PRE 2010 DOCSBUILDING PERMIT
Village of
Date
�,•� f,► .............. ...............
Owner
Fridley, Minn. N° 2354
Builder ..... ......................
Address .."°r+i.G Address
LOCATION OF BUILDING
No.. f:�QGf...... Street ..�, ..!:. ........... Part of Lot .......................
Lot .... // ...... Block ............. Addition or Sub -Division . � .. % .. � s,: k-Zt r'.. .
Corner Lot ........ ... Inside Lot ............ S '
. Setback �, .!o#/f Sideyard /,V.s . .Wvt ...........
DESCRIPTION OF BUILDING
To be Used as:
1
. ... t; Front f . * Depth . �.. Height /,,4r.. Sq. Ft.. �,d.41P Cu. Ft........ .
..... i, Front , .. Depth .�(... HeightSq. Ft.. ;�8 O . Cu. Ft........ .
Type of Constructioxl ... Est. Cos ...*j ? .......... To be Completed ...................
�b
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
I
In considera ' n mf the payment of a fee of $ permit is hereby granted to ......... .
. to construct the buildingoi- addition as described above. T per�tisg ted upon
co
.tion] t the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and Ripon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked_ at any time upon violation of any of the provisions of said
ordinances. i' _ _ .��•.
Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
•
CITY- OF FRIOLEY
6439 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
August 18, 19.80
Mr. Theodore Warburg
500 - 67th Avenue N.E.
Fridley, MN 55432
Re: Intersection Vision Safety Zone Obstruction
Dear Mr. Warburg:
TELEPHONE ( 612)571-3450
In order to provide -safe passage for vehicular and pedestrian traffic in
the City of Fridley, periodic inspections of street intersections are
conducted. An inspection on August 15, 1980 has determined that the
intersection on your property is obstructed and could present a hazard to
traffic.
Section 205.154 of the City Code requires that, "On a corner lot in a
vision safety control zone, nothing shall be erected, placed, planted or
allowed to grow in such a manner as to impede vision. . ., the vision
safety control zone is described as follows: That area bounded by the -
street right of way lines of a corner lot and a straight line joining
points on said right of way lines twenty five (25) feet from the inter-
section of said right of way lines."
Therefore, the City is requesting you, the property owner, to correct the
following problem and thereby make the City's streets safer for travel. A
reinspection will be conducted on or about September 2, 1980 to determine'
compliance. We are confident in your cooperation to correct this matter
and if any questions or problems result frau this letter, please contact
me at 5713450.
The inspection of your lot indicated that the following obstruction
existed and -should be corrected: 11
Shrub (s) or. bush (es) growing into sight line - trim down or back L
Tree branches growing into sight line - trim up
,Hedge growing into sight line - trim down or back
Fence extending into sight line - lower or remove
Other
Sincerely,
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
97-84-879001
• .. �r.'i.'i �Crt �'W:•!I111JO hf�G Lrl;, i", i, � ',.r�•!,
I T— t--•—
i U I tq, I G I f N
•- _ _I_� dryer•_.
IhCer JCC hL!JLC55 500 NE 67 Ave.
Ilt:att:r
-
ai I- DeparL:rr:nt cf tr� tl iir}gym
;Ls :l Lc City r,f rrldl,:y
Tel, b5ll-3.150
Thu tutdorelari, d h tt Cy «:;kt a applies t: c- fLr a ..rat,. f.;r 0.4o Wolk I,erelr,
®pacif;;
'ad agtecln� LJ dr al; work in str:et ..:o b-10- tL, Cltf Cv�t•
and rulings of the Ge::arLlrcnL of B,:L:Alrj;, _•-� -errt '.o
tho facia ,j n,,rcprur rtdL10fid Stal.O.I 1' tl,lo..y r la[Ot Ilan 61:
[tj0 and
8-20-80
I'1� I , : e.:Lcd w1Lh Sever
tel:,lo, G1.1 G3.to:r J Nater
[1IJ!IL k:%i Es RATS
t�,..,re7 x 53.Go
J'uL,+t r. F:mc.tLe Gl.cr.r:7
x $2.00
Lea l 1.t.1Ld, Old Gl,e :: s $
::.CO
Ct(e„ usa1U
$ 5. 00
irate, 11eAtnr - to 51,030 b -J Y $5,00
1 uo, J00 bIu to 15 w0 I, -,L, x $10.00
decor �„ftenor x $7.00
Icd t.tu,u,.l ktn O15 b,tlJlr.l x 55.00
I:leLttI; w,ler cloacae x $5.00
5 I I I I I Nc FUs;
14 t.traa x 43,00
h.L11tt,,,a1 Ilaturae x $1.00
l-ts h,,,Jo t;, 199,GOu bIU x $10.00
PA1tti 4 AI.TEIL•.TIDNS
rl:.t i Ow.ou
ae.lr a•1.1, S1J0:�0 �e [taeuon 5:.00 $
SLat® Surcharge $ 50
$ 8.00
TOT„I.
Tcjrr,L t t.L•
CWNER Doyle —
KIND OF UUILGI;;3 fr�Trie
USED AS red
TO DE COOPLCTED Ut;UP 8-27— 0 _
ESTIMATED COST 50.00
OLD - IIL41 UUILGI:L; Pt.l, 111
St.lne.l By MINNEGASCO
ROUGH I11SP .
Da k d
rimIL I11sp.
Once .
APPRUVAL holt FElulif J♦�
MIUIh1U11 113: Jt,q WY PLUt:u111.: PCI6;;Ir IS $7,50 FLUS p.5D SI1.8E SURt1ul1116E
tAmA 1 ��
It :?JD _�
'ITY OF FRIDLEY INSPECTION DIVISION qlqoo
Effective On May 10, 1999
5431 University Ave NE �
=ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
372.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS_��"1
RATE SCHEDULE OWNER
-lesidential Rate TOTAL P 1
Furnace Shelf and Duct Work, Burner . BUILDING USED AS --S � � 1�� '
Also Replacement Furnace $ 30.00
(Side Vent - Fill Out Back) ESTIMATED COST � � • � PERMIT NO. / /u
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 Cne (Steam) (Hot Water arm )
Gas Dryer $ 10.00 $ Trade Name Size No.5VT""_� �
BTU Lrb,C7�cS� HP EDR
*Air Conditioning . All Sizes $ 25.00 $ FuelTotal Connected Load
J
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
117. of Value of Appliance or Work $ BTU HP EDR
Commercial/Industrial
1.2517. of Value of Appliance or Work $ 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 ar
State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
TOTAL FEE $ �� F� iARCUAL�TY,C•
2619400N RAPIDS
.COON RAPOS, MN 66433
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION :HEATING 12 757-5040•REFRIGERAT14N/AIR CONDITIONING PERMIT IS $25.00 �PLUS THE $.50 STATE SURCHARGE d; �, ;. =� DATE-
. /
REINSPECTION FEE$47.00/Hr ZRough-In
"Air Conditioners can not be placed in a side yard without Approved Date Final D
written permission from adjoining property owner.
• FILt. OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE
CHIIWMY 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 (j. No ( )
3. Has no foreign objects lodged within Yes (\X 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 �r
All other BTU's
TOTAL BTU's' q
7. Has a liner been provided for water heater Yes) No ( )
8. Has combustion air been provided for water heater Yes No ( )
Remarks-,
:List ALTERATIO, S_Beina Done: �n ' rJ `�
n S'v
rta
.• N
rtf .
DEPENDABLE IN MAIRQUALff, INC. gig
2619 COON RAPIDS BOULEVARD
COON RAPIDS, MN 55433 �.
HEATING CO: (612) 757-5040
Signed By:
Date: I C
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
October 17, 2001
Jody Hoglund
500 67 Avenue NE
Fridley, MN 55432
Re: Final Inspection at 500 67 Avenue NE
Contractor: Dependable Indoor Air Quality Inc.
Dear Jody Hoglund:
A mechanical permit was issued on September 19, 2000 to install a furnace at your address.
According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be
conducted on the mechanical work authorized by this permit. As of this date, no inspection has
been called for.
The permit fee that was paid covers the inspections to make sure the work was completed
according to the Mechanical Code. We will keep your permit open for another 30 days and if we
do not hear from you within this time to set up the inspection, we will expire the permit and no
further action will be taken.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DAVE J
Building
DJ/mh
JUL-27-2005 14:15 CITY OF FRIDLEY
P. 02/03
City of Fridley Building Inspections Dept Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit# a�adS- b>av9
Residential Application
City of Fridley
See Back Side For Required Information
Date (')1 1;1-11 C)� Site Address: umA_
The applicant is: cidee one) Owner
Property Owner.
�h-
State:ne: -jlb �� - Ceil•
Contractor Information
City: State: &\ 0 Zip:! --XDV
Phone:1(63-491-el &V) Cell: Fax::Ilv5 �l-Oi-Ot
Email MN Bon d# & Exp Date00'
of Work (circle one): New
Detailed Description of work.
Alteration/Remodel
MFG: Model: Size/BTU:
MFG: Model: Size/BTU:
check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00
$25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00
to Air exchanger $15.00Furnace $35.00 _Pool Heater $35.00
ler $35.00 _Gas Dryer $10.00 _Ventilator $15.00
mney Liner $10.00 Gas Piping $10.00
ntWork $10.00 Gas Range/Oven $10.00
t Fee $ oe (Total from above -Minimum fee $35.00)
urge $ 0.50
Due $ 3� h7 Make check payable to City of Fridley
This is an application for a permit- not valid until processed
1 hereby apply for a mechanical permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and
with the Minnesota Construction Godes, that I understand this is not a permit but only an application
for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in case of all work which requires review and approval of plans.
Signature of Applicant:J& LJ JJX \A MD, I f(�L Date:
Approval Inspector Signature: v Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Building
BUILDING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By
763-572-3604
CITY OF FRIDLEY
Date Rec'd: L/
DATE g``I1l -Z-V /SO_ YOUR E-MAIL ADDRESS 1twlWa z ,� (`� '�/ C G
SITE ADDRESS -5-a) C-7 6 - �rP . �E ,
THIS APPLICANT IS:
JZ.OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME; a �- A.
TENANT
ADDRESS: SDD 6{= ".. CITYSTATBtWl?
�SZ-
PHONE: `7 3— -5-2% --0) 7 9
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
IrSINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH PROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
,IrMAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING -i- M - f 0V
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES /
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
I. Existing Floor Plan
2• Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �2 i I '�-) OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
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 codes of the City of ridley with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for permit and work is t to s wi out a permit; that the work will be in accordance with the approved
plan in the case of all work c equir review a a roval o pl //
SIGNATURE OF APPL�IC T NAME 2'� h//U. —� DATE 4S / V • b-(1
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
understand that the State of Minnesota
requires that all residential uilding contractors, remodelers and roofers obtain a state
license unless they qualify for a specific exempt' fro the licensing requirements. As
the owner of the property at 5%D &7� 1�- NE , Fridley, I
am exempt from the state licensing requirement only if I am not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that I
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable building codes and city ordinances in connection with the work bein
performed on this property.
�a� f
C J" •� '
Date l �4 -2 ���