PRE 2010 DOCSkity Fridley, of FidlMinn. 6
BUILDING PERMIT N? 4249
Date:----------..._.._..._...._............._............._._m...__..._..�------
Owner: ............. ............................... ......................... _._...... __------ ------------------- Builder
Address
rT1:=
/�� O TION OF BUILDING
No. IL
- _........ Street ....._...�.........._...--- _. - - ��!1�..._........................._.............. Part of Lot .................................. ._......._...._......_... _ _
Lot .........0 .................. Block ...............
...._....... �+................................... Addition or Sub -Division G� ... ......Z ...... ............. ..._._..
Corner Lot .._ ................................ Inside Lot ......-'.........._.-.._ Setback_.........-- _........
Sideyard....._......_............. .............. _............. _._.._
Sewer Elevation ------ .............4F....L......0m......._...._.......-...._.........._............ Foundation Elevation----.....Oi...af....Y... ..........
- W -e : r%. S -9
DESCRIPTION OF BUILDING
To be Used as: L�f
,4f........_............,..------------..... Front . c f Depth/..... Height .....`'� Sq. Ft. 1 cu. Ft.�®_®f6
.... ............... _............._....................... Front ....._................. Depth ................ /. ?Height ....�..... Sq. Ft....................... Cu. Ft.
Type of Construction ........................... ......................_. .. Est. Co /WY. .�.�......... _._........ To be Completed .........................
In consideration of the issuance to me of a permit to construct the buy&ng described above, I agree to do
the proposed work in accordance with the description above set forth in compliance with all of
ordinances of the city of Fridley. yy��r' � �
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
within the city limits and this permit may be revoked at any time upon violatiof the provisions of said
ordinances. r
Building Inspector
NOTICE:
This permit does not cover the construction, installation 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, M:INNEPOTA
Owners N z Builder
Address AL1 Fes' ��"� Address .
LOCATION OF BUILDING
No Street _ Part of Lot
Lot _Block Addition or Sub. Div.
Corner Lot Inside Lot,_Z Pet , Back/ Side -Yard
SEWER ATION y C, FOUNDATION ELEVATION
MORA y .�
App scant attar d this form Certifica.te.of Survey of Lot and proposed building
location.
DESCRIPTION OF "BUILDING
To be d as:
'Front Depth ,-v�2 Height_ �-
Sq. Ft. ��, �� + Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction o Estimated Cost
To be completed
The undersigned hereby makes application fora -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 al a facts and'representa-
tions.stated in this application.are true and corre
' SIGNAT f
(A Schedule of Fee costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE �TOTTAAL
Number Fixtures 6 x $1.50 $
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: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 t
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE •�
Dept. of Bldgs. Phone SII 4-7470 y
Location Cr / 'oe
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. ,��,
Fridley, 1Vlinn 19
Owner 19—
Kind of Building J J , 19—
Used as��
To be completed about
Estimated Cost, $-
®®
Old—New. Building Permit No
Sign
By -
OCT 1 1959 Rough
,4§130.11 POST 1M-12-58
Business Phone No
4F5� ga!
u�QS
�8 <Z
e N
°L
w
2
• • WATER HTR.
R N GAS ELEG
( 90
Base
1st
2nd
3rd
4th
' Future Connection OpeningsI
Connected with
'k New Fixture, Old Openings
Bower El
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE �TOTTAAL
Number Fixtures 6 x $1.50 $
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: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 t
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE •�
Dept. of Bldgs. Phone SII 4-7470 y
Location Cr / 'oe
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. ,��,
Fridley, 1Vlinn 19
Owner 19—
Kind of Building J J , 19—
Used as��
To be completed about
Estimated Cost, $-
®®
Old—New. Building Permit No
Sign
By -
OCT 1 1959 Rough
,4§130.11 POST 1M-12-58
Business Phone No
0°
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE TOTAL
8.00 $
5.00 $
5.00 $
2.50 $
8.00 $�
2.00
$
5.00
$
5.00
$
2.50
$
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ L;
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x 1.50
$
$
Additional Fixtures .................
x .50
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
TOTAL FEE
It
REMARKS:
Dept. of Bldgs. Phone SII 4-7470
Location (� / C/ b o (4
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.
Fri , Minn_ , 195
Owner e Lv'� 195—
Kind of Building --= -z g__a
Used as —12 ,a
To be completed about
Estimated Cost, .$
Old—New. Building Permit No. 4(•i ^'
DESCRIPTION OF WORK
195—
HEATING or POWER PLANTST-Steam, Hot Water, Warm Air—No/ A
Trade NamSize
�dd
No-
e-
Capacity—Sq. Ft. E.D.R d BTU® y H.P.
Total Connected Loa � Kind of Fuer
BURNER — Trade Name_ Size No
Capacity.
11 POST IM -12-58
Sq. Ft. E.D.R BTU H.P.
City of Fridley, Minn.
BUILDING PERMIT
Date:
Owner:
Address
4841
a f
Builder
Address'_
O0, 7_1. OF BUILDING
No....: Siaeet _._.._.._.._.._ ......_.:.,t......_......._..... PartLot....__.....
