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PERMITSCity of Fridley, Minn. N° 8878 BUILDING PERMIT Date: JUNE 10, 1966 Owner: MEDICAL CLINIC Builder FRED 0. WATSON CONSTRUCTION CO. Address Address 1409 Willow Street Minneapolis, Minnesota 55403 LOCATION OF BUILDING No. 7675 Street MADISON STREET N.E,, Part of Lot Lot _ Block Addition or Sub -Division Corner Lot _ Inside Lot Setback -- Sideyard — Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING d 0 To be Used as: DOCTORS CLINIC Front 124' Depth 46 Height 12'611 Sq. Ft f Ft" -=— Front Depth Height Sq. Ft. Cu. Ft Type of Construction FRANK Est. Cost _ $.8.4, 00 .On ___ To be Completed NORTH m 400 FEET OF THE WEST 217.8 feet OF OUTLOT 1, MELODY MANOR, 4TH ADDITION, SUBJECT TO AN EASEMENT OVER THE WEST 30 FEET THEREOF FOR STREET PURPOSES. 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 Po in com=wia2llons of ordinances of the city of Fridley. o C/ c9 9 , f In consideration of the payment of a fee of - , permit is hereby granted to WATSON C. CO. to construct the building or addition as described above. This permit is granted upon the expressXtiontdone in, arand upodin cea y, Mtaormitsnn permit may be revoked at any time upon violation of any oP the Provisions of said WILLIAM H. SANDIN Building Inspector NOTICE fhb permit dos not cover the canstruction, bnfaWan for whing, phanbing, gas beating, awn or wafer. Be sun to sea the Building bar for operate permtn for thea Neon. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME FRED 0. WATSON CO. BUILDER FRED 0. WATSON'CO. ADDRESS 1409 Willow Street ADDRESS 1409 Willow Street Minneapolis, Minnesota 55403 Minneapo, Minnesota 55403 7 _ LOCATION 0 BUILDING NO, STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. - To be used as; DESCRIPTION OF BUILDING Front�Depth Height Sq.. Ft. Cu. Ft. Doctor's Clinic Front 12410" Depth 46'-0" Heightl2'-6" Sq. Ft. 0 G Cu. Ft. Type of Construction_ Masonry with Wood TrimEstimated Cost $849000.00 To be completed September 15, 1966 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 -,04 //tic/ /ygd�, S (Schedule of Fee Costs can be found -on the Reverse Side). 0 C) FJ BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit for the erection of any,fire-proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building, shall be at.the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2 For any such permit for the erection of any fire -proof garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the. rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permitfor the erection of any non -fireproof building, other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory, o; grain elevator, or for the erection of any non -fire -proof addition, for similar occupancy, to'any existing building or for each such building or addition - ninety cents ($0.90) for each.one thousand cubic feet or fraction thereof, in the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees for building permits, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred.Doilars ($500.00) or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: Residential: Estimated Cost of work up to t500.00 - $5.00 Estimated Cost of wog, c•. r Y'-, Yr - 1_ ��0 Commercial; EstimatelM4t of r„ r„•iK u tri Estimate ost of work over $51' 0.UO - $ EEO FRED O. WATSON CO. GENERAL CONTRACTORS 500 LORING BUILDING 0 1409 WILLOW ST. • MINNEAPOLIS, MINNESOTA 55403 i 335.6714 May 24, 1966 City of Fridley Minnesota Re: Building Permit Gentlemen: We enclose herewith our application for a building permit for the construction of the Fridley Medical Center on the Southeast corner of the intersection of Madison Street and Osborne Road. We also enclose a set of plans for the proposed Medical Center which has been stamped and approved by the State Fire Marshall. RS:va encl's Very truly yours, FRED 0. WATSON CO. V�r Roger Sheehy Application for Power Plains and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace 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. EDR 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 $ n n/� AIR CONDITIONING / S /OY!T S 26P,kJ i o.✓ FAN HEATING SYSTEM See Fee Schedule—T VENTILATING SYSTEM_ $ "�� ALTERATIONS ft REPAIRS TOTAL FEE ,,en�� $�_ ROUGH FINAL Dept. of Bldgs. Phone SII 4-7470 Locations 75' M&4-15614 / , AI -E. City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn Ale) e) y Z- 7 19 4j+ Owner Kind of Building V1 lei q- ea"el Used as �� G )4e j1,,t To be completed about 3 3 Estimat Cost, $ D 0 Q Q % Old New. wilding Permit No. Permit No. 3 DESCRIPTION OF WORK HEATING or PO PLANTS -Steam, Hot Water, Warm No Trade Name �� / z`' /2 Size No Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe 4�&141'�-d- JL�--- By L, <: Business Phone (REMARKS -OVER) i aUJdi CT Permit Yo. 60 2:2 CRRY of 17'rMey Fa AT TMF TOP oa TMF TIVING PLUMBING PERMIT ADPL I CATI O.J r rL,-------- C0B MVNITY DEV4T.L0-7WENT DIV, i PROT(;CTIVH Vs",'--;rCYIoW "PT' CIYY HALL FAIDL9V -C DCA= Ntl;'C'M RDLIV. pAT,Z: PAGE OF AP?ROVED BY .J lad$ 0'36 ® 0- 0 2 15 73 1 1 800 Job Address Miner Address Phone Con race , �1 ress , Phone t©� l 3'q- �c 6 Kind of Building Use 1 QA<�. Comp et'on Date stimate ost � 4 13 1773 Plumbing Fixture Rates: NO. RATE TOTAL Number Fixtures x $2.00 $ %O Future Fixtures New Fixture -Old Open. Catch Basin x $1.50 x 1,50 $ x $3.25 3'JEtlfll ( ( I •� U I I I ® Etl�l Water Heater -99,000 BTU x $3.00 •�9�W I I I I! Ground Run Old Bldg.x $3.25 saa� a v�Nltlal I I II I I Elec. Water Heater x $2.00 y„I 8N18tl81 x I I I ° Gas Fitting Fees: sw i I I I 6 OI aoo11A ,d C ¢, 1st 3 Fixtures x $2.00 ;w •g , � ;mal sa3MCHsl I I I I Additional Fixtures x$ .75 �atj'1Nf10d HN�aa I I I I I Gas Range -199,000 BTU Re airs & Alterations x $5.00 •U •o .A HSVMI '— I I I I O See 9 E>iwsl ISI I I Description: Code State Surcharge .50 BNISV9 I�I Il TOTAL FEE sone I H.LV13 I I I I a The undersigned hereby makes . application for a permit E,tlN�a°I I I I I ; for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling 813S01D 0 U3.LVM) ( I I I U of the Department of Buildings, and hereby declare that all the farts and representations stated in this applicaLicVre true and correct. Ei qQqI ei Oa I PNd 4V 03 V , 'Signature Date i I/ .LVA I J SUBJECT O. City of Fridley rE 1231 AT THE TOP OF THE TWINSBUILDING PERMIT CEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �� CITY HALL FRIDLEY 55432 "-j NUMBER REV. DATE 9/10/73 PAGE OF APPROVED BY ---- 612-560-3450 910-F15 JOB ADDRESS 7675 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Outlot 1 1 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Center 7675 Madison Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. McCall &Company 5435 Lyndale South 55419 827-578'1 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Medical Center 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [j REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire Repair 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, ORIF 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 ISTALLS 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. $3O OOO $15.00 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. $180.00 e- N 1 /. .4 @ ®" PLAN CHECK FEE TOTAL FEE SIGNATURE OF CONTRACTOR r AUTHORIZED AGENT (DATE) H N PROPERLY VALIDAT T S YOUR PERMIT r D SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI I/ .LVA I J City ®f Fridley SLO.IEGT Permit No. AT THE TOP OF THE TWINS VI-', ", BUILDING PERMIT APPLICATION ajr Receipt No. . r ------- COMMUNITY DEVELOPMENT DIV. 1 1! PROTECTIVE INSPECTION DEPT. CITY MALL FRIDLEY 882 �„j 012-8803480 IMXOER REV. DATE PAGE OF APPROVED 8r • 910-F1'4 0 1 15 73 1800 Job Address: /' 1 ' ®-- Legal Lot No. Block Tract or Addition See Attached •,,�/— ��✓ Sheet Descr. o 6 e , " E y d ® Property Owner Address Zip Phone Contractor Address Zip Phone License No. s� a S N 3S—''S 1 Architect or Designer Addre s Zip Phone License No. Eng neer Address Zip Phone License No. Use of Building Class of WorkRemove ® ® ❑ ORepair BMove New Addition Alteration Describe Work Change of Use From To SPECIAL ASSESSMENTS: If lateral assessments have not been placed on this property, an agreement must be signed, agreeing to assume such lateral assessments before a permit will be issued Agreement Necessary: Agreement Unnecessary: Finance Director J OUTSIDE UTILITIES: Z Sewer Elevation: Water Elevation: O • Stub Location: Stub Location: W U) BUILDING INSPECTION I— Plumbing H.V.A.C. Electrical Fire Insp. V Signature & - Date Approved OC O U. Registered Engn. Stamp. Legal Description Check Exterior Devel. Check Performance Bond Check Easements, R/W, Special Agreements Final Approval Date Certificate of Occupancy Date r FOR CITY USE ONLY DIMENSIONS• Length: Height: Cu. Ft. Width: Accessory Buildings: Length: Sq. Ft. Height: Cu. Ft. Width: Sq. Ft. VALUATION: Sq. Ft. X Cost = Valuation ) Totd.l Valuation Basement X Cost = Valuation ) PERMIT FEE: Residential Total Valuation Fee XL $1.00 to $500.00 $5.00 $501.00 to $2,000.00 $5.00 for the first $500.00 plus $1.00 for each additional $100.00 or fraction thereof, to and including $2,000.00. $2,001.00 to $25,000.00 $20.00 for the first $2,000.00 plus $3.00 for each additional thousand or fraction s.� thereof, to and including $25,000.00. $25,001.00 to $50,000.00 $89.00 for the first $25,000.00 plus $2.50 for each additional thousand or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $151.50 for the first $50,000.00 plus $1.50 for each additional thousand or fraction thereof, to and including $100,000.00. PERMIT FEE: Commercial and Industrial Total Cu. Ft. X $2.15/1,000 sq. ft. Permit Fee X - ®• tJ�d PLAN CHECK: Take one half of permit fee = STATE SURCHARGE: Valuation X $.50/$1,000.00 0 X $.50/$1,000.00 PERFORM4CE BOND VALUATION TOTS F Blacktop 1.50/sq. yd. Curbing 2.00 lin. ft. Sod 0.40 sq. yd. Fencing 2.00 lin. ft. " Bushes and Trees 5.00 - 30.00 TOTAL BOND VALUE Application for Poww Pkmft and Heating. Coolies. Yenlita&n. Rftrigor�afion and Air CORMOning Sydem and Doritos PARTIAL RATE SCHEDULE 0109 1 WARM AIR: IIATE TOTAL Furnace Shell & Duct Work ................ .. $10.00 $ Replacement of Furnace... W. ..... .. 6.00 $ ... .... Repairs & Alterations—up to $.00 6.00 ' 00 $ -- _--- Repairs & Alterations each add. $500. 