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sus�ecr PER .���
City of Fridley _ 15 7 51
ATTHETOPOFTHETWINS gUILDING PERMIT �
r
; � CEIP .
� ; y _.____ COMMUNITY DEVELOPMENT DIV. �� �� �
r � � PROTECTIVE INSPECTION SEC.
i � �
� � /���1 i CITY HALL FRIDLEV Sb432 NUMBER REV. DATE PAGE OF APPROVED BY
�"""� � ,�� 612-571-3450 910-F15 5f 28/80 � �
JOB ADDRESS 6259 Baker Avenue N. E.
1 LEGAL LO7 NO. BLOCK TRACT OR ADDITION
DESCR. 2 Moore Lake ?3ighlands 4th
�
2 PROPERTY OWNER MAIL ADDRESS
Dale Beihoffer 6259 Baker Avenue N.E.
3 CONTRACTOR MAILADDRESS
5ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
8 USE OF BUILDING
Resideritial
7 CLASS OP WORK
571-1555
ZIP PHONE
ZIP PHONE
21P PHONE
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
LICENSE NO.
0 NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
�� Reroof Dinrelling
9 CHANGE pF USE FROM T�
STIPULATIONS
Raof can be 2nd but nat 3rd roof. Install ridged galvanized valleys.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Asphalt
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL 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
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 GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED y�],�OOO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7� 5O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATUR�C�F CONTRACTO� OR
OCCUPANCY GROUP OCCUPANCY LOAD
S0. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$. 5Q
PLAN CHECK FEE TOTAL FEE
,�__„ �, �`8.��
ioaTEi WHEN PROpP�ERLY/ ylALIDATED THIS IS Y
�2. i � IA � /1 b A n // / Y�i r. � �l .
�ERMIT
�/��
A
CITY OF FRIDLEY � •
ARPLICATTON FOR RESIDENTIAL QUILQIP�G PERMITS
{PJew, Alter�tions, Additions, or Repairsj
� .
(iWPdER: � �L� � / I'� � � � � � BUI LDER : � �1"G'n � ,
m
ADDRESS: � 2, � /��'K�/� �l� ADDRESS: -
TEL �d0: S`� �'" lSS ;a 7EL NQ: '
Construction Location
STi�� NO : !� � S ` STREET: ,��F� �� ��.�_.i._'� �. ��...
LOT: � BLOCK : ADAITION : J�6�:`� � �idCl� T�
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certiticates of Surv�y of lot and
proposed buiZding location drawn on certi.ficates to scale.
DESCR�PTIOtJ OF CONSTRUCTION -
Q � Front: Depfih: Height:
usc� Squa�e.Feet: Cubic Feet:
Front: Depth: Height:
Squa.re• Feet: Cubic Feet:
Type of Construction: ����� �P�1"��` Estimated Cost: $ %�0 �
�' . ' .
�b Be Cbmpl.eted: ��G( I / < ���
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $�$
, SEE REVERSE SIDE OF SHEET�,
The und�xsigned hereby makes application for a perniit for the work herein specified,
agreeing to do all work in strict accordance wfth the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application e true and rect.
r� � � i�. � � ��
nAT�: �2(� Z �"r l i�'��
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Stipulations:
� �.��
,�v
� �.�
SIGNATURE:
c
.._�
��� C� ��� �� �
�.�� �vo � � � �
��� � �YL�,_ �� � ��6J �� U "r��r Z � � ��L� .
_ y,�'
0
_,,,g,�,+�s,.
BUILllItJG P�Rf�1IT FEr S�HCDULE' .
S�CxI01�. 2. The 7nspector. ot l3uilding� :�}ia]:�., r,cfore a.ssuing ��cr.miL•s for the crect•ion
of any }�ui7.ding or struct:ure, or �or a�iy addi.tian t-o any exi�ting buildinq or structure,
. oz for any alteration or repairs to•any exa.�tinq b.ua.lding or sL-ructurc, up�n applica�ion
�L-hereiore, requzre the rayment by the applicant i'or. such permit of fces to. L•he amount
hcrein bel.ow set tarL•h and in the manncr herein proviclecl to-wit: �
I�r4� CONSTP.UCTION: Single i'amiJ.y FIomes and Garages: $4.00/1,000 cubic ieet. • �
P]'�N C1iI:CY.: 25 percent of bui.lding pexmi.t fee.
