AF - 36503sue�ecT PERMIT NO.
City of Fridley � 15 3 7 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � COMMUNITY DEVELOPMENT DIV. RECEIPT NO.
' ; ..-------, � G (o !o �
r i � PROTECTIVE INSPECTION SEC. �6 �/
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i
� � ��—�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� ----�: `,�
612-571-3450 9� o-Ft 5 8/ 7/ 79 � �
JOB ADDAESS 1643 Brenner Pass N. E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 1 Innsbruck North Townhouse Plat S SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane, Brooklyn Park, MN 55428
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same 560-8110
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Res iden tial
7 CLASS OF WORK
[�. NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOFIK
Construct an 18' x 28' 7.bwnhouse (A Unit)
9 CHANGE OF USE FROM TO
STIPULATIONS party wall must be two separate 1 hour walls from bottom to roof.
Firestop soffits. Provide combustion air for furnace from outside.
SE'PE�tAi'E �ERMITS REQUtREO Fp� YYtat �ARNiNG
�A��NG• PL�MB�NG AND SlGNS. � 1 EPHOIM� ElE n i�! utilities
C1�IC • CAS Ek.
REQUIRE� dY LAW
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING. WOOCZ FZ'dIIl2
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 ZSZZ 14�112
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2$ 1(O 14. O8
DOES NOT PRESUME TO GIVE '°'�T RITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF Y O ER T1�. OR LOCAL LAW REGULATING CON-
STRUCTION E F M CE OF CONSTRUCTION. �j 4 425 ��
PLAN CHECK FEE TOTAL FEE
. � �' ' ��� 4
SiGNATUREOFC N� OFIOR ORiZEDAGEN7 IDATE� WHEN R V IDATED THIS IS YOUR PERMIT
. s. "�_. X.��.�4
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SiGNA7URE OF OWNERUF OWNER BUiLDER� iDA7E� B�DG WSP ��FTE
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. ' /tl'i'LiCltiTIUJI t"Oft ItI:STI)!_t•tT1/1L PUIt_DJf�IG f'Ct2t�tITS . �
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_(3,t�,�„_,�.E.-� fr. � .t i� � %y�-�-� ;l:;� � 'xc�.. k:o . : � D� 9� �•� � .
1to. : / � `� � 5tx cet : � � ��-a�.aJ • . .
7�07'r / }3UJCl;: / e ADUXTIOJ'3 : �� - ' "
C012i'.?.i2 L�J1': '✓ Xl�Sxll� 7AT: S;:TPI1CY.t SxUliX11RDS: '
�pl�2ica'r.t attach �:o this tonn �t•�� Cert•iii�cates of Survey af: 7,ot and pxopased . .
bui_ldir�g loca::ion drao�n on these Certificat-es. . -
. . . � . . . . . - . � -
' , DESCRI PTI OI•d OF BUI LDI I�G ;{.} �i,Li� .'-
, • ' . - • : . � - � �.
To T3� Used 7�s: � � � : . _ - - -
° .GO��--- . Fxont s / � Depth : - a � ' I�ei.ght : � � ' - .
. _ ' . . . Sguar_e �eet: /S/�_ � .Cubic Feet: . /�//� � � . ' .
, •i'xont: Depth:. - Neiqhtc .
�_ Squa�-e I'eet: �. Cubic I'ee�: � ' '
� �j�p> o.; Con$txuction: �/ �-C ,� o�.f,r�rrc�`.. Estzmated Cost: $ �� /�"�O .
��
'db �e Corin�et.ed: `�iC�e��-- '�� � - • � Al'L-. A Alt. B
" rxot �sed Dzive:aay t•7idL-}i 7f. New Openinq xs Desixed $ $
� • � (STI� 1'.�V�F•SE SIDF OF SIIEETj
Tile Lndersic�»ed he�'cLy mak�s a��pZication £or a perm�t to� L-he worl: lierei�i
specifS.cc3, �zr,zeei.ng to do a�l �cor1: in strici: acc��_dai�ce �aitli tt�e Ca.t�� of .
Fxi�dle�� Ordinances and xulSiigs ot tlie bct�axi.aicnt ot }�uilc3a.ngs, �nd hczeby -
dec]_��zc� tti� t a�l ihe iacts and zek�rc :cni:atioiz � sL-atcd in tliis ap��lication
Z�:e t-zue �-u�d coi_rccL-. 'See xeve�se side for acldiL•ioiizl �i�fo��iaL-�.oi�_ _
V , i. \
ll���: $ � G��g `____ SXG2.A'.('URL: �
sSt�u:.aI.ZL�osis: , ��21 y C�14 l�1U�S i,8�. 7'c�10 .��p��A7'� /�u2
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��. y� ��c-�L -
��. � � t�'-�'� R,e6�- . �FF'� %� -�� oJ, o� �rn 8 u�-S i c��J �4� 2 F� 2
i �. og `�--�� ' ��2� �c�. �,��,� cx�1 s � � �
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SuBJECT
City of Fridley _ 15 6 0 4
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� .