3.00 $_L_2_ 00 MECH. WARM AIA Furnace Shell & Duct Work to 120,000 BTU ........ .. $10.00 ; each add. 60,000 BTU .................... .. 3.W = Replacement of Furnace .. ... . .... 6.00 Repairs & Alterations—up to $500.00 .. 6.00 ; Repairs & Alterations each add. $500.00 .... &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 198,000 BTU) 6.00 ; over 199,000 BTU See Fee Bch*"* GAS FITS-ING FEES: NO RATE TOTAL 1st 3 Fixtures .. .... x$ 2.00 $ Additional Fixtures a .7 $ Gas Range to 198,000 s$ 5j* $ AIR CONDITIOIRNG FAN HEATING BYSTEN m Fee Schedule YEl1TILATING SYSTLM -_JW -i , b0 ALTERATIONS & REPAIRS YIITOTAL FEE $ ie4h`® ROUGH FINAL Z, — 457- 7 5/ (SURCHARGE $_,50) Dept. of Bldg& P hone 880.4MM ) Lecyien ! l® �J� NE ,E 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 a true and/correct. Fridley, Mian ��/ / 18 �2 Owner 2i� ddJ . 6/&p-y)z Q?d"`� Kind of Building v Used as To be completed about �j__.�'� Estimated Cost, Old—New. Building Permit No. Permit No. OR OF WORE TING qr POWER of Wa , arm Air No Tiede "am Size N�� Capacity E.D,R ' NY Total Connected Load Rind of Fuel BURNER — Trade Na+ne Size _ Capacity Sq. FL E.D R- BTU ap. (REMARKS-O"RI s' 1g. SUBJECT P6 City of Fridley ®139'74 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT N0. COMMUNITY DEVELOPMENT DIV. v r PROTECTIVE INSPECTION SEC. Q.57/ C� /'•'1 CITY HALL FRIDLEY 55432 �'••' ,'J NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910415 3/31/77 JOB ADDRESS 7675 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N. 400' o the W. 21 .80' of Outlot 1, Melody Manor 4th Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE FMC & Associates 7675 Madison Street N.E. 786-2700 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. C. F. Haglin & Sons 4005 West 65th, Edina, Mn. 920-6123 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. Bill Clynes & Bob Roberts 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Medical Center 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR El MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 46' x 94' and 48' x 56' Addition to Building 9 CHANGE OF USE FROM TO STIPULATIONS All building entrances must be ramped at 20:1 for handicapped. Submit drawings for handicapped restrooms (must meet Chapter 55 of the S.B.C. for handicappe Corridor and exit doors on south end must have panic hardware. See Fire Department Check List. Provide 20 minute self closing door at corridor to Room B107. Provide closer on all existing doors on existing building. Provide sprinklerjd heads over corridor openings from rooms that cannot be closed off with doors (4) existing buildi Submit second set of plans. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Block 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 4416+2688 48,576+29,56S ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT 1 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. $222,050 $111.02 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 Sc PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $168.00 f STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. p� � ` ©�� 1 � F 4 PLAN CHECK FEE TOTAL FEE � CJI $109.20 $1,488.22 SIGNAVURkOF CO ACTOR OR AUTHORIZED AGENT (DATE) • 4WHEN PROPER Y VALIDATED THIS 17YOUR PERZ31-/74 / SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG. INSP AT 1g. � 4 " (Form Developed by the State of Minnesota building Code Division) TO BE SUBMITTED WITH BUILDING PERMIT APPLICATION . EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: FR. 117 L L Y M C E ki T F a � 2 � LEY t4 I N w .Es0TA SITE ADDRESS: % CO 5 MAD 1 S O w 1 `I — L a CONTRACTOR: C N 14 iv c-r'r 4 '� S DATE: J/ (n 7 ? PHONE DETERMINE WORKING SQUARE FOOTAGE OF EACH: � 1. Total exposed wall area ................ '331t sq. ft x "rte 2. Total roof/ceiling area..*..*.*.**.**** q. ft x 3. Total exposed wall area calculations: Total exposed wall area above floor -33 sr a) Total wall window area... 114 b) Total door area ............................................. c) Total sliding glass door area ........ 0 .......... 0 ....... .... d) Total fireplace wall area .................. .. ..... ... .... ... e) Total wall framing area (Average 10%) ....................... f) Total net wall area above floor ............................. S)` Total rim joist area ........................................ Total exposed foundation area m . h) -Total foundation window area................0............0.. " i) Total net foundation area above grade ....."-- .................. DETERMINE "U" VALUE OF EACH WALL SEGMENT: X fluff 22 /041900 b X nun C = X nun d -�--- X $full e X nun o �Wf X nun a -3 g• X $full . /3 S ✓yl'�-DyL .INS h X nun m i. X llull 3. TOTAL If item #3 is the same as, or.lass than item 01, you have met the intent of S.B.C. #6006(c) 2• '�9: 4. Total exposed roof/ceiling calculations: Total exposed roof/ceiling area �A s J) Total skylight area ................................ �! k) Total roof/ceiling framing area (Average 10%)...... , 1) Total net insulated roof/ceiling area ..:........... DETERMINE "U" VALUE FOR EACH ROOF/CEILING SEGMENT X uUn k. 7210- x nUu D� 639' x $fu" 4. TOTAL71 +3 If total of 44 is the same as, or less than #2, you have met the intent of S.B.C. 06606(c)l. ALTERNATE BUILDING ENVELOPE DESIGN To-utilize,the.total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items X11 and #2. 1 + 2. 3 +4. CERTIFICATION I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. WL nn -- (Signature) /7Z (Date [6/15/76] 4-4 SwifoT Permit No. A City ®f Fridley BUILDING PERMIT APPLICATION AT THE TOP OF THE TWIN$ Receipt No. r P i ry-------COMMUNITY DEVELOPMENT DIY. PROTECTIVE INSPECTION DEPT. -�� i CITY HALL FRIDLEY 68432 �.� 012-560-3460 REV. DATE PAGE OF APPROVED 6Y fflFR 0-F1'4 1' 7/8/76_goo Job Address: 7675 Madison Street N.E. lck Tract or Addition See Attached Legal Lot No.�e) Sheet Descr. N. 400' of W 217.80' of outiot 1. melod Property Owner Address Zip Phone 786-2700 FMC & Associates 7675 Madison Str ontractor AddressPhone License No. Q-. ('a 000 L) GcZ -(Al Z3 Architect or Designer Address Zip�g�2r- Phone License No. �L-�.r �L �V -� 1�a Q 044 L'jS� Eng neer Address Zip Phone License No. Use of Building Medical Center Class of Work ❑ New ® Addition ❑ Alteration PRepair 8 Remove Move Describe Work Construct a 46' x 94' and 48' x 56' Addition to building Change of Use _From To Signature, SPECIAL ASSESSMENTS: If lateral assessments have not been placed on this property, an agreement mast be signed, agreeing to assume such lateral assessments before a permit will be issued Agreement Necessary: Finance Director Agreement unnecessary: bUTSIDE UTILITIES: J Z Sewer Elevation: Water Elevation: O Stub Location: Stub Location: tai N = BUILDING INSPECTION >- � V Plumbing H.V A.C. Electrical. Fi ns . Signature &% Date Approved //`lop ® Registered Engn. Stamp. Legal Description Check Exterior Devel. Check Performance Bond Check Easements, R/W, Special Agreements Final Approval Date Certificate of Occupancy Date 14rL. DIMENSIONS• / Length: �10 Height: �� Cu. Ft. CAF, -S-) b Width: Sq. Ft. N` AC Accessory BuildVy s: Length: Height: / / Cu. Ft. Width: Sq. Ft.,�(0 VALUATION: Sq. Ft. X Cost = Valuation ) t P4 f)' G 13 (,l6 ) io 222. , (�s� ) Valuation basement X Cost = Valuation ) Permit Fee PERMIT FEE: Commercial and Industrial Total Cubic Ft. X $2.15/1,000 Cu. Ft. Q = W.co ALTERATIONS and ADDITIONS or REPAIRS $3.00/$500.00 or fraction up to $50,000 Valuation $1.50/$500.00 for each addition $500.00 over $50,000 SEWER AVAITLABILITY CHARGE (SACJ = I'; 400 Id ; 2 ego = 7.9(. C -U 3 x PLAN CHECK: 65 percent of permit fee = �C79•o1a STATE SURCHARGE: Valuation X $.50/$1,000.00 PERFORMANCE BOND VALUATION Blacktop yd. Curbing _4.50/sq. lin, ft. Sod. _3.50 0.do/sq. yd. Fencing 5.00 lin. ft. Bushes and Trees 2,; a0 _ 9.0.00 0 TOTAL FEE 50% of Total Value = $ Bond Fee M: Ift i. i�ep�7 II11r �O 441(, l t 4-` -- --------------- - - - - Gil oq- --- Vol i IST. ov - - 1I I� 'Iil -- - ISI i, I, -- - --- - - R Am FRIDLEY FIRE DEYAk1MEN'1 � PLAN INFORMATION AND CORRECTION SHEET - FIRE PREVENTION CHECK LIST BUILDING NAME & ADDRESS OCCUPANCY ZONING FIRE LIMITS Area Proposed 0 1. Automatic Sprinkler System a. Valves & Piping b. F.D. Connection c. P.I.V. ' 2. F.D. Standpipes a. Size"° b. Location 3. Hose Cabinets G 4. Fire Extinguishers 5. Grease Hood, Duct & Surface Extinguishing; 6. Fire Alarm & Detection 1*7. F.D. Access 8. Exits 9•. Exit Signs 10. Exit Illumination Ill. Roof Access 112. Stairwell Vents 113. Ventilation Shut -Down 114. Elevator Over -ride 15. Smoke & Heat Venting 16. Horizontal Cut-offs C� 17. Vertical Cut-offs 18. Exposures 19. Interior Finish 6 '7 20. Incinerators 21. Flammable Liquids Room 22. Paint Spray Rooth 1;1A 23. Flammable Liquid Tanks 24. L.P. Tanks 25. S eclal Hazards 126. Fire Hydrant Location 27. Yard Hydrant Location 0 PtG • �Ja�-1 =NEM—RING INe inneapu`'r6.�:�.u M1rn! snw: lele ail & Afurui/ml Engtnecrug oSuit Tr;ttng a LandSurtytng • Land Planning ,ct A. Q hLrnasota Certificate of Survey forF RIDLEY MEDICAL OE TEP P -ROADL--- S 69*17 !9"E. t 4' ,n 9a�.td'T.. 5 Corrc�plP wo/lr !! fl7 Z 71 4G.og M jA . p /3 . 8 g a I s (� O 4-1 o Denotes Iron monument ry �, sear°,rl�s Srlowrl a, � �xssui G J c� 0 JULYl976 The riorlh x'00 reef oE' thee' t6ef of;, OU//j/ 1 /'1>7e,b, �W subjee1 b on eoremed over fh v lhereo{'ror sheer ouruses, a, over lht:' east iD t`al- 117e,,w;`i 1.77 9 — 2/7-92 N.89"IT 1911 \ �' ulh line of the norlh 400*of"' Oudot 1 Oe/o y Manor ei,1W*111vn �J 1 hereby certify that this is a true and correct representation of a survey of the boundaries of the alp described land, and of the location Of all buildings, thereon, and all visible encroachments, if any, from said land. As surveyed by me this ��day efy,! —A.D, lyz! 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'X ro � k t ' a x, . ,, . ti t s •ty 1 t ,� y !+ il�h T f fi' +� 'I + .fir r �'` F ' i 10 r k n 1� $ �t � s 'ac �� * 3 t r y �! c r t U� 0.x H,y s s �" i F c M +'s ' r, �'„ 1 �.,,,,, * r f ro . r - F �, + z , red { .r Y r ,i f* n I g k? r P f s ' 6, a, ` 'k„,.. B I ? r yi5 �� Ivy � tiF t� 9 F F¢ +�+� I a € cM x �' ! r sy �,� 'p#kr t, 4 'c r r t .,r r 4�. ^a^ ., r} a ' trr a v W. + +f °k lb t s. ,` '� '� �,r F d ' y, x `' _ r y� +} tri +y r r c �' (-m d a N Hary r m' ` .