PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 3173
Date: ....! . ... ...... .
Owner ��Builder ........ ............... U .
Address...................................... Address .............................................
LOCATION OF BUILDING
No. Street...
'0' ....... ..... Part of Lot . .... . .
.. ...........
Block ....,......... Addition or Sub -Division ........
Corner Lot ............ Inside Lot . I ....... Setback Sideyard ..70 .....................
DESCRIPTION OF BUILDING
To be Used as:
. ... Front .. Depth Z S�C .. Height /i.ss. s.. Sq. Ft. g.44. Cu. Ft. ........
Front ........ Depth ......... Height ........ Sq. Ft. ........ Cu. Ft. ......
Type of. Construction /�� ..... Est. Cost ........ To be Completed
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
....................................................
In consideration of the payment of a fee. of permit is hereby granted to lir.... .
..ftruct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location,. construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
0
0 0
City of Fridley, Minn.
BUILDING PERMIT N® 6574
Date:
s
Owner: Builder
Address Address
&"/-?OCAT OF BUILDING
No. �// Street_ .—Part Loin
Lot Block rip Addition or Sub -Division
� r
Corner Lot . _ Inside Lot aback' Sideyard
Sewer Elevation — ._ Foundation Elevation
DESCRIPTION OF BUILDING
T"
U
cA• Front Depth Height _/jO— Sq. Ft. Cu. Ft
t Depth -41H t� Sq. Ft. Cu. Ft.
Type of Construction Fast._� To be Completed
�r
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 f x th and Y �liance with ai]/�rovisions of
ordinanoea of the city of Fridley. ' / /� �/
lel v9_
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, orany part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within city limits and this permit may be revoked at any�pon,of any of the provisions of said
Building Inspector
• NOTICE:
This permit does not cover the construction, buitalytion for r mh& plumbing, on heating, sewer or water. Be are to we
the Building Inspector for separate permits for thus hems.
•
•
•
City of Fridley, Minn.
BUILDING PERMIT
Date: — OCTOBER 6, 1966
N9 9045
Owner: FRANK KOWALSKC Builder J - T - —UKQER ••-•----
Address 5330 - 7TH STREET N E Address 10823HAND BQITLFVARn
FRIDLEY, MINNESOTA 55421 MQW RAPT'nG_, MT NF.SCYPA
LOCATION OF BUILDING
No. 5330 Street __ 7TH STREET N, E.__ part of Lot
Lot 11 & 12Block 16-- Addition or Sub -Division •__.._ HAMILTON'S ADDN, TO MECHANICSVILLE
Corner Lot —_ Inside Lot —?t Setback --- Sideyard —
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
ADDITION Front — 7' Depth 13' Height 18' Sq. Ft. 91 CtL Ft, 1,638
TO KITCHEN Front Depth Height — Sq. Ft. Cu. Ft.
Type of Construction ` Est. Cost To be Completed
In consideration of the issuance to me of a permit to construct the buil ' g described above I agree to do
the proposed work in accordance with the description above set forth and compli with a'll pr ons of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to J. T
RANGER 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, construct�fon, alteration, maintenance, repair and moving of build�ngs
within the dty limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinaacm
CLARENCE BELISLE
Building Inspector
NOTICE:
This permit does not cover the construction, hstelletion for wiring, plumbing, ear heating, sewer or water. Be sun to see
the Building Inspector for separate permits for thus Mena.
V
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME �*'''` • m -�' = BUILDER
a
ADDRESS � . a 3,4- Y� e io - ADDRESS
LOCATION OF BUILDING
NO S_ STREET i /;�. PART OF LOT
LOT__Z BLOCK 114-1 ADDITION OR SUBDIVISION
r
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION
FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
1
��a�2�(r (r� re .y� Front 7 Depth Height I f
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction %(s � � K,� '11Z. ,;Estimated Cost "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.
DATEZt/-SIGNATURE.
(Schedule of Fee Costs can be found on th Reverse Side).
INDUSTRIAL
BUSINESS
CITY LOTS
TOPOGRAPHIC MAPPING
Btacrr/�; .�.sTirJid ro es 149,p/7/O1✓ Ta
C. E. COULTER N PLATTING
LAND SURVEYOR FARM SURVEYS
' LAKESHORE
REGISTERED/ UNDER LAWS OF STATE OF MINNESOTA JUDICIAL
LICENSED By ORDINANCE OF CITY OF MINNEAPOLIS
3300 LYNDALE AVE. SO. MINNEAPOLIS 8, MINN.
TAYLOR 4-0370
S�i,�vF r. fo.P %vry L-; �.P,�sa� �`..�.✓ /rvc. _
. �urnrttnr'�II �rrtifir� .,�.9�'E•' / ��=�Q '.
