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AF - 36445City of Fridley, Minn. 6431 University Ave. N. E:, Minneapolis, Minn. 55432 BUILDING PERMIT Date: ...._...�L4.3� �Ill�?��.�.._.�.27 2 �� o 11795 Owner: _-----..Pkl.�,1�..��..g.1�.S.�..._.__._..______ _ Builder _�B��X �311ma �n- jn�- Address ... ....._..0 Address 151�5 ilver Lake Road, New Bri�hton 633-0536 LOCATION OF BUILDING No. ..-.--1-5.3.7.----...._. Street -------.----Berne__Road-- N�,E� _:--. Part of Lot Lot ..._........�1._........_._._ Block .__...._...__1........_.._...._...._........_.._. Addition or Sub-Divisian .�._Innsbruck 5th Addition Corner Lot ---------------•--..-•-----_ Inside Lot ----•--.--X---------------..___ Setback -----.-- 35 t_._..._... Sideyard 17 �& 20 � ��/ylq�'/Elevation -------.-982_,.47_._---------...____-.-----.._____..._..._..__:___ �`�y{r�ii,6�L/t�1�f�'qh�/-- 985,47----(Minimum) Wve Top of Footing � DESCRIPTION OF BUILbING To be Used as: �_.,D�E11ing---•----------_ Front __._53.�._ Depth ._2�i.' ...&2�E#eight .__2.�..�__ Sq. Fk Cu. Ft �q,� .. __Garage-----_....._---------_ Front 20 �_9 n_ Depth ___24 �._ Height __ 10 �.._.. Sq. Ft. 496' Cu. F� 4960' Type of Construction JaTQ.QSL..F.�� —_.__ Est. Cost .._a�2�.�.2�Q.QQ_..___ To be Completed �� }- � 9 �� Stipulations: Drainage to be as designated by Darrel Clark. Grade to drain out to southeast corner of Lot 20. Provide a hard surface driveway. Provide a verifying survey before capping. WATER LOCATION: 17' East of Manhole (Inv. 982.98) SEWER LOCATION: 10' West of Sewer Service `�pERaTE PERMITS REQUIRED FOR 11V1i�t'�v �ATtl�S, PLUMBfNG ANQ SKiNS. In consideration of the issuance to me of a pernu o construct the building described above, I agree to do thg proposed work in accordance with the description above sex, forth and in co ��e wi.th all provisions � Ordinanc�es of the city of Fridley. , �//y�c� c�s•b,�� ?��r� =- =1.�� - ' In consideration of the payment of a fce of $_—.73.�.Q_.._�.., permit is hereby granted to R,Qdn�y Ri llm?n Inc. ._.._._........._....._.__..._ ......................__......_ to construct the building or addition as described above. This permit fs granted upo�i the express condition that the person to whom it is granted and his agents, employees and workmett, in all Work done in, around and upon said building, or any part thereof, shall conform in all xespects •to the ordin�ntx8 oi Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildit!►g8 yyithin the city limits and this permit may be revoked at any time upon violation oi any of the provisions of said o�cdinances. � �� > �� NOTICE: This permif does not eover fhe eonstruction, installafion fo� wiring, plumbeng, gas heafing, aswer or water. B� suw to sY� t�hs Building Inspectar for separafe permifs for these items. a � � � --m �� APLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : BU ILDER : �-�C-r d/i "/� �� i ADDRES S• ADDRES S: �� -, e�-�-- -yu��J /�Y�-C� `�� h,z n ✓ 1 NO:. �� STREET: � LOT: Z/ BLOCK: t ADDITION: ��%.--�-o G�-c- /L J�!k- ��- CORNER LOT: INSIDE LOT:� I/ SETBACK: �J� SIDEYARD: J �-- z p Appli�ant attach to this form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As : `� �ESCRIPTION OF BUILDING =�. �---- �-k-�---�.�. Front : -a� 3 Depth : :Z � ¢--2,� Height : � �� Square Feet: Cubic Feet: � . .__ ' Front; ��} f:� _..� �pth: '� i` Height• ,� � � �•�,` :RY � . . . Square Feet;��_Cubic Feet: e of Construction: ti� � �'P �`h � Estimated Cost: $ y� _� . � To Be Completed: �> l��,i ! / cl 7-2 ' I - The undersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in stfict accordance with 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 are true and correct. � , ll /� --�—�---- �-� : ° \ `��L `�� ' ^ DATE : _ � � r" � _� �i S IGNATURE : ' � �-c- /�--` (See Revexse Side For Additiona,l Info�nation.) � � � � , ,� � �' s "�' �� t_ t� � � �:` a ; ,+ , .