PRE 2010 DOCSVillage of Fridley, Minn..
BUMMING PEW=
9'53
Office of INSPECTOR OF BUILDINGS
Fridley, Minn.
LOCATION OF BUILDING
YA
No. L7L Street---L,;� Part of
Lot Block /(9 Addition or Sub -Division
DESCRIPTION OF BUILDING
Front —"�L— Depth---.; Height— Stories —12'- --Manner of Construction
To be used To be completed f Estimated Cost
7,9
Permit is hereby granted to
the building----- _,.: described In the above statement. This permit is grm
upon the express condition that the person to whom It Is granted, and his agents, employees and workmen,
k, it
the work in,around and upon said building, or any part thereof, shall conform in all respects to the c
nances of Fridleyr Minn., regarding the construction, alteration, maintenance, repair and moving of build
within the city limits, and this permit may be revoked at any time upon violation of any of the provisions of
ordinances.
-"Snspqctor of Bull
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridle
the above permit, I hereby agree to do the proposed work in accordance with the descript
above set forth and according to the provisions of the ordinances of Fridley, and, being first d
sworn, I hereby state and say that the facts stated by me and contained in the above permit
true as therein! stated.
1:
Subscribed and sworn to before me at Fridley,
day of —A.D. 19-L—
BUILDING PERMIT
Village of Fridley, Minn. N? 2504
-
Date7 ...................... .
Owner ... ......
Address ... .. ................
Builder ... .......................
Address.........................................
LOCATION OF BUILDING
No. ...:� .... Streets ..>% ..'...."............... Part of Lot .......................
Lot .... ....... . Block ................ Addition or Sub -Division .......................................
Corner Lot .... ..... Inside Lot ............ Setback ............ Sideyard .......
m
DESCRIPTION OF BUILDING
To he Uedas•
i;."(-ont Depth..+�i .... Height ......... Sq. Ft... !�11. Cu. Ft. ........
Front ........ Depth ........ Height ......... Sq. Ft. ........
,/� Cu. Ft........ .
Type of Construct o `b��.... Est. Coft of -19410! . � G.
........ To be Completed -fwa , ow ...
4,04
_44:_ P
In consideratiPn of the issuance to me of a permit to construct the building described above, I agree to do
the proposed word in accordance with the description above set forth and in compliance with all provisions of
ordinances of the in
of Fridley.
consi r of the payment of a fee of $.: , . ~'. , permit is hereby granted to °1 .........
..... ... ... 1 . to construct the building or addition as described above. This permit is granted upon
the express conditiion 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, Minneso regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village lima and this permit may be revoked at any time Upon olatio any, of the provisions of said
ordinances. G X. -P A R
"W -Building Inspector
NOTICE: ,
This permi� does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water Be sure to see the Building Inspector for separate permits for these items.
40 0
Origin
PERMIT for Power lants and Heating, Cool-
ing, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be installed--altered—repaired
Make 7d ;
Oil fired ; Coal
Approved
Final Inspection
; Gas fired-? ; Gas Authorization No.
19_
Inspector
Permit N ° _ 4567
Fee $--13.
D -o
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. X0. 191
Owner 'o - �/
Location &2220--," d
Kind of Building
How Occupied - 1
Work to be Commenced /�O� ,�� ,19�
To be Completed 0 ,19-�4
Estimated Cost, $ jo-v . °''o
Old -New, Building Permit No.
Permission is hereby granted to to install—erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named and the specifications set for in the approved application for this
permit on file in the office j'ice o f the Inspector of Buildings. -
�' Inspector of Buildings
42 2M11 -VV
City of Fridley
SUBJECT
PERMIT
1348
AT THE TOP OF THE TWINS
PERM
BUILDING
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
I CITY HALL FRIDLEY 55432
NUMBER
REV-
DATE
PAGE OF
APPROVED BY
%.J 812-580-3450
910-F15
4/30/76
JOB ADDRESS 40 - 6212 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5, 6
18
Fridley Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Raymond K. Humann 40 - 62111 Way 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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 241 x 18' Addition to Dwellin
9 CHANGE OF USE FROM TO
STIPULATIONS Submit design for ffm= to City prior to installation.
SEPERATE PERMITS REQUIRED FOR WIRING
HEATING, PLUMBING AND SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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 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.
$6,300
3.15
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-
$24.30
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$27.45
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROP RLY VALIDATED THIS IS YOUR PERMIT
'0
SL
2 /'�'o v
BLDG INSP OATS'
T'SI TURE OF OWNE IIF OWN
ER BUILDER) (DATE)
OR ADDITION -BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
• OWNER'S NAME % 4f o4 /1� BUILDER •
• , '
ADDRESS: Y -Q G a ✓ W-4 1 ADDRESS: .
