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AF - 46974SUBJECT . City of Fridley 108 AT THE TOP OF TME TWINS g U I L D I N G P E R M I T f ; � RECEIPT NO. • COMMUNITY OEVELOPMENT DIV. ' ; L��"�� r � � PROTECTIVE INSPECTION SEC. � � . l---• �;�'��;'� CIiY MALL FRIOIE� SSIjj NUMBER pEV DATE PAGE Of AVVROVED 8V L 1� 612-571-3450 9t0-Ft5 6/22/00 / / 108 ADORESS 6330 Arthur St. NE t LEGAL �OT NO. BLOCK TAACT OR AODITION SEE ATTACHEO oesca. N 160' of2 2 Spring Valley Addition s►+eer 2 PROPERTY OWNER MAIL ADORESS 21P PHONE 3 CONTFiACTOR MAIL ADORESS 21P PNONE LICENSE NO Timberlane Homes, Inc. 1512 - 92nd Lane NE, Blaine, rIN 55449 784-2200 2309 � ARCHITECT OR DESIGNEFi MAIL AOORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL AODHESS ZIP PHONE LICENSE NO B USE OF BUILDtNG Residential 7 CIASS OF WORK � NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 OESCRIBE WORK New Construction 9 CHANGE OF USE FROM TO STIPULATIONS For stipulations, see attached plans. TYPE OF CONST. OCCUPANCV GROUP OCCUPANCv LOAp SEPARATE PERMITS ARE REOUIRED fOR ELECTRICAL, PLUMBING, MEATING. VENTILATING OF AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT. AUTHORIZED IS NOT COMMENCEO WITHIN 60 OAYS. Op IF CONS7qUCTION OR WORK IS SUSPENDED OFi ABANOONED POR A PERIOD OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIfV THAT I HAVE REAO ANO EXAMINEO THIS APPIICATION 1 STALLS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION SUFiTAX ANO OROINANCES GOVERNING THIS TVPE Of WORK WILL BE COMP�IED WITM WHETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $166,349.00 �H3.17 �OES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TME pEqM1T fEE SAC CMARGE PROVISIONS OF ANY OTHEA STATE OFI LOCAL LAW REGUTATING CON• STRUCTI TME PERFORMANCE F CONSTRUCTION � 1, 368 . 95 Fire SC $166 .35 PLAN CNECK FEE OTAL FE Lice S 5. $3 73.47 •TU ONCPACT Oa• TMOpf2EDAGENT io�rE� P P L A ATE S IS UQ��T� r S�GNniUAEO�OWaEA��FO Ep8WL0EQi iO�TEi 8�0 �NSo � ��R�E s ,' . 1-� N E1lV [ ] ADDN [] ALTER [ ] Construction Address: �' I � Legal Description: ,�' % CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � �l� r�r� i��z �� . .f�l. �1 �i �� _�,�i2�a'� �, �( (�� Effective 1 /1 /2000 (763) 572-3604 Bldg Insp .� BP��o 8� Owner Name & Address: Tel. # Contractac: ` � M ��'t�C , �ir('1� �S�C MN LICENSE # ��`"i Address: � �� q �C� l ,A �r � iV��, �� I � � .�%�� Tei. # �,� �J° t �'�`-�� U Attach to this application, a Certificate of Survey of the lot, with the proposed constnaction drawn on it to scale. DESCRIPTION OF IMPROVEMENT � / !/ LIVING AREA: Length J� Width �� Height Sq. Ft. � i� �� ii GARAGE AREA: Length r�� •'� Width s�Z_'� Height Sq. Ft. �ECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �C�/7- /�`rjv t�Clf.v� �' / l�/f.%� . ,` (�,,,�,� ��s „ L'.�o� x G 3, ss� : r18 d s.S' Construction Type �N„�,i� �-�I \� , Estimated Cost: $ � � X � �+ � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _��G� .� �� DATE: C 52-�4'�� APPLICANT: l� � Tel. # 1� OJ ��5�'� v�J CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Call (763) 572-3604 for Permit Fees if mailing in application � l3G$.1�✓�Fee Schedule c $ /G �o, 3S' .001 of Permii $ �'� � /% $.50/$1,000 � $ //GY, • d 0 $1100 per SAC $ v� �U $5.00 (State Lii $ Alt. "A" or Alt. "I $ $450.00 Conse $ 7`�_ O �J Fee Determine � Lisa Blomquist 784-2200 Fax 784-2394 1512 - 92nd Lane N.E. Blaine, Minnesota 55449 Bldr # 2309 Sewer Main Charge $ Agreement Necessary [] Not Necessary [] T�TAL STIPULATIONS: �7.