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AF - 44518City of Fridley AT THE TOP OF THE TWINS r � � � � � i y_._.__ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � . � � � �""1 � CiTY NALL FRIDLEY 55d32 i � • ""'�' '� 612-560-3450 SUBJECT BU ILDING PERMIT NUMBER REV. DATE PAGE OF 910-F15 5/6/77 � � JOB ADDRESS 101 Alden Circle N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 2 1 Henriksen Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP E1mer Pligrim 3 CONTRACTOR Leif Henriksen 4 ARCHITECT OR DESIGNER 5 ENGINEER 6 USE OF BUII.DING Residential 7 CLASS OF WORK �I NEW �14062 RECEtPT NO. APPROVED BY SEE ATTACHED SHEET MAIL ADDRESS ZIP PHONE LICENSE NO. 6434 Riverview Terrace N.E., Fridley, Mn. 560-4560 MAIL ADDRESS ZIP PHONE LICENSE NO. MAIL ADDRESS ZIP PHONE LICENSE NO. ❑ ADDITION ❑ ALTERATION p REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK �� Construct a 32' x 36' Dwelling and a 24' x 26' Garage SEPERATE PERMITS REQUfREQ F.i�R W1R TECEPNONE - ELECiR{C - 9 CHANGE QF USE FROM A PLUMBING A1�1DT��, REQUtRED 8Y STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Provide 2" x$" rafters or submit alternate design for approval by May 16, 1977. Provide vapor barrier in ceiling. SEWER LOCATION: (approx. LO' Deep) 166' East of Manhole (Inv. 849.01) WYE ELEV: 851.85 TOP OF FOOTING: 854.85 Minimum WATER LOCATION: 171' East of Sanita.ry Manhole, 102' West of Sanitary Manhole DRIVEWAY DEPRESSION: N/A ? t�r Crnr oF �tix�r DOES Nor avaaa�c TtlE 30 DAY NOTlCE TO CITY R��.u�cY oE ur�unr �oc�►navs avo ELEVATIGr�:: p�y, REQUIRED FOR i�HS DA7A IS K)R iNFORMATION PURPOSES ON1Y AN� REMOVAL AND REPLACE ��RSOWS USING t'�' SHOUtD VERIEY TliE WFOtLyIAitON Otr tH� �E AT DRIVEWAY OP�t� TYPE OF CONST. SEPARATE PERMITS AFiE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC� FYdIll@ THIS PERMIT BECOMES NUL� AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R—�. ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT yS`44� S3O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEI. THE p�RM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ].L�1 .%6 J � �w /� � �� PLANCHECKfEE T / n !1 D.,' -- i/o ��—.% % ter ne Of CONTRACTOFf OR dUTHbRTZED A(`iENT L� .\ N SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI . HLDG. I 1488 STALLS L LOAD CU. FT. 568 35,440 OFFSTREET PARKING �GARAGES SURTAX $22.26 SAC CHARGE $375.00 TOTALFEE $574.46 D THIS IS YOUR PERMIT _� I__HH Etc. ,w __ _ . ,.r ��. � . '�:<, , � ��pTq�,Q� MINNESOTA VALLEY � ! �pTRYa � S_.� � ;` ._ �F� SURVEYORS $� ENGINEERS CORP: �r ;�1�, � < �' r ;- x N �� ; �'n ,� � 12120 RIVEBVpOD DHIYE BCRNSVILLE, MINNESOTA SSJ37 � � �L�` , .. ��r `'C PMa.. 690,Pap �G .,�• , � Y�RS Er'c� F�ORS:�NG�� . (�crtificate of Sur��ey for: I,ief xenricksen �p flAY Nt�TICE T4 CITY E URB '� ` `�1V. REQUIRED 'FOR � '�j �1��i��' ��Vp,t p�ND REPLACEMEN� call � IC � G� Etc. ' nR1VEWl�Y �Pf��t�GS' r��o�� dtg��nELECT4� !,✓ �t ,��taNE - E� �Y `A� � � - -� �� —_ ,� , -� _ . � —z j .. _ _ . .. . __ .. ' —__..