PRE 2010 DOCS•
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City of Fridley, Minn.
BUILDING PERMIT
N® 6655
Builder -- -
Address
LWT
V I iy4 r DUILIA V
No. — Street .._ _ ...Part of Lot
Lot Block Additi T Sub-Divisio� . _
Corner Lot . _ Inside Lot Setback ,-I _ _ Sideyarrl
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
Tfill
Used �v
Front Depth i.G_� Height//— Sq. Ft. cu. Ft. V—&
Fro Depth Height ___._� ®5q. Ft. Cu. Ft.
Type of Construction –____ .1CoA/-4, To be Completed
In consideration of the issuance to me of a permit tocons the buil bed above, I
the proposed work in accordance with the description above se rth S% co� p with all
ordinances oP the city of Fridley. V
j( //
V—
A
i
In consideration of the payment of a fee of $ (,2(r — , perfnit is hereby granted
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 location, construction, alteration, maintenance,, repair and moving of buildings
within the city limits and permit maybe revoked at any tune upas viola f any of the provisions of said
ordinances. ra ®B Oi
NOTICE:
rats permit don not cover the construction, InstaMon for wiring, plumbing, gas heating, sewer or wafer. Be sure to we
the Building Inspector for separate permits for thus Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No. Street Part of Lot
Lot ' Block Addition or Subdivision r
Corner Lot __ Inside Lot2L Setback j _, Side -Yard L Q
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:
-�' Front,�V Depthl.6
Sq. Ft. Cu. Ft.
Front Depth height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
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 Ordinances and ruling of
the Department of Buildings, and hereby declares thaj all the facts and representations
stated in this application are true and correct. !2 ,a -
M
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Pitying -Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures .........
7 x $1.50
12
Future Fixture Opening ................
a
a
u°ri
New Fixture Old Opening ..............
w
?
•
•
WATER HTR.
3.25
$
2.00
Water Beater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
a
O
GAS FITTING FEES:
N
GAS
ELEG
x
$1.50
$ 1.50
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
1
1
l
Base
1st
1
l
I
l
l i os
1
2nd
_
3rd
4th
• Future Connection Openings
Connected with
I
Sewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures .........
7 x $1.50
$ 10.50
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
2.00
Water Beater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ...........................
x
$1.50
$ 1.50
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $--L4. 00,
Dept. of Bldgs. Phone SII 4-7470
T_w M4 -n 134 — 63rd W,
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.
Fridley, Minn August 9 19
Owner haul 8chw9jrtz Const. Co.
Kind of Building Frame
Used as Dwelling
To be completed about Dec. 19,63
Estimated Cost, $ 800.00
Old—New. Building Permit Nc Permit No.
SigneAT DARD PLUMBING APPUMCE CO.
-
Businds Phone No We 8'3589
ROUGH
FINAL
-QW42 2M 7-59
APPLICATION FOR HEATING OR POWER PLANT AND SPECIAL DEVICE PERMIT
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE
Furnace Shell & Duct Work ......................... 8.00
Replacement of Furnace ............................. 4.00
Repairs & Alterations—up to $500.00 ................. 4.00
Repairs & Alterations each add. $500.00 ............... 2.00
MECH. WARM AIR
DepL of Bldgs. Phone JU. 8-4614
TOTAL Locallo134 - 63rd Way N. E.
$ FRIDLB
$ Village ofX*XWJ605ffM:
The undersigned hereby makes application for a permit for the work herein
$ specified, agreeing to do all work in strict accordance with the Village 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.
Furnace Shell & Duct Work to 120,000 BTU 8.00
each add. 60,000 BTU ........................ 1.00 $
Replacement of Furnace ............................ 4.00 $
Repairs & Alterations—up to $500.00 ................. 4.00 $
Repairs & Alterations each add. $500.00 .............. 2.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.00 $
OIL BURNER --to 3 gal. per hour ........................ 4.00 $
over 3 gal. per hours—See Fee Schedule
GAS BURNER .......................................... 4.00 $ 5.00
GAS PIPING (Up to 5 Fixtures) .......................... 1.25 $ 1.50
AIR CONDITIONING =
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
TOTAL FEE 8 14.50
REMARKS:
Plan ALi On File'
•
Brooklyn Center, Minn_ 8-14-63 , 195_-._
Owner Paul Schwartz Construction Co. 195—
Kind of Building
Fr.
Used as !te s .
To be completed about 9-14-63
Estimated Cost, $ 400.00
Old—New. Building Permit No.
DESCRIPTION OF WORK
195—
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No
Trade Name Westinghouse Size No GUE-100
Capacity Sq. Ft. E.D.R. BTU 100y_ H. P.
Total Connected Load 45,631 Kind of Fuel Gas
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D R BTU H. P.
Siga�
By FRED OGTA�
_
1 1 3M-3-59 Business S6,114to 8' AIR CONDI71011Ina
6530 West Lake St. * WE. 9-6767
St. Louis Park, Minnesota
•
6&
Ci f Fridley, Minn. ` -0
City oY' 'zi-,207
BUILDING PERMIT N® 715 6
Date:N�y
Owner: ��� -�� Builder
Address Address
LOCATION OF UILDING
No. ` _ _ Street _�� Z Part of Lot
Lot __ Block Additir Sub- on .� •
Corner Lot , Inside Lot __ I-- Setback Sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
Tff a8:
r Front y{- + Depth Height Sq. Ft.;, /— Cu. Ft;_XZZV
Front Depth Height _ Sq. Ft. Cu. Ft
Type of Construction r Est Cor�� __ 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 set forth and in compliance with all provisions of
ordinances of the city of Fridley. i
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
Fress condition that the person to whom it is granted and his agents, employees and workmen, in all work
rld:l
Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
tho�.
Building Inspector
• NOTICE:
ibb permit don not cover the construction, hwhMon for WIFIM phnabing, ga hoods& sewer or water. Be sura to see
the Building Inspector for separaM permits for than itenm
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME BUILDER_QG�,-yam-
ADDRESS /. `�. •��%i ADDRESS .Ocyeyc�..
LOCATION OF BUILDING
No. Street. s Fart of Lot
Lot Block . Addition. or Subdivision
Corner Lot_Inside Lot_etback Side -Yard.. .
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach -to this form Two Certificates of Survey. of Lot -and proposed,build-
ing location drawn.on these.Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front % .. Depth a lJ Height
sq. Ft. Cu. Ft.-
Front Depth Height
Sq. Ft. Cu...Ft.
Type of Construction Estimated Cost
To be Completed
The undersigned hereby makes application fora permit for the vo.rk 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
representatious'stated in this application are true and correct.
(Schedule of Fee Costs can be found on the Reverse Side).
SUBJECT
City of Fridley
13530
AT THE TOP OF THE TWINS
PERMIT
i
BUILDING
RE T N0.
`
-------COMMUNITY DEVELOPMENT DIV.
-7
r PROTECTIVE INSPECTION SEC.
1 S �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
----� �'' 812-660-3450
910-F15
5/19/76
JOB ADDRESS 134 - 63rd Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
3
3
Eva Erickson River Manor
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
Lloyd Staedy 134 - 63rd Way N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
J & T Construction 14405 18th Avenue No. Plymouth
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
Cover trim and install new combination windows
9 CHANGE OF USE FROM TO
STIPULATIONS
StPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Alum.
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,
$1165
. S8
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-
$9. oo
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$9.58
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
` 1,'4W ' '^,5` toZ2.LDG
®L /t Y-YlR
INSP
/C.iV / -12
DATE
CIGNATURE OF OWNER IIF 9 NER BUIL RI j IDATEI
Ax x'1,1UAl 1UN FOR lZL51DENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDI.EY, MINNESOTA
OWNER'S NAME BUILDER: nJ I C
ADDRESS :1.3 9 A] � £ _ � � 3 W tiY ADDRESS: ) 9 y p C— / K O AOA) O
- - eLY'Mtu `-t+A1AW
NO:.
1�
!