NO • .0 STREET: to
IAT: BLOCK: ' .ADDITION•
� G �
CORNER LOT: INSIDE LOT:- 'SETBACK: - SIDEYARD :
Applicant attach to this fork Two Certificates. �f Surve .of Lot and.proposed °
building location diuwn on these Certificates. '
•DESCRIPTION*OF BUILDING
To Be Used As: '
- —Front : Depth: •!� Height:-
Square Feet: Cubic . Feet
Front:' Depth: Height:
Square Feet; Cubic Feet:
ype of Construction: Estimated Cost:
• To: Be Completed:/ - – ,7'. • , • • .
,w a 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: 1Y S• - % SIGNATURE:
(See reverse Side For Additional Information.)' �'A
7'0
•<�/i; ��lA%� IT144�q`TI�II�,
• ' e ✓ .
. ' . i�= 939 _ - •.
J1
10 a,
��
Page 1 oz 4
• EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
DATE r1 tg • _ _
OWNER: �r
SITE ADDRESS: - - '.f' • r PHONE:
CONTRACTOR:
7
l� Determine working square footage of each _
1. Total exposed wall area...... sq. ft. x .17 _
2. Toal roof/ceiling area ...... `:J sq. ft. x .05 -
Total exposed wall area above floor =
a. Total wall window area ................................. vt.
b. Total door ..area .......................................
c. Total sliding glass door area
d. Total fireplace wall area
e. Total wall framing area (average 100)........... I
f. Total rim joist area .................................. -
g, wall area above floor ..........................
h. wall area above floor ..........................�
i, wall area above floor ..........................
j, wall area above floor ..................
Total exposed foundation area =
k. Total foundation window area ...........................
1. Total net foundation area above grade .................
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section)
a. S _ X plus
b. X fluff
C.
X "U"
d. X
e. r fe X
X
9- X
sluff =
"U" ®� _
lout a _
louts e 6
h. X plus c
i.. X
J. - X
k. _ X
plus a
sus c
lout a
1 X out =
Total INS 4
16
If item #3 is the same as,
or -less than item Ole ,you
have met the intent of
SBC 6006 (c) 2•
Wterior Envelope Average "U" Computation
Total exposed roof/ceiling area =
m. Total skylight area ............................
n. Total roof/ceiling framing area (average 10%)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
M. X "U"
n. X nun =
o. X "U" _
Page 2of4
4 ........................... Total =
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006 .(c) 1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum o£
items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. + 2. _
3. + 4. _
WALL SECTIONS '
NOTE. Use 10% of opaque wall area for
frame construction
FSG. #03
M x a t
t.
Page 3 of 4
Construction
R -Value
I.
Interior air film
0.68
00
0
3.
3 .
3 �,� , GAJ C3 --N
_ o
4.
• 5 •_fro
6.
F 01�
6.
ExterSor air f ilm
0.17
i
Total
1.
Interior air film
0.68
2.
4-
.5
s
5.
6.
Exterior air film
0,17
Total
1,
Interior air film
0.66
2.
J,, -t, /
00
0
3.
4.
6.
Exterior air film
0.17
Total
1A- ,0(2-;
1. Interior air film 0.68
2.
3.
4. _
6.—JRXterior air film 0.17
Total
--� /it
V • •
FIG. 09
let d
fit Y,
NOTE.: Indicate type, "R" 'Value, depth and
ROOF/CEILING
Vented
FIG. Ir
x5
Il�tl�_
Heat f 1'0W
up
Heat flog up ;-vented
Page 4 of 4
Constniction R -Value
1. Interior air film 0.61
>r
2.
3.
4. Exterior air film (still) 0.61
Total
1. Interior air film 0.61
2. c r _ a •��
3. ,?� rP >e_ `�_::.�_� /:s._'/. a✓ ate.
