PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N? 2306
Date...{.:':e!�.�!.�.�t.................
Owner �"� �''r`. Builder Z''t.... .
Address........ ............................... Address .........................................
LOCATION OF BUILD[NG
No. Street Street ...� .� Parmf Lot ' .. .
Lot ......... Block ... ...... Addition or Sub -Division .L� 4 ...........
Corner Lot ....... Inside Lot ............ Setback ............ Sideyard ..........................
DESCRIPTION OF BUILDING
To Le Used as:
... . .. . .....'. Front Depth . :. Height ......... Sq. Ft. f.. �t b Cu. Ft........ .
Front Depth .71!!�Height�"_.. Sq. Ft. Cu. Ft.
Type of Construction ............'.. Est. Cost .ed�................. To be Completed ..........
In consideratior i of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work i I accordance with the description above set forth and in compliance with all provisions of
ordinances of the vi i,age of Fridley.
In consideration of the payment of a fee of $.. ..�'Sermit is hereby granted to .... .......
................... r *that
construct the building or addition as described above. This permit is ted upon
the express condition that the person to whom it is granted and his agents, employees and workm , 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 with-
in the village limits end this permit may be revoked at any time upon , violation of any of the .provisions of said
ordinances. f
f
.:.. ........ Building Inspector
NOTICE: JI 1
_ This permit toes not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. 6e sure oto see the Building Inspector for separate permits for these items.
City of Fridley, Minn..
BUILDING PERMIT
Date:
r
Owner: Builder
f
Address_ ._Y..`?r"e"t` ?_!�:!, Address
r
y;
N(4964
v'
".041 LOCATION Street . OF, %BUILDING
NO.:,,�...C41 ...... _:. L _ zr,� 22 meq. �..._.._._. ..._._
.s... i--...._......._.... Part of Lot ....._...,.._...._.. _........
Lot ................................... Block ..... ... _... ....................................... Addition or Sub -Division ..... .............. - ............. ....... _..._._....._.._.._....__............. _.....
_.._.
Corner Lot ..... . ................... _........ Inside Lot .....- ........... Setback .......... .ar , ,k.._...._........ Sideyard ....._.
+� f
Sewer Elevation ._..__....._...^ ---------- ----- _.._......._.................................... _ Foundation Elevation
DESCRIPTION OF BUILDING
To be7j7/'..4
_— '.ir. r.1.L.... Front .. f1_---.. Depth . ---..I.... Height ...,C ._.. Sq. Ft.'s, � Cu. Ft.• •--.............._....---............ Fro Depth ...................... ght ....._......... Sq. Ft. ................. _. Cu. Ft. .....................
Type of Construction .`�G.... Est. Cost............-•--:--........ To 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 in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
ff i w C/ -"
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, rep and moving of buildings
within the city limns and this permit may be revoked at any tim�}pon vip�lati 'X o y of the provisions of said
ordinances. a
Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
r • 4
APPLICATION FOR BUILDING PEEWIT
CITY OF FRIDLEY, MDINESOTA
Owners Name dar,
Address
LOCATION OF BUILDING
No.
d,46,
of Lot
Lot Block. Addition or Sub.Div.
Corner Lot Inside Lot ,--S.t Bask Side -Yard
SEWER ELEVATION a FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
Frost / 5 Depth Heights
Sq. Ft. Cu. Ft. G �1�
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction �: - Estimated Cost
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in striet accordance with the City Ordinances and ruling of
the Department of Buildings.. and hereby declares that all the facts and representa-
tions stated in this application are trues and cc
(A Schedule of Fee costs can be found on the Reverse Side.)
`, e
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
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
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
Gas Piping (NBeded with new furnace)
Gas Range
Gas Dryer
Rate TOTAL
$ 20.00 $
$ 10.00 $
$ 10.00 $
$10.00 $
"Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
I % of Value of Appliance or Work $ } �o C)
CommerciaUlndustrial
I % of Value of Appliance or Work $
State Surcharge $ .50_
TOTAL FEE $ NO_(;0
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.
JOB ADDRESS �5_ a-- V 7 1( -IE
The undersigned hereby makes application for a permit for the work
herein specified agreeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
that all the facts and representations stated in this application are
true and correct. - -'ti ,1991
J
OWNER C°����e� /� , g �F (� %1- 16 L/5--
BUILDING
/5®BUILDING USED AS-
C'
ESTIMATED COST �� < �O PERMIT NO. / C' / "r
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING COMPANY
AM; Judy
Signed By Minnegasco #34+
TOO W. Avenue
P. 0. Box 1165
*By
nneapoiis, MN 55440-1165
ApprovRough-In Date nal Date
FILL OFOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACE VERIFICATION
t
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:
s,
HEATING COMPANY
MI r
AW
Signed By �,�@��® 3 2.5386
n ®n Avenue
Date R, 0- BOX 1165
1111-11 INFIR Pull*; MN 0-1165
a
NIL
SUBJECT
City of Fridley
=28
4
THE TWINS
BUILDING
PERMITo
COMMUNITY DEVELOPMENT DIV.
