PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn.
N° 2993
e/
Date ... .......... a •� _ /
Owner r f;V ........... Builder `�' ....... .
Address JR1 A .............. >Z -u, Address (.. `o. ay ........... .
e,
LOCATION OF BUILDING
No. ./ ....... Street .��?. !! :............................ Par4jo Lot ..Yui..��. ®........
Lot ................ Block . A ........ dition or Sub- i .. ............
Corner Lot ............ Inside Lot ............ Setba Sid
DESCRIPTION OF BUILDING
To be Used as:
• . Front PJ. (.% Depth �.eOp Heiht . Ft.
/./ -`4p .�
5 ../4 . Cu. Ft ........
g ��2�
.................... Front ........ Depth ...Height ......... Sq. Ft......... Cu. Ft, ........
Type of Construction Est Cost ...! ..:....... To be Completed ...........
0e/11" A -4c
mitis✓ a ������
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 incompliance with all provisions of
ordinances of the village of Fridley.
r
In ;consideration of the payment of a fee of $./r... '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 with-
in the village 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 or alteration for wiring,d, u_mbfiig, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
CJ
•
qty of Fridley, Minn. 0
BUILDING PERMIT N® 6793
Date:
Owner: Builder
Address Address
LOCAT ON OF BUILDING
No. Street _ _• — Part o L14 ,ot
zf
Lot ._ Block Addition or Sub -Division .
0
Corner Lot Inside Lot _ _ Setback _ Sideyard _ A'
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
T be Used as:
t Depth 1.1e Height _ _ Sq. Ft. Cu. Ft. C ��
Front W Depth Height Sq. Ft. cu. Ft.
Type of Construction Est. __ `'- To 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 setfo in, pliance with all provisions of
ordinances of the city of Fridley. /1?
In consideration of the payment of a fee of $--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. N /--1
Building Inspector
NOTICE.
ibis penult dose set cover the construction, huteWa► for whdng, phnnbing, gas hating, sewer or water. Be ams to see
the BuNing Mqm for for separate p wffdb for thus hens.
•
•
City of Fridley, Minn.
BUILDING PERMIT No 7044
Date: If "— �T
Owner: Z2&2: ' Builder --
Address Address
LOCATION OF -BUILDING
No. Street 6�� az — Part of Lot —
Lot __ Block Addition orSub-D1vWon _
Corner Lot �_� ____ Inside Lot ._ _ Utback ideyard
Sewer Elevation ___ — Fo dation Elevation
DESCRIPTION OF BUILDING
To Used as:
a—Front 2=4 -Depth Height Sq. Ft. Cu. Ft.
Front DepthHeight ---
. - Sq. Ft. Cu. Ft.
Type of Construction Fst.-C oX---=To be Completed _
In consideration of the issuance to me of a permit to construct the building descrl-15R—RNove, I agree to do
the proposed work in accordance with the description above set fo pliance wi all provisions of
ordinanos 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 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 reg location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and permit may be revoked at any time upon violation any of the provisions of said
ordinances. rs ®9 a
Building Inspector
NOTICE
M permit does not cover the construction, Installation for whdng, plumbing, gas hating, sewer or water. Be ams to we
the Building Inspector for separate permits for these Rena.
City of Fridley
SUBJECT
13564
AT THE TOP OF THE TWINS
PERMIT
i
BUILDING
CEIPT
`
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
6/3/76
JOB ADDRESS 100 - 58th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
W12 81 91
10 25
Hyde Park
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
John E. Keppler 100 -58th Avenue N.E.
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
Construct a 10' x 14' Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
Must be on permanent foundation or tied down permanently with ties.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood 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
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
$250.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.50
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-
$5.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$5.50
IATURE FCONTRACTOR ORAUTHORIZED A((QGENT IDATEI
WHEN PR PERLY VALIDJ1ATED THIS IS YOUR PERMIT
BLDG INSP
DATE
+' SIMATURE OF OWNER IIF OWNER BUIL R IDATEI
2 P*"
C/ -5`b,9 ,LA' 11/
Q ! . --p I
0
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF. FRIDI EY, MINNESOTA
OI,iNER' S .NAME : �e�C¢ BUILDER : 'S Q Inyl F • Ve" j r
ADDRE SS :' / 00 5. /zIdg ADDRESS: 'Sm w, e -
NO:. STREET • S- %4Vel
LOT Y� C BLOCK : S ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Talo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION
To Be Used As: S10Y, a-cyt S ��
Or BUILDING
Front. IO Depth:_ /e% Height:
Square Feet: --Cubic Feet • !T 0.0 r._a�p
Front:
Depth:
Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:
To Be Completed: �� i)20 �.
