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AF - 45905City of Fridley, Minn. 6431 University Ave. N, E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: ____.---.Au.gus.�...21,.__1.sJ.2._.._ _._:._. �ex, Robert DeGardner Realty �`N.M� . Builder Same Address ._...7950__Ea_st._.River__Road._N-'E-'-----.-,----...._.._ Address Sam� __.. � �1605 LOCATION OF BUILDING No. .._�22-1.---------...._ Street ---•--.---..A�d�]a�I�ir�,�_..�I...E...._._.�..__.---------._.__._....._ Part of Lot Lot ------------------14......_._.__. Block .---------],.----.-----------------__...-,----- Addition or Sub-Division _._.Aa.._.�25 �_Add; ; on Corner Lot --------------•-•------------ Inside Lot .....---•----,X--•-•.._._._......._. Setback _..._ __,_ Sideyard �`�Vf'�iElevation --•----------82�..67----------------------..........._.--�----------��---- �'b�d�'�i�/��'..___$2�..,_.67---AA�=Qx_-- _Wve Top of Footin� , DESCRIPTION OF BUILDING To be Used as: ...�nte.11.ing .............____._. Front _...2fi�._. Depth __3$! _ Height _2II!...,.... Sq. Ft. _.�.D3$.� Cu. Ft .25y.$9b Total Garaga 22&27 24' . 10' S78 �. � 5780 ......---------..._ Front .------------• Depth _.__._.___ Hei�ht ___..__._----. Sq. Ft. _. Type of Construction .._j,�.pp�__.��.a,�_—.__...__ Es� Cost _......_�20s_�:.�_7__-•_._�__-. To be Completed _..__�months Stipulatinns: Provide a verifying survey before capping. Provide a hard surface driveway. WATER LOCATION: 20' West of Ma.nhole B�H& SEWER LOCATION: 9' West of Ma.nhole � In consideration of the issuance to me of a permit to construct the building escribed above, I agree� to do �he proposed work in accordance with the description above set for and c pliance with all provisions o! Ordir►ances of the city of Fridley. _ / �/f �� 10.07 State In consideration of the payment of a fce of $_____4$ •..._._�� _.._.._., permit is hereby granted to...�o��rt pg��r.d_ner Realty .....__..._._._....._...._ ......................_......._ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, itt aII work done in, around and upon said building, or any part thereof, shall conform in all respects •ta the ordinanCes OF Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings yyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said oxdinances. c � �� CLARENCE BELISLE NOTICE: I This permit does nof eover the construction, installation for wiring, plum6ing, gas hsating, sewar or wAter. B� suw to sN � Building Inspector for separate permits fo� ihese items. \ a APPLICATION �OR R�SIDENTIAL� ALT�R.ATION' OR AllllI��qN BUILD�NG ��MIT CITY OF FRIALEY, MINN�SOTA owr��, � s ru�r� : ��` � �� ,� ��r� .r BUILDER : � � � a vcl,�� Y �a� . , .�_ ., l� ADDRESS : �,7 � �� /f r v � �' /�Q'� ADDRESS : NO:,. �;; �° STREET: c� � t.U� a�(' � LOT : , � BLOCK:� � ADDITION s� � �CJ.S � �� +� CORNER LOT : INS IDE LOT �SETBACK: SIDEXA,Itp;,,,,,,,�,,. l� �pplicant attach to this forni 1�o Certificatea of Survey of Lot and pxopp$�d building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As; Fzont• . � Depth: %� Height• �' -� _..v� ""'.. �t' Square Feet: ,� �� Cubic Feet: ''`�' r �� " ' :' �� 1! '11 R �� . ' Front : ' " * Depth : , .