PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT 11TH C437 )
Owner: Builder
Address Ad
LAT OFVILDING
No. Street — Part of t
Lot_ Block ddition or Sub -Division -- VY�
Corner Lot — Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To used
Front Depth`-- Height Sq. Ft. Cu. Ft
d=-~Fwnt Deptheight Sq. Ft. Cu. Ft.
J
Type o nairuction Est.+ — 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
ordinanc�a of the city of Fridley.
In consideration of the payment of a fee of $-;-/ 7 , 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 of any of the provisions of said
ordinances. ,s.
Building Inspector
NOTICE:
This permit does not cover the construction, tastailation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PFRhIIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder J04", -
Address
Address 7117-
LOCATION
117-
LOCATION OF BUILDING
No. ®� Street6 f� �- G� Part of Lot
Lot Block Addition or Subdivision„&, � � r �ZA *,o,44
�l
Corner Lot Inside Lot Setback Side -Yard
SZM ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be
as:
DESCRIPTION OF BUILDING
rJ
FA
Sq. Ft. 12, IF- Cu. Ft.
cont 2�2- Depth ZZ Height
Sq. Ft. L/09 Cu. Ft. Me
d�
Type of Construction r tggrm� Estimated Cost_ ��J Z929—
To
be Completed DC -,e7" /157—
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 the facts and rntations
stated in this application are true and correct.
DATE SIGNATURE �epre /
(A Schedule of Fi(e Costs can be found on the ReverWAJde.)
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK���
Number. Kind and Location of Fixtures Loaatio
q
3 CU3
RATE
=
ai
Number Fixtures .................
VI
; F-
Y
C LL
Future Fixture Opening .............. I.
Z
LL
N
U
3
v!
U� G
W
�z
U4a
Z
a
90
.
F
`
N
WATER HTR.
GAS
EIEC
Base
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
jO
/
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
Additional Fixtures ....................
x
.50
1st
Gas Range to 200,000 BTU ..............
x
2.00
$
2nd
3rd
4th
• Future Connection Openings I
New .Fixture, Old Openings 1
Connected with
Sewer
Cesspool �
PARTIAL RATE SCHEDULE
City of Fridley:
The undersigned hereby makes application for a permit for the work herel
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_$rue and correct.
Fridley, Minn
Owner
Kin of Building
' Used as
To be completed about
PLUMBING FIXTURE RATES:
NO.
RATE
AL
Number Fixtures .................
x
$1.50
$
Future Fixture Opening .............. I.
x
1.20
$ G
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ...... .....................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
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
$
REPAIRS & ALTERATIONS—Refer to Code
Description ...................
TOTAL FEE $
Estimated Cost, $
Old—New. Building Permit No
ROUGH
FINAL
Business Phone
194-1
Application for Power Pkmts and Healing. Coding. Ventilation..Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 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 §.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. IDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. IDR 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 BTL) ....................... 5.00 $ • e_�
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 See Fee Schedule
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $�
ROUGH
FINAL
Dept. of Bldgs. Phone SII. 4-7470
T.nrnt;nn ®f 0 % — W _*� 9
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.
Frivn Minn 19 4=J
Owner ✓�
Kind of
Used as
To be completed about
Estimated Cost, $ //7d
Old('—'Newuilding Permit No. Permit No. Z,5-
DESCRIPTION 4F WORK
HEATING or POWER PLANTS-Steap"Hot Wa , Warm Air No—
Trade NameS� 46'&&t-U&S9ze No 16r
Capacity Sq. Ft. E.D.R- T' d BTIT // H.P.
Total Connected Load��� �� Kind of Fu e i�illv�.
BURNER —Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Slg,,edRAyN. WEtTER HEATING t:(
By 4637 i;H(cAcn Avr_
MINNEAPOLIS 7, MINNESOTA
4Z 2M 7.59 Business Phone No
7
(REMARKS—OVER)
SUBJECT
NO.
City of Fridley
O
AT THE TOP OF THE TWINS
BUILDING PERMIT
_19280
RECEIPT NO
�
COMMUNITY DEVELOPMENT DIV.
_
r PROTECTIVE INSPECTION SEC.
9ig
CITY HALL FRIDLEY 55432
NUMBERDATE
REV.
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
11/19/87
JOB ADDRESS 209 - 69th Avenue N.E.
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
$
1
Rice Creek Plaza North Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
John Boser 209 - 69th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Beitler Building Systems 2751 Mississippi Street, New Brighton 55112
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
63 6-192 7
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remodel Kitchen
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS RF-QUIRED FOR
JiEATING, PLUMBING AND SIGNS.
�AJIRVXTIG,
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
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
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
$1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,000
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PR VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$32.50
ST R CTION OR THE PERFORMANCE OF CONSTRUCTION.
n
PLAN CHECK FEE
TOTAL FEE
r
$33.50
S GNAhJRrOF CONTRACTOR OR AUTHOR[ DAGE T IDAA)
WHEN PROPERLY ATED THIS IS YOURZMIT
9 a°
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
BLDG INSP FIAT
NEW [ ]
ADDN. [ ]
ALTER. [)4
Construction Address
Legal Description:_..[
Owner Name & Address:
Contractor:____
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
City of Fridley
R-1 AND R-2
Building Permit Application
I _ A ,
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Effective 4/1/86
Tel. # _
Tel . # 3�
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length J Width Height Sq. Ft.
Length _� Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
mo
Type of Construction: Estimated Cost: $ Z �--
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
/S -z 7
DATE: / APPLICANT: Tel.
(��TY USE ONLY
Permit Fee $ so Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 1,00 $.50/$1,000 Valuation
SAC Charge $ $ 525 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS: I -ASC J•��.C� V �p�, `l"
. W
Building
Inspections
763-572-3604
DATE_ L�
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
TYPE OF WORK:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
0-1 _ . YOUR
n
ADDRESS:
COMPANY NAME; 01ANDANO
CONTACT PERS( jC&Q , L.S', 410
MIN
STATE LICENSE #
PHONE
`SINGLE FAMILY ❑ TWO FAMILY
❑ NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK
FAX
9
Permit
Received By:
e1�eOC n �
MN 55408
STATE ZIP
❑ TOWNHOUSE
❑ ALTERATIONIREMODEL
PER MS 16B.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 futures. (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='
FOR PROJECTS WHERE LABOR EXCEEDS $500 ARE BASE ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: MEDICATE TOTAL
NUMBER OF EACH BELOW) o�CJ��1
BquipmentlnstalIC4 MFG. cl--, MODEL:3-LS- S1ZE/B
MFG: MODEL: SIZFIBTU
MFG: MODEL: SIZFJBTU
C $25.00 CE (GAS) $15.00 GAS RANGE(OVEN $10.
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
FURNACE $35.00 GAS UNIT HTR $10.00
BOILER $35.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.15.000
DUCT WORK $10.00 GAS PIPING $10.00 VENTII.ATOR $15.00
Permit Fee $
Number of fixtures @ $10.00 x $IU.UU =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00= $
TOTAL DUE $ Number of fixtures @ $25.00x $25.00 = $ 2 - db
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge= $ .50
THIS IS AN APPLICATION FOR A PERMITNOT 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 a City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an n for d work is not to start without a permit; that the work will be 7z)r7
ce with the
approved plan in the o rk whi review and approval of s• ATEl b
SIGNATURE OF APPL _ RSTL4Y!:�� ni�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS [EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXIS_T,.INQ MQDIt:S >:
1. Combustion Air (See note below)
a_ Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or PropanmVGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MIST Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation .
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per TMC 1346.0603.2
a_ ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
.combustion and make up air calculations