� i 2i�� a�� oa� % .�'� .�� p6��1. � � , �I . ,- r 0 t , ► CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATI�N, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BAC� 1% of Value of Appliance or Work Commercial/I ndustrial 1.25% of Va{ue of App{iance or Work Rate TOTAL $ so.00 $ �, DO $10.40 $ �Q►Q � $10.00 $ $10.W $ $ 25.�0 $�p State Surcharge �� TOTAL FEE Effective On January 1, 1999 •: �� / � � / � s . 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 re true and correct. . �� OWNER_ ��i")'ll. �.G.Gap �m�vC BUILDING USED AS �� Q�,��,{ ESTIMATED COST� DD I�C� PERMIT N0. / �� DESCRIPTION OF FURNACE AND OR BURNER � � �,� No. of Heating Units � Circle One (Stea�j�'�)(Hot Water) (Warm Air Trade Name `✓� 58' 0�0 �Z�-/�ize No. BTU Qd� ' HP EDR $ Fuel ' Total Connected Laad�� Cf , $ .50 �, � �. MINIMUM FEE FOR ANY HEATING/COOLJNGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without F� written permission from adjoining property owner. Burner Trade Name Size No. B� HP EDR HEATING COMP Y ,¢ ' • �r`�� Signed Sy 1 ^ Tel No._7�3 -�%17-�7d Approved Rough-In Date Finaf Date /--�� CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No () 2. Is free from rust or deterioration 3. Has nn foreign objects lodged within � 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes()No() Yes ( ) No ( ) HEATING CO: Signed By: Date: � 0 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: NO. RATE TOTAL New Fixtures � Old Opening, New Fixture Beer Dispenser Bfow 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 $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 p� v� 0 /d•oo JOB ADDRESS C9J �C7 /7rT�•�f S�'�' 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. Owner 1 � `'H � M f �-, .-L �'" "'�� . Building Used As � � � Estimated Cost $15.00 PLUMBING � � � , 20 C° PERMIT NO. / � / ��' ' ,r� �- k s �f�-. ��.- �r' C' Reinspection Fee $47.00/Hr SIGNED BY TEL N0. �� .� s� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5°to of Vatue of Fixture or Appliance Approved B Rough-In Date Final Date /d �3 '� State Surcharge $ .50 TOTAL FEE $ J} �, Sv PLUS THE E.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 1-u.. 1., .... .... „ „„ .'.i�l il�.,Lu1,, lit.,......�l.,t� i.... �t�.. „'i_ .Uf �J7..'1 i. 1 � � �/Y�Yr1Ait+�M+�V�..f v.v. . .. T1�t�1Cd B�ALANT �3Y iN3U�ATOR9 1/7' F�'LYUlOOC7 l�ti��f�l._A`R'�1�NT CJ'I�i 3/8' f�I..YWOOq flU��,f�OR ; � : �� i-JC�1�T8 �Is't F�AN ; ; ► ; � ��rt .�oi�T , 's . a, 0 .- , . S!8' GYPStA"t BaA}�D � � E �/\��V� W��..i . E>cT. FIN18N P�f� �LE. t Zg��2' gN�ATNlNG ! 2 k b �TUi73 �16` O.C. � �• 19 IN3tJLATION ; � MIL PO�Y v�Ai'OR � I!Z' C�e1'F'�3UM E�OARD CAULK J01Ni ��TW�EN PL`rU100D t l31LTf21TE C�NTINUOUB t�EAD OF G�U� 3�4' O.S.lS. 9N�ATNIN�'s I t/�' �01�.�AGK F21GID INgl.1L,A710N GAUI�K JC�fN1' ��Tt!lE�N PLYL170vC9 ! F3lLTRItE l�l:tl 1'.. _., .-a. „__ :.i:i 1�vi.L'1, ilivt;L::ilvil l:... ii:. U1:. iU'Y U�.)l . � w.......-..... . ._._. .�,..... .. ..._. . . , .. . , . . . • tf�MCO 9LA�ANt �Y }NSUI.ATOF2g i�� • �t. Yw�av UNp�IpL�YMENT �+i ��8' PLYIlaDOD �!,l�I,.00R I-JO(mT4 P�R PLAN y . 0 � • ., ��` C9YF'3UM �ARt� i ,, 2 A�r.a a r. � -.�. �......_... � �ycT�RROR U1Al..