�_ � � . . . � '� <.•f. i - '_. -_'_ ._ ... _..._ ..� � - - � - � � _ �,, �_,- r , G�A�� tH� � .;�r� h�'..�7 qT10N� � Tti� �li'I OP FRIDLEY �e:T�C'��`IS AND EtEV ' ;.GCURACY OP UTILIZ`( a ' r �� • �� .:•; �iTtO� FU�POS�S ONLY AN� , -- •r�k�dpATA IS FOR rINF�. � VE�:iFY 7HE INfOR�AP�� , ! � 4' tJ�11�-- �' � P�RSO^NS ;� 1� �.}� `�, C�N THE S13E \t # � ; ` ' -} -�.{ ____ -\ :�- . l � _ �;. � �� } � , - -_ � _ f ;. k �, f�' � ...._,.�....:.,, ; _ � -__ � � _ ----__ � _ _ —~ __ _ _ ' ``E .�-r:, . _ _.. ;- . '_ . �-' f- ✓:�, . ` -._.__..__;.._ . . . .-._ , ., r��. — . - � ., � . r, � '. - � ��-....... _ , _ / ti' � - � � ., � . . — •.Clj�c,.-:-, � . . .. . . .. . ._ . .. . - . � _. . . � ' - � . � �� . . .. /L 'v� __`, � � ' . . � . � L " � `^ "---_'_ � /-J — , --..._ � �; . -- -- -- _ •_ � Y " �,w_�..,., � : � _— --- - - -- ,-� �!��`' ,� �� Lct 2, �lock 1,:?e:Lricksen! s Addition, accordi_.�€ to the p:l_at on i'i�e in the register of deeds, �:��ka ('�tznt;,y, '°ii�~�es��tz•. � ' : / _ . . ,�,� � � � l � _ __---' l\ �� • � / �� i ��. 1 hrrrby cer�ilr thar this is U IfyF und cotrc�t rcpretieo�atioa �'�l11RRSOi 8 Fs11e}• Surt•e��ors & , ' of c� sur.ey of the boundaries of lhe above descr�bed iaoa� ER=IBCC�S� ('orp, _ � _ und of 11ie location o( vli 6uildmgs� �hereo�, ood uli vi�ibir' ' � '��. b � ' _• �. . � r�%' __'..'".` . . R L S � lnC�Op{i�TCOfS� :f uny, f.om oi on suid lund. ��- " —""' ---- �. Ai Survcyrd by mc Ibia � du of 7F ✓ � �' . L.� Y i-1 J!'i / A. D. 19-� �:a, . - 1.b !Fi i n n. R e g. N o._.7.�._r _ ---_._— ` . � t,� �-. i�-, �',,� ,�°x• CO' 1�� ,� �� l� �` �, o F�, r-{ �.Z"�v v. GvY� � G� v. —�' S C, g� � f� � �T � N.� f�- -� � � '7 . � J � � �s�'�� ..� �,��, 1 il � �, o �/Y.H � ' �rJ, a �°`$�, N aa S �'/ 9r O / > IGG �� /��N��,n> � � � �� °�� .� 3 � � �g , �l � � Q �� ._ � _ � w , �� /V�I -'� w�I �/i/ �O S � I � � � A � � �r �� /� r �•�. �. �i'�� / � +� � �r �!� �.� ,l r � . . ,, �' /�r�� ,�.u-'�- �' � � �3z ' _ 1��•� /5� �- .z � ' = `.�.3 �. /�8 8 ��%�..�t �� 6' x �-�' = �� X aY� = �G / S�b� x �� x �Z` = �°zQ �6 °> � 02 `t�k �G ' = � a?�/ � S/aC /�' _ .S� .3-� 8 � cv = ��, 4�ya �a �' 4��-�-�� - � �� Q�, �� ' / `r�� X y. �� - l- ��s g x� L. � �= � — .�lo �j X ,�,4< � ' 5� y�'�� 330 �� lro �1.. 0�1 �33� � z8. 80 y� �..o ,�.Z.� 5�� ' 8 .. t•. �� / 90� �7�� 3` 8c� -----�..- ; �� ,to � �y/- �� 3', Y�/ 1. z,�` ��"", dv ��%i��G CITY OF FKIDLEY r� APPLICATION FOR RESIDENTIAL BUI� DING PERt�tITS -� r �� '''`� ��VEW� ALTERATIONS, ADDITIONS, OR REPAIRS) � OWLdER: � I Yv��.?�_ I ^ e�� BUILDER: ��,��° �:� � i SP �_ Rddress : Address : (y �+'„� � � F �� ,f E �. ,� � �� .. �,�,, Tel. No. Na.: �� Street:__�%�!