PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N°5 0 9 6
Date: '" ,�
,'Builder—
i
Address Address, — —
,1
CA, TION 0Fr WILDING
No. Street ' ,f 'e E Part t
Lot __ Block � pAddition or Sub-DI,A1 f "f ` � '
-01N'
Corner Lot _ Inside Lot ___ Setback Sideyard —
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To
OE
�/Used
yr
Front Depth : C� Height Sq. Ft. Cu. Ft. �r1
Fron Depth _.A -Height ..�- Sq. Ft. Cu. Ft. N-1
Type nstruction f , j�w 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.
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 viola f any of the provisions of said
ordinances
Building inspector
NOTICE:
This penult does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate peradts for them. items.
4
APPLICATION FOR BUILDING PERMIT
CITY OF FR.IDLEY, KDWSOTA
Owner's Nameya�
Af 4�-�-e Builder i.
Address Address
Q LOCATION OF BUILDING
No. 6 Street_ _ �L1 :/G i�d-Part of Lot
Lot
Addition
or Su ivis3onna a
%r� �,0,
Z Az?�
Corner Lot Inside Lot
16
Setback
�s� Side -Yard
2 '7
SEWER. ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
� ® /i
Front yy Depth y Height L�
Sq. Ft. /e 40� Cu. Ft. / 1 � 3 ,JV
Sq. Ft. X !P, 3 Cu. Ft. S � 0
Type of Construction_ Estimated Cost
To be Completed kdajg-� - ,L —
/o 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.
.i--- �
(A Schedule of Fee Costs can be found on the Reverse Side.)
App!•icwion for Power Plants and Hewing, Cooling, Ventilation, ReMgeration 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 $
MECiL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00
each add. 60,000 BTU ..................... I . 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. IDR 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 $ 'y
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x $1.50 $ i
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU .......... , x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
I
VENTILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $
S
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
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 area true and correct.
'dley, Minn.. FEB 2 8 1961 _, 195_
Owner -y' t. Z 195_
Kind of Building
Used as
To be completed about
195—
e�
Estimated Cost, $
'New. uilding Permit No.�� �j 9
i
DESCRIPTION OF WORK
HEATING or -29W = TS— Ste , - Warm Air—No-
e,
ir—No- f4�
Trade Name .,far f c�� ,L,,,,� Size Nom
CJ I ' ����� i f
Capacity Sq. Ft. E.D.R- :21__ BTU H.P.
,j
Total Connected Load C : S `-.' Kind of Fuel
BURNER — Trade Name Size No- � 7 �i o
Capacity Sq. Ft. EM Ick ��' �� aU H.P.
' GEO. S,EDGC(, 19G. Q AIR-CGi-,4,.
75- 1001 Xenia Av. 55,
Sign Minneapolis 16, Minn.
Bye
oglD.11 posr 1M-12-58 Business Phone No
i
HEAT LOSS CALaJLATIONS: DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
Yes—,No Yes—, No 19—
F1.1 Rnnm Length Width Heiaht 11 R-1
Windows and Doors—Crackage and Area
Width Height of No of Lineal fi. Area
No. of pane 01 pane llg�ts of crack sq. ft.
—No.
21
7.
Coef. Btu
Coef. Btu
Coef. Btu
Infiltration
Infiltration
Glass
Glass
Exp. wall
I Lj
Exp. wall
4
�2' ;
Int. wall
Net exp. wall
Ceiling
Int. wall
Floor
Ceiling
Int. wall
V
Floor
Ceiling
Total Btu:
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl -1 Room lLength Width Height
Windows and Doors—Crackage and Area
Width Height No of Lineal ft. Area
No. of pane of pane llff�ts of crack sq. ft*
—No.
21
7.
Coef. Btu
Coef. Btu
Infiltration
Btu
Coef. Btu
Infiltration
Glass
Net exp. wall
Exp. wall
Glass
Net exp. wall
Floor
Int. wall
Ceiling
Net exp. wall
Floor
Total BtW'
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
e R.k Room I Lenath o 0%, Width .o 14eiaht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. M
—No.
21
7.
Coef. Btu
Infiltration
Btu
Coef. Btu
Infiltration
Exp. wall
Net exp. wall
Glass
Ceiling
Floor
Exp. wall
Net exp. wall
4"
Int. wall
Ceiling
Floor
Total Bt ud 44 1-144
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
MINNEAPOLIS, MINN.
Insulation
Kind How. Applied
Rnnm I I .math Width Heistht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
—No.
21
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total W. s.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I -
r in I RrW%M I T.Pnath - , Width ' . 14eiaht
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
—No.
21
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
'o FI -1 , -1 vl Rnnrn I I.Priath -. Width Heistht -
Windows an Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total BW'.'
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
0
•
•
City of Fridley, Minn..
BUILDING PERMIT
Date: _._,Tune 2. 1969
Owner: DennisPesxson .u -
Address ' s e n_,- X.E.