� , Y w, I ' n' � a € } / yy Y W r .'� F I t m?q '� " tl� N I Q 3CK .t lµ. f _ � Y 4 i b -r. r u_ 6'#' s m .� . '6 ' I 'S I, r •%`V K itC .� T, GI '; ,err 1Fti + } �r as r r r 1 y , I. .: .. !, . '"-,. . , F ;' s.c}:li .. „ , ,. , a -r - ... A. ,i ._ , k ?.,... .':t. ' -. . _ . .'.'�' . . .. f ,� �t . >.,:ri.. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING P8 WIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures '2I x $3.00 Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $2.00 x $2.00 X $5.00 >r m x $10.00 x o x $5.00 d $5.00 Water �i E CC TI Ca m ro N pa, .14v 44 Heater m �O x C 3 gc+�� -.rm v r+ w o °c 49 g m ami lec m U M) M al y 3 Q w cn W U M 3 O O s lst 1 2nd 3rd 4th (R) Future Connection Opening Connected with Sewer (*) New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures '2I x $3.00 Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $2.00 x $2.00 X $5.00 x $5.00 x $10.00 x $7.00 x $5.00 x $5.00 TOTAL $ '93•®0 x '$3.00 $ x $1.00 $ x $10.00 $ $5.00 $2.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) -Job Address 7675 N. E. Madison Department of Buildings City of Fridley Tel. #571-3450 * 1 -vi® 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 29 April , 19 77 OWNER Fridley Medical Center Association KIND OF BUILDING Brick USED AS Medical Building TO BE COMPLETED ABOUT ESTIMATED COST $40,000.00 [Mechanical] Addi t on ,"QJ- OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company HORWITZ MECHANICAL I14C. Signed By. ✓=� e� Brien, Project r. Tel. No. 350 / 6 ROUGH INSP. Date FINAL INSP. A A Date APPROVAL FOR PERMIT s MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PEF111T i s�"s+fie„� .wi a w w u a w 11 w a b• M Mater Heater lot / 2nd 3rd 4th (R) - Future Connection Opening V) - Now Fixture, Old Opening Connected with sewer Mater RATE SCHEDULE PLUMBING FIXTURE'RATES: NO. New Fixtures • Future Fixtures Old Opening, now Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Nater Leader NYdraulto Valve 8usp or Receiving Tank Mater Treating Appliance Not Nater seater Gas Range Gas Dryer RATE $ 5.00 $ 3.50 s 1.50 $ 4.00 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE TOTAL i Cf�.v v $ S .5o s �(%• Sal% tutective Aug. 1, 190L Job Address /44J4,1> I%,=, a-) Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby sakes application for a permit fortM sin Fork her specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Bu..ldings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. omit f=!/y 1� 1® �% %l�C rf-- l=1 l .cam RIND OF BUILDING fes-! C- t4— USED 4 USED AS To BE COLLETED ABOUT /e ESTIMATED COST /-'2 OLD - NEN BUILDING PERMIT No. pWIT NO.�: Ccspany ro PF t't -'7— signed signed By Tel. No. ROUGH IMP. Date FINAL INSP. Date APPROVAL FOR PERMIT'9� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE 0 SUBJECT PER City of Fridley 1716 2 AT THE TOP OF THE TWINS BUILDING PERMIT _ rp REC O 01. _____ COMMUNITY DEVELOPMENT DIV. S r PROTECTIVE INSPECTION SEC. Q y CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 5/24/83 JOB ADDRESS 7675 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N. 400' o the W. 217.80' Of Outlot 1, Melody Manor 4th Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Center & Assoc. 7675 Madison Street N.E. 786-2700 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dailey Homes 8510 Central Avenue, Mpls. 55434 784-3910 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. Robert David Durow 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Medical Center. 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 48' x 68' Addition 9 CHANGE OF USE FROM TO STIPULATIONS Side yard variance of 13' approved. Temporary concrete curbing must be upgraded to permanent 6 inch poured concrete. Implement outside improvement schedule determined by the City. WARNING Before digging Call kcal utilities ISEPERATE PERMITS REQUIRED FOR WIRINGa TELEPHONE -ELECTRIC - GAS Etc. E HEATIN(;. PE s iMBINCI AND MGM. REOUIRED BY LAW 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THP TYPE OF WORK WILL BE COMPLIED $88.55 WITH WHETHER SPECIFIED HER. OR NOT. THE GRANTING OF A PERMIT $177,100 DOES NOT PRESUME TO GIV AUTHORITY TO I LATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTH STATE OR LO AL AW REGULATING CON- STRUCTIO E OR ANCE O C ST UCTIOR 63$00 $$SO.00 �3 11 / PLAN CHECK FEE TOTAL FEE 1 $1,991.25 SIG NATU -. ONTRACTOR CM AUTHORIZED AGENT (DATE) II WHEN PROPE RLYYf LI DATED THIS IS YOUR PERMIT 9 BLDG INSP nAT SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI Building Address: Ci(Dc CITY OF FRIDLEY ""Canmercial and Industrial Building Permit Application I � ro t Effective Aug. 1, 1981 mss ZIP: — PNE: — ................... AWRLbb. 2•LICENSE ARCHITECT: ADDRESS: R o%' P'�4 .418 row ZIP: ICENSE ENGINEER: ZIP; _ LICENSEN . USE OF BUILDING' eo e-eAjpeti F.WWA USE FROM: TO: .l K: y FA W; N: N: A REMOVE: Y • -77 75 - LUI AKLA: — LOT COY N M a TM 3LEASE CHECK, IF REQUIRED: IARIANCE SUBDIVISION ACCESSORY BUILDINGS:JWECIAL USE CUBIC N LENGTH WIDTH sQ. FT. IE16HT CUBIC SPLIT IALUATION'- SO.FT. X : COST/SQ. FT. • VALUATIONS/ OTHER_ X ,___ COST/SQ. FT. • VALUATION • TOTAL VALUATION 17 �� YPE OF BUILDING CONSTRUCTION _ `j0!� S: OCCUPANCY GROUP CLASSIFICATION . PERMIT: COMMERCIAL, INDUSTRIAL OR) _ �W . ALTERATIONS/ADDITIONS/REPAIRS: ) See Fee Schedule on Reverse Srde . SEWER AVAILABILITY CHARGE (SAC) • 3 toe ® & c la a k&.)& n -t i' -,v 3/ PLAN CHECK (05% OF PERMIT FEE) • �'°��'"" A . STATE SURCHARGE ($.50/:1,000.00 VALUATION) • TOTAL FEE $ CIAL ASSESSMENTS: 1. IF LATERAL ASSESSMENTS HAVE NOT BEEN PLACED ON THIS PROPERTY, AN AGREEMENT MUST BE SIGNED, AGRtEING TO ASSUME SUCH LATERAL ASSESSMENTS BEFORE A PERMIT WILL BE ISSUED. Y. PARK (10% RESIDENTIAL, 39 INDUSTRIAL) (REAL PROPERTY OR CASH) 3. PERFORMANCE GUARANTY (FILED • NO YES LOCATION) AMOUNT AGREEMENT NECESSARY AGREEMENT NOT NE ESSARY CIAI ASSESSMENTS:o DATE o ITE INSPECTION: SIGNATURE DATE REGISTERED ENGINEERING STAMPLA 4T 1 .UMBING EXTERIOR DEVELOPMENT CHECK .V.A.C. LEGAL DESCRIPTION CHECK ACTRICAL PERFORMANCE BOND CHECK IRE DEPT. EASEMENT, ROW, SP. AGREEMENTS ANAL APPROVAL JILOING INSP. PUBLIC WORKS DIRECTOR CITY MANAGER ERTIFICATE OF OCCUPANCY ISSUED DATE Building Permit tee SchOdules .oTAL • nALUATION a $1.00 to $500.00 $10.00 (dim= pee is $15.00 plus surcharge) $SOl to $2,000 $10.00 for the first $500 plus: $1.50 for each additional $100 or fraction thereof, to and including $2.000 $2,001 to $25,000 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to. - and including $50,000 $50,001 to $1000,000 $293.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 and up $443.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof PLRN CHECK: 65 percent of building permit fee SAC Charge: $425.00 per SAC unit 100. aw) -:--.P* -s►Cv t -,W -777700" FILF71 INATr,- COMPLETE REVIEW CHECKLIST RETURN TO PLANNINC3 oupj3w M MI, wrownsm COMMENTS lam`-' .JV'"�'""� 11ei/ .ie.�. e_/ tatdsccf A re- la cenockefc- 64 /o 4 I CITY OA FRIDLEVal SUBJECT MII�+nI�9oTA I . COMPLETE FIEVIEW CHECKLIST RETURN TO 13UILDING INSPt,ECT1014 BUILDING PERMIT REVIEW ilg.• h►O/ ^cons as 'll■ OST• �2, COMMENTS 21' Dwa CAT• urlfi • i-. DARREL N f • yl/IA r� MODE oil I c BUILDING PERMIT REVIEW ilg.• h►O/ ^cons as 'll■ OST• �2, COMMENTS 21' Dwa CAT• CITY OF FRIDLEY Page of BUILDING PERMIT MINNESOTA REVIEW ZONE: CR -1 FILE NO. / ADDRESS: If blank or asterisked, see current code requirements ITEM REQUIRED ACTUAL OK COMMENTS Lot Area 15,000 sq. I f 1:4 751143 Kear Yard SetdacK Setbacks When Abutting Any Other District District Separation Bui wing air ing Parking 3i Size o TffiuffiFe—ri riveway iveway ur E Tn tripping internai irattic raffic Sieg Landscaping (SEE PLAN) s t.IptZC? e X s" / 2 ? a� 0,V nec✓ ady; a^ 312- 13 V46o4ore (Cj✓ii`"�"`�/ �S 5 Al, eld C°4eck "ek5► jh q heY 11 s ory 4 0 s tory 5 story 30. 4 story 25 �. 5 story Off story regular '35 re u I ar I b tt. drive 25 ft. corner 25 t. re u I ar 25 ft. across from alley None across from �- street None Across ow: 5 ft. si ewa c Res. dist. 15 ft. planting stri ee'' add. to other district approved screenin 3 story 45 ft. max str. ROW 20 ft. s e d. t. Y rear t. bidg. 5 tt. ✓ 5 ft. 20 10 t. x 2 t. �. ---oM—cel Per '250 sq. ft4 wnse. i per suu sq. rt 1r intersect 5 t or 2/3 0 of wi t angle 60 max. vision 2-1/2 ft -10 ft at 25 ft radii 10 ft. curb o n. 32 t. of line 5 ft. dg. 5 ft. d poured concrete blacktop/ hard surf. on rear yd./side yd. screened from tion- rear yd; side yd. if screened ern s a_ ry Plants rdd cv�er. 5 kln . system other water ava . roof eau D. vision safety not disruptive F�e(� t hPGkne�� t� Si'-�rl/s f®®e l J �is/B s il-oa n a A,+ s \1, CITY OF FRIDM APPLICATION FOR PLUMBING AND GAS FITTING PEralT ra RATE M 01 10 1 �. � w iia to e ' aye uo��a u S. n Beer Dispenser 11 w w • tp c w M Mater Heater $ Catch Basin $ 5.00 $ Rain Nater Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving lank $ 5.00 $ Nater Treating Appliance $ 7.00 $ Not Nater Neater $ 5.00 lot an Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection tem $ State Surcharge $ .5o _ ($15.00) TOTAL 2nd $ /®• S7Z) 3rd 4th IR) - Future COMection Opening (a) - New Fixture, Old opening Connected with Sellar Nater RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening. New Fixture $I.So$ Beer Dispenser $_ 4.00 $�_ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Nater Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving lank $ 5.00 $ Nater Treating Appliance $ 7.00 $ Not Nater Neater $ 5.00 $ an Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection tem $ State Surcharge $ .5o _ ($15.00) TOTAL FEE $ /®• S7Z) a S1160tIVO Aug. 1. 1901 Job Address -2 4-- 7,S- b4 --t !