, � R
� ' COMMUNITY DEVELOPMENT DIV.
� i L'�'��� ,
r � � PROTECTIVE INSPECTION SEG ��
� �
i
�l � /"'1 � CITY HALL FRIDLEv SS432 NUMBER REV. DATE PAGE OF APPROVED BV
`��_'�./ �.J
612-571-3450 910-F15 12/26/79 � �
JOB ADDRESS See Below
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. %—].2 1 Innsbruck North Townhouse Plat �J SHEET
2 PROPERTY OWNEF MAIL ADDRESS ZIP PHONE
Darrel Farr Development 7286 - 72nd Lane No., Brooklyn Center, MN 55428 560-8110
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOFK
Construct a 6 stall ara e 64'8" x 22'
9 CHANGEOFUSEFROM TO
STIPULATIONS
Lot 7 = 1643 Brenner Pass N.E. - � � -` �- �'-� ; � �"`
Lot 8= 1641 Brenner Pass N.E.
Lot 9= 1639 Brenner Pass N.E.
Lot 1� 1637 Brenner Pass N.E.
Lot 11= 1633 Brenner Pass N.E.
Lot 12= 1635 Brenner Pass N.E.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS AFE REQUIFED FOR ELECTRICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING. WOOCI FYaIC12
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING 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 1425 14, 250
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THtS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S1�-r 927.25 y�S. 96
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $S%. OO NONE
PLAN CHECKFEE TOTALFEE
NONE $62.96
S�GNATUFEOFCONTRACTOROFlAUTHOFIZEDAGENT i�are� WHEN PROPER�Lj VALIDATED THIS IS VOUR PERMIT
�- ' � C ��.Q�� l� � �v
S��GNATURE OF OWNEf7UF OWNER BUILDERI IDATEI BLDG INSP �1a7E
Ot�fdL- fZ:
ADDRESS:
TEL i�i0:
CITY OF FRIDLEY •
ARPLIC/�TION FOR RFSID(-NTI�.L. E3UILDIPdG PERI�1ITS
(fdew, Alter��tions, Addii;�ions, or Repairs)
BUILDER: �� �r o � - �cz_r��Z� 1iE � ��_� �
AQDRESS: !��� - '")���c� �rlc,tc �t,� ��, �'-�i�l %
TEL I�dO : �� - c� / � C�
` i �. � �,t �� Construction Location
J\ F �
STRL'�T N0: ST12��T:
LOT• �J -�� BLUQ:: I ADDITION: �/l, l�! f)( fi /:�^
Corner Lot: Insicle Lot: Setback: Sideyards:
npplicant attach to this form two Certi�icates oi' Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOId OF COI�STRUCTION �
� C < ` " De th; .�-� ` Height: /�3 �
��-/'�i � �,�n C Front: �r, � � p --
� (�, ��`,�� ��� c 1 � � Squar.e Feet:_f ��.� � Cubic Feet: ���, ...�_� (�
Front: Depth; Height:
Square I'eet: Cubic Feet:
% /� -
?'�1�pe of Constriic�ion: � < <���1 �� �, k /) �( Estimated Cost: $ //, �%'). �",
�-
Zb Be tbm�leted:
Alt. A Alt. B
Proposed Drzveway Width Tf New Opening Is Desired: $ $
SEE I2EVERSS SIDE OF SHEET _
Z�ze undersigned hereby ma�:es application foi: a permit �or the t�rk herein specified.
agreeing to do all work in strict accordance with the City of T'ridley Ordivances and
ruliiigs of ttie Dcpartmeilt of Builda.ngs, and hcreby declares t:hai� all the facts and
r�presentations state3 in this applicaL-ion are true and cor.rect.
DATE: '�/;���1 � %��_ SIGNATURE :
Sti.pul�tions a
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13U1Lp}WG ('Cf2(r11"1' f=ri: SCf{�DUI_F
51�C`1'IOI� ?.. 'Z'lie :f,n:;��eci.or. of 13ui.1clincJ�, �;}��iJ.l, befor.e i:;��uir,ct I�c,nnit-s for the erecL-i.on
of �iny }�ui7.cl:inc� or. :,Lrucf:ui:e, or. far. a»y aQci�.Lioi� Lc, a»y exi::t:i.ng uuilaing or, sLr..uc�ure,
. ar. f:or any altcr�zt.io�i o�.- z-c����i�°:.; to •ai�� c:>:i.,1,.i�lg 1�u5.].cl�.rig ar sL�:t;.c;tur.c, i:���o�1 ap1�].i.c�at_i.o�;
t.lzer.eior.c, icqui��c t.}�e }�tiyment by tl�c� apZ�J.icant: for. s;ucl� ��er.mit oi fees i:o tlie amount
hcrcin be].ow sr.t for.L-)i al��l in t.he mtu�nc� here�_n k�rov�.�led L-o-wi.L-: �
J�Ii'vJ C0:1`�TI;UCTIOt1: Si.r�gle I?c�mi.].y IIomes and Gar.agca: $�.00/l,OQO cubi.0 £ect. •
J?7�7�N Cli):CY.: ?.S percei�t of bu�.ldi_ng }�erm�_t 1:ec.