0
/i-oq
O �A
1 '
c
I hereby certify that the above is a true and correct plat of a survey of:
Lots Eleven (11) and 'Delve (12)0 .Block Sixteen (16), HAMILTON'S ADDITION TO Nl:cHANICS_
VILLE, Anoka County. Minnesota. .
As surveyed by me this 28th day of July 1958 A. D.
Signed
AW. afttui,.P@-ww dn", x Coang. Tem
PARTIAL RATE SCHEDULE Dort. of Bldi". plwne am-=
GRAVM WA» AM:
RATZ 'DOTAL
F1anace Shell & Duct Work
..... .. $10_00 $
Replacement of Furnace
6.00 $
Repairs & Alterations—up to $500.00
6.00 $
Repairs & Alterations each add. $500.00
300 $
umm WAMM ASR.
$._�„�,
Furnace Shell do Duct Work to 120,000 BTU
..$1000 $
each add_ 60,000 RTU . .........
3.t10 ;
Replacement of Furnace
6.00 g G �-
Repairs & Alterations --up to $500.00
6.00 $
Repairs & Alterations each add. $500.00
3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines --to 400 sq. ft. FMR Steam `10.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00
$.
Each add. 200 sq. ft. EDR Steam xon
$
Each add. 320 sq. ft. EDR Hot Water 3.00
$
OIL BURNER—to 3 gal. per hour 6.00
$._�„�,
over 3 gal. per hour—See Fee Schedule
—00
GAS BURNER (up to 199.000 BTU) 6.00
$
over 199,000 BTU See Fee Schodula
GAS FITTIPNG FEES: NO RATE TOTAL
Ist 3 Fixtures ( x$ 200
d
S
Additional Fixtures x .78
$_
Gas Range to 199.OW affi 6.00~
$
State Surcharge
.50
AMY aT100
�
FAN RZATMG STBTM 4/5��
/�• o
Trema sTaym
ALTZnATTOM & REPAEM TOTAL F=
3 3 v
City of Fridley:
&e
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Depai tment of Buildings, and hereby declares that all the fac
and representations stated in this application.are true and correct.
Fridley Minn_
Owner Y1z'e_ T 9 -
Kind
of Building
Used as
To be completed about. � � � � � r 7
Estimated Cost; S. Z C,[_' ED. c^ a
Old7New. Building Permit No, Permit No.
HEATING or POWER PLANTS ---Steam Piot Water, Warm Air—No /
Trade Name she NOL 3 �
Capacity—_-- — Sq. 7t E.D.R S O BM lu
Total Connected Load in d of Foe
BURNER — Trade No a Size No
Capaacl Sq. Ft. E.D-R E'A°iJ in
to l
HOUSE HEATING TEST RECORD
ADDRESS 3 36 `
APT. FLOOR CITY SUBURB `
OCCUPANT F1 _ OWNER
HEAT LOSS SOLD BY N t,—� HT��S ` '� INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA-!:n'—HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
MAKE �`� �"�-�kn MAKE OF BURNER_
Model Model
Serial q 2 r -L, Max. BTU Rating —
INPUT®,- ®nd MAKE OF FURNACE
Model
CONVERSION
CONTROLS
I 1U
"S
THERMOST T
Heat Plug '
Vent Size
Valve
KIND OF LINER
SIZENONE
Limit _1kJ
I
Draft Hood )-5 �"�`"�'
Regularor
Limit Setting
�
Filters Size IV
JQT YJ Number
Fan Setting
46 0 —1 ` ?X-
Chimney Location
Inside y Outside
Pilot Type
Chimney Construction'"`��-+
'
Pilot Make
"'"=ti,
/
Pilot Model
Smoke Bomb
Wiring !o
Pilot Timing
��''
Draft
Test Tag L
L.W. Cut Off
Door Pressure
L ghting Inst. e�
Percent ` ^
all
Pressure'/
CO2
Date Tested
Input CFH
Percent 02 r
Company Testing
Stack Temp
0 Percent CO
Name of Tester
Xj-
Form 235
D•!6'`��� aiJ "'� � . •�1ity`�y�il� � WIVS
.� ,e�� 1 ! ' ,� ���/ �. ��.�iii��?► �• '�1��' i
HEAT LowtaaAxnoNs DEPARTMENT OF, INSPECTION M-SMEUVA MIM.
