PRE 2010 DOCS`City of Fridley, Minn.. 0
BUILDING PERMIT N° 4162
Date:..------_._..._.._..._.---............._........-------_....----__... ____..._-----......._...._..
Owner- ----- ------------------------------------- ------------------- ----- --- ----- -------------------------------------- Builder ............................. _............_.... ...._.. _..� ._ ..... _.._
Address
Address
'10 TI N BUILDING
No....... .. - -...-Street ....._..... ...._.......:._.........................----........... P. f t . ...................................
Lot ..........r1 ............. Block ..... ........ .......... /.... _................. Addition or Sub Division _... .......................... ..._...........
Corner Lot ......... ....................... Inside Lot ........................... Setback o -y ......... Sideyard . ..... -............_............. _... _.._
Sewer Elevation ... ................. .............. ---...........---..........._........•-------••------............ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: �j f� /
/ �" ............................... Front .1.._.®....`Depth ...® Height _!...... Sq. Ft.. .........9 cu. Ft. (...Q..... !
...-......................................_.............. Front ........................ Depth ........... .._.. Height
ffjj...................... Sq. Ft. ...... ................. Cu. Ft.
Type of Construction........................................................... Est. Cost ..11.�®@.-----. ..... To be Completed .................... _.....
In consideration of the issuance to me of a permit to construct the buijdfng described above, I agree to do
the proposed work in accordance with the description above set forth in compliance all r2 visions of
ordinances of the city of Fridley. f
In consideration of the payment of a fee of $..-./.pf..=!7....., 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.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
Owners Name
Address
No.
LOCATION -OF -BUILDING
of Lo
Lot Block Addition or Sub -:Div.
Corner Lot Inside ,Lot Set Beck!' Side -Yard
SEWER ELEVATION f FOUNDATION ELEVATION
Applicant attach,to.this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be use as:
Front Depth 0Heigh.
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Cons
To be
ted Cost ',��® ® C!�'7
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 a facts and representa-
tions stated this pplication are true and correct.
DATE SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
h
(s. City of Fridley
Application for PlImnbing and Gas Fitting permit
Dept. of Bldgs. Phone SII 4-7470�� ��
DESCRIPTION OF WORE Location—Coe--C2 l '- 4 z "e `��
Number, Kind and Location of Fixtures
OJ
6
90
F
N
WATER HTR.
GAS
ELEC.
Base
1st
2nd
3rd
4th
• Future Connection Openings I
New Fixture, Old Openings
Connected with
Sewer
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures x $1.50 $ r o d
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 $ 2-0-0
d
New Ground Run Old Bldg. x 3.25 $
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 $
REPAIRS & ALTERATIONS --Refer to Code
Description................................................$
TOTAL FEE $
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 applicati n are true and correct.
Fridley, hlinn
Owner �. 19—
Kind of Building
0
Used as
19—
To be completed about
p' _
Estimated Cost, $ �1 �® oma
Old—New. Building Permit No
Sign' �Ca�9z
B_ -
Business Phone No
SEP 3 1959 Roue
l
fy
11 POST 1M-12-58
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
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 $
MECIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $A
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
NO RATE TOTAL
1st 3 Fixtures ......................
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
$
CIL 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 $
GAS FITTING PEES:
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 is REPAIRS
TOTAL FEE
$
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
Location :-® �, l
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,
y
Owner -_-✓f� E __--x;� ,a s
(e-. ?,: r 195—
Kind of Building
Used as
195—
To be completed about k
Estimated Cost, $
Old—New. Building Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name! / P �' �""' d>r Size No-rs
Capacity. Sq. Ft. E.D.R BTU H.P.
Total Connected Load Rind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Si 2ed
By 9 1:�✓s,9 �C' i
11 POST IM -12-58 Business Phone No
HEAT LOSS CALCULATIONS
Weatherstrips A.S.H.V.E.
