PRE 2010 DOCSCity inn i
0 C ty of Fridley,
BUILDING PERMIT N® 4426
Date: .�- --°� - - -® _..._ __..... .---..............
----:-/- - - .... Builder ......... - '/ 9 ............._........-----
Owner__._.._.._..._�_...
/
Address .�� ...Q,
........ .. ._.�.. .. Address --•-----_-............ ..... .-....... ................................. ............ _..__............... ___......
TION OF BUILDING
No... .. _4C._�... Street ..... ..• •... _.._..... _ .......................... _.............. ParL of
fideyard47
Lot.........................
....._..------....._............._......... _.....
Lot ........... .......... _........ Block .............. ... /........... .... ....... Addition or Sub -Division ........ ... ............ a�.. Z .... _.....
Corner Lot ..-----.._.------------_---- Inside Lot .._......f/ - - . Setback ...... � _ ......_.......--...---------------......._--•-- -
Sewer Elevation .-J.._...- � ...$�-16...........A) .........-........................... Foundation Elevation .............�J1b J ............... _......
// _ , it 'e
DESCRIPTION OF BUILDING
To Used as:
_..........._.. - Front .._.. Depth .._I.VHeight ./.....%�..:....-. Sq. Ft. 1.. Cu. Ft.,.M�
..............
.._..........
...........
- ........ Front ...................... Depth ..._.. ........... Height ..... .......... .... Sq. Ft. ........................ Cu. Ft.........................
q �9 Qr
Type of Construction Est. Cost )....9- Y--.--.---...-----..... 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 fo compliance with�provisi
!PS70
ordinances of the city of Fridley. `t
C CP
In consideration of the payment of a fee of $26....." ............:..... permit is hereby granted to ............ ....... _.....................................
_._......_._._................. ._.......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. ri 3
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
LOCATION OF BUILDING
No. Street �� ' Part of Lot
Lot Block Addition or Sub.Div.'
Corner Lot' Inside Lot_><Set Back ide-Yard "
SEWER ELEVATION,aw! FOUNDATION ELEVATION(
Applicant attach to this form Certificate of Survey of Lot and•proposed building
location. y�7
DESCRIPTION OF BUILDING
To be used.as:
Front
Sq. Ft. Cu. Ft.
Frpnt.. Depth Height
Sq. Ft. Cu.. Vt,=:. :.
Type of Construction.. Estimated, Cost
To be completed
The undersigned hereby makes -application for a permit for the work herein specified,
agreeing to: do ali work., in striae accordance with the Cit Ordinances and ruling of
the Department of:oBuildings, and -hereby declares. that the facts and,representa-
tions stated-•' t , s .application are• true; and correc
DATE SIGNATURE
(A Schedule of Fee costs can be found on -the Reverse Side.)
9'City of Fridley
Application for Phunbing and Gas Fitting Perndt
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures$%m
...................... x $1.50
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Ary
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 .......................... z— x $1.50 S7T
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Dept. of Bldgs. Phone SII �4-74470 f
Location
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. o
Fridley, MJnn_
Owner >� zz 19—
Kind of Building gzea� 19—
Used as
To be completed about
Estimated Cost, $ AV
Old—New. Building Permit No
Sign s•(7y*"
f
By
Business Phone No
FEB 19 9960 Pc'�
Description .............................
TOTAL FEE $ q 11 POST IM -12-58
I/
u�i
�t
11--
naZZ
g
Z
eeee
Oyu
J
0
?
�
•
F
s
N
WATER HTR.
GAS
ELEC.
rn
!k
O
Base
1st
/
2nd
3rd
4th
• Future Connection Openings
Connected with
New Fixture, Old Openings
I
Sewer
Cesspool 0
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures$%m
...................... x $1.50
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Ary
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 .......................... z— x $1.50 S7T
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Dept. of Bldgs. Phone SII �4-74470 f
Location
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. o
Fridley, MJnn_
Owner >� zz 19—
Kind of Building gzea� 19—
Used as
To be completed about
Estimated Cost, $ AV
Old—New. Building Permit No
Sign s•(7y*"
f
By
Business Phone No
FEB 19 9960 Pc'�
Description .............................