+ . �'' `� J t...,.. i> � . � � � ("��? :r „� ,.� '�+"` ?�./{ . ,��.�''. � +� '�^/�, " ,m A"9�..•` �!} ,� w1^.� ��-. .. �"F y.3�'° �� y ,.a'a;` ,.�i �l�:�� , c�'�. %` � /� � i rt: f �' ff �'"�� . (1,% • . ?� , . . . '}`� H. � R l.. � {' :r'r .,.d� � . . � e bj s..:,.� . � . .: � � j. � . .,w�e, �... ... � ♦ w � .#. ,? `� 0 BUILDING PERMIT FEE SCHEDULE SECTION 2. The inspector of Buildings shall, before issuing pennits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs 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 pravided to-wit: UIJIFORM BUILDING CODE: �pe 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of camputing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the averager height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any pezmit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the ti.me of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it ha� been constructed, will be required before proceedin� with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. • _ �. , _ _ Basc !st Znd 8rd 4th . s � �i�y o� Fridtey �,� �PPEic�on for Pk�bing �d G� l�ttt% P� — Dopt. of Bldqs. Phor►� 560-3450 DESCRIPTION OF WORE � J�� liumb�r. PCind and Locaf#on of flxtue�s • ' r-"•`_� �.,.,.. � p� w��t� �. �Ln w Z • • 30 � �� i � �� , � �0�3� Z � �� O� / M GAS [IEC. Fvt��r� Co�ed�oa Oy�daqs N�w Fixlun. Old O�dnq� Cit� of lYidley: The uadersigned hereby makes application tor a per�it [or the vsark herei= specired. agreeing to do an work in strict accordance with the Cit� Ordin�ace and ruling of the Department of Buildings. and hereby declares that atI the tact and representatlons stated 1n tl�is application are true and correct l�idlp'. Hina %l�'�' �• � : i9Z= � Owner v Kind of Buildiag �� l � Q Used as ,�� . To be completed about PARTIAL RATE SCHEDULE pLIIltS1NG FiXTURE AATES: I10. R11TE TO?AL Number F`ixtures . . . . . . . . . . . . . . . . �._. x a200 : % �l. 027 P1�ture Fixture Opcning . . . . . . . . . . . _.,��' ._ a i1.50 t U � New Fiature Old Opening . . . . . . . . . . . x :1.50 i__ Catch Basin . . . . . . . . . . . . . . . . . . . . x :3.25 = Water Heater 'Up to 99,000 BTU1 •••• _L_ x=3.00 i d� New Ground Run Old Bldg. ........ x i3.25 S El�ctric Wat�r Hwt� . . . . . . . . . . . . . . : :2.00 = GA3 FiTTING FEEB: NO. RATE TOTAL lst 3 Fixtures . . . • • • . • • • • • • . . . • x =200 ; Additional lrlatui+ea . . . . . . . ... . . . . . x = .76 i Ga� Ran�e to 19a.000 BTU . . ,.. . . . . ... s =5.00 R State Surcharge $ .50 REPAIRS k 11LTEAATIONb—R�i�s !o Cod� _ �� ••�•��••••a�••.••.•�w�.�••��w.�•�.��.�.��.�•w �tW � � - Estimated Cost, s Old—New. Building Pprmit No. P•rmit No. �v Signed � ay Business Phune No ROUOii FINlIL � �� ' %,S` App�iaation �a' Pow�r Maets and H�aNng. Cootiag, Yentiivrion, Rrf�i�ra�ion a�d Air Conditioning S�t�ms �d Deric�s PARTIAL R�1TE SCHEDULE tiRAY*TY WARM AIR: �� Tp�u, lhirnace Shell & Duct Work . . . . . . . . . . . . . . . a10.00 � Rrplacement of F1�rnace . . . . . . . . . 6.00 � Repairs & Alterations—vp to ;500.00 6.00 a---- __--- Repairs & Alterations each add. s500.00 . 3.0(1 �____ ______ MECH. WARIrt 11IA � ;--�-- �lunace Shell dc Duct Work to 190,000 BTU . . . . . . . . a10.00 • each add. A0�000 BTU .......... .. ... .... 