PRE 2010 DOCS#CitY oFridley, F , Minn.
BUILDING PERMIT S® 4404
Date: .......... .._.. r° .._.-..........._............._....... ....... _............._........._............................... '
Owner: ,{� ��
%^^-......_.-.`................................_........_.................... Builder ........... .......... _... ....._............._......... - ......... _....
�_....
Address- - ----•--...-.......... . _ _. _ _....._................. Address ....................._............._.
n v� / / LOWTI�N OF BUILDING
No.....:.../...1....... Street ........... (�!._W - -` ..j.._.. Vii..... < Part of Lot
Lot ...................................... Block .............. .................... .................. Addition or Sub -Division ............................
CornerLot .................................... Inside Lot ...................................... Setback ............................................. Sideyard
Sewer Elevation .................................._....--------------------------------- ._--------.-....---------- Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as:
_.._.......... ront ..1.... -.. Depth Height .L..-- . ' Sq. Ft.. .
.................. __...................................... Front ..... _................. Depth..._........_. ... Height ....... ... Sq. Ft..__...... ........ _..
Type of Construction ... ........................ ............._................. Est. Cos'i�'-.............. To be Completed
0
Cu. Ft....�/.....0
Cu. Ft........ .................
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.
ie sAnn�ill � o .ar9?s2�'
_-In consideration of the payment of a fee of $...-/.._:..-........._...
P ym 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. i
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
City of Fridley
AppRcarkm for PhunMng and Gas Ruing Pero*
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
Ti
�
�_
�
�
Z Z
°-t
,°QC Z
Z_
O
,
O
�
00
•
F
•
N
WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• nftre Connection Openings I
* New Fiiztum. Old Openings
Connected With
sealer
COMP001 El
PARTIAL RATE SCHEDULE
PLUMBING FISTORE RATES: NO. RATE TOTAL
Number Fixtures ......................S x $1.50 $
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 200,000 BTU) ......
New Ground Run Old Bldg. ............
GAS FITTING FEES:
1st 3 Fixtures .........................
Additional Fixtures ...................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
x 1.20 $
x 1.00 $
x 3.25 $
x 2.00 $
x 3.25 $
NO. RATE TOTAL
x $1.50 $
x .50 $
x 2.00 $
Dept. of Bldgs
. Phone SU 4-7470 jX� �/ //��+
Location �7 7 7 SCS/ 6 �" / oy a / Y .)E s
City of Fridley:
The undersigned hereby .makes application for a permit for the work hereil
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn- �/ ado
Owner ;nm -ss A, 7-T/ Ay e. /R
Kind of Building WOOD D EA&M E
Used as 5% N G L e ^FA/Way pyv m i-i-w�
D
To be completed about - -- E- r.,
d
Estimated Cost, $ -To D
Old —YoO.' Building Permit No ` ® Permit No. d Gi v
Sign
By
lkwe4aess Phone No �A
ROUGH �� �-3'y �(• -
FINAL
Description .... ............................................ $�
TOTAL FEE $ %• 5-0 42 2M.
Apprication for Power Pkmts and Healing, Cooting, Ventilation, .Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470
GRAVITY WARM AIR: RATE TOTAL, Location 377-64 -A Ave M g �
Furnace Shen & Duct Work .......................... am $
Replacement of Furnace$ City of Fridley.
............................. 5.00
The undersigned hereby makes application for a permit for the work herein
Repairs & Alterations—up tG $500.00 .................. 5.00 $ 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
Repairs & Alterations each add. $500.00 ............... 2.50 $ and representations stated in this application are true and correct.
MECH. WARM AIIl
Fridley, A inn � , 19 OL
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 . B 0
each add. 60,000 BT....................... 2.00 8 _ owner �iq /V WOO ,Et �.S �i . / f//�i - ��
O'
Replacement of Furnace ............................. 5.00 $ Kind of Building O O Z IrRAM 9
Repairs & Alterations—up to $500.00 ................. 5.00 $ Used as SINGLE PAM / L V DWELL / Al G
Repairs & Alterations each add. $500.00 .............. 2.50 $ MA 19C H 19102- 91O 2
To be completed about
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ Estimated Cost, $ 14 5"0
.