Weatherstrips A.SuidV. Constructiort No. Insulation
Ge
Vindows Dogra Reference Out. was Int. Wall Ceiling Roof Floor Kind How Applied ' '
'es --No es— 0 19_
, R Room Length , �� Width 4 )- Height FI -1 Room Length Width Height .
Windows and Doors—Crackage and Area
width xeight Noof
No, of pane of pane lights
W idth Height No. of Lineal ft. Area
No.of pane of pane lights of crack sq. ft.
Aro`
sq. ft.
Required sq. ft. E.D.R. or aq. WA. Leader aicA y'
'Room Length Width eight
Coef.1 Btu
infiltration,
Q.
Glass$bLIZ
Exp. wap x h
Meta Height.. .. No. o Lineal ft. Area
No. of panb of pane lights of crack - sq: ft.
Net exp. wap
Int, wall `
i
Ceiling
Floor .. .a
Glass
Windows and Doors--Crackage and Area
®
width xeight Noof
No, of pane of pane lights
lineal M
of crack
Aro`
sq. ft.
Required sq. ft. E.D.R. or aq. WA. Leader aicA y'
'Room Length Width eight
FLI Room I Liength. " ` Width . Height
Windows aad' Doors---Crackage . and Area
Window's and Doors—Crackaga and Area
Meta Height.. .. No. o Lineal ft. Area
No. of panb of pane lights of crack - sq: ft.
o
;�_o coeE Btu
Llfiltratto – ��°"
Glass
Exp. wall
Net esp. wall
Int. wall
f
Cottf. . Btti
Ceiling
f
Infiltration, d r'.
bifiltratioµ :, .; .
Floor
Total Btu.
Total Btu. a t
Required sq.'fL E.D.R:, or sq. ips. WA. Leader Wea '
Required sq. ft. E.D.R. or aq. WA. Leader aicA y'
'Room Length Width eight
FLI Room I Liength. " ` Width . Height
Windows aad' Doors---Crackage . and Area
Window's and Doors—Crackaga and Area
Meta Height.. .. No. o Lineal ft. Area
No. of panb of pane lights of crack - sq: ft.
°
Width Height No. of Lineal ft.,' ,' Area
iG
No.I of pane of pane !lights of crack A.Btu
f
Cottf. . Btti
f
Infiltration, d r'.
bifiltratioµ :, .; .
GIBas y.
Glass r, t
Exp. wap .'
E:p. wap
Netexp. wall
°r
Net exp. wall
lot. welt ¢ .; , .. M , r . ;,'
'Int,wall
Ceilut6
Ceiling
Floor 't
q
Floor ;
Total Btu. r
Requires# . & ED.R. or iat. W.A: Leader area
Required liq. ft, E.D.R. or .its. W.A.°laa&r area
FI. Room—I Length Width. ''; �, Height
F1, Room I Length °,Width ` Height
Windows and Doors-Crackage:and Area F' '
Wi
Windows and Doors --C rackage and Area
,
�Vldtq eight No. of j loeal tt. Area ,
N0. of pans ` of pane I lshta ' , of creek N• it.
'�
Width Height• No o Llamtl tt. Area
No. or Paas :.ef pane' tights of craek t1.
4 "
p
• ,
Coef �'
Coef. tq
Infiltration
Infiltration '
Glass
Glass
Exp.. wall
Exp. wap
Net exp. wap
Net exp. wall
int_ WAll
a'
Int. w 1
ed sq. ft. ED.& or
Ceiling
Floor
l__•• ora' Dr°�
W.A. Deader area RV"uira s;
E.D.R. or sq: ins., W.A. LAades area "
1'i
0
SUBJECT
PERMIT N
City of Fridley
0 18064
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RET NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
1 �
i CITY HALL FRIDLEY 55432
IL'"--A
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
6/12/85
JOB ADDRESS 5360 - 7th_ Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt. 5, 6, 7
16
Hamilton's Addition to Mech. SHEET
2 PROPERTY OWNER MAILADDRES$
ZIP PHONE
Richard Meuleners 5360 - 7th Street N.E.