- 1,-> L Department of Buildings City of Fridley Tel. 0571-3450 ¢l�a•�t,e undersigned hereby sakes 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 Department of Bu..ldings. and hereby declares that all the facts and representations stated in this application are true and correct lridley, ma. �19-2. OWNER RIND OF BUILDING 45 USED AS 70 BE COMPLETED ABOUT ESTIMATED COSTo,3G �i OLD - NEN BUILDING PERMIT NO. PERMIT NO. gnocD Company L-5 ;z 12644 c, 7—G - Signed Sy Tel. No. '7 51 - `� S ROUGH IMP. Date FINAL INSP. Detre APPROVAL FOR PERMIT e� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE GITY OF FRIOLEYI SuBjECT E _ 6439 NNIVERiiTY AVB. NB. N? 0670 FRIDLEY, MN. 58438 X6967 a79-340110 SIGN PERMIT R COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION BEC. NUMBER REV DATE PAGE OF APPROVED BY 8-1-81 7/27/83 / / 800 JOB ADDRESS 7675 Madison St. N.E. T LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. Ipt of 1 1 melochr Manor 4th Add. Z PROPERTY OWNER MAIL ADDRESS ZIP PHONE Benson's Red Circle Dr. Minnetonka 3 SIGN ERECTOR MAIL ADDRESS ZIP PHONE LICENSE NO Nordcruist Sign Co.R93-7991 • SIGN TYPE ( ) WALL ( ) PYLON ( ) ROOF ( ) OTHER S CONSTRUCTED OF: S. ZONING Aluminum C -R-1 7 BUILDING LENGTH 8 EXISTING SIGN AREA 8 MAXIMUM AREA ALLOWED 50 f t. 0 106 f t 10 CLASS OF WORK OX NEW O ADDITION D ALTERATION O REPAIR If DESCRIBE SIGN LENGTH: 71611 HEIGHT: 2' SQ.FT: 15 HEIGHT ABOVE GRADE: 12 MESSAGE (SEE ATTACHED SKETCH) "Benson's and a Logo" STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, WIRING, OR REVOLVING BEACONS, ZIP FLASHERS, ANDSIMULATED DEVICES, ALTERATION OF THE BUILDING. INCLUDING ANY SOURCE OF LIGHT WHICH CHANGES IN INTENSITY THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ARE PROHIBITED. AUTHORIZED IS NOT COMMENCED WITHIN SS DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $600.00 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE TOTAL FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $24.00 $24.50 STRUCTION OWTHE PERFORMANCE -OF CONSTRUCTION. SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT (OATEI 1/y PERLY VA I THIS IS YOUR PERMIT rBLDG INSP f r)A7E SIGNATURE OF OWNER JF OWNER BUILDERS MATES u CITY OF FAIOLBV,I SUBJECT MINNGSOTA DepartrnentiD�no�ar COMPLETE REVIEW CHRCKLIST RETURN TO 6UILOINO INSPECTION DARREL i E Rear-�• BILL OHN SIGN PERMIT REVIEWpu . Iwneer Approved by P1Lm roo.* ^commton .. COMMEIV' ,."/ l o" FILA OATM -7, z(- ,PJ own OAT& Dote hioel(2 /All i ✓ I g STEVE ..�, _ 1'. rm Jr O m r tje,,V&�, -a' r'�51" W 4� rx_� CITY OF FRIDLEY SIGN PERMIT APPLICATION OWNER: ,1+ S�°v .S SIGN ERECTOR: J1J®�RDA,41 S,_1 S/&1% de), ADDRESS: t J / ✓C C�it,t 2)A I V'G ADDRESS: 312- W 6S% 1,4K$ s%: M 1,Q n/ e7&J)c 4 InPJ , %-S M ni . TEL NO.: /2.0&e)L -j-&4rjSad TEL NO.: pA3- 7,A9 I r� SIGN LOCATION STREET NO: / `J STREET: Z22ADI SO S , LOT: �T 'r- 1 BLOCK: ADDITION: "`' "`� DESCRIPTION OF SIGN SIGN TYPE: *Wall.2�,_**Pylon ***Roof Temporary ' 51TrA I Length Height Z `f Sq. Ft. I S Constructed Of Aw;-n/nlvlm Illuminated P�® Estimated Cost $ (00 Be Completed q/1 11r5 Sign Message I S (,b CTu 5 * Length of building wall sign is to be placed on Area PRI�� ** Distance From: Property Line Inter./Dwy Hgt. Above Grade *** Roof Sign in Lieu of Pylon Sign G'myr: C_ - F- `1 Permit Fees; Up to 40 square feet - $24.00 More than 40 square feet - $60.00 Add $.50 State surcharge if sign not illuminated. Temporary signs; porta panels, banners, pennants, etc., NO FEE Political signs; $15.00 deposit, refunded when signs are removed after election. STIPULATION FOR ALL SIGNS: Revolving beacons, zip flashers and dimilar devices including any sources of light which changes in S° intensity are prohibited. 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 ares rue and correct. DATE: SIGNATURES . mil+!/ lsGffht y2 5V/&r CITY OF FAIOLEY, SUBJECT P T N0. 15431 UNIVERSITY AVE. NE. N%_ 0744_ FRIDLEY, MN. 1515438 961M 15'11_34150 SIGN PERMIT _ RECEIPT N COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. J NUMBER REV DATE PAGE OF APPROVED BY e-1-8I 6/20/84 / / Boo 10B ADDRESS 7675 Madison Street N.E. 1 LEGALLOT NO. oatlo BLOCK TRACT OR ADDITION DESCR. Pt. of 1 Melody Manor 4th Addn. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Benson's Optical 600 Osborne Road N.E. 3 SIGN ERECTOR MAIL ADDRESS ZIP PHONE LICENSE NO Nordquist Sin Co. 312 West Lake Street M is PIN 55408 823-7291 4 SIGN TYPE (31 WALL ( ) PYLON ( ) ROOF ( ) OTHER S CONSTRUCTED OF: I B. ZONING Plexictlas CR--1 7 BUILDING LENGTH 6 EXISTING SIGN AREA S MAXIMUM AREA ALLOWED 235 1 1 230 10 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 11 DESCRIBE SIGN LENGTH: 11'611 HEIGHT: 112" SQ. FT: 13.4 HEIGHT ABOVE GRADE: 12 MESSAGE (SEE ATTACHED SKETCH) "Benson's pptical & Lo o" STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. WIRING, OR REVOLVING BEACONS, ZIP FLASHERS, AND SIMULATED DEVICES, ALTERATION OF THE BUILDING. INCLUDING ANY SOURCE OF LIGHT WHICH CHANGES IN INTENSITY THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ARE PROHIBITED. AUTHORIZED IS NOT COMMENCED WITHIN 66 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $100 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE TOTAL FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $24.00 $24.50 STRUCTION OF(THE PERFORMANCE-OF CONSTRUCTION. SIGNAIUAEOF CONT RACTOR OR AUTHORIZED AGENT IOATEi 4 IL WH P OPERLY VALIDATHIS IS YOUR PERMIT F 0!!� Z w BLDG INSP DATE S.GNATURE OF OWNEROF OWNER BUILDERi IDATEI 01, CITY OF FRIDLEY SIGN PERMIT APPLICATION Owner: �✓�01&/7M-Ll Address:®® i�S��'�(r� AtD TaL. No: r -,7,1 Effective August 1, 1982 Sign Erector: i" ace a) u Isj-16�✓ (foo Address: 30 w2- Tet. No: ' `' �S SIGN LOCATION Street No. Street: c� �'�'` �— �° 1 Lot: rT 01,'oG'-f ( Block: Addition: lite 1-h 1-7-11. (-/ 7, DESCRIPTION OF SIGN SIGN TYPE: *WeLL **Pylon ***Roof Temporary Other: length: 1L= \ ei�'� _ Sq. Ft.. Constructed Of: '�! Illuminated: Estimated Cost:$ To Be Completed: SIGN MESSAGE: h ofmattsign is to be placed on Z . ALLow. Area: **Distance from Prop. Line: Inter./Dwy.: Sign Hai ht: ***Root Sign in Lieu of Py Lon Sign ZONING: di ' / lkRMIT FEE-S-.---U0-`to 40 sq. A�=-424.x. More than 40 sq. ft.= WOAM- `Add t.5D-_$este Su rcha rga _ if -sign TEMPORARY SIGNS: Ports panels, banners, pennants, etc.= NO FEE POLITICAL SIGNS: $15.00 deposit, refunded when signs are removed. STIPULATIONS Revolving beacons, zip flashers and similar devices including any sources of Light which changes in intensity are prohibited. 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 representat ons stated in this application a trye and cor t. DATE: Customer Address city State Scale �" Revisions Drawn By Salesperson P, AN CY Customer Approval Date Date 16 1J ' (+ This drawin3 is the property of NOWNPIIIST N1(PI IN 1;111N1: 312 West Lake Street Minneapolis. MN 55408 612.823.7291 SUBJECT CITY MINNESOTA FRIDLEY, MINNESIGN PERMIT REVIEW � COMPLETE REVIEW CHECKLIST FILE NO. ADDRESS FILE DATE RETURN TO BUILDING INSPECTION DUE DATE �G 7 S ./h,� D � Sin � . /��. �°- � i-aC•�> STEVE COMMENTS D A R R Elmo L JIM �MIKE -M YT/A 0 H N CITY OF FigOL EYE SUBJECT PERMIT 6439 U1YIVER81TY AV6. NE. 0775 FRIOL.EY, MN. 68439! [69M 679-3450 SIGN PERMIT RE COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION ((��2J /5-0G SEC. 7 REV DATE PAGE OF APPROVED By r"7 B-1-SI 11/19/84 eoo JOB ADDRESS 7675 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR, pt. Cutlod 1 1 Melody Manor 4th Addition 2 PROPERTY OWNER MAIL ADDRESS . ZIP PHONE Fridley Medical Center 7675 Madison Street N.E. 3 SIGN ERECTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sububran Lighting Inc. 6077 Lake Elmo Avenue N., Stillwater 439-7440 4 SIGN TYPE ( ) WALL ( X PYLON ( ) ROOF ( ) OTHER S CONSTRUCTED OF: S. ZONING ta.l tic I CR-1 7 BUILDING LENGTH 8 EXISTING SIGN AREA S MAXIMUM AREA ALLOWED 10 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR it DESCRIBE SIGN LENGTH: HEIGHT: SG. FT: HEIGHT ABOVE GRADE: 4 4 a 48 12 MESSAGE (SEE ATTACHED SKETCH) a R STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, WIRING, OR REVOLVING BEACONS, ZIP FLASHERS, AND SIMULATED DEVICES, ALTERATION OF THE BUILDING. INCLUDING ANY SOURCE OF LIGHT WHICH CHANGES IN INTENSITY THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ARE PROHIBITED. AUTHORIZED IS NOT COMMENCED WITHIN SB DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 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 OFA PERMIT l x 40.0 $None DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE TOTAL FEE ON- PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TION OF THE PERFORMANCE -OF CONSTRUCTION. TION S60,00 $60.00 SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT MATEI WH LY LIDATED THIS IS YOUR PERMIT B: DG �pSP OAT E °,- SIGNATURE OF OWNER JF OWNED BUILDERi IOATEI Effective August i, iBB2 CITY OF FRIDLEY SIGN PERMIT APPLICATION Owner: 'moi-laL 5L 1 /yam CxEI/725f Sign Erector: 5/./ MXWW11/ LLGf/T/,G .,,WC Address: 76 ?S /�i4�/ !�' �, /j�� Address: A07Z ZA�-AeQAIO Alv% , A/. To L. No: ToL. No: SIGN LOCATION Street No. 76 7-:5" Street: lli4dl0D/K 1-5T //Q �f-7, Lot: BLock: Addition: DESCRIPTION OF SIGN SIGN TYPE: *Mall **Pylon X ***Roof Temporary Other: Length: '9' Height: Z/Sq. Ft.: Constructed Of: HE'r-41-9'P44�rGILLuminoted: Estimated Cost:$ To Be Completed: 1l16-- SIGN l/6--SIGN MESSAGE: ('607W .5-161V.5 *Length of well sign Is to be placed on: Max. Allow. Area: r / "Distance from Prop. Line:�Inter./Dry.: Sign Height: 5 ***Roof Sign in Lieu of Pylon Sign ZONING: C - je -/ PERMIT FEES: Up to 40 sq. ft.= $24.00. More than 40 sq. ft.= $60.00 Add $.50 State Surcharge if sign is not illuninstad. TEMPORARY SIGNS: Porte panels, banners, pennants, etc.= NO FEE POLITICAL SIGNS: $15.00 deposit, refunded when signs are removed. STIPULATIONS Revolving beacons, zip flashers and similar devices including any sources of Light which changes in intensity are prohibited. 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 end hereby declares that all the facts and representations stated in this application are true and correct. DATE: /® -- -' 0 — e� SIGNATURE: SUBJECT CITY OF FRIDLEY, MINNESOTA COMPLETE REVIEW CHECKLIST RETURN TO BUILDING INSPECTION El STEVE SIGN PERMIT REVIEW FILE NO./ADDRESS "eL; e", e COMMENTS FILE DATE /e�ZZ—o"K/ DUE DATE CITY OF FRIOLBY, SuB.,ECT PER 6431 UNIVEAVE. NE. AVNE. U 8 4 FRIDLEY, MN. 68430 WISID 571-3450 SIGN PERMIT REC COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� NUMBER REv DATE PAGE OF APPROVED BY 9-1-a1 8/20/85 / / Boo JOB ADDRESS 7675 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. Pt. Outlot 1 Melody Manor 4th Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Center SM 7675 Madison Street N.E. 786-2700 3 SIGN ERECTOR MAIL ADDRESS ZIP PHONE LICENSE NO Crosstown Sign 10166 Central Avenue N.E., Mpls., MN 55434 784-7742 4 SIGN TYPE ( ) WALL (,V PYLON ( ) ROOF ( ) OTHER S CONSTRUCTED OF: G. ZONING Metal/Plastic 7 BUILDING LENGTH a EXISTING SIGN AREA 9 MAXIMUM AREA ALLOWED 10 CLASS OF WORK NEW O ADDITION O ALTERATION O REPAIR 11 DESCRIBE SIGN LENGTH: 81 HEIGHT: 21 SG. FT: 16e HEIGHT ABOVE GRADE: 12 MESSAGE (SEE ATTACHED SKETCH) "Hours/Weekdays 7-9/Saturday 8-12' STIPULATIONS Electrical permit needed for wiring of sign. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, WIRING, OR REVOLVING BEACONS, ZIP FLASHERS, AND SIMULATED DEVICES, ALTERATION OF THE BUILDING. INCLUDING ANY SOURCE OF LIGHT WHICH CHANGES IN INTENSITY THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ARE PROHIBITED. 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $l, 500 None WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE TOTAL FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $24 . QQ $24.00 STRUCTION ON THE PERFORMANCE -OF CONSTRUCTION. SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT MATEi WHEN PROPE Y VALIDATED THIS IS YOUR PERMIT -, • _ FLOG INSP PAT SIGNATURE OF OWNER 0F OWNER BUILDERI MATEI CITY OF FRIDLEY Effective Aug. 1, 1981 SIGN PERMIT APPLICATION OWNER: ri d i04'r- et 1 l.. @ (.: ?e SIGN ERECTOR: C� Coss !Q —h, C y c c� AA4. ADDRESS: 76 73' A eu>4 S TS N ADDRESS : /Q/,Kj� ,l ¢ru/ Allil Y3 TEL NO.: 7efw-" a Zt7o TEL NO.: �T 77 22 BLOCK; ADDITION: DESCRIPTION OF SIGN SIGN TYPE: *Wall **Pylon ***Roof Temporary other X.&I,` j a Length Height Z Sq. Ft. /�'oL Constructed Of _��- If- PIIESI� C- Illuminated �c'l Estimated Cost $ ��®�,-- To Be Compl=eted Sign Message ® f/ %- sem/ u cl 12 *'Length of building wall sign is to be placed on Allowable Area ** Distance From: Property Line '01// p ty Inter./Dwy Ze0 Hgt. Above Grade *** Roof Sign in Lieu of Pylon Sign ZONING: Permit Fees; Up to 40 square feet - $24.00 More than 40 square feet - $60.00 Add $.50 State surcharge if sign not illuminated. Temporary signs; porta panels, banners, pennants, etc., NO FEE Political signs; $15.00 deposit, refunded when signs are removed after election. STIPULATION FOR ALL SIGNS: a- Revolving beacons, zip flashers and dimilar devices including any sources of light which changes in intensity are prohibited. 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 d c rrect. DATE: -- LF"' - �SIGNATURE: o �'' SIGN LOCATION STREET NO: 7 6`75" STREET: r � o BLOCK; ADDITION: DESCRIPTION OF SIGN SIGN TYPE: *Wall **Pylon ***Roof Temporary other X.&I,` j a Length Height Z Sq. Ft. /�'oL Constructed Of _��- If- PIIESI� C- Illuminated �c'l Estimated Cost $ ��®�,-- To Be Compl=eted Sign Message ® f/ %- sem/ u cl 12 *'Length of building wall sign is to be placed on Allowable Area ** Distance From: Property Line '01// p ty Inter./Dwy Ze0 Hgt. Above Grade *** Roof Sign in Lieu of Pylon Sign ZONING: Permit Fees; Up to 40 square feet - $24.00 More than 40 square feet - $60.00 Add $.50 State surcharge if sign not illuminated. Temporary signs; porta panels, banners, pennants, etc., NO FEE Political signs; $15.00 deposit, refunded when signs are removed after election. STIPULATION FOR ALL SIGNS: a- Revolving beacons, zip flashers and dimilar devices including any sources of light which changes in intensity are prohibited. 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 d c rrect. DATE: -- LF"' - �SIGNATURE: o �'' a r n i V 1 DFrl i j171 i"7jo ;!CC) 3 :fa i 3 o% a z CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL N 40M u _ '� x $ %r Future Fixtures Y 0W1 $ Old Opening, New Fixture N `; 1 b N W $ ) 8 i—i f c r Y .-al a $ 5.00 $ W Rain Water Leader pn', $ 5.00 $ Hydraulic Valve $ 5.00 $ •a An $ W Wq W $ Hot Water Heater 37 .0 M pp Gas Range $ 10.00 1 '!. b yapp Gas Dryer $ 10.00 qW ALL OTHERS AND/OR REPAIRS AND ALTERATIONS H U a 00 PO W 3 D Gr N W u o0 K 3 t7 $ l7 O da `;•! ec ($15.00) TOTAL FEE $/ let 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures _ '� $ 5.00 $ %r Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Bear Dispenser S 4.00 $ Blow off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ..� 1s of Value of Fixture or Appliance $ State Surcharge $ 50 Reinspection Fee $ ($15.00) TOTAL FEE $/ Ettective Aug. 1, 19th Job At"ic ess I /fY� Department of Buildings City of Fridley Tel. 1571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct OWNER KIND 0 USED A M BE COMPLETED ABOUT ESTIMATED COST <�: 7 OLD BUILDING PERMIT NO. ROUGH INSP. Date c1 , r - PERMIT NO. Company /',- < llc� t'-1 Signed By t d / Tel. No. FINAL INSP. � - A 7 — �e % Date APPROVAL FOR PERMIT 41?` MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE I CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective Date May 1, 1988 Job Address-/ &2% Department of Buildings City of Fridley Tel. 5571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mo. 2 r% 19� OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT RATE SCHEDULE TED COST PLUMBING FIXTURE RATES: NO. RATE TOTAL Water a 49 m New Fixtures $ 5.00 $ M .�i m O company r' , u a p, p, qCf Beer Dispenser $ Heater S Blow Off Basin5.00 $ C Tel. No. Catch Basin $ Mkt 3 Rain Water Leader S d $ a N $ ROUGH INSP. Sump or Receiving Tank $ 5.00 Uarl Date Water Treating , Apl a ce&$ 7.00 $ a NO C g rom�ro Gas Range $ 10.00 $ m awl vii I Back Flow Preventer Required. . . Yes ( ) No ( ani a� w S o w �n w u a aq 3 ch c� o s lec PLUS THE $.50 STATE SURCHARGE Reinspection Foe State Surcharge $ $ .50 ($15.00) TOTAL FEE $� lat 2nd 3rd 4th (R) . Future Connection Opening Connected with Sewer (�) w New Fixture, Old Opening Water Effective Date May 1, 1988 Job Address-/ &2% Department of Buildings City of Fridley Tel. 5571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mo. 2 r% 19� OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT RATE SCHEDULE TED COST PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - BUILDING PERMIT NO. PERMIT NO. New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ company r' , Old Opening, New Fixture $ 1.50 $ Signed By Beer Dispenser $ 4.00 S Blow Off Basin5.00 $ $ Tel. No. Catch Basin $ 5.00 $ Rain Water Leader S 5.00 $ Hydraulic Valve $ 5.00 $ ROUGH INSP. Sump or Receiving Tank $ 5.00 $ Date Water Treating , Apl a ce&$ 7.00 $ FINAL INSP. Hot Water Heater $ 5.00 $ Date Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ APPROVAL FOR PERMIT Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 S ` ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE Reinspection Foe State Surcharge $ $ .50 ($15.00) TOTAL FEE $� r SUBJECT PERM+T-Nfl:- - City of Fridley �23 AT THE TOP OF THE TWINS BUILDINGPERMIT o COMMUNITY DEVELOPMENT DIV. ^ r PROTECTIVE INSPECTION SEC. o O� ----nCITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By "'j 612-571-3450 910-F15 11/12/93 JOB ADDRESS 7675 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Ptl--Outlot Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Clinic 7675 Madison Street NE 785-8535 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. J M Bruggeman Co. 420. E Co Rd D, Little Canada MN 55117 483-5144 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Medical Clinic 7 CLASS OF WORK ❑ NEW ❑ ADDITION JD ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Add partition walls and 1/2 bath 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 80 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 STALLS I 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 $6180 $3.40 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- $90.00 Fire SC $6.80. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. . PLAN CHECK FEE TOTAL FEE $58.50 $158.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHP PE VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER t IF OWNER BUILDER) IDATEI r Prepaid Plan Check $ Estimated Cost $ Receipt I M C .1W,I C . •l i111V'l* ! Ttt l 0ointLwtion LY.O.a.1..+r4. s z -s' Effective 5/26/93 �L o C 5-z? 15-19 7181. 9,-P&-'5-1 App]..icant Signature�_ Tel �ieJ—s/ Date l/ 73'0- 07 d? IAngth Width Leight Sq. Ft. # of Stories CSC. AM: Iength I Width M 07M AREA: I+ength Width Height Sq. Ft. Height sq. Ft. Heid. sq. Ft.. VALUMO +i sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ �e�. o Sq. Ft. x $ Coost/Sq. Ft. = Valuation $ ) TOTAL VALUE DWIdi ng use Cxonst n=tion Type Ocm panty Group Air oanditioning []Yes []No Fire Protection Provided []Yes []No Ferfornence Band Amount $ See Reverse for Schedule Received. [ ]Yes [ ]No Permit Fee $ &, 06) Plan Check $ '58, �S-n Fixe Surcharge $ C' -'e>0 State Mmduxge $ sAC aumve $ Erosion C arft=l $ Park Fee $ Spec. $ Driveway ESC 0W iVii>WI b " e j-rIt- See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $750 per SAC unit (Plans to NNOC for determination) $450.00 Conservation Plan Review .1 - C7i i.=� ter-. �+.: -1 • >r�."- 1 c s.I 4 4N 11; BUILDING PERMIT FEE SCHEDULE $1 to 500 $15 (Minimum Fee is $15 plus surcharge) 501 to 2,000 $15 for 1st $500 plus $2 for each addn'l $100 or fraction, to and including $2,000 2,001 to 25,000 $45 for 1st $2,000 plus $9 for each addn'l $1,000 or fraction, to and including $25,000 25,001 to 50,000 $252 for 1st $25,000 plus $6.50 for each addn'l $1,000 or fraction, to and including $50,000 50,001 to 100,000 $414.50 for 1st $50,000 plus $4.50 for each addn'l $1,000 or fraction, to and including $100,000 100,001 to 500,000 $639.50 for 1st $100,000 plus $3.50 for each addn'l $1,000 or fraction, to and including $500,000 500,001 to 1,000,000 $2039.50 for the 1st $500,000 plus $3 for each addn'l $1,000 or fraction, to and including $1,000,000 1,000,001 and up $3539.50 for the 1st $1,000,000 plus $2 for each addn'l $1,000 or fraction PREPAID PLAN CHECK FEE SCHEDULE It r• �. 111 ,: .. •; Y ffI • :w •: • .•• t1f •; ■ .•w • ■• _i • • • '1►.+. 111 ,. f U r• 1 11 I A :°I r, - "Y.. 111 • R-917 WAN u; a: s ow. • • 'f 111 •: • . �.[ • r• .i • •� • 'bl 111 1 111 ■• Ii 111 �.• •; 1 f11 • . • �:• .••: 111 •: ■ ..w ♦ ■• .i • s • 11 111 I1 1t u . 11t •: 'f 11 111 • Y •: o:• .•• 'f 111 •t ■ ..■� • ■•Zile • • . 111 • .a 'Y IIf 111 .� •- • - rt ■ ti ., •- •; • � •t • •:.;rut PERFORMANCE BOND POLICIES o• ► - cutsicb n3 s_a Perfamance :• • cr a letberoE Ctedit stall be subdtted to • - CLty. 1 - •• • ill ww all • tsvm •- hpmwmts, � • t rut 1nnted to •ice • irrujkim, • u•t • • .