LOCATION OF BUILDING
N° 10255
No. — 266 .— Street 69th A -venue e N.E. , --- — Part of Lot
Lot -- _4--.-_.__ Block 3� Addition or Sub -Division .R i o, ('repk ?I Nnrth Ad d i +i on
Corner Lot . Inside Lot _ _ Setback
Sewer Elevation
Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
S=age Front 22 Depth 4 Height 10 Sq. Ft. 528 Cu. Ft. 5280
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Iteame Fust. Cost — $800 -no — To be Completed 5 Monibs
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 orth and in co ante with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to
to construct the building or addition as described above. This permit is grantedupon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
dace in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Bliinaesota regarding location, construction, alteration, maintenance, repair aad. moving of buildings
within the dty limits and this permit may be revoked at any time upon violation of aay of the provisions of said
ordttumc�s.
CLARENCE BELISLE /h•
NOTICE
This permit don not cover the construction, b ataMan for wiring, plumbing, gas heating, sower or water. Be sun to as
the Building Inspector for separate permhs for thea home.
d +A
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER IS NAME mo✓. S
ADDRESS c?��� a �r , W X£ ADDRESS
LOCATION OF BUILDING
NQ. STREET
LOT `' BLOCK -3 ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDEYARD
SEWER ELEVATION TOP OF FOOTING
Applioant 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;
�-cr Front Depth Height /d
Square feet S,A Cubic Feet
Front Depth Height
Square feet Cubic Feet
Type of Construction Estimated Cost���'0
To Be Completed d� a
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. �
a �
DATE 6 SIGNATURF�Z��=:i-�
(Schedule of Fee Costs can be found on the Reverse Side.)
C\@�4'-�-a't�k/ g:� r L el—L-V -* --e ".." 5"0 V.00 -S
r
AppReation for Power Pkuds and Heating, cooling, Ventilation, Ite/Eie O oion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIS: RATE TOTAL
Furnace Shell & Duct Work ................ $10.00 =
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $ _
Repairs & Alterations each add. $800.00 3.00 $--.-
MECIL WARM AIS
Furnace Shell & Duct Work to 120,000 BTU ... .. . .. $10.00 $__
each add. 60,000 BTU .................... 3.00 ;
Replacement of Furnace 6.00
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00 $.
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
10.00
Each add. 200 sq. ft. EDR Steam
3.00
Each add. 320 sq. ft. EDR Hot Water
3.00 $___
OIL BURNER—to 3 gal. per hour 6.00 $ _
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 196,000 BTU) 8,00 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
Ist 3 Fixtures x$ Zoo $
Additional Fixtures x .75 $
Gas Range to 199,000 ag 8.00 $
AIR CONDITIONINa
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH �J�
FINAL r/ �' I
r
See Fee Schadnis
$
TOTAL FEE $�—
Dept. of Bldgs. Phone sso..sM
Leek 2 (P &
? �v
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
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 truet.
�rand correc
Fridley, Minn- 611 7 11!
r
Owner
Kind of Building ._
Used as -- - -- - To be completed about
Estimated Cost, $_.L?_/Jv
Old—New. Building Permit No. Permit No.
a.� j DPaCRI>P i IOR OF WORE
HKATING or POWER PLANTS—Steam, Not Water. Warm Air—No
Trade Name _ +(`"moi— ® 0 Size Ne -
Capacity Sq. Ft. E.D.R BTU � T f gp
Total Connected Load Kind of Fuel
BURNER —Trade Na.eee Size No
Capa i Sq. F't. E.D.R BT U
BP.
(REMARKS -OVER)
Sie..ert
Business Phare No- 19 —/ /(®
Building
$ 97. A5
BUILDING
Permit No.:�-/4171
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Surcharge
CITY OF FRIDLEY
D 'A G 1 7
,
$
SATE O �
YOUR E-MAIL ADDRESS
$
3ITEADD S ` 6'97,9LVF,I�NIsV,7 Z_
Curb Cut Escrow
THIS APPLICANT IS:
DOWNER ❑CONTRACTOR
Erosion Control
PROPERTY OWl�TER!
NAME: �JeAl iV i S da�aPSoN
Park Fee
ADDREssA-6i� ,4'?71V l ile. M A'�,' CITY d!!i g�
sTATE zT&—f
TENANT
$
PHONE: r.irf °- d�71— 41,/2.e3—
Total Due
CONTRACT R
NAME:
STATE LICENSE 4 EXP DATE
SUBMIT A C Y OF
YOUR STATE ICENSE
ADDRESS: CITY
STATE ZIP
WITH APP CATION
PHONE FAX
PROpEp&y TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ;2-6
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑soffit
ADDITIONS. & PORCHES SUBMIT:
❑ 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 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
$ 97. A5
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 511
.001 times the total job valuation
Surcharge
$ -1` �t O
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( }
Total Due
$
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 re ew and approval of plans.
SIGNATURE OF APPLICAN�j.1�� PRINT NAME DATE %