�' Height : % � Square Feet; � j;k` Cubic Feet: " �pe of Construction: Estimated Cost: $ `�) `� 1 �'i 1 " ':� !!"' i 1�llw��l�91�4 To Be Completed: The undereigned hereby makes application for a pesmit for tk�e wp�c� ��,� spec�fied, agreeing to do all work in attict accordance with the C��y q� �'��.d�.e�r Ordinances and rulings of the Department of Buildings, aad k�e#�eby de�la�ee that all the cts and representations stated in this appliCA��4� are t�cue and co rect. ��: � C� � SIGNATURE: � J (�ee �Le�rerae Side For AdditioaaY Information. ) � � , � t , ��, .�� ^��yf , � �� r � lohd Planning sf,�!�r{��yl Oi7S Mi�wer No.��N:f, la�d ivrv�yinq � • • �: Miwn�N►oti�, � 1 lI1PF'l�ll� ��C� Mfwn. SS1S1 Soils T�tf ing � �� Civil Engin�erinq T�I�pl�ont 1i�-dObb Munitipal Enqinee►in9 Engineers dc Surveyors �•.p cod. s�z Certificate of Survey for A� IYlA EN ►14�0 �� / �� `1/ `� '9l- �i i , r - _= �enote� 't�ro►�nQ�e and �tiii�� aStm¢nt LOT �- glOCl� 1 � � �cno�e5 ►ron monumeclS .�. ; s' � ,a► � oSE Ao0 ��r� oN a ;-�,noka �,o�tn� 1 h��by c��tiir thot fhis is o fru• and correct repr��ento +o� of o survsy o{ tl�• bo�ndari�s of fM ob�v� d�scribed land, ond of the focotion ol oll buildin9s, the►eon� ond oll visible •ncroacl�en��ts, if ony, f�•m er ow �oid lond. As su►vtyad by me this doy o� �sio+vor� A.D. 197i . SU�UROAN ENGINEERING, INC. , n i � � �� Engin��r Su� y rs � � � . �, e� I� � ,��h . 4� 4«4 b � � ��-��:.. _ � _ r ,� , App�ication �or'owt�r Ptael�s and Hta1�g. Cooliag, Yenh'ta�ion, R�ig�r�rtion aed Air Co�oning SYstNns and Devic�s PARTIAL RATE SCHEDULE GR1lY*TY WARM AIA: 11ATE TpTAI, lLrnace Shell dc Durt Work . . . . . . . . . . . . . . . . . i10.00 i Replacement oi P1�rnace . .. ..... ,..... .. 6.00 � Repairs & Alterations—up to ;500.00 . 6.00 E— -. -_-_ Repairs dc Alterationa each add. SS00.00 . g.p(� j_____._ Kccx. w�►nx un ��I�mace Shell & Duct Work to 190,000 BT[T . . . . . . . . . $10.00 ° each add. 60�000 BTU .......... ... .. ..... 3.W i Replacement oi fi�rnace 6.00 � Repairs dc Alterations—up to 5500.00 6.00 � Repairs & Alterations each add. =500.00 g,pp ; STEAM or HOT WATER SYaTEiI FLrnace Shell & Lines--to 400 sq. ft. F.DR Stesm giQ.Op $_______ fl�rnace Shell & Line—to 640 sq, ft. EDR Hot Water 10.00 y_.— Each add. 200 aq. ft. EDR Steam �,M1 �.._ _____ _ Each add. 320 sq. ft. EDR Hot Water 3.pp s-- OIL BIIRNiER—to 3 gal. per hour g,pp � _ over 3 gal. per hour�ee Fee Schedule GAS BURNER tup to 199,000 BTU) over 199,000 81'fJ See FN Seludul� GAS FITTING FEEB: lst 3 Fixtures . _ Additional Fixtures _ Gas Range to 1�.000 _ AIA COIEDITi0Ift110 F11N HEATIYfG sY3TFJ! v�x�ia►nxa avan� AL4'ERATIONa t� REPA1Ra Rovax FINIIL Q - 3 - % `� 6-00 ;� li0 Rl►TE T07AL - XE Z00 a. �?( � _ � .�a s - :i b.0� ; _ � SM PN sch�dat� TO'I11L FEB � • � (SURCHARGE $ `50� D.pt. of Hldys. Phon. H60-3450 C7 ". (/%� y /a -/�'� � ctty o� �xat�: The undersigned hereby makes appIicat[on for a germit for the worlc hereir. specified, agreeing to do all work in strict accordance with the City f)rdiaance. and ruling of the Depai•tment of Buildings, and hereby declares that aIi tke facts and representations stated in this apptication are true and correct. Owner Kind of Building ._____ �� tJse� as —�4£�-9 g � - � - To be completed about _-__.�iL� _./�� 7r Estimated Cost, �-.----- - ��'-- — Otd� Building Permit No. P�:mit No. v y Q�'�j DBSCAIpTtOlf OF WORI[ HEA7'ING or PO PLANT3-�5team, Hot Water, ��Na ` 1'rade Name �"' �� Size N CapacitY�� C�� Sq. I�'t. E.D.R...,L� g� Total Connected Load �� af �� -«"/ BURNER — Trade Nam � Siu No Capadt;�G� 'r`� (� � 89. !'t. E.DR g� I�! - si•� RA��l4. WELTER HEATI�IG C6,' � �� B�, �1�11$NEA�OLIS, MINNESO�'q �,5'4071� B� Peone rto ' 0 !