PRE 2010 DOCSVillage of Fridley, Minn.
BUILDING PERMIT
•
-,I®A 4
�o
Date: ................................
Owner %../.. Builder .... ......
Address...... .... Address ..... .......
`� ezltrON OF BUILDINGrNo. G. "...... Street �`�...�.!�...................... Part of Lot . 1✓�. A� //............ .
Lot .... /........ Block ...................Addition or Sub -Division .......... ... .........
Corner Lot ........... Inside Lot ........... Setback ........... Sideyard.............. ..
DESCRIPTION OF BUILDING
To be tis das:
amu, Front J ..... Depth ! .... Height Sq. Ft./PO Cu. Ft. ........
..................... Front ........ Depth .. Height . Sq. Ft. ........ Cu. Ft. ........
Type of Construction �Q !�..... Est. st ..�.� �........ 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 village of Fridley. J
6
In consideration of the payment of a fee of $. 1/ ......, 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 violatio f any of the provisions of said
ordinances.
....... .. � ding 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: RM July 28, 1967
owner: Duane E. Haason Builder dame
Address _365 66th Ave. N. E. Address Same
No. 365_ Street
Lot --1-0--- Block
LOCATION OF BUILDING
66th Ave. N. E. part of Lot
Corner Lot --- Inside Lot
Sewer Elevation
5
N9 9378
Addition or Sub -Division Rive Creek Terrace
— Setback —_ Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Breezeway Front 12t Depth ._._..101 Height 101 Sq. Ft. Ca. Ft
Front Depth Height Sq. Ft. _ _ Cu. Ft.
Type of Construction _Frame Est. Cost ,^_._500.00 __ To be Completed NRV: 1. 1967
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 afl provisions of
ordinances of the city of Fridley. Al ,
In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to Duane
Hanson to construct the building or addition as described above. This permit is granted upon
the express condition that thele to whom it is granted and his agents, employees and workmen, in eII work.
done in, around and upon said building, or any part thereof, shall conform in allrespects 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 asdd
ordinance.
CLARENCE BELISLE Building motor
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas hosting, sower or water. Be aro to ago
the Building I gmftr for separate permits for these innuw
I.... IN
AMLI.".�'G:i 3jIIi,D.,,r..G
Ci sY OF. i :i+_O:�ti i, MINNESOTA
OWNER'S NAI -19 BU'',1-DER
` 1p e
ADDRESS �6 5 6
LOCATION OF BUILDING
170. STREET � -- _ - PART OF LOT
LOT L.' BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SET -BACK SIDE -YARD
SMMM ELEVATION FOUMATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To fie Used M: ,--
Front ! Depth Height ` D
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construct'io A P-701 �� 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 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 J_/ SIGNATURE `
(Schede a of ee Costs can be found on the Reverse Side}.* '
i
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. ``Phone 560.3480
6
GRAVITY WARM AIR: RATE TOTAL Locatlo 2 5:� " 6 C s �-
Furnace Shell & Duct Work ........................... $10.00
Replacement of Furnace ............................. 6.00
Repairs & Alterations—up to $500.00 .................. 6.00
Repairs & Alterations each add. $500.00 ............... 3.00
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00
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 ...................... 3.00
Each add. 320 sq. ft. EDR Hot Water .................. 3.00
OIL BURNER—to 3 gal. per hour
........................ 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) .......................
5.00
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:
NO RATE TOTAL
1st 3 Fixtures ......................
x$ 2.00
$
Additional Fixtures .................
x .75
$
Gas Range to 199,000 ...........
x$ 5.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee
Schedule
VENTILATING SYSTEM
It
ALTERATIONS & REPAIRS
TOTAL FEE
$�
ROUGH
FINAL A0 IV-
City of Fridley:
The undersigned hereby makes application for a permit for the work hereit
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- R y 19 LL
Owner
Kind of Building Q
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No.
Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No
Trade Name �".e 234� Size No-i"� �
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load Bind of Fuel.�o
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
V 4E
(REMARKS—OVER$
Signe ftLf
By --Z IAI-= �P
Business Phone No -7 `�
Cify of Fridley
Appka*m for Numbbq and Cat Rnk9 Femb 52_84-915.51
Dept. of Bldgs. Phone 980-3490
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures I 365 NE. 66 Ave.
�a•
`
•
3`
irA
�
�
O
t
V
�Qj
<
•
-�
•
N
WATER MTR.