DRIVES�?AY D�PRI:SSS021: (Concrete, Curb Streets Only) ' �
� Ali�ernaLe A: R�moval. and regl.acement of concrete curb and
gutter only.; Driveway width plus 6�'eet x Yi5.75
Alternate B: Removal and rep].acement of cancrete curb and
. ' gutter and a.nstal]. a 3 fooi: wide approach with '
' . � 6 i.nch depth; Driveway width pZus 6 feet x$17.85
•� . � ADDI T IOf�/�L I NFOf3�"�AT I ON
I'or the purpose of camputing £ees for building permits, the cubica3. contents of any
building or addi�ion, is dctermi.ned by mu1L-iplying fihe ground area covered from a
paxnt sir. (6) inchcs below `thc floor line of the basement or th� cellar to the
average heights of i:he upper surface or to the average height of the roof surface -
of tlze riain gable of a pitched roof .
For repaixs or alterations to an existing structure, the fee shall be at the rate
oi $3.00 xi�r each �ive hundred dollars-($500.00) or £raction thereo£ in the cost
of all pxoposed work. � . '
Tn•no case sha]1 the fee charged for any permit as set forth in Section 2 be less
�itan $7.50 p].us $.50 state surcharge. , '
• : � � � ►1; �
NOTE: Pcrmits �or construci.a.on tai.11 be issued a minimiun of 24 hours from the time
of application to allow for pxoper review ot the proposed sfixucture and of the
construction site.
11 Certz.ficate of Suxvey of the lot, showing the location of the foundati.on OIlC� i.t
has been constnicted will be required before proceedi.ng with the framing.
C�RTIFICATE QF OCCUPl�NCY �
Application for a Certificate of Oceupancy shall be�made ten (10) days prior �o the
use or occupancy of any si:ructure for which a building permit has been a�ssued; and
sa.id structure shall not be used or occupied until a Certificate of Occupancy has
b�en �ssued.
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� Dear Siss:
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CITY O� FRIDL.EY
UNIVERSITX �VEMUE N.E.� FRIDLEY, MIMNESO'T� b5932
TELEPHONE ( 812)571-3450
1980
�
This letter is to release the City of Fridley and _ Churchill Heating & Cooling
from damage alaims, due to possible chimney deterioration fran lack of a
chimney liner at 6259 Baker Street N.E.
It is not possi.ble to line the existing ch:i.mney, due to the rectangular
conf iguration of the tile, not perznitting a liner of suff icient size.
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CHIM�dEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (,)
2. Is free from rust or deterioration Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported Yes ()
- 5. Meets all current Code require�nents ��r size arrd
total BTU connected
6. Has Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
No ( )
No ( )
No ( )
No ( )
Yes ( ) No ( )
Com pa ny
Signed By
Da te
�
��
sue�ecr IT NO.
City of Fridley 2 7191
AT THE TOP OF THE TWINS g � I L D I N G P E R M I
�
; � IPT NO.
� `y _ COMMUNITY DEVELOPMENT DIV. �� �
f � � PROTECTIVE INSPECTION SEC.