� �„r 11��, lF _ LOT: � BLOCK: �� ADDITION: ��_�� CORNER LOT: INSIDE LOT: SLTBACK: SIDEYARDS: Applicant attach to this form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING �// Front: .3�, Depth: ,� Height: L 7 Square Feet: ��U � Cubic Feet: �� c� T Front: �� D�pth: Heigh.t: _ Square Feet: lj� B Cubic Feet: �� v '1'ype of Construction: )�(f �� ' Esti.mated Cost: $ �'''f � 5!L% s .� o To Be Completed: __� ��"� ��'� "� �% Alt. A Alt. B '_"_y" Proposed Driveway Width If New Opening Is Desired � Q��$ $ (SEE REVEiZSE SID� Or SHEET) The undersigned hereby makes application for a permit for the wnrk herein spc.cifi.ed, agreeing to do all work in strict accordance with the City o� Fridle:y Ordinar_ces and rulings of the Department of Buil ; gs, and hereb� declares that aZl the facts and representat' s state r�`this pplication ar_e true and correct. See reverse side f��, ': ,.�infor�an. ,� DATE: 'a �� ° ! � SIGNATURE: Stipulations: �) �,��o� ax g'' ,2�lFt� s d � �uB�a T- •4 c.T+E��ti�'4�''�- ��s �y � �= d� ,f�,�/,er�!'� cr - t3 �' �'Il-� �� i� � % . �` 'l�•��7c i.` � r � �.. �:.:'r��'°�`,� /.3��oe'. �e �. l�N C' Et�-•�� c�- . � /��`i'' /�` �"�`� 5'�� /�/. �'� ��; yy �z. 2 � � �}� 375 � o0 �� Jf a T� �/� � I��yUTA�,q� MINNESOTA VALLEY � � ' s��^� SURVEYORS $� EI�+GfNEFRS CORP: �:-� :�. �, r, x � ��I -�,�� 12120 RIVERwpOD CRIVE BCRNSV1l_lE, MINHESOT� 553J7 (C�RS'� P1.w�� k96�1756 (�ertificatc: a{' Stjr�ey for :_ I,iel iJ:enrzckser. i`�r� +� i ( i �� { ; `• N I ' i -----_ ; :. ._� __ _, _ . -; , _ _ _ _ _ _ -___ �. �. : , , _ - . . i _. . ' . . °i � -r �' � S _ _ '^G � ! T /, C��.� �t., ��50TA �,��f � �'r�� , ; . � �,� C ��. r , � W / LFya+�s.ENG�� r `. , \ ,, �_ , � � . .. _ . .�sa„'.s""� .:"�:� '_ . . J( . ( � . �� . � . _... _ f ``� � . L :. . r+� . . .. �..... `� ` � " �--._ -' - ♦ . . ."'_ . . , �-. �'/":y . . - . . � �.� - .. �� -._.. " ) " -._�,_ —, .� , , � .�_ ' t•__ — . _ ,�, — i � / Y' � �+.j %,—✓ � ----�,_! �,��_`��-�, � _— L- <= — __ � — _ .: . _ _. _ _ ,_ �: �;,r_. _,,.�,, � _ -- " J c` - -----�-�� " i,�t ?, :�lcck i, �erLricksen's A�diti�n, accord�_:z� tc t:-ie p' at on filr: in t'�e re�isi-�r of deeds, R.n�xa +:�ount��, '';in�r�;t� . ' , a K' � �d' __.. �� , ,�� . .. � � 1 hr�eby cr.rti(y tbat this is a true und corrrct �ep�esentofion '�linnesot at ��${i:} �(fi'�'C�'OiS Bi �, . af a sv��Fy ol fhe �boundur�es af tihe above described �a�d� EQg/I:CE79, (�OTj1. . - � � _.. �. . ._._ .. �' -_",.+: ' . _ unA of the location of all build�ngs, thrreon� ond ull ris�ble � � , -�: �� bi_.s.s _ s R�.S � � . ea�routhmenft, .} pny� from or on said lund. � . .- J"--�--- -'�" . .%`. . . . . As turveyed hy mc �.h�s �/.�_ Jay of ._:�.�,jL-- � A.D. 19_� �!