/ Block ._._... _......._.._._ Addition or Sub-Divsi _.. _+- ...��._.....
Lot ...-_....._..
Corner Lot .................................... Inside Lot .................................... SWback :.:.: `. ideyard .___........:.�.s......._•-------------..---------
SewerElevation ----- _......._...._..--------- _...... _--- _------ _...._......._..__..---------._.._�.. Fc�tion Elevation .--- _.------...._.------..------- ._......_.._....._. _......
DESCRIPTION OF BUILDING
To be Used as.
y
_ 441---: ` Front ... .. Depth Height :.. - Sq. Ft. iri� - cu. Ft..y
...................... ------------------------...... Fro ........... Depth ......... eight _...._.. Sq. Ft... - .............. Cu. Ft.._._......._...._:.
Type of Construction 'AA -Salle...... Est. Cost..:: _.. Completed ....._...........__..._...•----...... To be Com._........
01
DO
P�� ovENPN�s
PERrn\� DOSlE `\gs c
I\A\S Fk\`�P j\OF110N.
\ON
01 G R0'1 C
RRv\\'DVc4
In consideration of the issuance to me of a permit to constrict 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. Y W�
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
within the city 'limits and this permit may be revoked at any uP�n olation o anX of the provisions of said
ordinances./
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wlrhig, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
4
f
r
APPLICATION FOR BUILDING PMWT
CITY OF FR.IDLEY, MINNESOTA
Address L, 1 Y V)
LOCATION OF BUILDING
No 16
J
of Lot
Lot - Z® Block Addition or Sub.Div,=
Corner Lot __ Inside Lot Set Back Si a -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To b used s:
(r, r
Fron a 0 Depth_a
Sq. Ft. —L-/ Cu. Ft. � 61
Front Depth Height
Sq. Ft.
Type of
To be
Cu. Ft.
ted Cost��
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 representa-
tions stated in this application are true and correct. _
DATE »_ 1.0 SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
CJ
0
Nj
I
................................... - ....................... - .................... . ................................. * .......
'.
L) -
a o
yum v ,
SIZE
BLOCK
ADDRESS
V.UMT=
ADD.
ME
r-
.... ..... . ...... .. .... ... . .... . .............
.. ............... ............. .. ........ .....
..... ... ............ . ...... ..... ........... ............
..... .................
................. ....................
Nj
I
................................... - ....................... - .................... . ................................. * .......
'.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1993
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Stories Urinal :
... '...
ower .
Wash #J:�tnk<� Floor �:�[tOY:i:i:`::
. 'nDr:
Auto.
Washar
.
Gas
Range
Water Heater
Gas ElTraY ec
Basement
o
FI or 1
Floor 2
Floo 3
r
Floo 4
r
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater –Electric
Water Heater – Gas —L
Gas Range
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 to • pu
$10.00
$10.00
$5.00
Reinspection Fee $30.00 ill, q_
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $ -j ) J6D
JOB ADDRESS�p
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.
`.
ULA
Owner LL C�
V
Building Used As, /
Estimated Cost 0 0 - t7o PERMIT NO.
PLUMBING COMPANY
SIGNED BY am mac. TEL N0.
i
_cW
Approved By Rough–In Date Final Date G
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By•
763-572-3604
CITY OF FRIDLEY
D'�8 2009
763-502-4977 FAX
EFFECTIVE2-19-09
DATE
YOUR - L ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER
CONTRACTOR
PROPERTY
NAME:
ADDRESS:
0 CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
COMPANY NAME.
SUBMIT A COPY OF
CONTACT PERSON:
YOUR STATE
LICENSE WITH
STATE LICENSE #
XP DATE t
ADDRES50�S-9:990
CITY STATEALIUZIPda c, �
APPLICATION
PHONE 4P/a
,� EI FAX
PERMIT TYPE
DINGLE FAMILY
13TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DES RIPTION OF WORK
FEES ARE BASED ON $10.00 ER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG:
MODEL: SIZE/BTU
MFG:
MODEL: SIZEBTU
MFG:
MODEL: SIZEBTU
A/C $25.00
_FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15
_FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_BOILER $35.00
CHIMNEY LINER $10.00�GAS
FURNACE $35.00 _,GAS UNIT HTR $10.00
DRYER $10.00 _POOL HEATER $35.00
WORK $10.00
_GAS PIPING $10.00 VENTILATOR $15.00
_DUCT
F
F .•.'M k
�„
,�,
��".�"m.
3'fge.
`yrs b{'1[ ; �k �' >,"\,: ..'' +. • l9-tnuA"dA,
Y' * �A y°4'� �' ii il `$��e,_:�..,'�1'� il� p L i�. g`rXk'(l..vy' f�
3�e;"
r;�.�
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
s.
approved plan in the case ofal!Ovork which requir , review and approval of pl-09
IV
SIGNATURE OF APPLICANT PRINT NAME I DATE 10
KkW
City of Fridley
Building Inspections Department
6431 University. Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME' ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.