i . �
i_-_- � �'�';,� CITY HALL FRtDLE� 85432 NUMBER REV OATE PAGE OF APPqOVEO BY
L J� 612-571-34b0 � 910-F15 8/14/98 / /
JOB AODRESS
6259 Baker Ave
1 LEGAL LOT NO. BLOCK TpACT OR ADDITION SEE ATTACHED
DESCR. 2 1 Moore Lake Hi hlands 4th SHEET
2 PROPERTY OWNER MAIL AODRES�S ZIP PHONE
Dan Caneva
3 CONTFiACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
M.P. Johnsen Const 8011 60 1 2 Ave N New Ho e 55428 720-3025 20146064
4 ARCHITECT OR DESIGNER MAIL ADORESS IIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK � REPAIR ❑ MOVE O REMOVE
O NEW � ADDITION ❑ ALTERATION
8 DESCRIBE WORK
Reroof house and ara e 23 S Tear-off
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBINCi, HEATING, TYPE QF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2E0 IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE HEAD AND EXAMINED THIS APPLICATION STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT L .96
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION O TH PERFORMANCE OF CONSTRUCTION. 6 Fire SC 1.92
PLAN CHECKFEE TOTALFEE
7 .13
SI N RE OF CON'RACTOA OA AUTHOAIZED AGENT IDATEI N P OP ALIDAT D HIS IS R PE IT �
� r
SiGNnTUREOFOWNEAiiiOWNER8U4DER� iDATEi BlD �NS� - � ryaTE
NEW '
ADDN
ALTER
[l
Ll
[l
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor: N .
Address: �Ql { �i�,� �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
` � �9 BUILDING PERMIT APPLICATION
��
��-- ��1� � �
n
;�" "' Tel.#
MN LICENSE #��� (�./�,��_
Tel. # ��-('J �(���
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
�
��2 � o,C�
� °� � �
Construction Type: � Estimated Cost: $ ���C�
(Fee Schedule on Back)
Drivevvay Curb Cut Width Needed: Ft. +d6 Ft = Ft x$ _$
DATE: � ��/ �� APPLICANT: Tel. # � —�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��•�S
$ l, 9�
$ �9�
$
� � Q�
$
$
$
$
$ ��- !3
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 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 [ ]
BUILDING PERMIT FEE SCHEDULE
The Chief Building O�cia1 shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit: �
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $SOO,Q00
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,0(� plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 fQr first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 000, 000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Altemate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth = Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
0
City of Fridley
AT THE TOP OF TME TWINS
�
� �
� • COMMUNITY DEVELOPMENT DIV.
� i V � ���
r � � PROTECTIVE INSPECTION SEC.
` --_-�� �"' �•� CITY NALL FRIOLEV 55132
� 763-571-3450
SuB�ECi
BU ILDING PERMIT
NUMBER NEV OATE PAGE
s�aF�s 8/13I03 /
10B ADDRESS 6259 Baker Avenue NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
OESCR. 2 1 Mo�re Lake Hig:
2 PROPERTY OWNER MAIL ADORESS
Pam Caneva 6259 Baker Avenue NE
3 CONTRACTOR MAIL ADDRESS
Affordab3.e Concepts Inc 5738 Nicollet Ave S
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER
Residential
7 CLASS OF WORK
❑ NEW
8 DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM
MA1L ADORESS
4th
33797
R NO.
� � �
OF APVROVEO 8Y
/
SEE ATTACMEO
S1iEET
763-57Z-8817
ZIP PHONE LICENSE NO
., MN 55419 612-866-2315
ZIP PMONE LICENSE NO
20276331
ZIP PHONE LICENSE NO
� ADDITION O ALTERATION �] REPAIR O MOVE O REMOVE
TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a wea�.hEr resistive
� barrier be placed over exteri.or sheathing to protect the interior wall covering.
Exceptions for this provision would be if she�.thing is an approved weatherproof
panel or whe�. the siding is an approved weather barrier. Vinyl siding is not
a weatherproof covering u�xless the manufacturer states this in their application
guidelines. Call for inspection of wrap before covering or take pictures. Caulk
and flash all exterior ogenings.
�ermi� �n�����oon �ards
i!I e Mail�d
To Ho �o ��r To P�st
SEPARA7E PERMITS ARE REOUIRED FOii ELECTRiCAL, PLUMBING, MEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
VENTI�ATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULI ANO VOID If WOFK OR CONS7tiUCTION ZONING SQ. FT CU FT.
