PRE 2010 DOCSCity of ]Fridley, Minn.
BUILDING PERMIT
•
Owner: Builder — D. T. h .r _r
Address Address 652 _ 2-nd t. M.E.
Fridley
LOCATION OF BUILDING
No. 150 Street 62nd Hay N.E. Part of Lot
Lot 6 _ Block 1 Addition or Sub -Division .___Potaseks
Corner Lot _ Inside Lot X _ Setback 351 — Sideyard 9 R, 10
Sewer Elevation _... Foundation Mevation 21 above street
No 8569
3 // VA
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front ) In Depth 8— Height Sq. Ft. 1,2$2_ Cu. Ft. 17$
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction' Est. Cost r. 6 00.00 -To be Completed
•
20 x 24 garage attached - house same as 6001 Gardena Circle
•
In consideration of the issuance to me of a permit to c tract the buil described above I agree to do
the proposed work in accordance with the description above fo and incQmpliangp with ail provisions of
ordinances of the city of Fridley. v �/
In consideration of the payment of a fee of $ 98.00 -,permit is hereby granted to D.L. gcbp-rer.
to construct the building or addition as described above. This permit is granted upon
the express condition that the peion to whom it is granted and his agents, employees an workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances sof
Fridley, Minnesota regarding location, itmay yoked a any time upn�o maintenance,
n of rand any of the provisi bona of said
within the city limits and this
ordinance.
NOTICE:
ibis permit does not effer the donstruddon, hutaWen for robing, plumbing, ga hesting, =wet or wsbr. Be pure to as
the Butldhrg kMmmr for cpm to pemdb for thea Neva.
I
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER * S NAME BUILDER . ° �l� AOS
ADDRESS_ADDRESS 2 e
LOCATION OF BUILDING
–�� Street Part of Lot
..LOT R ADDITION OR SUBDIVISION
Corner Lot Inside LOT--A—Setback _3 Side -Yard 9 /
..SEWER ELEVATION, k066A ioit i=VAtT6X_
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 L140 Depth,_ _Height
Sq. Ft. % Z �2-, Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost % / �-6
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.
'6 _�
DATE SYGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
2.0 X2-�'
6001
Application fOr Power Plmh and HtWhM Cooling. Ynnfflaftn. Rn/Eign�otion and
Air CondNonkq Systan and Dnricns
F
PARTIAL RATE SCHEDULE lhwL of Bldg.. Plwne
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ................ .. $10.00
Replacement of Furnace ..... .. 6.00
Repairs & Alterations—up to $500.00 600 $
Repairs & Alterations each add. $500.00 3.00 $—__ _
MSQL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ........
..$10.00
h5 " 0°"0
each add. 60,000 BTU ....................
.. 3.00
=
Replacement of Furnace ....
6.00
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. EDR Steam
$10.00
$.
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00
$_
Each add. 200 sq. ft. EDR Steam
3.0n
Each add. 320 sq. ft. EDR Hot Water
3.00
$—
OIL BURNER—to 3 gal. per hour
over 3 gal. per hour --- See Fee Schedule
GAS BURNER (up to 199,000 BTU) ... ......
over 198,000 BTU See Fee Schedule
GAS FITTING FEES:
1st 3 Fixtures .....
Additional Fixtures
Gas Range to 198,000
AIR coNDrrioNnMa
FAN HEATING SYSTEM
VENTA.ATING SYSTEM
ALTERATIONS & REPAIRS
rmu //- I9- 7 V
6.00 $ _
5.00 Q
NA RATE TOTAL
_ x$ Zoo $ 6-0
- x .76 $
- s$ &W $
See Fee Sc6edols
TOTAL FEE $
(SURGhARGE $_058)
!M@91=
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 true and correct.
Fridley, Minn �2 ®
Owner
Kind of Building
Used as
To be completed about
Estimated Cost,
Building Permit No.
Permit No. Q9 q>
DESCRIPTION OF WORK
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No
Trade Name 1.[ - Size N ®� eZ>
Capacity Sq. Ft. E.D R- BTU
H.P..
Total Connected Load- Kind of filet
BURNER — Trade Nance Size No
Capacity Sq. Ft. F;.D R BTU IS.
p j62 42
.HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows Doors Reference Out. WallInt. Wall Ceiling Roof Floor
Yes—No Yes—No 19_
Fl.j i Room I Length ! Width f Height II FLI rR _ 0S4
Win ows and Doors—Crackage and Area
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
L 2-
EWidth
Coef. Btu
Infiltration
1A W
Glass
,05,70
Exp. wall
aw
Net exp. wall
Int. wall
-
Ceiling
'
Floor
1 otal btu. 1
2
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 n .'a / Room I Length / ', Width 9 Heistht S'/
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
L 2-
EWidth
JCoef.1 Btu
Infiltration
1A W
Glass
f
Exp. wall
aw
Net exp. wall
Int. wall
-
Ceiling
L,%
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Length "y Width -7 Height Sr
Windo s and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. ofvans of pane lights of crack sq. ft.
rr
EWidth
Coef. , Btu
Infiltration
0
Glass
f
Exp. wall
aw
Net exp, wall
Int. wall
-
Ceiling
/37 KQ
Floor
I btal Btu.
ft. E.D.R. or sq. ins. W.A. Leader area
FRIDLEY, MINN.