3.W i RePLcement oi F%rnace 6.00 � Repairs dc Alterations--up to 5500.00 6.00 ; Repairs & Alterations each add. s500.00 3,pp ; STEAM or HOT WA1'EA SYaTEDt F�rnace Shell & Lines—to 400 sq. ft. F.DR Steam g1Q.00 g__�_____._ F�unace Shei] & Line—to 640 sq. ft. EDR Hot Water 10.00 $____ Each add. 200 aq. ft. EDR Steam �,(N1 �.., ____ ._� _ Each add. 320 sq. ft. EDR Hot Water 3.pp s—_--- OIL BIIRNER—to 3 gal. per hour g,pp �__ ` over 3 gal. per hour-�ee Fee Schedule ,° �,.' G113 BURNER (up to 199.000 BTU) b.00 s� over 199,000 BT[T $ee FN Se2udul� GA3 FITTING FEEB: NO AJ►TE TOTAL ist 3 FSxtures —, xa Z00 5---�i•y Additional Fixtures x .76 S — Gas Range to 199.00� :i 6.0� _ — AIA COI�DITiOIEIl1O FAN !i$J►TIIfG SYSTEN VE]�TILATII�G sY8'PEIi/ ALTERATIOI�Ia ! REPAIAS ROU(3H FtN�►i. �_ ,�5-- � �/ i _ Se� F» Sel�dnt� '[OT11I. FES S � � (SURCHARGE $_.50) n.pt. of �aq.. ri.�.. seo-�sa r�'�` n 0 ,v ^�, � City oi I�idiey: The undersigned hereby makes application ior a permit ior the work hereii specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department ot Buildings, and hereby decIares that aI! t6e lacts aad representations stated in this application are true and correet. �F`ridle�+r�Minn-_ �/� � 1�� / /"'l oWneT 6�,1'✓ Kind �f Building .____l�`�i%/>>,/,� Usef� ag - --._.��74� /�� - / /�. To be completed about ____ �___� � Estimated Cost, a_._._._ ._9�� —_-- — Old-Sate�►!Buildin8 Permit No _. P•rmit No. �� DESCAIPTIOI� OF WOAE HEATING or PO PLANTB..-�team. Ho! Water, ana Air No. � Trade Name ��`�C 3ize No � � Capacity �4r�v�/ � gq, I�`t, E.D.R._s��T� g� 1Ap 6f' � Total Connected Load �d af �� / BURNER — Trade Nam � � Siu 1�10 - Capadty �c�t� L�1'�/3'1 gq. !'t. EDR BTU i�,p! S�� 'AY Lq. WE: _ , ;�,ti; iivv �;0. ��i3%-t�; ri;,.hu � `+1iL�lEAPOLIS,, MfNNE_SOT,9tl b�i4py B� � No_ �1�.�-�G�G � (REMARKf—OVER) �""`-�� .. Application for Power Plants and Hesrting, Cooling, Yentilation, Refrigeration and Air Conditioning Systems cmd Devices PARTIAL RATE SCHEDULE GAAVITY WARM AIR: Furnace Shell & Duct Work . . . . . . . . .. . . . . ... . . . . .. . . . . Replacement of Furnace ............................. Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . . . Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTIT . . . . . . . . . . . . each add. 60,000 BTCT . . .. . ........ ... .... .. . Replacement of Ftixrnace ............................. Repairs & Alterations--up to $500.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 .............. RATE TOTAL 8.00 � 5.00 � 5.00 $ 2.50 $ 8.00 $ 2.00 � 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURIvER—to 3 gal. per hour . . . . . . .. . .... .. . .... . . 5,00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $ GAS FITTING FEES: lst 3 Fixtures ...................... Additional Fixtures . ............... Gas Range to 200,000 BTU . . . . . . . . . . . �� NO RATE TOTAL _ x $1,56 $ _ x .50 $ _ x 2.00 $ �-�-�=— AIR CONDITIONING FAN H I G SYSTEM See Fee Schedule VENTILATING SYBTEM ' ALTERATIONS & REPAIRS ROUGH FINAL� -/D - � o� TOTAL FE $ E a .-J�'� ✓�� t � �� Dept. of Bldqs. Phone 560-3450 � � City o4 F�idley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. d�+ �'� �i , Minn. r , 19/� � � �l.J .�� Owner ��--��- Kind of Building _ �� ) ''�� % 6 Used as T % To be completed about �� y' , � .�>. Estimated Cost, $—_l/ �` Oid� Building Permit No. Permit No. �� 7� DESCRIPTION OF WORK HEATING or POWER PI.ANTS-�team, Hot Water, Warm Air—No. Trade Capacity Total Connected Size Sq. Fk E.D.R. BTCT H.P. Kind of Fue1 BURNER — Trade NamP Size No. Capacity Sq. Ft. E.D.R BTU g,p, %� �!� � G�4''L` _ ,��a� ." .��ar'�' ��t1 f��tJ✓'�� C� �L'G��l C� 4�l/C Cad S� ._ 6�j c� v�v` -° F.�l, Signea - , . . _ _ _ . . _ , ... (REMARKS-OVER) By � - _ _ , .,, �.