PRE 2010 DOCSCity of Fridley, N mn.
BUILDING PERMIT
Date: _ —fir'
Owner: ��. Builder — — -----
Address _ _ Address —
,r _r,�r LOCA N SOF B DING
No. 411.5-7 ° Street — 7' ._�^� ! _•f -� _Part ofLot
Lot — —__ Block —„fir — Addition or Sub -Div ion
Corner Lot _ _ __ Inside Lot $-� Setback 0 - Sideyard Ze
Sewer Elevation ___ _ ---Foundation Elevation
DESCRIPTION OF BUILDING
To Used Am or lr_e
Front Depth — Height Sq. Ft. Cu. Ft
From Depth .a► Height Sq. Ft. !� Cu. Ft.
h� ea
Type i Construction Esta Cost o 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 forth and in compliance with all provisions of
q npmr ccs of the city of Fridley.
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 .grhnted' 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. �'°'-'� _'
NOTICE:
This permit does not cover the construction, installation for wkIng, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, IOTA
Owner's Namef---
Address Address
LOCATION OF BUILDING
No. Street Part of Lot
Lot 4 Block 2r� Addition or Subdivision
Corner Lot Inside Lot A-�- Setback --r-- Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as: f
Front
Sq. Ft.
Ft. I� ®=
Type of
To be Completed
i
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.
DATE t`: d SIGNATUREA 142
(A Schedule of Fee Costs can be found on the Reverse Side.)
l9
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 $
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 $ It
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
w ROUGH—
OUGH
FINAL—
FINAL
Dept. of Bldgs. Phone SII//4-7470
T.MO*Cnn
City
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.
Owner
6
19 —
Kind of
Used as
To be completed about a
Estimated Cost,
Old—New. Building Permit No. putt No. /F,?
DESCRIPTION OF WORK
HEATING or PO team, Hot Water, Warm Air—No te-A
Trade Nam Size No 0 000
Capacity MafO Sq. Ft M.R BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name 2 Size No
Capacity ��$ Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
w <z 7M
SUBJECT
PERMIT
City of Fridley
3105
AT THE TOP OF THE TWINS
BUILDING PERMIT
11
� t
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r F PROTECTIVE
3706
1 . F
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I 1 CITY HALL FRIDLEY 55432
' 612-571-3450
910-F/5
6/12/00
JOB ADDRESS 1357 53rd Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
2
1 Swanstromt s Court
SHEET
2 PROPERTY OWNER MAIL ADORES$ ZIP
PHONE
Thomas Trygg 1357 53rd Ave. NE Fridley
571-5143
3 CONTRACTOR Sons MAIL ADDRESS ZIP
PHONE LICENSE NO
Tabor and )?'s Roofing, Inc. 10547 Terrace Rd. Blaine, MN
55434 789-1902
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20014248
S ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION M REPAIR
❑ MOVE O REMOVE
B DESCRIBE WORK
Reroof House and attached garage (27 sq) Tear -Off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
Sp. 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
I
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND
VALUATION
SURTAX
�%
ORDINANCES GOVERNING THIS TYPE OF WORK WILL iBE COMPLIED
$2,360.00
18
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-
STRUCT ON OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEETOTAL
F
Licens C $5 . 0
$91.79
SIGNATURE OF CON'RACTORORAUTNORIZEOAGENT IDATEI
EN ROPE IDAT
$ is Y R PERMIT
S.GNATURE OF OWNEROF OWNERSUILOERI IDATEI
9LEG INSP
gAtt
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
Address: 1 o q -Y 7
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1/1/2000
(763) 572-3604 Bldg Insp
Tel. #
MN LICENSE # 02 oo/5' Z VY
Tel.# '7fS q-/qa2
Attach to this app, cation, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length V*th Height Sq. Ft
Length Width Height Sq. Ft
Length
Hgt/Ground Sq. Ft
Construction Type: �� �? 7 SQ Estimated Cost: $ aPS?3 (O 6