� (REMARKS-OVER) � �'' �°� � �'i w s �' ; I��h �2, 1933 i��`�k�e� ��t':��3��iox� i9�� R�� ,� � .: �. �xi��:�y, r�� a�a s�� Ft�: �r� �:-_�g� �.� �2�.5 �fxd �22�. ��s�erd �a�r �a� �_� : �C�rr�-�e� . �7� ��: r�c�i.ved � c��pi��r�� ab�u� ��ax;d�r� �a��r ar�ri ��t�� a3x i�speet:.�� caf G215 Alc�r� i��y ,�d 6�23. A1.c�+�z� �*�y m�td� or� g��c� �, 1973 i.� .;es �.n avidence �".�2},[� � ��.�� T� 1S %.�.t E��''�� 'j�'' �'�'"a3�?�.�I t�.OP.�t` � `3$ �'. r '��uic3 pss� p�� ubm$ t t�s us �rc�� p�a ar� h� �v �o�.v� ��e �te�d�r.g ��et�s prc�bl.�sz� �a�i'o��► �.mpi�r.t�tic�r� �� it. W+� r��.11 z��t r�,�i�e ��,�a�. �.�u�e apPxcs�r�I u�til this p�c�is�.� �e b�n correcred. If �a� ��ve �n� qu�tio�s: ��ea�e feel free �a cs��c� t�f� c��f�,ce. �C/,�h G�; E�gi��i�x�.�g �e��r�t Sfi�+�'�I�e�; _.f {f f ; �,� =�-}-'� �� `��'i � �. �� r�ity T�tr��s�pme�� Ac3�i� � , !�; 4 �' �I, i: �. Aprik 2�� i�7� llc�G��t�n�� c�nta Cr�t�ct a.c�rr 795� ��t Ri�'�1r �o�d �i.�. F�' #.dl��, k2in�e�� s� t� 55'�� Re� R��:r L�� i��.��ge �.n ;��. 1Rose Additicaa� �?e�r �r . 1��rd�.er ; W� wro�e �rau .� 3.�t��r on Ma�ch 12, �.973 ca�.l,ing y�u� �.t�e�Yt�a�n t� a c€r�iir.�ge pro'�lem a� 62�1 anci 62�.5 Al,d�n W�y�. On Apx�.1 �3� 19�`3 Qux �urir�y �r�a t�ak � zseta �u��'vsy �t�s� t3e��nirs �.ng th� ��t�p�� d��.ta�tg�t ,�nr� �ttund t%� t.J�exe� �� i7.1 e�c�� t8 � d��nite g��rob3:em �lc►n� �he� b��k 1ot la.xe�r of B�ock 1. �in��t �hi� w� brought t4 qau� at��tion #.� M��tx ��d 3.n��sur 1+�Cte� ar� ��d ycru tc� ��bmit y�ou� �s�ap��ci g1.�tn cs%ic.h �o � lcz�cr�l,+�dg+� �e did not ��c�ive, we n�xa ��k th+�t ya+� stsi6mit � p1:an ��: �p�rav�ai an c�r b��r��c� 'I�y I,, i17� atn�l s+c�►edu�.� �hz� n��ry sao�rk �� :��p�.e�t tha.� p�.�n bp �y �,� ��7'�. �i+� h�v� �rr� fielrt i�n�a�ri�n rsf �rhi.�h m��r b� us�fu7. �a� �uw: 3.0 r�i.s�g up yous` g��rs�;l.. 'We �tx� ��in� fc+ar q�u� p�az�� ette�t�.c�n ec� thia �� o t%t you�r n,e�t h;�err��:�r� m��► g�� on �rith t'h��.� 1�S��p3n� i.�p�t��n��. �/�uh 5in��iy"� j�� 1 j i,,^• t ; .. �r�u�rut,ni�� i��.r�puna�t ,t�c�m, HOUSE HEATING TEST RECORD � � _ , � � r� � �, .. ` ' ��,,� r j,�,�.-'k'•'�`� / � ��.r- `_ ADDRESS �� -��-� �' �-"�-�� I�="+- l'��" �� APT. FLOOR�CtTY ,�'�"�SUB�B OCCUPANT •��.._ -� T OWNER ��`'"�� "*�.�� ` ., J� s i HEAT LO55 DATE HTG. INST. GAS C0. METER BA GE # ""��' SOLD BY INSTALLED BY � 1�� .'��%- �'� .` Eleetrical Work By �S L��e gy K; ` '1 e -• Ya TYPE OF HEAT GA FA �HW STEAM SPACE HTR. UNIT HTR. OTHER G �ESt6,r� CONVER510N MAKE -��'°�' -:-=- �l �--'��'� ""�"z- MAKE OF BURNER Modsl _ ��' /�� 1- %� ..s i� �' :,,�� Model . Seriol '�:�- � �:�-' ` .:�"- � Max. BTU Rcting INPUT � �` �' �f� MAKE OF FURNACE Model r�'�"j CONTROLS �, r .- / THERMOSTA7 -3 �+ � �-=� `;`Weat P�ug � ` �� Vent Size � yc�ve '�7" "' �` �:"/ � ^ �`='" //''`+�'c / i ``�'— KIND OF LIN�R , `" SIZE ONE Limit �x"�'� �'-%� �� "� �� Droft Hood ' �� ° f f�' � Regularor " ,- .,.:_ y Limit Setting ��- _(_� Fi Itera � ize,// ��-� �� Nu ber � /� •.i �� - / �1-,i� Fan Setting Chimney Loeation Inside Outside ,.�p� / J� . �, � Pilot Type �7 ° ' Chimney Construction ,LJL��= , Pilot Make �,��.�-�� _.,-1' r� -�--�P .-:.-..�. Pilot Model `-- Smoke Bomb Wiring '"'� Pilot Timing �=?'� y'`�� ' Draft - �,% Test Tag i-�' L.W. Cut Off Door Pressure Lighting inst. "� . j{-- ;.-� ' �;� `p. � - Pressure �-' - Percent CO --,r � Date Tested "'>- � = y-- ' -- �� f , y,. 2 � :��/� Company Testi � ;{ if.