PRE 2010 DOCSCity of Fridley, Mian..
BUILDING PERMIT N°(E6 4
Date:
Owner: Builder
Address ....._._..___.. __. __ Address:_.._.._ .5
TSO F BUILDING
No. _..._.i.._. Street
Lot .................................... 131ock ... ._................ .................. Additi or Sub-Divisloij.... _..
Corner Lot ...._.......................... Inside Lot ....._....f '"............... Setback ... .......... Sideyard`..sem_......._------_......
Sewer Elevation .... _............................ _.................................................... Foundation Elevation
DESCRIPTION OF BUILDING
To he Used aSA
>.
M . _:- _ ... Sq. Ft: f�' Cu. Ft .. ._ _.:
_..._....... top
Front Depth .. Height..--
o FConstructi Fron Depth
plpdj�t-.. Sq: Ft...." � ..� cu.Type OnEst. Cost.,, ... ......... To be Completed ....._............_.._........ -----.._..------
THIS PERMIT DOES NOT AUTHORIZE VIOLAT-
ION OF ANY PRIVATE LAND COVENANTS AND
BUILDING RESTRICTIONS.
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 violation kf any of the provisions of said
ordinances. ,r-' A /7
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Bo sure to age
the Building Inspector for separate permits for these hems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Address
LO AT ON OF BUILDING
No.' Street C� Part of Lot
Lot BlockAddition or Sub.Divt��
Corner Lot Inside LotSet Back_ -L 3 6- Side -Yard
SEWER ELEVATION 61.9. a FOUNDATION ELEVATION _.,9;!!5-r7.6__
:6
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
44 -
Front ,-�� � Depth___2 b Height c� /oma
Sq. Ft. 0� Cu. Ft. '
—Front Depth Height AD
Sq. Ft. �c14 Cu. Ft. I
Type of Construction Estimated Cost //
V.
To be completed (---') co /
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 representa-
tions stated in this application are true and correct."_)1U4 _.' �J
DATEi c./ I�� SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
0 • .o
City of Fridley
Application for Plumbing and Gas Fitting Permit
DepL of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK 0 ®s
Number, Kind and Location of Fixtures Location
q
NO.
y
TOTAL
Number Fixtures ......................
x
$1.50
$
Future Fixture Opening ................
KK ul
Z
�j y�i
New Fixture Old Opening ..............
w
aa'
Z
•
F
•
N
WATER HTR.
GAS
ELEG
Water Heater (Up to 200,000 BTU) ......
a
2.00
$ —2°
New Ground Run Old Bldg. ............
x
3.25
$
O
Base
1st
2nd
_
3rd
4th
• Future Connection Openings
Connected with
Sewer
New Fixture, Old Openings
Ce80001 El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures ......................
x
$1.50
$
Future Fixture Opening ................
x
1.20
$ •��
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
Water Heater (Up to 200,000 BTU) ......
x
2.00
$ —2°
New Ground Run Old Bldg. ............
x
3.25
$
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
x $1.50 $
X .50 $
x 2.00 $
City of Fridley:
11
2
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.
Fridley, ellinn / ® 19 6
Owner f4&✓K�o L.
Kind of Building
Used as '46
To be completed about
Estimated Cost,
Old—New. Build
ROUGH
FINAL
Descriptton........ ..
..........
..................
TOTAL FEE $ 42 2M 7-59
AMPE (AMERICAN REMODELIM INC)
3700 ANNAPOLIS LANE
PLYMOUTH, MN 55447
612-553-0020
WD114WIllwap)
C)� vt.�
WE HAVE PULLED A PERMlIT AND WRITTEN A CHECK ON THE EUL10AING JOB(S), BUT
THEajsTcmm CANCFUM THE ORDER BEEM WE COULD RUN IT. COULD YOU PMM
CHlKX AND SEE IF A REMND IS DUE AMPE, IF SO SEND IT TO THE ABOVE ADDRESS?
SORRY FIOR ANY INOCNVMXE AND TBNK YOU F`OR YOUR TIM.
S
SUE M. lUVLATZ
PRODUCTION COCORDINATOR
JOB NAM:
JOB ADDllESS'-,, �� /`� G� �� �� G�
DATE OF CH13CK
suBJEcr
—
City of Fridley
720389
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RE
_ COMMUNITY DEVELOPMENT DIV.
a. PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
5/24'/90
JOB ADDRESS 60 — 70th_ WayN, E, k ..
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 9, Bl.
4, Ostman
Is Third Addn. & Pt, -`Lots 1-4, Bl. 14, Camp SHEET
2 PROPERTY OWNER MAIL ADDRESS Howard and Hush.�'s 1st Addiiion to ftTft -ey Park
Gary Hedman 60. - 70th.Wsy N.E, 571-7912
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Amre 3700 Annapolis Lane Plymouth, MN 55447 553-002
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ .:ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Cover Soffit/Facia
9 CHANGE OF USE FROM TO
STIPULATIONS
x-,,,
1
II
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$4300
$2.15
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
If
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$72.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$74.15
SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPE Llf..7VALIDATED THIS IS YOUR PERMIT
- /
BLDG INSP OA
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
Prepaid Plan Check $ Effective 5/1/88
Estimated Cost $ CITY OF FRIDLEY
Receipt # R-3, CMGMRCIAL & MMUSTRIAL
Building Permit Application
Construction Address �Q ✓�'� �Q d Atl,)Q
Zoning
Engineer & Address
TYPE OF WORK �] New [] Addition
Reg. #
pteg• #
[ ] Alteration -Describe �DC� A
Applicant SignaZtLTel # CC -e: ateQJ
Length Width
in m Tmn1G DIIMEMIONS
Height Sq. Ft.
# of Stories
OFC. AREA: Length
Width
Height Sq.
Ft.
WHSE AREA: Length
Width
Height Sq.
Ft.
MI -M AREA: Length
Width
Height Sq.
Ft.
VALUATION
Sq. Ft. x $
Cost/Sq.
Ft. = Valuation $
Sq. Ft. x $
Cost/Sq.
Ft. = Valuation $
- Sq. Ft.-- - x $
Cost/Sq.
Ft. = Valuation-- _ -. •)_--
-- _ -TOTAL VALUE_
Building Use bion Type Occupancy Group
Air Conditioning []Yes []No Fire Protection Provided []Yes []No
Performance Bond Amount $ See Reverse for Schedule Received []Yes
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Spec. Assessments
Driveway Escrow
TOTAL
[ ] NO
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$575 per SAC Unit
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $13.50/foot
ADDITIONAL STIPULATIONS ON REVERSE(40 OG
SIDE
x(306
SUBJECT
City of Fridley
2 0 414
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
-�O N ,
i
`y COMMUNITY DEVELOPMENT DIV.
� ______
r PROTECTIVE INSPECTION SEC.
I . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
/ I�
�'
J 612-571-3450
910-F15
6/8/90
JOB ADDRESS 60 - 70th Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1-4
14
Camp Howard & Hush's lst Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Gary/Tony Hedman 60 - 70th.Way N.E. 571-7912
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
M. Fitzgerald Construction Inc. 2650 - 137th Lane N.E., Ham Lake, MN 55304
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
755-9748
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW jJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 201 x 20 WI Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS provide Frost footings. Provide treated bottom plates. Existing door
to house must be a fire door. See notations on plan. Provide a hrd surface driveway
WARNING
Before digging call for
SEPARATE E'ER all utility45locations
800
I
WIl�ING HEATIN ITS REQUIRED F UIIED BY q
DR EQ t Aw'
G, pLUMB1NG
A
AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT. ,•
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING,
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$6,100
$3.05
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$93.05
SIGNATURE OF CONTRACTOR OR AUTHORIZED' AGENT MATE) IrWHL44
PROPERL V IS IS YOUR PERMIT
MIED
n- d
BLDG INSP OATS
SIGNATURE OF OWNER OF OWNER BUILDER$ IDATEI
NEW [ ] Effective 1/1/90
ADEN [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address
A.
Legal Description: LO Ts - �/, (1f� / `�("l?� CEJ ?-g - . 1s
Owner Name & Address: Gx4 r�j 4 TO /nPi y � b M i�-4� Tel.
Contractor: _ FiTZZ r-2A4Lb t'"M-"M
- �r-N C Tel #
Address : Py5bb 137 '06- 9- , k - ,�- , WA -,ti C A s'� 3d 4
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIvnJG AREA: Length Width Height Sq. Ft.
GARAGE AREA: length o2 0 ` Width ao.' (c Height Sq. Ft. tj
DEM AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks
Type of Construction: E11411'J>6LL -N N C -w Estimated Cost: $
Approx. Cmnpletion Date: --?- l- g b 4,100
Proposed Driveway Width If New Opening Is Des' Ft. $ $
dth + 6' See Back Page
DATE: � l� V APPLSCANT: Tel.`7��
CITY taONLy
Permit Fee $�,
State Surcharge
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Marge $
$ G'3,O;!�
k4% S O O
STIPULATIONS: I ,
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
l
®0
a-0 ucf' qoo oo
�.vJ
PLATTING
INDUSTRIAL C. E. COULTER FARM GURYETS
SUSINK" LAND SURVEYOR - LARSSHORR
am LOTS JUDICIAL
TOPOGRAPHIC MAPPING REGISTERED UNDER LAWS OF STATE OF MINNESOTA
LIC[N8ED BY ORDINANCE OF CITY OF MINNEAPOLIS
3300 LYNDALE AVE. SO. MINNEAPOLIS S. MINN.
TAYLOR �1-0370
N SVRVEY OTTO OSTmpm
�urnegut a glrrY{firsfr
SCALE ►"
�0 TN Waw
�._• •_{20_8'Z' _- ' - • • ' .. - -140 •— — .g -- — — —
OT
0000
J I J
I ta. 10 S O •�
cr I q
Q Zp
w�-----------
.� i a
I �
D j', LOT 3
I T
LOT 4 �I
•' _-_ 140 .,.
I hereby certify that the above is a true and correct plat of a survey of:
The Easterly 20 feet of Lot 9 as measured at right angles to the Easterly
line thereof, Block 4, OSTMAN'S THIRD ADDITION, Anoka County, Minnesota,
together with the Westerly 60 feet of Lots 1, 2, 3 and 4 as measured along
the North and South lines thereof, Block 14, Camp Howard and Hush's 1st.
Addition to Fridley Park, Anoka County, Minnesota.
As surveyed by me this 3rd day of June 1960 A. D.
Signed
Ninnesota Registration No. 2584
77
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
a
Effective On January 1, 1993
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT C
v
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
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
Gas Range
NO. RATE
--i-
Gas
i
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
$5.00
TOTAL JOB ADDRESS 60 V tA)
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.
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance )6,0D
State Surcharge $ .50
TOTAL FEE $ �6, 6D
09
Owner
U
Building Used As
Estimated Cost (� _ PERMIT NO.
PLUMBING COMPANY L-,', 4b
SIGNED BYI '(�'y —c, TEL No.�
Approved By Rough—In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
d
CITYOF j
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
September 19, 1995
Sue Defore
First Security Title
4525 White Bear Parkway
White Bear Lake, MN 55110
RE: Gary Hedmand
60 - 70th Way
Dear Miss Defore:
It is my understanding that a closing is to occur regarding the above referenced property on
Tuesday, September 19, 1995. I believe that it is come to the attention of your company that the
single family dwelling unit located on the above referenced property is located on a 10 foot
drainage and utility easement. In reviewing our records, the City has not vacated the easement
nor does the City have any utilities located within the easement area. The property owner should
vacate the easement in order to provide a clear title to the buyer. I have provided Mr. Hedmand
the appropriate paperwork to complete the vacation request. It will take approximately ninety
days to complete the vacation process. I believe it is Mr. Hedmand's intent to process the
vacation to provide clear title to the buyer of the property.
