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PRE 2010 PERMITSsueJEcr City of Fridley Ti13005 AT THE TOP OF THE TWINS BUILDING PERMIT f COMMUNITY DEVELOPMENT DIV. r y PROTECTIVE INSPECTION SEC. RECE O. l CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 6-9-75 JOB ADDRESS 68 East River Road N.E. Fridley, Minnesota 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 ST SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR ;;� MAIL ADDRESS KFN AmBpIngem., Sha Minnesota kC ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL A DRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Detached garage 7 CLASS OF WORK F1 NEW ] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK CONSTRUCT DETACHED GARAGE 20 x 24 x 10 9 CHANGE OF USE FROM TO STIPULATIONS IF FROST FOOTINGS ARE NOT PROVIDED, GARAGE CAN NEVER BE ATTACHED TO THE HOUSE. PROVIDE HARD SURFACED DRIVEWAY WITHIN ONE YEAR. WARNING Before digging call local utilities TELEPHONE - ELECTRIC - GAS E SVERMTE PERMITS REQUIRED FOR WIRING, REQUIRED BY LA tjE,,jkVNrPLI..IMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 R-1 480 4,800 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,552 $1.78 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. $9,00 PLAN CHECK FEE TOTALFEE 10.78 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PRO ER V TE THIS IS YOUR PERMIT ALDG SIGN URE OF OWN ER IIF OWN ER BUILDER) IDATEI SP DATE •APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER `S NAME :A'Ar d q L - 14 aa 0_• BUILDER: 1.6 's c'° j ADDRESS : &d a R, /)is F: -.-ADDRESS:- NO:. ADDRESS: NO:. /, FQ �7 STREET: ,4 5 F t� , U E le Rd LOT: —BLOCK: ADDITION: CORNER LOT: INSIDE LOT:_ SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey.of Lot and propose. building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: o 1,akh Ed Front: -a () Depth: 2 4- eight: / rJ Square Feet: t{ ,1 Cubic Feet: `-{�%) Front • Depth: Square Feet; _,_ Cubic Feet: Height: Type of Construction: wo ld ;Le Estimated Cost: c) To Be Completed: (Ilk M A A �% _ The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: (�l \1 3 SIGNATURE: i (See Reverse Side For Additional Information.) �o-7j'�� File No. 15687 /1— Exhibit A k CQ "The plat above shown indicates correctly the size and location of the buildings on premises herein insured; also the improvements, now located on premises in question are entirely within the lot lines, and the improvements on adjoining premises do not encroach on the premises herein insured." AGREEMENT 7--7 owner of the property located at ��%�� /��, have no objection to the City allowing the construction of a• _ to be located at /oy�/�� ,, 0.� without the required certificate of survey that the City ordinarily requires for all new construction. Signature (,Jv31 Address Date CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL y Job Address _6j, / Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ Dy facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ F id ley, Minn. 19 STEAM OR HOT WATER SYSTEM: OWNER Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING each addn. 50,000 BTU 4.00 $ Boiler only up to 1.00,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT OIL BURNER- to 3. gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ ESTIMATED COST _ �� Q GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ /a. 00OLD - NEW BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ DESCRIPTION OF FURNACE/BURNER Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ HEATING or ZPOR PLANTS, Steam, Hot Wate Warm Air No. AIR CONDITIONING $ Trade Name r �'L Size NoJ� FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ Capacity /Sq. Ft. EDR BTU HP State Surcharge $ .50 Total Connected Load (I Kind of Fuel TOTAL FEE $) 7. -Tz BURNER - Trade Name Size No. ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date (.$10.00) i Company FINAL INSP. Date Signed By 6Zls APPROVAL FOR PERMIT Tel. No. MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE SUBJECT N City of Fridley ePERMIT 6724 AT THE TOP OF THE TWINS BUILDING PERMITT r NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/11/82 JOB ADDRESS 6827 East River Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 1 OstmanIs 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Randy Hansen 6827 East River Road 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 571-5652 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING zw residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK entryway and deck 9 CHANGEOFUSEFROM TO STIPULATIONS SEPERATE PERNItTS REWIRM fQ W IM TYPE OF CONST. Y GROUP OCCUPAN('- LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. wood frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 72 & 32 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 $2550.00 1.28 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- STRUCTIO R THE PERFORM CE OF CONSTRUCTION. 