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water ... 8.00 $
Old—fir. Permit No.
Building Permit No. ,
Each add. 200 sq. ft. IDR Steam ...................... 2.50 $
Each add. 320 sq. ft. IDR Hot Water .................. 2.50 $ DESCRIPTION OF WORK
OIL BURNER—to 3 gaL per hour .................... . ... 5.00 $ HEATING or POWER PLANTS—Steam, Hot Water, arm No
over 3 gal. per hour—See Fee Schedule f�` 0®C Trade Name 4M/4'�r �®0 Size No
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $
Capacity Sq. Ft. E.D.R BTU H.P.
GAS FITTING FEES: NO RATE TOTAL )/4*Kind
/�
1st 3 Fixtures ...................... 1 x $1.50 Total Connected Loa !t �V of Fuel �� T. (�+,-+5
Additional Fixtures ................. x .50 $ f
BURNER —Trade Name Size No
Gas Range to 200,000 BTU ........... x 2.00 $ ®O0b�s�
Capacity q. Ft. E.D.R BTU H.P.
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $�� Signe
/�I Sri y
ROUGH �,r+
w 4 z 2M 7-59 Busiaess Phone No-
FINAL
(REMARKS—OVER)
I p
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRILiEY, MINN.
f Weatherstrips A.S.H.V.E. Construction No. Insulatione- 0
Guide
I. WindowsDoors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
Yes No IYes No 19_4z�
/ S Fl.j 134el Room Length /W Width /O - Height �` F1.1 Room Length Width Height
Windows and Doors—Crackage and Area
Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Width
No. of Dane
Haight No. of
of pane lights
Lineal ft. Area
of cr, ck sq. ft.
of crack sq. ft.
Coef. Btu
Infiltration
(� 7
Glass
w I .. ./
Exp. wall
a a '
�
6„
Int. wall
' 2—
Ceiling
Floor
,61
®76
/ 01' „
•'�
/ ("/" $,
Coef.
Btu
Infiltration ,
9Y1 66
.437-
3124
{ Glass
FI. $A,Se'oM
. ®.
Width 3®
Exp. wall
Windows and Doors—Crackage and Area
Width
No. of pane
Height No. of Lineal ft.
of pane Ilghte of crack
Net exp. wall.23,-T-
J
D 9
,;,-0 0 .0
Int. wall
11* /2
20 , R v tI
Id /�
Ceiling
Floor
7
Windows and Doors--Crackage and Area
Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Lineal ft. Area
No. o[ pane
of pane lights
of crack sq. ft.
Coef. Btu
Infiltration
(� 7
Glass
w I .. ./
Exp. wall
2-0 2-
Net exp. wall
5
Int. wall
' 2—
Ceiling
Floor
,61
Total Btu. 1 91 W 7 5 Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. h. E.D.R. or aq. ins. WA. Leader area
I Fl.I 15P Room j Length / a Width /p Height Fl.1 Room I Length Width Height .
Windows and Doors--Crackage and Area
Width
Height No. o[
Lineal ft. Area
No. o[ pane
of pane lights
of crack sq. ft.
I a r N
I.2 it
(� 7
— . —1f
w I .. ./
1,4.1 ,om ."
Btu
Infiltration
®` `
.43
.a '
Glass
Coef. Btu
Exp. wall
Glass
Net exp. wall
2-0 2-
0N
5
Int. wall A'(,
' 2—
15'2-
52Ceiling
Ceiling
,61
®76
/ /
Floor
66
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
1,5661, .< �l
FI. $A,Se'oM
Room I L_e_n_vZ_3_3_7
Width 3®
Height 7
Windows and Doors—Crackage and Area
Width
No. of pane
Height No. of Lineal ft.
of pane Ilghte of crack
Area
eq. it.
3d'
/lo °'
3,,33
R 16
20 , R v tI
Id /�
Coef.1 Btu
Infiltration /S Ir 431
Glass f Z (o
Exp. wall 6}o o ve Gra 11 2-
W
clef exp. wall be o w 't �1 2
Int. wall
Ce.4ing
Floor
1 tf 1 Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sQ. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room I Lenath Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
suB�Ecr
PER
City of Fridley
6996 1
AT THE TOP OF THE TWINS
BUILDING PERMIT
RE O.