�� i nn. R eg. :�i O, _�_�ry �� 1 • + , � CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATIN6, COOLING, VENTI�ATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTI�L RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Job Address Ui/'L £urnace Shell & Duct Work $12.00 $�j2�0U , Replacement of F�rnace 7.00 $ Repairs & Alterations-up to $500.00 �•�� S Department of Buildings Repairs & Alterations each add. $500.00 4•00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations-up to $500.0� Repairs & Alterations each add. $500.00 STFAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3.ga1. per hour each add. 3 gal. per hour The undersigned hereby makes application for a permit for the work herein $12.00 $ specified agreeing to do all work in stzict accordance with the City Codes �. 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the 7.00 $ facts and representations stated in this application are true and correct. 7.00 $ 4.00 $ Fridley, Minn. � . 19�� OWNER O.c �✓ �iYl/2.[1K�,9-�-�� - $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ GAS BURNER- from 100,000 BTU to 199�999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) S GAS FITTING FEES: • lst 3 Fixtures x$ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x$10.00 $ AIR CONDITIONING g%Q, O d FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS �, REPAIRS $ State Surcharge $ .50 TOTAL FEE $ ZZ, SQ ROUGH INSP. Date FINAL INSP. .3 � � l - %� Date APPROVAL FOR PERMIT Q��-v REINSPECTION FEE ($10. 00) MINIMUM FEE FOR ANY HEATING PERMIT SS $7.50 pLUS $.50 STAT� SURCHARGE KIND OF USED AS TO BE COMPLETED ABOUT (,1.(.LD� ? O I� 7 / ESTIMATED COST l�% �"' � � OLD - NEW BUILDING PERMIT NO. PERMIT NO. llJ 7�0 � � DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- . / Trade Name L� ti�Jc �. Size No. Co �� V1� -�� Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel G�4 BURNER - Trade Name� Size No. � Capacity Sq. Ft. EDR BTU HP Company . Signed By �/��<� Tel. No. ��f� c,7 ,j � CITY OF FRIDLEY � . APPLICaTION FO R PWMBING AND GAS FI�TING PERMIT >. N �ro u x� a� Water aNi � .-�i � mp H� ro y Q y"roQ w p°i, w � Heater •N� O •� . L � •N�tl � N �� O O 1 � N+� N � N U l � v�i ro U � aAO w v�i 3 A w v�i w U oroa � 3 � � c.�7 O as lec t ,� �� 1� � � �St r •� / � � 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening r Wa`ter PARTIAL RATE SCHEDULE PLUMBING FYXTURE RATES: N0. RATE TOTAL Number Fixtures �(� x S3. Q0 $.J v' �� Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2,00 $ Catch Basin x $5.00 • $ Water Heater - to 99, 000 BTfI / x $5. 00 $ �-� v 100,000 BTU to 199,000 BTU x$10.00 $ Water Softener x $7.00 $ New Ground Run Old Buildi:►g x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: - lst 3 fixtures % x '$3, 00 $ �- vi� Additional Fixtures x $1,00 $ Gas Range to 149,000 BTU x$�:0.00 $ REPAIRS $ ALTERATIONS Eirst $100.00 $S.QQ $ each add. $100.00 or fraction $2.00 $ Stata Surcharqe $ ,50 TOTAL FEE S � •S� REINSPECTION PEE ($10.00) � Job Address _ f " L � �/�� -�C�ofC-f!��_� �t .�� _ Department of Buildings City of Fridley . Tel. #571-3450 The undersigned hereby makes application for a pexmit 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 representatione stated in this application are true and correct �, Fridle�. M�.�7 � �_, 19zz 1� , /� .� /� // OWNER KIND OF BUILDING f ,(� �.�-d�ily�� USED AS � ` TO BE COMPLETED ABOUT �^ ESTIMP,TED COST / G � C� � � �] 1 OLD - NEW BUILDING PERMIT NO. PERMIT NO. �,C,_� Company Signed B Tel. No. ROUGH INSP. Date FINAL INSP. � - Z S�" / � ' Date APPR�AL FOR PERM2T �� MINIMUM FEE FOR ANY PLUMBING PERM2T IS $7,50 pLUS $.50 STATE SURCHARGS CITY OF FRIDLEY aPPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL FATE SCHEDULE GRAVI'I'Y WARM AIR: RATE TOTAL Job Address �� 1.��.�ti �� Furnace Shell & Duct Work $12.00 $ , Replacement of Furnace 7.00 $ Repairs & Alterations-up to $500.00 7•00 $ Department of Buildings 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations-up to $500.00 Repairs & Alterations each add. $500.00 STEAM OR HOT WATER SYS'TEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 Bi;J Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour $12.00 $ 4.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10. 00 $ GAS BURNER- £rom 100,000 BTU to 199,999 BTU 510.00 $%Q,� (over 199,999 BTU see Fee Schedule) S GAS FITTING FEES: ' lst 3 Fixtures x$ 3.00 $� ,p V. Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x$10.00 $ AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharqe $ .50 TOTAL FEE $ � . S� ItOUGH INSP. Date FINAL INSP. 3' sZ l�� O Date APPROVAL FOR PERMIT /� REIN5PECTION FEE ($10.00) MZNIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE ,� The undersigned herehy makes application for a permit for the work hereln 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, Minn. ��Z � . 19� OWNER s� �� -¢�Cf.�-- KIND OF BUILDING �✓l�l�� i USED AS /L.�-�'-�/�� TO BE COMPLETED ABOUT �,(_.�l i_-� ESTIMATED COST �,% 6� OLD - NEW BUILDING PERMIT NO. PERMIT N0. r�C��f � DESCRIPTSON OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Wasm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP _ 7bta1 Connected Load Kind of Fuel BURNER - Trade Name� L,� Size No. � Capacity Sq. Ft. EDR BTU HP Company � c�� c� f�2�' /�24�SryLC/ Signed By ,!��.0 /c>�u.a!L� Tel. No. �76—Zlsg ��:.�;� -�. .�_-��' % ,�.�.....�'�,� ; r. �� . � September 9, 1977 CtTY O� IFRlD��' 6�131 UNIVERSITY AVENUE N.E., FRIDLEY. MINNESOTA 55432 TEL�PHONE ( 812)571'-3450 0 0 Leif Henriksen Builder 6434 Riverview Terrace N.E. Fridley, l�tn. 55432 Re: Final Inspections at 101 Alden Circle and 110 A1den Circle Dear Mr. Henriksen: Final inspection were made on September 6, 1977 of the above addresses and the following items were noted which must be completed before the structures can be finaled out; 101 Alden CircZe 1. Provide door closer on doore between house and garage. 2. Provide sad in the front and side yards. 