Insulation
Kind How Applied
Room I Lensith .tom Width/ Z,- Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of Dane lights of crack sq. ft.
Z�
EWidth
Coef. Btu
Infiltration
0
Glass
5
Exp. wall
aw
Net exp. wall
Int. wall
-
Ceiling
/37 KQ
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
171.1 Room I Lenath 'Z/ Width Height
Windows and Doors—Crackage "and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
� o
EWidth
Coef. Btu
Infiltration Z0190
Glass
Exp. wall
Net exp. wall
Int. wall
-
Ceiling
/37 KQ
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l AJI R Room I L.enath /'3 Width / Z--Heiaht
Windows and Doom—Crackage and Area
Height No. of Lineal ft. Area
No. of pane lights of crack sq. ft.
EWidth
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
-
Ceiling
/37 KQ
Floor
1 otal Btu.
ft. E.D.R. or so. ins. W.A. Leader area
ase .:_ • .42
HEAT LOSS
CALCULATIONS
DEPARTMENT OF BUILDINGS
FRIDLEY, MINN.
Weatherstrips
A.S.H.V.E.
Guide
Reference
l9_
Coef.Btu
Construction No.
� 1340
Insulation
Windows
I Doors
Out. Wall Int. Wall Ceiling Roof Floor
Kind
How Applied
Yes—No
Yes—No
IJ
Floor
FI.[,L:' , JEV
Room I Length i . t:, Width
® Height X
II Fl.l Room I Length
Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of panne lights of crack sq. ft.
Coef.Btu
Infiltration
� 1340
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.I Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
rota! Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
171.1 Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
1 btal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. ofLineal ft. Area
No. of Dane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Inc. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Inc. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl.l Room I Length Width Height
Windows and Doors—Crackage and Ana
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader arra
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
PLUMBING FIXTURE RATES
Effective On January 1, 1997
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 /0-00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance 0•06
State Surcharge $ .50
JOBADDRESS AS0 ""�Oa�A° ltJ /�J 6jQ4a'/&/V o-V?Z
The undersigned hereby makes application for a permit forthe work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
, 1997
Owner f � 619 (0/MyE3))117 S' 7/ - Ln y q
Building Used As resl�4 rce
Estimated Cost n PERMIT NO. /YO
PLUMBING COMPANY AW eJ)
jj T
SIGNED BYU ';4 TEL N0.
Approved By ( Rough—In Date
MINIMUM FEE OR ANY PLUMBING/
TOTAL FEE $� XOR PLUS THE $.50 STATE SURCHARGE
Final Date? ! 7
NIT IS $20.00
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
SUBJECT
0ffMWTN_V---,_
City of Fridley
26099
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
• ______ COMMUNITY DEVELOPMENT DIV.
tr
r PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
' /"'1 CITY HALL FRIDLEY 55432
�"" 612-571-3450
910415
5/28/98
JOB ADDRESS 150 62 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6
1
Patasek's Addition
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP
PHONE
Ron Backstorm 150 62 Way NE
571-4849
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Midwest Restoration 1628 Hwy 10, Mpls.,
MN 55432
784-2772 5267
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
Reroof House & Garage (34 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the State Building
Code.
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
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
$2,835
$1.41
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-
$74.75
Fire SC $2.83
STRUCTION OR T PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
�^ �`
License SC $5.00
$83.99
R AUTHORIZEDAGEN7 IDATEI
WHEN PROPER ALIDATED THIS IS YOUR7PERMIT
VV a
BL G INSP
DATE_
SIGNATURE OF OWNER 0F OWNER BUILDERI MATEi
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Effective 1/1/98
Legal Description:
Owner Name & Address: Tel. #
Contractor: ,� /�! a;:&9777 MN LICENSE # �5�� 6 7
Address: Tel. #�--�7��
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
GARAGE AREA: Length Width Height.
DECK AREA: Len W' th Hgt/Ground
OTHER: D �3
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Sq. Ft.
Sq. Ft.
So. Ft.
QQ
Estimated Cost: $CU'
(Fee Schedule on Back)
Ft x $ = $
Tel.
TOTAL $� °
STIPULATIONS:
CITY USE ONLY
Permit Fee
r/
$ , / S
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ %
$.50/$1,000 Valuation
SAC Charge
$
$1000 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: