PRE 2010 DOCSDate:
Owner
City of Fridley, Minn.
BUILDING PERMIT
zonj _ Builder
Address Address
N° D21
No. Street -- - -- - --- --- -aISleyard
t - --
Lot Block •... dition or ub-Division—
!5
ivisio —
Corner Lot - Inside Lot Setback
Sewer Elevation ___ _ Foundation Elevation
DESCRIPTION OF BUILDING
To Used • �t .. Front -7 Afie JA0Depth 4 aU Height Sq. Ft. Cu. Ft4XfVFA -
Front Depth Heiglit Sq. Ft. Cu. Ft.
Type of ction _ _ ^' Est. Cost *eb 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 6 accordance with the description above set forth and in compliance with allprovisions of
grdinances of the city of Fridley.
In consideration of the payment of a fee of $'—`++, permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
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 o€lany of the provisions of said
ordinances. ,- . t
AV 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 Rema.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, AgINNESOTA
Owner I s Name
` � � Builder
Address�ij�//y���/l�
LOCATION OF BUILDING
No. Z 2 Street Part of Lot
Lot Block Addition or Subdivisio �,� - (?A1
Corner Lot Inside Lot Setback c�? Side-Yard:5 V{2
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot -and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
oV%Y�k.-eight /-
v Sq. Ft. fJ i ® Cu. Ft./5-
Front
Depth
t./5FrontDepth Height
Sq. Ft. Cu. Ft. Z-
Type of Construction L(/UIV - Estimated Cost ,/4/ EC, ®_
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representations
stated in this application are true and correct. �} _
6 �= ;:, n -
(A Schedule of Fee Costs can be found on the Reverse Side.)
a 40 - .. . . .
1 0
EXHIBIT "A"
Ll
DECLARATION OF COVENANTS AND RESTRICTIONS
AND
NOTICE OF SPECIAL ASSESSMENTS
We, the Undersigned, CHRUM L. GMM & MURM M- GLISAN
hereby declare and give notice that we are the owners of the following descr;
land, to -wit:
Lot 8. ®lock So Ndgwstcr Gwdoae 9
(70 • 88th May N. B.
Further, we declare and give notice as follows:
1. That the City of Fridley has effected or has caused to be
effected certain local improvements relative to such lands
under Minnesota Statutes Chapter 429, and the City Charter,
for the benefits of which said lands are subject and liable
to special assessments, and for the payment of which the
City of.Fridley has a lien until the same are fully paid
with payment to be in one full and complete installment
thereof (unless otherwise hereafter provided by the City
of Fridley). That the improvements effected or caused to
be effected and of concern herein are:
Special Assessments to be paid to the City of Fridley $595.83
2. That pursuant to the ordinances of the City of Fridley
the sale and transfer of record of any of said lands by
the owners herein without first making payment of said
special assessments is unlawful; and the said sale and
transfer of record is prohibited under the terms of said
ordinances and any building permits granted thereunder,
until the said special assessments are fully paid (or
payments otherwise, excused or waived).
3. That pursuant to the provisions of said ordinances, the
terms of the building permits granted thereunder, and
the representations and agreements made relative thereto
by the owners, the Owners and each of them represent and
covenant for themselves, their heirs and assigns that no
sale or transfer of said premises or any of them shall be
made or attempted of record except and unless said
special assessments are fully paid, (excused or waived)
and the lien of the City of Fridley therefor satisfied;
and that any sale or transfer attempted in violation thereof
without the knowledge and consent of the City of Fridley is
and shall be void. That upon receipt of said payments, the
lien of the City of Fridley shall be satisfied and the City
may and shall execute and file notice there of record.
4. That this instrument and the notice of receipt of payment
or excuse or waiver, executed by the City of Fridley may
be filed of record P..mong the land records of the County
of Anoka, and State of Minnesota.
IN WITNESS WHEREOF the undersigned have set their hands this
28th day of Aupet , 19 62
\ 1i ' `►_U_
STATE OF MINNESOTA )
as.
COUNTY OF. i91 )
•
CHESTER L. GLISAN & SHIIt= M. GLISAN
ACKNOWLEDGMENT:
CITY CLERK
On this -14,04— day of • 19 " L •
before me, a Notary Public within and for said County, personally appeared
nj_ _ -j- _ / ^ ,P. _ __
to me known to be the person described in, and who
executed the foregoing instrument,
and acknowledged that he executed the same as
free act and deed •
�3*
MARVIN C. BRUNSELL
Notary Public ..N �. A-1 c',,—tY_ W". County, Minn.
