PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 4 K6
Date:
Owner: _ ..-' ---. - _
�
_.... ..,. L....._ �:� Builder ....._..�,.'�
Address Address
No. _..f,-- GP! --/_... treet
Lot .........Block
Corner Lot ..... .................... _........
Sewer Elevation
17
X
u
_ #` .. . ✓Part of Lot
- ..... _ ...._.------_....._ ddition or Sub -D ..'�:....._ ----
Inside
.
Inside Lot .......... A ^............�tback ...,.iQ"... Sideyard ..--•---....3......._...--.............------------_...-..---
............. ... ... ... ............... _................... ........... F dation Elevation ......................... .... _.... ........ -_..._..._.....------------.-•----
DESCRIPTION OF BUILDING
To U ed
..._ Front .. .. Depth .._; Height .... ._.. Sq. Ft._-; Cu. F't..- ....
_........................ ................. _..... Fro t ...................... Depth ........................ #Height ................... Sq. Ft. ...................... Cu. Ft. _-------- :............
Type of Construction? -�'r �:'L -... Est. Cost.:..._.../!/.. „t...a.,rei.....b.._........ 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::`r ...... _ _....., 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-ppo�pn violation of any of the provisions of said
ordinances. /' /1 4 /--)
' °e r'._!�t ►zj 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
Owners Name
Address
LOCATION OF BUILDING
No. 1zdr Street - C . Part of Lot
Y �
Lot Zj= Block. Addition or Sub.Div.
Corner Lot Inside Lot A- Set Back Side -Yard M,
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:
Front Depth Height
Sq. Ft. Cu. Ft.
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 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.
DATE SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
VJ
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City of Fridley, Minn.
BUILDING PERMIT N° 5 6 3 9
Date:
I
Owner; wilder —
Addres� Address
�O(=ON F No. /-6 r...�. Street � ....._.L. I. r!'_____ Part of Lot ...�-.-.•---,,+g
Lot _ Block Addition or Stlb-Division_ __ ,+•••-••
Corner Lot Inside Lot _ _ Setback =� --- Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
Front 47 Depth f^_ Height '� Sq. Fh"' Cu. Ft.
Tiroepth eight_ Sq. Ft. Cu. Ft.
Type of Construction 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 ail 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 violati f any of the provisions of said
ordinances. .. -) , ,,If ; '
Building Inspector
NOTICE:
Uls permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to sae
the Building Inspector for separate permits for these hems.
City of Fridley
App cation for Plumbing and Gas RMP7/ �7
Dept. of Bldgs.. Phone SII 4-7470
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
3cc
RATE TOTAL
�
O0
zr�
u�
��
a�j
U
�l
<•�
�U'
00
�O
•
F
•
N
WATER HTR.
GAS
ELEG
Base
x
3.25
$
' Water Heater (Up to 200,000 BTU) ......
x
I
$
New Ground Run Old Bldg. ............
x
3.25
$
lst
[
1
t
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer El
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
C, O
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
$
New Ground Run Old Bldg. ............
x
3.25
$
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 truce and correct.
Fridley, Minn a ` &�I- 3 19!�
Owner
Kind of
Used as
i
To be completed abdtit `Z' 4
Estimated Cost, $
2,.5—ds �v
Old-�5 Building Permit No Permit No.
ROUGH , : 6 -6 f
I
l•, GAS FITTING FEES: NO. RATE TOTAL FINAL
z 1st 3 Fixtures ..... S U
' x $1.5Q $
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ...........$ d
TOTAL FEE $ • A2 aM
Business Phone
Application for Power PMnts and:Heating, Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
1.
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 ............................. P.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 $
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 SU. 4-7470
City of Fridley: f/
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, Minn 19 —
Owner
Kind of Building
Used as V�4o—v 0
To be completed about Z I �✓ /
Estimated Cost, $
DESCRIPTION OF WORK
HEATING or POWER NTS --Steam, Hot Water, Warm Air—No-
Trade Name Size No- 7-6
Capacity Sq. Ft. E.D.R- BTU H.P.
Total Connected Loader 0 p �`� Kind of Fue 131
�
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU—
H.P.
(REMARKS -OVER)
Signed z),&Z
By 7 /e)
4z 2M 7_59 Business Phone No
IY76 z.r�e � -
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor
Yes—No I Yes—No 19—
Fl Room I I -an th Width i Height u m
Total 13tu. ___ . _
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area E 4, `
R Fl.l ?. Room I Length Width a Height
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
Y ,
w
Width Height No. of Lineal f . Area
No. of pane of pane lights of crack sq. ft.
i
r
Cod. Btu
i yJCoef.j
Btu
Infiltration
Glass
Exp. wall
r'
Net exp. wall
i
Int. wall
a,
Ceiling
t
Floor
Total 13tu. ___ . _
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area E 4, `
R Fl.l ?. Room I Length Width a Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane llghte of crack nq. ft.
Y ,
w
r
Cod. Btu
Infiltration
i
Glass
Exp. wall .
Net exp. wall
r'
Int. wall
Ceiling
a,
Floor
t
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl.l j-) Room I Length Width Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
i.
Coef. Btu
Infiltration
i
Glass
Exp. Wall ,r r
Net exp. wall
r'
Int. wall
Ceiling
a,
Floor
t
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area � r'
Lj
FRIDLEY, MINN.
Insulation
Kind How Applied
Rnnm i Lanath . Width : � Height
Windows and Doors—Crackage and Area
Width Height al No. of Llneit. Area
No. of pane of pane lights of crack sq. ft.
i.
Coef. Btu
Infiltration
i
Glass
Exp. Wall
Net exp. wall R
r'
Int. wall
Ceiling
a,
Floor
t
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area r'
N F1.1 I 1 Room I Length I Width a' ; Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. 1t.
i.
Coef. Btu
Infiltration
t
Glass '
Exp. Wall ? e
Net exp. Wall
a
Int. wall
Ceiling
a,
Floor
t
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
F1.1Rmm I i math Width Height-:
Windows and Doors—Crackage and Area
Width Height No. of I Lineal ft. Area
No. of pane Of pane lights I of crack sq. ft.
i.
Coef. Btu
Infiltration
Glass
Exp. Wall % f
P �
Net exp. wall
a
Int. wall
Ceiling
, =
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
•
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City of Fridley, Minn.
BUILDING PERMIT N® .6797
Date:
Owner: ��.�� `"' Builder
Address Address
TION OF BUILDING
No. Street _ — Part o t
Let @ _ __ Block A tion or Sub- on
Corner Lot , Inside Lot !� Aetback _ _ _ deyard R
Sewer Elevation ____ -- Fodndation Elevation
DESCRIPTION OF BUILDING
To as• �+(� �
Front Depth ;;(:20 Height Sq. Ft. Cu. Ft.�
t) Deptheight _ _ Sq. Ft. Cu. Ft
Type of Construction ��� Est^C.o�E�L 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 sem 7 and 1q comp ce f a�, provisions of
ordinances of the city of Fridley. // /� �//
In consideration of the payment of a fee of $ ,-2 , 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. . A —%
Building Inspector
NOTICE:
This permit don not cover the construction, Installatlon for wiring, plumbing, gn heating, sewer or water. Be sure to see
the Building hxpeator for separate permhs for these home.
- At
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME
ADDRESS ADDRESS
` LOCATION OF BUILDING
No. / l Street 7 19 VA Y AI CPart of Lot
Lot J- Block Addition or Subdivision
Corner Lot Inside Lot X Setback Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
' Front Depth ZO Height
Sq. Ft._ Cu. Ft. d
Front Depth Height
Sq. Ft. CU. Ft.
Type of Construction 11
Estimated Cost
To be Completed
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.
DATE Id°- l Y • &J
(Schedule of Fee Costs can be found on the Reverse Side).
0
1'ZAKY Wgy
May 9, 1975
6A
Mr. & Mrs. C. J. Floer
LO 161 -79th Way N.E.
Fridley, Minnesota
0
W
a' Dear Mr. & Mrs. Floer,
N
r
It has been brought to our attention that the existing fence
C` encompassing.your rear yard extends beyond your rear lot line
and encroaches upon the 12 foot public alley right-of-way which
LO is established for public access. After a preliminary survey
Q was conducted by our office, it was determined that your fence
H
0 extends approximately 6 ft. into the alley right-of-way which
z is a violation of City Ordinance No. 213.05 which states:
z
All fences must be located entirely upon the private
> property of the person, firm or corporation construct -
LU the same or causing the fence to be so constructed
o and erected, except that adjoining property owners
cc may agree in writing that said fence shall be located
U_
° on the division line of their said properties.
r
Q
Presently there are only two options available to solve this
w problem. Either the fence must be relocated to your rear
N property line, or a request (attachment) to have the alley
p' vacated must be submitted to the City for processing. If the
z alley is vacated, half of the right-of-way that abutts your
D property would revert to your clear ownership, with the City
z retaining a utility and drainage easement upon which, fences
w
Gand planting are permissable.
h- On the attached vacation request form, a $40.00 fee is indicated
for this processing. This fee is a one time charge for vacating
w all or part of the alley and such fee may be shared by any or
> z all concerned property owners. Any request for the vacation
should be sent to the attention of Mr. Darrel Clark, Community
Cn Development Administrator.
° In any event, either the fence relocation or the vacation request
must be undertaken by June 2, 1975. If any further clarification
z is needed, please contact Mr. Clark or myself.
w
U
U Sincerel ,
U
HOMAS A. COLBERT
Assistant City Engineer
TAC/as CC: Darrel Clark, Comm. Dev. Adm.
Enclosure
City of Fridley
SUBJECT
P
25338
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
' ,
gECEIPL
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r �
� . I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
8/1/97
/
JOB ADDRESS 161 79 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
7 s 8
4
Spring Brook Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Michael Lund 161 79 Way NE
783-1180
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
❑ NEW ❑ ADDITION ❑ ALTERATION Lj REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Install building wrap and have inspection
of same unless
manufacturer's specifications state it is not required.
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 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
$1,200
$.60
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 FEE
TOTAL FEE
$42.05
SIGNATu OFTRACTOR AUTHORIZE NT (DAT
WHEN PROPER VALIDA ED THIS IS YOUR PERMIT
PL G INSP
IIATE
SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2�'���
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: Ir �i e ,e 'T .. etc/ Tel. # . � -- C
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.
DESCRIPTION OF EVIPROVEMENT
LIVING AREA: Length 0 Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Re 6- sl- e N® v j e 9�- 6-.1 ry 9--e
Construction Type: o` Estimated Cost: $ IAO O
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft ;x $ _ $
DATE: $1 7
Tel. #
STIPULATE ONS:
CITY USE ONLY
Permit Fee
$ (� . �S
Fee Schedule on Reverse Side
Fire Surcharge
$ Q
.001 of Permit Valuation (1/10th%)
State Surcharge
$ . BOO
$.50/$1,000 Valuation
SAC Charge
$
$950 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
$ �®S
STIPULATE ONS:
CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000
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 �(�( g� A'y
RATE SCHEDULE
OWNER /L (t
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner - BUILDING USED AS DLO CL[ 1�1 A -1e
Also Replacement Furnace $ 30.00 $ 3C -OO
(Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. IS135
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)
�A�ie? 2 c��2
Gas Dryer $ 10.00 $ Trade Name Size N.�.5$f" K"!9'0BTU �n �0 HP D
*Air Conditioning - All Sizes $ 25.00 $ gZ,100 Fuel A-) A'T_ Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No.
11y. of Value of Appliance 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 SUPEMOR^OITRACTORS,INC,
612142NDAVENIJE NO. DATE
CRWAL, MN 55422
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00j�
PLUS THE $.50 STATE SURCHARGE Signed TEL # 96 —
REINSPECTION FEE $47.00/Hr 4y
*Air Conditioners can not be placed in a side yard without Approved By Rough -in Date Final Date?
written permission from adjoining property owner.