TOTAL FEE $ q 11 POST IM -12-58
I/
ej Application for Power Plants and Heating. Coaling. Ventilation. ReFrigeration and
Air Conditioning Systems and Devices
Y
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 1240,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
AARepairs & Alterations each add. $500.00 ..............
St AM or HOT WATER SYSTEM
r'
-Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... .
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
Each add. 200 sq. ft. EDR Steam ......................
Each add. 320 sq. ft. EDR Hot Water ..................
8.00 $
2.00
$
5.00
$
5.00
$
2.50
$
8.00
$
8.00
$
2.50
$
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 o
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ /-? d
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
REMARKS:
Dept. of Bldgs.Phone SU 4-7470 A
Lnm linn 1 /®'i n I ® 6
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 t e and correct.
e,195—
Owner �YMin'-o J 195—
Kind of Building �� 195—
Used as
To be cc
Estimated Cost,
Old—New. Building Permit No.
DESCRIPTION OF WORK
HEATING or POWER. PLANTS Steam, Hot Water, Warm Air—No
Trade Nam Size N
Capacity 6� Sq. Ft. E.D.R / BTU H. P.
Total Connected Load s !F 'z !F - z Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Sign
11 POST 1M-12-58 Business Phone No
S co lu J -T co _
HEAT LOSS CALCULATIONS, DEPARTM NT �BUILDINGS A 5 FRIDLEY, MINN.
Weatherstrips _ A Guide Construction No. Insulation
WindowsI rs Reference Out. Wall Int. Wall Ceiling Roof Floor in How Applied
es No es o 195t lc�u I I i E. Ibax
Fl.� V Room Length 19Width lZ Height 1 FI.I R Et, Room I Length J I 0 Width It u Height
Windows and Doors—Crackage and Area
,z`
l9
Width Height No of Lineal ft. Area
No. of Dane of pane lights of crack as ft.
2 2 V Z '3 Z Z'
4-8 +8 1 IS �
Z 4 3o L 3(0 1,6
S 3DM�
J 1 Z Q
19
Ze
JCoef.
Btu
Infiltration
Btu
Infiltration
C`
4-C
Z0,00
Glass
0
zoo
61
50
30 5 L
fW--well
o ez .-1,
5o
19
10 1
i-959
Net exp. wall
Ceiling
19
J91
10
1910
Int. wall
Ceiling ZZ !v Z Z 5 o
Floor I G
Total Btu. 11.2 9
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
FLI Vir. I ) I fel Room I Length l � _ Width I 1 Q Height R
Windows and Doors --i rackage and Area
tt
I y
Width Height No. of Lineal rt. Area
No. or pane of pane lights of crack sq. ft.
ZD z, o L 4'
Z 4 3o L 3(0 1,6
J 1 Z Q
(.9
Dbt, Ll
19
IS
lCoef.
Btu
Infiltration
Infiltration
16
4 o
50
0
zoo
Glace
5150
Net sap. wall
1 Q
Z
5o
zi o o
'6'p.'Waa
Ceiling
Ceiling
19
10SI-19SI
Floor
Net exp. well
'
'
50
101
15 O G
Int. wall
Ceiling
4
O
3p
Floor
7 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.
RoomI Length Width
r
i I . 0
Height -i c
Windows and Doors—Crackage and Area
IdthHeight No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Z 4 4 z I
Btu
Infiltration
37-
o
Coef.
Btu
Infiltration
16
4 o
C
Glass
Exp. wall
Floor
501
5150
Net sap. wall
1 Q
�,4-
(P ,
Int. wall
Ceiling
Ceiling
1 -4 10
Floor
Floor
'
'
Tetal Btu
sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
It
n
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack ea. fl.
L4 i'4 Z 3 Z.z z.
Coef. Btu
Coef.
Btu
Infiltration
37-
o
1 Z go
Glass
Z
50
11 Lo
Exp. wall
Floor
(o
Net exp. wall
154.1
1 Q
�,4-
Int. wall
Ceiling
1 -4 10
Floor
21
'
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
I Fl.I >C N Room I Length I I I- Width it 9- Height '
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. fL
24 -z4 I. Z zz_
Coef. Btu
Infiltration Z
4c M80
Glass ZZ_
SO 1100
Exp. wall
Net exp. wall
I
Int. wall
Ceiling )78
Floor
(o
Total Btu. 1 S 19 (p
Required sq. ft. E.D.R. or sq. iris. W.A. Leader -area
Fl.I&-r d Room I Length Width S Dight i
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack p. ft.