4. Exterior air film (still) 0.61
Total
1. Inside air film 0.61
J 1 i
2. G. z
r 3.4. Ire
_ ��-
��
�nsy,t'1r'l
- • 5. Outside air film Total 0.17
f �' �::--:. : i-_ , ; . ''= :-� i ��-.�Yi'�+ • I
flow my .. • '
rrr,. hq '
Note: Use additional sheets if more space is
needed for details and calculations
Ag�@ .. .+.rte^'•gym -,! fi MR, .-c�-�.� C� fir, .� er��'�+� rt.n: Q� Rer•r.��grn•.g
g rtJ- C6 v9? 4a'6 aerts a* t� r•....o t8 Ca:i:':8 ewa.4Gv+'� ✓4a3►[ �p II�aitoG:kw BCW � Y°�. J:l vitl:ra66tDWf
btiGS' Qc.—ew OeV'Z:iCt9 mrsdeoa6'J m..n.:9 6`m t�tvl=
PARTIAL RATE SCHEDULE
GRAVITif WARM ASR: R'r%4LE TOTAL
F.astce Shell & Duct Work 310.00 $
Replacement of F urnare 6.00 $
P.cpat-s & Alterations- up to $500.00 600 $
Repairs '..t Alterations each add. 5500.00 3W $
NZQi WARM AIR
'Fernee Shell & Duct Work to 130,000 BTU ..$1000 $
nch add. 60,000 BTT
R.eDIacement of Furnace 6.00 $
Repairs & Alterations --up to $500.00 6.00 $...
R_eepairs & Alterations each add. SSM.00 3.00 $
STEAM or HOT WATER SYSTEM
F.Jrrace Shell & lanes— to 400 sq. ti TDR Steam sio.w • 3
Furnace SheU & Line --to 640 sq It. EDR Hot Water I000 S.
Each add 200 sq. fl EDR Steam 3M $
Each add. 320 sq. ft EDR Hot Seater 3.00 $
OIL BUF?A=-to 3 gal. per hour 6.00 S.
over 3 gal. per hour -See ree Schedule
GAS. BURNER (up to 1_9.000 BTU) 5.00 $
over I89.000 BTU See Fee >£ckmdule
GAS FITTING FTFZ: NO RATE TOTAL
1st 3 fixtures z$ 200 5
Additional Fixtures _ x .73 -
Gas Range to M.000 xS 5.OD $
AIX • COXZiTIOXI%Gt
FAN f=A1.72no STSTZ3
7E38T=TI,ZG STSAZU
RLTa't'_&TiCi+3 & FZPA:IS
State Surcharge .50
Ir -04 Fee SCbPfa.1s
TOTAL 7=1
bopt. of Bl sm Piton WO-US3
r
City of Fridley:
The undersigned hereby makes application for a permit for the work herds
specified agrrving to de all work in strict accordance with the City Ord:aamcev
and ruling of the Depat trnrnt of Buildings, and hereby declares that alt the f&cts
and nvpr,sentatiuns Stated in this appLcation are true and correct.
Fridley. Minn �1!
Owner/Z-4 rOh'rP Ar-' 1_V e �a A__V,
Kind of Building
Used as
To he completed about S.a r 5;>6 _
Estimated Cosmo $ 1 ZS_1
Old -New. Building Permit No. - - permit No.'�%—
rzwnlmon or w0ax
HEATING or POWER PIL ANTtr--Steers, Hot Water, Warne Air -No
Trade Name _r_ _ Size No
Capacity—_-- — Sq. rt. £.D.R BTU—
Total
TU Total Connected Lcad. Bind of iUel
BURNER - Tirade Name Size Irlo
carsacity Sq. F!. E.D R IiZU LF_
a
WMAaxS-otaa)
SUBJECT
ISERMIT NO.
City of Fridley
WRECKING
a - 6 94 6
AT THE TOP OF THE TWINS
} E R M I T
.P
r
CEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
t: ------
r � PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/17/83
JOB ADDRESS 40 - 62!1 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5,6
18
Fridley Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ray Humann 40 - 621 Way N.E. 574-0912
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
Garage
7 CLASS OF WORK
_
❑ NEW ❑ ADDITION El ALTERATION ❑ REPAIR ❑ MOVE ❑X REMOVE
8 DESCRIBE WORK
Wreck a 16..3' x 28.2' Garage
9 CHANGE OF USE FROM TO
STJfULATIONS
Lot must be cleaned of all debris.
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
SQ. 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
$
$none
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$15.00
PLAN CHECK FEE
TOTALFEE
$15.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DA
ATURE OF OWNER OF OWNER BUILDERI (DATE)
Effective Aug. 1, 1981
City of Fridley
�.T
Permit No.
AT TME TOP Of THE TVW$
L
WRECKING PERMIT APPLICATION
Receipt No.
-------- COMMUNITY DML~NT aw.
t
i PROTECTIVE pVECTo% WT
CRT MALL MOLE. 994E
t�
M
v.
PATE
ME
A" R OVIND Tf
L..w.i\iI -ifO-NMO
N1M
r
-.,,,,7.
r
Ann
Job r►ddres s z y � /V1
Legal
Lot No.
Block No.
Tract or Addition
Desc.
6-�L t,
l8-
f �-�`d
.1
Property Owner Addresfi Phone
Contractor Address Phone
Description
Front
Deth
� 1
Height
Sq. Ft.