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina 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 (,j 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. Yes( )No(
)
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input jEogoo 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) r(D rc)ROJ A2C— '¢- ,1.; 6:e -j
HEATING CO
Signed By
`- Fl -U 6-- I— / A-)oj'
8UP!`RIOR.^.OMMC rr;-1,
, !�—
612142NDAVr`MUE PCO.
CRYSTAL, MM w4:2
Date
SUBJECT
ERMIT NO.
City of Fridley
33240
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
E >r PROTECTIVE INSPECTION SEC.
r
,
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY MALL FRIDLEY 55132
763-571-3450
910-F15
11/8/02
JOB ADDRESS 161 79 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7,8
4
Spring Brook Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mike Lund 161 79 Way NE
763-783-1180
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Eagleview Construction 16323 Edison St NE, Ham Lake MN 55304 413-5115
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20076043
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION a REPAIR ❑ MOVE O REMOVE
X
8 DESCRIBE WORK
Replace windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING.
VENTILATING OR AIR C DITIONING
THIS PERMIT BECO S NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS C MENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS 5 PEN ED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AF R RK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
1 HEREBY ATI F THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNO THE AME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORD NAN ES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$7,000
$3.50
WITH WH TH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NO ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$139.25
Fire SC $7.00
STRUCTIO THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT FEE
License $5.00
54.75
S1 N URE OF CON'RACTOR OR AUTHORIZED AGENT IOATE�
NEN ROP
ALIO T THIS IS YO R PERMIT
SIGNATURE OF OWNER,IF OWNER BUROERi tDATE,
BL SNS
GATE
NEW (] CITY OF FRIDLEY Effective 1/1/2002
ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: z
Legal Description: c�
Owner Name & Address: M /KOL Tel. #
Contractor. 4,4cAeu eaey.Si�ecOeu MN LICENSE# 00c)740el3
Address: / Z3 Dt.San) Sr 04//� �/ r L.✓,A{ �S3� I. # 4113 --5-111 C219 3
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: p �+
Construction Type: stimated Cost: $(0
D�
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$
DATE: APPLICANT: ` #tk 7,19Z,,J S4 C Tel. # ?��Z�s� r 61 Z
Cali (763) 572-3604 for Permit Fees if mailing In application or 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
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$_ 13 9,
$
9,00
$ � _ S70
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
TOTAL $ /��- 7S- STIPULATIONS:
0
FEE
Building
BUILDING
Permit No.: d OD F--()
Plan Review
$ 65% of Building Permit Fee
Fire Surcharge
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'
' O
YO E-MAIL
$ ft + 6 ft = ft x $21= $
DATE
ADPRESS
Park Fee
SITE ADDRESS / / 'T �-i , y»
3
THIS APPLICANT IS:
❑ OWNER 1 (CONTRACTOR
$ Make checks payable to: City of Fridley Attach
PROPERTY OWNER/
NAME:
ADDRESS: IlD 7 CITY /��
STATI/ZIP9V-3 :U
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE 7 EXP DATE , /
%Z O)y
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE/�
if j
WITH APPLICATION
PHONI&O Wel— -Wt-& FAX
PROPERTY TYPE
INGLE FAMILY N SIZE
❑ TWO FAMII Y/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH WROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ ADDITION
IAZMANCE/RE
❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH
DIGHT Sq. Ft.
ROOFING //�� ❑HOUSE ONLY
NUMBER OF SQUARES ..G WHOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
3.
Proposed floor plan
List of strucnual members to be used
PROPOSED HEIGHT:
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.
2.
Two sets of construction plans
WINDOWS
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 HE 1997 U.B REDUCE)
TOTAL JOB VALUATION $BOO CCUPANCY • TYPE
Permit Fee
$ See ack Page for Fee Schedule
Plan Review
$ 65% of Building Permit Fee
Fire Surcharge
$ ( .001 times the total job valuation
Surcharge
$ .0005 x Permit Valuation Minimum $.50
License Surcharge
$ $5.00 (State Licensed Residential Contractors)
SAC Charge
$ $1550 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
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 applicati or a permit and work . not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work hic requires review ap roval of plans.
SIGNATURE OF APPLICANT PRINT NAME /� DATE w • / r O U