STREET:
LOT:
J
BLOCK:_
ADDITION:
CORNET'. LOT: INSIDE LOT: ✓ SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates. r
DESCRIPTION OF BUILDING
To Be Used As:
V F -!Z I P -1(n Front:
Depth:
Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic feet:
Type of Construction: LUa'n Estimated Cost: $ //68
To Be Completed:
The undersigned hereby makes application for a permit for the work herein'
specified, agreeing to do all work in stxict 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 SIGNATURE
(See Reverse Side For Additional Information.)
City of Fridley
SUBJECT
PERM
® 14'74
AT THE TOP OF THE TWINS
BUILDING
PERM
s
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
L
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-680-3450
910-F15
6/8/78
/ /
JOB ADDRESS 134 - 63rd Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
3
Eva Erickson River Manor SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
Lloyd G. Staedy 134 - 63rd 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.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
x❑
8 DESCRIBE WORK
Construct a 8' x 20' garage addition, a 12' x 12' Deck, and fireplace
9 CHANGE OF USE FROM TO
STIPULATIONS Footing inspections required for each and every footing to be poured.
Approved of structural in garage conditional on
field inspection at
footing time.
W&RN'NG
SEPMATE PERMITS REQUIRED
Q FOR WIRING, Before dinfng an local.
HEATING, PLUMBING AND SIGIIIS,
u#�itie
TELEPHONE - ELECTRIC 'GAS Etc
REQUIRED BY LAS
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 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
160
1600
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,
$3,660
$2.83
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-
$23.00
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$25.83
SIG EOFC R TORORAUT ORIZED NT (DATE) _
HEN PROP RLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP
DATE
GNATU FOWNER 0F( UILDERI IRATE)
• CITY OF FRIDLEY .
• APPLICATION FOR RESH)EA-ITIAL BUILDING PERMITS
(NEW, ALTERATIO(JS, ADDITins, OR REPAIRS)
OWNER: L, L 6 rA;E n V BUILDER:
Address: /?j�^ � L`.•�, �� ynddre::s: /a 7 • /U� �. l 3AQ y
Tel. No.;
NO.:
Street:
LOT: M6CY.: ADDITION:
CORDER LOT: IIISIDE LOT: SETBACK: SIDEYARDS:
Applicant- attach 'to this form 1Vo Certificates of Survey of Lot and proposed
building location drwein on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Gri• Front: -a--- Depth: — v ( - Height: Z _
,,,,Square Feet: ® Cubic Feet: 16 oo
Front: Depth: Height:
77111 F /1L4Ct—o' Square Feet: Cubic Feet:
Type of Construction: A Estimated Cost: G Q,
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 cork 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 fo cidditional information. /,�"d
Aa y
DATE: SIGNINM 13%
- a
%.
e
Ica
r r J
�. el o
6G
L 5'
1 ;�_ , g3
01
SUBJECT
PERMIT
City of Fridley
17 6 0 3
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
CEIPT NO.
�
COMMUNITY DEVELOPMENT DIV.
<: -
5
r PROTECTIVE INSPECTION SEC.
/
I CITY HALL FRIDLEY 55432
I.J
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/10/84
JOB ADDRESS 134 - 63rd Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
3
3
Eva Erickson River Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Lloyd G. Staedy 134 - 63rd Way N.E. 571-2870
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sme
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 Dwelling
9 CHANGE OF USE FROM TO
'STIPULATIONS
Roof can be 2nd layer but not 3rd. Utnift,xg install ridged
galvanized valleys where necessary.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Fiberglass
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
900
$.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.
