PRE 2010 DOCSCity of Fridley, .Minn.
BUILDING PERMIT
Date: ... /..®.s .. .........
Owner.......................................
Address ......................................
N® 3655
Builder .. /.. .........
Address.............................................
//�' oofJ
LOCATION OF BUILDING
No.. /1 911 . Street ... �®.. ... /. (. ..... Part of
Lot .117...... Block .... � ......... Addition or Sub -Division r , .
Corner Lot ............ Inside Lot X ........ Setback ..f....... Sideyard /.........................
DESCRIPTION OF BUILDING
To be Used
... .... Frontes. . , Depth .f�.: Height / Sq. Ft. �/Q��.. Cu. F't.���
......... ....... Front ........ Depth ........ Height .. ..... . Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... l�L Cost.� be Completed .......... ........ .
In consideration of the isaance 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 fo d in compliance/,wiM 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 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.
ili6
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.
'0
Y"A
A
City of Fridley
'
Application for Ptnmbing and Gas Fitting Permit
DepL of Bldgs. Phone SU 4-7470 _
DESCRIPTION OF WORK Location �� _
Number, Sind and Location of Fixtures
N
K
Vl
12
N
YyN�
6' VI
VI
W
W
�U
.
?
F
N
WATER HTR.
GAS
ELM
3Cied
m'F
A
3�
G�
n
LLe
S
Q3
�Q
(�90
M
Base
1st
d
2nd
3rd
4th
Future Connection Openings
Connected wlth
°F New Fixture, Old Openings
Sewer �
Cesspool ❑
PARTIAL DATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................7 x $1.50 $-- f'
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
x $1.50 $� ry
— x .50 $
_ x 2.00 $
City of Fridley:
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.
^eyy, Minn
Owner .19—
Kind of Building.–,,/ 119—
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit
Connection Permit No . .......................................................
3 Water
Sewer
�• e
Description ................................................$
TATA, mm $ 11 IM -8-58
Meter Deposit
•
• .
City of Fridley, Minn.
BUILDING PERMIT iv® 6773
Date:
Vz�Owner:�,�t.Build
Address Address _
O T F BUILDING
No. Street _4 __�_ Part of Lot _
Lot ---- __ Block Addition orSub-M"ideyard
Corner Lot _ Inside Lot _ _ k/ AEback a
Sewer Elevation — Fo dation Elevation
DESCRIPTION OF BUILDING
To ® r
Front Depth Height ! Sq. Ft. Cu. Ft.�e�s
Front __ DepthHeight Sq. Ft. cu. Ft.
Type of Construction r Est. 4 �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 oP 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 reg location, constructaton, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked atany time u tion of any of the provisions of said
ordinances /`i�
Building Inspector
NOTICE:
This perm* does not never the construction, hutallation for whtng, plumbing, gas henthM sewer or water. Be sura to no
the Buil ft hnpecmr for separate permit for theta *ams.
•
•
City of Fridley, Minn.
BUILDING PERMIT
Date: June 4' 1965
per: Duane W. Johnson Builder
Thomas S. Silvis
Address 6120 6th Street N. E. Address 6020 mood Rd.
N° 7'739
0�g-145y
LOCATION OF BUILDING
No. 6120 street 6th Street N. E. part of Lot
Lot . 17 _ Block 2 Addition or Sub -Division . U�lan&s tad. 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 85, 347 a00 To be Completed
Storm damage repair
In consideration of the issuance to me of a permit to construct building described above I agree to do
the proposed work in accordance with the description above set fo 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 Thomas S • Silvis
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, Minnesotalocation, construction, alteration, maintenance, repair and moving of buildings
within the city ]units s
ordinances. permit may be revoked at any time upon violation of any of the provisions of said
Allen Jensen
NOTICE:
Tide pemdt den net own the coestrnadoe, Instailattee for wiring, pinmbtng, gas bating, sower or wtlor. Be son to no
the eotidtag Inspector for separate pamhs for thea Mann.
OWNER'S NAME
ADDRESS�-
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
e ADDRESS �� 4�41A/60 a
LOCATION OF BUILDING
No. Street_ PartofI :Lot
LOT BLOCK ADDITION OR SUBDIVISION . a /
Corner Lot_,,,_,Inside LOT__„_ Setback Side :Yard ,
SEWLR ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTf.ON OF'BUILDIN(;
To be used as;
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq, Ft. Cu. Ft.
Type of -Construction Estimated Costk.,
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 rue and correct.
./
.e,of Fee Costs can be found on the Reverse Side).
Proposal
Proposal No.
FROM ThOmae S. Silvis
Sheet No.
6020 wynnwood Road
Date May 22, 1965
Mpls., Minn. 554.22 544-3919
Proposal Submitted To
Work To Be Performed At
Name Duane F. Johnson
Street edge
Street ---!f----20 6th St. N. T. ___
City State
Date of Plans—
lantState_.__—
City Fridley
_
State- Minn. _
Architect
Telephone Number____--_—
We hereby propose to furnish all the materials and perform all the labor necessary for the completion of -
House
Remove roofing
Replace broken structural members
Repair sheathing
Replace roofina
Remove siding
Replace broken studdings
Check location and re—anchor loose exterior walls
Replace siding
Replace faceboards
Repair and clean soffits
Continued on reverse side.
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings
and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
Dollars ($ ).
with payments to be made as follows:
Total amount due on completion -
Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will
become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our
control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Public
Liability Insurance on above work to be taken out by Contractor
Respectfully submitted ��'7`Per
Note — This proposal may be withdrawn by us if not accepted within ten days
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. Payment will be made as outlined above.
Accepted____--_ Signature —
_
Date__—_ —_ — — Signature
TOPS FORM 3480
qW .1111,
W
LITHO IN U. S. A.
1
IiL._ . _ 0
Repaint entire exterior of structure (2 coats on replaced materials)
Replace brokenswindow frames
Replace broken glass -
Replace broken screen
Replace two entrance doors
Replace two combination doors
Replace two roof vents
Replace three interior doors �--
Replace rear entry, kitchen and
Replace bath floor
Sand and re -finish all hard wood Boors
Replace all broken plaster board
Re -nail all walls and ceiling where loose
Re -tape entire house
Spray ceilings
Paint walls 2 coats
Job clean-up and rubbish removal
Clean furnace duct work
Furnish roofing materials for owner to replace garage roof
Furnish 5 sq. siding for owner to replace garage siding
Total amount due $5,347.00
Five thousand three hundred forty seven and no/100
y L � S y '. c 7 K'• -
ra
SUBJECT
PERMIT NO.
City of Fridley
o 1296'7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 } �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATEPAGE
OF
APPROVED BY
L ' , 612-560-3450
910-F15
5-28 -75
1 1
JOB ADDRESS
6120 - 6th Street N.E. Fridley, Minnesota
55432
1 LEGAL
LOT NO.
BLOCK
ACT OR ADDITION
TRUplands,
SEE ATTACHED
DESCR.
17
2
2nd
Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
E.J. Kazmierkoski, 6120 - N.E. 6th
Street, Fridley, Minnesota
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
B & L Construction , Route #3, Elk
River, Minnesota
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residence
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Roof Repair
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
R-1
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
$1,000,00
$.50
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.
$6.00
PLAN CHECK FEE
TOTALFEE
6.50
UREOFCONTR T FOR HORIZEDAGENT (DATE)
WH PRO E AL
TED THIS IS YOUR.PERMIT
AIPIGNATURE
BfDG INSP
GATE
OF OWN YAXFOWNBUILDER) (DATE)
ra
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: BUILDER • 4 `7
ADDRESS:— � a 0 of . 4' . L -t'4 .a. ADDRESS:
NO • . Jo 12-0 STREET: c4 kt
LOT: ADDITION
CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and propos( I
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth:
Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost: $ 'il/0010.00
To Be Completed: ate/' %�—
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.
Cs
MTF.- - 7S STMA"MR..
(See Reverse Side For Additional Information.)
�-a
97 -8b -b16051
CITY OF FRIDLEY
• APPLIcATION FOR PLUMBING AND GAS FITTING PERMIT
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0Water
tn
5
a
W
w
0
Heater
as
lec
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
_
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
1st
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
'$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
2nd
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
3rd
$ 8.00
4 th
(R) - Future Connection Opening
(�) i New Fixture, Old Opening
Connected with Sewer
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures
X
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00 0
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
_
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
'$3.00
$
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$ 8.00
REINSPECTION FEE
($10.00)
Job Address _ 6120 6�Street NE
Department of Buildings
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 declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 7-19-78 , 19
OWNER KAZMERKOSKI
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 7-26-78
ESTIMATED COST 20.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.. h 0
6 Company Z7®�&0e. '
Signed By MINNEGASCO
Tel. No.
ROUGH INSP..
Date '
FINAL INSP. -/ ^
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCBARGE
-
CITY OF
FRIDLEY -
®-APPLICATION
.3D
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE -SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
f
Job Address
e
: -,r^ ace' S :ell & Duct Work
$12.00
$
Reclacament of=Lrrace
7.00
7.00
$
$
DcpartmeFr of Buildings
Repairs & Alteraticns-un to $500.00
4.00
$
City of Fridley
Repairs & Alterations each add. $500.00
Tel. #571-3450
MECHANICAL iiAR}i AIR:
The undersigned hereby makes application for a permit for the work herein
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
Furnace Shell & Duct Stork to 100,000 BTL'
4.00
$
and rulings of the Department of Buildings, and hereby declares that all the
each add. 50,000 BTU
7.00
$ P7,06
facts and representations stated in this application are true and correct.
neplace:..ent of Furnace
Repairs & Alterations -up to $500.00
7.00
4.00
$
$
Fridley, Minn '� 19
Re:airs & Alterations each add. $500.00
--
ST: OR HOT titiATirR SYSiL'�1:
Ea}
/.
OWNER
Boiler o Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each adiz. 50, COO BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
USED AS
each adn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
n
each add. 3 gal. per hour
10.00
$
ESTIMATED COST yZ ` 0
PERMIT NO.
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ /e,CO
OL - NEW BUILDING PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$ 7.00,
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
Gas Range to 199,000 BTU x
$ 1.00
$10.00
$
$
CEAING_or POWER PLANTS, Stearn, Hot Water, Wa Ai No.
AIR CONDI l'1JN' NG al (��
$�QZ%
Trade N.6( � 1 1� P/✓`� �Y Size No. �� 3c;;�
FAN HEATING S i SI L -MS See Fee Schedule
VENTILATING SYSTEMS
STEM
$
$ —
Capacity BTU P
ALTERATIONS t, RS
State Surcharge
$"-
$ .50
aaSgpFt. ryEDR
/�
Total Connected Load � J, ` �� Kind of Fuel s
TOTAL FEE
$ 30`
QlrGa
BURNER - Trade Name C-0 \ Q- VV\a.-Y Size No. CJv
Capacity Sq. Ft. EDR BTU IM HP
ROUGH INSP. RUINSPL•'CTION FEE
Date ($10.00)L
Company
FINAL INSP.
Date
Signed By
APPROVAL FOR PERMIT
Tel. No.
/
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50
#'c +.GiJ1a�Tt4is DEPARTMENT SUIL& _ ' -n ST. PA UL. MtNN.'.
W#�fPMIRItRIM i
Ma •L
Refsnnaa
1t._....."
TY►1 OP CONURUCTION
INBULI►TION
(� .
+-Ne Ya—No
Out. wap Int: Wap
t:eipno
Reef
Hoer
Kind
Cepin
yyaq
W. "� Roeiu` Length Wtdta'" lfiight
N. Room Length width' Hdgbt
" VIN DEWS: and DOORS — CRACKA6E and AREA
r q o. nae Ana
NO. of of a BIW of erae� ft.
a � �� gp -q�j
WINDOWS and DOORS -- CRACKAGE and AREA
No. et pane ofe Uoa
Asg.� H• .
,•r
'' ' `'�
. ` Coef. Btu_
Coef.
`DOM Vare
Infilfration ndows
Door3
—Btu.
"–—"----^
WON ,f
Q �'
&P. wan
a
Glace
Net Wall
Wall:
�'" as
fiA►iirtll
Int. Wap
4
w I 'Y�r O ,
cefung or floor
Total Bfu.
rad - . fi: E. D R. or ins. W. A. Leader area
Required tq. ft. E D. R. or sq. Ins. W.A. Leader area
1,1K V$117' Roml Length . S Width V Height
a
_FL Room Length Width Haight
�IilNDC1WS a.nd DOORS,- CRACKAGE and AREA
HaP9ht No,. Lineal Area
of paao 1f of era sq. ft.
WINDOWS and DOORS — CRACKAGE end AREA
d Haight No. of Ana Arca
No: of as of ane item. of cradi ft. "
Coef. Btu.
Coef. Btu.
1wf'dhatiOn
Ir�4iltration Windowsn
Wap p ` ., �'
t y
Wap
E+lass
. 1 n r` ! F Wi t;
Glass
Net Wap
' a.,l`�,;,
Net Esp. Wall
` M. well
ki
Int. Wap
Floor
a"f"t
Calling or Floor
Tofal Biu. / `
Total Bfu.
Required sq. ft. E. D. R. or sq. ins. W.A. Leader arae
Required sq. ft. E. D. R. ors . ins. W.A. Leader area
FL I Room Length Width Height
FL Room
Length Width Height
` -WINDOWS and DOORS — CRACKAGE and AREA
WINDOWS and DOORS — CRACKAGE and AREA
Idth Height No. of Lineal ft.
He. of pane of ane lights of crack
Area
Area
ft.
Width a ghf. o. of
No. of pane of pane lights
neat Area
of crack sq. ft.
Coef.
Bfu.
Coof. Btu.
Windows
la4iliration Doors
ndows
InfiMrationjDoors
Wap
Ery. wap
Qhp w
Glass
x )# 5&P_.Vdall
Net Wall
t
5.V1jap
Int. Wap
q or Floor
Calling or Floor
'"Total IN.
Total Bfu.
E.6. R. or Sq. 14. W.A. Leader, area
Required sq. ft...LD. D. R. or sq. ins. W.A. leader area
ION
GRAND TOTAL
CITY OF FRIDLEY INSPECTION DIV, Effective On March 1, 1996
6431 University Ave NE ,D
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS�p
RATE SCHEDULE:
HEATING COMPANY
MINIMUt�v FEE FO AN HE/TING/gnOULjgNV NTIL.A7jON
REFRIGERATION/AIR CQNiOITIONIING PERMIT I5 25.00 Signed By Tel No.2S�F'Z l t J
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42,00/Hr Approved By a Rough—In Date Final Date
'Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE OR STACK VERIFICA 1 NN ON
written permission from adjoining property owner, EPLACEMENT FFUR ACE��� �����c � �
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
I
'�O
rulings of the Building Division, and hereby cleclares that all the facts and
Also Replacement Furnace
$ 30.00
$06
representation3 stated In this application are true and correct,
(Side Vent —Fill Out Bach:)
Gas Piping (Needed with new furnace)
$ 10,00
$
�7 1996
OWNER
Gas Range
$ 10.00
$
BUILDING USED AS A'3 64 ce
Gas Dryer
$ 10.00
$�
ESTIMATED COST —?7 PERMIT NO,
*Air Conditioning — All Sizes
$ 25,00
$ �� 0'O,
lOESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
$
No, of Heating Units Circl On` (jj eam) (Hot Wate m Air
Commercial/industrial
Trade Name /P.�GrGC Size No O?.
BTU_ DoO� HP EDR
1.25% of Value of Appliance or Work
$
Fuel_ Total Connected Load1,,
State Surcharge
50
Burner Trade Name Size No,
TOTAL FEE
BTU _ HP EDR' ,
HEATING COMPANY
MINIMUt�v FEE FO AN HE/TING/gnOULjgNV NTIL.A7jON
REFRIGERATION/AIR CQNiOITIONIING PERMIT I5 25.00 Signed By Tel No.2S�F'Z l t J
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42,00/Hr Approved By a Rough—In Date Final Date
'Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE OR STACK VERIFICA 1 NN ON
written permission from adjoining property owner, EPLACEMENT FFUR ACE��� �����c � �
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CIIIIVINEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes j
No ( )
2.
Is free from rust or deterioration
Yes (11F
No ( )
3.
Has no foreign objects lodged within
Yes
No ( )
4.
Is securely supported
Yes 96
No { )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()I
No ( )
6
Has total heating BTU's of
All other BTU's 3Sda
TOTAL BTU's //OjDc
7.
Has a liner been provided for water heater
Yes �
No ( )
8.