�;,, :,.f' .,r :Y ... ..�.._ °:e Input CFH � r` Percent p ' Staek Tem �� " 2 �� rl p. f Percent CO Name of Tester '/'" ��'• -=°�y =� Form 235 � .R J CITY OF FRIDLEY Effective Oate January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONlNf SYSTEMS AND DEVICES RATE SCHEDULE QESIDEATUL Furnace Shell and Duct Work, Burner (1►l,o raplaceasnt furnace) Gas Piping (pipinq n��ded vith nav furnace) Gas Range Gas Dryer • Air Conditioning (all sizes� Al1 Others/Repairs and Alterations li of Value of Appliance or Work COMMERCIAL/INDUSTRIAL la of Value of Appliance or Work REINSPECTION FEE $30.00. w�TE To�rnr. $ 20.00 $ $ 10.00 S $ 10.00 S $ l.0 . 00 S I (i s io.00 s_�_ State Surcharqe TO?�L TSE Rough Insp. Date Final Insp. � "' � �� / Date Approval for Permit --�� s Job Address �G�a ( � /e��,v �l�(� I�E Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 The undersigned hereby makes application for a permit for the wrk herein specified agreeirtg to do all vork in strict accordance vith th� City Codes and rulinga of the Department of Buildings, and hareby d�claraa that all the facts and repreaentationa stated in this application ar� trut and correct. �-•. l�(� . �9�I OWNER KIND C USED 1\S S TO BE QOI+�LETED ABOUT `'� �—\ 1, � � ESTIMATED COST �� D� � O $ . 50 p� _ Nb%i BUILDING PERMIT NO. PERNIT NO. ! C,IC �/ S S�S� DESCRIPTION OF FURNACE/HURNER MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLU9 THE 5.50 STATE SURCHARGE •Air Conditioneis can not be placed in aide yard vithouL written pemission fr� adjoinirg reighbor. HEATiNG or POWER PLANTS, Steam, Hot Water, Warm Air- tio. Trade Name Size No. Capacity Sq. Ft. EDR BTU 11p Y+otal Connected Load Kind of Fuel BURNER - Trsde Name Capacity Size No. Sq. Ft. EDR B'N NP Compan Attn: JUd � � �p #"'�,� r3 ' ��- Signed�Q � I inrinr, A —�+rvv+'rT'TY�' • - TQ No. P• 0• Box 1165 I�inne o is, 44�-I16� Fill out back ide "or stac ves%� atio �eplaceme� furnaces � ' MlNNEGASCO CITY QF FRIDLEY INSPECTION DIV. � • Effective On August 1, 1995 6431 University Ave NE � � Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTiLATiON, 572-3604 _ REFRIGERATION AIVD�AIR CONDITIONING SYSiEIVIS AND DEVICES RA_ T�SCHEDUtE Residential Furnace Shell a�d Duct Work, Burner - Aiso Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Canditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACKj 1% of Value of Appti nce or Work �� .� L� c � i c C' "1 ,C ��. �l� � C �1.� �Com�er�al/tnd �st i � 1.25% of Value of A lianc r Work Raie 70TAL $ 30.00 � $ $ 10.00 $ $10.00 $ $10.00 $ $ 25.00 $ . • $ �� . C"C-, . $ State Surcharge TOTAL FEE PLUS THE $.50 STATE SURCHARG REINSPECTION FEE $42.00/Hr E .� � � � *Air Conditioners can not be placed in a side yard without written permission from adjoining property owrter. � $ �S,S C� JOB ADDRESS � � Z- / /�1 L� E � � �'I The undersigned hereby makes application for a permit for the work herpin specified agreeing to do all work in stric# accordance with the City Codes and rulings of the Building Division, and hereby declares that ail the facts and representations stated in this application are true and correct. l/ — � 'r ,1995 OWNER�rp ��1 v�1 � L-. 5 i7 /l� BUILDIIVG USED AS ��r % ESTIMATED COST ��o � o c�. PERMIT NO. �_�C-'C 'l i •►' : � •- � No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade..Name_�sA7 •v-C��.,� Size No.6�� v�'/'� BTU 27, ��,3�,�IP EDR Fusi � 7 �y 9qS' Total Connected Load Burne� Trade Name Size No. `BTU HP EDR � HEATING CO Tel Na.