`L ------ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
�
1--'1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/4/83
JOB ADDRESS 377 - 66th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 3 � 4
2
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James A. Thayer 377 - 66th Avenue N.E 571-8583
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 32' x 14' Three Season Porch
9 CHANGE OF USE FROM TO
STI ULATIONS
SEPERATE PERMITS REQUIRED FOR WIRING
HEATING. PLUMBING; AND SIGNG
VVAR'N" NG
Before digging call local utiliW
ELEPHONE - ELECTRIC - W Ete.
SQUIRED 4Y 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
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
$7,400
$3.70
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PRO ISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
\S249CTION OR THE PERFORMANCE OF CONSTRUCTION.
$68.50
NONE
PLAN CHECK FEE
TOTAL FEE
17.13
$89.33
NATURE OF CONTRACTOR40RrH.RI!1:ED AGENT (DATE)
,\A/
WHEN PRO PERIXVALIDATED THIS IS YOUR PERMIT
_t4)-'huad ( lzjc-
BLDG INSP ,A TE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI —
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(News Alterations. Additions. or Repairs)
OWNER: -m as A. %—HA
ADDRESS: a 7%
BUI LDER .'B
ADDRESS:
TEL NO:6' "5 7 f �' 6-9 3 TEL NO: c -5A --M E
. Construction Location
STR= NO: a 77 STREET: / �. ,., 'Al am,
!VTo 'P 147. 3
LOT: _6 �a'o®F—aT q n=: ADDITION: P/CX C -R&9 -a -7-0A9A4':-
.E-4S.sr
Corner Lot: Insiae Lot: �_ Setback:50"f r Sideyards: Og
Applicant attach to this fora two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF MNSTRUCTION
f'3 SEASON RDACH Front: Depth: j� Height:�
Square Feet: W49 $ Ouble Feats ?SSLI
Front: Depth: Height:
Square Fest: Cubic Feet:
Type of Construction: _ Woo b E P 14M � _ Estimated Cost: S
'lb Be Wrapleted: o,,5
Alt. A Alt. 8
Proposed Driveway Width If New Opening Is Desired: W OV E- S S
SEE MEMSE SIDE OF SHEET
Tire undersigned hereby masses application for a permit for the viork herein specified,
agreeing to do,all work iza 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.
Stipulations: � , �/
t
�`8.��
o
Land Play pnmy &875-fOMY #C5 WE
La Ad Swiryny 4finnru/nlS31,
Solsusluy ENGINEERING, INC. A'," olO
Casal & SUmd 44066
£n�meer'�ny Engineers E Surveyors —
certificate of survey for
- iso- A�C
p ( r — 1 1
r. 1
PO Re m
41��
v
?fry^ !s'c�sl` T� {���1 " o.= � � f - .:" a.7:? f%'.� �"a's•f -�G ;c� � :f o f
Xi I- -, .7 r -P a , -,- -
1 beneby ctrfiiry llhof flus K P free and wrad rePresenfofian'00 surrey q�'lhit lwndlp ies q�' a ubo�
I"q&n oJ'ol/ duilDrn9s , flrrew , &-doll nsib/e axrnorhmenfs , !fawn, f rn or a7 sold lard. As wrreyed by me J*5
9[' A>oy A.D 11 G'� SUB URBAN ENGINEERING, INC.
Lnp�neers Fr 5q-rtyors
mr
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 kRATE
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $ 20.00
Gas Piping $ 10.00
(piping needed with new furnace)
Gas Range $ 10.00
Gas Dryer $ 10.00
* Air Conditioning (all sizes) $ 10.00
All Others/Repairs and Alterations
1% of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
1% of Value of Appliance or Work
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
k -
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00-
PLUS
15.00PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
TOTAL
Job Address ZJ I — Ute -AA Ve-
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
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. ��� 'j'�f� , 19VD
OWNER
RIND OF
USED AS
TO BE CC
ESTIMATE
OLD - NEW BUILDING PERMIT NO.
PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, ,e Steam, Hot Water, Warm Air- No.
/
Trade Name f ,fir(od, 'I 1 / Size No. / J (rV/T ®d � _
Capacity Sq. Ft. EDR BTU HP C /a
Total Connected Load f� C Kind of Fuel nnzk)f-a'
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company P '
Signed By
Tel. No.
Fill out back side for stack verification on replacement furnaces
J
Company
Signed By
Date --Tv►tic
CHIMNEY 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
(✓f
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 --Tv►tic
To whom it may concern:
James A. Thayer, who lives at 377 - 66th Avenue Northeast,
has my permission to install a central air conditioner
compressor unit on the west side of his house. This is on
the garage side of my house, located at 3755 - 66th Avenue
Northeast.
(Signed)PNLL
Octave L. Sayther
375 - 66th Avenue Northeast
Fridley, Minnesota 55432
June 21, 1988
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace $ 30.00
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace) $10.00
Gas Range
Gas Dryer
o
*Air Conditioning — All Sizes
All Others/Repairs $ Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Effective On January 1, 1998
JOB ADDRESS 37 7— LL k�
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.
,l LuAe 15' ,1998
$
OWNER J ALS Th=L
$10.00 $
$10.00 $
$ 25.00 $
H
State Surcharge $ .50
TOTAL FEE
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.
BUILDING USED AS
P9 /
ESTIMATED COST Jac" U PERMIT N0. /_3 l
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (HotAi
ater) (W rm kL
Trade Name B u— Size No. p�
BTU _HP EDR
Fuel Total Connected Load
Burner Trade Name
BTU
M
Size No.
EDR
HEATING COMPANY
Signed By Tel No.
Approved ByRough—In Date Final Date
FILL OUT BACK SIDE FO4STCK ERIFICATION ON
REPLACEMENT FURNACE
1
CHD INEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (/�'No ( )
2.
3.
4.
5.
i
7.
1.1
Is free from rust or deterioration Yes () No ( )
Has no foreign objects lodged within Yes (/�'No ( )
Is securely supported Yes( ' ' No ( )
Meets all current Code requirements for size
and. total BTU's connected Yes (,J'No ( )
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Has a liner been provided for water heater Yes (,I' -No ( )
Has combustion air been provided for water heater Yes (,-)'�No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
14
SUBJECTT
NO.
City of Fridley
1p
27513
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
7/
I✓
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/1/98
JOB ADDRESS
377 66th Avenue NE
1 LEGAL
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
VOTN?.
48 T o
2
Rice Creek Terrace Plot 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James A. Thayer
571-8583
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Town & Country Roofing 4 Minnesota
-
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
O NEW 0 ADDITION 0 ALTERATION xg REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof house and garage 37 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
DOES NOT PRESUME TO GIVE AUT ORITY T VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STAT OR LO L LAW REGULATING CON.
STRUCTIO OR THE PERFORMANC OF CO TRUCTION.P
$87.25
Fire SC 3.18
PLAN CHECK FEE
TOTAL F E
agA Ql' e
. - I' R
Licen
5 .990
97 1
SIGNAT R FCO T CTOROR AUTHORIZEDAGENT IDA FI
EN R
G INSP
V L ATE T IS IS PE M9-->zD
DATE
SIGNATURE OF OWNER IIF OWNERBUILDERI IDATEI
AUG -13-1998
...,.. L J
08:42 FROM CITY OF FR I DLEY
TO
8589320 P.01i02
ADDN j ] ,CALMUvet ti liya
CITY OF FRIDLEY
ALTER [ 1 SINGLE FAMILY AND DUPLEXES R.1 AND R-2
BUILDING PERMIT APPLICATION
CoasavctionAddress:�f--A-
Legal Description:
Owner Name & Addresses
Contract
Address:
�.M7 Tel. # C;�� \ .. "2
MN LICENSE # CD 569 12a -
Tel. # S ci F:Z----Z.1 2 ZZ,
Attach to this application, a Certificate of Survey of the
lot, with the Proposed construction drawn on it to scale.
