PRE 2010 DOCSm
City of Fridley, Minn.
BUILDING PERMIT No 4 s o`
Date:
-30010
r'
Owner:
_._! _._......... _ r Builder .....................
Address ___._..._...._....__.._ . _ _ Address
__ ��.._.�_ OF, BUILDING
TION
No. _..� .-. _ .. Street _.__ ... ... __ ....._ ..�..._......._..._ Part of Lo_......
.... .. .......
Lot ....._......'�.._........ Block ....._........... .......................... Addition o Sub-Divis`....
Corner Lot .......................... -........ Inside Lot ....._... ............. Setback .... ..._...._....... Side and .. - . .._ ` "...........--.._..
Sewer Elevation ............ _..................... _._._._......._...._-----.---._..-..._...._.._---- Foundation Elevation ....................... ....... _........ ...... .......................................
_.
DESCRIPTION OF BUILDING
To Used as
J Front ..... Depth Height-•- Sq. Ft. Cu. Ft.
Front _ 4Depth ....�.. Height
!. Sq. Ft. � Cu. Ft......_:..:.
f,
Type 1 Construction .....W -W .. Est. Co �.�t t -........... To be Completed ..... _............ _..............................
�P
Tf,dS
PER-,,,; p
0R ZE °Vj0LAT-
�iL��'ic L ,FAL C®ViE(Vagn1TS AND
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. �y►
_.,fl;_......_._.._...____._.
In consideration of the payment of a fee of $ KIW4 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 timeu� viol4tfon�f any of the provisions of said
ordinances. ---,%I 11J
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION pF BUILDING
No. � L Street - & 1� �.�- Part of Lot
Lot '�i Block `S Addition or Sub.Div. -4.Atj j&ZL"�
Corner Lot_,.�Inside Lot_2LSet Back_LZL L.Side.YardzE je)
SEATER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION -OF ,BU=ING ¢� i
To be used as t�
Front Depth Height
Sq. Ft.
Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
To be
The undersigz%d hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordanc®'with the City Ordinances and ruling of
the Department of Buildings, and hereby declar s that all the facts and representa-
tions stated in this application are true and orrect..
(A Schedule of Fee costs can be found on`the Reverse Side.)
W � I .-, 9 9 - - -
08
0
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-/7470
GRAVITY WARM AIR: RATE TOTAL Location -3,F —
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 ............... 2.50 $
NIECE. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ®®
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .......... . ...... 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
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 ...................... 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: NO RATE TOTAL
.�
1st 3 Fixtures ...................... x $1.50 $ l Sb
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
REMARKS:
$
See Fee Schedule
$
TOTAL FEE
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 ar/e true and correct.
Fridley, Minn./,) P/ 19�o
Owner FA � A i' !� I (! 195—
Kind of Building
Used as
To be completed about , --5— ®
$ 5-- 5--C, if'®
Ing Permit No. Z-6 10
195—
DESCRIPTION OF WORK
HEATING or POWER team, Hot Water ar�A:I:r No�
Trade Nam Size No_ _�trV 141–
Capacity Sq. Ft. E.D. ��,!®� BTU H.P.
Total Connected Loa Kind of Fuel Oy ,� �sQ,
BURNER —Trade Nam ' �" Size No�
Capacity Sq. Ft. E.D.R 1* BTU H.P.
Sign �t
CIO
V AJ
11 Posr 1M-12-58 Business Phone No— �� !�✓
City of Fridley
Application for Plumbing and Gas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
IL6XJ�r
z
LZ3C7
,<�iW
W
Z
«
WATER HTR.
a ?
3�
o�
g�Li0
<
F
N
GAS
ELEG
Base
1st
2nd
3rd
4th
Future Connection Openings
Cowith nnew
I
Sewer E]
New Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL.
Number Fixtures ...................... x $1.50 $
21067
Future Fixture Opening ................ x 1.20 $ =4
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTI) ...... x 2.00 $ ® d
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures .........................