The undersigned hereby makes application for a permit for the work herein'
specified, agreeing to do all work in stzi.ct accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and rcpresent:ations stated in this application
are true and correct.
DATE: SIGNATURE
(See Reverse Side For Additional Information.)
AGREEMENT
V
owner of the property
located at //,g ` 6-Y tit 1 , have no objection to the
City allowing the construction of a a r d err, %,� to be
located at J o t) 5 e e- without the required
certificate of survey that the City ordinarily requires for all new
construction.
Signature.
Address
it _ a - -)
Date
Witness
p ki
SUBJECT
PERMIT
L4L
of Fridley
AT THE TOP OF THE TWINS
BUILDING P E R M I T
Ir?City
RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 i
� CITY HALL FRIDLEY 55432
• •��
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---- 612-560-3450
910-F15
8/24/77
JOB ADDRESS 100 - 58th Avenue N.E.
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8,9,10
25
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Keppler 100 - 58th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Lloyd's Home Improvements 4911 - 4th Street N.E. 560-4857
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 O ADDITION] ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS Install ridged galvanized valleys. New roof can be 2nd but not the
3rd roof.
PERMITS FEQURED F -OR WRING)
SEPERATE
MERTING, PLUMBING AND SIGNS -
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 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
'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
]
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
$750
.50
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.
$7.50
9 ,a
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGNATURE OF CONTRACT 8ORAUTHORIZEDA (DATE)
WHEN PROPERLY VALIDATED THIS. IS YOUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DIATE)
p ki
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: k -:BUILDER:
Address: - . �`k%l�u E �� Address: q /l �% / e2//' �✓ – .
Tel. No.:— L/, cl
No.: / U U Street:��–
LOT:
BLOCK:
ADDITION:
CORNER LOT:
INSIDE LOT:
SETBACK:
SIDEYARDS:
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:
Front:
Depth:
Height:
Square Feet:
Cubic Feet:
Front:
Depth:
Height:
Square Feet:
Cubic Feet:
Type of Construction:
Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway
Width If New Opening
Is Desired
$ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information.
DATE: SIGNATURE:
Stipulations:
j'� vAA k
SUBJECT
PERMIT NO.
City of Fridley
15244.
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• _____ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
-�, CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
6-6-79
JOB ADDRESS
100 58th-Ave. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
Al 8r9r10
25
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Ke ler 100 58 th.Ave. N.E. Fridley 55432 571-8563
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
C¢ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 28' X 28' Garage.
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hardsurf'ace driveway within one year.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R 1
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
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
$6 562.08
$3.28
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$37.63
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$40.91
S aNATUR FCONTRACTOR O UTHORIZEDA NT (DATE)
VLH E T SIS YOUR PERMIT
A
LPROMPERLVID
57
S NATURE FrF OWNER IIF OWNER BUIL E IDATEI
BLDG INSP DATE
CERTIFICATE OF SURVEY
JAMES L. KURTH
LAND SURVEYOR
730 -40TH AVENUE N.E.
COLUMBIA HEIGHTS 55421 788-9769
1 HERESY CERTIFY THAT THIS SURVEY. PLAN, OR REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION
AND THAT 1 AM A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS OF THE STATE OF MINNESOTA.
, r
DATE
a.• ..- SCALE 1
MINNESOT REGISTRATION NO. 5332 0= IRON MONUMENT
iN kCCL4rx'i�i'.FJ'_.�:
w^ 4
• 2v�..�rsc.4 ,
A ` I
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it (7CI (.I 1-sb
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CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PE HITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWtiER: "� I C BUILDER:
Address: L013 X AV9-_ 0616 Address:
Tel. No.:
No.:
LOT: tovet.a
Street:
BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS:
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:
�°- `r o�� �- Front: Depth: Height: i
Square Feet: Cubic Feet: q y
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ��°" 0-
7b Be Completed:a O
Estimated Cost: $cz
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse sid or additional information.