�.� �xT. FiN18W f�ER ELE. 73�3?' gN�AtNtt�iCs Z x b 8TUD8 s1b' O�C. R-19 INSU�.AtiO�l 4 MIL PO 1" 1iA1"'OR �n' GYPg�A�t !'�OARO C,AU1.lC JDINT �ETU��N PLYWOO� 1 ESILTRiTE c.c.�vrir�.�oua �Aa oP' Cs�.u� 3/4' OgRS. 9N�ATWfT3G ? x !?� P 7. �.�i�Ei�i DD. W/ 3/8' RNL�. E�i�TB PER GOp� v�ERlfY W/ BUPERINT�hifaENT tfME��2 t3O/�f2� OR L Vl.. Rlh'i _ CAULK JOINT �i'UI�EN P4YUf04L"�� 0 Si�.tRiTE 1_. � � � � � � a �4 t'�. � � � �,� I l� �.�._ _ �CA�.� i'=I'�Q�� uu.� 1.. .,., .-., ,. __ .:ri i�'.rf.L'�., lli.Ji.:.i1'.;li ' �a M►v.•��..• • Yt�!"iC0 8EA4.ANT �r lN9ULmTOR9 !/� ` 0°L.1ru�i� 1�1p�I�AYMENT G�N �3/8' 1''i.YUK��7 8�!°.�LOC�� • �� 1-J41at8 h'��2 1�'LA�1 d , ��i'`� JC��a 1 a . , --` �/t°�' G'Yp$UM BOARD �t�l�t�1" U)Al.L= 4 Ml�.�. P�L7 vAPOR � x�$'Y1.ID 9 � I b' O�C. �'2-1t lt�l8U1.ATIC�hI d 1`�tt�, t�'Oi.Y v�4PrJ1Q �n' GYP�UM SOARD 0 c:... �i:. 1.�1� rG�f G�Jt r. 3 m �XT�i`'tlor� tu,�l.�t �XT. ilNi9� f'�R El.�. 7S/3?' 3NEQ1WiNG ? x b 9TUD� �!b' O�C. � R-�9 �Ngu�.aTicx�t 4 M1L pOLY vAp01Q I/Z' GYPaUM l�30ARU � Cc71�iTINt,tOU9 �3�At� �-OF G�U� J----G�4ULK OR g�ALANt �- ► � ---3/d' O 3.�3 B�ILATNtNC3 1� 1!'1' �OI�. i�3AC1C�D �f�IGID IN3U�,ATlON � ?x%(bF'7.$1L1. ----�--�- UJ/ i/?' RNi�. t�4LTS � 4' - m' O.C. �-- G�ULK C�R 8i�/�LANt �, .. , . ' � 91LL g�At��l�2 � �• . Gt�D� .. . .; . , . • . ��• � . ,•'. . � �. � � . � : - �� ., .; � .: . �, a . 9' x 8' P.Ci.U. w� �AM�r�t� �� i i : i - _ CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVER5ITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 � FAX (612) 571-1287 October 18, 2000 Timberlane Homes Inc 1512 92 Lane NE Blaine, MN 55449 Re: Final Reinspection at 6330 Arthur Street NE, Fridley, MN Dear Sirs: A final inspection was conducted on October 17, 2000 of the above address and the structure was approved as constructed. The structure is approved for occupancy. If you have any questions concerning this matter, please feel free to contact me at 763-572-3603. Sincerely, RON JULKC�W: Building Of�fcial RJ/m h ___, _ _�-. CITY OF FRIDLEY PERMIT :: 2004-00826 �_ _ _ __-�'` 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004 ►63) 572-3604 FAX: (763) 571-1287 � ADDRESS : 6330 ARTHIJR ST NE PIN : T000045 LEGAL DESC : SPRING VALLEY : LOT 2 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. ADD THREE FIXTURES IN BASEMENT BATHROOM. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # GAS WATER HEATERS 0 # GAS RANGES 0 # WATER TRMT APPLIANCES 0 APPLICANT CHARLESKOCOUREK 6330 ARTHLTR ST NE FRIDLEY, MN 55432 OWNER CHARLESKOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ord'mances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating constr�ction or the performance of const}-uction. Annli nt : /I Date � � Bldg # GAS DRYERS # OF NEW FIXTURES PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 � 0.00 30.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 30.50 _� CITY.OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 ��c�3z Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE �� $ $3c�� JOB ADDRESS � � � � ��'T��Y �l � .� I/. � The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with ihe 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. � Z� � DATE: � , 20 OWNER Cl�cc�f �s �o c� vr-� �' BUILDING USED AS �-r �so w� I ��si (�'' �H �-� ESTIMATED COST PLUMBING COMPANY SIGNED PERMIT NO._ /�' 1.