Additional Fixtures ...................
Gas Range to 200,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
— x $1.50 $ �®
— x .50 $
— x 2.00 $
Dept. of Bldgs. Phone SII 4-7470
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,
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New Building Permit No WZMI 10 Permit No.
Signe
ROUGH—, /—
FINAL
Description ................................................$
TOTAL FEE $� 42 2M
By _
Business Phone No 4�5C'A;045;
19W
City of Fridley
Application for Pkl&ng and Gat Fktbg Pelmh
Dept. of Bldoe. Phone MD -3490
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
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 .............. a $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures 1 x 32,00 ; 2.00
Additional 313durea .................. x $ .75 $
Gas Range to 199,000 BTU ... ,........... x $5.00 $
install (1) gas lite 3.00
REPAIRS & ALTERATIONS—Refer to Code
Description ............................................ ;
TOTAL FEE $ 5.1?�
Lao1e, 38 NE 66 Way
City of Fridley:
53-84-V15.51
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 May 19 1972 19,
Owner Perry Hoag
Kind of Building frame
Used as residence
To be completed about i` U 19, 1972
Estimated Cost, $ 10 000
OMPLNew. Building Permit No. Permit No. �SCDS�
Signed 'Z� I&
By
Business Phone No
ROUGH
FINAL
CVass "R" Surcharge -EC',:
IVA
•
•
WATER MTR.
GAS
ELEC.
Base
1st
2nd
3rd
I
4th
I
I I
I
I
I
I
i
i
ruture Connection Ojenins
+ New Fixture, Old Openings
Connected with
Sewn ❑
Cesspool ❑
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 .............. a $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures 1 x 32,00 ; 2.00
Additional 313durea .................. x $ .75 $
Gas Range to 199,000 BTU ... ,........... x $5.00 $
install (1) gas lite 3.00
REPAIRS & ALTERATIONS—Refer to Code
Description ............................................ ;
TOTAL FEE $ 5.1?�
Lao1e, 38 NE 66 Way
City of Fridley:
53-84-V15.51
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 May 19 1972 19,
Owner Perry Hoag
Kind of Building frame
Used as residence
To be completed about i` U 19, 1972
Estimated Cost, $ 10 000
OMPLNew. Building Permit No. Permit No. �SCDS�
Signed 'Z� I&
By
Business Phone No
ROUGH
FINAL
CVass "R" Surcharge -EC',:
City of Fridley
SUBJECT
PERMIT NO.
12965
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
_ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i -_-•� �i " "'j CITY HALL FRIDLEY 55432
L s12-Sea345o
RECEIPT NO.
1-16tr
aeyo
r91F15
REV.
DATE PAGE OF
APPROVED BY
JOB ADDRESS
nre
1 LEGAL
DESCR.
LOT NO.
4
BLOCK
5
TRACT OR ADD) I N SEE ATTACHED
Edgewater Gardens SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Perry Hoag, 38 - 66th Way N.E., Fridley, Minnesota
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residence
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Insulate and reside with steel
9 CHANGEOFUSEFROM TO
STIPULATIONS
����UtIlIt18S �IRIN��,
Before digging call local D F®R
���V1t�
TELEPHONE . ELECTRIC . GAS Etcw E PER�il Is N� SIGNS.
REQUIRED BY �' S�PERA P1LuAgING A
HEASING„
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE OF CONST.
Frame
OCCUPANCY GROUP
OCCUPANCY LOAD
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ZONING
-1
SQ. FT.
CU. FT.
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$l, 5OO.00
SURTAX
.7S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$9.00
PLAN CHECK FEE
TOTAL FEE
$9.75
ZLQNATURE OF CONTRACTOR 9R AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�-7JP
5=27-75
BLDG INSP DATE
SIGNATURE OF OWNERIIF OWNE(BUILDER, ' 1 ATE)
— - 1 s ,
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: �� �/a- BUILDER:.