DATE: Cr SIGNATURE:
Stipulations:
3 r) `�
• � CITY OF FRIDLEY
C�i ooh "
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWfdER: BUILDER:
---®- .
ADDRESS: ADDRESS:
TEL NO: I S�'�Lo� TEL NO: '
Construction Location
-STREET NO: /(, D STREET:
LOT: BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Squane.Feet: Cubic Feet:
Front: Depth: Height:
Square - Peet: Cubic Feet:
Type of Construction: Estimated Cost: $
7b Be Oompleted:
_ Al //// Al B
Proposed Driveway Width If New Opening Is Desired:
SEE REJ F SHEET
.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 appl•catio a true d correct.
DATE: / SIGNATURE:
Stipulations: A ,�j L '
Uc
�1
7� - .
HOUSE- HEATING TEST RECORD -*1419
ADDRESS , IAE - "Z!,ftdcl/U APT. FLOOR CITY SUBURB
OCCUPANT OWNER
HEAT LOSS nATE HTG. NST. L^,U 4`
SOLD BY INSTALLED BY 1_24"VC"-g:A
Electrical Work By Gas Line By " 'e
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER.
GA ESIGN
MAKE'`= oa aG?J MAKE
Model Model
Serial 8.00-r .� Max. E
INPUT 7S-/"1 MAKE
Model
CONTROLS
THERMOST Heat Plug �-
Volvo '
Limit '
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model 0�l✓4-/i2�
Pilot Timing 'Z
L.W. Cut Off
n �
Pressure Percent CO2
Input CFH Percent OZ
Stock Temp. Percent CO -
Form 235
CONVERSION
OF BURNER
ITU Rating
OF FURNACE
Vent Size✓c�
KIND OF LINERy'-f SIZE 10 NONE
Draft Hood Regularor
Filters Size/G x .CSx / Number
Chimney Location Insiidd e"' Outside
Chimney Construction e ele ii
/
Smoke Bomb
Wiring
Draft
Test Tag
Door Pressure
Lighting Inst. rl
Date Tested . Al
Company Testing //, E
Name of Tester /L//K6
CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Commerclal/Industrial
1.25% of Value of Appliance or Work
State Surcharge $.50
TOTAL FEE $ , SCS
MINIMUM FEE FOR ANY HEATING/COOLIN_ GNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT LS $26M
PLUS THE $.5o STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
BTU : _ HP
Fuel A/A � Total Connected Load114,
Bumer Trade Name Size No.
BTU HP EDR
HOME ENERGY CENTER
15210 25TH AVE. N. 9126
HEATING COMPANY PLYMOUTH, MN 55447
Signed B ��� Tel No. -/9 9l)
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard withouf
written permission from adjoining .property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
JOB ADDRESS 14,V - JW Z11
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all'work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace
$ 30.00
representations stated In this application are true and correct.
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
$10.00
$
_
OWNER
Gas Range
$10.00
$
BUILDING USED AS
Gas Dryer
$10.00
$
ESTIMATED COSTS /p = PERMIT
*Air Conditioning — All Sizes
$ 25.00
$
NO. !`',%g
All Others/Repairs & Alterations (UST ON BACK)
DESCRIPTION OF FURNACE AND OR BURNER
1% of Value of Appliance or Work
$
No. of Heating Units/ rcle One (Steam) (Hot Wat Warm Air
Trade Name/; --,,,4417/ ���ps SizeNo,���r,�
Commerclal/Industrial
1.25% of Value of Appliance or Work
State Surcharge $.50
TOTAL FEE $ , SCS
MINIMUM FEE FOR ANY HEATING/COOLIN_ GNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT LS $26M
PLUS THE $.5o STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
BTU : _ HP
Fuel A/A � Total Connected Load114,
Bumer Trade Name Size No.