��j ^ Gc�r� / � ' Approyed By �� Rough-In Date Finai Date �f��-� FILL OUT BACK SIDE FOR STACK VERIFICATION ON �'�� REPLACEMENT FURNACE �/ . /�`, '�, �� jl- G-�'J� SuB�ECT City of Fridley ,�.� � �5 AT THE TOP OF THE TWINS g � I L D 1 N G P E R M I T � f ; � RE O. � ` _____ COMMUNITY DEVELOPMENT DIV. r � v � PfiOTECTIVE INSPECTION SEC. , � a�a- ' ' /'��1 � CITY HALL FRIOLE� SS432 NUMBER REV OATE PAGE UF qVPqOVED BV �'""'�� ,�' 612-571-3450 910-F15 11/6/95 � � )OB ADDRESS 6221 Alden Way NE 1 LEGAL �OT NO. BIOCK TRACT OR ADDITION SEE ATTACHED DESCR. (F 1 A1 Rose Addition SHEE7 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ted/Kim Olson 6221 Alden Way NE 574-1146 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO Fireside Corner 2700 N Fairview, Roseville MN 55113 633-2561 1068 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE �ICENSE NO 5 ENGINEER MAIL ADDFiESS ZIP PHONE IICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WOFK O NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOF1K Install built-in gas f�replace 9 CHANGE OF USE FiiOM TO STIPULATIONS Follow specification/stipulations as per testing agency. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERM�TS AFE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING i HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPL�CATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPLIED $3�000 �1.SO WITH WHETHEfi SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE pERM1T FEE SAC CHARGE PROVISIONS OF A Y OTHER STATE OR OCAL LAW REGULATING CON- $74.75 Fire SC �3.00 ST ION R T PERFORMANC OF NSTRUCTION �' PLAN CHECK FEE TOTAL FEE `f � - �S License SC $5. 0 $84. 25 siGNATUaEOFCON'�aCTOaoAnuTHOaiZEDaGEr+r I�ATE+ HEN PfiOPER�Y A IDATED THIS IS YOUR PERMIT � �/� _ ___7�� __ SiGNATURE OF OWNER�IF OWNER BUILDERi IDATE� `�. � �OG NSP O�tE I�tEW ADDN ALTER !1 Ll �. l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Buitding Permit Application Cffective 8/ 1 /95 ConstructionAddress: � Z- �- ( /Q L..D �1 �1�1 �/ Legal Descripdon: Owner Name & Address:�E � Cr � l._S � ,J Tel. # �� - /�� Contractor: �u.,l �SO �`�t2s.,��D� rL„��/��' �j'�,_ MId LICENSE #�T� 6� Address: 2. 7 0 0-- dtI l' � 2� c�S�Y L.,�.� �� Tel. # �� Z S� Attach to this application, a Certificate of Survey o the lot, - witli the proposed coastructioa drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: UTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Length Width HeigUt Length Widrh HgtlGrourtd Sq. Ft. Sq. Ft. Sq. Ft. Coraer Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: �A5 P2�.�cA C�/'r�:s >�Ou��Q T/�timateci Cost: $�-�� o ��"� , Approx. Completion Date: � q �J � �- %' � (Cost on Back) �33riveway Curb Cut Wi�th Needed: +¢ Ft � Ft x� $ i =$ ri �ATE: 1 � ^ (, - �S APPLIC Fermit Fee Fire Surcharge State Surcharge SAC Charge iicense Surcharge D►riveway Escrow �rosion Coutrol �'ark Fee Sewer Main Charge TOTAL STIPULATIONS: � ' �-/ ,. ��` $ .� ✓ . �� $ /. ; �' � $ `:r � C' � � $ $ $ $ $ ��/.�s Tel. # 6�3 "Z J�6 �ITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valua,tion (1/lOth%) $.50/$1,000 Valuation $850 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conseivation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] - � .. SUB�ECT . . .. . � , City of Fridley AT THE TOP Of TME 7yVINS � u� L D I N G P E R M I T r � . � � � • COMMUNITY DEVELOP�ENT DIV. � ►y �� , � � � PROTEC7IVE INSPECTION SEC. � � . , l•_--�,��"';.