110 Alden Circle Provide door closer on door between house and garage We will expect all of the above items to be completed by October 1, 1977 when a reinspection will be conducted to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh 0 0 .,..�,M �..,....��.r. ... •. . . _ „�,.. _..____ � � : _ . CIT�� F�IDL�Y . � 97-8l,-1�16051 ' APPLICAtION FOR PUJl�iBING AND GAS �I;TING P�RMiT � � a [ � � � � � � Water � r, A � w a•.� m Q ++ cL w H�ater CJ a> .�4 sl N .•a�� h la uf ro l+ W t"�i a�i � .0 �.�i , [ .0 C A 3 9 t�i �.Ci O .�c � U � � 0 0 �+ +� tl! � N •.i a O 0 � N L y y � q c " v � � apc v�i 3 c�'a w m w U m� a 3 � � c� o as lec °P lst 2:� d 3:d Y C.1 (�) ffi Future Connection Opening Cor�nected with Sewer (•) = Neu £ixture, Old Opening Water PARTIAL RATE SCNEDULE PLUbiBIhG FiXTURE RATES: N0. RqTB N,�er Fixtuzes Fstuzp Fixture Opening 2�e�.r Fixture, Old Openinq � Catch Basin � Hatez Fieater - to 99,OQ0 HTV 100,000 BTt3 to 199,000 BTU ' Water Softencr Nev Gro��nd Pua Old Buildinq 2iectric Wat�r Heater G�'.S FITTING FEES: . lst 3 fixtures Additional Fixture5 Gas Range to 199,000 BTtJ REPAIRS f, ALTERATIONS First $104.00 each add. $I00.00 or fractiosf x S3.Q0 x $2.00 x 52.00 x $5.00 • x $5.00 x $10.00 x $7.00 x $5.00 x $5.00 x '$3,00 x 51.00 x S10.00 S5.0� 52.00 State Suzchtsrge TOTAL FEE REZHSPF;^7'JGN £EE �.,_ , TOTAL S S $ $ S S S S $ . S $ S $ S $ .50 S 8.00 Job Address 1pl Alc7en ('irnlp Department of Buildinqs City of I'ridley , . TeJ.. #571-3450 � The undersigned hereby makes application for a permit !or the aazk hereia specified agreeing to do all work in strict accozdn�ce �ith the City Cbdes and rulings of the Department af Buildinqs, and hereby declares that al2 the facts and representations stated in this application are true and cor.rxt Fridley, Mn, 5-].( -'j$ , 19 owrrER pTT.��TM • KIND OF BUILDING frame USED AS res. �� TO BE COMPLETED ABOUT �� ESTIMATED COST 20��0 OLD - NEW BUILDING PERMIT NO. PERMZT NO. CbmPanY � / c9NSR.��' d. . GE��`�" . signed By MINNEGASCQ Tel. No. • ROUGii INSP. Date , �ZN)1L INSP. "'l � ' Date APPRO'VAI, FOR PERMIT _�� n MINIMUM FEE FOR ANY ?LUMBING PERM2T I3 S7.50 py�$ ,�.50 STATB SII� � � � �1'I'�f C�F F4�IDl.E'Y It;l��E�71c�1 C3i'Vi�tai� F�431 kl�niversi�t Ave 1� Fridbey, MtFJ 55432 57�•�-�fi44 i�Al`� SCH�t7U�.� AI�I'1�CATI+�N FC?N� P'GUV�A F'f.ANTS A�tU NEATIMC, �Cil.l��, V�i'1l.�t�#f3N, RE��1�CC�RATICYIV �INt� A�1 �AN[�I7ifJNI�JC; wY'ST�MS ANb f�I�VIC�S R�sid�er�tial Furna�o�e Shell �nd L1t�ct Wark, Burne�r - Al�o IRept��ement �umact �sia� v�r,r -- ��1� a►�,� a�� Gia� Piping �6�eded with new fumace) Qas Range Gas dryer *A,iP�c�nditioning -- �li Siz�s All L�ih�r�Ji�ep�irs � Ah�ratinns (LKSi +�N aA�K} 1� af V�lue �f Appilar�e ar IMark Cam�n�rcPal�l �dustri�t 1,259'� af Va�lue af Appliance r�r Work pala �'C�T+�1. � �o��a � 0 . o c� � �v,o� �...�,_.._..�.... $ �{3,AQ $ � �a.ao �� .� ��. $�_ - �� 4�1e Surcharge T�iAL FEE $� N�4MUAi� F�� P4R ANY HEA�'I��f?I.,,1jV. +�C VENTILATtt�N R��RIQERA71CiN,(A!