PRE 2010 DOCSJ
BUILDING PERMIT
Village of Fridley, Minn. No
Date 1�..-........................
Owner .....��l�i�? ................
2762
Builder...........................................
I
Address fJ3..4...�e*V Address .........................................
LOCATION OF BUILDING
No. . 669:�r ...... Street .103 . ............ Part of Lot .......................
Lot ....,l4 ' ....... Block ... ........... Addition or Sub -Division . � `°fin! ...........
Corner Lot ............ Inside Lot ............ Setback Ww.. Sideyard/.0. "�0/............... .
DESCRIPTION OF BUILDING
To be Used as:
� 1..... Front J.4.... Depth . ... IFeight ��AS'c .... Sq. Ft. s'�Si.. Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........
Type of Construction . P... Est CoA6. `2— !odd , =0"T • .... • .. To be Completed 'tel•
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 an in compliance with all provisions of
ordinances of the village of Fridley. ®A/
7... .•..• •••. ••••• .....•••...•..•
consideration of the payment of a fee of $.1 Vii. , 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, '1 'e n
.... Building Inspector
NOTICE:
This permit 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.
City of Fridley, Minn..
BUILDING PERMIT
Date: June U, 1965
Owner: Betty Johnson
1:; 977i
N° 7667
Builder Home Repair Service Co
Address 632 63rd Ave. N.E. Address 4471 Hyy 10 New Brighton
LOCATION OF BUILDING
No. x63 Street 63rd ave. N.E• Part of Lot
Lot 1�_ Block 9 Addition or Sub -Division Christie Add.
Corner Lot _ Inside Lot
Sewer Elevation
To be Used as:
Type of Construction
Setback Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. t.
Cu. F
Est. Cost _�rr''00 To be Completed
• Storm damage Repairs
•
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 sal provisions of
ordinano2s of the city of Fridley. �, r
In consideration of the payment of a fee of 10'- , permit is hereby granted to
Home Repair &c Service 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 regardinglocation, 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.
LUen Jensen
Building Inspector
NOTICE:
This pemb den net eewr tis eonstruedw, huteWon fur wkk& p1mbing, gn h n&& sewn w wdu. Be sun to no
tis Building Wspeeter for sepuete pwm is for these Neva.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY,. MINNESOTA
OWNER'S NAME 0 71- BUILDER A 6 M �e- r
� v
ADDRESS_ ,�� 3 ''`� f/�-� l�✓ ADDRESS '7
LOCATION OF BUILDING
No.. Street Part of Lot
LOT BLOCK I ADDITION OR SUBDIVISION
Corner Lot Inside LOT Setback
Sine -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front —Depth height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. F Cu. Ft.
Type of ConstructQ � vn-
Estimated Cost y�
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.
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: August 17, 1971
Owner: _ Jn✓ph_ R nh a Builder Same
Address —532 -__6.3x.4 -Avenue N -E Address Same
No. _ 632_— Street
LOCATION OF BUILDING
63rd Avenue N.E. parr of Lot
Lot ._.._..14.—_ Block Addition or Sub-Divisioi
Christie Addition
Corner Lot _...__..__.__.._ Inside Lot --X--- Setback — Sideyard
Sewer Elevation
Foundation Elevation __.._.
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24' Depth 24' Height 10' Sq_ FL 576' Ca. Ft. 5760'
Front ._ Depth Height Sq. FL Cu. Ft.
Type of Construction Frame Est. Cost __ 2___;__,52, To be Completed 2 months
Stipulation: Provide a hard surface drive.
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 a'lt provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $-1.0.,50 , permit is hereby granted to Joseph Rohe
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
rrdindone in, around and upon said building, or any part thereof, shall conform in aIl respects •to the ordinances Of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiAgB
an� city limits and this permit may be revoked at any time upon violation of any of the provisions of Said
NOTICE:
This. permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items, jl
�I
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: ��� O BUILDER:
ADOBE'SS: � � Co Al.[- ADDRESS:
NO:. � 3 2- STREET: (OlX.,-,k `1 \ . C
LOT : BLOCK: 17 ADDITION:- G 1OW /frI E
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
,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:
�1 Front: Depth: �2 4 Height:
Square Feet: r 4(z-
-,Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
roo
Type of Construction:2�n1E. Estimated Cost:
a .m
To'Be Completed: 2% ,M.eo'3TNS
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in attict 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: � l Ii 7 I SIGNATURE: JLCJ
(See Reverse Side TQr Additional Info tion.) 4`
a
/~)V
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
: ,rr_aee' S .ell & Duct Work
$12.00
$
Re=lacament of Furnace
7.00
$
Repairs o Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
MECHANICAL AIR:
Furnace She!! & Duct work to 100,000 BTL'
$12.00
$
each ad--. 50,000 BTU
4.00
7.00
$
$
Replacement of Furnace
Repairs & Alterations -up to $500.00
7.00
$
Re::.irs & Alterations each add. $500.00
4.00
$
STca.%: OR HOT WATER SYS LM:
Boiler S nes up to 100,000 BTU
$12.00
$
each ad.n. 53,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
each adan. 50,000 BTU
6.00
$
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 100,000 BTU to 199,999 BTU
$10.00
$ .0
(over 199,99: BTU. see Fee Schedule)
$
GAS FITTING FEES:
1st 3 Fixtures x
$ 3.00
$
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
AIR CONDITIONING
$ /0-00
FAN HEATING SYSTEMS See Fee Schedule
$
VENTILATING SYSTEEMS
$
ALTER.A.TIONS $ RE?AIRS �
$
_
State Surcharge
$ .50
TOTAL FEE
$g-11,_�Cb
ROUGH INSP.
Date
FINAL INSP.
Date
APPRCVAL FOR PERMIT �
REINSPECTION FEE
($10.00)
:•ftLINUZ4 FEE FOR ANY HEATING PERMIT IS $7.50
Job Address & 3 2- — (n Wd tw & 45 -
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. :% - 19-- '19-219
OWNER
KIND OF
USED AS 4
TO BE COMPLETED ABOUT Z' L
ESTIMATED COST Z
OLD - NEW BUILDING PERMIT NO. PERMIT NO. `
Z WIP,
, C'DING�a�t o��C
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. /
Trade Name C_/�/'/C�/V Size No.
Capacity Sq. Ft. EDR BTU �f2�HP
Total Connected Load S S Z C 3 Kind of Fuel - 'ds-!
BURNER - Trade Name (,,-) 1e %y? H Size No. $ (3 / y3
Capacity Sq. Ft. EDR BTU 100 0X>P
Company
Signed By efiz?/r� %
Tel. Ni. � `f � 1?6
tp.;+',�eSrat`,r9{Ftp `f'li'itaY fe9�€}v y�7,�hg t�4j)A'�tTlt"pi',iw�Ufn "`
f
app f�
�,' �' ' f et � fid:' crit � t f i '- tq � !�.•p�l ra 1 � �t' ya {�,x' it; , �i� t '7,� ' (
ae 1 i§-��r d j d F .� + f Y i Y �, ��� � ..if{ bs►;�" .ww, t
.meq /����y �p p �y rn
T ,USS VALC.tLtid'\t A(*S ... j a t,.. nEPARTMr,.N OJ." INlf1:4. d10N ® �, �hIW1017A 1)1 �.-1n V'�II���I
,ql k w "a,.'AE�,.
{ �r%A, ICrQiripa 'Cond1N6tioa 140.'. „ InOt7lFltie7ft r .,di.
i Guide&.....
;; Wimdowal ' Dwra Reference Chit. W.M4 lat. Wall Ceiling Roof Floor Kiad `' HOW Applat d
`0 es-- o 19—
boom Lxngth Width �' Height �'. , Fl.) bras Length Width � Htight
"' �lindawa and Doors—Cfacisage end Area' Windows and Doom--CPeebe andArea
tIdt Height
140. of vans of Dana
No. of
lights
Lineal f6
of crack
Aeon
ap. ft.
1�r t
�,
1
of Dnns
®v -
tr;,; •, ,� �r�•� ram i�
h
01y
s.18 0
�,
ro
Coef. Btu
1 i
Infiltration
,
;asp
Btu
lafiltrateoA
c)
Celaos
7h
a
Glace
!o
0 V 14.03
r^ a �
r
fxp. wall /
Fasp. wall
E ��`�
Net exp. wall
II:4
Vet exp. cash
Net a :p. "All
+1 P
Int. wall't'
2�
�--•...,--.
r '
Int -Brill
Int. mll
p
Net esp. an
�4
Ceiling
Fid_'
Gelling
Floor
4
a ��
0
r.r
! .
"
Floor
wall
r
..�
Ceiling
Total Btu.
'
Required sq. ft. E D.&d. or gq. iPia.li�✓A. Leader area '.
Y
'. ' -
width
Ha16ht
Ne. of Lls mitt.
,Arndt
1�r t
�,
No. of Dsna
of Dnns
Ilahts of crack
aq. Ct.
h
01y
�' ; 4 r
�,
1 i
,
;asp
Btu
lafiltrateoA
c)
Infiltration ,.
7h
a
Glace
� °��•
r^ a �
,q
�, r,� �7
Coe f. Btrs fy,�>tu
Fasp. wall
Infiltration'
E ��`�
Net exp. wall
II:4
Vet exp. cash
Glaas
+1 P
Int. wall't'
e
Eap. wall�7
Ceiling
Ceiling
Q
Int. mll
p
Net esp. an
�4
Ceiling
Fid_'
b1
Floor
Int.
'
"
wall
r
Ceiling
'
Floor
Total Btu.
t;
Required eq. ft. E.ME or sq. ins. VIA. Lzader area
; 7 Width ?< Height � a t.l R421tn I IJ.'n$il1 Width 4 i»t$ltt,
Vindows and boors--Crackage, and Area
{
,
width Ueight
' !a. of Dane or Dane
No. oS
Itghts
Lineal ft.
of Crack
Area
W ft.
A as
vq. ft.
1 i
,
Coaf.
Btu
lafiltrateoA
c)
Infiltration ,.
7h
a
Glace
� °��•
r^ a �
,q
�, r,� �7
Ercp. wall4 �' k,
Fasp. wall
E ��`�
Net exp. wall
II:4
Vet exp. cash
+1 P
Int. wall't'
r1Pt ev". wall
Ceiling
Ceiling
Q
Int. mll
Floor''
Floor
�4
Ceiling
Fid_'
b1
Windom and Doors,-Zrackatge'and Area
{
iVa
Width Haight' No. of Lineal tt.
ateana ofVtno )Ishtsofc:aeh
Area
sq. CL
X91 tl Hataht No. of
of Dane of Dane liiih Yo
•t.
04 Crarh
A as
vq. ft.
1 i
,
t �i,Iash
Infiltration ,.
i -
Glass
COA. Btu7777
Fasp. wall
E ��`�
II:4
Vet exp. cash
Jf Y,�l
k.I�
Int. wall
r1Pt ev". wall
Ceiling
Q
Int. mll
Floor''
t �l
�4
Ceiling
k
,.f
dotal Ftu. Total Btu. i'
R cl tied sq, P. C.D.n. or aq. ins. Y.A. Lead_r area d Requir,.Nd Gg, ft. E.D.R. or sq. ices. IA. d ec s7rr e cra _ _-
r Fl. Room ! Length Width 6 iciaht 11.0 Ros+rat l l enjti � Vid"h
{ Windows and Doors•—Crachage and Area
{Vlach He1Qht No. of Lineal it. Aran
Na of Dane of Dane lights of crack e0• IL
Coef. Etas
Infiltration
' Clij
aa6
t' Epp. wail
Net exp. wall t
t ry
s Y Int. well
a
Floor
Total Btu.
Windo%M lira• CTa4:l:a_ and AM&
and
`Unn_il
L' 0r�`
No.
X91 tl Hataht No. of
of Dane of Dane liiih Yo
•t.
04 Crarh
A as
vq. ft.
t �i,Iash
�----•
COA. Btu7777
In6lt-scion
E ��`�
Ere. rmU
r1Pt ev". wall
Int. mll
t �l
�4
Ceiling
k
Floor
Total Btu.
Required sq. ft. F_D.M or sq. inn. WA. PSC2er area Mquired etc. ft. E.D.Q. as txt. area, tlA. Boma r er�>a � d l',
e
0(,0
-
SUBJECT
PVWIFTN 0. a
City of Fridley?
5 2 3 6
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
' '
COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
r
CITY HALL FRIDLEY 55432
NUMBERDATE
771
PAGE OF
APPROVED BY
612-571-3450
910415
7/1/97
JOB ADDRESS 632 63 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
14
9
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Joseph Rohe 632 63 Avenue NE
571-7325
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 a
❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14' x 16' Three Season Porch With Windows
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARNi1
Before digging call for
all utility locations
SEPARATE PERMITS REQUIRED FOR
454.0002
WIRING, HEATING, PLUMBING AND SIGNS.
REQUIRED BY LAW
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 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
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
$5,846
$2.92
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-
$112.25
Fire SC $5.85
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL F
$12 2
SIGNATURE OF CONTRACTO OR AUTHORIZED AGENT IDATEI
N P OPE LIDATED T IS YOUR PERMIT
1 U • � �
t '7-.1 • ?�
BLDG INSP DATE
StNATURED OWNER SIF OWN ER BUILDERI IDATEI
NEW [ ) Effective 1/1/97
ADDN CITY OF FRIDLEY
ALTER [ ) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: Tel. # 6-7(- 73 a
Contractor: MN LICENSE #
Address: 6 3.)— L 3 %� Al E 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:
, 3
-4-p� / y
�—
Construction Type: ALI-4 Estimated Cost: $ G 6 o o. `��ck
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: `7 7 APPLICANT: 4:L4:�� �JLA-
Tel. # 57(- 7 3 ZS
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Z 2�
$ 1
$_ i2
$ / 0 2-
-2. S v
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$950 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 [ )
4.9
—po
Clti
ti
'ICATE OF
OF LOCATION- OF TVTI',f;I"IG SURVEY
cerWnily that. lmrtifv that
:i�-atjoii of the bu;*,.�'-ninIO
of hz�
-I - I U.; 'preperty desty-;�: that the abo,-i
-ci! nm� tbnt the o' sni d
:orr(-cc survey.
s-� ou tho--abov,�. pl, a
OF PROPERTY OF
L-CCATION----
',-)1 -7
DESCRIBED AS FOLLOWS
4.9
—po
Clti
ti
'ICATE OF
OF LOCATION- OF TVTI',f;I"IG SURVEY
cerWnily that. lmrtifv that
:i�-atjoii of the bu;*,.�'-ninIO
of hz�
-I - I U.; 'preperty desty-;�: that the abo,-i
-ci! nm� tbnt the o' sni d
:orr(-cc survey.
s-� ou tho--abov,�. pl, a
SUBJECT
PERMIT NO.
City of Fridley
28449
AT THE TOP OF THE TWINS
BUILDING PERMIT
r?
572-3 41
@�
RECEIPT NO.
`� ___--_ O ITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
73,—IR
r
OP
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
L 612-571-3450
9�0-F15
10/28/98
JOB ADDRESS
632 63rd Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
14
9
Christie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Joe Rohe
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Exterior Design Service 6391 Monroe St NE Fridley 55432 571-3220 3237
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Rk REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage 24 S Tear -off; Siding and trim (Storm damage)
8 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Call for building wrap inspection before covering.
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 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
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
2556
$1.28
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 PERFO M E OF CONSTRUCTION
$74.75
Fir SC $2.56
PLAN CHECK FEE
TOT F E
is LC1 5.
.59
GNATURE bFCO TRACTOR dh AUTHORIZED AGENT IDATEI
ENP OP AL A7 HI$ IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BWLDERI IDATEI
/9 2:2U MAD
IN nA E
NEW [ ]
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
a
ConstructionAddress: f)
Legal Description:
Owner I`
Contract,
Address:
Effective 1/1/98
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E%lPROVEMENT
ENSE #
Tel. # -,577/ -3 �
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: A / i77'-7�
A,,t4 f ',-7-, 1'� P -T / —
Construction Type: Estimated Cost: $
(Fee Schedule on Back) os�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
ds s"
DATE: APPLICANT:.6Tel. # Jr�
TOTAL $
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ .57 6P
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$ ��
$1000 per SAC Unit
License Surcharge
$ 45—
$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 DIViSION
-6431 University Ave NE Effective On January 1, 200
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
JOB ADDRESS I4.3 01 _ Gsdxco
`
36 SQ-rP�'1 �d h�
Residential Rate TOTAL OWNER
Furnace Shell and Duct Work, Burner - BUILDING USED AS W ¢. W l rl
Also Replacement Furnace $ 30.00 $,3&.
•—
(Side Vent - Fill Out Back) ESTIMATED COST J300 , O O PERMIT NO. 1-
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement) DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) arm r)
Gas Dryer $ 10.00
$ Trade Name 'Rv_v_O Size No. o 0
BTU HP EDR
*Air Conditioning - All Sizes $ 25.00 $ Fuel_ A CoAS Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. DR
1% of Value of Appliance or Work $ BTU HP E"s,.
Commercial/Industrial
1.25% of Value of Appliance or Work $ 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 at
State Surcharge $ 50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE $ 30.5 O River City Sheet Mehl,
9928 Bluebird St. N.0 ---9 ��
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING Cocoon Rapids, MN 55433
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 —7547-2199
PLUS THE $.50 STATE SURCHARGE Signed" TEL #
REINSPECTION FEE $47.00/Hr
Z*Air Conditioners can not be placed in a side yard without Approved B .` �, Rough -In Date Final Date
written permission from adjoining property owner.
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
_ U •
When replacing an existing 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 (.,f No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
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 Vy No( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturers 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
A
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 r% `BTU Inp Fan Assisted o N
Appliance #2 Type BTU Input Fan Assisted
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input 5
Common Vent Type Vent Height Diameterr/ inches
Appliance #1 Vent Connector Heightft Length ft Diameter in Type
Appliance #2 Vent Connector HeightAft Length ft Diameter min Type ,�
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING C(
Signed By: