PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 4 7 s
Date:
Owner: ........... _....................... _...__.._..... ............ ...... _......... .................. Builder
Address..... ........ ........ .... __...... ...... _..._.._ __ ____... Address
,�. LO TSN OF BUILDING
No. +........J t.+.._✓ .. Street _:.._ . Par, obi of ._..
I . Block .-----....---... ...........---•----. Addition or Sub -Division
Lot ...._ ...........................
Corner Lot ........... I .............. ..... Inside Lot ....._ ............._......._........ Setback .. ..._...................... .Sideyard .. �„�... ...........G.:'
Sewer Elevation ..... .............. _............._............._......................_...._.___...._........ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: E "
:: .. Front .... ? .. Depth .... Height �'"' ^` Sq. Ft./
` .. �.:_.. Cu. Ft. 4?.;./ _..
... f
.................... _........... I.......................... .... Sq. Ft. ................. Cu. F't....._...............
..
Fron Depth ......... , r He�h�td _r,.,
Type of Construction �R . ^ Z....... Est. oG` s +"� . �F ' ... To be Completed
,
_ X1_5 70
THIS PEM,W D:..lE3 NOT AUTHORIZE VIOLAT-
ION OE .f'�;`;',' ,., : Aa"t: LAI�I� COVENANTS AND
BUILDING RESTRICTIONS.
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 permit is hereby granted
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 v1djA on of. any of the provisions of said
ordinances. Z11 r► 4 I
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see
the Building Inspector for separate permits for these items.
4 0 .,
APPLICATION FOR BUILDING PERMIT
CITY OF "MLEY, MINNESOTA
Owners Name Builder L`iwd A•ttF
Address Address _
LOCATION OF BUILDING
No. 5390 Street `Z Jr. jus • Part of Lot
Lot / Block Addition or Sub.Div. 4% Meclt•til�/4
(c.esw,4%) (�y
Corner Lot,�side Lot t Back 19' Side -Yard f S
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To used a
Ali Front ,....� Depth....�� Height,--- .
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft. _C-)
Type of Construction�®ti� Estimated Cost
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are trine and correct.
Z
DATE,_„_' �'' �' SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
•
'cation for Power Plants and Hoofing. Colin Ventilation ReFri a17on and
APPS 9. g. 9m'
I Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work .......................... 8.00 $----,,X--
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 120,000 BTU ............ 8.00 $
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
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
$
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
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
I,-.-
,REMARKS:
w
I
$
See Fee Schedule
TOTAL
Dept. of Bldgs. Phone SII 4-7470
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.
�,,'7 Q .Fridley, Minn C? '-' `.5 , 19
Cs % ..TT—�l����
Kind of Building
195—
I
Used as
To be completed about ` /S--
Estimated
SEstimated Cost, $ -�-0-0
Old—New. Building Permit No.�
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, -Hot Water, Warns Air No 0 t-�
Trade Name Size No-<:9��I-/ ®®C
Capacity Sq. Ft. E.D.R-AQ0 000 BTU H.P.
Total Connected Load Kind of Fuel/
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Signe `
By I
11 POST IM -12-58 Business Phone No
At .K/
f CJ /.0 /7 Coef. Btu 0 E Btu
Infiltration -- �S/ /9-T- Infiltration / /-1-
Glass-1�
6HEAT'LOSS �NS 3 9c)
r
�I e
_ Exp. wall ca,47
DEPARIMIM F BUUMS
,���.�, Village of
Weatherstrips
A.SJLV.E,
;?/,r le
Coa,traction No.
In,dation
Exp. wall 9 %
Guide
ference
Ceiling
Int. wall
ee 2 /®
�Q
(1
Out. wan
Int. Wall Ceiling Roof Floor
Kiqd How Applied
o
zwl
1,16Q
19-
9Room
Requu
.D.
or sq. ins. W.A. Leader area
Ceiling
-RoomI Length d, '/ Width
/4" Height
Fl.
Length /.yl— Width ®E.
Windows a
re—Crackage and Area
ckage and Area
No of Lineal ft. Ares
.1ights of crack sq. M
L
Window, and Doors—Gacitage a" Area
wldth
6fo. of psae
eight No. of Lineal t . Ares
1 pane 11g is of crack sq. ft.
Coef.
Width Height No. of Lineal ft. At"
Na of pane of pans lights of crack sq. M
Q
d
J.�1
1.6f
®.