BTU HP EDR
HOME ENERGY CENTER
15210 25TH AVE. N. 9126
HEATING COMPANY PLYMOUTH, MN 55447
Signed B ��� Tel No. -/9 9l)
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard withouf
written permission from adjoining .property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes(/) No ( )
2. Is free from rust or deterioration Yes (✓� No ( )
3. Has no foreign objects lodged within Yes (� No ( )
4. Is securely supported
5. Meets all current Code requirements for size
and total BTU's connected
6 Has total heating BTU's of ;7,5 -
All other BTU's
TOTAL BTU's 5 ,�
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:, _ ,
HEATING CO:
Signed By:
Date:
Y
HOME ENERGY CENTER
15200 25TH AVE. N. 0125
PLYMOUTH, MN 55447
,�e r� i -41-
Yes No ( )
Yes(/) No ( )
Yes () No ( )
Yes () No ( )
I
HEAT TRANSFER
CALCULATIONS
HEAT
0INSIDE
LOSS: ± 20 ° OUTSIDE
HEAT GAIN: + 955 o INSIDE
+ 9OUTSIDE
SQ. FT. COEF. BTU's
SQ. FT.
COEF.
BTU's
1.
GLASS
7q 90 R1&o
1.
GLASS
N
fi3—
25
zoo
E/W
ie.
75
A/WQ
S
.5-v
40
X000
2.
DOORS
4000/ea. S®DO
2.
DOORS
300/ea.
G od
3.
CEILING
3.
CEILING
12"
3
12"
1
9
4
9
2
6
5
6
3
3
-;ZR4 8 dz
3
-,ZV
4
/,0
4.
WALLS
4.
WALLS
3"
7
3"
3
11/2"
IMts_ 10 IA-010
11/2"
8
4
5.
BSMT
5.
PEOPLE
600
z 0-2 2
Below grade
zd 5 tr
Walkout
10
6.
APPLIANCES
2500
6.
Subtotal
7.
Subtotal
7.
TOTAL
A/D3J�A-
8.
TOTAL
/ ao
8.
FURNACE SIZE
9.
A/C SIZE
a ��
9.
FURNACE MODEL le 19 10.
A/C MODEL
��'
I.v 7E.0 �1- 'r' .4 &D saw 7—$
/y�✓ad
AI
I
SUBJECT
PE
City of Fridley
31615
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
246
NUMBED
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
1/16/0
JOB ADDRESS 100 58 avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
W$ 8,9,10
25
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
John Keppler 100 58 Avenue NE
763-571-8563
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Brian Balow Construction 4355 Upper 156 St W, Rosemount MN 55068 651-246-6222
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20186225
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (24 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
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
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
$2,454
$1.23
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$83.25
Fir SC $2.45
TRU ON OR THE O OF CONSTRUCTION
PLAN CHECK FEETOT
L FEE
/
Licens C
$5.0
$91.93
SIGNATURE OFCON'RACTORORAUTNOR12EOAGENr IDATEi
ENPRO
VALID TE THIS IS Y UR P R IT
S-GNATURE OF OWNER,.F OWNER BUILDERI IDA TEI
INSP
rIArE
NEW [ ] 21 ',,0 Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
1 G► ..11
Construction Address:
Legal Description:
Owner Name &,2Address: S ►� tPfp lam' Tel. # Z(o 3 - 5'71- �s'G3
Contractor: &4r•3 Px+lco� MN LICENSE # Za/ gCo z z!�
Address: L155-5- uAd-e� c50-Sf w 9&V-rMb;t olti 575-0co"5 Tel. # U�s t - 2-44P-ce2z2
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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 Height Sq. Ft.
Length
Length
Width
Width
Height
Hot/Ground
Sq. Ft.
So. Ft.
Construction Type: 4d- - '0 r v Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: I - / Lt - 01 APPLICANT: r --rlQ rzm 1 "-�D Tel. # �-�� " Zic4 `4 2 ZZ
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit FeeFee Schedule on Reverse Side
Fire Surcharge ?,t1!r$ .001 of Permit Valuation (1/10th%)
State Surcharge/,:23$ $.50/$1,000 Valuation
SAC Charge $ $1150 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: �/"