ADDRESS : 3�– �v %2 ?�/ Q-c�, ADDRESS:
NO:. R S STREET: a --
LOT: '� BLOCK: -S ADDITION:
CORNER LOT: INSIDE LOT: V1 SETBACK: SIDEYARD:
.Applicant attach to this form Two Certificate, 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:�Y62sek 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 : '`"'Z /' /� SIGNATURE: �'�'
(See Reverse Side For Additional Information.)
97-8t,416051
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
•
PLUMBING FIXTURE RATES: NO.
RATE
a
1%%"- er Fixtures
'�
$3.00
u
Future Fixture Opening •
x
o
$
water
x
$2.00
a�
Catch Basin,
x
$5.00
$
b
„n
$5.00
G
d
x
w
$
Water Softener
Heater
o
o
..
x
$5.00
$
Electric Water Heater - �_
x
01
M
w
GAS FITTING FEES:
iC
'
lst 3 fixtures
►1
Eel
$3.00
$
A3diticnal Fixtures __�
x
$1.00
$
�
x
b
w
REPAIRS 6 ALTERATIONS
'
3n
First $100.00
$5.00
$
as
lee
0
- U
a
of
$ ,_. 50
vi
3
$ 8,00
'1st
�
•
tad
]rd
'
4th
(R) - Future Connection Opening
Connected with Sewer
(•) - Ifew Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
1%%"- er Fixtures
x
$3.00
S
Future Fixture Opening •
x
$2.00
$
Now Fixture, Old Opening __
x
$2.00
$
Catch Basin,
x
$5.00
$
Water Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 199,000 BTO
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building �
x
$5.00
$
Electric Water Heater - �_
x
$5.00
$
GAS FITTING FEES:
lst 3 fixtures
x
$3.00
$
A3diticnal Fixtures __�
x
$1.00
$
.Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS 6 ALTERATIONS
'
First $100.00
$5.00
$
each add. $100.00 or traction
$2.00
$
State Surcharge.
$ ,_. 50
TOTAL FEE
$ 8,00
REINSPECTTION FEE
Job Address 38 66 way NE - -
Department of Buildings
City of Fridley
Tel. $571-3450
The undersigned hereby makes application lora permit for the work het
specified agreeing -to do all work in strict accordance with the City Co(
and rulings of the Department of Buildings, and hereby declares that al;
the facts and representations stated in this application are true and cc
Fridley, Mn. - 7-5-77 , 19
OWNER PERRY HOAG '
KIND OF BUILDING fr�ma
USED AS res.
TO BE COMPLETED ABOUT 7 =12 -77
ESTIMATED COST 10.A0
OLD - NEW BUILDING PERMIT N0. PE
T NO. %
Company
M1 CO
Signed By'
Tel. No.
ROUGH INSP.
Date
FINI}L INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
;lass "A" Surcharge .500
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
8
0"
RATE
TOTAL
New Fixture&
$
5.00
b
w
$
e
u
A o
�'t
w
a
a
a
w
yyo
Mater
Heater
$
4.00
$
blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Nater Leader
$
5.00
$
Hydraulic Valve
$
5.00
$
BuNP or Receiving Tank
lot
5.00
$
Mater Treating Appliance
$
7.00
$
not Mates Neater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
2"
3rd
4th
(R) 0 Future Connection Opening
(e) - New Fixture, Old Opening
Connected with Sewer
Mater
RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixture&
$
5.00
$
Future Fixtures
$
3.50
$
Old Opening. New Fixture
$
1.50
$
Beer Dispenser
$
4.00
$
blow Off Basin
$
5.00
$
Catch Basin
$
5.00
$
Rain Nater Leader
$
5.00
$
Hydraulic Valve
$
5.00
$
BuNP or Receiving Tank
$
5.00
$
Mater Treating Appliance
$
7.00
$
not Mates Neater
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
Is of Value of Fixture or Appliance
Reinspection Fee $ State Surcharge
($15.00) TOTAL FEE
IN
sttective Aug. 1, avtll
Job Addriss
Department of Buildings
City of Fridley
Tel. 0571-3450
The undersigned hereby uakes application for a permit for the work herein
specified agreeing to do all work is strict accordance with the City Codes
and rulings of the Department of Bu..ldings, and hereby declares that all
the facts and representations stated in this application era true and correct
Fridley. at.