DESCRIPTION
DESCRIPTION OF ndpROVEMENT
LIVING AREA: Length _ Width Height Sq. Ft.
GARAGE AREA: Length _ Width _ Height Sq. Ft.
DECK AREA: Length Width HgVGround Sq. Ft.
OTHER:
37&
Construction TM:.
1 -ate, '2£i
Estimated Cost: $ — 3 70. o _.
(Fee Schedule on Back)
Driveway Curb Cut
Width Needed: _
Ft. + 6 Ft = Ft x $ — $
DATE-._qz / APPLICANT:
YA, Tel. #
Permit Fee
$ 7. ZS
CITY USE ONLY
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1110th%)
State Surcharge
$ • `lam
$.501$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$S : Qd
$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
$ . v
. STIPULATIONS:
NEW [ ] CITY OF FRIDLEY Effective 4/1/2004
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
Pp aiw BUILDING PERMIT APPLICATION
Construction Address: 37 ���n l„ 1&ke— /6
Legal Description:
Owner Name & Address: Tel.
Contractor: � MN LICENSE #
Address: - Tel. #6 S
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
1
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Co struction Type: Estimated Cost:
ir
Drive ay Curb Cut Width Needed: Ft. + 6 F - Ft x $ _ $
DATE: X17'0 5 APPLICANT: Tel. #4
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
�0.�1 055
$ 00
$ ,00
$
TOTAL $ D . a
1011Cal >;�Eel ZIwe
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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:
From: 2 Page: 2/6 Date: 5/6/2010 8:27:52 AM
Building MECHANICAL Permit No. _
InspectionsRESIDENTUL APPLICATION Received By:
763-572-3604
763-502-4977 FAX CITY OF FRIDLEY Da dN
1-1-2010
DATE YOURE-MAILADDRES9J�uCe��Pa�1n� O iFYiA?
SM ADDRESS
THIS APPLICANT IS: ` W nwNMI M ru...., .....e _ —
OWNW
'TENANT Moms CITY
PHONE.:ZA?__-+4A3���13l.P
�••�•••••••• ave COMPANYNAME:H��fJrcd-%PJ'�.s.ffl�a
SUBm1T A COPY OF CONTACT PERSON .31 \
YOUR STATE STATE LICENSE # EXP BATE
APPLICATI� ADDRESS.�3 j BA�Si9.r,n A A CITY
PHONB'T(p3-Lir31-�S7-� FAX �STAT�Z 1
PERMTT TYPE XSINGLE FAMILY D TWO FAMILY O TOWNHOUSE
TYPE OF WORK: E3 NEW LACEMENT Q ALTERA770NMEMODEL
DETAILED DESCRIPTION OF WORK &a �e_x t - O �-
FEES ARE BASED ON SIa00!'ER FIXTURE, I7XCEPT WHERR NOTEDL
PROVIDE HEAT LOSS CALCIS @ER MANUAL : (dVDICATE TOTAL NUMBER OF EACH BELOW)
opAE
J 2WB ASn HANDAROFO L
Eghdpn�t Installed MFQ MODE
p_ 4q M -6j lZ ATU (i
MFG: MODEL:
SIZEMTU
GC $45,00 hate. MODEL:
—AIRTO AIREXCHANGEER $IS FIREPLACE (GAS) $15.00
FIREPLACE (WOOD) $35.00
S1ZFJgrU
GAS RANGElOVEN $10.0- 00 —�, .
BOILER $35.00
00
—NEW GAS GRILL $10.00
CHIMNEY LINER $10.00 -GAS DRYER $
DUCT WORK $10.W ._._GAS DRYER $10.00
,GAS UNIT HTR $10.00
POOL HEATER $35.00
GAS PIPING $10.00
Niuriber of tlxttl 810.00 x $10.00 = $
VENTIIATOR $15.00
Number of &tures @ $15:00 x $,5.00 = $
Number of fhtares r@ $25.00 x $25.00 - $
Number ofd @ $35.00 1 x $35.00 =$Ll- 00
State 3'WrGhup a $fig
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 s requires review and approval of plans.
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
a