PRE 2010 DOCS•
•
•
City of Fridley, Minn.
BUILDING PERMIT
Date: — August 5, 1968
Owner: X% Harold J. Thim mes ch Builder
Robert DeGardner
Address 527 Queen Ave. N. ____ Address 2010 17th Ave. N.
LOCATION OF BUILDING
&/3?,'(-,
M 9861
No. —.. 11_ Street .—. 66th Way N. E. _ _ Part of Lot
Lot _ _ .__ Block 4 Addition or Sub -Division ._ _ _Edgewater Gardens
Corner Lot --2L- Inside Lot — Setback 35' _ _ _ Sideyard --- 35 ' 10'
Sewer Elevation —832.57 83.5.5Z
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwelling Front 47.8' Depth _ 41.3 Height _ 20 Sq. Ft. 2396 CtL Ft.
Garage Front _ Depth __ Height Sq. Ft. Cu. Ft.
Type of Construction Frame Est. Cost _j , 000 ___ To be Completed Dec . 1, 1968
Sewer Location- 106.5' West of Manhole
Water Location - 96' West of Manhole
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. a _A, .
In consideration of the payment of a fee of $ 48.00 ., permit is hereby granted to Robert
Degardner 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.
Official
Building
John Breher
NOTICE:
This permit dose not cover the construction, hutallation for wiring, plumbing, gas heating, sewer or water. Be atm to as
the Building htspeetor for separate permits for those hams.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MTI.MSOTA
OWNER i 5 NAME,�4 L F BUILDERR-1���..��
ADDRESS oA ADDRESS_"/r�
LOCATION OF" BUILD3NG
No. 1-.t STREET
LOT_BLOCR__ ADDITi3ON OR SUBDIVI5TOB..�.�+1}1.�
CORMR LOTSIDE LOTSETBACR. _ 3 _ SIDEY
SEWER ETZVATION TOP OF FOOTING.'
A6iplicanC attach to this form Two Certificates of Survey of Lot and proposed
buildink;'i'ocation• drawn on -;these Ceittificates.
DESCRIPTION OF BUILDING,'.,:;'
To Be Used As:
Y-;7 :F;oatDepth_ Height_-
:Square feet_, ( `Cubic Fent, .
Front - Depth ' He4ht
r.
Squ
are feet c • Cubici:Feet/o %dL 5 l.3 s `6
Type of Construction- - =F- :' S EstiWm ted CgFst' S` 0 0 02
7�
To Be' Completed ..
The undersigned hereby makes application £ot 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 _ _ ,?��,SIGNATURE�.
(Schedule of Fee Costs can be found on the Reverse Side).
(Z • t F %l
6-13 7 41'�
City ®f Fridley
Appl!= lzm for Numbing and Gas r-! ncj Pena%
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORE; -1 n .
Number, Kind and Location of Fixtures Location
I
Z
�
Q S
(9
WATER HTR.
o�
u'1
�a�
(�70
N
GAS
ELEC.
rn
Base
1st
2nd
3rd
4th
• Fu'ure Connection Openings Connected with
New Fixture, Old Openings Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ..................... x SM $�OV-cc 182o00
Future Fixture Opening ................ x$ 10 50
New Fixture Old Opening .............. x $ $1.50
Catch Basin ... .................... x 3.25 $
Water Heater (Up to DTU) ...... x $ $3.00
New Ground Run Old Bldg . ............ x 3.25 $
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 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 & // . 19 Lg
Owner 1sot-6 /d Z: h
Kind of Building - a >,' F
Used as
To be completed about ,1 -- 3�y
Estimated Cost, $ / c 4 &2
Old—New. Building Permit No Permit No. �✓ % ��
ROUGH
Signed 1 D01',1
Business Phone
Electric Fater Heater -9-00 $2.00FINAL_
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1,'fJ;Qx $ — $2,00
Additional Fixtures .................... x 7c $ 0�5
Gas Range to ' 23n .............. x J $ $5.00
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FEE $ 0.0 O az
Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and u
APP Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470
GRAVITY WARM AIR: SLATE TOTAL
Furnace Shell & Duct Work ....................... 8.00 $
Replacement of Furnace ............................ ! 5.00 $
Repairs & Alterations—up to $500.00 .............. .., 5,00 $
Repairs & Alterations each add. $500.00 ..............i'' 2.50 $
MECH. WARM AIR Westinghouse AGO12 (Eleo�tis heat)
Furnace Shell &Duct Work to 120,000 BTU ...........; 8.00 $ 10.00
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................
yt
5.00
$
Repairs & Alterations each add. $500.00 .............