14
Coef Btu
__
_ Infiltration - 4146
5,6 c,
Glass
Q
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Iota] tstu.
Rxquired sq. ft. LD -X or sq. ims. WA Leader area 1 1
City of Fridley, Minn.
BUILDING PERMIT
• Date: — Oct. 9, 1967
Owner:
Address
Harold Johnson
Builder
fate 6201 6th St. N.E . Address
Same
Same
N° 950
LOCATION OF BUILDING
No. 6201 _ Street 6th St. N. E. _ Part of Lot
Lot 9 _ _ .__ Block 1 Addition or Sub -Division — Upland 2nd Addn .
Corner Lot — Inside Lot — Setback .--_ Sideyard
Sewer Elevation ___ _ _ — Foundation Elevation
DESCRIPTION OF BUILDING
• To be Used as:
Garage Front 24' Depth 22' Height — 101 Sq. Ft, 528 Cu. Ft. 5280
Front Depth . Height . _ Sq. Ft. — Cu. Ft.
Type of Construction Frame Est. Cost _ $1300._00 _ To be Completed
•
I�
U
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 co Nance with all provisions of
ordinances of the city of Fridley. / (/
In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to_.._Harold
Johnson 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.
CLARENCE BELISLE Building mor
•
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be ams to see
• the Building Inspector for separate permits for these items.
C17Y O-., i r _ 2.. MVN %J13SCT!`
01•11MER'S NA211-11«_ r _..d t- :� Po F>`•_�,:'i;ii it ^� r. Z' =�_„_ — -- �..
ADDRESS �'����r ._._ __..AT�D:.ESS
SEWER ELEVATION
F013:;DATtO"I", ELEVIVIVION
Applicant attach to this form Two Certificates of'Survey of Lot and proposed
building location drawn on these Certificates.
DESCR_CPT'I.ON OF BUILDIKG
To Be Used Ad: _
r -
-
.-u_F:� a Front .. DepthHeight_--c.
Sq. Ft•-- wCu. Ft.—
—Front Depth--- Height
Sq. Ft. Cu. Ft,
Type of Construction Estimated Cost f G"c" 6"o
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE a `f ` I ' r > SIGITATURE /ice? ' -'V k -
(Schedule of Fee Costs can be found on the Reverse Side).'
LOCATION OF BUILDING
..PART OF LCYI..�
L4T w ^�BLOCK
Y f .
- ADDITION OR
SUBI)'<.VISIOcI Le
CORNER LOTINSIDE
LOT.� _XM�
�.SE.'! BACKSl:D�,«1�+�.n
e
E A
SEWER ELEVATION
F013:;DATtO"I", ELEVIVIVION
Applicant attach to this form Two Certificates of'Survey of Lot and proposed
building location drawn on these Certificates.
DESCR_CPT'I.ON OF BUILDIKG
To Be Used Ad: _
r -
-
.-u_F:� a Front .. DepthHeight_--c.
Sq. Ft•-- wCu. Ft.—
—Front Depth--- Height
Sq. Ft. Cu. Ft,
Type of Construction Estimated Cost f G"c" 6"o
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE a `f ` I ' r > SIGITATURE /ice? ' -'V k -
(Schedule of Fee Costs can be found on the Reverse Side).'
0
0
J � f
c
J 0-0
City of Fridley, Minn. N° 10
BUILDING PERMIT
Date: July 9. 1970
Owner: M, j ghns on Builder W - M - Mens on
Adm 6201 - 6th Street N.E. Adams 1110 Irving Avenue N.