GAS C.
Base
1st
2nd
3rd
44th
• Future Connection Opening's
* New Fixture, Old Openings
Coanecled with
sower ❑
spool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... x $1.50 $
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 $
Water Heater :Up to 99.000 BTU) .... x $3.00 $
New Ground Run Old Bldg......... x $3.25 $
Electric Water heater .............. : $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures .................. 1 x $200 $ 2.00
Additional Fixtures .................. x $ .75 $
Gas Range to 198.000 BTU ............. x $5.00 $
install (1) gas grill 3.00
REPAIRS A ALTERATIONS—Refer to Code
Description ..............................................$
T,oTAL FEE s 5.00
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the Cita Ordinance
and ruling of the Department of Buildings, and hereby declares that aR the fact
and representations stated in this application are true and correct
Fridley, Minn Aug • 3, 1971 „ 19_
owner _ Duane Hanson
Kind of Building - .frame
Used as residence
To be completed about Aug. 6., 1971
Estimated Cost, $ 10.00
Old XNew. Building Pe ' No. Pe `/
By -
Business Phune No
ROUGH
FINAL !J' til. .
CAa$s -pr Surcharge .50%
SUBJECT
PERMIT N,.
City of Fridley
2 O31
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
16 L ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
9/5/73
JOB ADDRESS 365 66th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR.
10 & W 20
a LOT 9, B ock 2, Rice Creek Terrace Plat 2 SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Duane Hanson 365 66th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central N.E.
4. ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside, gutter, aluminum trim
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Aluminum
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
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
$2,000
1.00
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 MANCE OF CONSTRU TION.
PLAN CHECK FEE
TOTAL FEE
$13.00
SIGNATURE OF CONTR OR OR AUTHORIZED AGENT- (DATE)
N PROPERLY VALIDAZED THIS IS, YOUR PERMIT
18tDkTj
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME • 1 u A- P L -s`` -(—
(i N S c� n) BUILDER:_
r �
ADDRESS: 3 �-� - �v� A u&- N Le ADDRESS: Le :V r
NO • . 3 Co S STREET: A,) cs A%
LOT:— --BLOCK: ADDITION•
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.
To Be Used As:
DESCRIPTION OF BUILDING
-Front:- Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction; ° G
ti*v Estimated Cost: o� d ®O,
n ..............
f
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stfict 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: S, ` � `�`.
SIGNATURE:
(See Reverse Side For Additional Information.)
/a.
SUBJECT
PE
City of Fridley18045
AT THE TOP OF THE TWINS
BUILDING
PERMIT
R
• COMMUNITY DEVELOPMENT DIV.
' Lu ------
r 1 PROTECTIVE INSPECTION SEC.
/
t7
1 �
= CITY HALL FRIDLEY 55432
NUMBERR
EV.
DATE
PAGE OF
APPROVED BY
612-571-3450
I
910415
[ 1
6/6/85
/ /
-- --
JOB ADDRESS 365 - 66th. Avenue N.E.
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt. 9,10
2
Rice. Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Duane Hanson Al 365 - 66th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
D & D Home Trnprovement Inc. 7401 Central Avenue N.E.
784-7543
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 Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be the 2nd layer but not the 3rd.
Install ridged galvanized
valleys.
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
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
$li 410
$.7o
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
PROVISI S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$25.00
ST O OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
y dS s)
$25.70
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DA TEI
WHEN PROPERLY V I ATE T IS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATEI
BLDG INSP
DATE
NEW [ ] City of Fridley Effective 4/1/84
ADDN. L R-1 AND R-2 I
ALTER. [ ] Building Permit Application
Construction Address: .5- 1/0 f ��e_ lie -
Legal Description: --
Owner Name & Addre��s��s^^: /����e NSO Tel. # s71 3�S�S
Contractor: � /J #ho %e /� ,_ G�� Tel. #
Address:— �Z�IO/
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:
Corner Lot [ ] Inside Lot
Type of Construction: We-
[ ] Ft. Yd. Setback
D �
Estimated
Side Yard Setback
� /J � d
// 1
Cost: $ 1a
Approx. Completion Date:
6 �® g�
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel.