AUTHOR12ED IS NOT COMMENCED WITHIN 80 DAYS, Op IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UN17S OFPSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICA710N 1 STALLS GARAGES
AND KNOW TME SAME TO BE TFUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION SURTAx
AN� OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITN WHETMER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT �SyOOO �Z.SO
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pERMIT FEE SAC CMARGE
PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• �111.25 Fire SC �S.00
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
SIGNAIURE OF CON�AACT0�7 OR AUTMOAI2ED AGENT iDATE�
iD�iEi
S� , Y
;K FEE TOTAL E
e S�✓�.00_ $1 .75
`�Co3-5y7 !-10� ��J ���C
N� I J CITY OF FRfOLEY EFfective 1/1/2002
ADDN j J 64.31 University Ave NE, Fridley, lbtN 55a32 (7&3) 572-3604 Bidg insp
ALTER (] SINGLE FAMILY AND OUP�.EXES R-1 AND Ft-2
BUILOING PERMIT APPIICATION
Constructian Address: �5� ��,�� Q. �I� , � L , � � •
Legal Description:
Owner Name � Address: __�bM �' �i�10� Tel. #
s
co�tracto►: �4��a �r�,�R�� ��,���-7^S IN(', MN 110ENSE�
Address: 5'i3� /�/(��/(G��' }�j/, �O� 11d� p%5• Tei. #
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
1ot, with the proposed construction drawn on it to sple.
DESCRlPTION O� 1MPROVEMENT
Length wdth Hcight � 'Sq. Et
length Width Height Sq. F�
Length Width HgUGrcund Sq. FL
.
rw�•�-�—
Construc#ian Typc: � f�J� ��� Estimated Ca,t: 5 ����- '�
�J
r`
Driveway Curb Cut 1Ndth Needed: Ft. + 6 Ft = Ft S =�
DATE: ��iz' dJ APPUCANT: � ��?� (O/���,lJ�
� Tel. # �
d`` ���% / j���-� d�'Ir�
Call (763) 572-3604 for Permit Fees if mailtng ir� application o� ax to 763-571-1287 ii usi�g credit card and we will
call you for card number. ��
CI7Y US� ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escraw
Erasion Control
Park Fee
Sewer Main Charge
- TOTAL
� l� re �� r
$ � a �,�,�
�
� �'P � �'
$
$ � � (°' �'
$
�
$
$
s �.�� . l�
Fee Schedule on Reverse Side
.001 of Permit Vafuation (1/'[Oth%)
$.50!$1,000 Valuation
�1�00 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$454.00 Cons�rvation Plan Review
Fee Determined by Engineering •
Agreement Necessary [ j Not Necessary j]
S7IPULATIOIVS:
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THE gELOW MUST BE FILLED IN WHEN REP�CING FUEL BURNING APPLIANCES OR THE
APPUCATION WILL BE RETURNED
. .,,_ •► . � ' r•►
• �� �i � ► / ► / ► �{�l►`I►���.�a:':�_"'.�-._....- - -- - -
�en .n.,i �ina �n Y'etina furanGB, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
The venting system is plastic/F'VC and meets ail current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
The undersigned also verifies that the replacement unit is a listed assembly
and meets the curren�t ed o al C ntral Fumace V n gcTables or fanoes
include AGA-GAMA 9 rY .
assisted and natura� draft appliances.
-me is sized and installed to meet the current codes
and manufacturers speafications.
When required to '�° a ne�' cem ���en air_ it will be sized and installed
to meet the current codes an d manufacturers specifications.
�en ��� , the undersigned hereby verifles that
it is a listed assembly and meets the current codes and ma en a�ctu umace
specifications. This does include AGA-GAMA Category I C
Venting Tables for fan assisted and natural draft appliances.