� CITY NALI fRIDLE� 55�32 N�MeEr+ nEv i 612-571-3a50 staF15 �oe nooaess 6221 Alden Way NE � t LEGAI LOT NO. BLOCK TFACT OR AODITION oesca. 4 1 A1 Rose Addition 2 PROPERTY OWNEFi MAIL AODRESS Ted & Kim Olsen, 6221 Alden Way, Fridley, MN 55432 3 CON7RACTOR MAII ADDRESS LeMaster Construction, 430 Gateway Blvd, Burnsville a ARCHITECT OR OESIGNER MAIL ADDRESS 5 ENGINEER 6 USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW 8 DESCRIBE WORK Repair fire damage / 9 CHANGE OF USE FROM MAII ADDf;E$S OX ADDITION � ALTERATION small bedroom addition STIPULATIONS See notations on plans. ��pAR'�� PERMITS REQUIRED FOR: �i �'er1�NG� ��G AND SIG�IS OATE 1/16/02 ZIP MN 55337 ZIP ZIP X REPAIR -- ---- --- AqATE PERMITS ARE REOUIRED FOF ELECTRICAI, PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION ZONING SO. FT AUTHORIZED IS NOT COMMENCED V�!ITHIN 60 OAVS. OR IF CONSTRUCTION ; OR WORK IS SUSPENDED OR ABANQONEO FOF A PER100 OF 12Q DAY$ AT ANV TIME AFTER WOqK IS COMMENCED. " NO OWLG. UNITS I MEREBY CERTIFV THAT I HAVE READ AND EXAMIN�D TMIS APP�ICATION STALIS ANO KNOW TME SAME TO BE TRUE ANO CORRECi. ALL PROVISIONS Of LAWS VALUATION ANO ORDINANCES GOVERNING THIS TVPE Of WOAK WI�L B� COMPtlEO $125 � OOO . OO WITM WMETMER SPECIFIED MEiiEIN OR NOT. TME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITV TO VtOIATE OA CANCEL TME pEqM1T FEE � • PROVISIONS OF ANY OTHER STATE ii LOCAI LAW REGULATING CON- �5.00 License STRUCTION THE PERfOAMAN E CONSTRUCTION PLAN CNECK FEE boZ S�G at E OF CON" . OA Op A TNOA�2ED eGENt � �TE� EN P PEp V r S�GrvatuaE O� OwaEQ��F pWHEQBWtOEQ� �D�TE� �- � B�OG So � P�GE Of � � 3239� �� RECEIPT NO. _'%��___� �niROVEO er SEE ATTACHED SMEET PHONE PMONE LICENSE NO i2-707-1256 202Fi161 PHONE LICENSE NO PHONE LICENSE NO O MOVE ❑ REMOVE OCCUPANCVLOAD CU FT. OFFSTREET PARKING GARAGES SURTAX $62.50 SAC CHARGE $125.00 Fire SC TOia�FEE $1 26.25 IAT D IS IS VOUR PEQMIT .�-�4-d1-- r��rE NEW [ ] ADDN [ j ALTER [ ] Construction Address: Legal Description: �,Q �' CITY OF FRIDLEY Effective 1/1/2002 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �22! � Q� 1 n Owner Name & Address: �� .�- Ki ,.� �l5� Tel. # Contractor: �-%ria�o� MN LICENSE # Address: y 3 O C,�u� `.� i�3 I �'e9 ,T �;;:,-,�,�� 'In1 Tel. #°IS 2- 7 0 7-/ ZS � LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length % � Wdth 7 Height o Sq. Ft. �7 � Length Wdth Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. �"`h �� Construction Type: .5i�.�1 �,�t „�,,,� G�Q�,� 'E,�. Estimated Cost: $ � 2 S�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � ��/ �2- APPLICANT: �oi�._. �c�w.-�� Tel. #�15�'707-1 Z-5�, Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we wiil call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - � t ! 33 .'� � � ��5. 60 $ �.7.,� !� $ ,�� $J S�6 v $ $ $ $ $ /.3�� .� Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [) Not Necessary [ J r, STIPULATIONS: � _ CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 ": :`= - �1Pt�LICATION Ft�n �O�VEr� PLANTS AND HEATING, COOLING, VENTILATION, (763) 572•3604 , REFRIGERATION AND AIR CONDITIONING SYSTEMS AND RATE SCHmULE Residential Furnace Shell and DuctWork, Burner - Also Replacement Furnace (Side Vent • Fill Ot# Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Srzes Rate TOTAL $ 30.00 � 30� � $ 10.00 �: $ 10.00 $ 10.00 $ 25.00 All Others/Repairs & Al�erations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25°Jo of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANYHEATING/COOLING/VENTILATION REFRIGERATION/AIR Ct�IDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE S�JRCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can notbe placed in a side yard without written permission from adjoining property owner. $ $ $ $ $ $ $ .50 $�V • 5� DEVICES JOB ADDRESS � I Effective On January 1, 2002 OWNER�°�i21'� �� I Y wc:.ti��b n � BUILDING USED AS�� I ESTIMATED COST ��, CS� PERMIT N0. ��'��Z DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units � Circle One (Steam) (Hot Water) arm Air Trade Name � O Size No. �li BTU �l 0 �f� HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all v�ork in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING CO �'I(� ,�"�Qj'1_ � i'� O.�+ Signed - Q� TEL # `?(D3"��U "��C�7 FAX # �?(D3�" �� —�lid�� Approved By _�� Rough-In Date Final Date S'1 °�� THE BELOW MUS'!" BE FILLED IN WHEN REPL.�.ClNG FUEL L'URNING APPLIAN�ES OR THE APP _ICATION WILL BE RETURNED � •„��► ► ► �►► •: e►i •��:--- • _ ; : ,� •► Wheri _r� �� a_ing ar� existina f�,ranr.e, the undersigned her�by verifies that the venting has been examined and is free from rust, deterioration, obstr,actions, and i� securely supported anc! r"irestopped where required. Yes � No () The venting system is plastic/PVC and me:�ts 4!I current codes and n,�nuf�:cturer spec::ications including sizing, lenc�th, number of elbov��s and termina� on. Yes O No �) i(/'`,9- The undersigned also venfies that the replacement anit is a listed as� �mbly and ;neets the current codes � nd manufacturer's speciflcatior�s. This ;oes incluc-fe AGA-GAMA Cat�gory I Central Furnace Venting Tables for f�. � assisted and natural draft app;ianres. Til@ �?l�iii�fl� ['C„i�f',iicibn�i aii` IS SIZB�i aiiC iilSicciic� tu iYi22t iii�� CGiic:� �i CACi@� and manufacturer's specifications. When required to in�tal� a r, .�N .Qm��;;n a.rir" it will be siz��.l and i,�stalled to meet th�: :�rent codes and manufacturer's spscif;cations. When it]s�t sin� a riew ventina s�stem, the und�rsignE d hereby verifies thUt it is a listed ,ssembly and meets tfie current code� and ? �ianufacturer's specificatio� 7. This does include AGA-GAMA C�.�egory 1 Central Fumace Venting Ta} ,ps for fan assisted an��i natural draft applia; ..es. Is the comr ��on ver�t and vent connectors sized and inst :{ed correctly after an applianc � has been removed from the c�mmc:n vent �nd vented separately r s per current codes. Y�s �j No ( ) /' ''es� No ( ) '(es� No � ) '�'es� N� ( ) Yes� No ( ) : � � � w ' � � • �1 1 • � � • - � � � • � � r ■u • � Appliance #1 Type d��rDc.,'T1' BTU Input �_ F n AC ' te or Nat Appliance �;.: Type _ BTU Input i Fan Assisted or N�t r'�ppliance #3 Type BTU lnput _ Fan Assisted or Nat . Tofal Appliance�_ T�tal Bt� � Inp� �t _ _ Common Vent Type C�-��S �Y Vent Height �_� � Diameter_ � inche5 - Appliance #1 Vent C,7nnector Height __ ft Length ._ ft Diameter in Type _ Appliai �ce #2 Vent C.�nnector H;�ight ft Length ft Diameter in Type _ Appliar�ce #3 Vent Cr;nnector HE;ight _ ft Length ft Diameter in Type i 9LIFE �Tl�r� � ` (� : _5cri� � HEATI�:� CO: 2 � < .�� - Signed :3y: _ _ ____.: � Date : Gt i � +.u�- � � �w w... . ,: a:::�� 3 �. � ivN DIV. � ��:L�:�v�. :��3 .� �rua i i , ...u�ti 6431 UnWersity Ave NE ,� ��, a-� �`, Fr�dley, MN 55432 �.