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:I� f�� Tel. # 79'Y'1,9Ol
CITY USE ONLY - Call (763) 572-3604 fo� Permit Fees if mailing in application
Permit Fee $ 83 --?3r- Fee Schedule on Reverse Side
Fire Surcharge $-��o .001 of Permit Valuation (1/10th%)
State Surcharge $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
� 6®
License Surcharge $ $;.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ �ee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ (9 1, gq
STIPULATIONS:
Building MkCHANICAL PerrnitN 31
Inspections RESIDEN IAL APPLICATION Received By: -
_ 04, Date Recd: d ��
7.63-572 36 CIT OF FRIDLEY
DATE 10 3 --OG YOUIR E-MAIL ADDRESS
SITE ADDRESS rd OLe (1Q
THIS APPLICANT IS: ❑ OWNER Pr4ONTRACTOR
PROPERTY NAME: —rong
OWNER/ ADDRESS: /3.517 53 o–d /1^� CITY STATE/�1N.1;IP S$`
TENANT i/_ 2 _ ch/ _ eYc12
CONTRACTOR COMPANY NAME:
SUBMIT A COPY OF CONTACT PERSON: r'
YOUR STATE STATE LICENSE # EXP DATE
LICENSE WITH ADDRESS: &VO nlroiln Sf n4 3 CITY ,�%� STATEI ZIP5Y&
APPLICATION PHONE 7G 3 - 7sy-,At99 FAX
PERMIT TYPE I ❑ SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: I ❑ NEW ❑ REPLACEMENiT )<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 P00 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) MODEL: SIZE/BTU
Equipment Installed MFG: MODEL: SIZEBTU
MFG: SIZE/BTU
MODEL:
A/C $25.00 ,FIREPLACE (GAS) $15.00 . —GAS RANGEIOVEN $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
—_CHILER S LINER $10.00 —GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00
_ _ _ . _.. _ _ _._ . , _ .. k.� ..... __,..,� �:��:....,a�.;:...r•_�.;Erni::+rt',+vr+ra�.`i.sv+Yiia�4R��'
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50 Number of fixtures @ $15.00 �x $15.00 = $ I S• On
TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Total = $ IS -C,6
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 w k/which re uires review and approval of plans.
SIGNATURE OF APPLICANT 7A PRINT NAME DATE & 3-�_
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propan&UGC 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 &573
MECHANICAL
Permit No. 6
jt
'v
Inspections Cw
RESIDENTIAL APPLICATION
Rec
B�
763-572-3604
CITY OF FRIDLEY
Date a d: o
DATE YOUR E-MAIL ADDRESS
A
E
SITE ADDRESS ,35 S 3r pU,G 1 v
THIS APPLICANT IS: ❑ OWNER ]CONTRACTOR
PROPERTY
NAME: 11&0M s Yy G G
OOWNN
TEANT
ADDRESS: 135-1 Sar �u � N E CITY f r STATE*ANIP K154
PHONE:
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
CONTACT PERSON: JOANN Z INKEN
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 3320 EVERGREEN BLVD STE B= ''COON "RAPIDS sTATEMNzIP55433
APPLICATION
PHONE 763 - 757 - 6202 FAX 763--757--6701
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
DETAILETDES_. TION OF WORK �v�5 ` IQ �ri�� Y`c�c Clan cI fkDr
PER MS 1613.665 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, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW) `
Equipment Installed MFG: + MODEL: LkR-A ' div SIZE/BTU LA MO $7�
MFG: MODEL: V y SIZE/BTUa-�o+r1 1_) $Le!
MFG: MODEL: SIZEIBTU
A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_AIR
_BOILER $35.00 -EFURNACE $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 _VENTILATOR$15.00
PERMIT FEE PROJECTS FOR UNDER $500
PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00,_ x $25.00 = $ V6•CP
Number of fixtures @ $35.00 x $35.00 = $ 35.00
State Surcharge = $ 50
Total = $ &4.-W
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.
g
ROGER HOFFHE IN I I U
SIGNATURE OF APPLICANT .PRITTT NAME DATE
PLEASE NOTE: SEPARATI? PERMITS ARE RE UHIED 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
h
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS YrEXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC 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.