• •r•••t • w1sbaw- Cal-flaticn •r •• • .: t• n tk tdll be •vro•ui c• by the • •U • •u•ui - 1 - •• • amurit wD.1 be of the buildiM pemdt value up to , 2 nillim rhl I.t pmject •; $60,000 •• •. Actual amasts udnbe rounded to the c:r - 11 Mn CLty reservesthe M • t to regAm gr sp I nr cr lesser•• • .4t• ti based cn unusualw • ucr-.; •oma :• •. t ut: ••c w ■ - • • _� ••n• ter_• •• •� i •- - • • - • - i c • ■ t • •. • , •t • 7 • -�• r• - r - •t - •ars•- r. . w • 1 - M t ■ - �•c« • - - �•: ••�: M _ • � •1 ■ - Oa • • A • l - w . • Iw • :• •� il:' ■ •- - - �_• �•.r••C; •7 ■ :I �a FEW! a W-11.0 :F077 I Ic �s_ .t - 7r•rr. •• t• M c• s _ . 9'6yn r 7._ .7 s s A -e j. - .; C•. . Se fa ra/e �;�� :GLAZING SHAD RE r, :IN ACCORDANCE WITH3. CK,64 TT �� ere t1rJPse�1K�, ya�re RPs tot/s� 5 �� b' z31 '.• � � Glia PY1 � /'IKKes'p� s>� � /Q4�''sC'C C� BUILDIRG OFFICIAL REVIEW AND oc OCAS REQUIRED FRIER TO cr+ GFf f1iGES MODIFICATIONS OR ALTNATIQNS. r Gatt eK rG r+t , COMBUSTIBLES a EE, ��D I t H�� SPACES fir. '}t ,•; • vzwr �e UT �) l� / G4•L�O�Tj / •�"'L s s A -e j. - .; C•. . Se fa ra/e �;�� :GLAZING SHAD RE r, :IN ACCORDANCE WITH3. CK,64 TT �� ere t1rJPse�1K�, ya�re RPs tot/s� 5 �� b' z31 '.• � � Glia PY1 � /'IKKes'p� s>� � /Q4�''sC'C C� BUILDIRG OFFICIAL REVIEW AND oc OCAS REQUIRED FRIER TO cr+ GFf f1iGES MODIFICATIONS OR ALTNATIQNS. r Gatt eK rG r+t , COMBUSTIBLES a EE, ��D I t H�� SPACES fir. '}t ,•; 0 , r ft a CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Job Address RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are and correct. * Air Conditioning Call sizes) $ 10.00 $ /true Fridley, Minn. All Others/Repairs and AlterationsOWNER e e 1% of Value of Appliance or Work $ KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS 1% of Value of Appliance or Work $ • TO BE COMPLETED ABOUT ESTIMATED COST State Surcharge $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. TOTAL FEE $ Reinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough insp. Date HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Final Insp. I 4 Trade Name Size No. Date Approval for Permit �� Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, �n Company PLUS $.50 STATE SURCHARGE M Signed By R, Attach stack verification form with. replacement furnace permits�(-)65' T� *Air Conditioners can not be placed in side yard without Tel. No. �� s� written permission from adjoining neighbor. CHIMNEY 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 connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 4 N. Urinal Shower Wash Tray Floo r Drain RATE TOTAL Auto. Washer Gas Range ... . . . . . ... Water Heater Stories Gas Elec Basement specified agreeing to do all work In strict accordance with the city codes Beer Dispenser $5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $7.00 and representations stated in this application are true and correct Catch Basin ............ ................. Floor 1 $7.60 .,1993 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $7.00 Floor 2 Water Heater — Gas $10.00 Building Used As Gas Range $10.00 -Mk-- 900 PERMIT NO. ZZtQ U Gas Dryer $10.00 Estimated Cost Back Flow Preventer'Required ()Yes No Floor 3 P PLC) P I— I T N AN Type -$5.00 PLUMBING COM Reinspection Fee $30.00 .... . .. . .D By SIGNED BY TEL NO, Floor 4 1 % of Value of Fixture or Appliance Approved By Rough—in Date Final Date State Surcharge $ .50 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS Now Fixtures $7.00 The undersigned hereby makes application for.a permit for the work herein Old Opening, New Fixture $ COO specified agreeing to do all work In strict accordance with the city codes Beer Dispenser $5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $7.00 and representations stated in this application are true and correct Catch Basin $7.00 Rain Water Leader $7.60 .,1993 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $7.00 Water Heater — Gas $10.00 Building Used As Gas Range $10.00 -Mk-- 900 PERMIT NO. ZZtQ U Gas Dryer $10.00 Estimated Cost Back Flow Preventer'Required ()Yes No P PLC) P I— I T N AN Type -$5.00 PLUMBING COM Reinspection Fee $30.00 .D By SIGNED BY TEL NO, ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved By Rough—in Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE PLUS THE $.So STATE SURCHARGE 0 SUBJECT P City of Fridley 2297 1 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir • COMMUNITY DEVELOPMENT DIV. _ � PROTECTIVE INSPECTION SEC. r � NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 j 10/5/94 JOB ADDRESS 7675 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I Pt OUtlot Melody Manor 4th Addithn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Clinic 7675 Madison Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO J. M. Bruggeman Companies 420 E Co Rd D, Little Canada MN 55117 483-5144 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. RDC Architects 14119 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Clinic 7 CLASS OF WORK - EJ1:1Xp NEW ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remove exterior entry and install new entry foyer 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED 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 STALLS GARAGES AND K W E SAME TO BE T I E AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND RDINA CES GOVERNI THIS TYPE OF WORK WILL BE COMPLIED WIT WHETHE SPECIFIEQ' EREIN OR NOT. THE GRANTING OF A PERMIT 5,000 $27.50 D ES NOT PRESUME TO' IVE AUTHORITY TO VIOLATE OR CANCEL THE PE MIT FEE SAC CHARGE P OVISIONS OF ANY,OT ER STATE OR LOCAL LAW REGULATING CON- S RUCTIO R THE E ORMANCE OF CONSTRUCTION $437.00 Fire SC $55.00 PLAN CHECK FEE TOTAL FEE 284.00 $803.50 SICrNATU RE OF COIV RA ,TO R A THORIZED AGENT IDATEI PE gLp VALI�DATEDH YOUR PER IT D ^ � DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 0 Prepaid Plan deck $ Effective 1/1/94 Estimated Cost $ Cfl'Y OF FRKK" Receipt # R-3, CON MERCIAL & INDUSTRIAL WELDING PERMIT APPLICATION Construction Address 76% t5 11 Go -g/ �, o 4- ) 5r" Zoning Legal Description I-& -/- PrZ- 6 u r e -,a T /91 e ego Cramer & Address ! CONTRACI{OR & ADDRESS P Tel Architect & Address 41-20 Engineer & Address Reg.# TYPE OF WOW I [ ] New ,-j ] Addition ,K Alteration -Describe Applicant Signature BUIIDDG IS E(= Width Height Sq. Ft. # of Stories OFC. AREA: length Width WISE AREA: Length Width OTIM AREA: Length Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. VAUPMC K 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 j- Construction Type Occupancy Group h C4 Air Conditioning []Yes []No Fire Protection Provided []Yes []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee s q.3'7.60 Plan Check $ Fire Surcharge $ ® - OD State Surcharge $ i • 57) SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Esarm 70TAL See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $800 per SAC Unit (Plans to MCC for determination) $450.00 Conservation Plan Review Fee Determined By ming Amit Necessary [] Not Necessary [] feet x $13.50/foot T If r t-1 F a� Fry An oil ��... 1' {�' II{ 4N i ;44QY.tYV !1 � z � e I K �� ` — 4 I i �� 77a 77 r T 7 t , I MANS �!, IA a �I lot a = �T i _ x \ r � I " - k � a cY� V I 11G 'D,x I IN iP _ � 1 1 I n l 4 I � �� I � � � dl I I � \ �`�rO ski �a -— — — i I a° BUILDING PERMIT FEE SCHEDULE $1 to 500 $15 (Minimum Fee is $15 plus surcharge) 501 to 2,000 $15 for 1st $500 plus $2 for each addn'l $100 or fraction, to and including $2,000 2,001 to 25,000 $45 for 1st $2,000 plus $9 for each addn'l $1,000 or fraction, to and including $25,000 25,001 to 50,000 $252 for 1st $25,000 plus $6.50 for.each addn'l $1,000 or fraction, to and including $50,000 50,001 to 100,000 $414.50 for 1st $50,000 plus $4.50 for each addn'l $1,000 or fraction, to and including $100,000 100,001 to 500,000 $639.50 for 1st $100,000 plus $3.50 for each addn'l $1,000 or fraction, to and including $500,000 500,001 to 1,000,000 $2039.50 for the 1st $500,000 plus $3 for each addn'l $1,000 or fraction, to and including $1,000,000 1,000,001 and up $3539.50 for the 1st $1,000,000 plus $2 for each addn'l $1,000 or fraction PREPAID PLAN CHECK FEE SCHEDULE 'f . • t t 1 w; ,1. 11 ■• ,c. 111 w, ,c. •. Y /i1 • .. 'S. :r •; es• .•• '7 111 •: ■ ,w.n • ■• .1 • r i 1 ■• / 1 / f :Y t •; - Y,.. / 11 • .la• r•: e:.• .066 •; ■ . w 1 • r• .! • • 1 • '4.1 111 1 111 e• I/ 111 ,.• [•: 1 I/t • _ w •,. • :w• .••. '1 I11 r, ■ .•+■1 • 0 ■• • • • 11 111 fl It we Ike, `1 11 111 • _ Y •: e:• .•• `f t11 •: ■ .•r • .• • •1 • 'L 111 • Lt•. 111 It1 •- • - 1 ■ v ,I •- •; • •� • •e•m PERFORMANCE BOND POLICIES c a Wading •e:•w c• fcr - amercia, inlzbAalcr a mAtiple dadWny resid3tial rmjec;t vtdch rewires • titi •- n•. • el e tia ParEammm :• • cr a Istbercf • c•t be sxbmitbed to ■ - City.1 •• • 1 cover• I■_Y •- 11 •. • e11= 1•.: d • • ( not 111 ■e• to a•Q•q • • •: M • • 1••1 • • .• tr•••1 • �• e- • e •e_ • Ir. • .1 • ter•:• I •I . :• sysbems. Ca3allaticn•1 •• • .41• • J be eb •UI e• by ■ - • ! •i •permitw1ues.1 - •• • wmrt will be •1 • - ?=M51 $100.1 CLty reserves■ - •t• i a• e•d•I - - •; ewe: •• • .ul• •_ets anunim3l amiarsbmumes. :• •_. II � ell: ••e M • - •' • CV ••11• e:■e• •• •_ / •- - • • e. • - / t e• .: • • I • •. ■ - oe,. •I • N I I* tza *in r• - ■ - •; 67,7:;4- ,r. N • 1 - •I - - - 1 WMJF-r-- • el a I•_ .1 - : M .•r•: ••1 • - e• BUIL�iING PER&HT REVIEW CHECKLIST AND ROUTE SHEET/ FILE DAT DUE DAT ADDRESS COMPANY VAME {: P ING`. , Barbar Dacy, Michele Peorma McPhrso q�lR j J Bond Amount.