$16.00
PLAN CHECK FEE
TOTAL FEE
$16.50
EI
I RE OFC TR�TOR 7 RIZEDAC N7 IDXgT_�
ro<
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
a
BLDG INSP f1AT
SIGN O OW NEA IIF OWNERS ILDERI MATE)
01
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: -3 g --p W /� y
Legal Description 3 — Lem �, PlUE)e AAid
Owner Name & Address: L L 6 -S 71 AL0 Tel. #77/-A?14
Contractor:
S /! DSI Tel. # L(
Address:
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:
F- -/yy F /T/d U S'1�7
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: F/ /3 g dr -),ifs - Estimated Cost: $
Approx. Completion Date: Z M b A -Z14
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
40 57
DATE: � b 7 APPLICANT • Tel. #
TY USE ONLY
Permit Fee $-U O Fee Schedule on Reverse Side
Plan Check $ 25$ of Building Permit Fee
State Surcharge $ �Z) $.50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ A S7)
STIPULATIONS•
CITY OF FRIDLEY
Effective Date May 1. 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL RATE TOTAL
Job Address 134 63rd Way NW
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $ 20.00 $ 20.00
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping $ '10.00 $
Tei. #571-3450
(piping needed with new furnace)
Gas Range $ 10.00 $
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
Gas Dryer $ 10.00 $
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
• Air Conditioning (all sizes) $ 10.00 $ 10.00
Fridley, Minn. APRIL 18 1989
All-Others/Repairs and Alterations
OWNER Lloyd Staedy
18 of Value of Appliance or Work $
Frame
KIND OF BUILDING
COMMERCIAL/INDUSTRIAL
USED AS Residential
1% of Value of Appliance or Work $
TO BE COMPLETED ABOUT
$5100.00
ESTIMATED COST
State Surcharge $ .50
30.50
OLD -NEW BUILDING PERMIT NO. PERMIT NO.
TOTAL PEE $
Reinspection Fee ($15.00) $
c 4- y�i/o 6 -<D q -f lF -rnV /tic r DESCRIPTION OF FURNACE/BURNER
Rough Insp, *installing one (1) Carrier
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. one
Date 58SXBO80CC furnace, one (1)
Final Insp. -�[ Carrier 38TKO24 2 ton air
Trade Name Carrier Size No. 58SX380('('
Date conditioner, one Carrier.
Capacity Sq. Ft. EDR BTU 88,000 HP
49BG humidifier and one (1)
Approval for Permit
Electronic Air Cleaner
nat. a
Total Connected Load Kind of Fuel g s
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
MINIMUM FEE FOR ANY HEATING PERMIT IS $15-00-
Company Dependable Heating and A/C
PLUS $.50 STATE SURCHARGE
�y n
Signed By��i�%A i� {� r Q- 1.�1�/- /�
Tel. No. 757-5040
*Air Conditioners can not be placed in side yard without
written permission frau adjoining neighbor.
Fill out back side for stack verification on replacement furnaces
CHIM14EY 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
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No ( )
6.
Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed By
Date
SUBJECT NO.
City of Fridley 29493
AT THE TOP OF THE TWINS BUILDING PERMIT
� iPT NO.
COMMUNITY DEVELOPMENT DIV.
f - ______PROTECTIVE INSPECTION SEC. cR of i ,2
I I � -!
i ---.� "'�•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By
L 612-571-3450 910415 15/18/99 / /
JOB ADDRESS 134 63rd Way NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 3 Eva Erickson River Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Lloyd Staedy 571-2870
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Right -Way Roofing 1200 E 79th St Bloomington MN 55425 612-853-0049 3999
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 )0( REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (25 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 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 $2142 $1.07
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 -
TIO Fire SlIIi $2.14
T TIO R THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE TOTAL FEE
Cn License SC $5.00 A 1$91.46
IF SIGNATURE OF CONTRACTOR ORA THORIZEO AGENT IDATEI WHEN PROPERL3!�YA LIDA TED THIS IS YOUR PERMIT
& -
S-GNATUREOFOWNER,1cOWNER BWLDERI I -DATE' Ir - BCDOr IN$P OAiE
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
i -Z ConstructionAddress: \�� W \Q➢
Legal Description:
Owner Name & Address:
Contractor:
Address:
��• �. �� � �� . " ter •
LIVING AREA:
Length
GARAGE AREA:
Length
DECK AREA:
Length
OTHER: .
�Ssy
Effective 1/1/98
Tel. #
MN LICENSE #
Tel. #
;ate of Survey of the
drawn on it to scale.
IlVIPROVEMENT
Width
Height
Width
Height
g Width
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
U
Construction Type: b� QC Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: \ APPLICANT: \ �'�XX Tel. #b��� W'� 1
TOTAL
STIPULATIONS:
$ ry
CITY USE ONLY
Permit Fee
$ cDFee Schedule on Reverse Side
Fire Surcharge
$ _ l
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ U Q
$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:
$ ry