Guide
lowsDoors Reference
-No �. No 19 `
1.117 V -t 1, r, Room I Length 1
�. DEPARTMENT OF BUILDINGS ���� �'S ROSEVILLE, MINN.
Construction No. Insulation
Out. Wall Int: Wall Ceiling Roof I Floor Kind How plied
Width 1 9F Height c-10 Il 1 F1.1 i- Ronin 1 Lenath I I Width 1 Height ,
Windows and' Doors—Crackage and Area
Room J Length I , �,
Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
1 6
' Win ows and Doors--Crackage and Area
Windows and Doors—Crackage and Area
77
CA P
Coef.1
Coef.
Btu
Infiltration
Coef.
Btu
Glass
-
n,
Btu
Glass_
Ceiling
Floor
Exp. wall
Exp. wall
Net exp. wall
S-
Net exp. wall
o
Floor
Int. wall
Int. wall
s V7
.,
a
Ceiling
�.
Floor
Floor
=, (r
Floor
_Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Total Btu. I `�`
Required sq. ft. ED. R. or sq. ins. W.A. Leader area
A FI.) r' f� 0 Room I Length 0 U Width 1 1 0 Heiaht :l 0
Windows and Doors—Crackage and Area
Room J Length I , �,
Width
tt"
Height -
' Win ows and Doors--Crackage and Area
Windows and Doors—Crackage and Area
WidthHeight No. of Lineal ft. Area
No. of pane of pane tights of crack sq. ft.
Coef.1
Btu
Infiltration
Glass
Exp. wall
I tfj1
Coef.
Btu
I Itration
I
-
n,
Btu
Glass_
Ceiling
Floor
iNii
Exp. wall
S-
Net exp. wall
o
Floor
Int. wall
s V7
.,
a
Ceiling
�.
Floor
=, (r
Total Btu. I `�`
Required sq. ft. ED. R. or sq. ins. W.A. Leader area
A FI.) r' f� 0 Room I Length 0 U Width 1 1 0 Heiaht :l 0
Windows and Doors—Crackage and Area
FFI.1 ' -
- Room I Length
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq.
qft
��� ��`�'-, @✓'� pit
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
No.
Coef.1
Btu
Infiltration
Glass
Exp. wall
I tfj1
Net exp. wall
`l
I
Int. wall
Coef.
Btu
Infiltration
Ceiling
Floor
iNii
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
FFI.1 ' -
- Room I Length
Width Height No. of Lineal ft. Area
ffppanelights of crack sq. ft.
No. of pane of
/
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
No.
Coef.
Btu
Infiltration
Glass?
`l
I
Exp. wall
Coef.
Btu
Infiltration
Net exp. wall
t t -,
Int. wall
Ceiling
Exp. wall
o
Floor
Net exp. waU
s V7
Total Btu. � ?
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
t IM 11A r!' 77 0__— It __—L I A 1Q1:.1.L &7Yi tJ_:–L. � �u
Total Btu. t�- l "
Kequtrea sq. it. t:.t,.t(. or sq. Ins. w.A. teaser area
FFI.1 ' -
- Room I Length
Width
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
No.
Width Height No. of Lineal ft. Area
of pane of pane lights of crack eq. ft.
Height No. of Lineal ft. Area
of pane tights of crack eq. !t
Coef.
Btu
Infiltration
�,n
Glass
Exp. wall
Net exp. waU
.,
a
Int. wall
-
Ceiling
=, (r
Floor
c`
Total Btu. t�- l "
Kequtrea sq. it. t:.t,.t(. or sq. Ins. w.A. teaser area
Total Btu. `) r n 4;
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
FFI.1 ' -
- Room I Length
Width
Height j� "
Windows and Doors—Crackage and Area
Width
No. of pane
Height No. of Lineal ft. Area
of pane tights of crack eq. !t
Coef.
Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
-
Ceiling
=, (r
Floors
Total Btu. `) r n 4;
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
City of Fridley, Minn.