�, ., _ �' �� , ��,�4z Business Phone No � � ~ HQ115E HEATING TEST RECORD � . . ,._ : . . ,.. . � ADDRESS �� -� APT. f 0 CITY/�` j[U 8__�.,,�. OGGUPANT OWNE R ,.-� �°�'i,e�1� � � : HEAT L�SS DATE HTG. INST. GAS GO. METER BADG ` 50LD BY INSTALLED 8Y EleehFca! Work By Gas Line By TYPE OF NEAT GA FA HW. STEAM SPACE HTR. UNIT HTR. O'f#�IER' � ''� �:�' � . �� G DES � CONVER610N T MAKf MAKE OF BIlRNER �L Mod.f .0 !/ 2 Model _ - , '� ! S�ricl ��-�/7d"' �3+d Max. BTU Ratinti 1NPUT �„�3�I MAKE OF FURNACE � Model CONTROLS �J THERMOST Neat PI V�nt Sizs Yolve ' KIND-0F LINER 51ZE f4iEi!!#�.�� `s ��: Limi! �E 3�"��-�'� Draff Hood RsQulatar Limit S�ttinq -�'� Filters Sizs Numbsr ;:� Fan 5etting �� Chimn�y Location Inside �"�� OvTsid� �_ Pi1ot Typs � � Chimn�y Construetion - =� w Pitot Malu 1•sa � �j. � Pitat Model Smokt>Bomb Wiring �/�,. - , �, ,� `� PilotTiming �"�D��— Draft � Tesf Tag �'""'.,: ',� L.W. Cut Off ,d--''%�� oor PtesaFure �iy6t{nq.lnst. �""'"�R � �;; Pressurs .,� �� Pereent CO Date Tested Z— � t�ut CFH � 32 Per 2 � e�i�'� 1? �•2. --eF � CcmpanY T�sting Siaek Temp. �Z -� Perant CO �� — Nanw of Tsmter } FQrm 235 � . . . . . . . . �.i. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: 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 Re uired�Yes Type �j�G u��.. �,�:r�� s 3 -� /�-�,-�-e � NO. RATE TOTAL JOB ADDRESS � �� $ 7.00 The undersigned hereby makes appiication for a permit for the work herein $ 4.00 specified agreeing to do all work in strict accordance with the city codes $ 5.00 and rulings of the Building Division, and hereby decla�es that alt the facts $ 7.00 and representations stated in this application are true and correct. � $ 7.00 $ 7.00 �S✓� , 1991 $7.00 ��. c�s�� s � $10.00 Owner $ 7.00 5� �, �j L`' � "�`, �% $10.00 Building Used As $10.00 $10.00 (� No $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance State Surcharge TOTAL FEE � � -�Ii Estimated Cost � PERMIT O. ��'��' � `�� ✓'(�/ / �j S PLUMBING COMPA ► l�?-L- � s��-Gl�� SIGNED BY TEL N0. A roved By � Rough-In Date Final Date � 5� J/ PP $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 $ �-S • �� PLUS THE �.50 STATE SURCHARGE c�ty of Fridley ��+�V� AT THE TOP OF TME TWINS � � f L D I N G P E R M I T r � � � � � ; y�� COMMUNITY OEVELOPMENT DIV. r � � Pq07ECTIVE INSPECTION SEC. � 1 � l--_-�� "� �'� CI7Y HALL FRIDLE� SSIJ2 NUM9ER pEV O�TE i 612-571-3450 9t0-F15 3/15/00 J09 ADDRESS 1537 Berne Road NE t LEGAL ��T NO. BLOCK Ti;ACT OR ADOITION oesca. 21 1 Innsbruck 5th Addition 2 PiiOPERTY OWNER MAIL ADORES$ ZIP Ann Waldren 1537 Berne Road NE 3 CONTRACTOR MAIL ADDRESS Z�P Huber Construction Co PO Box 403, St Michael MN 55376 4 AFCHITECT OR DESIGNER MAIL ADORESS Z�P 5 ENGINEER MAIL ADDRESS ZIP P�GE O� � � PERMIT NO. 30727 RECEIPT NO. /�/� �bPROVED 8Y SEE ATTACMED SHEET PMONE LICENSE NO 497-4484 20102687 PHONE IICENSE NO. PNONE LICENSE NO 6 USE OF BUIl01NG Residential 7 CLASS OF WORK ❑ NEW O A�DITION ❑ ALTERATION �7 REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) 2nd Layer 9 CHANGE Of USE FqOM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE Of CONST. SEPARATE PERMITS ARE REOUfFEO FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHORI2ED IS NOT COMMENCED VjIITHIN fi0 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WpRK IS COMMENCED. NO DWIG. UNITS I HEfiEBV CEHTIFY THAT I MAVE READ AND EXAMINED THIS APPLICA710N 1 AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION ANO ORDINANCES GOVERNING 7HI$ TVPE OF WORK WI�L BE COMP�IED @ WITM WMETMER SPECIFIEO MEREIN OR NOT THE GRANTING OF A pERM1T W 1� 444 ES N07 PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT fEE P VI IONS OF ANY OTHER STATE OR IOCAL LAW REGULAT�NG CON- @ ST ION OR THE PERFORMANCE OF CONSTIiUCTION y�S�F.00 � �� y PLAN CHECK FEE � L�� S �y('.NA UAE OF CON'AiCiOA Op �UTNOp�2E0 AGENi ID�TE� .. uCU Cf SGN4TUAE O� OWNEQ��t OwNEpBUi�DE:ti iO�TEi ,� . OCCU S7ALlS $5. A IOAp CU FT. OFFSTFEET PARKING �GARAGES �.