1
2.50
$
STEAM or HOT WATER SYSTEM
1
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ....:
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
::
8.00
$
Each add. 200 sq. ft. EDR Steam ....................:F
2.50
$
Each add. 320 sq. ft. EDR Hot Water ...............
,
2.50
$
OIL BURNER—to 3 gal. per hour . ........... ... ...
5.00
$
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ......................
5.00
$
GAS FITTING FEES:
Nf
RATE TOTAL
1st 3 Fixtures ......................
$1.50
$
Additional Fixtures ...............
.50
$
Gas Range to 200,000 BTU ...........[
2.00
$
AIR CONDITIONING Westinghouse HL036(3TOn)
$ 18.00
FAN HEATING SYSTEM See Fee Sched*6
VENTILATING SYSTEM
j
$
ALTERATIONS & REPAIRS TOTAL FEE
$ 28.00
ROUGH Heat loss attached --
FINAL
:d
ti
Location #11 - 66th Wav N. E •
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. uA d -AR 19
Owner Robert DeGardener Bldr•
Kind of Building Frame
Used as Residence
To be completed about 12-19-68
Estimated Cost, $ 2000.00 �/
011 New. Building Permit No. Permit No. ' 5"�3
DESCRIPTION OF WORK
HEATING or POWER PLANTS—.Steam, Hot Water, Warm Air —
Trade Name Westinghouse Size No. HL036
Capacity Sq. Ft. E.D. 6.000 BTU H.P
Total Connected Load 18•4 KW Kind of FueL Electric
BURNER — Trade Name Size No
Capacity
(REMARKS—OVER)
42
Sq. Ft. E.D.R BTU H.P
FRED V®D T & D®o
Signer] HEAImia& AIR CONDITIONING
By 3260 Gorham Ave • 929-6767
St. Louis Park, Minnesota 55426
Business Phone No
MEAT LOSS CALCULATION SHEET
CUSTOMER Iye. -,. �`.@. ^'-A• k
PHONE
ADDRESS _
FORM 0960.6
CITY
STATE
900 TD
AREA
ROOM OR AREA
x r
♦ ��.
'f /`4c
-
,t.
LENGTH
WIDTH
HEIGHT
,
R.C.C.H.
FACTOR FACTOR AREA
HEAT
LOSS
AREA
HEAT HEAT
LOSS AREA LOSS
AREA
HEAT
LOSS
AREA
HEAT HEAT
LOSS AREA LOSS
HEAT HEAT
AREA LOSS AREA LOSS
Infiltration 1 air change/hr.
.48w/cu'
Infiltration 3/4 air change/hr.
.36w/cu'
Infiltration 1/2 air change/hr.
.24w/cu'
Infiltration 1/4 air change/hr.
.12w/cu'
Gross Wall (R-14)
Gross Wail
Windows (Triple Pane)
10.8w/sq'
Windows (Double Pane)
14.5w/sq'
_V? 4
Door (With Glass Storm)
8.2w/sq'
Net Wali (R-14)
1.8w/sq' �,
TS
j7j-lfg
Net Wall (Above Grade) R-10
2.6w/sq'
Net Wall (Below Grade) R-10
1.2w/sq'
Ceiling (R-36)
.72w/sq'--
Floor (R-24) (Crawl Space)
1.1w/sq'
Floor (R-24) (Unheated Bsmt)
.48w/sq'--
Basement Floor (Belowgrade)
.6w/sq'
Floor (Slab on Grade)
14.6w/lin'
J (,
TOTAL HEAT LOSS
$
p
1
--
KW INSTALLED
CUSTOMER
ADDRESS
FORM 0880-0
MEAT LOSS CALCULATION SHEET
PHONE
CITY _
STATE
900 TD
AREA
ROOM OR AREA
rnz��',
,�
�^
LENGTH
•.