BUILDING PERMIT
Date:
Owner:
Address
.Builder --
Address
�..��
`0
LOCA
B,�ILDING
No. aG! �,`� Street �- P f- t _
Lot —. _ 81ockA tion or Sub -
Comer �
Lot Inside Lot +- �Pback '�' Sfeyard
s.
Sewer Elevation _ F
yrn tion Elevation _
DESCRIPTION OF BUILDING
T Front' Dep - Cu. Ft.)Height/0— Sq "�
DepthHei t Sq. Ft. Cu. Ft.
Est.-`
of Constructs To be Completed
Type —
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 ill provisions of
Ordinances of the city of Fridley. y
�i�
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 viola�WA of any of the provisions of said
ordinances.
4;6�11uilding Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing,gas heating, sewer or water. Be sure to we
the Building inspoctor for separate permits for than Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINMSOTA
Owner's Name
Address..._Builder
Address
LOCATION OF BUILDING
$treet��
Lot Part of Lot
Black_1_Addition or. Subdivision
aaCorner Lot Inside
---- Lot Setback
SEWER ELEVATION Side -Yard
FOUNDATION ELEVATION
APPlicant attach ta'this,form Two Certificates of
building location drawn on these Certific Surveyof Lot and proposed
,
aces
To be used as; DESCRIPTION OF BUILDING
Front Depth 29
_Height
Sq.
Cu. Ft.�S-
Front Depth
Height
Sq. Ft.
Type of Construction � �• Ft.
To be -- Estimated Cost
Completed
The undersigned hereb
sPeci€ied a y makes application for a
speci ' agreeing to do all work in strict accordanceowithetheor�it of
rull
declares Ordinances
all sthe dfactsAandof the Department of Buildings, and y o€
are true and correct. Presentations stated in this a hereby.
application
DATE /
SZ(�TATURE .
(Schedule of Fee Costs can be
-found on the Reverse Side).
1
I/
SUBJECT
City of Fridley
32
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r I PROTECTIVE INSPECTION SEC33+1
1 �
I
NUMBER
REV
GATE
PAGE OF
APPROVED BY
=� /-"S CITY HALL FRIDLEY 55432
�•J 612-571-3450
910-F15
8/29/94
JOB ADDRESS 6221 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
Upland 2nd
Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Sommers 6221 6 Street NE
571-3126
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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof House & Garage (17 Square) Tear-off
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with
the State Building Code.
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,275
.64
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC $1.28
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$31.00
PLAN CHECK FEE
TOTALFEE
$32.92
SIG NAT URE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
d
WHE AO
LOG )NSP
Y IDA THIS IS YO - IT�
GATE
SIGNATURE OF OWN ))P OWNER BUILDER) IDATEI
1
I/
NEW {) Effective 1/ 1 /94
ADDN {) CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R -I AND R-2,
Building Permit Application
ConstructionAddress: (2- 2-1
Legal Description:
Owner Name & Address: �,d, �,, ,, S® ,,,, m e= n 5 Tel. # s 7 /—,3 / z �
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
Length - - Width 4�� Height Sq. Ft.
LIVING AREA: Len ` _ �.____ ,_._.—
GARAGE AREA: Length _ a- - Width -Height Sq. Ft.
DECK AREA:Len Width Hgt/Ground Sq. Ft.
OTHER: -
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: _
Ft. Yd Setback
Side Yard Setbacks
Estimated Cost: $ /,� %S
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ — $
DATE: P)/,-)e/-/0c/'APPLICANT: Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ Jj,
Fee Schedule on Reverse Side
Fire Surcharge
$ / ,.28
.001 of Permit Valuation (1/10th%)
State Surcharge
$ • �� �Z
$.50/$1,00 Valuation
SAC Charge
$
$800 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:
01
SUBJECT
P
City of Fridley
31606
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
'
. L
COMMUNITY DEVELOPMENT DIV.
f � � PROTECTIVE INSPECTION SEC.