� CONDITIOl+lING_P'�RMIT 1&�25.Q0 � PIUS TH�_ .50 STaTE SURGHARGE f��Ih1SP�CT1aN FIEE $42.OQiHr • • EH�kt� C�n ,ta.r►uary 1� 1�99 JC1� RpC1��S5 � Q� ��,,,�- � C �...�-�.�.� Tt�e unc�ersfgned hereby rnakes apphaation Far a p�mii tvr the work tt�reitt speeitied �gteeing to do all w�rk in s�ict �c�a�rdance wlt� t�e City Gad�es and rulir�g� oE kt�e 8uliding Giv�slvr�� e�nd h�reby �el�t�s thert a�l Ohe iacts �nd r�pr�ssntatians slsteri in t�is apptica�arr ar� Uru� arx� correct, �qqt� �� .�.e_.�...__..__.,_� � � �tJIL�1NwlG USE�} AS � ✓� ,��rt�p �QST 1 � C� n � 0 � �� .! � �.%s � i��SGfi1�11C?N 4� FURNA�E ANp QA BURIV�R N4, of Heating l�rtils � Circf� �ine {Steam) (Nflt Water} arrn AI Tl�.de Name_....,�.-'�..__.__._.,� SiaePdc�. � l�. B7U �S' _ r��C� �IP ' ED�1 �uei� IV�±. _.�„�.s Tata! Conn�ted i.��d ,,,,,,,_. Burner Trade Name Size Nu., -- -- -- 8i'U FCP �'DR�,,,,, .�,. River City Sheet Metal, Inc. H�ATING CdMPA�JY 9928 B�uebird St. N.W. � Signed �y_...�..�� /.�i.v� -- -- - TeTt�"2199 � . S Rpproved By Raugh-tn Da�e Final pat�� *alr Care+�ianers can not t�e ptaced in a side yard witFwwt FftL O�UT BNtt�kc slp� FQR STpCI� RiF1CAT1+CNr9 l�P! Ca�' �� written permiesion trom ad�Oining prope�ty �wne�. R�W ACEM�hI�' FU�iNAC� ,/�j>'p� -- Ct�.e�-� � � ,,C�i»L,¢> � �O.b �,/mez ��`l `�n�' y�-1 • � / � / � ! �/.e � �c�� ` �� L CIiIN1NEY AND STACI� VERIFICATI4N The un�dersigned hereby verifies that the existing chimney or stack: 1. 2. 3. 4. �_ 6 7 � Has been carefully examined Is free from rust or deterioration Has no foreign objects lodged wiihir, Is securely supported Meets a!1 curreni Cade r�quiremen� for size and tota( BTU's connected Has tota! heating BTU's of 7 T��(� All oti�er BTU's TOTAL BTU's j� � r Has a liner been provided for water heater Has combustion air be�n provided far water heater Remarks: Yes 4�0 ( ) Yes �No ( ) Yes �No ( ) Yes (Jj� I�ia t ) Yes (.�No ( ) Yes - No � ) Yes �No ( } List AI.TERATIONS Beine Done: HEATING CO: � e l i�� e2 T�2 /.A Signed By: - L� /,�� Datc: P'I f (o �99 --y�- -- - CITY OF FRIDLEY INSP�CTION DIV, Effective On March 1, 1996 6431 University Ave NC ' � Fridley, MN 55432 �QPPL1CATlON� FOF1 PQWER PL,4NT�, AND Ht:A'TI�dG, CUOLING, VEN'fILAI'I��N, 7�� 572-3604 REFRIGERATION AND AIR C�)NC7ITION!NC S`�S'r�MS AND UEVlCES RATE SCHEf�ULE Residential Furnace Shell and Duct V✓ork, Burner - Also Replacement Furnace (Side Vent - Flil Out BacF;) Gas Piping (Need�d with new turnacE) Gas Range Gas Dryer *Air Conditioning - AI� Size� All Others/Repairs & Alterations (LIST 0(� BACK) 1% of Value of Applianc� or Work Commercial/Industrial 1,25% of Value of Appliance or Work F�at� TOTAI. $ 50,00 $ $ ti 0,00 $r , $ 10,00 $ $ 10,00 $� , $ 25,00 $ � � State Surcharg�e 'fOTAL FEE JOB ,�DDFiES��_�l�e� G rc� � The undersign�d hereby makes application for a pErmit