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AF - 444797— ' . BUILDING PERMIT _ � � Village of Fridley, Minn. N� 2�? 2 5 Date �•~ ��.� � ....................:. . Owner �. . . . . . . . .'l% . . . . . . Builder . . . . . . . . . . . . . . . . . . f,/�, ,� l�C� . . . Address V . � � � . . . . ��. /1�. . . Address /. � � . . . . .�. . . ��:� . . . . . . LOCATtON OF BUILDING No. .� �: .[P. li . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . Lot . . ��. . . . �. �. . Block .� . . . . . . . . . .. . Addition or Sub-DivisiorL . . . . . . . . . . . . . . . . . . . . . . . . . . �� 'jLD' Corner Lot ............ Inside Lot ............ Setback ............ Sideyard .......................... DES�RIPTION OF BUtLDWG To be Used as: • . . . . . . . . . . Front �(!�. . . . Depth �!�!�Height . . . .. . . . . �r ., .�� `�aj�. . . . . Front . �6. . . . . Depth.t�.� .�'�. . . Height . . . . . . . . . Type of Construction�./.�.'yOr.^.'*�... Est. Cost �,�.��.f?. �. ,....... , �C �'� Sq. Ft. . .. .. ... Cu. Ft. ... .... . Sq. Ft. ..... ... Cu. Ft. ... .... . '/.►�✓ . To be Completed . �l . .�!�� . . . . in consideration csf the issuance to me of a permit to construct the building described above> I agree to do tHe proposed work in accordance with the description above set forth and in compliance with all provisions of ardinances oi the village of Fridley. .:��;� � � � �d,�' ............... . ....................... �Tn co�Ylsj'�eration of the p�yment of a fee of $. .tO. . . . , permit is hereby granted to . . . ��;�l. . . . . . . . G�Z�iL.W-Lr1. ..�. to construct the building or ad dition as described above, is permit i5 granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, aroUnc� and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, 1VTinnes�t� regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violationy� any of the provisions of said ordinances. .+� � / \ _ . Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspeCtor for separate permits for these items. • • • City of Fridley, Minn. BUILDING PERMIT Date: ...�.... J�Y 12, 1965 �9�3 7 N° 8177 Ovvner: LEONARD KOS Builder CLAUS H. JOHNSOft & SOftS Address _.._..._��1:68,..,�:tu�a._.$!aa _....._........__..___..___ Address _..__._�__..�-�.?S_�...�.��t.s�..Av�rll.l�.�s1Y.t�_...�. Fridley 21, Minnesota Rebb�nsdale, Minnesota 55422 LOCATION OP BUILDING No. .....__5!�68 .._... street Altura I�oad �,�._.._....._.____._..._.._..__..W Part of Lflt Lot _._..___._..�_._.__ Block _._..�....__..._...__._._ Addition or Sub-Division ....._.._._..._...._..... Corner Lot _--•_._..____ Inside Lot ..__.._._.._.....�.._._ Setback _.._.._..._.._..._.__._.._ Sideyard Sewer Elevatiari ______.___�..._.. ._..._._.__._._ Foundation IIevation ._._...� DESCRIPTION O� BUILDING To be Used as: ._..__ k�ont Y.. Depth _. Height .._._..__�� Sq. F'L _.. Cu. Ft �.. _._..____._... _�..� k�ont _.....__ Depth ._.__......_.. F%ight .___._.___ Sq. Ft. �...__._._.. Cu. Ft _ Type of Construction _____.._...__..._..__..._...._�.. Es� Cost a�12�,_000,� 09.__.._........ To be Completed __._ REBUILD HOUSE� PORCH & GARAGE � STORM DAMAGE In consideration of the issuance to me of a permit to construct building th� proposed work in acc�rdance wlth the description above aet fo in ca cmdin�aneea of the city of Fridley. �. I agree to do provisions of In car►sideratfon of the payment of a fee of � 10.00.._.._._, pe�t is hereby gran�_.._..�AUS H. JOHNf & SONS to construct the buflding or addition as described above. This permit is granted upoa� the express condition that the person to whom it is granted and his agents, employees and workmen, in all work dane in, around and upon sa.id building, or any part thereof, shall conform in all respecta to the ordinances of Fridley, Minnesota regarclfn8 location, construction, alteration, maintenance, reP� and moving of bufldings within the dty limits and this permit may be revoked at aqy time upo� violation of any of the provisio�ns ot said ordinancea ALLEN G. JENSEN B�� NOTICE: 7bis p�rmit dws aot eowr th� eon�eualbe. indallaNen io� rrieino, Piumbino. Yas 6�aNn�, s�w�r er wabr. E� sun fo sM fh� Buildiao In�p�elor hr s�puaN p�n�ih fer fba� it«or. APPLICATION FOR BUILDiNG PERMIT CITY OF FRID�LEY, MINNESOTA OWNER' S NAME�. f �A/ �4 �1` �, 1 1 D�� BUILAER � 1/4L' S�� O h�Y S`�( `�' Sa ll� S ADDRESS -�Y (� � � 1 �,� {� 10 � annx�ss �5-5 d (�'� �au e e � ✓ e ��o LOCATION OF BUILDiNG N0. J�S� !��./�TREET ��! j--.� PART OF LOT -��- —.T �. L4T I� BLOCK_� ADDITION OR St3BDIVISION �1�}j�-/.'Sd N S' U N�,� �/ l%.�. �lj p F- �l(J, CORNER LOT INSIDE LOT�_SETBACK SIDE-YARD � SEWER ELEVATION FOUNDATION ELEVATIQft ' ApplicanC attach to this form Two Certificates of Survey of Lot and propoaed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Tyge of Construction Estimated Cost �� (��Ca �� -,--�- To be completed The undersigned hereby makes application for a permit for the work herein specified, agreaing to do al]. work in strict`acc.ordance with Che City of Fridley Ordinances and rulings of 'the Departnttenti of Buildings, and hereby �� declares that all the facts and representations stated in this applicatian are true and correct. D ' DATE SIGNATiJRE G�� , (Schedule of Fee Costs can be fi�und on the Reverse Sidej.� ��1� ha�� .� �� S�l�/�( ��.�� ,.� � � � �-��h��-� � � � �a' �� CITY OF FRIDLEY APPLICATION FOR PWMBING AND �.5 FITTING PERMIT u� >, N m u • K a� Water u1 N N � N[� m q � q, w � Heater w ,� � u, F.+ m►, u, ro s+ a Sa W N q .0 �.i N .0 � q 3 O U��.G � U N °u ro.° � ro `m� � m u o ,°a r°+ ro ro� m ro �' ro � �n u 5 al on cn 3 Q G+ m w u al � 3 �7 � �7 O as lec -� c z c ��. lst 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treatinq Appliance Hot Water Heater Gas Range Gas Dryer NO Ef fecti ve Da te May 1, 1988 r-.. � Job Address ;[;f�; r;L (^1�;�:a7'i. ��.R Department of Buildings City of Fridley Tel. #571-3450 Leon�r�c� Kc�, �57��.5494 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. � � y;; , 19 ��1�1'• i �R �.c�,j;;:_ �,L�onar�i�Kos,.;.,,�572�9594 ,- KIND OF BUILDING �7'�]TlQ USED AS P.e s TO BE CONIPLETED ABOUT _ � O ,7L7n $$ ESTIMATED COST �JOO. RATE TOTAL OLD ��W BUILDING PERMIT NO. PERMIT NO. �� g 5. OU $ 3.50 S 1. 