-7
1
NUMPEAAEv
DATE
PAGE Of
APPROVED By
CITY HALL FRIDLEV 55432
1 612-571-3450
910•F15
12/26/00
JOB ADDRESS 6221 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
1 Upland 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
.Tames Sommers 6221 6 Street NE
763-571-3126
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 ❑ ADDITION Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install wood burning stove
9 CHANGE OF USE FROM TO
STIPULATIONS
Install per manufacturer's specifications. Provide combustion air to
burner.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 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
@2 oOQ
$1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
WW
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 F
TOTAL F
$721A5
SIGNATURE OF CONTRALTO OR AUTHORIZED AGENT IDATEI
EN PRO ER LIDATEO
IS IS YQUR PE IT
AA
S,GNATURE 01 OVfTEP.,FOWNER BUIL DERi IDATEI
OLD INSp -
DAtE
01
NEW []
ADDN []
ALTER [ J
Construction Address:
Legal Description:
Owner Name & Address:
31&0(
Vi Effective 1/1/2000
(763) 572-3604 Bldg Insp
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
- r"ina Z A 9 Ar\
el. # 763 �' 7/ -33/ 2 6
MN LICENSE #
Tel. #262
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: 6I,U
-
_
Construction Type: Estimated Cost: $ 2,_00 d G E
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: / 1 — 2—c '-0aAPPLICANT: ?G3 `�7 �— 3 / 2L Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ .� S ^ Fee Schedule on Reverse Side
Fire Surcharge $ en 10 .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1100 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 [ J Not Necessary [ ]
TOTAL $ rr
TIPULATIONS: fitAf
FROM :City of Fridley
Building
Inspections
7.63-572-3604
FAX NO. :W05711287 Nov. 18 2M09:17AM P3 -1,,o5-6 o 03
.0` Permit No-:
MECHANICAL Received sr -
RESIDENTIAL APPLICATION Date Rec'd:
CITY OF FRIDLEY _ _► . _
SM ADDRESS
�O OWNER CONTRACTOR
TMS APPLICANT IS:
PZtOPBRTV
OWNEW
ADDRESS:
TENANT
PHONE: --"7
CONTRACTOR
COMPANY NAMI3
CONTACT PERSON:
SLB1eAT A COPY OF
YOUR STATE
STA7ELiCENs6 N .
11CL•NS8 WITH
j APMICATION
ADDRESS
p14C*1RQG,,.5
hSINOLe FAMILY E3 TWO FAMILY
PERIVUT TYPE
EV DATE
O TOWNHOUSE
O NEW *REPLACEMENT D ALTERATIONUMOD81-
TYPE OF WORK:
DETAIL W DESCRIPTION OF WORK v
to I,
PP
MS 168.665 the permit fee is a minimum of SIS.00 or 9% of the total cost Yp X0.00, whichever i9 greater. for the
improvement, installation or replacement of a residential &MM excluding the fixturts. ('1 9 shoul flea onlythe cart of labor)
Labor cost under S3001- $15.00. Labor cost between $300 to $500 =cost of labor
.os pyi , Lir
FOR PROJWrS WME AOR EXCEEDS Si00, FEES ARE BASED ON $10.00 PER FIXTURE. IEXCSVr WHMNOTED. PiXTt M: i0'�t 0 TOTAL
wommoEAcH Bae xa- MPO:\ by
MODELMODEL -�11.I�
. SIZE/DTU O �[
WO
OA3 RANOZ OV9H $10-00
JOAS) S I3.00 NPpEWpl,O}AIS ORLL SI0.0
0
(WOOD) SS—RAGAS UNIT HTR SI0.0000
CtTO Agt FCCfNEF55 .00
MS35.� ACE 335AS DRYER 510.00 A5ts30e0
.—
THIS IS AN APPLICATION FOR A P1rRM1T NOT VALID UNTIL PRS
Y hereby apply for a building perntt and I acknowledge Codes-, the information above is complete and accurate, that the work will be in
and with the Wonesota ContructiOn
of
conformance with the ordinenccs an ccodes of and work isnW to start willfotu a permit; that tho work will be in accordatica with the
not a pewit but only an application I� —evvi d approval of lens.