38.50 PLAN CHECK FEE TOTALFEE -q d' W63 1 4941 SIGNATURE OFCO TRACTOR ORAUT RIZED AGENT (DATE) HEN PROP LY V ID TED THIS IS YOU MIT SIGNATURE OF OWNER I IF OWNER BUILDERI IDATEI BLDG INSP BATE CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATI94 FOR RESIDENTIAL BUILDING PERL'�ITS (New, Alterations, Additions, or Repairs) OWNER _ Aro g 1 S e -i ADDRESS: TEL NO: BUILDER: t4ry'4o -.S v e_ ^-I ADDRESS: /" If " Q TEL 140: .S y Construction Location STREET NO: � ' STREET: :7-�- CZ S �- i l` ✓ e (- T?1 IAT: ZC) BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF COI-ISTRUCTIO14 �l" WO l " Front: (� Depth: —O Height: l P ~ �.iti •� are Feet: Cubic Feet: !F 4 S,s 40 - Front: %�'�' 4 u Depth: ,� � 9 a Height: ^ 4 �` O Square Feet: Z Cubic Feet: 2 � � Type of Construction: 1� J®Oj Estimated Cost: $±3ty—� Rb Be Oompleted: O� '�/ �d L Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Ziie 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 Delwirtment. of Buildings, and hereby declares that all the facts and representations stated in this application arp true and porrect. DATE: 7 -- �2- SIGNATURE : / �fil( Stipulations: Q0 --J d%C'38. 38.E • Pe q.43 File No. 5 6 7 Exhibit A 47 � 5 0 I I Q I VI Q N U £~� 24 � /S0.04 - _ j << Val above shown indicates correctly the size and location of the buildings on premises herein insured; alsc the CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () Nc Type NO. RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ 20. JOB ADDRESS `�I'llE_ ts dW>I IE f? The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 1)�I�rZC r"Y1ixn� 6827 EAST RIVEF� ROAD` '^I 20_ FRIDLEY, MN 55432 Owner (763)574-0185 _ Building Used As _6S_,61Q4t-:E7AV Cit, 00 Estimated Cost PERMIT NO. C;7 PLUMBING COMPANY O►ZC 0)1 Pj-)ly?t4A1(, C �L SIGNED BY Approved COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as`;per current codes. Yes( )No( Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : City of Fridley 6431 University Ave NE Fridley MN 55432 -765— (763) 572-3602 or Fax (763) 502-4977 aQ51 Water and Sewer Permit Application ❑ New Connection ❑ Existing Date: — �) �) -G f Utility Line Repair/Relocation Water and Sewer Connection Job Address: & 9,- 7 P4 Name of Applicant (Plumber): S /9I -le c/ pA,1 e ia. 4 -rry N, Name of Property Owner: py /% i S Oh G d A- r y Existing Structure Permit # Permit Type: Sewer Fee: Water Fee: Meter Fee: Repair Fee: Relocation: State Surcharge: SAC Charge: Special Assessment Fee: G 00 Total: $ V Applicant Signature: Inspector approval: Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineerin Cost of Water Meter See Utility Billing SAC Charge $1450 State Surcharge S.50 Water Tap See Engineering 04/04/05 Building BUILDING Permit No.: 010J_a)C) Plan Review $ 65% of Building Permit Fee Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dai'dn 763-502-4977 FAX $ L 5,SC— $5.00 (State Licensed Residential Contractors) SAC Charge EFFECTIVE 1-1-08 $1825 per SAC Unit (Plans to MWCC for determination) DATE /� �✓ D Cs 6?i''4:5 6 YOUR E-MAIL ADDRESS $ 7 Z'/ VC4 Erosion Control SITE ADDRESS - e�-7as7 $450 Conservation Plan Review THIS APPLICANT IS: ❑ OWNER (CONTRACTOR $ PROPERTY OWNER/ NAME: $ TENANT ADDRESS: 7 L`\Y-23'/ /V 11iZ/0 CITY i STATE V, ZIP��t/3Z Make checks payable to: City of Fridley Attach St i ulations PHONE: NAME: 2r_7/ L_�;'72e:JeL ADDRESS: i9 .S CITY P~ X ,4L t:— STATE*ZIP CONTRACTOR SUBMIT A COPY OF PHONE 3 ZA /'&> 3 FAX YOUR STATE LICENSE STATE LICENSE ►! - CS�a 6?d ✓3 r EXP DATE PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAI ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING / ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES / ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I . Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: USN T 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ��, / OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ (• .0005 x Permit Valuation Minimum $.50 License Surcharge $ L 5,SC— $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 4 Make checks payable to: City of Fridley Attach St i ulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I ack owledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesot Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accor nce with a SW case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT �:�� PRINT NAME �-�`/1 ifiLC �f/c z DATE APPROVED BY DATE