-�ja. j. J Pa k Fee Amount: j Sei 5acla . [ J Pa*ing l 1 La I J W daneb [ I Co Pnplianm wl Council Stipulations ENGI '.FERIN John ra Scop', Erickson Clyde Moraveli [ J,Gr glDrainage Plan j j Conservation/Erosion Control Plan Fee: f I Selver Laterals Required Few J Weter Laterals Required Fee: J La ul Alteration Permit Issued j I Po Maintenance Agreement [ JRk e Creek WSD Petmit.Required j J IEa wments Required [ ] Obtained ectiot7s LEON4DSEN BILL IHAMPA `JOHN i ALACIO --c4=--V-GARY ORD -SICK { } MARYI EUM TIPU TI NS: Pk yve Print or Do C SUBJECT • '- City of Fridley 794 2 ® 9 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. '---1 CITY HALL FRIDLEY 55432 NUMBER REV DATE P PAGE OF APPROVED By 612-571-3450 910-F15 5/24/96 JOB ADDRESS 7675 Madison Street NE 1 LEGAL LOT NO.BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt Outloti Melody Manor 4 Addition I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Clinic 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Berwald Roofing Inc 2440 N Charles St, N St Paul, MN 55109 777-7411 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Clinic 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 1 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Roof repairs - built-up roof system 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 $15,295 $7.65 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STAT�R LOCAL LAW REGULATING CON- UCTJON OR THE PERFORMAI[CE QF CONSTRUCTION. Ituft $237.25Fire SC $15.64 PLAN CHECKF E OTAL FEE J P� $260.54 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DAAi N PR LY V LI ED THIS Ilr E IT a/ i 3T + IN GATE SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE)LOG Prepaid Plan Check $ Estimated Cost $ Receipt # CITY OF bREM" Effective 3/1/96 Construction Address 7.-57/� j�f P4 Zoning Legal Description Owner & Address 7 � 7 S o -ma c^-- 2�Tel . # OONTRACPOR & ADDRESS (,I/ Z-0 Tel . # 77 7-71,-` Architect & Address Reg.# Engineer & Address Reg. # TYPE OF WORK [] New Applicant Signature , Width OFC. AREA: Length WHSE ARFA: Length OTAIIt AREA: Length [] Alteration -Describe X�z5_ # 777- 7'/ / / Date Z -y B=IW DIlMENSICNS Height Sq. Ft. # of Stories Width Width Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. VALC=CN 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 Construction Type Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee $ 3 ;7 as See Fee Schedule on Reverse Side Plan Check $ / In Excess of Prepaid Amount - See Reverse Side Fire Surcharge $ /.57_4�1 .001 x Permit Valuation (1/10th %) State Surcharge $ $.50/$1,000 Valuation (See Sched. for > $1 Million) SAC Charge $ $900 per SAC Unit (Plans to MCC for determination) Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined By Engineering Spec. Assessments $ Agreement Necessary ❑ Not Necessary [] Driveway Escrow $ feet x $13.50/foot TOTAL $ , •,:V , 3 . BUILDING PERMIT FEE SCHEDULE $1 to 500 $21 (Minimum Fee is $21 plus surcharge) 501 to 2,000 $21 for 1st $500 plus $2.75 for each addn'l $100 or fraction, to and including 25,000 $2,000 2,001 to 25,000 $62.25 for 1st $2,000 plus $12.50 for each addn'l $1,000 or fraction, to and including $25,000 including $25,000 25,001 to 50,000 $349.75 for 1st $25,000 plus $9.00 for each addn'l $1,000 or fraction, to and including $50,000 50,001 to 100,000 $574.75 for 1st $50,000 plus $6.25 for each addn'l $1,000 or fraction, to and 100,000 including $100,000 100,001 to 500,000 $887.25 for 1st $100,000 plus $5.00 for each addn'l $1,000 or fraction, to and including $100,000 including $500,000 500,001 to 1,000,000 $2887.25 for the 1st $500,000 plus $4.25 for each WWI $1,000 or fraction, to and including $1,000,000 1,000,001 and up $5012.25 for the 1st $1,000,000 plus $2.75 for each addn'l $1,000 or fraction PREPAID PLAN CHECK FEE SCHEDULE $1 to 2,000 $29.25 2,001 to 25,000 $29.25 for 1st $2,000 plus $5.85 for each addn'l $1, 000 or fraction, to and including $25,000 25,001 to 50,000 $163.80 for 1st $25,000 plus $4.225 for each WWI $1,000 or fraction, to and including $50,000 50,001 to 100,000 $269.43 for 1st $50,000 plus $2.925 for each addn'l $1,000 or fraction, to and including $100,000 100,001 to 356,000 $415.68 for 1st $100,000 plus $2.275 for each WWI $1,000 or fraction, to and including $356,000 Over $356,000 $1,000 (Balance due with issuance of building permit) PERFORMANCE BOND POLICIES When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, and storm drainage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3 % of the building permit value up to a 2 million dollar project or a $60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects with no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed. SUBJECT P NO.'' City of Fridley 3 3 2 7 2 AT THE TOP OF THE TWINS BUILDING PERMIT ' 1 R 0 COMMUNITY DEVELOPMENT DIV. r V PROTECTIVE INSPECTION SEC.6 NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 763-571-3450 910-F15 11/22/02 JOB ADDRESS 7675 Madison Street NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt Outlot I I Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fridley Medical Center 7675 Madison Street NE 763-785-8535 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO J M Bruggeman Co Inc 2379 Leibel St White Bear Lake MN 55110 651-426-8845 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Medical Center Clinic 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE B DESCRIBE WORK Convert conference room into exam rooms 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 WH"ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $16,000 $8.00 DOES N RESUM TO IVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVIS, OF AN HER STATE OR LOCAL LAW REGULATING CON - RUC N OR T FQRMANCE OF CONSTRUCTION $265.25 Fire SC $16.00 PLAN CHECK FEE TOTAL FEE L $172.4 $A1.66 $IGNAT R QF CONTRACTOR OR AUTHOAi2ED AGENT (DATE, E PRO VALIOAT THIS IS YOUR RMIT -=G IN-RPFf $-GNATURE OF OWNER,1F OWNER BUILDER- CITY OF FRIDLEY Effective 1/1/2002 6431 University Ave NE R-3, COMMERCIAL & INDUSTRIAL Fridley, MN 55432 BUILDING PERMIT APPLICATION (763) 572-3604 CONSTRUCTION ADDRESS / D A� dsG� �7� Zoning Legal Owner & Address bald JACK Y Tel# CONTRACTOR & ADDRESS y �, iL �/� �' Tel# 3 C, 4-C AIZ Ilk Ar- Architect Reg .# /lyA— Engineer il/.4 Reg.# BUILDING CONSTRUCTION TYPE OF WORK [] New [] Addition kAl terati on -Describe ��Ycr�7� ��izsGc IVJ,*/ A44 OFC. AREA: Length ��' Width Height Sq. Ft.'S'dd WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Sq. Ft. s APPLICANT Te # �� r��—� Date_` Sq. Ft. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use /y[Yd Construction Type µLrcce 7 Occupancy Group Air Conditioninglo Yes []No Fire Protection Provided Eves []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee $ . 25— P1 an Check $ , !*_// Fire Surcharge $ /G as* State Surcharge $ SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ TOTAL $ -®U PERMIT FEES See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. $1200 per SAC Unit (Plans to MWCC $450.00 Conservation Plan Review Fee Determined By Engineering Reverse Side for > $1 Million) for determination) Agreement Necessary [] Not Necessary [] feet x $.17.00/foot L et,Jfg ATTACH STIPULATIONS PREPAID PLAN CHECK FEE SCHEDULE Per Minnesota Building Code - 65 % of building permit fee. PERFORMANCE BOND POLICIES When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires outside improvements, a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, water & sanitary sewer services, and storm drainage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3 % of the building permit value up to a 2 million dollar project or a $60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects with no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. Reproducible "as -built" drawings of all exterior underground utilities must be submitted to_, the City Engineering Dept before the project is considered complete and the bond released. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed. BUILDING PERMIT FEE SCHEDULE $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23.50 for 1st $500 plus $3.05 for each addn'l $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1st $2,000 plus $14.00 for each addn'1 $1,000 or fraction, to and including $25,000 _ $25,001 to $50,000 $391.25 for 1st $25,000 plus $10.10 for each addn'1$1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1st $50,000 plus $7.00 for each addn'1 $1,000 or fraction, to and including $100,000 $100,001 to $500,000 $993.75 for 1st $100,000 plus $5.60 for each addn'1 $1,000 or fraction, to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1st $500,000 plus $4.75 for each addn'1 $1,000 or fraction, to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1st $1,000,000 plus $3.15 for each addn'1 $1,000 or fraction PREPAID PLAN CHECK FEE SCHEDULE Per Minnesota Building Code - 65 % of building permit fee. PERFORMANCE BOND POLICIES When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires outside improvements, a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, water & sanitary sewer services, and storm drainage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3 % of the building permit value up to a 2 million dollar project or a $60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects with no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. Reproducible "as -built" drawings of all exterior underground utilities must be submitted to_, the City Engineering Dept before the project is considered complete and the bond released. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed. PLAN � E �S 9PROYED***s/ u bj!RI d o Final ; 101 � `` •� La1J �LC�� fill ELECTRICAL PANEL R---___-�-------- ----- -- --T -% /y 0— 1 11 1 I --------- --------- y �=-------dal �--------dal v� 4° SAGE BRIGK 6'-0" HIGH D 0� i EXISTING PLAN I 1/4° = I' -O° 1of2 l SON 6 '31VO 0 w>9�w.w 4I8t19Z411li4i Si5�61117Ji ours g t'qn 5855:SBL �E9u y64S5 W'AMMU ` 4 f� 'V1ASM"K d0 MV15 -39L d0 SINV'1 SHO151/� a& va" I' 9187 iV �J.SISM n I ooiiqm'vBPQPI �,� 1�LL5 IOSICYN 519L o A -W V WV 11VHL CW blO SLAZEk 9 L'-NjT110 AN tGCM Wo aI ,g 433aVaaad •p� '� �7Io3W J19101 au ffJV 'A9 'Tye u9 rr�vaa q� cq SVM ivoc LI 2I0 tunvoIdl03dr Zo/ZVII 10IVLW 11Va 'NV W SWL 1VM AAJ.I 9 AMRM I I I I 1 IC� -- I\I / I y I I I I 'a -LAI 101 0 n I IL ----y �� ---y I I I 1 IC� -- I\I / I y I I I I 'a -LAI 101 Nov,ll• 20041 1:52PM NORDOUIST SIGN COMPANY No.6763 P. 102/02 CITY OF FRIDLEY SIGN PF'RIVIIT ARPLICATION Effective 1/1/2003 6431 University Ave NE Fridley MN 55432 " 763572�593 Owner. �L-G4_� Sign Erector: Address: LQZz astx (X-0. City2P:.,,KNEE. `= r'� Tel. No: "'3 -L 5;S --3* Address: L:gjry S -r C rty/Zlp: b ►-`J`'n' � baa 4 \ S N-'+ v.