nATF
amoved plan !n the case of atl which r W ppr p
SiONATURE OF APPLICANT
City of Fridley
Building Iinapections Department
6431 University Avenue NE, Fridley, MN 55432 ®'
763-572-3604
FAX: 763-5024977 �� '
Building
BUILDING
Permit NO.:
Received By: N.f6
Inspections
RESIDENTIAL APPLICATION
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
I � �®�
Q 3 YOUR E-MAIL ADDRESS 6- �r1n�� �\C
jZTD,�.lil'`
DATE -
—
SITE ADDRESS 6 -a
S T- '; C. \ VY►-►
THIS APPLICANT IS:
O OWNER OCONTRACTOR
PROPERTY OWNER/
TENANT
ADDRESS 1-- CITY
STATE ZIP1y
PHONE: J22 / c-:�' -310 -'- 3'ah
CONTRACTOR
NAME 0 1 C
_
STATE LICENS&rip -- EXP DATE
1-7qt,=) CITY
STATE ZIP
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
O TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
O ADDITION ❑ GARAGEISHED 0 WINDOWS
❑ BASEMENT FINISH O ROOF O DRAIN TILE
O DECK O SIDING O OTHER
O SWIMMING POOL
TYPE OF WORK:
1.0 O ADDITION
ANCE/REPAIR 17 REMODELING
DESCRIBE WORK BEING DON S T,
SIZE OF IMPROVEMENT O�1 LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
O HOUSE ONLY
NUMBER OF SQUARES
+ ❑ HOUSE & GARAGE
BASEMENT
REMODELINGSUBMIL
GARAGES
❑ ATTACHED GARAGE
1.
2.
lan
ProposFloor ed P
>m floor plan
PROPOSED SIZE:
O DETACHED GARAGE
3.
List of structural manbers to be used
PROPOSED HEIGHT:
do ,�'
SID/a /
l] Vinyl Soffit "/ fADDITIONS,
FOR NEW CONSTRUCTION INCLUDING DECKS.
& PORCHES SUBMIT.
O Aluminum
13
/+ at� ® 17 Trim
1.
Site Plan/Survey showing the existing structures
O Other
O Fascia
and proposed project.
Two sets of construction plans
WINDOWS2.
3.
Epergy Calculations
IN EXISTING OPENINGS Oyes 103 o LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ (.0005) times the total job valuation - Minimum $.50
Fire Surcharge $ .001 x Permit Valuation (1/10%)
License Surcharge $ /-Y) $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 "ork whih1'c requ review and approval of plans.
SIGNATURE OF APPLI ANT PRINT NAMED 1 C -'%v \'�� �� DATE a "G
Building
Permit Fee
BUILDING
See Back Page for Fee Schedule
Permit XT- M. (� umtop
InspectionsRESIDENTIAL
65% of Building Permit Fee
APPLICATION
$
Received By:
763-572-3604
$
CITY OF FRIDLEY
License Surcharge
Date Rec'd: '-1— 1-3
763-502-4977 FAX
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
EFFECTIVE 1-1-09
Erosion Control
$
DATE — 13 _Z 60 G I YOUR E-MAIL ADDRESS h e y �< 4q
M s M, c ®nJ
SITE ADDRESS (e 2 2 1
(,*—J' -/ -ki5 Fndlev, AIN ✓ 5-OZ3
U
THIS APPLICANT IS:
)[ OWNER ❑CONTRACTOR
Total Due
PROPERTY OWNER/
NAME: {�lG
TENANT
r l� ,ate
ADDRESS: � S-1 NE CITY ARIN-G T STATE's ZIP Z
/
PHONE: 76 3 — S'71- /�/— �Z S%/
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE�1SINGLE
FAMILY/NEW CONSTRUCTION SIZE /4ZDd
,S�
❑ TWO FAMILY/NEW CONSTRUCTION STORIES /
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
)d BASEMENT FINISH Q ROOF ❑ DRAIN THE
❑ DECK ❑ SIDING ❑ OTHER
Q SWBA IING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR 0 REMODELING
DESCRIBE WORK BEING DONE:/ /,* U S
/7
SIZE OF DAPROVEIVIENT
LENGTH / WIDTH S/ HEIGHT -7 SQ FT o2 3
ROOFING
K HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
1.