CITY USE ONLY
Permit Fee $ D C) Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 176 $•50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
TOTAL $ C) Agreement Necessary [ ] Not Necessary [ ]
� . %
STIPULATIONS:
LIQ L3 7`18'91
HEREOF I sons WELL DRILLING FOR FOUR GENERATIONS
15650 Jarvis Street NX, Elk Rinr, MN 55330
INCORPORATED (692) 427-61Q0 Fax: (612) 427-0533
Date: JULY 11, 1991
MINNESOTA DEPARTMENT OF HEALTH
717 SE DELAWARE STREET
DIVISION OF ENVIRONMENTAL HEALTH
MINNEAPOLIS, MINNESOTA 55440
ATTN: Mr Jim Nye
(612) 623-5339
SUBJECT: WELL ABANDONMENT
RE: NOTIFICATION
Dear Mr Nye,
NORTH
SITE DIAGRAM
This letter is to notify you of a water well in your district that should
be sealed according to the Water Well Construction Code MCAR §4725.2500-2900.
E.H. RENNER & SONS, INC has been notified by the owner of this property or
an interested party and have subsequently submitted to them an estimate for
the sealing of this well under our LICENSE #71015. We have also included
a copy of the current code with our estimate.
In submitting our estimate, the owner may also receive additional estimates
and hire any number of Minnesota licensed water well contractors in the area
to seal this well. However, there is a possibility that this well may not
be properly sealed and thus jeopardize the ground water and Public Health.
E.H. RENNER & SONS, INC. wishes to provide you this information for future
reference with the=baridonment report when submitted.
PROPERTY OWNf:
ADDRESS:
365
LOCATION:
Sincerely Submitted,
Raymond T. Renner, V -President ",-
E.H. RENNER & SONS, INCORPORATED
STATE LICENSE #71015
cc: CITY OF FRIDLEY
6531 UNIVERSITY AVE_ N_E_
FRIDLEY. MN. 55432
ATTN: DARRIL CLARK
Equal Opportunity Employer
PHONE # 571-3158
DATE -1-31-91
WELL DIA. 3n
DEPTH: 251 air less
r, (-, (r--
CIN OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
Rate
$ 30.00
$ 10.00
$10.00
$10.00
*Air Conditioning — All Sizes $ 25.00
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
State Surcharge
TOTAL FEE
Effective On January 1, 1997
• : ADDRESS La6 Edi' 1
The undersigned hereby makes application for a permit for the work herein
TOTAL 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.
J 1 ,1997
$
LI
$
BUILDING USED AS
ESTIMATED COST / PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
$ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
50
Burner Trade Name
Q ,QFcr e1u
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
HP
Size No.
EDR .
BLAINE HTG. AIC ELECT., INC.
135M CENTRAL AVE. NS
HEATING COM ANY h ANOKA, MN 55304
Signed ByLAOilk o.
Approved By ' I Rough—In Date Final Date
FILL OUT BACK SIDE F R STACK VERIFICATION ON .
REPLACEMENT FURNACE
CE[IM NEY AND STACK VERIFICATION
The undersigned hereby verifies that the. existing chimney or stack_
Has a liner been provided for water heater
Yes(
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's connected Yes () No ( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes(
)
No
(. )
8.
Has combustion air been provided for water heater
Yes(
)
No .
( )
Remarks: .
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SUBJECT
City of Fridley
26303
AT THE TOP OF THE TWINS
BUILDING PERMIT
�
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
a.
r 1 PROTECTIVE INSPECTION SEC.
� CITY HALL FRIDLEY 55432
NUMBER T7DATE
PAGE OF
APPROVED Br
612-571-3450
9104156/22/98
JOB ADDRESS 365 66 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9 f 10
2
Rice Creek Terrace Plat 2
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Duane Hanson 365 66 Avenue NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Jayson Lindsay Roofing 2638 Clearview Ave, Mounds View MN
55112 792-1857
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20098263
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Residenital
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) -Tear -off; 6 Sq of Siding
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code. Install
building wrap and call for 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4,168
$2.08
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF"—
FTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR HE PER MANCE OF CONSTRUCTION.
$99.75
Fire SC $4.16
k
CHECK FEE
TOTAL FEE
Jo—1XPLAN
-
License SC $5.00
$110.99
SI NATUREOFCONTR CTOR AUTHORIZED AGENT ID TEI
WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
E
SIGNATURE OF OWNEROF OWNER BUILDER) IDATEI
r• • BLD INS
JUN -12-1998
NEW [ ]
ADDN [ ]
ALTER [ ]
12:16 FROM CITY OF FRIDLEY TO
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R -ll AND R-2
BUILDINGr PERMIT APPLICATION
7860893 P.01i01
Effective 1/1/98
3
ConsttuctionAddress: 3(0's -
Legal
(o's-Legal Description:
Owner Name & Address: J44, -e- MA-rJSdrJ Tel. #
Contractor: -, &)nJ ,s MN LICENSE!! i Fp() i'i F,3
Address: Oq--� 58 C. CA1v '.0'-; A, -e-- Tel.
