PRE 2010 DOCSr
-
City of Fridley
4T TNR TOP OF THE TWINY
------- COMMUNITY DEVELOPMENT DIV.
t i PIIOTECTIV[ 0209CY OM DIK,
CITY "LL FJUOLRY YMY
j 418-600-3460
s
53 -8l' -s-915.51
iwileT
PLUMBING, PERMIT APPLICATION
1
406/
200 N. E. 53rd. Ave.
ner Address P one
games R. Fegely 566-2495
Contractorress Phone
7G11NNEGASCt3 M IOG4RQUETTp AVENUE
Kind of Building
Frame Res.
omp etion Date Estimated Cost
11-29-7b .10.00
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Plumbing Fixture Rates: NO. RATE TOTAL
I1
! Number Fixtures x $2.00
II
Future Fixtures x $1.50
New Fixture -Old Open. x $1.50
I
Catch Bastn x $3.25
Water Heater -99,000 BTU x $3.00
I
Ground Run Old Bldg. x $3.25
Elec. Water Heater x $2.00
Gas Fitting Fees:
1st 3 Fixtures x $2.00
Additional Fixtures x $ .75
I
Gas Range -199,000 BTU 1 x $5.00 5.00
Repairs & Alterations
See
Description: Code
State Surcharge .50
- 101asS ®A® �aCcfiarge ..509
TOTAL FEE $ 5.50
!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 rulinj
of the Department of Buildings, and hereby declare that
all'the facts and representations stated in this
appl ation re true d rrect.
dswArir � �
'Signature Date
City of Fridley
SUBJECT
PERMIT
®1299'7
AT THE TOP OF THE TWINS
PERMIT
t
BUILDING
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION
r SEC.
/'--1 CITY HALL FRIDLEY 55432
i
�----� 'J
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
812-580-3450
910-F15
6-4-75
JOB ADDRESS
d Avenuq
1 LEGAL
LOT NO.
BLOCK TRACTOR ADDITION SEE ATTACHED
DESCR.
8 Carlson"R Summit Manor. North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
3 CONTRACTOR AIL ADDRESS IP PHONE LICENSE NO.
Lifetime
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
I
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Attached Garage
7 CLASS OF WORK
CA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct Attached Garage 24 x,24 x 9
9 CHANGE OF USE FROM TO
STIPULATIONS
Demolish Existing Garage
Provide Hard Surface Driveway
local Elides
call
gla�a dim ELECTRIC GAS Etc.
PERMITS REQUIRED F08 WIRING, -
SEFMTE I TELEPHONE
Dy 'AW
PLUMBING AND SIGNS. 0V 1,ReD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Frame
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
R-1
576
5,185
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
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.
LAN CHECK FEE
TOTAL FEE
$1 5.33
SIGNATURE OF CONTRACTOR OR HORIZ? GENT
I 1WHEN PROPERL ALI�HIS IS YOUR PERMIT
u€�A7S
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
� �Z—
BLDG INSP
.,, APPLICATION FOR RESIDENTIAL., ALTERATION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER :
y�
ADDRESS: �,�'f� �c���/�=� . /� 4!5,- ADDRES S : �: �✓ d��� o
NO:. STREET •
LOT: BLOCK: d' ADDITION: C�G��`�� V��i%/�®lam•®,
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach :o -this form Two Certificates of Survey.of Lot and.proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
♦j
ont• Depth: 025P-" Height:
Square Feet: Cubic.Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of : Construction: Estimated Cost: $ _,g
To Be Completed: LY0 L7--/
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: �(�GCdd' SIGNATURE:
(See Reverse Side For Additional Information.)'
Q�eYWtluglu,v o? / 1(jc% < 0-9Y S01 u 01$ 4O .7 z Miocer Z.
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30.5Is—
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SUBJECT
City of Fridley
2 6 5 2 8
AT THE TOP OF THE TWINS
BUILDING
PERMIT
� �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r ~ PROTECTIVE INSPECTION SEC.
�•(/
NUMBER
REv
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
7/10/98
JOB ADDRESS 200 53 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
8
Carlson's Summit Manor North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Virginia Felegy 200 53 Avenue NE
572-9585
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Viking Home Improvement Co 4832 2 1/2 Street NE, XM Mpls, MN 55421 572-1821
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
4772
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION lJ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off; Reside House &
Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code. Call for inspectio
of building wrap before covering.
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
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
1 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
$6,885
$3.44
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
PROVIS NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$124.75
Fire SC $6.88
STR ON OR THE PERFORMANCE OF CONSTRUCTION.
P
PLAN CHECK FEE
TOML FEE
- 6 /17
7-16-
1)i�a�la-eaz/(� d
Licens C $5.
IZ140.07
SIG/ ATURE OFC NTRACTOR OR AU HORIZED AGENT IDATEI
E P
._ G INSP
Y VALID T T�IIS IS YOUR PERMIT
ale
(( hA TE
SIGNATURE OF OWNER IIF OWNER BU4DERI IDATEI
NEW [ ]
ADDN [ ]
AL -TER [ ]
a
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUELDING PERMIT APPLICATION
ConstructionAddress: _j A_
Legal Description:,
Owner Name & Address: A
Contractor: 016 N
Address:. Lf 9_ 3 2 * E
44, -e .:Y-,44 p/
z ('0
r
�y
Effective 1/1/98
Tel. # J�� 77- -W '
MN LICENSE # Z
Tel. #
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:
04L� j
V s 0at"
U fS.
.10.1
Construction Type:
Estimated Cost: $
'Back).
(Fee Schedule, Zli
Driveway Curb Cut
Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: ?-/02-APPLICANT:Tel.
#
&��- 3r 3T
CITY USE ONLY
Permit Fee
$ `76
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$ -3. L/-/
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ d0
$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
$ NO. 0/7
STIPULATIONS:
SUBJFCT
City of Fridley
3245
AT THE TOP OF THE TWINS
BUILDING
PERMIT
R C
�COMMUNITY DEVELOPMENT DIV.
v______
r - PROTECTIVE INSPECTION SEC.
�
�.9� l/(�•�
1 ; r
J
1 1 ----I CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
3/12/02
JOB ADDRESS 200 53rd Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
8
Carlson's Summit Manor, North SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Virginia Felegy, 200 53rd Ave NE, Fridley, MN 55421
763-572-9585
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Ber Con Inc, 3450 153rd Ave NW, Andover, MN 55304
763-427-0207 3193
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Dwelling
7 CLASS OF WORK
�f
] NEW ❑ ADDITION ❑ ALTERATION 7� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replacement windows and one exterior door
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Caulking and flashing for all exterior openings.
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 80 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
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
@@
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,520.00
$3.76
DOES N91PRESUME TO GIVE THORITY TF VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
ON
PROVISI S OF ANY OTHER TA E OR L AL LAW REGULATING CON-
ST UC 10 OR T PERFOR OFC STRUCTION
VT
$153.25
$7.52 Fire SC
PLAN CHECK FEE
TOTE
$5.00 a se
$V9.53
1 TURF OF CON'aA TOR Oq AU DACE iDATEi
N PR PERL DATE/DTIS IS OUR PERMIT
BLDG ASP -
pATE
S,GNATU AE OF OWNERoF OWNER BUILOERI iOATE,
NEW [ ] CITY OF FRIDLEY Effective 1/1/2002
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
31
Construction Address: S
Ve /UC
Legal Description:
Owner Name & Address: b1l i / t Tel. # "lod•' 7� ��
Contractor C MN LICENSE #
Address: — Tel. #
Attach totis a plication, 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:
Construction Type:
�Wiok)�sti ated Cost:
Driveway Curb Cut Width Needed: FO 6 Ft = Ft x $V
DATE: 1c;? ®APPLICANT: Tel. # _ �®
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 7 3-5714287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee $ 1-53.c,?S—Fee Schedule on Reverse Side
Fire Surcharge $ 2, Q .001 of Permit Valuation (1/10th%)
State Surcharge $_____3 2� $.50/$1,000 Valuation
SAC Charge $ _ $1200 per SAC Unit
License Surcharge $- UC� $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
643" University Ave NE
Fridley, MN 55432
(763) 572.3604
RATE SCHEDULE
DIViSION
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
TOTAL
1;
$ .50
$
It:
OWN
BUILDING USED AS L0 L"l 5e—
ESTIMATED
t
ESTIMATED COST
Effective On January 1, 2002
ICA
42,
PERMIT NO. ZS'
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units._ Circle One (Steam) (Hot Water)IVarm ',
Trade Name: t_tl Size No.
t
BTU Cly-TG'v��', HP �j EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
HEATING
Signed
FAX #
DATE
TEL # ?, :3)4-�\Ijx? 5`l
Approved By `rte Rough -In Date Final Date Al—I _0 -)-
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
V
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON V NTS VENT .ONN TOR AND COMMUSTION AIR V RIFT CATION
When _re In acing an_xis ing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes WNo ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes( ) No( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes No( )
The existing comb is inn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No (l
When required to install a new r-nmht ,s+ion air. it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes No( )
When installing a new ventingsyc m, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes( ) No( )
Is the common vent and vent connectors sized and installed correctly after •
an appliance has been removed from the common vent and vented
separately as per current codes. Yes M No( )
Appliance #1 Type '?- ._�,P .yAc 4P BTU Input l a CCC Fan Assisted or Nat
Appliance #2 Type ��. BTU InputFan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height � e Diameter _ f inches
Appliance #1 Vent Connector Height -_ft Length -2- ft Diameter _ in Type
Appliance #2 Vent Connector Height __I_ft Length __�ft Diameter in Type C
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
HEATING CO: y. -&j ox, �A
Signed By: Date: 12
•.