REMODELING SUBMIT:
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SING
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.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
S 1 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 13 t OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks oavable to: Citv of Fridlev Attach Stiuulations
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 on site; that the work win be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT��/f/ t •,/ PRINT NAME�Y/ G� DATE 7—O3 -2O C�2
I PLEASE NOTE: SEPAIRATE PERMITS ARE REOUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK I
Building
MECHANICAL
Permit No.: `
Inspections
RESIDENTIAL APPLICATION
Received B.
763-572-3604
IU L 14 2
CITY OF FRIDLEY
763-502-4977 FAX
EFFECTIVE 2-19-09
DATE ?-13-200q _ YOUR E-MAIL ADDRESS
p
SITE ADDRESS ��I I /�
THIS APPLICANT IS: OWNER OCONTRACTOR
PROPERTY
NAME:
OWNER/
ADDRE SS:_ �J®1 / �W6CITY f'� 1 STATE/_ZIP
TENANT
/�
PHONE: 163-5-71- % 5sy
CONTRACTOR
COMPANY NAME:
CONTACT PERSON:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: CITY STATE ZIP
APPLICATION
PHONE FAX
PERMIT TYPE
SINGLE FAMILY O TWO FAMILY O TOWNHOUSE
TYPE OF WORK:
0 NEW O REPLACEMENT O ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK 19/4z 40A 114 ws-'
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZMTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEIBTU
_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 _FURNACE $35.00 _GAS UNIT HTR $10.00
LINER $10.00 DRYER $10.00 POOL HEATER $35.00
_CHIMNEY _GAS
DUCT WORK $10.00 GAS PIPING $10.00 A< ENnLATOR $15.00
Number of fixtures @ $10.00 x $10.00 = $
Number of fixtures $15.00 $15.00 = $
@ x _J_�
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
"��
FEE $35.50 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 al work which requires review and approval of plans.
/ - �y
PRINT NAME�i�/� a�I [�GDATE �/ v
SIGNATURE OF APPLICANT64
IF
PLEASE NOTE: SEPARATP, PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL 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 B
763-572-3604
CITY OF FRIDLEY
D 0
763-502-4977 FAX
EFFECTIVE 2-19-09
� A
'7-13-2601
DATE ! -1 3 `- 2 ®V 1! YOUR E-MAIL ADDRESS be, 7VYk 41
SITE ADDRESS 4La a J &4-2) S / E
THIS APPLICANT IS: OWNER ❑CONTRACTOR
PROPERTY
NAME: 0_- n C
OWNER/
TENANT
�1
ADDRESS:lp 2 oZ I (o 15-fN 6 CITY Fri d e N STATFNA/ZIP s_" A
PHONE:_7( 3 -,611 — ? 5`11
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
ADDRESS: CITY STATE ZIP
INSURANCE
PHONE FAX
PERIMT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
1' NEW ❑ REPLACEMENT
DETAILED DESCRIPTION OF WORK .T S D�%�Vl hAoem
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
BATH SINK/LAV _FLOOR DRAINS X 'SHOWER WATER PIPING
_ BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35)
CLOTHES WASHER KITCHEN SINK K WATER CLOSET _ BACKFLOW PREY. ($15)
-DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
Number of fixtures @ $10.00 x $10.00 = $ U
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge $
$35.50 Total = $ e
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 on site; 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 , f PRINT NA MEj / ) l kkk/lif/d DATE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK:J
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977