If you have further questions or concerns regarding this matter, please contact me at 572-3593.
Sincerely,
Nfic ele McPherson
Planning Assistant
MMre
C-95-238
CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996
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 _�° �
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) ,1996
Gas Piping (Needed with new furnace) $ 10.00 $
OWNER �' �,%'� 3 ��/.CX0 �,� ����' S 7.2 -12 `I 1
Gas Range $ 10.00 $
BUILDING USED AS
Gas Dryer $ 10.00 $
ESTIMATED COST PERMIT N0.
*Air Conditioning — All Sizes $ 25.00 $
%11 DESCRIPTION OF FURNACE AND OR BURNER
All Others/R pairs & Iter�'tlons ( ST ON BACK)
1% of Valu of Appliance or Wo k $ _ 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.
BTU HP EDR
TOTAL FEE 22L. -S 6
HEATING COMPANY�I;�
MINIMUM FEE FOR ANY HEATING/CQOLIPL VENTILATION a °
FIEF
RIGERATI�AIR CO�IDITIONIIVG PERMIT IS X25.00 Signed 8y.:!Tel No,
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr Approved Byg4 Rough—In Date Final Date
"Air Conditioners can not be placed in a side yard without FILL OUT BACK SID OR STACK VERIFICATION ON
written permission from adjoining property owner, REPLACEMENT FURNACE
CHESINEY 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 ( )
6 Has total heating BTU's of
All other BTU's
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:
1
su6iEer
ERMI
City of Fridley
31
AT THE TOP OF THE TWINS
I� G PERMIT
BUIII D C R M I
-al-7
r
'v
L L
RECEIPT NO.
� 16.COMMUNITY DEVELOPMENT DIV.
� -?2-360
SEC.
r � � PROTECTIVE INSPECTION
1
NUMBER—
aEv
DATE
PAGE OF
APPROVED BY
i CITY MALL FRIOLEV 55132
' 612-571-3450
910415
4/6/01
JOB ADDRESS 60 70 Way NE
1 LEGAL
LOT NO.BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt 1-3 & 9
4
Ostman's 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Philip/Nancy Ayu 60 70 Way NE
763-571-4612
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
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION CR REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof House (23 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the State Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING.
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
$2,352
$1'18
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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
PLAN CHECK FE
TO L FEE
A -
$86.78
Si U EOFCO �aACTOaOaAUT OpIZEDAGENT iDATEo
cI��D
EN P VALI T D THI$ I UR ERMIT
MGNATUAE Of OW ER.w OW NEa BWLDERDATES
BL NSP �mtE
1
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: eo -7o - N W,4 Y WE
Legal Description:
Owner Name & Address: PL �Ia h c v xyc- Tel. # (7G 3)
Contractor: MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
I
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
rf-Z2 1/0
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Re- ra houses — -rear -,:A& 9L re Sh%��/P 6o X3.,;7-
0 n I y,
3sonly, p'
Construction Type: Estimated Cost: $�—
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
X763-/
DATE: APPLICANT: ` - Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee
Fee Schedule on Reverse Side
Fire Surcharge
$ a.,3S
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /. /° $.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 [ ]
6- 9J
TOTAL
$
STIPULATIONS:
s
Building
Inspections
763-572-3604
DATE
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
SITE ADDRESS ��� ' ��_n
THIS APPLICANT IS: ❑ OWNER
PROPERTY
OWNER/
TENANT
CONTRACTOR
,kDDRESS: _1
PHONE: ldMe
YOUR E-MAIL ADDRESS
CONTRACTOR
Permit No.;
Received BY:
DatBjPd:A P R 2
CITY—
COMP
ITY_ STATEPY1_I�1 P�
COMPANY NAME: Anderson Heating and Air -Conditioning
ERSON• P�-LC��
CONTACT P
SI 3MIT A COPY of ,"/p 4341 Central Ave N.E. —
i'OUR STATE STATE LICENSE STATE ZIP
LICENSE WITH ADDRESS
APPLICATION PHONE _&3 -2T/- 4s�r Col, Hts, Mn 55421 -