for th� �,vork herein specitied agr�sEin�,� to do aN w�rk in strict �ccorc�ance with the Clty Codes ar�d rulin�s of tr�e Bullding Division, ��ncl hereby cleclare� that all the iaets and repressntation� stat�d in this application are true and correct. , L � � � ,1996 UWNEF; �\Y�C�N ��k `� 1� 5 7 I - BUILI�IrJG U�3ED A5 �` `� v �STIMI�TED C�ST �� U U PERMI7 N0, � � I�rSCFiIf�TiON �OF FUFiNA�� ANL7 �0�1 BURNER $ � , No, of F�leating Units Circie One (Stoam) (Hnt Water) (Warm Air) . Trad�, Name Size No, . E1TU_ � Hp EQR � Fuel_ ^ Total Cnnnected Load �_ ,�0 �� MINIMUM FEE FOR ANY HEl�TING/CnULiVVG�VENI_ILATI(�N. REFRIGERAtiON/AIR CO�IDITI��NIIVC PEF�MI71> 25.00 PLUS THE $.50 S7ATE :iURCH,ARGE RcINSPEC710N FEE �42,00/Hr 'A,ir Conditioners can n�t be placecl in ��id� yard withaut �vritten permission from adjoinin� property owner, Burner'frade t�lame Size N�. BTU_ _ NF' EnR� , � �� '� � 1 V�e^�a-c� � HC'AiING CCIMPANY �• I Y K-W 1� S V�F.'�p � Signed 8y �x� �' � Tel No. �� -�� _._�- � 1 Appr�v�d Sy '�� _ I�ouc�h-In Date Final Date FILL OUT E3ACK SIDE FON STACK VERIFICATION ON REPLACEMEfJT FUP,NACE � ,. _._._._ ,, _____ _— �-�-�--- - s �, �,; _ ��l r � �NSQ t A Building MECHANICAL Permit No.: o�-�� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'c1: � DATE I�� a� vJ� YOUR E-MAIL ADDRESS S.ITE ADDRESS � ,'1_ . THtS APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY NpME; y OWNER/ �D�S: CIq-y /' STAT ZIP % TENANT PHONE: � CONTRACTOR COMPANY NAME: ' SUBMIT A COPY OF COMACT PERSON: ' ` YOUR STATE STATE LICENSE # EXP DATE L, LICENSE WITH pDDRESS: ��o� � d' �j vl�i CITY L%2�1/. STATE �%^�ZTP ✓� APPLICATION PHONE �Z,�' ��_� F� PERMIT TYPE ��GLE FAMILY O TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ��W ��PLACEMENT ❑ ALTERA7'ION/REMODEL � DETAILED DESCRIPTION OF WORK � , � PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURFS: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU �G: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 � GAS RANGE/OVEN 510.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GR1LL 510.00 BOILER $35.00 FURNACE $35.00 GAS IJNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GA3 PIPiNG $]0.00 VENTILATOR S15,00 f �?�RMi'�;�F�E.pRC?��C�`$ �OR 7lNDETt;�$,30�.��r` ��,��",`��`�� ;� �� 'r��`��-� , :��RI��E�°�0��'�� 7'��13,`�RM$SOb� .. �.�.,. . Permit Fee $ . Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $�<r�G TH1S 1S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work wilI be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all k which requ' s review and approva] of plan SIGNA7'URE OF APPLICANT PRINT NAME L/ L'� DATE 1�� "'��;I'LEASE �OT�'�,SEPARAi'E?;P.ERMITS fARE°RE UIRED3:�OR:B[1iT:DIN,G.,F'�LEC�'R�GAL�AND„NJECH'A'�TIGA1.'��R�ORK,��,,'p "`: � City of Fridley Building Inspections Department � 6431 University Avenue NE, Fridiey, MN 55432 763-572-3604 FAX: 763-502-4977