%2 SAC CMARGE Fire SC $1.44 TOT � FEE $61.16 ) TMIS IS VOUp PERMIi 3 /�S�l�r� r��t( N� [ l Effective 1/1/2000 ADDN [] CITY OF FRIDLEY (763) 572-3604 Bidg insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � f �/ f ; �� ; �;,.1,� Construction Address: IS.�� Ra� J� Legal Description: Owner Name & Address: �'1f1 (.�%lS��-' n 153% ,� � Tel. # Contractor: ��.r�(' LOn `'�"t'� Co MN UCENSE #� l C'j od� ,�'� Address: PO �X �D3 �(}� ��+1.e� , Uyl j,i -�,53`r �v Tel. # �7 �'�" LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT , _.___. Length Width Height Sq. . a`- ''�,� Length Width Height Sq. Ft. DECK AREA: Length OTHER: � 3round Sq. Ft. �'� �� Construction Type: � t��-� - �t�c�� Estimated Cost: ��` ,/�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ - DATE: � rU� APPLICANT: - Tel. # �� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ � r DD Fee Schedule on Reverse Side Fire Surcharge $ /- �� .001 of Permit Valuation (1/10th%) State Surcharge $ `�%� $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � $1100 per SAC Unit $ � �(� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ $ � l.� Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUII,DING PERMIT FEE SCHEDULE The Chief Building O�cial shall, before issuing pemuts 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 $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional$1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�,irb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "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 $23.25. 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. New Houses Onlv �a CITY OF FRIDLEY INSPECTION DIViSION �� Effective On January 1, 20�0 6431 University Ave NE �� Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential 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 BACK) 1�'Jo of Value of Appliance or Work Commercial/Industrial 1.25 Jo of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE 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. JOB ADDRESS �� N� R� N �_ OWNER A'NN (.JA'�J7�2 � BUILDING USED AS �l.�w ��-'-«'� ESTIMATED COST �� PERMIT NO. C�f�' DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heafing Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ � ��Q Fuel � Total Connected Load � $ $ $ .50 $� 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 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. SllPER�Q� �G'�fTRAf�'�� ^-�:r � �— Jlo--oo 6121 42nc1 Av�nue`".K!'o. Cryst�.y, Mn 5��2 H EATI Signed Approved By � `� Rough-In Date TEL # %(c=3-�3``�-b'`�( Final �.."� � -'� . � i COMMON VENTi VENT CONNECTOR AND COMBUSTfON A1R VERiFiCAT10N When replaciny an existinq furance, 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. Yes () No () The venting system is plastic/PVC and meets all cunent codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existinq combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and instalied To meei the current codes and manufacturer's specifications. Yes()No() Yes ( ) No ( ) Yes ( ) No ( ) When instalfing a new ventina svstem, the undersigned hereby verifies that it is a listed assembly and meets the cuRent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEAl'ING CO: Signed By: Date : � i � � CITYOE FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 iJr1IVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 January 18, 2002 Ms. Ann Waldren 1537 