Cu. Ft.
of Bldg.
16, 3
f�, 2
`®
No. of Dwelling Units
Taxes Paid TTax
Receipt No.
Estimated Cost of Wrecking
To Be Completed
6Al�
r.x Za
Utilities to be Notified and date Services Disconnected
Npis. Gas Co. N.S.P. Northwestern Bell Tel. Co.
Engr. Dept. Cust. Bus. Ofc. Bus. Ofc.
372-4850 330-5540 332-4112
Date Date Date
Wrecking Fees: $1.25 for each 1000 cubic feet or fraction
For structures which would be impractical to cube, the fee
shall be based on the total cost of wrecking such structure
at the rate of $6.00 for each $500.00 or fraction.
NINIIrIM FEE: $15.00 No State surcharge on Wrecking Permits.
Approved By Water & Sewer Department:
All Bills Are Paid Services Are Disconnected
The undersigned hereby makes application for a permit to wreck the building
described above, agreeing to do all work in strict accordance with the City
Ordinances and rulings of the Department of Buildings, and hereby declares that
all facts and representations stated in this application are true and correct.
Cont actor
co Date
SUBJECT
PE
City of Fridley
a 16 9 74
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
%EQE
L'_ _ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
p
]vl
r PROTECTIVE
CITY HALL FRIDLEY 55432
,j
NUMBER
REV.
DATE
PA GE OF
APPROVED BY
612-571-3450
910-F1514/11/83
JOB ADDRESS 40 62 1/2 Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5 & 6
18
Fri dl ey Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Raymond K. Humann 40 62 1/2 Way N.E. 574-0912
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
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
�J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construction new 24' x 24' detached garage
9 CHANGE OF USE FROM TO
STIPULATIONS
1. garage cannot be attached to house unless frost footings are
provided.
2. Provide a hard surface driveway.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
wood frame
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
576
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
69150 3.08
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.
PLAN CHECK FEE TOTAL FFg 58
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) ''
WHEN OPERL A T IS IS YOUR P R IT
q-1
A.
SI NATURED OWNER IIF OWNER BUILDER) IDATEI
BLDG )NSP DATE
Effective Aug. 1, 1981
CITY Of FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDVIG PERMITS
1 (New, Alterations, Additions, or Repairs)
OMER: BUILDER: ® ��
ADDRESS: , 114 - e, ' PV x �� '� ADDRESS: .
TEL 110: I' `� �"' ,i' TEL NO:
Construction Location
STR= NO: O STREET: (e e2-
IAT: (Q HLOCiC s g -- 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.
DESCRIPTIOR OF CONSTRUCTION
_ �0 Front: _ . e - L/ <` Depth: �- Height: ` -S 7_ S^ __
Square Feet: �O Qibic Feet: �
Front: Depth: Height:
Square Feet: Cubic Feet:
Zype of Construction: Estimated Cost: S '_
'lb Be tbripleted: /, f _e,?
Alt. A Alt. H
Proposed Driveway Width If New Opening Is Desired:
SEE MENER;E SIDE. OF SHEET
Mie undersigned hereby makes application for a permit for the viork herein specified,
agreeing to do ,all work ir, strict accordance with the City of Fridley Ordinances and
rulings of the Delk-ixtmcnt of Duildings, and hereby declares that all t1e facts and
representations stated in this application are true and correct.
U,%TE: ;Y—/l �.3 SICNATUIE:
Stipulations:
GDJAII�
ITY 3 08
CoArL" e 0 4►NN a Q' ► �Xed
��-rTrau 'f a J-Joua4 UAJ OW
FnoS, �
Lona Surveying
6275 Highway No. 63 OLE.
Sells Testing rlt�fltPP«1rl� •Aa a Minn
ea
Engineering S3S4 2
342
Man.
Municipal Engineering Telephone 724-6066
Engineers & Surveyors Area Code 612
Mortgage Loan Survey !or R&MON"/ WUMANN
G1 III Way
-80.00-
A
A:
IC'
0V
FRAME -�
r AIME N tv
B 8!
15 Is ' 1
I t 4
\ e
P
Z4 4
i CTORY
FRAMs
40
3
12' ALLEy
Note:
The lines o{ occupation were used to make Ehls location
surrc .