My Commission Expizes Dec. 26, 1964
My Commission Expires , 19
SUPPLENENTARY AGREEMENT
THIS ACREEMENT supplements and shall be construed as an addendum
to the foregoing agreement.
WITNESS:
WHEREAS, it is understood and agreed that; CHNSM
8EB9AN
1. Subsequent to the execution of the prior agreement, AMMM & SHIMY
Ian has acquired rights and interests in further and addi- M. GLISAN
tional lots and parcels of land for which he requests a
building permit.
2. That the sales of the dwellings on other lots for which
permits have already been granted are not yet consummated,
and the dwellings constructed thereon are in varying stages
of completion or awaiting sale or approval for mortgage
loan purposes.
3. That should the City of Fridley grant any permit for a
dwelling to be constructed by the said MINIMUM on any CMBSM
lot or parcel of land, whether the game be already noted :GWM
within the terms of agreement or not, that then the pro-& SH3VM M.
visions of said agreement relative to escrow payments GLISAN
shall apply.
4. That to insure to the City the payment of eudh sioneys
(assessments for improvements) the said A 1 and
the owner of the lot or parcel involved shall execute a Q,IM
notice in favor of the City of Fridley, which may and & SHIRMY M.
shall be filed among the title records of the County, GLISAN
such notice shall be in substance like that attached
hereto as Exhibit "A".
IN WITNESS WHEREOF the parties hereto have set their hands this
day of 1_
CITY OF FRIDLEY
M M- OIZ MU14: Supplementary Agreement Applies
Lot Description Date Permit IsAued
Lot 8, 3100k S, 8/28/82
gma l ,#tdfte
BY: -
M.9.
CT r_*G Ato the following additional lots.
Permit Received by Whom (Initialsl
City of Fridley, Minn.
BUILDING PERMIT N° 6110
Date: ..�• '"r'o"
Owner:udder '.............
Address Address
1 N OF BUIL ING
No. SiaeetAFIFAW
Part of t
Lot —._ Block Adds .or Sub -Division .
Corner Lot _. Inside Lot . _ Setback .._—_ Si
Sewer Elevation _ Foundation Elevation
To be Used as:
DESCRIPTION OF BUILDING
Front - Depth Height Sq. Ft. Cu. Ft.
DepthHeight Sq. Ft. Cu. Ft.
Type of Construeff ~ � ,�/�Est.. � o be Completed
J
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.
err
In consideration of the payment of; a fee of ; permit is hereby granted to
to construct the building or 'addition as described above. This permit is granted upon
the express condition that the person io 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, re moving of buildings
within the city limits and this permit may be revoked at any v�platio f of the provisions of said
ordinances.
Inspector
NOTICE: ,
na pan* doss net corer the cendrUdhm, buteihbien for w1rhim phmbinB, ea hedb & -awr or Wder. Be Mrs to ae
the BUM* lntpeetor for apende permit for thea Mems.
Owner 1a Name
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Address - ,w. Address �= �•
76
LOCATION OF BUILDING
No. - Street Part of Lot
Lot B1ock�Addition or Subdivision X1
Corner Lot Inside Lot_.x_Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
o FrontDepth 7 Height.
Sq, Ft.
Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
To be Completed 19.®
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
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
Application for Plumbing and Gas rifting Pornritt
Dept. of Bldgs. Phone SII 4-7470 ,
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................---(a
x $1.50
$ O O
Future Fixture Opening ................—a�
x 1.20
$ / a
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
-U'
Water heater (Up to 200,000 BTU) ......
x 2.00
$ c O O
�jp[
�i
Q:
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
y
1z/{
K
Z
TAW
�Od
W
7z
?
�a
R
N
WATER HTR.
GAS
ELEG
3
7
N
3 F
C LL
u"f
LL G
U
l<
3
C� G
6'
C� O
Base
�
1st
2nd
3rd
4th
• Future Connection Openings
Comiected with
I
Sewer �
New Fixture, Old Openings
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................---(a
x $1.50
$ O O
Future Fixture Opening ................—a�
x 1.20
$ / a
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water heater (Up to 200,000 BTU) ......
x 2.00
$ c O O
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $1.50
$ 5 U
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$ ry
TOTAL FEE $ ZZ- r cO
City of Fridley:
The undersigned hereby .makes application for a permit for the work here!