572-9182
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
8 DESCRIBE WORK
xMx Replace front window
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
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$2 000,
$1.0.0
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$33.50
T A AUTH IZED AGENT (DATE)
WHEN PROPERLY V DATED THIS IS YOUR PERMIT
��
XASiGNINjATUEOFCO
nL
BLDG )NSP
GATE
ATURE OF OWNER IIF OYNER BUILDER) IDA.TiE)
NEW [ ]
ADDN. [ ]
ALTER. [ ]
Construction Address:0
Legal Description: Pr p .�
Owner Name & Address:
Contractor• S
City of Fridley
�R-1 AND R-2
Building Permit Application
- 7 Ty S?•• /!/Z_
Address • .-3 ( G - 7 Tfi S r `-
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
E W'e A J
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
Effective 4/1/84
!/4rd/✓s J ddyt , r,4.
Tel. # Jr7a - f Z
Tel. # Y 7.:)" 9/ j
Height Sq. Ft.
Length
Width
Height
Sq.
Ft.
Length
Width
Hgt/Ground
Sq.
Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
j%O C
Type of Construction: !e j ZIA c f //IQllr WI RJO W Estimated Cost: $0V06
Approx. Completion Date: Ld aAl /4.(-- �°-CJ 1124 e
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: S
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
)?tC' 1.4.4 /! k (l/ /,t Xi Tel. #700ZAPPLICANT:_ _
CITY USE ONLY
$ Z6 Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ �/� $.50/$1,000 Valuation
$ $425 per SAC Unit
$ Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
24 -in. wide trames
2-35/s 4-3516 6-35/e 8-35/8 10-3%
2-1 4-1 6-1 8-1 10-1
191/2" 1912" 191/2" 191/2" 191/2"
Qm
2432 24322W 24323W 2432-4W 2432 -SW
Q Qj 11110
2470 2"UM 24403W 2440-4W 24406W
0 EO11110
2446 244a 2W 24Q 3W 2448AW 2446-%V
2456 ID
24563W 24564W 1-11111
56
0 ID El I I U
2464 24642W 24643W 2464dw 2464-5W
I-'---1
2472 24722W 2472 3W24724W 2472 5W
UU11m
Picture window units can be
furnished with ether one or two
side windows. These units are
available with a variety of glaz.
ing options.
Me Side Window
Iecifexterior RH Two Side Windows
or LM Flanker)
Jnit Rouh Unit Rough
No. Oponfng No. Opening
4040 5.1 x 3.41% 20.4040.20 6.9 x 3-4y2
-4840 5-9 x 341% 20-4840-10 7-5 x 3-41%
4048 5-1 x 4-01% 20.4048.20 6-9 x 4-0%2
-4848 5-9 x 4-0% 20-4848-20 7-5 x 4.0%
-5648 6-5 x 4-0% 20.5648.20 8.1 x 4-0%2
-6448 7-1 x 4 -OW 20-6448.20 8.9 x 4-0%2
.5656 1 6-5 x 4-81/2 20.5656-20 8-1 x 4-81h
-6456 7-1 x 4-8%2 20.6456.20 8.9 x 4.8%2
5669 6-5 x 5.4%2 20-5664.20 8-1 x 5.41%
6454 7-1 x 5-4h 20-6464-20 8-9 x 541%
-7251 7-9 x 541% 20-7264.20 9-5 x 5.41%
28 -in. wine trames
2-75/e 4-11% 7-35/e 9-7% 11-115,18
2-5 4-9 7-1 9-5 11-9
231/2" 231/2" 231/2" 231/2" 231/2"
ININNIMENIMENNIENNNEI
i� 11 11� 1111 11111.
- N --m. 0 V, - m- Im 0 � I I " .
2872 26M -2W 28723W 2872.4W 2072.5W
0 111 Ij . [I I ID
With 24 -in. gide
Window
wide sides Glass
Size
Center
Glass
Size
One Side Window
(Specify exterior RH
or LH Flanker)
Two Side Windows
Unit
No.
Rough
Opening
Unit
No.