ONMER Yma!5-N-C-0
RIND OF BUILDING
USED AS
70 BE COMPLETED AMM
ESTIMATED COST V(41 OV
OLD - NEW BUILDING PERNIT No. PERMIT NO. f D l
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
-suejEcr MI N0 .
City of Fridley
2'R 4 19 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
Ir?
RECEIPT NO.
• _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r � �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
AGE OF
APPROVED BY
612-571-3450
910-F15
5/22/96
JOB ADDRESS 38 66 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
5
1 Edgewater
Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Jim Mastro 38 66 Avenue NE
574-9317
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
D & D Home Improvement Inc 7401 Central
Ave NE, Fridley, MN
55432 784-7543
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
4840
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION 0 ALTERATION REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof (22 Sq) 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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
@
$1, 760
$.88
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-
Fire SIC $1.76
STRUCTIO THE PERFORMANCE OF CONSTRUCTION.
$56.75
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$64.39
SI N TUREOFCONT A T RORAUTHORIZEDAGENT f (DAktj
WHEN PROP V`VAL
a CQ�y..L
B G NSP
ATEDTHIS IS YOUR PERMIT
)A r
_
S,GNATURE OF OWNER,1F OWNER BURDERI iDATEi
NEW C ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: -q.5 _ /a a //-?- A_�_' J/z _
Legal Description:
Owner Name & Address:
Effective 3/1/96
_ Tel. # 5`2V--e731;Z
Contractor: D & D Home Improvement, Inc MN LICENSE # 4 R 4 n
Address: 7401 Central Ave NE Fridley, MN 55432 Tel. # 784=7543
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 ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: A9L_��� Estimated Cost: $ "J"G-1
Approx. Completion Date: jig=Z4 /ft UA
.(Cost on Back)
Driveway Curp Cut Width Needed.: Ft. + Ft = Ft x $ = $
DATE: APPLICANT: Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 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 [ ]
CITY OF FRIDLEY INSPECTION DIVISION
Effective On January 1, 1998
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
5723604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS�(�+h
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —�
U orepresentations
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Fumace
$ 30.00
$
stated in this application are true and correct.
(Side Vent — Fill Out Back)
- `�� 11998
Gas Piping (Needed with new furnace)
$10.00
$
`nn
OWNER 1 yn 1 V 1 yAS-T�. Q
Gas Range
$10,00
$
BUILDING USED AS
Gas Dryer
$10.00
$
_
ESTIMATED COST O d PERMIT N0. 3Z
*Air Conditioning — All Sizes
$ 25.00
$i t
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work
$
No. of Heating Units Circle One (Steam) (Hot Water) arm
Trade Name Size No.
Commercial/Industrial
BTU -15,000 HP (3 EDR
1.25% of Value of Appliance or Work
$
Fuel N X—\ Total Connected Load _15 !p O a
State Surcharge
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.
Burner Trade Name Size No.
BTU HP EDR
HEATING COMP Y V U7<T 12 � N e.
Signed By Tel No. 7,--3q 33��
T
Approved By Rough—In Date Final Date
FILL OUT BACK SIDE FO STACK VERIFICATION ON
REPLACEMENT FURNACE
CHEMMY 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 04 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 '3� 0 0 o
TOTAL BTU's I 13, O C7 b
7. Has a liner been provided for water heater Yes M No ( )
8. Has combustion air been provided for water heater Yes W No ( )
Remarks:
I 1A 50vy\-F- -SCALA �,)6 I t N Eg k—, 0.1<
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
C�)yAC\-Tcr i I2 ,` t,)C -
SUBJECT
City of Fridley
29 337
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
�
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
1 . �
6�3`/L��
7 �J
"e-1, CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
1 J\ 612-571-3450
910415
4/29/99
JOB ADDRESS 38 66 Way NE
1 LEGAL
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
ILOTNO.
