PRE 2010 DOCSto 0
BUILDING PERMIT
Village of Fridley, Minn. No
Date;?..N� .!;!FK..........................
Owner .. /.`'!4!v,� . .... 7 ..' ........... .
Address % 3 .?Q .®.. F'�^� t .. ��V .. 4:.... .
2Q5y
Builder`!.�s�.... .... �...� .
Address a
r 9�OCATION OF BUILDING
No. .� �� %.�? ...... Street ... i ........... Part of Lot
.p..
Lot ................ Block ................ Addition or Sub -Division ... .. ....... .. ........
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ..........................
DESCRIPTION OF BUILDING
To��jLb�eeU�Used as:
0 :""� ........... Front ...#. Depth7A .... Height Sq. Ft. Cu. Ft. ........
.................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft........ .
Type of Construction . - ....... Est. Cost .... Q.0.0 ........... To be Completed . a?,-.i'1�L4� o ... .
,Or / f ,/.
'�
�f ®�
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 pr io f
ordinances of the village of Fridley.
In jHeide io f 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 with-
in the village limits and this permit may be revoked any tim upon�gto]Vpof 'any of the provisions of said
ordinances. J / 1�2
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 Fridley, Minn.
BUILDING PERMIT N?s i 3
Date: u*A6
Owner: — yAet Builder
Address Address --
No Street
�
-Block
Corner Lot, _ ) Inst Lot
-r-f
)F_ BUILDING
Part of Lot
Ilion or Sub -Division
Setback r . iot � 2 _� Sideyard
Sewer Elevation ____ — Foundation Elevation
DESCRIPTION OF BUILDING
T .fie as:
fit...._. Front Depth Height L.-4.G�_ Sq. Ft. Cu. Ft lk�
From Depth Height Sq. Ft. Cu. Ft.
Type of Construction = r = 4W_ Est. Cost 00!=�= 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 for , 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, reRpdr and moving of buildings
within city
city limits and this permit may be revoked at any time upon yiolati6n o any of the provisions of said
ordinan
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 Items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
LOCATION OF BUILDING
No. I 4; StreetPart of.. Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and
proposed building location.
DESCRIPTION OF BUILDING
To be used ac
FrontDepth Height
Sq. Ft. Cu. Ft.
—
Front Depth Height
sq. Ft. Cu. Ft,_
Type of Construction Estimated Cost 16 0-0,
To be Completed
The undersigned hereby makes application for permit for the work
herein specified, agreeing to do all work in strict accordance with
the City of Fridley Ordinances and ruling of the Department of Build-
ings, and hereby declares that all the facts and representations
stated in this application are true and correct -.k
DATE SIGNATURE
(schedule of Fee Costs can be found on the Reverse side).
City of Fridley
Application for PkmMng and Gas fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
q
NN
$
15Q
F
Z
12
u�<y Y c Z G�Z �jO
3 � c �a
U�'
f�'� a�
aG
Z
'
0 0
•
F
•
N
WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings
Connected with
I Sewer �
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 99,000 BTI) ......
x $2.00
$
x $1.50
$
x $1.50
$
x $3.25
$
x $3.00
$
New Ground Run Old Bldg . ............ - L_ x $3.25 $
Electric Water Heater a $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ...... ................... x $2.00 $
Additional Fixtures .................... x $ .75 $
Gas Range to 199,000 BTU .............. x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $ J `� ��
Dept. of Bldgs. Phone 560-3450 / g,
Location / 3 7 `,
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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, 1Vlinn �--Y 1915
Owner h///%' rZ //Q L S D ti
Kind of Building
Used as
To be completed about
v �
Estimated Cost, $ �O
Old—New. Building Permit No Permit No.
Signe
By
Business Phone No.
ROUGH
FINAL
CITY OF FRIDLEY INSPECTION DIVISION v 40.
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 Rate
Fumace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00
(Side Vent - Fill Out Back)
X Gas Piping (Needed with new furnace) $10.00
Gas Range $10.00
Gas Dryer $10.00
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
TOTAL
$ 50-06
$ 25.00 $ S.00
Effective On January 1 1998
JOB ADDRESS / � It , & q� �)Ve /Uf-
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
,1998
OWNER e del " a t-kie, hd i -te
BUILDING USED AS
ESTIMATED COST
PERMIT NO. g 13tl/
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units / Circle One (Steam) (Hot Water (Warm Air)
Trade Name_ ['C)/emah 'FUC,6 n Size No.
BTU gG, boc) —HP—" EDR
$ Fuel_/U,J, &vtJ Total Connected Load
State Surcharge $ .50 Burner Trade Name
TOTAL FEE 5�
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
BTU
Size No.
HP EDR
HEATING COMPANY
Signed By JC4 Tel No.
� 1
Approved By Rough -In Date Final ee
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON d1lod
written permission from adjoining property owner. REPLACEMENT FURNACE
0
CgIlV NEY 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 ()
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
( )
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks: .
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
Yes No
Yes No
s�
su9JEtT
PaR
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT.
r?
11"
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
7140
r � �
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
10/19/98
JOB ADDRESS 1370 69th Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
pt.1,p.540
Rev. Auditor's
Subdivision #10 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Todd & Jackie White
571-9072
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 iEc ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Alterations to existing interior walls, adding interior wall in basement,
replacing window; Construct a 20' x 24' Addition to Dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
Install smoke detectors to meet the State
Building Code - in each sleeping
room and on each level of house.
VV
UPARATE PERMITS REQUIRED FOR
Beall
MING, HEATING, PLUMBING
utility locations
AND SIGNS.
454-0042 ..
REOWRED BY LAW
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
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$35,976
$17.99
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$448.75
Fire SC $35.98
PLAN CHECK FEE
I
TOTA EE
75 .72
SIGNATURE F ON'RACTO RA rNOFuZED AGENT iOATEj
lo^P 40e V=1DATIS IS YOUR PERMI
BLD NSF' SIA
S-GNATURE OF OWNER,IF OWNER BWLOERI iDATE,
s�
C ] Ok
ADDN [jC] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 /
BUILDING PERMIT APPLICATION I
ConstructionAddress: I X70_ (> TVT 1,filel N6, Frid le
J�indi�v5 9a$d;vis/uhNo. iovrv,'sew,"ofFrzil�y.Td,
Legal Description: be ;nniv�a a a�i�i-an/UG'rFl. 1,,te dal�riee'73ri kei f" /- 64
hhe i�fee{ FG e�ue S pav�le `�rrfh eW ahe 3o? -Few+-themv- vv ",p"v. iej WJ-Qu ►,
Owner Name & Address: Tdd��iar.�l� Whi�P
1/1/98
sve��/nf// am.;l ro,n c/.l.e �. rie �'i1r< Si�tiila iAi�ai-�i�
CAI pOVIel Wi+hh/i1hc
Tel. #
Contractor: -r -f MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length 0 Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
.DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: -41he him t0 //rii°_t lir milk alidi/[ti %d,-ktiw igllj-l/ 81 I1Q�l71sodzfii'ei
GL'is760i'✓• J J���9��� �
Construction Type: Wad- 6Amc Estimated Cost: $
(Fee Schedule on Back)4px .
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
cS
DATE: 1011319k APPLICANT: % Z L Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$. 7S Fee Schedule on Reverse Side
$�� .001 of Permit Valuation (1/10th%)
$ %. 7 $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ / $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
0 17J
e 2 Uc)
/13. Isz
8,217
DEC 22 '98 09:24 FR M M TRUSS SPECIAL 1 715 876 5565 TO FRID P.02i02
Cb dtMd 5 ;6CtrC5C � ub :till tib • dd JdU
$�
06
g1,
is 112 1
a
it, I III JLX IV
fit
Alf
all'Fri
, ���: �Ci �.� QRS � �q�� •��e �R��� • rte s � M .
� �><�
111qs o��{�a��
fy,
�Y
6EI-9or zona d vii -1 5111i892821
�5-1 p
J
IJ ••_��
' Q R
®> Milo t ��� NC
hx
sw
? ,'
, g E�
:w g �
= Q1 ;211
h
N
aaa�� 'sem 0
o 0�
. o e
g �° p•! � HX
5�~"
��oC�SSo�
�� f±� �Mlwio�l�egf! f'1 f7�lyA1�i PUN
7i i� • ; 1 1 1 1
«er MwpNIp..
.Oi.Ji.P..O.