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 7 195
Owner �G�` !°,/r/
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New Building Permit No sZ ,",.Z Permit No.
Signed
01
By
Business Phone No.
ROUGH
FINAL
APPI'ication for Power Plants and Heating. Cooling. Yentilation..Rehigerai'ion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
r 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 $
MECH. 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 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
Dept. of Bldgs. Phone SU 4-7470
Location 0�_ 70 - t/2 6'y
600144 /6 m F°
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, T n /U `' :�_ 19
Owner 4�z
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old New uilding Permit No. Permit No. 9
DESCRIPTION OF WORK
HEATING or POWER PLANTS—,Steam, Hot Water —No
Trade Name Size No 3 CAI- // -2-
Capacity Sq. Ft. E.D.R- BTU H.P.
Total Connected Load :Kom Kind of Fuel
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
See Fee Schedule
$
TOTAL FEE $ y Sjoetj
MWIG PLUMBING & HLQTV U
By ANOKA, MINN. 9FE1:. HA. qA392
s,+42 1M 7-59 Business Phone No
(REMARKS -OVER)
CITY OFN6#8F!
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
Windows Doors Reference Out. Wall Int. Wall I Ceiling Roof Floor Kind How ApplieJ
Yeo- I Yis - 0 19_ r2'� '
Fl Room I Length .43 Width /3 Height P II Fl.1 Room I Length Width / 6 Height
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
"' 1 »a». 1 0
Width Height No. of Lineal f . Area
No. Open.- of pane lights of crack sq. ft.
3`% / 7.
t. W / -
.3 6 `.o
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
/ 6 .? /1 d'
a3 (- go a- as,
Coef.1
Btu
Infiltration'
r,,p
,
Btu
Yo
L Q',
Glass'
"/D
2 ( y
~f
✓�
3ya 0
Exp. wall
G
y�
3 0� ✓� a y
Net exp. wall
Net exp. wall
S/ v
/0
/ V
Int. wall
Ceiling
Ceiling
ac3J�/3
/sem
aQQ
/.S®
f
Floor
..I
"' 1 »a». 1 0
Width Height No. of Lineal ft. Area
No. ofpane of pane lights of crack sq. ft.
_.o»
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
/ 6 .? /1 d'
a3 (- go a- as,
Infiltration
I A.3
A10 1
r,,p
Coef.
Btu
Infiltration
t2.
Exp. wall
"/D
2 ( y
Glass
Net exp. wall
,�
o�
a % $10
Exp. wall
3 0� ✓� a y
Ceiling
Net exp. wall
0
Flogr
O
Int. wall
Ceiling
/�
a 6
/sem
a g/ 0
Floor
a yV
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
) >:I_I 'R-0 Rttnln ILe..th 4 Width HeiQht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. ofpane of pane lights of crack sq. ft.
Coef.1
Btu
Infiltration
I A.3
A10 1
r,,p
Glass
/O IL
SD
6 3 O
Exp. wall
O
/ % 0
Net exp. wall
9
/o
G
Int. wall
Ceiling
0
Flogr
Int. wall
Total Btu.
Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area
B.D. 218
Width Height No. of Lineal ft. Area
No. of pane of pane it,
hts o! crack sq. ft.
2 .2 30. G /-
Coef. Btu
Infiltration C V .2 o7
Glass i Sv 9d
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.
Btu
Infiltration
6
0
Glass
/ % 0
-0
9
Exp. wall
Net exp. wall
Int. wall
Ceiling
G
/
a yV
Floor
Total Btu. 1h*X6'Y
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r
F1.1 Ak45t Room I Length Width y Height d'
Windows and Doors—Crackage and Area tt -e
Width Height Naos of
k Area,
No. of pane of.,
tights of creek eq. !t.
a 6 E,
Coef. Btu
Infiltration /.?-3 O 33�
Glass 7, 3 7
Exp. wall (�
Net exp. wall �5;3 c71 J-3 0
Int. wall
Ceiling X 17 O '1_6
Floor
Total Btu. v
W7—
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
CITY OF FRIDLEY INSPECTION DIV.