A
WIDTH
15
HEIGHT
HEAT HEAT HEAT HEAT
AREA LOSS AREA LOSS AREA LOSS AREA LOSS
Infiltration 1 air change/hr.
Infiltration 3/4 air change/hr.
Infiltration 1/2 air change/hr.
R.C.C.H.
FACTOR
.48w/cu'
.36w/cu'
.24w/cu'
HEAT
FACTOR AREA LOSS
HEAT
AREA LOSS
AREA
,
HEAT
LOSS
HEAT
AREA LOSS
Infiltration 1/4 air change/hr.
.12w/cu'
7✓S
Gross Wall (R-14)
IY2/
Gross Wall (R-10)
Windows (Triple Pane)
10.8w/sq'
Windows (Double Pane)
Door (With Glass Storm)
14.5w/sq'
8.2w/s '
/7,
i f
9'
/
Net Wall (R-14)
1.8w/sq'
Net Wall (Above Grade) R-10
2.6w/sq'S
f�
Net Wall (Below Grade) R-10
1.2w/sq'
CeiIirtg (R-36)
.72w/sq'
Floor (R-24) (Crawl Space)
1.1w/sq'
Floor (R-24) (Unheated Bsmt)
.48w/sq'
Basement Floor (Below rade)
.6w/sq'
Floor (Slab on Grade)
14.6w/lin'
TOTAL HEAT LOSS
o
KW INSTALLED
ic�J s -co for 19L AC 4✓
fl �r5 /5.
City of Fridley, Minn. N? 10045
BUILDING PERMIT
•
Date: Dec. 12, 1968
•
Owner: Harold Thimmesch Builder Brisson Stucco & Plastering
Address Address _ 10701 Morgan Ave. South
LOCATION OF BUILDING
No. 11 _ Street _ 66th Way N. E. Part of Lot
Lot 23 _ Block 4 Addition or Sub -Division — Edgewater Gardens.
Corner Lot — Inside Lot __ Setback — Sideyard
Sewer Elevation ____ ___ — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
R t n cr c n Front w Depth Height _ _ Sq. Ft. Cu. Ft
Front Depth Height _ _ Sq. Ft. _ _ Cu. Ft.
Type of Construction - Stucco Est, Cost ._,_„9.50.00 _ To be Completed
In consideration of the issuance to me of a permit to 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. 0.
In consideration of the payment of a fee of $ 6.00 , permit is hereby granted to Brisson Stucco
& Plastering 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 thereof, shall croffiorm 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 oY any of the provisions of said
ordinances.
NOTICE:
This pem* doss not corer the construction, Insiallafion for wiring, phmnhing, gas heating, soarer or water. Be sure to we
the Building Inspector for separate psrm6s for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUIL//DIffNG
No. ,Z. STREET 15"" 6
LOT BLOCK ADDITION OR SIIBDIVTSION�_ Lj a 1.d_, CC)
COR'K'ER, LOT INSIDE LOT SETBACK SIDEARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form Two Certificates of Survey of Lot and
proposed building location drawn on these Certificates.
To Be Used As:
DESCRI.PTION OF BUILDING
Front Depth Height
Square'feet Cubic Feet
Front Depth Height
Square feet Cubic Feet
Type of Construction Ice� Estimated Cost
To Be Completed M W-e4�
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 i,.:. resentations stated in
this application are true and correct.
DATE o73 / /%6 � SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side.)