50 S 4.00 $ 5. 00 $ 5.00 g 5.00 s s.00 $ 5.00 $ �.00 $ 5.00 $ 10.00 _�_ $ 10. 00 Back Flow Preventer Iaequired. .. Yes () p� (� �e S 5. 00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 18 of Value of Fixture or Appliance Reinspection Fee $ ($15.00) State Surcharqe TOTAL FEE S $ S S S S s s S S $ $ $�QQ .$ $ $ .50 s Z5�50 ROUGH INSP. FINAL INSP. compau}�° � <; �"L�gt3.e� �+� � ar j s�°'",� . ,c�- � , ��., yi'-:.."`;>,� � lT=T Tel. No. ��►� r.._._._.t..— _ ,..�.�.. ,.,.,k Minnegasco #342-5337 �te — 700 W. Linden Avenue P. 0. Box 1165 Minneapolis, MN 55440•1165 Date APPROVAI; FOR PERMIT �✓� P4INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 ST?1TE SURCHARGE sus�ecr PERMIT . City of Fridley � g 2 � AT THE TOP OF THE TWINS g � I L D I N G P E R M 1 T r S � RECEIPT . � �L__..___ COMMUNITY DEVELOPMENT DIV. r � � PFOTECTIVE INSPECTION SEC. � / � � � � . � tp � � � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVEO BY �.---'�; ,.� 612-571-3450 9�0-F15 11/17/87 i i JOB ADDRESS 5468 Altura Road N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDfTION SEE ATTACHED DESCR. �.S 6 Carlson' s Summit Nianor North ADdn. SHEET 2 PfiOPERTY OWNER MAIL ADDRESS ZIP PHONE Ilenard/Dona Kos 5468 Altura Road N. E. 572-9544 3 CON7RACTOR MAIL ADDRESS Z�P PHONE IICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS Z1P PHONE LICENSE NO. 5 EPJGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITfON �7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install �ireplace (32" x 10" - 11" Chase) 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan 1N�Rl�iiVG �� I �`�` p � �8efare digging cail locai utiiitia� �� 'AT �� E�U�RED ��HaNE - ELECTRIC - � Ef�: , �'L I�M.BING A�� (� �,��[�� B�Y L,�,'� !G�$� SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, P�UMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD 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, 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 ANO EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUfiTAX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT S4�OOO S?.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONS7RUCTION. �44. SO PLAN CHECK FEE TOTAI FEE � $46.50 SiG IRLSREOFCON'RACTOAORAUTHOAIZEDAGENT IDATEI WHEN PFOPERLY AL DATED T S IS YOUR PERMIT � � • �� O TURE OF OW i1F NER B LOER� 1DATE1 BLDG INSP itiTE � N� �� City of Fridley Effective 411/86 ADDN, �G,l � R-1 AND R-2 ALTER. �� Euilding Permit Application Construction Address: �� uR� -�—""'"� --�l+ -- Legal Description: -'�""' pwner Name & �fldress: _. e� o,�r K b S Tel .� 5��- � Tel. # -- Contractor� Address: LIqING AREA: GARAGE AREA: DECR AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTIOlt OF IMPROVEMEI3T Length Width Height Sq. Ft. ___ Length Width Height Sq. Ft. Length Width _ Hgt/Ground Sq. Ft. ____._. �f��.�S�.� --i��--� �3�`� �C � ��'' � � � C 1-� E3S � Corner Lot [� Inside Lot [�-} Ft. Yd. Setbaek __ Side Yard Setback Type of Construetion: � 6O� �Y' �'�lc�° Eatimated Cost: $�%dd� Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: �$ $ See Back Pa�e for Explanation , � : �ATE: �� /G� ° APPLICANT: ��/ � Tel. #, CITY IISE ONLY Permit Fee Plan Check State Sureharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: � � t�, �U $ ..�...r � a.�u $ � $ �� 5� Fee Schedule on Reverse Side 25� of Building Permit Fee $.50!$1,400 Valuation $ 525 Per SAC Unit Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ ] �lo�� oov-- "�,�n �� 4 u, �� 'G---- ,.1 /y —i' � � � ______� ------.::_. ____ � 1��a'� !�, �> �-, 2., ,_,_ � ,� � - --� C �i .. _. . ----- � - �--�- -- - -- ._. . __� —_ � _ -- -�-- --- ^ . � . � � __ _ ___. _ _ . _ _- ,; I�- --; - :I . . ��_ , �� j ;�; __ � ;I � i- . . _ � � I ( ; , . ---- --- ;.: . -- --- � , _ __ - --- I- -- , .�� , -,l � � - �' - { _ _ __� � � � �--, � -� � � . ,,, < < � � ,� ,` , ,. �: ___. ______ _ p F' ; �.! �,r �'' ' � ' ; �► � c ' - i i � _=_ -�--. _._.__ - i i- -- _- I I �� ]� � � � � �� ` . �l �� _ L• , � ' ' ! 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'o — �T , i/7 � � \- �� '�= C?. _ -a � �: � `-1 �� „ �,;; �� - � � �I� G m � Y�� i i� ;� � �r , ,; ,� � _ - _ _ _, I + � - - - -- ; �� 0 �, r -- — - '-[--}-- � i � -� � .�,� . —- ---j o;w O -1;��. � �i--- -�� i �� r; � � �' � � i � � �__ _ _ � � ► �I�.- — — , T � `i� � i I� i� � I� �— — — —i + � � I � t�3 �� t� r- r I ^ �. r�f _� f � � :. r : < Z < � L} S� � � s � G � i �� C.� t � .� � �� „ ; 1--�� ,' ;.. .� ►� a Z' l9 %T� - - V �' V f' oo� _ x � �_ � t--� i 'J � 9' .t�, •_— � � ' �i � � � � ` . [i. ..�. `r' _ � � { � � � �� —� _...--,.__---+_ __�� . _ __ I . Y � �/v��. . �� - - - --------- ___. _ _ _ . _ _ _�`- - j _ — �� .> � ti ,- _ u - __. � e.., ac - _ f ``� � n_ � ; n o� �- -• T v ! � � � ^► �-b r' � i �. . �- � � t�` � �: .. V T � � .. I � \ d � �� , � , . w � a N r a �� r- -- �� . ... ,- ui �: � ► � � i � � r V��- ��1 � � � z •S . � � � "� 11 +i� � �� ;� �'. � z '�� ` � � 'o 4 � ,-� a �� . � �� _ � � � � � _ _. . t . . ,_ _ � � � �c � � - _ ` , .... . . j , � .. . .. .... .. .. . ..... . . . ..-. ,� .. . .. . . . . ... . .. .... � cb al _ _ ti : i�� ._.. . . 1�.� ._.... .. , !.,. -,. -'.. . � , ... . ...., .... , .... . , ... .. . ... ... . -, , �1. . ...w_.._ .., ;., , .., .. .� _. !.., a � ... . .. _ . _., �. . ._,.. _._. .. , � . .. . ....� V .._. 0 � CITY OF FRIDLEY Effective Date January l, 1991 APPLICATION FOR POWER NU1NT5 AND HEATING, COOLING, VENTILATION, REFRIGERATION AMD AIR CCtNDIT10NING SYSTEMS AND DEVICES RATE SCHEDULE QESIDP.[�TIAL Purnace Shell and�Duct Work, Butner U►l�o r�placWnt furn�se) Gas Pipinq (pipinq M�d�d vifh n�r turnaca) Gai Range Gas Dryer • Air Conditioning (all �izes) J111 Othera/Repaira and Altarations lt of Valus of Appliance or work COMNERCIAL/INDUSTRIAL lt ot Value oi Appliance or Work RBINSPECTION FEE S30.00. RATE TO'tAL S 20.0o s � ,v 0 S 10.00 S� S 10.00 S S 10.00 $ S 10.00 S /D.Ofi State Surcharga Taru ssa Rough In�p. Date Pinal Inap. `-� �� / � Date , Approval for Permit ��t,�r S s S .50 S ti/1, Sv s MINIMUN FEE FOR ANY HEATING/COOLING/VENTING PPRMIT IS 515.00 PLU9 THE 5.50 STATE SURCHAt�E •Air Concli tioners can not ba placed in eide ya� vithout, writtan pcnission fra� adjoining reiqhbor. Job Address s�/�� .