Effective On January 1,199$'
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION;
572-3604 REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
'
RATE SCHEDULE
JOB ADDRESS
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
Fu ce S t Work, Bumer —
rulings of the Building Division, and hereby declares that all the facts and
Al Re acement Furnace $ 20.00
$_ 01 co
representation stated In this application are true and
Gas Piping (Needed with new furnace) $10.00
$�
RAr4
OWNER
Gas Range $10.00
$
BUILDING USED AS
Gas Dryer $10.00
$
ESTIMATED COST 1
'/ PERMIT NO.
*Air Conditioning — All Sizes $10.00
$
All Others/Repaim & Alterations (LIST ON BACK)
SCRIETION OF FURNACE AN- D OFABONER
1% of Value of Appliance or Work
$
No. of HeatinUnits Circle One (Steam) (H Water (Wang3AIr
Trade Name Size No a
910
Commercial/Indust"
BTU HP EDR
I% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
$ Ao
Bumer Trade Name Size No.
TOTAL FEE
$g�,,,,�
BTU HP EDR
Richmond & Sons Elec., Inc. db�
Golden Valley MR, R Air Cd
HEATING C 5i i,,fest CroadwaV
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
phony 53�, �on0
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
Signed B Tel No.
PLUS THE $.50 STATE SURCHARGE
✓`
REINSPECTION FEE $30.00
Approved By Rough—in
Date Final Date
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
I
F]
NOTE: #1 through #8 required when using a side vent furnace.
The undersigned hereby verifies that the exiling chimney or stack:
1.
Has been carefully examined
Yes&/I' No
( )
2.
Is free from rust or deterioration
Yes (1/(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
( }
-�J r
6
Has Notal 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:
HEATING CO:
Signed By:
Date:
n
SUBJECT
P
City of Fridley
2 77 10
AT THE TOP OF THE TWINS
BUILDING P E R
M I T
r
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/11/98
JOB ADDRESS
70 - 66th Wav NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DI'GAL
8
5
Edgewater Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Richard & Linda Hart Same 55432
571-1459
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Owner 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 O ALTERATION JR REPAIR
❑ MOVE O REMOVE
6 DESCRIBE WORK
Reroof house & garage (26SQ) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
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
$2,228.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$74.75
Fire SC $2.23
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FE
8.09
OF CONTRACTOR ORAUTN RIZEDAG NT IDATEI
N P PE
A E T I$ Y PERMIT
XX-SS7.�GNATUREOF
v
BLDG NSP
y
DATE
OWNER IIF OWNER BUIL DERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `C
BUILDING PERMIT APPLICATION �A h
a
ConstructionAddress:
Legal Description:
Owner Name & Address: ��5�
Contractor: MN LICENSE #
Address: �'( yr/j Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: APPLICANT: Gl/ G�2��'" Tel.
. STIPULATIONS:
CITY USE ONLY
Permit Fee
$ °�SJ
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /. /
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$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:
01
SUBJECT
City of Fridley
3 i 5 01
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
16.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
I
NUMBER
11Ev
DATE
PAGE OF
AionOVEO BY
= CITY HALL FRIDLEY 55132
612-571-3450
910-F15
10/19/00
JOB ADDRESS 70 66 Way NE
T LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
5
Edgewater Gardens SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Richard Hart 70 66 Way NE 763-571-1459
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Minnesota Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-935-9669 2173
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
O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace four windows within existing openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit Inspection Cards
Will Be Failed
To Homeowner To Post
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 1 HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3 805
$1.90
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$97.25
Fire S $3.80
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FETOTAL
E
Licen S $5.00
P07.95
SIGN AT URE OFCONTRACTORORAUTHORIZED AGENT iDATEi
HE PROP ALIDAT THIS IS YOUR PERMIT
200,
��I
I
SIGNATURE Of OWNER,IF OWNER BUILDER,�DATE�
-B G SNS' MATE
01
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 70 -
Legal Description:
Owner Name & Address:
1K
Effective 1/1/2000
612-572-3604 Bldg Insp
Tel. # 16L-271—/1-12%
Contractor. NUNNESOU RUSCO, INC. MN LICENSE # R1715
Address: 0.58 Smetana Drive Tel. # clW -W- %6 9
MinnMnIta, MN 55343
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:
Construction Type: o'u- tie Esttiim�aatte, d Cost: $ J806'
Driveway Curb Cut Width Needed: Ft. + 67t = Ft x $ _ $
DATE: %® r APPLICANT:� [ 2-111
Tel. #� 2-2 -&—/
07
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in application
Permit Fee $_ q7 ®Z5 Fee Schedule on Reverse Side
Fire Surcharge $ J 80 .001 of Permit Valuation (1/10th%)
State Surcharge $ /• q0 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$ $1100 per SAC Unit
$ 0® $5.00 (State Licensed Residential Contractors)
E
"A" or Alt. "B" Above
$450.00 Conservation Plan Review
$ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $/07,715-
STIPULATIONS: eC "/'V42'5-
SUBJECT
PORMIT NO.
City of Fridley
(.
31611
AT THE TOP OF THE TWINS
P,
B U
I L D I N G P E R M I T
r
_
RE I T NO.
`y COMMUNITY DEVELOPMENT DIV.®�
f PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE Of
AVvgOVED By
CITY HALL FRIDLEY 55432
�''
612-571-3450
910-F15
1/9/01
JOB ADDRESS 70 66 Way NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
5
Edgewater Gardens SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dick Hart 70 66 Way NE
763-571-1459
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Minnesota Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-935-9669 2173
d 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 O ADDITION O ALTERATION 10 REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 4 windows within existing openings
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
1 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
$2,422 $1.21
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$83.25 Fire $2.42
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK F TOTAL F E
Lice e C $5. 0 $9 .
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE,
EN PROP ,DAT D :)PIS YOUR PERMIT
SIGNATURE OF OWNERIIF OWNER BUILDER, IDATEI
BL INSP 10,MATE
S
NEW [ J
ADDIS! [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 70 --
Legal Description:
Owner Name &
Effective 1/1/2000
612-572-3604 Bldg Insp
Tel. #
Contractor.SE:.R -QMe��nyiy4 MN LICENSE # �f%�
Address: Minnetonka, MN 55343 Tel. # fZga-W 9669
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP i ION 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:
Construction Type:stimated Cost: $ElAL
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $
DATE: m/ APPLICANT: 2�-4,— Tel. #
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application
Permit Fee Fee Schedule on Reverse Side
Fire Surcharge .001 of Permit Valuation (1/10th%)
State Surcharge $ Aa7 / $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$ $1100 per SAC Unit
$ . OO $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. 'B" Above
$ $450.00 Conservation Plan Review
Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ AS
STIPULATIONS: /�` 1/l /�'c dhd� _���� TLS} "Ov
CITY OF FRIDLEY 4-NSPECTION DIViSION Effective On January 1, 2002
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESSOWNER (,1 �� Harr
U-L VVI�
RATE SCHEDULE �1;5 1'' `yd
Residential Rate TOTAL I �•
Furnace Shell and Duct Work, Burner - BUILDING USED AS CiVV*1
Also Replacement Furnace $ 30.00 $%.."
*)E50-60
(Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO.
Gas Piping (Needed with new furnace, $ 10.00 $
but not replacement) DESCRIPTION OF FURNACE AND OR BURNER
Gas Range $ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Gas Dryer $ 10.00 $ Trade Name Size No.
BTU HP EDR
*Air Conditioning . All Sizes $ 25.00 $ Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
1% of Value of Appliance or Work $ BTU _ HP EDR
Commercial/Industrial
1.25% of Value of Appliance or Work
I,C/VA"OK t�P(cc:UIbo
z�-
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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 an
050 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE n 2 CS
Rlemon & wn cue. IND
HEATING CO 933: GOLDEN VALLEY HTG & IR
F
FAX #
.—CRYSTAL, MN 55429
__x763) 535-2WO TEL #
Approved By jtl %/1 Rough -In Date
J
Final Date
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VFNT. VFNT CONNFCTOR AND COMM I AIR VFRIFI CATION
i r .
When reIn acing an Pxosfinu furanr-p, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
` and is securely supported and firestopped where required. Yes( ) No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
a
Yes( No( )
The undersigned also verifies that the replacement unit is a listed assembly
BTU Input Fan Assisted or Nat
and meets the current codes and manufacturer's specifications. This does
BTU Input Fan Assisted or Nat
include AGA-GAMA Category I Central Furnace Venting Tables for fan
Total Btu Input
assisted and natural draft appliances.
Yes( No( )
The Pxisting combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes( ) No( )
When required to install a new nnmhtjst9nn air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes( ) No( )
When installing a new ventina -gV m, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes( ) No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #2 Type
BTU Input Fan Assisted or Nat
Appliance #3 Type
BTU Input Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
HEATING CO:
Signed By: Date :