PERNIIT TYPE //
'1,SrNGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: ❑ NEW I� REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK
the total cost the
PER MS 1613.665 the permit fee is a minimum eof $15.00
15 0 fixture, excluding the fixtures. so (To,O.Oshould treflect onchever is ly the cost rof labor )
improvement, installation or replacement
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor
x.05=
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT ,'N,HERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOIA� MODEL: NyA SIZE/BTU
Equipment Installed MFG: MODEL: SIZEJBTU
MFG: SIZEBTU
MFG: MODEL:
_FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
I{ AIC $25.00 FIREPLACE (WOOD) 5.00 —NEW GAS GRILL $10.00
AJR TO AIR EXCHANGEER $15 FURNACE (WOOD)
_GAS UNIT HTR $10.00
—BOILER 535.00 GAS DRYER $10.00 —POOL HEATER $35.00
—CHIMNEY LINER $10.00 — VENTILATOR $15.00
DUCT WORK $10.00 _GAS PIPING $]000 —
n.. AFF' Ft)R`= .kOjECTS OVER $500
ffT-FEEPROi. CT Number of fixtures @ $10.00 x $10.00 = $
Permit Fee $ `2_ ' -�
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ 2s��— Number of fixtures @ $25.00 x $-25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
THIS 1S 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 o/f►all woorrlk which requires review and approval of plans.
SIGNATURE OF .APPLICANT C /�/t/�/�-"I�A SW� PRINT NAME G�1 T re�rq DATE
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/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propan&UGC 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 MN 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 IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
Building g4OZ- MECHANICAL Permit No.: -
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY
DATE 7 a-tp I O� YOUR E-MAIL ADDRESS
SITE ADDRESS �Gb �O'w` WW, M E 1�21�_1r
p
THIS APPLICANT IS: ❑ OWNER J]CONTRACTOR
PROPERTY
NAME: % U
OWNER/
ADDRESS: (on 70+"I W lAyl. M6 CITY �• STA ZIPS aZ
TENANT
PHONE: 7k, 3- 5 7 1— 416l 2
CONTRACTOR
COMPANY NAME: CENTERPOINT ENERGY
CONTACT PERSON: JOANN T INKEN
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: 9320 EVERGREEN BLVD STE BTTY "COON,-RAPIDS sTATEMN ziP55433
APPLICATION
PHONE 763 — 757 — 6202 FAX 763-757--6701
PERMIT TYPE
INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK.
❑ NEW WIEPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK:J�j154A
PER MS 1613.665 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 fixtures. (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, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
Equipment Installed MFG: PIU"l MODEL: ILI+Pi 3 - Oq SIZE/BTU :16, 000
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
_A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00
_AIR TO AIR EXCHANGEER $15 FJLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILER $35.00 1�URNACE $35.00 UNIT HTR $10.00
_GAS
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00
_POOL
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
. .: t m Fri'
— l �` .��` nY
v ftS s' = 3' � x ' , .. r,:.. �xr. a� '5 , T11"
Permit Fee $
Number of fixtures @ $10.00 x $10.00 = $
Surcharge $ .50
Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $
Number of fixtures @ $25.00 x $25.00 = $
_
Number of fixtures @ $35.00 1 x $35.00 = $
State Surcharge = $_50
Total = $�
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 review and approval of plans.
/J 1_
SIGNATURE OF APPLICANT �� v ' NAME ROGER HOFFHEIN DATE [ i 4 l�J �%�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS L/ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC 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 MN 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 IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.