�� l'' l�-� �-�` �" TEL N0. /�J'�S Z� z�� Approved By �V �i 1 Rough-In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE ADDRESS PIN LEGAL DESC CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 : 6330 ARTHUR ST NE : T000045 : SPRING VALLEY : LOT 2 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION ___..,.,�---�. PERMI O.: 2004-00823 ; DATE ISS . 2004 VALUATION : $ 3,000.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. BASEMENT REMODEL PER PLAN. APPLICANT CHARLESKOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 OWNER CHARLESKOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the yisi s of any other state or local law regulating ' n performance of construction. Applic Date b'Z-�� Bldg Insp Da�� BUILDING PERMIT FEE PLAN CHECK FEE FIRE SURCHARGE STATESURCHARGE,VALUE TOTAL ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 83.25 54.11 3.00 1.50 141.86 NEW ADDN ALTER [ ] �,��.-'� [ ) ��;i�' � � L� j �� ,, Construction Address: CITY OF FRIDLEY 12,'�'� �� Effective 4/1/2004 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 5�3 � - � ��- :S -�� (763) 572-3604 Bid (763) 571-1287 Fax � (\ ^�� ,� �JC, �` ' �1' �. \ Legal Description: -'" Owner Name & Address: ��G r�x J i'I G fGVr r�t ��m L��_ Te�. # 76 3--� UZ -`�� Contractor: !!/ D.'V E _ MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height ��` Sq. Ft. j� �� GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. QTHER: i� a� t r-t -� �� •� �`; h,�s % Construction Type: Wo oc� ��rm -� Estimated Cost: $ ^� � �� r Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ r DATE: �� k �y APPLlCANT: ' Tel.#7�3-sa�-�986 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee �4�.�s�$ �� Fee Schedule on Reverse Side Plan Review -�� t/ $_ -�"�fi 65% of Permit Fee Fire Surcharge .� GC.$ 7 .001 of Permit Valuation (1/10th%) State Surcharge%Slffi � $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] G � � � J . �: � _.-�- TOTAL $ '- ST{PULAT{ONS: RM1{� � ..,� i .�.'a�� . ;t•�.. ..{:;"...,,, y , i ., _. ` �,`. 'Z�-J N-� 2 2�l y S 2 �r � G, 2c.1 x 3� 2/X 3 i'` I ��uu��±�u�rya+�, a`sa,� �;v,,., , :�.,..::, . �. . ; ,,,... , . . .. � � � � --- — --� —.. -- ____ — _ _ .�� . _ . . _. ._ � � . . , � ; .. .. _ �-- — _�._ � � _ — ,y, *..: - _, , k . �_ `_ � —�... .�_. ..�. � .. _ ' • I ,w ^.w!. J-�� I J v `� � ll.l U � , 1^ i �i� a T`- !.� , � Q Q \ ' ; , �; � � � •� � ; �,:� J � � � ,, � i - N :� � � � � ` v% A .� �` . � / 1 .° i i J + � �S ��• � � U m x � � � � c v �� ! � � .� � u t . 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NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 2 PARK FEE APPLICANT CHARLES KOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 QWNER CHARLES KOCOUREK 6330 ARTHiJR ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) PARK FEE ELECTRIC FORM FEE STATE SURCHARGE, ELEC FLAT TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 40.00 0.00 1.00 0.50 41.50 CtiY OF FRIDLEY BUILDING INSPECTION 6431 Uni�.�rsity Ave NE � Friuiey, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes � ��3� Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee JOB ADDRESS v'•� � C/ ��- ��T� v!