� gl Address: -tUlS- r3p�nLsor-% _ NE Zoning LENGTH 6� HEIGHT GL {''�Z," SQUARE FOOTAGE 4-o ( ') Wall; Length of Wall Allowable Sq Ft 4-6 Pylon; Setback from property line 2 o From Ddvewa q Off Ground (� PY P PAY � y�� —� ( ) Roof; In Lieu of Pylon Sign ( ) Campaign; $15.00 deposit -refunded when signs are removed after election SIGN MESSAGE: F�\ Constructed Of ® u.s�z w Estimated Value $ 5C', 2che illuminated: Yes (-A) No ( ) IF YES, Electrical Permit Necessary to Wire Sign The undersigned hereby makes application for a permit for the work herein specked, agreeing to do all work in strict accordance with the City of Fridley ordinances and rulings of the Planning Divlslon and hereby declares that all the facts and representations stated in this application are true and correct. DATE: ' IIo APPLICANT OLA O`--' Q - al&7� EEE SCHE UI E Permit Fee 0 to 40 Square feet r $50; 40 Sq ft or more = SW Surcharge 5(1 SIItY`mhar®P if Cigin i- not lit if TOTAL, Received Time Nov •II 12:57PM TnTAI F - X17 Nov -16. 2004 11:19AM NORDQUIST SIGN COMPANY r 12-0. Xe4 �wa(n 4$444 N o . 6 9 3 4 P. N " U LT ` CoL t± bL71>c, "^�•'�•itl'V�"m7at4& P.OF'x vR44'!e`Yeh.G'J.. L�@. Sfll✓4tigfY' CITY DLEY 6431 OUniversity Ave NE R-3/COMMERCIAL/INDUSTRIAL/PUBLIC/INSTITUTIONAL�S Fridley, MN 55432 BUILDING PERMIT APPLICATION (763) 572-3604 FAX (763) 571-1287 CONSTRUCTION ADDRESS 2(A >E j`Uaj 1g2 ja:� �� Zoning 66 Zoning Legal vl+ic«e-e As < cc.i4-1-es e,-V4hc,-7i,-� r-h,Cj-4't- Owner & Cy CONTRACTOR & ADDRESS A ,,e �., ,� �-� � Tel# ( ) a ArcnMect TYPE OF WORK _ Keg.,' 1 [] New tngmeer Keg.# .sem BUILDING CONSTRUCTION [] Addition [] Alteration -Describe A r iC o o OFC. AREA: Length Width WHSE AREA: Length Width OTHER AREA: Length Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. ?43) APPLICANT �� Tel #Z 9 7 Date -2 g16 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 Construction Type Occupancy Group Air Conditioning []Yes []No Fre Protection Provided []Yes []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No PERMIT FEES Permit Fee $ Plan Check �® Fre Surcharge $ State Surcharge $ �• �® SAC Charge $ Erosion Control $ See Fee Schedule on Reverse Side 65% of Building Permit Fee .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1450 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Park Fee $ Fee Determined By Engineering Spec. Assessments Curb Cut Escrow $ TOTAL $ •'�� ATTACH STIPULATIONS I,g,5• 0 Agreement Necessary [] Not Necessary [] feet x /foot Vic Al'" <PAS 5,60() - X76 / - %6 / /cP/a6 BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Only FA- VILI W--- N n z 0 0 I— 108" CLEARANCE BETWEEN BRICK POSTS 14" 1 80" NEW CABINET 14" 13" 74" REVEAL 3" 0 ELEVATION FRI D LEY� MEDICAL C.E NTE R_ ALUMINUM REVEAL, FLASHING AND COLUMN CAPS PAINTED DARK BRONZE EXISTING BRICK BASE SCALE: 1" ='1'=0" .125" ALUMINUM CABINET FACES AND RETURNS PAINTED BRUSHED ALUMINUM .25" BLACKMHITE ACRYLIC PUSH-THRU COPY 25" WHITE ACRYLIC PUSH-THRU LOGO WITH 23049 BURGUNDY VINYL FIRST SURFACE (COLOR MATCH TO PMS 188 Q FURNISH AND INSTALL: EXTERIOR D F ILLUMINATED MONUMENT DISPLAY WITH FLASHING AND COLUMN CAPS ON EXISTING BRICK BASE ILLUMINATION: 8 - 60" CW HO LAMPS 2 - 468DR BALLAST 5.6 a @ 120 v CIRCUIT EXISTING FINAL CONNECTION BY OTHERS NOTE: INSIDE OF SIGN PAINTED WHITE INSTALL: - PLATE -MOUNT TO BRICK BASE - CUT THREADED ROD ON SITE - ALUMINUM FLASHING TO DRESS BRICK BASE - ALUMINUM COLUMN CAPS STUDDED INTO TOPS PHOTO OVERLAY This drawing is the property of: Nordquist Nordquist Sign Company, Inc. 312 West Lake Street Minneapolis, MN 55408 PH 612.823.7291 FX 612.824.6211 www.nordquistsign.com All design, manufacturing, reproduction, use and sale of this document is strictly prohibitied without the written consent of Nordquist Sign Company, Inc. This document is submitted under a confidential understanding that the recipient of this document assumes custody and agrees that the document and any part of its content is not to be copied, reproduced In whole or part, or any of its contents be revealed In whole or pan: to other parties except for which it is agreed upon by Nordquist Sign Company, Inc. and recipient, nor shall arty design features unique to this document be incorporated in any other projects. QUOTE: 21200-1 PREV. DWG: NOT APPLICABLE SALES: GS DESIGN: B1 DATE: 10.27.04 REV 1: REV 2: REV 3: REV 4: REV 5: MULTI CARE FRIDLEY MEDICAL CENTER FRIDLEY, MN AUSTIN LYMAN DESIGN SIGN TYPE: MONUMENT APPROVAL: REF: MULTI CARE DWG: 04-411 SCALE: 1NTS J I PAGE: , "� ELECTRICAL WHIP OUT BACK/CENTER OF REVEAL SECTION 12" .125" ALUMINUM TOP AND SIDES REMOVEABLE 1-1/2" X 3/16" ALUM. ANGLE .125" ALUM FACE W/ ROUTED COPY 1/8" MILK WHITE ACRYLIC BACKER 1/4" BLACKIWHITE ACRYLIC PUSH THRU V 1/8" MILK WHITE ACRYLIC BACKER 1/4" CLEAR ACRYLIC PUSH-THRU WITH VINYL OVERLAY 2-1/2" SCHEDULE 40 STEEL PIPE (3" DIA.) VERTICAL SUPPORTS (X 2) FLUORESCENT LAMPS 3/8" DIA. HIT 20 EPDXY ANCHORS THREADED ROD CUT IN FIELD 4" X 2" UNEQUAL ALUMINUM ANGLE 8" x 8" x 1/2' STEEL PLATE EXISTING BRICK BASE 19-1/2" HIGH X 27-1/2" WIDE X 146" LONG SURVEYED DATA SCALE: 3" WITH OR WITHOUT VINYL OVERLAY 1/4" ACRYLIC WELD ON GLUE #2447 ALL ELEMENTS ASSEMBLED AS ONE PIECE PRIOR TO CNC PROCESS FABRICATION DETAIL: PUSH THRU GRAPHICS MAINTAIN A MINIMUM 1" PERIMETER RELEASE FOR STUD FASTENERS ACRYLIC GRAPHIC -.125" DIFFUSER #2447 MILK WHITE AFTER ROUTING SCALE: 6" = V-0" This drawing is the property of: Nordquist Nordquist Sign Company, Inc. 312 West Lake Street Minneapolis, MN 55408 PH 612.823.7291 FX 612.824.6211 www.nordquistsign.com All design, manufacturing, reproduction, use and sale of this document Is strictly prohibitied without the written consent of Nordquist Sign Company, Inc. This document is submitted under a confidential understanding that the recipient of this document assumes custody and agrees that the document and any part of its content is not to be copied, reproduced in whole or part, or arty of its contents be revealed in whole or part to other parties except for which it is agreed upon by Nordquist Sign Company, Inc. and recipient, nor shall any design features unique to this document be incorporated in any other projects. QUOTE: PREY. DWG: NOT APPLICABLE SALES: GS DESIGN: B1 DATE: 10.27.04 REV 1: REV 2: REV 3: REV 4: REV 5: MULTI CARE FRIDLEY MEDICAL CENTER FRIDLEY, MN AUSTIN LYMAN DESIGN SIGN TYPE: MONUMENT APPROVAL: REF: MULTI CARE DWG: 04-411 PAGE: 1.2 106-5/8" SURVEYED FRONT VIEW FABRICATION DETAIL: BRAKE FORMED FLASHING COVER -.090" ALUMINUM EE=[]F-1 E:]==[:]E El=E:I=� PEL-1 19" COLUMN SURVEYED FABRICATION DETAIL: BRAKE FORMED COLUMN CAPS -.125" ALUMINUM uuL 26-1/2" COLUMN SURVEYED 1" LIP 27-5/8" SURVEYED SIDE VIEW SCALE: 1" = 1r-0" .125" ALUMINUM COLUMN CAPS TOPS AND RETURNS PAINTED DARK BRONZE SNAP -WELD STUDS INSTALL INTO EXISTING CONCRETE COLUMN TOPS SCALE: I"= V-0" A This drawing is the property of: Nordquist Nordquist Sign Company, Inc. 312 West Lake Street Minneapolis, MN 55408 PH 612.823.7291 FX 612.824.6211 www.nordquistsign.com All design, manufacturing, reproduction, use and sale of this document is strictly prohibitied without the written consent of Nordquist Sign Company, Inc. This document is submitted under a confidential understanding that the recipient of this document assumes custody and agrees that the document and any part of its content is not to be copied, reproduced in whole or part, or any of its contents be revealed In whole or part to other parties except for which it is agreed upon by Nordquist Sign Company, Inc. and recipient, nor shall any design features unique to this document be incorporated in any other projects. QUOTE: PREV. DWG: NOT APPLICABLE SALES: GS DESIGN: B1 DATE: 10.27.04 REV 1: REV 2: REV 3: REV 4: REV 5: MULTI CARE FRIDLEY MEDICAL CENTER FRIDLEY, MN AUSTIN LYMAN DESIGN >IGN TYPE: iAONUMENT PPROVAL: REF: MULTI CARE DWG: 04411 PAGE:' .3 El� 1-1 uuL 26-1/2" COLUMN SURVEYED 1" LIP 27-5/8" SURVEYED SIDE VIEW SCALE: 1" = 1r-0" .125" ALUMINUM COLUMN CAPS TOPS AND RETURNS PAINTED DARK BRONZE SNAP -WELD STUDS INSTALL INTO EXISTING CONCRETE COLUMN TOPS SCALE: I"= V-0" A This drawing is the property of: Nordquist Nordquist Sign Company, Inc. 312 West Lake Street Minneapolis, MN 55408 PH 612.823.7291 FX 612.824.6211 www.nordquistsign.com All design, manufacturing, reproduction, use and sale of this document is strictly prohibitied without the written consent of Nordquist Sign Company, Inc. This document is submitted under a confidential understanding that the recipient of this document assumes custody and agrees that the document and any part of its content is not to be copied, reproduced in whole or part, or any of its contents be revealed In whole or part to other parties except for which it is agreed upon by Nordquist Sign Company, Inc. and recipient, nor shall any design features unique to this document be incorporated in any other projects. QUOTE: PREV. DWG: NOT APPLICABLE SALES: GS DESIGN: B1 DATE: 10.27.04 REV 1: REV 2: REV 3: REV 4: REV 5: MULTI CARE FRIDLEY MEDICAL CENTER FRIDLEY, MN AUSTIN LYMAN DESIGN >IGN TYPE: iAONUMENT PPROVAL: REF: MULTI CARE DWG: 04411 PAGE:' .3 QUANTITY. TWO 73-5/8" X 80-1/8" PERIMETER SIZE CUT FILE: FACE -1/8" ALUMINUM 60" C/C PLATES DETAIL: BASE PLATE PLACEMENT SCALE: 1" = V -On SCALE: 1" = 1',0" FRIDLEY MEDICAL CENTER QUANTITY: TWO CUT FILE: PUSH THRU COPY -1/8" #2447 ACRYLIC / 1/4" BLACK WHITE ACRYLIC co SCALE: 1" = 1'-0" QUANTITY. TWO CUT FILE: PUSH THRU LOGO -1/8" # 2447 ACRYLIC / 1/4" CLEAR ACRYLIC / VINYL OVERLAY 8" 5" C/C BOLT HOLES QUANTITY. TWO DETAIL: BASE PLATE --1/2" STEEL SCALE: 1" = 1'-0" 1 1/2" HOLES SCALE: 3" =14" This drawing is the property of: Nordquist Nordquist Sign Company, Inc. 312 West Lake Street Minneapolis, MN 55408 PH 612.823.7291 FX 612.824.6211 www.nordquistsign.com All design, manufacturing, reproduction, use and sale of this document is strictly prohibitied without the written consent of Nordquist Sign Company, Inc. This document is submitted under a confidential understanding that the recipient of this document assumes custody and agrees that the document and any part of its content is not to be copied, reproduced in whole or part, or any of its contents be revealed in whole or part to other parties except for which it is agreed upon by Nordquist Sign Company, Inc. and recipient, nor shall any design features unique to this document be incorporated in any other projects. QUOTE: PREV. DWG: NOT APPLICABLE SALES: GS DESIGN: Bl DATE: 10.27.04 REV 1: REV 2: REV 3: REV 4: REV 5: MULTI CARE FRIDLEY MEDICAL CENTER FRIDLEY, MN AUSTIN LYMAN DESIGN SIGN TYPE: MONUMENT APPROVAL: REF: MULTI CARE DWG: 04-411 PAGE:' e4 Buturddk ... OAmtD12Nno m III TA117