LOCATION OF BUILDING
No. 6201 Street 6th Street Part of Lot
Lot --
Comer Lot --
Sewer Elevation
Block
Inside Lot
Addition or Sub -Division
Setback
Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Stucco Garage Front _ Depth Height — Sq. Ft. Cu. Ft
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Stucco Est. Cost $250.00 __ To be Completed 115,/70
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 $-5-- 00 permit is hereby granted to W . M . Muni on
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
o thhee city limits and this permit may be revoked at any time upon violation of any of the provisions of said
dinan
'-4z_ Building Inspector
HANK MUNICH
NOTICE:
'This permit don not cover the construction, installation for whine, plumbing, gas beating, sewer or water. Be sure to see
the Building Inspector for separate permits for these hems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: BUILDER
ADDRESS: _ 1- �i (p [ /y�ADDRES S :%%®���/`�,r/► Q ►, ��
NO: STREET:
e
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
i
Front• Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
D
Type of Construction: Estimated Cost:_$ 7�
To Be Completed: %— �►- ���
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE:* 9-_ /jr'�Q SIGNATURE.
(See Reverse Side For Additional Information.)
,'
E
SUBJECT
City of Fridley
? 4 2 9 1
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir?
i
�` COMMUNITY DEVELOPMENT DIV.
__-_--_
L PROTECTIVE INSPECTION SEC
r
--715
I ,
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
,'' 612-571-3450
910-F15
6/19/96
JOB ADDRESS -- 6201 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
1
1 Uplands 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Harold Johnson 6201 6 Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Richard Hastings Contr 6331 Riverview Ter NE, Fridley 55432 574-9966 4051
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 ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (19 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
ANY TIME AFTER WORK IS COMMENCED
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,567.50
$.78
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
09
4e; ��
License SC $5.00
$58.60
SIGNATURE OF CONTRACTOR OR AL&140RIZED AGENT IDATEI
HEN PROPERLY
BLDG SP
LIIDDAT THIS IS YoI:r) P� MIT
r/1(// it
e
DATE
_
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
E
NEW j ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 6 Z®i (1 S7`.
Legal Description:
Owner Name & Address: 11A PL oL D 7-04 AIS6,V Tel. #
Contractor: 2` G/App JIA C At r'S Co • MN LICENSE #
Address: (9 3 V —t -s!- l2 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: R F R c o F Estimated Cost: $
Approx. Completion Date: 71/,y /f l S
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: g� APPLICANT: y� Tel. # 5;>
-y9G
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
��^
Fee Schedule on Reverse . Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
%
$.50/$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$
$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
$.
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV. 101q
6431 University Ave NE
Fridley, MN 55432
572-3604
/0� € 0 &� 8 4'a- - 9-,21--,-) 0
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURtS TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
Heater
Elec
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
Water Heater - Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () Nc
Type
NO. RATE TOTAL
$ 7.00
$ 4.00
$ 5.00
•$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
.$10.00
$15.00
JOB ADDRESS_ 7"� FieW1 -q-3 �
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.,
Owner
w
Building Used As
Estimated Cost J��� PERMIT NO. /J l
PLUMBING COMPANY
Reinspection Fee $47.00/Hr SIGNED BY
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Approved By
State Surcharge $ .50
MINIMUM I
TOTAL FEE $ PLUS THE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
Rough -In Date
TEL N0. S �S
Final Date
COMMON VENT INFO ON BACK SIDE
.20 0,3
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
September 25, 2000
Dana Carlson
62016 Street NE
Fridley, MN 55432
Re: Final Inspection at 62016 Street NE
Contractor: KCJ- Mr. Rooter
Dear Ms. Carlson:
A plumbing permit was issued on May 8, 2000, for the above noted address,
to install a gas water heater. According to section 4715.2800 of the State
Plumbing Code, a final inspection shall be conducted on the plumbing authorized
by this permit. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
WSEN
Inspector
Building
BUILDING
Permit No.: s
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS CO 20 I
1X 4* 50- /y t
THIS APPLICANT IS:
❑ OWNER P(QONTRACTOR
PROPERTY OWNER/
NAME: ,rL r•• �Ld �,� /ftu a
TENANT
ADDRESS: to Zo / (Q S!- auC CITY
STA _ IP
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
STATE LICENSE # 4ft Lft PA MN TE
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE
PROPERTY TYPE
FAMILY/NEW CO SIZE
TLE
TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED 4&WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: WtL'--da4.JS
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2•
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS KYes ❑No LOCATION OF WINDOWSG,.
t a'W 5.5
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF lA-�I
OPENING CHANGES &
10 491-1
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I I e".7
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ CPO OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ _C5 (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $ .001 x Permit Valuation (1/10%)
License Surcharge $,()o $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME DATE