Rough
Opening
191% x 41%
51'h x 42
24-5648
6-9 x 4-01h
24.5648-24
8.9 x 4-01h
19% x 41%
59'h x 42
24.6448
7-5 x 4-%4
24-6448-24
9-5 x 4.0h
19%2 x 49%
51'/2 x 50
24-5656
6-9 x 4.81h
24.5656.14
8.9 x 4.8'h
19% x 49%s
59'h x 50
24-6456
7-5 x 4-81/2
24-6456.24
9.5 x 4-8'h
19%2 x 57%
51'h x 58
24-5664
6-9 x 5-41h
24-5664.24
8-9 x 5-4'h
19%2 x 57%s
59%2 x 58
24-6464
7-5 x 5-41h
24-6464-24
9.5 S 5.41h
19%2 x 57h
671/2 x 58
24.7264
B-1 x 5-4%2
24-7264-24
10.1 x 5.4%2
191h x 65%2
591/2 x 66
24-6472
7-5 x 6-0%
24.6472.24
9.5 x 6.012
1%6 x 65%
67% x 66
24.7272
8.1 x 6-0%
247272.24
10.1 x 6.012
MECHANICAL
PermzitNo.:3—co Ol[��
Building
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-36 4CITE'
OF FRIDLEY
Date Recd:
DATE YOUR E- L ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: aY1
OWNER/
ADDRESS: Y rt — _St�l
TENANT
PHONE: Y
COMPANY NAME;— STANDARD
CONTRACTOR
_Nil
CONTACT PERK 410 WEST 1 AKE STREET
SUBMIT A COPY OF
MN 55408
YOUR STATE
STATE LICENSE # 4
2,91 STATE ZIP
LICENSE WITH
ADDRESS:
APPLICATION
PHONE FAX
PERK UT TYPE
XSINGLE FAMILY 0 TWO FAMILY C TOWNHOUSE
TYPE OF WORK:
0 NEw Jl�REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
PER MS 16B.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 ARE BAS N $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES.: (INDICATE TOTAL
NUMBER OF EACH BELOW) ``CC O
�
C/✓1� MODEL: 3 Y S1zEB
Equipment Installed MFG:
MFG: MODEL: SIZF/BTU
JJ MFG: MODEL: SIZE/BTU
$25.00 6tt5EGAS) $15.00 GAS RANGE/OVEN $10.00
I&C
AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00
GAS UNIT HTR $10.00
✓FIREPLACE
_BOILER $35.00 FURNACE $35.00
LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
VENTILATOR $15.00
_CfIIMNEY
DUCT WORK $10.00 GAS PIPING $10.00
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ 50
Number of fixtures @ $15.00 x $15.00= $
Number of fixtures @ $25.00 x $25.00 = $Z�. OR
TOTAL DUE $
Number of fixtures @ $35.00 ! x $35.00 = $ ss+
State Surcharge = $ .50-
50Total
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 th ity of Fridley and with the Minnesota Construction Codes; that I understand this is
that the work will be in accordance with the
not a permit but only an a n for a work is not to start without a permit;
approved plan In the of all hich review and approval of
�rn
SIGNATURE OF APPLI PRINT i�ATE
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTINQ5H_:_Q E$ .::_. ,
1. Combustion Air (See note belotw)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropaneUGC 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
Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY PRO@
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS Sawn Q.S tnwr e.,
THIS APPLICANT IS: 0 OWNER KoNnAcTo Dean Johnson
PROPERTY-NAME:5330 7th Street East
OWNER/ Fridley, MN 55421
ADDRESS: --STATE ZIP
TENANT 7635720527
PHONE:
CONTRACTOR NAME:
SUBMIT A COPY OF STATE LICENSE # EXP DATE
YOUR STATE ADDRESS CrrY DI/1 STATE LIP S�fyo9
vjr �'
LICENSE WITH . PHONE — MO. FAX —
APPLICATION -
PERMIT TYPE
SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
0 NEW }(REPLACEMENT
)(REPLACEMENT
DETAILED DESCRIPTION OF WORK wl
PER MS 16B.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.shouldreflect only.the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
F-0",ROJECTS WHERE LABOR EXCEEDS$300;FEES ARE BASED ON $10.00 PER FIXTURE,-EXCEPT"WEMtENG:'1EEL. FJAM:-.(WDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINXILAV _FLOOR DRAINS SHOWER _ WATER PIPING
_ _
_ GAS PIPING (NEED cnyvcrost) _ SWIMMING POOL _ WATER SOFTNER ($35)
—BATHTUB
CLOTHES WASHER —KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREV. ($15)
_
_LAUNDRY TRAY LWATER HEATER ($35) FOR IRRIGATION
_DISHWASHER
WATER METER OTHER
Permit Fee $ Number of f xtures @ $10.00 x $10.00 = $
Surchar a .50 Number of fixtures @ $15.00 x $15,D0 = $
TOTAL DUE $ Number of fixtures @ $35.00 _� x $35.00 = $ 3S.Oo
State Surcharge = $ .50
Total = $
THIS 1S 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 ap . 'on 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 ork which r ices review and approval of plan's.
/
I Aeil D
SIGNATURE OF APPLIC PRINT NAME . WI DATE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977