Ouc a the lack oimonumenfatlons in Ihis block and also
because Orlhe bio deserwaney In the monumenfat,' n
in Ow blocks to the north and sou;h)
9%P f
GC01e:1+69�=304ed
April ,1976
• LoTs 5 F Block 18
Y
FRIOLEPAww
ANOVA COUNn
This is a true and correct representation o/ a survey of the boundaries o/ the land above described and of the
location Of all buildings, i/ any, thereon, and all visible encroachments, i/ any, from or en said loud. This survey is
nude only in connection with a mortgage loan new being placed on the property and no liability is assumed
esticapt fe the holder o/ such mortgage o► any other interest acquired by the reason o/ such mortgage. It is
understood and agreed n� enumeats hove been placed for the purpose o/ establishing lot lines h boundary
corners. Dated this 11-r. e i . A. D. /9 fi
SUBURBAN ENGINEERING, INC.
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NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: Tel. # e�
Contractor:
/�/n 6ev MN LICENSE
Address:c/C Tel. # �P
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.
i
GARAGE AREA: Length �Zq Width ZZ— Height ;9 Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
rpl��
Construction Type: Estimated Cost: $j 07
r�L,CJU
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:17/z//as—APPLICANT: Tel. # 6/Z Z F
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$
$ CD
$
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1450 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley, MN 55432
763-572-3604 FAX 763-571-1287
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance or Work
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater
boos - 0101q
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
Fee Total ,
$35.00 $
$10.00 $
$10.00 $
Owner
Building Used As
ESTIMATED COST /Vt� '&I) PERMIT NO
DESCRIPTION OF FURNACE AND BURNER
$10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
$25.00 $ BTU HP EDR
Fuel Total Connected Load
Commercial/Industrial/Institutional
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 for Commercial/Industrial/Institutional
State Surcharge
TOTAL FEE
REINSPECTION FEE $50.00/HOUR
$ 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
$ and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
$ HEATING CO ��� �z�/J' Z
$ /5, Si.
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
,ell Tel #l` /✓/��/%�
FAX # /'J���� u�� �/ Date
�7h, cS�Li/�✓
Approved by
f&J? L4WIV'411 lfi' Ltv%,J`h/
Rough -in Date Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, 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 () No( )
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 combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, 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 () No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
City of Fridley
6431 University Ave NE
Fridley MN 55432
(763) 572-3602 or Fax (763) 502-4977
---- _ -Water- and Sewer Permit Application
New Connection
Existing
Date: & -Z2--,5?6
DUtility Line Repair/Relocation
OWater and Sewer Connection
Job Address: //®- 21Z w /-q.
Name of Applicant (Plumber): % , CV. Amo%IRS
Name of Property Owner: 7Z h
Existing Structure Permit #
Permit Type: Sewer Fee: V40_00
Water Fee:
Meter Fee:
Repair Fee: w—
Relocation:
State Surcharge: - 5,0
SAC Charge:
Special Assessment Fee:
Applicant
Inspector
Total: $ 40.00
Water Meter Repair – Weekend & Holidays
$125/hour
Water Connections Permit
$50
Sewer Connections Permit
$50
Inspection Fee for Water/Sewer Line Repair
$40
Special Assessments
See Engineering
Cost of Water Meter
See Utility Billing
SAC Charge
$1550
State Surcharge
$ .50
Water Tap
See Engineering
04/04/05
Building BUILDING
�
Permit No.:%111
Inspections RESIDENTIAL APPLICATION
Received B
763-572-3604 CITY OF FRIDLEY
Date Rec'd-�
763-502-4977 FAX
$
EFFECTIVE 8-19-09
Fire Surcharge
DATE i 06/
YOURE-MAILAD R 0 ( taCh
PM (aS �'1$
,S
SITE ADDRESS q0 K� �j`
6;4,.
$ , j
THIS APPLICANT IS: OWNER ❑CONTRACTOR'
License Surcharge
PROPERTY OWNER/
NAME: �CG(�
SAC Charge
TENANT
ADDRESS: ^
STATE ZIP? ,4L�g
$
PHONE: 70 —_y�2)
` M
_
CONTRACTOR
NAME:
Park Fee
SUBMIT A COPY OF
Fee Determined by Engineering
Sewer Main Charge
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
Total Due
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
9,f SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH KROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT t0
ROOFING/ ❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT•
NUMBER OF SQUARES lY / (Q ❑ HOUSE & GARAGE
1.
Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS, & PORCHES SUBMIT:
❑ Aluminum ❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
and proposed
2.
Two eo f construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
FOR WINDOWS – PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL rJIM5 AKE BANED ON vALUAnON, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
OCCUPANCY TYPE
Permit Fee
$ ,
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$ , j
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridlev Attach Stiaulations
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 on site; that the work will be in accordance with the
approved plan in the case of all work which ires review and approval of pl��( p���QSIGNATURE OF APPLICA PRINT NAME ( � ATE 1 /vJ