4
5
Edgewater Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Charyl Mastro 38 66 Way NE
574-9317
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Rainguard Construction 12008 Pennsylvania Ave N, Champlin, MN 55316
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
421-8897 6061
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (24 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the
3rd.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS GARAGES
AND KNOW THE SAME TO RUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
ANDAG THIS TYPE OF WORK WILL BE COMPLIED
WITHHEREIN OR NOT. THE GRANTING OF A PERMIT
$1,545
$.77
DOEO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROT R ST OR LOCAL LAW REGULATING CON•TRU
$51.25
Fire SC $1.54
ANCE OF CONSTRUCTION
PLAN CHECK FEEOTAL
FEE
Lice S
$5.00 .56
5CTOAORAUTHORIZED AGENT iOATEi
ENMPjEATE�Dl
IN
YO T
gAfE
$-GN4TURE Of OW NEA iiF OWNER BU4 DERE IDATEi
NEW [ ] Effective 1/1/99
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
</ � L�
ConstructionAddress: ,�� G /�//�- (T
Legal Description:
Owner Name & Address: "- A5-1-Ifd Tel. #
Contractor: MN LICENSE # 6 6
Address: h76ciJ Tel. # L2/ f'r22
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EVIPROVEMENT
Length Width Height Sq. Ft.
Length
Width Height
Sq.
Construction Type: �,, Estimated Cost: $�
Wee Schedule on Back)
.Driveway Curb Cut Width Needed: Ft. + 6 Ft Z x $ _ $
DATE: Z APPLICANT:
Tel. #
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ a �'
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.501$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
_
$ a -CSU
$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:
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
DatMW U L 2 0
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
Darlene Toedter
THIS APPLICANT IS:
0 OWNER *ONTRACTOR 38 66th Way
PROPERTY NAME:
Fridley, MN 55432
OWNER/ ADDRESS: 7635713034 ZIP
TENANT
—
PHONE:
CONTRACTOR
NAME;
STATE LICENSE # CJ EXP DATE
SUBMIT A COPY OF
YOUR STATE
ADDRESS-. 21QS77fiC/ 2—le S CITY s'e..1 I sSTATE,&t4gIP S-f�000
LICENSE WITH ,
PHONE
7- yo3 FAX 2
APPLICATION
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE
TYPE OF WORK:
❑ 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 =
•FORXROJECTS WHERE LABOR EXCEEDS -S -500, -FEES ARE BASED ON $10.00 PER FIXTURE,'EXCEPT..'M. ERE-NDTED :FIXT4!RES,,tMIGATE TOTAL
NUMBER OF EACH BELOW)
— BATH SINK/LAV
_FLOOR DRAINS _ SHOWER _ WATER PIPING
—BATHTUB
_ GAS PIPING (xmD ctiyuc. z) _ SWIMMING POOL _ WATER SOFTNER ($35)
_ CLOTHES WASHER
—KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREV. ($15)
_DISHWASHER
--LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
s,
Permit Fee
$
Number of fixtures @ $10.00 x $10,00 = $
Surcharge
.50
Number of fixtures @ $15.00 x $15,00 = $
Number of fixtures @ $35.00 _/ x $35.00 = $ 3S.Oo
TOTAL DUE
$
State Surcharge = $ .50
Total = $ . SO
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 appH
. n 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 1
o w ' r uires review and approval of plans.
SIGNATURE OF APPLICANTPRINT
NAME Jed' 4/,011 rV7 DATE 15105-
—
""1'-'"e, �gq
MLI�` " E i t a� °3 �' B tYi a p rr r` `s a s E �'
AM
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977