�( S� �,,� �-(�j�C� APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604 'h MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRE 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 () No Type . Reinspection Fee $47.00IHr � $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge ��.00� .50 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. ��m � S Owner v��'� �� ,20Ua- Building Used As ' � Estimated Cost �Jr� � PERMIT NO. � �L�� PLUMBING COMPAN �`—� ( � 3 33 SIGNED BY � TEL N0. '`'�� 7?? � FAX # Approved By Rough-In Date Final Date ��%� �nn�n�w�n r�� nvr� r�� r�v�no�nwv�v rcr��n� � �.� TOTAL FEE $�• S� PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE _ _ CfIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 August 16, 2002 Mr. James Olsen 6221 Alden Way NE Fridley, MN 55432 Re: Final Inspection at 6221 Alden Way NE Contractor: Zell Plumbing Dear Mr. Olsen: A plumbing permit was issued on April 15, 2002 to install four fixtures at your address. According to Secdon 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the rough-in inspection has been completed but the final inspection has not been requested. The permit fee that was paid covers the inspecdon to make sure the work was completed according to the Codes. We will keep your pernut open for another 30 days and if we do not hear from you within this time to set up the inspecdon, we will mark the pernut "no inspection called for by homeowner after notificadon" and take no further action. To set up the inspection or to have any quesdons answered, please contact the Building Inspection Division at ('763) 572-3604. DJ/mh _ _ _ -�-: , Eng��i�ering WATER AND SEWER Permit No.: �. 763-572-3552 PERMIT APPLICATION Received By:�� 763-571-1287 fax CITY OF FRIDLEY � ' EFFECTIVE 1/1R0t0 Date ��z �O . APPLICATION DATE: YOUR E-MAIL/FAX: THiS APPLICANT IS: ❑ O R "[�CONTRACTO '� JOB ADDRESS: � ` � � ' �! 13EW CO23STRUCTION PERMIT# (IF APPLICABLE): _ � ; PROPERTY Np�: - OW�� ADDRESS: ( 2 ,,� TENANT 22�i b� r �•r(�i X crTV sTa��p�� PHONE: � CUNTRACTOR Nr�ME: , SUBMIT A COPY OF � ' ; YOUR STATE �DRESS: , � . CITY STATE�� ,, • ' LICENSE WITH PHONE '��- 4'S� �- O S�' CELL PHONE: �?�_ Q+� �1''� APPLICATION STATE LIC i! STATE BOND: EXP DATE: 1. Narrative/written description: -- - 2. Please attach sketch showing curb line, utility line, building, etc. with distances on back page. 3. Stipulations: k" � f PERMIT TYPE 0. SEWER CONNECTION PERMIT $50 . ❑ WATER CONNECTION PERMIT $50 � � � WATER LINE REP,AIR �40 _ # �wk i,,. C SEWER L1NE REPAIR �640 ' " ❑ ADD STATE SURCHARGE $.50 ❑ SAC CHARGE @ $2100 = TOTAL $ � V ' OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECfAL ASSESSMENTS — SEE FINANC� WATER TAP — SEE ENGINEERMG NOTE: WATER METER REPAIR, INSP OR SHUTAFF / EVENINGS, WEEKENDS & HOGIDAYS �125%H�URrB ` THIS [S AN APPLICATIO A P�RMiT-NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (ne connect' o pair) permit and I acknowledge that the information above %=.comg�e �d,?� ° accurate; that the work will be in con e ordinances and codes of the Gity of Fridley. I undairst�nd this is." '� `#�` , only an application for a permit o' n o without a permit - SIGNATURE OF APPLIGAN .� PitINT A[AME: � / DATE: � _ A�PROVED BY: / DA'fE: � I 1 ;�� COPY GIVEN T:❑ uTn.rrY I ING (only if aew meter) � PUBLIC WORKS ❑ ENGIlYLBR�G City of Fridley ,� Engineering Department 6431 University Avenue NE, Fridley, N1N 55432 � 763-572-3552 FA,X: 763-571-1287 