%�,�ic� ✓�G%� y L: 8uilding Inspection Div. 6431 University Ave NE Ftidley MN 55332 Tel. No. 572-3604 '17ia undersigned hezeby makes application for a pecmLt [or tM wck herefn specified agreeing to do all work in strict accordance vith th� City Cvde• and rulings of the Departaent of Huilding9, and hsreby d�clar�s that all th� facta and reprasentations scaud in this application ar� tru� aod oozrect. � -- :7 . 19� OMNER �p,p-yi.C� �'� /�r/�d.� KIND OF BUILDItiG ��L^.� USED J►S TO BE OOl�I.ETED J180UT + S"-/'] .-`� / —_ ' FSTIMATED C0.ST <.c7 7L' O� �v � OLD - N61d BUILDING PERMIT NO. PERMIT NO. � /� DESCRLPTION O!' FUFN1►CE/BURNEfI FIEATING or POWER PLANTS, Stau�, Hot Water, WarM Aic- No. Trade Namo ��r-- -...-,.�y„� ,_,_ Sise No. Cepacity Sq. Ft. EDR � 6Y11 L�li, (i4 V NP 1+nca1 Connected Load � Kind ot Puel C,.Gty _ BURNER - Trade Naue _ _ Sise 1b. Capacity Sq. Ft. EDR _ B'Rl NP ,,,l�_ STAA�DARD NGt!.T!"ia !'."'� F!'i C�.'!DITIO^JING �pany � 4i0 WCST LF�'r:L= STREET signed By � �MINNEAPO�IS, MN 55408 i PHONE 8242656 - �,� T„1. �o. Fill out back side for stack verification on replacement furnaces = � ' `'r.G�'"� ;:r; ��:?Fr _. 1'j _ . vi';,ii:'i { T( tit; :`:':?i=: v�.:. : i Y;:� :,`s : .-' ' - '-;._.,u [�'�. {?:"_.. 1>r,�._� :ii"��t ,"_. 3;rv_;.._ �•:^'. .1.!: '._ _fi _ i�' C;I__ r -�.:- _'. '"' t i r_� i _�..r_. v� ri_iauJi_�"i i itii�i ._.. i jv v:.rl �i.. .+..� � Fii� ��`a .. i�� L��' � �'i� e.�.. i i_.�i _� a`_..:; i .. __ . . . ;.)t.. _ :�-. r:i�i'rl �!If� �-. j.�:j�-��4 � J_";,GA�S�_.'. iT', f�j:'�L d:+._i�fii-J �. s1..r'.�rv i'.:'lu. . 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City of Fridley AT THE TOP OF THE TWINS f 1 1 � L � • COMMUNITY DEVELOPMENT DIV. � `ti: ----- � r � � PROTECTIV� INSPECTION SEC. � � � � �"'1 � CITY HALL FRIDLE� 55432 �'"'"�� ,�� 612-571-3450 SUBJECT BUILDING PERMIT� NUMBER REV. DATE �AGE OP 910-F15 7/15/94 � � JOB ADDRESS 5468 Altura Road NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION oescR. 18 6 Carlson's Summit Manor N 2 PROPERTY OWNER MAII ADDRESS Leonard Kos 5468 Altura Road NE s r.nNracr.ma eeau nnntuss .__ -- _ 5 22722 �� ! � APPHOVED BY SEE ATTACHED SHEET 410 W. LAKE ST. 1072 PAYN E AV E. MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101-3892 612/824-2656 HEATING AND AIR CONDITIONING CO 612/772-2449 "cservina The Twin Cities Siaee l930' ORSAT TEST RECORD ADDRESS �' CITY �`� OCCUPANT OWNER DATE HTG. INST. �• ,� —`�/ INSTALLED BY � � � 7� GAS LINE BY TYPE OF HEAT: GA FA�HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN � CONVERSION MAKE ��v _�_�� MAKE OF R MODEL �'�.(,,,�/d � ��? CG. .%,1i�.7 MODEL SERIAL ,c2 �jQ ��%'�'[� �3 � 7 MAX. BTU RATING INPUT /Q p p�� MAKE OF FURNACE CONTROLS MODEL THERMOSTAT ,f HEAT PLUG �-- VENT SIZE �� VALUE ��i�Z KIND OF LINER SIZE �� NONE LIMIT �f,�/� DRAFT HOOD ----- REGULATOR 1�� LIMIT SETTING j 7(� CHIMNEY CONSTRUCTION �p-�-f- FAN SETTING Q/� ��' �` DRAFT �- TEST TAG � PILOT TYPE ��„� �� LIGHTING TNST. �.,a,� '��r� _ P I LOT MAKE Le� /!2 PILOT MODEL �✓f/� PILOT TIMING � ��,�� PRESSURE� PERCENT CO2 L DATE INPUT CFH � PERCENT 02 �,� STACK TEMP._C��y� PERCENT CO Q NAME TESTED �— � --� � OF TESTER `� �` N F,W ADDN AI.TER �} ri ll Consfruction Address: C.egal Description: � Owner Name 8i A dr eontractor: 1 �. �G� G Acidress: �� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-i AND R-2 Building Permit Application n-�.