/
�0 /,=I;
At .K/
f CJ /.0 /7 Coef. Btu 0 E Btu
Infiltration -- �S/ /9-T- Infiltration / /-1-
Glass-1�
/
Width Height No. of Lineal ft. Area
No. of pane of pane lights of orsok sq. M
d?i
_ Exp. wall ca,47
IP713
Net exp. wall
Infiltration
;?/,r le
Glace
Int. wall
Exp. wall 9 %
Net exp. wall 4,9
Ceiling
Int. wall
ee 2 /®
�Q
FloorQ
Floor 91
F./ 74
i 7
Total Btu.
zwl
1,16Q
Int. wall
Requu
.D.
or sq. ins. W.A. Leader area
Ceiling
Fl. .ti
/6'
m I Length 17? Width/,
Height
W&Jows
Width
No. ' of Pane
nd
Height
of pane
4
ckage and Area
No of Lineal ft. Ares
.1ights of crack sq. M
L
Coef.
Stn
Infiltration
1.6f
Glass
Exp. wall oa
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. /® s/s
Required .R. or sq. ins. W.A. Leader area
F1.1 MUr9kV Room I Length 62 _ Width v �. ® MaInht
Windows and Doors—Craekage and Area
/
Width Height No. of Lineal ft. Area
No. of pane of pane lights of orsok sq. M
d?i
Exp. wall
IP713
Coef. Btu
Infiltration
%
Glace
/9 Q
Exp. wall 9 %
Net exp. wall 4,9
a
Int. wall
f
Ceiling 11,9
/Ly
Floor 91
F./ 74
falai L u.
Rft. E.D.R. or aq. ins. W.A. Leader area
0.9. g1 A
Glace
/
Width Height No. of Lineal ft. Area
No. of pane of lights of crack
d?i
Exp. wall
IP713
Net exp. wall
%
0
/9 Q
Int. wall
Can
Ceiling
f
O®
/ �7
Floor
F./ 74
i 7
/,-? o;CS'
Total Btu.
Required!q. ft.90,& or sq. in,. W.A. Leader area
FLI Mr MhqRflam I Leaath /,/-g Width O Heiaht 777
Wmdows amt Doors-4nAlige and Area
Width Height No. of Lineal ft. Area
No. of pane of lights of crack
Coef. Btu
[,filtration
Can
Exp. wall l
Net exp. wall
zwl
1,16Q
Int. wall
Ceiling
/6'
./Q
Floor
Total Ben.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FLI 6aZA&Room I Length % � Width
Windows and Doors—Crackm and Area
Glass
Exp. wall
Not exp.. I
Int. wall
Btu
f , ' City of Fridley
A lication for Plumbing and Gas Fling Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK _
Number, Kind and Location of Fixtures Locatiom—l—�e
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ 10 O
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 $ 00
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ S a
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $—Z2
e S 6
City of Fridley:
Ute"'
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.
�Fxic ey, ,-
Owner
Kind of Building
Used as — :Idk"L
To be completed about
Estimated Cost, $
Old—New. Building Permit
11 POST IM -12-58
19—Ap
19-
19—
12
>
Z~z
`a�
p� Z
1�3Z
UN'
R
N
WATER HTR.
GAS
ELEC.
Base
r
l
1st
2nd
3rd
4th
• Future Connection Openings
Connected with
New Fixture, Old Openings
I
SBW@P
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $ 10 O
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 $ 00
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ S a
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $—Z2
e S 6
City of Fridley:
Ute"'
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.
�Fxic ey, ,-
Owner
Kind of Building
Used as — :Idk"L
To be completed about
Estimated Cost, $
Old—New. Building Permit
11 POST IM -12-58
19—Ap
19-
19—
otrl�
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK �' °� [�40 — 7
Number, Kind and Location of Fixtures Location f
•�c�'.
NO. RATE TOTAL—
k/$1.50
f�n/1
Z
N
Future Fixture Opening
iii
$
w
Z
•
•
WATER HTR.
$
Water Heater (Up to 200,000 BTU) ......
3F3
$
New Ground Run Old Bldg. ............
x 3.25
3�
o�
NO. RATE TOTAL
�' o
c�3
$
c�°d
Uma
(70
Gas Range to 200,000 BTU ..............
x 2.00
GAS
EIEC.
rn
.��
uZ—i
Base /
/
1st
2nd
_
3rd—
4th
• Future Connection Openings
Connected withI
Sewer �
New Fixture. Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL—
k/$1.50
Number Fixtures ......................