� S`r": ✓(/. � Total r Owner C h Ccv l'�.1� %�p C' ��,, y-c � $35.00 $ Building Used As ��vs �n c. / Yc-�.f'; /'�� K C� $10.00 $ ESTIMATED COST � �� PERMIT NO �on�'' C�U��- $10.00 $ $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) 1°� of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Im/�provement whichever is gr ater y r-'/ �(� �V C �7 W >Y � �� G<J < M �l +t / � �DirS Commercial�lndustrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR $ DESCRIPTION OF FURNACE AND BURNER # 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 EDR The undersigned hereby makes apptication for a permit for the work herein speci�ed 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. $ HEATING CO3 $ l�;�O *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE FAX # -re� # �76 3 -v'-02�'�'� Dat Approved by � Rough-in Date Fnal Date ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE _ �----� CITY OF FRIDLEY rEx� rto.: 2004-oos2S ` NI � 6431 U VERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/02/2004 ^ 57L-36U4 r�AX: : 6330 ARTHUR ST NE : T000045 : SPRING VALLEY : LOT 2 BLOCK 2 : HEATING : RESIDENTIAL : ADDITION/ALTERATION :Y/ Q l��t��l VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A ADD DUCTWORK TO BASEMENT ROOMS. # A/C UNITS #FURNACES # GAS RANGES APPLICANT CHARLES KOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 OWNER CHARLES KOCOUREK 6330 ARTHUR ST NE FRIDLEY, MN 55432 0 VALUE OF APPL OR WORK 0 # GAS DRYERS 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law re cons�j ction ar the performance of construc ion. Ann ant I\ Date I� Bldg Inspt� HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS PIPING FEE GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 200 0 15.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 15.50 Bui��ing Inspections 763-572-3604 DATE � �� S SITE ADDRESS G33 � THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION YJ u ❑ OWNER PROPERTY OWNER/ N,q�: �_G�-r TENANT �D1�ss: (o3'�-d CITY OF FRIDLEY YOUR E-MAIL ADDRESS ,i�rn I�'J��G' ❑CONTRACTOR PHONE: 7(,r 3— 7roG `q�Qr Cc CONTRACTOR I NAME: Tv� SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: CITY i .� ^� STATE LICENSE # � f �ot�I G�� EXP DATE 3 i a G ADDRESS:_I�ao 37 � CITY_ �HONE C/>- Y� 3��7 FAX 7�03� a'° ��S �g SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADDITION � ❑ GARAGE/SHED ❑ WINDOWS BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER � ❑ SWIMMING POOL � ❑ MAINTENANCE/REPAIR DESCRIBE WORK BEING DONE: �.,. �� y��,w a SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other ❑ REMODELING Permit No.: Received By: Date Rec'd: , � - 1 , c-o � TH fi% � WIDTH l� � HEIGHT ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS 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 V � AT�IZIP, �� BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ L%(�p (� �% 5 U OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ �/%_ �� $ 7a . 3i $ �.� $ $ S , GY� $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( Make checks pavable to: Citv of Fridlev THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED Attach I hereby apply for a building permit and I aclrnowledge 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 pe it 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 wh' r revi and approval of plans. � o SIGNATURE OF APPLICANT PRINT NAME ��i J�'�� DATE �' �v � � �__ :� _ � ; , ; ; ; � ` � . , � c � �St v � �tJ �c +J ��';� �5 �� S� `t 11R-r , � `��. 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