MN m�1100
eoave�OeO
� t- kteoo�'R
Mr
0 0 0 0 wMe
NW w i -"g
m recur r M • /
1 i+ oovl+
1 oweev 1 �
i1 I I 1 i OPO w
o�irm
NolllsodV03 301 331;=Jd BV50 BB -Zi -330
** TOTAL PAGE.02
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1999
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
NO. RATE TOTAL
__
Gas Range**
Gas Dryer** _
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS 13
C7A4,4uc
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 rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner 1
add Building Used As ® `e
Estimated Cost 12 PERMIT NO.
PLUMBING COMPANY
SIGNED BY�TEL N0.�-107.
Approved By Rough—In Date Final Date
$ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
s'20-5-0 PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
IN
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
September 11, 2000
Todd White
1370 69 Ave. NE
Fridley, MN 55432
Re: Final Inspection 1370 69 Ave. NE
Contractor: Owner
Dear Mr. White:
A plumbing permit was issued on May 7, 1999, for the above noted address,
to install a gas water heater. According to section 4715.2800 of the State
Plumbing Code, a final inspection shall be conducted on the plumbing authorized
by this 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 (763) 572-3603.
Sincerely,
DA'bEANSEN
Buil g Inspector
CITY OF FRIDLEY INSPECTION DIViSION
/
Effective On May 10, 1999
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
E)
JOB ADDRESS
RATE SCHEDULE
Q
OWNER aC
Residential Rate
TOTAL
/
Furnace Shell and Duct Work, Burner .
BUILDING USED AS Ya ILI <Z
Also Replacement Furnace $ 30.00
$
(/ r
(Side Vent - Fill Out Back)
ESTIMATED COST PERMIT N0.--
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%f Val a of Applianc or Work
$
BTU HP EDR
Commercial/Industrial
1.25% 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 an
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
2S
$ 5�
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
HEATING CO
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
0�'"4 �� 9
PLUS THE $.50 STATE SURCHARGE
Signed DATE
REINSPECTION FEE $47.00/Hr
L'Air Conditioners can not be placed in a side yard without
Approved By i� Rough -In Date Final D e
written permission from adjoining property owner.
lbbtollo
CHIlMEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
L Has been carefully examined Yes () No ( )
2. Is free from rust or deterioration
3. Has no foreign objects lodged within
4. Is securely supported
5. Meets all current Code requirements for size
and total BTU's connected
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
Yes No
Yes () No ( )
Yes () No ( )
Yes ( ) No ( )
Yes ()
No
( )
Yes ()
No
( )
SUBJECT
PERMI
City of Fridley
31854
AT THE TOP OF THE TWINS
'BUILDING PERMIT
RECEIPT NO.
r
COMMUNITY DEVELOPMENT DIV.
572-36®4
/�
f PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED By
' i---1 CITY HALL FRIDLEY 55432
612-571-3450
910415
5/25/01
JOB ADDRESS 1370 69 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
oescR.
Pt 1
Rev. Auditor's Subdivision 410 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Todd White 1370 69 Avenue NE 763-571-9072
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Same
4 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 ❑ ADDITION O ALTERATION ER REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
SEPARATE PERMITS ARE REOUIRED 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
I 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
$
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$504
•50
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.
$23.SO,
Fre SC $.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
40TAL FEE
$24.
TNOR EOsGENT DATE ,
N P PEAL Y DATED TMI IS YAI�
�IGNeTUREOFC�ACBiORORs
C
S-GNATUAE OF OWNER SIF OWNER BUILDER, iDATEi
BIOG S� q�tE
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 13 ?
Legal Description: _ n
Owner Name & Address: p�� �� ��- Tel. # 06 !; % (" Qa7 2
Contractor: r r MN LICENSE #
Address: Tel. #
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: S, ���5 4-D IJSe Estimated Cost: $ ��`� � , < �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ I = $
DATE: !;--25--c:> I
APPLICANT: �c1-wx* C'Tel. # (76-0 5' %
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ or3 5-0 Fee Schedule on Reverse Side
Fire Surcharge $ C—d .001 of Permit Valuation (1/10th%)
State Surcharge $ .� D $.50/$1,000 Valuation
SAC Charge $ $1150 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 $ �v
STIPULATIONS:
%�
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
763-572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2001
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures .3
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range"
Gas Dryer""
Back Flow Preventer Required ( )Yes () No
$ 7.00 ::,?/ OCA
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $ 2 .. —ro
JOB ADDRESS /370
�-r,�rD I�
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 rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Building Used As�
Estimated Cost I/PERMIT NO.
