-;,
mb
nu e bbws'and, termination. r of el
js
specifications Including Siziog.
ce a,'ij ad
The. undersigned a . Iso verifi.es that tWePI8 ment unit ii, , ist assembly
and_ meets the current cod" and rrr4nufacturees specM6jtj6ns. This does
include AGA -LAMA CatSgGrY I Central Furnace Venting -Tables, for fan
assisted.'and natural draft appliances.
The existing combustion air is sizedand installed to meet the current codes
and manufacturer's specifications.
Y46 No
Yes�V No
When requted to Install a net *co rtan air, it� will be sized and installed
to meet thv-current codes ancfmanufact u . rer's-specifications. Ye NO
When installing a now venting system, the undersigned hereby verifies that
it is -a liste&assembly and meets the current codes -and manufacturer's
specificatio6s. This does i include AGA-GAMA Category I Central -Furnace Yd No
Venting -,Tables for fan assisted and 'natural draft appliances.
Is the c . omr,non vent and vent connectors sized and installed correctly after
an appilinc6 has been removed from the common vent and vented Yes No
separk iy=#s per current codes.
Appliancilyp4and SIzejtftiitd-n VeM.iknd Vent -Connector tnfdirmatfon
BTU, Input, 15.,--= Fan'Assisted or Nat
Appliance #1 Type
Appliance Q Type BTU Input Fan.Assisted or Nat
Appliance #3 Type BTU 4nput,-FamAssisted or Nat
Totaj,Appllance=s Total Btu Input 16
Common Vent Type Vent Height Diameter_,inches
in Type
Appliance 91 Vent Connector He* Length Diameter,�,�
eter
ft Length Diameter in Type
Appliance #2 Vent Connector Height ft in Type
Appliance #3 Vent Connector Height L-ength'____ft Diameter
CITY OF FRIDLEY PERMIT NO.: 2004-00776
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 05/25/2004
57L -36U4 YAN: (763) 571-IZ57
ADDRESS : 6111 6TH ST NE
PIN : 143024340051
LEGAL DESC : UPLAND 2ND ADD
: LOT 18 BLOCK 1
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE FURNACE AND AIR
CONDITIONER.
# INSPECTIONS 1
APPLICANT
KOVAR ELECTRIC LLC
23049 ARROWHEAD ST NW
ST FRANCIS, MN 55070
OWNER
HAMED FAWAZ A
6111 6TH ST NE
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 atter 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 worl
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 provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date.
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 6078
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY PERMIT NO.: 2004-01508
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004
572-3604 FAX: (763) 571-12137
ADDRESS 61116 ST NE
PIN 143024340051
LEGAL DESC UPLAND 2ND ADD
LOT 18 BLOCK 1
PERMIT TYPE ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114 -
OWNER
GILES MCCONVILLE
6111 6TH ST NE
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 provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 117431
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.