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
$
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 ell 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.
--,�Fridlev. A?inn- �V do A-6 0 , 19—
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit o Pe
e
Signe
By
Business Phone No ---
ROUGH
FINAL
4z 2M 7-59
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
m
a.
m
$
Future Fixtures
U
$
old opening, New Fixture
m
$
Water
m
$
Slow off Basin
$ 5.00
$
Catch Basin
$ 5.00
$
�3
Mp C
1.00
Hydraulic Valve
$ 5.00
$
Sump or Receiving Tank
Heater
M
p
$ 7.00
$
0]
$ 5.00
$
a
Q
o M
Gas Dryer
$ 10.00
U
al
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
1Bo�
$
State Surcharge
o�
a"�i
Mw
m
w 9A1
$
v
O
lec
lat
2nd
3rd
4th
(R) a Future Connection Opening
Connected with Sewer
(*) s New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
New Fixtures _
$ 5.00
$
Future Fixtures
$ 3.50
$
old opening, New Fixture
$ 1.50
$
Beer Dispenser
$ 4.00
$
Slow off Basin
$ 5.00
$
Catch Basin
$ 5.00
$
Rain Water Leader
$ 5.00
$
Hydraulic Valve
$ 5.00
$
Sump or Receiving Tank
$ 5.00
$
Water Treating Appliance
$ 7.00
$
Hot Water Heater _
$ 5.00
$
Gas Range
$ 10.00
$
Gas Dryer
$ 10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
$
State Surcharge
$ .50
Reinspection Fee $
($15.00) TOTAL
FEE
$
Job Address
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to da all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn.. ® SL / , 19
OWNER .�/ .aC-s
RIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT Ileo ;;5- I
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO. � L8
ROUGH IN".
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT c
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
sueJEcr
MIT NO.
City of Fridley
210 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
i �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
CITY HALL FRIDLEY 55432
NUMBER
REV
GATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/6/91
JOB ADDRESS 5390 - 7th_ Street NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
1, Pt 2
16
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Brian Sandberg 5390 .. 7th Street NE
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12k x 161 Deck.
9 CHANGE OF USE FROM TO
STIPULATIONS
Maintain a minimum of 10 feet clearance under electric service wires.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,450
$.73
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$35.00
Fire SC $1.45.
PLAN CHECK FEE
TOTALFEE
37.18
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WH PROPE LLI AE THIS IS YOUR PERMIT
-� /
SIGNATURE OF OWNER IIF OWNER UILDERI�
IN DAT
IM [ ]
ADCNR-1 AMID R-2
ALTER] Building Permit Application
Construction Address: 53ctv `4 `f- •lig -C
Effective 1,/1,/91
Owner Name it Address: N" IS/VQ 0 I 1 (V-&
CoiltractU 11e1. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn an it to scale.
LivXNG AM: Length
Width
Height
sq. Ft.
ARS: Length
Width
Height
sq. Ft.
n= AREM Leshgth 'L®
Width
Hgt/Grotn d
Sq. Ft. Its
ate•
�i L)e 7. 6
vis
Corryer Lot Inside Lot [ j
Ft. Yd Setback
Side
Yard Setbacks
Type of C 'cn: ► •
Estimated
Cost:
$
Approx. Ompletion Date:
Proposed Driveway Width If New opening Is Desired:
Ft.
$ $,
Width + 6'
See Back Page
DATE: APPISCANT:
Tel. #
Permit Fee $ C)
Fire Surcharge $
State Smid=Ve
SAC C arge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
5 30). /i�
s-rzpviAzza�:
�N-"AMI;1: • it
Fee Schedule an Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by;,,�,-; r
Necessary[ ] Not Necessary [ ]
�nJWMWA� 0a #71Z
C L. rL*V E
IL
lov I-
I�
3 ov
J
a
- - 1-2 13. 97 Meq s.
allOo
l/ l91 Mpi
tA
2r S 3 n.
In
Ljj
c, y-� S- V*l
+rko,��J- ploc*, )(S
/hereby /S
cerfily- fbai *6 1 a Mae and corred representation 00 survey 40ke bwndor;es j("Ac 4how disa4hed land, and
oj'� lor4lion. of a// bmildtny5, thereon , and o// Yisih& o7awachmeals , t!'mi
q, fmn or a7sed /and. AS surveyed
by Me flus-- *-q
SUBURBAN ENGINEERING, INC.
Surrvor5-
i