PLUMBING COMPANY
SIGNED BY
Approved By
TEL N0: 7�3 / u b 7? �7?
Rough -In Date 1a Final Da - ~
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, 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. Yes ( ) No ( )
The undersigned also verifies that the replacement unit 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 ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, 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. 4 Yes( )No(
)
Appliance Type and Size/Common Vent and Vent Connector Information
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
I
CfiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
March 14, 2003
Mr. Todd White
1370 69 Avenue NE
Fridley, MN 55432
Re: Final Inspection at 1370 69 Avenue NE
Contractor: JMT Plumbing
Dear Mr. White:
A plumbing permit was issued on December 27, 2001 to install three plumbing fixtures at
your address. According to Section 4715.2800 of the State Plumbing Code, a final
inspection shall be conducted on the work authorized by this permit. As of this date we
have conducted the rough -in inspection but the final inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. 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 mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
1
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SUBJECT
PE
City of Fridley
34056-
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
`v _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
`
A CITY HALL FRIDLEY 55432
..•- ; �
L J` 763-571-3450
910415
12/17/03
JOB ADDRESS 1370 69 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt 1
Rev. Auditor's Subdivision #10 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Todd & Jaclyn White 1370 69 AVenue NE
763-571-9072
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Haram Restoration 8013 6 St NE, Minneapolis, MN 55432 612-644-3674 20247730
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 O ALTERATION O REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Construct a 16' x 12' Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
Before digging call for
SEPARATE PERMITS
all utility locations
REQUIRED FOR: 45"00
MIRING, HEATING,
1RY LAW
PLUMBING AND SIGN
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
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
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
$2,384
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1.19
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-
STRUCTION OR THE PERFORMANC OF CONSTRUCTION
PLAN CHECK F
TO AL FEE
�� �^ ®�
Lice $5.0
$91.82
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATE,
HE PRO VALI AT D THIS IS YOUR P MIT
_
Z
B G iNSP I r)AT
SIGNATURE OF OW NER iii OWNER BUII DE Rj iDATE�
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572- - dg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763 -1287 Fa
BUILDING PERMIT APPLICATION
Construction Address: 47"t- A c— ' Fyl d
Legal Description:
Owner Name & Address: �/ �� �� AL1' Tel. #
Contractor. tf A iZA ✓ A ( srteA, l ne _ MN LICENSE # Zz::)Z- ' -77- Z�
Address: `��►�✓ (off Sr �� Pis rtil� oZ Tel. # 6AZ
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
t
Sq. Ft.
DECK AREA:
Length
Width 12 Hgt/Ground Q
Sq. Ft.
OTHER:
J 0138f . Ce4
Construction Type: `�� Estimated Cost: ${--
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: ZL A APPLICANT: Tel. # %
Call (763) 572-3604'for Permit Fees if maiikki in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$�. �� Fee Schedule on Reverse Side
$ Q• _-_S` 8 .001 of Permit Valuation (1/10th%)
$ I a fi $.50/$1,000 Valuation
$ _ $1275 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
�. A mmW. Cz11 G=� d8 oxG60 4L-(s4_0CXS7:).-.
THIS JOB COPY SHALL BE
AVAILABLE ON THE JOB
SITE FOR THE FRAMING
AND FINAL INSPECTIONS 391,
6'
existing 2''x 12'', 12'
green treated I e ger boa
aSk A I ( 5-K 1. (OR 4 EN I m
x - gf eep i It rea Led
I edger bo �and . Bo I t)e� to ex i st i ng
w`3''boIis (2, 16''0+.C.)
N�►1 �-�61Cc
I.
I,
I'
2'' x 10'
green treatem j 0-1sts
16'' 0 .0 .
12
11
I�
li
I,
l
I,
(2) 2" x ' r im j o ists
perimeter , j
14
II
II
42 .5"
I
Ili 2" x 10", 4 '- green trea ec
I edger extens Ion . Bo I ted
+ to other w/ 4" ccrr iage bolts
(2, 16" C .0 ;)
nc
i i
I I
Frost foot , nqs
12 I (4 @ 42" deep
size C-3)
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