Has combustion air been provided for water heater
Yes 04
No (" )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SUBJECT
PERMIT NO.
City of Fridley
27 64 3
AT THE TOP OF THE TWINS
P
BUILDING PERMIT
'
58,60
i
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIOLEV 55432
612-571-3450
910415
9/9/98
JOB ADDRESS 6120 6th St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
17
2
U land 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Don Elt roth 6120 6th St NE 55432
571-1378
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Tabor & Sons Inc 1805 Polk St NE Minneapolis 55418
789-1902 20014248
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 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house & garage (24SQ) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$2056.00
$1.03
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
TOTAL EE
L i c ep, ay4$5.00
$82.84
SIGNATURE O CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN OPE
A HIS IS
BL SP
�PErfjdIT
ff
BATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
13P
ConstructionAddress: elpl2 0 2(f
Legal Description:
Owner Name & Address: ob c Tel. # 5:71—,, -3 ,U
Contractor: ` MN LICENSE #
Address: Yd �" Tel. # �727
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:
spa r y
Construction Type:
Estimated Cost: $
C;®Sto
(Fee Schedule on
Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
_ $
DATE: `�
APPLICANT:
�,i�n- —
Tel. # `�%- / 9 a 5.
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ 06p
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 1,03
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 00
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary
[ ]
TOTAL $ Po
CA- L97
STIPULATIONS:
Building
MECHANICAL
Permit No:—003V4
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE 1 0-7 YOUR E-MAIL ADDRESS b'nct4AP com
SITE ADDRESS 6,02-0 6 S Nuc. 16`P�' &lev, mu 5-S43 a
THIS APPLICANT IS: ❑ OWNER INONTRACTOR
PROPERTY
NAME: 4c. y vt V S
OWNER/
ADDRESS: 6oa-D- t�� 5 QF_ •c ITY � l_ STATEI/1INZIP SSV3a
TENANT
_w
PHONE: -:7b-5- 5-71- 0(,1*;,
CONTRACTOR
COMPANY NAME: gov
CONTACT PERSON: a " WN71ib
SUBMIT A COPY OF
��
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ppDd°��
ADDRESS:5D S Fc,,,�ep[101n CITY S aw STATEWW ZIPS S1 0';31%
APPLICATION
PHONE Gla --366_ q57 4,g FAX 763--7%- Z S%
PERMIT TYPE
XINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW REPLACEMENT 0 ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor.cost,under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
_A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00
_ _FIREPLACE
BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
_DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00
tstiFrIC
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $ 10-00
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $ 5%co
State Surcharge = $_ .50
Total = $ (A IT. SO
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 01 wo whi requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME wW w� DATE a
PLEASENOTE: SEPARATE PERMITS ARE REQUIRED FOR BIADTNG, ELECTRICAL AND NIECHANTCAT ,WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: ela `7
DATE ,YOUR E-MAIL ADDRESS
'�-
SITE ADDRES
THIS APPLICANT IS: ❑ OWNER tw6NTRACTOR
PROPERTY
NAME: j
ADDRESS: C S CITY STATE IP
OWNER/
TENANT
PHONE:
CONTRACTOR
NAME:
/
STATE LICENSE # yPJq e(JL EXP DATE l r a f
-2,��
SUBMIT A COPY OF
YOUR STATE
ADDRESS: Llr %/ _CITY STAT4&r P
e
LICENSE WITH
PHONE FAX
APPLICATION
PERMITTYPE
MZ<GLE FAMILY ❑ TWO FAMILY 13 TOWNHOUSE
TYPE OF WORK:
13 NEW aePLACEMENT
DETAILED DESCRIPTION OF WORK
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
SINK/LAV DRAINS SHOWER _WATER PIPING
—BATH _FLOOR _
GAS PIPING (mEED crryLjmF aE) SWIMMING POOL _ WATER SOFTNER ($35)
—BATHTUB _ _
CLOTHES WASHER KITCHEN SINK CLOSET _ BACKFLOW PREV. ($15)
_ _ —WATER
DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
_
WATER METER —OTHER
17, ixww
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge =—�0
Total — —
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 wor hich r qu' review and approval of plans01.
�� a
SIGNATURE OF APPLICANT PRINT NAME DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977