Berne Rd NE Fridley, MN 55421 Re: Final Inspecrion at 1537 Berne Road NE Contractor: Superior Contractors Inc. Dear Ms. Waldren: A mechanical permit was issued on March 21, 2000 to install an air conditioner at your address. According to the 1991 Uniform. Mechanical Code a final inspection shall be conducted on the work authorized by ttus permit. As of this date, no inspection has been called for. The pernut fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for" and no further action will be taken. To set up the inspecrion or to have any quesrions answered, please contact the Building Inspecrion Division at (763) 572-3604. Sincerely, DJ/mh CITY OF FRIDLEY INSPECTION DIViSiON 6431 University Ave NE Fridley, MN 55432 APPLICATICIN FOR POWER PLANTS �4ND HEATING, COOLING, VENTILATION, (763) 572•3604 REFRlGERATION AND AIR COND1710NING SYSTEMS AND DEVl�ES FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent • Fiil 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 BACK) 1�'Jo of Value of Appliance or Work Commercial/Industrial 1.25 Jo of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 � 25.00 State Surch�aYge TOTALFEE MINIMUM FEE FOR ANY HEATING/COOLING/VE�lTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS_:n25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard �vithout written permission from adjoining property owner. $ $ �YYective J�iivary 1, LUUj JOBADDRESS��Z� L.__ ��rn� �d�J. OWNER��('is F u � BUILDING USED AS� 5��.� � � ESTIMATED COST 1�GCiV�Gv PERMIT N0. l�,�� DESCRiPTIQ�! �F FURNACE AND OR BURNER No. of Heating Units � ._ Circle One (Steam) (Hot Water Warm Air irade Name Size No. BTU t�P EDR � � Fuel Total Connected Load BurnPr Trade Name ea�"�� ti Size No.S��'� i�% $ BTU G U�✓� __ HP EDR_ �nSf�// /�e�� f�Cl�v Cus ��/G�� w��s $ � �2�.�v V—/.{ � v �� I � � /, � � � � �� r �� C � The undersigned hereby m4ikes application for a permit for the work herein specified agreeing to do a!� work in strict accordance with the City Codes an rulings of the Building Divi�:�ion, and hereby declares that all the facts and representations stated in i:��is application are true and correct. �� /" � � � 1 �� DATE �IG/"�� HEATING CO Cc.S 7�� a S /�r T��rS ��n� � G - �1'Y�1 TEL # �-�Y� ' �p� 7% FAX # � S � %�K' ��lY roved E�y �,�� Rough•In Date r F L OU i �tA� �iut � �v f� � �� f � � � � � � � � � Final Date /d ��1� THE BELOW MUST BE FILLED IN WHEN REPl�4CING FUEL BURNiNG APPLIANCES OR THE APPLICATION WILL BE RETURNED G�ti"IL"nl� t�l`T� t�14T ��I`EC'T[�R AI`D (`(�ti"BtIRTI(�t� IR VFRIFIt_ATI�N N/j�gn �nla 'p,0 an _Yie in0 f�rancP, the undersigned hereby venfies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where requiced. Yes (► No O The ven6ng system is plastidPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (► No () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () The pyr�t111p �eme ��t�en a�r is sized and installed to meet the current codes and manufacturers specifications. Yes () No () When required to �r��t,�� " new cemb��etien air� it Will be Sized 811d I�Stalled to meet the current codes and manufacturers specifications. Yes () No () �e� �� a new v�ntin� cvs em, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () ls the common vent and vent connedors sized and instal{ed correct{y after an appliance has been removed from the common vent and vented separately as per current codes. Yes O No O �,� " ^� T�� and �i7p/Gemmen ��ent and Vent Cnnnecter Infnrmation Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Tot�! Arp!iances Tota! Btu Input� Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type w � r �.► .- ...- HEATING CO: Signed By: Date :