Attach to this application, a Certificate of Survey of the,..--
lot,
he=lot, with the proposed construction drawn on it to sca15"- r,-
DESCRIPTION OF EWPROVEMENT �
LIVING AREA: Length Width HeightSq:-Ft: "
GARAGE AREA: Length Width Height 1 Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:_ 12c,466 f dr 6 Srcirtilq Estimated Cost: $ -
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: -q&' APPLICANT: Tel. # 7942 IW5--7
Permit Fee $ Q %S
Fire Surcharge $ /
State Surcharge
$ , o
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $
STIPULATIONS:
MY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
k
TOTAL P.01
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit #
Residential Application
City of Fridley
See Back Side For Required Information
Date &31-6S Site Address:
34g,,,� &�� sL%iir" Ik'
The applicant is: (cirlce one) Owner ntracto
Property Owner: 5461�7 04
Address: 31� ��/0 6`�✓L
City: 122
/'✓E
State: AN/ zip: 53/32-
Phone:.,533 - - 3oj Cell:
Fax:
Contractor Information 17
Company Name: r�
Contact Person:
Address:
City: / i//% - - -State:
eo4+/ Zip: 555i�Y
Phone: Cell:
Fax:
Email:
MN Bond# & Exp Date
Type of Work (circle one): New
Replacement r Alterati Remodel
Detailed Description of work:l
Equipment Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU.-
MFG:
Model: Size/BTU:
Please check all that apply: _Fireplace
(gas) $15.00 New Gas Grill $10.00
_AIC $25.00 _Fireplace
(wood) $35.00 _Gas Unit HTR $10.00
_Air to Air exchanger $15.00 _Furnace
$35.00 _Pool Heater $35.00
_Boiler $35.00 _Gas
Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10.00 _Gas
Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00
Permit Fee $ (Total from above -Minimum fee $35.00)
Surcharge $
0.50
Total Due $ !L,U Make check payable to City of Fridley
This is an application for a permit- not valid until processed
I hereby apply for a mechanical 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; that the work will be in accordance with the
approved plan In case of all work which requires review and approval of plans.
Signature of Applicant: � 4 Date: g 3�
Approval Inspector Signature: Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropaneliFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. RCCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
Building PLUMBING Permit NO.:2Q�S'�
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY % ej
DATE YO1J,R E-MAIL ADDRESS
�y
SITE ADDRESS �� J �CD*W
THIS APPLICANT IS: 0 OWNER *ONTRACTOR
PROPERTYNAME:
V1
®� CITY STATI C ZIP
OWNER/ADDRESS:
TENANT
��
PHONE: --A (Q,?) 5�� ) ,
CONTRACTOR
NAME:
STATE LICENSE # C�-7EXP DATE `off^I 1 "
ADDRESS: bL CITY1( 3L�C�� STATIZIPI L(1
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
PHONE � `1 FAX__W� �%moi
APPLICATION
PERMIT TYPE
0 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
0 NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV _FLOOR DRAMS _ SHOWER WATER PIPING
BATHTUB GAS PIPING (xrrnc�rrucF_mvE) SWIMMING POOL WATER SOFTNER ($35)
_ _ _
CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15)
_ _ _
DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION
_ _ _WATER
WATER METER —OTHER
�1�4i 77,s
s ...'. ...� ..:P.. i �. 'i. Y., ;: § si�3.':F.'.,.
.
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures cr $35.00 _L x $35.00 = $
State Surcharge = $ .50
_
Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
1 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; that the work will be in accordance with the
approved plan in the case of all work which equires review and approval of plans.