�t,ers< �� : �r► x�
S C
0
.te V '4's
N° 4913
Original Permit for PLUMBING AND GAS FI ING��$ 19 77
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Pe� rmit
'.co
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit.,
F
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
to M W WATER HTR. City of Fridley °L" ,19- (ell
Stories
M
O
Q J
3 U
m
z
7
_ .�
x m
F m
Q 7
M F
z
m
Q
m
r
Z
m
m y z Z
Q :1O
Q E K O
3 F ❑ LL
N
3
I
y
o Z u z
O Q F M
J K Q Q
z m
¢
¢❑
m x
J
m a.
¢ a
a
m 2
Q a
GAS
ELEC.
Basement
1st
2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
Permission is hereby granted to do the plumbing and
gas fitting in the building described in the state nt hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection
Inspector.
Final Inspection Date
Owner
Location (r & 'I
AL,
Kind of Building -4;C-6"
Used as
To be Completed '19—
Estimated
19
Estimated Cost
Old -New. Building Permit No.
Date
4
Inspector. Inspector of Buildings.
a z 91N -6.65-V
City ®f Fridley
Dept. of Bldga. Phone 580-3450
DESCRIPTION OF WORK J
Number, Kind and Location of Fixtures LB�inn / m
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
F
� � ,Y� 3c"
Z � ygT�j p � Tu y�L �� �J
�
�
•
•
WATER HTR.
$
Catch Basin ... .............. ..
rsi
,
�F
N�p
$
New Ground Run Old Bldg.
x $3.25
I
N
GAS
EIEC.
Base
NO. RATE TOTAL
lot 3 Fixtures ...... ..................
x $200
O
Additional Fixtures . ..................
—x$.75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
1t
-
-
—
2ad
- ---
3rd
_
4th
_
° Femme Connection Openings Connected with
* Now Mdur+s, ON OpeningsSewn
I ❑
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......
x $200
$
Future Fixture Opening ........
x $1.50
$
New Fixture Old Opening ..... ..
x $1.50
$
Catch Basin ... .............. ..
x $3.25
$
Water Heater (Up to 89,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg.
x $3.25
$
Electric Water Heater
: $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
lot 3 Fixtures ...... ..................
x $200
O
Additional Fixtures . ..................
—x$.75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ...............................................$
TOTAL FEE $
t E
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 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
J� n
Fridley, Mann J —1 D- �+ 10
A
Owner l/ R O L- �[1/T / M M c �7 C."/,z
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.
Signeti
By _
Business Phone o_ Al*-
*"
ROUGH—
ROUGH
FINAL
FINAL
U
Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. hone 560-3450J�
GRAVITY WARM AIR: RATE TOTAL Location / / Z9 /.9 IJAY A J' edr
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$ 200 $ eAL
Additional Fixtures x .75 $
Gas Range to 199,000 ........... x$ 5.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ r 4'
ROUGH
FINAL
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.
Owner
Kind of Building
Used as
To be completed about
Estimated
09mCost, $ � `
Old-6;"uilding Permit No. Permit No. U�
DESCRIPTION OF WORK
HEATING or PO PLANTS—Steam, Hot Water, No
Trade Name ��� Size No
Capacity 10 CAM Sq. Ft. E.D.R.�� � BTU P.
Total Connected Load ��F� Kind of Fuel Aldras
BURNER — Trade Name Size No- k4° 1_e
Capacity d OWN Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signed RAY N. WELTER HEATING CE
4647 URIUA00 AVE.
By 941"WEA &LIS
C41130.42 Business Phone No-
(REMARKS-OVER)
o
FIRE DEPARTMENT MEMO
TO: BUILDING INSPECTION
ASSESSING
SUBJECT: FIRE DAMAGED STRUCTURE
FIRE HAS OCCURRED AT
11 - 66th way
ADDRESS
June 30, 1982
DATE OF FIRE
FPB -6
DATE: July 1, 1982
Richard H. Larson
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
B U I L D I N G P E R M I T
PE
1672
r
• COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
1 ` �
/---1 CITY HALL FRIDLEY 55432
612-571-3450
R PT N
7�
NUMBER
910-F15
REV.