�c'.��o' -✓ MN LICENSE # Attach to this appiication; a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVTIdG AREA: Length Width GARAGE AREA: Length DECK AREA: Width Wi Effec:tive 1 / 3 /94 Height Sq. Ft. Height Sq. Ft. Hgt/Groun Sq. Ft. �a�/a- OTHER: a�"r -��ot/,�� sL,�'l.q�G .�//!� � 2. Q� T � ,��r� /�" : K Corner Lot [] Tnside Lot Ft. Yd Setback Side Yard Setbacks Type of Construcdon: Estimated Cost: $��l/�'i�/,� �CI� ��/C Approx. Completion Date: �� (Cost on Back} Drivew urb Cut W'dth Needed: F. 5 Ft = t $ =$ ATE1' "/� , APPLIC el. # -�� CITY USE ONLX Permit Fee $ �•� Fee Schedule on Reverse Side Fire Surcharge $ � ° � ` .001 of Permit Valuation (1/lOth%) State Surcharge $ � � $.50J$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ :� - C14 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above � Erosion Control $ $450.00 Conservation Pian Review Park Fee $ Fee Determinerl by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary (] TOTAL STIPULATIONS: , I � �i I � i l . �� ',�"�' � � . ;�� _ . -..e . �� -� g-� � , � `� . �� 5 _ __ _ _ __._ ___ _ _ _. _ _ __ ., _ �� _ _ . � . _ � " �'�� -� �� i �J , � �, ;I �ry� � I _ CO ; �; � � t � j l 'i` 1 � '� , I �� `1 .. �,_` � � � � ti , ._. ___ --- :_�� -__ - ��,. , --i ! ; 1 'y ' �'� t � : .� -.L.\ �. . � ..... .�. .. _ _ . .. .. _ _ _'. - _ ... . __".__._ , /^i ___ /' -,Ji il %� ! � / t . � . \ i� . �� y / � ; ' ' �� -_ -� ; ; � � �'� ,� /' � ;�_,� i �� . ;i : I�� )Ci = l� � � � �; 1' — � 1i i ;'�. •,�� y ��;� .- � n � ti� �� = �:_I ; �v l ° ,- i.� � � � � / ; �;� �:. �. ,L� � :ti'' ' :�/� i E _ 1! F � � --' �_—._.�.: .: � : „. e s � _ ..��_�_ -� __ �.:-_ - - _,; �; _ �.�i..�.�...-,-. - .— / Y.. . __ . � � -..r � , r�� , �' , � i \ 1 , _. __ __ . - -- - _._ _ ; , ,_= .,.�_..�_� _ .____ _ _ , _ �_-- _ _ _ ��f - , � i . � _ ; . :,� - - --- - . - ,_ -_ _ . , , �.. _ _ _ _ _-- -_ , , .-� _ - , - � - - - ; , . `' f �'- � �._ ' . ' ' ...d____-- - � _ _. ____ , . . - __ � ,. : _- __�.__ y , ` ; _, ; , , , � ;�-- � `� � ; � _. ,__ , , — -------._, --• - - - -. r; - , � �-._-� �, T-,. � �:.'� � . , . :: � ; • - - �. - , _ _ �_._ __. . -- - � , , . . _ � _ _-- ------ �" � ! �. , . t � _ _ ._ . _ . _ __ - � ,_, _ . ;.. - , . . � ' . - _ ; J �- �___- ,� � - -- - , --_ _ - - --..t_- _ _.,_ ,- � ' , � .L_ __ � � �f�. ,�j;� i `� � �U 0� �� : �X ��, � � �� x �� X.�� )/ / l �.� . (� / �' � / � �. � �"� r. /�� %l�j� l/1� /1.�j �t� U - � � �� C� I � a � �/ �(.� / l 5 �,��- �. l� s �� k� � . �� c11/l?b`' l ��. �� - t 1� ��1 � t�.k � � � � �, � L; /�: �� , � X�- _ _� . � �� _ _. _ _ � _ . _ __ _ _ _ ', � rc� l �� n - : , `� _ -- --s- .--._ :___ . _ _ _ _ _ _ �_ _ _ S-_ --- � i � � , _ _ � __ _ ,� _____ _) . _ _ i, �� % � c� � .� , ; CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002 6431 University Ave NE Fridley, MN 55432 APPLICATtON FOR POWER PLANTS AND HEATING, COOLING, VENT!lATION, (763) 572•3604 REFRIGERATION AND AIR CONDITIONING SYS7EMS AND DEVICES JOB ADDRESS � �� `� � �' � '-� . f �/ r � � RATE SCHEDULE � _ -n f OWNER �� C� ✓� CA-(�C, �\� S Residential Rate Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 but not replacement)� �;,r-e��qce Gas Range $ 10.00 Gas Dryer $ 10.00 *Air Conditioning - All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1°Jo of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTALFEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE ffi.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. TOTAL $ $ $ $ $ $ $ $ .50 � ��= ��`c'� �`�� C� BUILDING USED AS �L U�P �P '�['�� l,i/ ESTIMATED COST �QQ� PERMIT N0. �� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP ED The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO � Signec� ��¢�� FAX # �� Approved By � I DATE � — �l `Q � �a�`fl�� 1c � s �,tiC _ _ � � �S Rough-In Date TEL # C2 ��- 7��' � yl�l�� Final Date z �% -G� Building Inspections 763-572-3604 763-502-4977 FAX DATE� SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 YOUR E-MAIL ❑ OWNER CONTRACTOR NAME: t' �'1 �t. ✓ % ADDRESS: �� lv � /� � PHONE:^��,1j "�7 �� —� NAME: , ' ADDRESS: PHONE ��•— , � ° STATE LICENSE # � S r� �i V f � �/t.� LC.� PermitNo.: [:�x-� �t�3� Received By:� � �� %E' �_ � •''''L � �l�C CITY �.^.' > Iv STATE �hZIP= �� ? � /� � d�2 CITY STATE ZtP �9 l F� �r�>: L z EXP DATE ❑ SINGLE FAMILYMEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADD[TION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH �ROOF ❑ DRAIN TILE ❑ DECK � SIDING ❑ OTHER ❑ SWIMMING POOL � NEW HOME CONSTRUCTION ❑ ADDITION �'MAiNTENANCE/REPAIR ❑ REMODELING W INDOW S IN EXISTING OPENINGS ❑Yes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LENGTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE HEIGHT FT �� BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project. 2. Two sets of construction plans 3. Energy Calculations LOCATION OF WINDOWS NUMBER OF ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: n SUSING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ �� 1 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow � Erosion Control Park Fee Sewer Main Charge Total Due $ 4�7 ,� �'"� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ `', �— .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ ' $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that 1 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 accordance with the app ved plan in the case of all work which requires eview and approval of pl n. SIGNATURE OF APPLICANT �%�j'' ��b'� PRINT NAME �'%e✓� ��'Y1 DATE y—�"� APPROVED BY DATE Building PLUMBING Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-]9-09 _ .._ DATE �Ii�I -�'�'F' y YOUR E-MAfL ADDRESS SITE ADARESS ��IQ �j � I 1�.1�Pi. �� I�I.'�` THIS APPLICAI�IT IS: ❑ OWNER '{�ICONTRACTOR PROPERTY NAME: LPD�'i,�� I�OS OWNER/ ADDRESS: �J�� lAi✓� 1� � � __ _C1TY TENANT pHnNF.