Is the common ven en ��ov d fro the commonv nt alnd en ed y after
an appliance has be
separately as per current codes. -
Yes ( i No ( )
Yes ( ► No ( )
Yes( ) No( )
Yes ( ) No ( )
Yes( ) No( )
Yes ( ) No ( )
Yes( )No( )
'� / emmon V nt and Ven� �'^^^°��r InferinatiflII
BTU Input ��1 Fan Assisted or Nat
Appliance #1 Type � -` — gTU Input � Fan Assisted or N
Appliance #2 Type � p g� Input Fan Assisted or Nat
Appliance #3 Type Total Btu Input
Total Appliances
uent Height Diameter inch�s
Cammon !/ent Typ� ""' �
ft Diameter �in Type
qppliance #1 Vent Connector Height � ft Length�ft Diameter '� in Type �
A liance #2 Vent Connector Heigtit�ft �.ength in T e �
PP
liance #3 Vent Connector Hei ht ft Length _.ft Diameter
qpp • 9
. � - � r � . .,- . .,-
HEATING
Signed �
Date : � � '
_
CI 1 1 �F
FR[DLEY
FRIDLEY MUNICIPAL CENfER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 23, 2004
Ms. Pam Carson
6259 Baker Avenue NE
Fridley, MN 55432
Re: Final Inspection at 6259 Baker Avenue NE
Contractor: Anderson Heating & Air Cond
Dear Ms. Carson:
A mechanical permit was issued on October 31, 2003 to install a fumace at your address.
According to the 1991 Uniform Mechanical Code, a final inspection shall be conducted
on the work authorized by this permit. As of this date the final inspection has not been
requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pemut open for another 30 days and if we do
not hear from you within this time to set up the inspection, the permit will be maxked "no
inspection called for by homeowner after notification" and expire the permit.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
Building pI,UMBING Permit No.:
Inspections - �S�ENTIAL APPLICATION R�I°� By: r�--
763-572-3604 CITY OF FRIDLEY D��'� P R 2� s� a 1
DATE � �l � YOUR E-MAIL ADDRESS
SITE ADDRESS �+.�L �s �w�tr✓' �
THIS APPLICANT IS: ❑ OWNER ,�ONTRACTOR
PROPERTY Pam Caneva
N'�' 6259 Baker Avenue
ow��v pDDRESS: STATE z�
�N� Fridley, MN 55432
� pH��` 6123603066
CONTRACTOR NaME: � I — — — —
SUBMIT A CQPY OF STATE LICENSE # C> EXP DATE
YOUR STATE ADDRESS• rrt� I / ,s' CITY '.' ., � i:f STATE�� ss'yop'
t,�c��s���- . �orr� ? - �0.3 Ffvc 2 -
�
APPLICATION � - - - -
PERMIT TYPE �SINGLE FAMIL.Y ❑ TWO FAMILY � TOWNI-IOUSE
TYPE OF WORK: ❑ NEW . . �REPiACEMENT
DETAILED DESCRIPTION OF VJORK
� 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
: improyement, installation or replacement of a residential fixture, excluding the fixtures. (This.shoulcirEflect only.the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
:=.ROR:�ROJEGI's Wf�RE L?:BOR EXCEEDS�i00;�'EES ARE BASED ON $10.00 PER FTXTURE,�EXCEP3'�:WS3EitEN�T�H :RI�CI��: .(A�DICA.7'E TUTAL
NUMBER OF EACH BEIAVi� -----_-- - - - - -- - - -
BATH SINK/l,AV _FLOOR DRAINS _ _ _ SHOWER __ -- - _ WATER PIPING
BATHTUB GAS PIPING pvEmcrirucfavvsE) SWIMMIIJG POOL WATER SOFTNER ($35)
CLp'I'HES WASHER KITCHEN SINK � WAT`ER CLOSET BACKFLOW PREV. ($15)
DISHWASHER =-LAUNDRY TRAY �WATER I-�ATER ($35) FOR IRRIGATION
WA'TER METER OTHER
Permit Fee $ Number of fxtures @$10.00 x$10.00 =$
� SurcI�ar e _ .�fi -- *-- _��::.ahsr s�f�"ixturES_� $I5� _x $15'>0_0 = $
TOTAL DUE $ Number of fixtures @$35.00 ,� x$35.U0 =$ 3S.Oo
, . . . .. . , State Surcharge = $ .50
Tota1= $ . O
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED '
I hereby apply for a building pemut and I aclmowledge 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 Co`nstrucrion Codes; that I understand this is
not a permit but only an appli ' n for a permit and work is not to start without a permit; that the work vuill be in accordance with the
approved plan in the case 1 o w' r uires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME JL' .'� NO/�IOi�Yi DATE �T I���� o
City of Fridley
Buildia�g Inspections Department
6431 University Av�nue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977