DATE
8J12/82
PAGE OF
APPROVED BY
JOB ADDRESS 11 66th Wa
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
23
4
SHEET
Ede Water
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Harold Thiiimp-sch 11
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Shepard Con 933-484-3
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION X] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Fire Damage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEpERATE PERMITS REQU
HEATING, pLUMBIMG AND
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$35,000
SURTAX
$17.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISI OF AN OTHER STATE OR LOCAL LAW REGULATING CON -
OV" ION OR THE RFORMANCE OF CONSTRUCTION.
PERMIT FEE
$215.50
SAC CHARGE
PLAN CHECK FEE
TOTAL FEE
233.00
SIGN URE OF CONTRACTOR OR (DATE)
W EN PR E L ALI TED THIS IS YOURPERMIT
UHORIZEDAGENT
9
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
BLDG INSP GATE
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIal FOR RESIDtNTIAL BUILDING PERMITS
(NEwo Alterations, Additions, or Repairs)
OWUER: Z�f ele_ o
ADDRESS:
TEL NO:
BUI LDER :
ADDRESS:
TEL 110: _ 213- Vf"
Construction Location
- STRITT NO: STREET: wA 111
LOT: Z 3 BLOCK: ADDITION: 1COC C � �V 4►v:i s
Corner Lot: Inside Lot: Setback: Sideyards-
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
Flak DESCRIPTION OF CONSTRUCTION
Not& 04% Front: Depth: Height:
R� Pg�r . Square. Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of construction:�' -
_ Estimated Cost: _$ 2°-
2b Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: A-- $ $
SEE MVER.;E SIDE OF SHEET
The undersigned hereby make: 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 Dej%irtment of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct. j
DATESIGNATURE:
Stipulations: /
P�' 3 •�
03. d
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 1 66 fiJ
Furnace Shell and Duct Work,
Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432
Burner (Also replacement furnace) $ 20.00
City of Fridley
Was Piping $ 10.00
$ i6. n
Tel. #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
�,p
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
S
Fridley, Minn. 19
All Others/Repairs and Alterations
OWNER
It of Value of Appliance or Work
KIND OF BUILDING�e
COMMERCIAL/INDUSTRIAL
USED AS
J 9
It of Value of Appliance or Work
$
TO BE COMPLETED ABOUT bn
ESTIMATED COST '2
State Surcharge
S .50
—'^
TOTAL !EE
�D
OLD -NEW BUILDING PERMIT N0. PERMIT NO. (D
,•
Reinspection Fee ($15.00)
$
DESCRIPTION OF FURNACE/BURNER
Rough Insp.
HEATING or POWER PLANTS, Steam, Hot Water, Wasm Ai No.
Date
Final Insp.
Trade Name Size No. 60 &1>:-0
Date
Capacity Sq. Ft. EDR BTU Hp
Approval for Permit
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity _4�:Sq. Ft. EDR BTU NP
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
Company
PLUS $.50 STATE SURCHARGE
/
Signed By
Tel. No. •S
•Air Conditioners can not be placed in side yard without
written pemission fros adjoining neighbor.
.Fill out back side for stack verification on replacement furnaces
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 ( )
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
Rema rk s
Company _
Signed By
Da to
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Effective On January 1, 1991
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATIOA AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (Nbeded with new furnace)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
Rete TOTAL
$ 20.10
$10.")0 $
$ 10.00 $
$ 10.00 $
$ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work
CommerciaUlndustrial
I % of Value of Appliance or Work
State Surcharge
TOTAL FEE
JOB ADDRESS ! 1 -- ('_ L W a 'J
Iu L
The .mdersigned hereby makes application for a permit for the work
herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
that all the facts and representations stated in this application are
true and correct. /a - ,1991
ESTIMATED COST , o o PERMIT NO. �'
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units_L_ Circle One (Steam) (Hot Water)�r
Trade NameW k-�Z T11= -'O Size No.
BTU HP EDR
$ Fuel Total Connected Load
.50
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY
Signed By
tel No. Ci,D-
Approved By Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
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 ( )
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
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date