� �7''7 ti �'2� - �I �7 `1 `I CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSUR.ANCE PERMIT TYPE NAME: I�iV'C.{�' STATE LiCENSE # STATE BOND # ADDRESS: `� Z� tv �%L� � �1� � �I __ CITY� PHONE �iyJ��.ri�' �ilr?� --- FAX � �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � a NEw DETAILED DESCRIPTION OF WORK �REPLACEMENT Permit No.: Received By:_ Da�d�� STATENi/�I ZIP EXP DATE EXP DATE �_STATE�ZIP � � �'i'Sl�� 29�Sr FEES ARE BASED,ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. F(XTURES: (INDICATE TOTAL NUMBER�OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER _ WATER PIPING BATHTUB GAS PIPING (t�IEED CITY LlC) SW[MMtNG POOL _ WATER SOFTTIER ($3 CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. $1 ) DISHWASHER LAUNDRY TRAY =WATER HEATER ($35) FOR IRRIGATION — ! WATER METER _ OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT l��wV�' t�`��t n,� PRINT NAME i�'i'� C�ffY'�_DATE � r S D City of �ridley Building Inspections �epartment 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 r AX: 763-�02-4977 tit«�$ Building MECHANICAL Permit No.• Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLE�' Da{��' '� DATE t�p�('. Oc-0 � Oc�� t YOUR E-MAIL ADDRESS SITE A DD �ss �(05'6 A��t� �� `�l 1J& THIS APPLICANT IS: ❑ OWNER �7CONTRACTOR PROPERTY NAME: `.. � koS OWNER/ pDDRESS:_ �� p� `�la.r � �-d �� CITY �r �� '�l STATEmN ZIPSS�1�� TENANT pHONE: ��3 � 51 oZ - G S�L �{ CONTRACTOR co�rArr� NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN � INKEN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH pDDRESS: �32� EVERGREEN BLVD STE HITY COON RAPIDS STATEMN ZIPr3S433 APPLICATION PxoNE 763 — 757 -- 6202 FAx 763--757�-6701 PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY � TOWNHOUSE TYPE OF WORK: � NEW �.Q REPLACEMENT ❑ ALTERATION/REMODEL DETAILE1D �ESCRIPTION OF WORK �` �AC► r +� Q,i r it�c� � � O`C1 e 1� PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or reptacement 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. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) ^ Equipment Instailed MFG:I.A�'r''f' ��' MODEL: �� m�!C � SIZB� �� O�� MFG: Q r r i B r MODEL: �p I�Sa SIZEBTU ��S MFG: MODEL: SIZEBTU ✓C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 �URNACE $35.00 GAS UNIT HTR $]0.00 CHIMNEY LINER $1 �.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $]0.00 GAS PII'ING $10.00 VENTILATOR$15.00 PERMIT FEE PROJECTS FOR UNDER $500 ' PERMIT FEE FOR PROJECTS OVER $500 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 l x$25.00 =$ aS•dC� Number of fixtures @ $35.00 � x $35.00 = $ 3S ,� State Surcharge = $ .50 Tota1= $ (� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII. PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT J p-� �' � T rrnt� ROGER HOFFHEIN DATE '-t' �� ( PLEASE NOTE: SEPARATE PERMITS ARE RE UIIZED FORBUII..DING, ELECTRICAL AND MECHATTICAL WORK' `': City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS �XISTING HOME ❑ MA.KE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 S. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manu�l D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.