M}� I IIqR",
SIGNATURE OF APPLICANTS RMT NAA�I 1 is 1C�ATE
•fia ��' :� S�;N .... ' :..... ' .. _ ��» : ;:5 . >;7"IR�D!a1���;�fJI:�7�IN�� 1��E+�,'�`Ri.:i4L AiVD. ` ` . G�:L; ,.' =�i3 �'•�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building MECHANICALrG`ilu� 1�"..i
Inspections RESIDENTIAL APPLICATION Received By: W
7.63-572-3604Date ' JAN 0 8 2
CITY ®�' �' LEY _
DATE /- 9- O 9 YOUR E-MAIL ADDRESS
SITE ADDRESS 3 (6 S* 4, 6 °`- A v g N 1_
TEAS APPLICANT IS: ❑ OWNER -.2000NTRACTOR
PROPERTY NAME; A 01A n s
OWNER/ ADDRESS: 3 G$- GG ut- N G CITY �/L# STATEI�N_ZIPSS 3a
TENANT PHONE: i G3— 5'I% — !9-101
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
COMPANY NAME: Kull✓ 1-14,
CONTACT PERSON: r-'--"4 0-
k-- Mq_�.l
STATE LICENSE # EXP DATE
ADDRESS: oppa9 0 Heti Sk t" 0 -CITY Ff2l .oi rL_ STATd1N ZIP SS`�3Z
PHONE 7` b 'i S `f I rl ti FAX
I�SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK XnS�A 1 (2�.,r� f! �.�•- �wA- ^ a `�
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)SIZEIBTU
Equipment Installed
p u o
MFG: UV o MODEL: jfr�R L06 �
MFG: MODEL: SIZEIBTlJ
MFG: - MODEL: S1ZE�BTU
A/C 525.OD
0.00
FIREPLACE (GAS) $15.00 . —GAS RANG $100..00
L $
NEW GAS GRILL
—_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00
UNIT HTR $10.00
BOILER $35.00
—_CHIMNEY LINER $10.00
Y FURNACE $35.00 _GAS
_GAS DRYER $10.00 _POOL HEATER $35.00
V TOR S15.00
_DUCT WORK $10 00
GAS PIPING $10.00 _ENTILA
.. �
'`r ' '
.. L .. ...... _. •..... ..
Permit Fee
_��L��AY ... ...... � _S.: M ,.. ,. ., PSA ....,. ..::..�
Number of fixtures @ $10.00 x $10.00 = $
Surcharge
$ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE
$ 3 J Sb Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $
Total = $
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT olta= _PRINT NAME l rc J Q,P 12 DATE I
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-772-3604
FAX: 763-502-4977
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received B)PW
763-572-3604
CITY OF LEY
D'Ao
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE I - 5'- del YOUR E-MAIL ADDRESS
SITEADDRESS 2 E Pali -%(S6
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME:S so H A d Arts
OWNER/
ADDRESS: 3� .1GLEE- >Q V�. N� CITY -roLl o(� STATE HN ZIP
TENANT
PHONE: '7 (s 3 - S33- $ 3 0 (
CONTRACTOR
NAME: ie W I / Cc 1 P (k ✓►
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE y
LICENSE, BOND AND
STATE BOND # EXP DATE"r
CERTIFICATE OF
I
ADDRESS: Slot 9 O A r. IV r CITY �i21p(t . 1- N ZIP J S 311
INSURANCE,,
_____STATE
7 63 7 S U --A9 9' FAX
�PH/ONE
�'SiNGLE 13TWO
PERNIIT TYPE
FAMILY FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW 64EPLACEMENT
DETAILED DESCRIPTION OF WORK _Tn.S4A L1 W,a C .. Wa"f-6111
PER MS 1613.665 the per,, fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the Fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = plus .50 surcharge
OR
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE $15.50.
BATH SINK/I.AV FLOOR DRAINS _ WATER PIPING
_ —SHOWER
—BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL —WATER SOFTNER ($35)
CLOTHES WASHER KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15)
_ _
LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
DISHWASH_ER
_ _
WATER METER OTHER
- }tl r!J1S'7:1Lthi.
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
OR Number of fixtures @ $35.00 x $35.00 = $ J
TOTAL DUE $
State Surcharge = $ .50
(MINIMUM $15.50)
(MINIMUM $15.50) Total = $ 3S• S <'
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 requires review and approval of plans.
SIGNATURE F APP ANT l r �PRINT NAME, h 1 J 60 DATE
APPROVED BY DATE �- V
PLEASE' NO ARATE: PERMITS ARE REQUIRED FOR BUiL'DING,.ELE..CrRICAL. AND `MECHAC 4L: WORK
City of Fridley
3uilding Inspections Department
6431 University Avenue NE. Fridlev. ivlN X432
763-572-3604
FA;�: 763-502-4977