_
e PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEV 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910 -FIS
12/29/98
JOB ADDRESS
524 67th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
7 1
Rice Creek
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Joyce Riento
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Builders & Remodelers Inc 3517 Hennepin Ayp R Mplg SS4nA
R27-S4RI
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION x® REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
eroof house andTear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCYLOAD
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
E READ AND EXAMINED THIS APPLICATION
1 HEREBY CERTIFY THAiR^NITNIG
STALLS
GARAGES
AND KNOW THE SA T WE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER S C IED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2142
$1.07
DOES NO PRES GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS F Y HER STATE OR LOCAL LAW REGULATING CON-
TRU P RMANCE OF CONSTRUCTION
$74.75
1'' a SC $2.14
PLAN CHECK FEE
T T L FEE
Licens $5.
2.96
SIGNAfuRE OF CON'RACTO AUTHORIZED AGENT IDATEI
HE P
Y VA
D THIS IS YOUR PERMIT
S-GNATURE OF OWNERoF OWNER BUILDER, IDATE,
g G INSP
riAfE
a
NIL
w
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 52 64 (7 A Aft Af Iters- J L -e
Legal Description:
Owner Name & Address:, K IW -r-b P Tel. !/
Contractor: �trs# Qi,"Ode l•orS MN LICENSE # % C�
Address: 35 /1 1-kmoepi-,+ 44 S Tel. # P7- Sy 9 /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width
GARAGE AREA: Length Width
DECK AREA: Length Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
OTHER:
Construction Type:
SOS
�� 0 ' e,! - ;0'07'Estimated Cost: $ .7111
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft= $ _ $ a' / V �
DATE: Z'.•�
APPLICANT:
Tel. # 2 % �y
.000
CITY USE ONLY
Permit Fee
$
74/-75-
Fee Schedule on Reverse Side
Fire Surcharge
$
oj, iii
.001 of Permit Valuation (1/10th%)
State Surcharge
$
/,07
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
S,60
$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
$
�o7. 96
STIPULATIONS:
FR�IDL�EY t
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
June 1, 1999
Joyce Kientop
524 6r Avenue NE
Fridley, MN 55432
Re: Final inspection at 524 6r Avenue NE
Contractor: Lakeland N. Heating & AC
Dear Ms. Kientop:
A mechanical permit was issued on June 25, 1998 for the property located at 524 670'
Avenue NE for a new air conditioner. According to Section 305(a) of the 1991 Uniform
Mechanical Code a final inspection shall be performed on the mechanical permit. As of
this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, we will expire the permit and any inspections on this installation will
require a new permit.
Any questions can be addressed to myself at (612) 572-3603.
Sincerely,
Barry Riesch
Building Inspector
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,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS S_�2 Y
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 -
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace $ 30.00
$
representations stated in this application are true and correct.
(Side Vent - Fill Out Back)
,1998
Gas Piping (Needed with new furnace) $10.00
$
OWNER L-0 c e—
Gas Range $10.00
$
BUILDING USED AS
Gas Dryer $10.00
$
ESTIMATED COST/ � coo "% PERMIT NO. l
*Air Conditioning - All Sizes $ 25.00
$
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) (Warm Air)
Trade Name Size No.
Commercial/Industrial
BTU HP EDR
1.25% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
$ .50
Burner Trade Name Size No.
S!&
i
BTU HP EDR
TOTAL FEE
t4 4 4910
HEATING COMPANY
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signe I� Tel No. ��- o
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
Approved By Rough -In Date Final Date 4/,01—
*
*Air
49&t
Conditioners can not be placed in a side yard without
FILL OUT
BACK SIDE FOR STAI VERIFICATION ON
written permission from adjoining property owner.
REPLACEMENT FURNACE
CHEgNEY 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
3.
4.
5.
6
Has no foreign objects lodged within
Is securely supported
Meets all current Code requirements for size
and total BTU's connected
Has total heating BTU's of
All other BTU's`"`
Yes () No ( )
Yes () No ( )
Yes () No ( )
Yes ( ) No ( )
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:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
Building
BUILDING
See Back Page for Fee Schedule
Permit No.: (�
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATE / ®- �2z' - O !�' YOUR E-MAIL ADDRESS
.001 x Permit Valuation (1/10%)
SITE ADDRESS "'vZ `{ — lv 2 %i" /� i/ E - /Z, E 4
$
THIS APPLICANT IS: Z OWNER []CONTRACTOR
SAC Charge
PROPERTY OWNER/
NAME: '::5 c' U C. e— /-�-/ �ti 70'e
Curb Cut Escrow
ADDRESS: � 7 7;4: A 41-C . 2) C _
CITY F fe/ ,0z-- ,r—S/ sTATEnfZIP6'-'5�-g3a
TENANT
$
PHONE: 74,3 — S"7/ -l6 yam"
Park Fee
CONTRACTOR
NAME:
Sewer Main Charge
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY STATE ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
[A SINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH [AROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWRvIMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
I
4f MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: �it',o e�✓� ['.�
/���.
SIZE OF RAPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES i G> R'HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES IATTACHED GARAGE
1. Existing Floor Plan
PROPOSED SIZE: ❑ DETACHED GARAGE
2. Proposed floor plan
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS. & PORCHES SUBMIT:
O Aluminum ❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
and proposed project
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
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 .B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 9/1OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Surcharge
$
(.0005) times the total job valuation — Minimum $.50
Fire Surcharge
$
.001 x Permit Valuation (1/10%)
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ VIA0
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires reyivv and approval of plans.
z
SIGNATURE OF APPLICANT
�'s�� D PRINT NAME �- / � P� ®� DATE / �
i