I�ItI�'�t�;�l' I�;.PI:LS�IOi�: (Concret�c, Curb SLreets Only) �
' niter_n�Ai:e A: Feinova7. and rep]_acemet�t. of concrete curb and
�� guL-i�er orily; Dr_zveway wicli�li plus 6 feeL- x y<:�„�',o��
Alternai:c� B: 12emoval and ropl.acement oi' concrete curb and
. � gutter and i_nstalJ. a 3 foot wid� appr�ach with �'
' . 6�_ricii depth; Dr_ivcw.ay widtll p�.us G feet �: $17.£35
ADDi TTOn�L I NFOf�tii/j�LION
J�'or the puri�se o� comput�_ne� fees for_ builcling permits, the cubica]_ cont.ents of an�
building o1: addit.i.on, is deter_miried by xnulti.pJ.yiny i11e gr.ound area covered from a
pai�7t six (6) inc.hes be)_o�,�* the floor line of the base.meni: ez th� cellar to the
average i�eic��iLs of the iipPer_ surface or to the average hezght of the roof surf_ace
of t11e ;:lain nabl.e of a pitched roof .
For_ repairs or alterations to an existing sLructure, the fee shall be at L'�e rate
oi' $3.00 �er each five hunclreci dollars ($50U.00) or fracLion t:liereo.i in tile cost
o� a].l proposed work. .
Tn �no case shall tha fe� rt�a?°ged for any pex.mit as set. fort}i in Section 2 L� 2e�s
than $7.5U plus $.50 state surcharge. '
VFRTFIC�TZO_�F FOUNDA�"ION
P.OTI:: I=err,�its� �or construci�ion will be issued a minimum of ?_� hours �r.om t}.-:e time
of app)_icatioi� to al.low for proper review of tlie pr_o�sed structure anc� ot t:he
COIZSt.1'11CL1011 S1tP.
�1 Certi�ir.ate of Suivey of i.he lot, showing tlie location of the foundation once iL-
has beei�: consi:i-�icted will be required bef.ore pr.ocecdi.ne� with the framing.
.���;T I F I CQTE�F O�C� l�f'I�NCY
11p��lication for a Certifi��te c>f Occupanc,� shall be r.lade i.en (10) days prior ta the
use or occuZ�ancy of any si:ruci�ure �or which a buildiiig permit has been issued; anu
�aid structure =>hall not L4 u�ec�l o:� occu}�i.ed ur,�il a Certi�i.cat�e of Occ:upancy has
�L'�71 1SSll�'CI.
{ •,
HOUSE HEATING TEST RECORD
ADDRESS 1 � I APT. LOOR CI Y UBURB
OCCUPANT [�TIO�q � OWNER � a ���/1'� �
HEAT LOSS DATE TG. INS .
SOLD BY c INSTALLED BY ��,�''r �
Electrical Work By "' Gas Line By ��� �-�
TYPE OF HEAT GA FA � STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE ��� e�-n MAKE OF BURNER
Model � ['n 2�/l��_/g Model
Serial Mox. BTU Rating
INPUT ��n�� MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT � Heat Plug � � �/
� 1 Vsnt Size
VO1Ve Lt � f KIND OF LINER �� SIZE NONE
Limit �--y��4' Droft Hood � � �> � Reyularor
Limit Setting �-��� Filters Size Numbsr
Fan Setting �� Chimn�y Location Inside � Outside
Pilot Type -� Chimney Construction
Pilot Make '�
Pilot Model 3�� �gy $moke Bomb W����9 �
Pilot Timing �^�� '���'��� Draft (i � Tsst Tay �_
L.W. Cut Off Door Pressure Lightiny Inst. �-
Pressure �•4-Percent CO2 � Date Tssted
Input CFH ��J Percent OZ Company Testing ,/�- ��'
Stack Temp. ��5d Percent CO Name of Tester -� � N��
Form 235
� � . . '. . . A !:. . . . . , .. . . � .. Q . . . . . " ..v� .. � _ . . .
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�, i.� �, I j< y.� � I-, ,., � o, . �o� n�a«„ 1643 Brenner Pass
4� � � r� 1 ��° 7 y'. � 4; c�.' c: �' S liea tnr —�---__
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' c �i I:� ;a � �i I a;a ;.; `. ',,. �� .,'��' s.�9 s� � �;us :1ec CiCy ot PrLd1�y .
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sue�ecr P�AM1T N0.
City of Fridley 20300
AT THE TOP Of THE TWINS g U I L D I N G P E R M I T
i • REE .
� � �
� • COMMUNITY DEVEIOPMENT DIV. � � � C-+
' `ti: ---�—
r i � PROTECTIVE INSPECTION SEC. � �
� �
� � /'��1 � CITY HALL FRIDLE� 55432 NUMBER iiEV DATE PAGE Of APPROVED BV
` ..��.�.i �.J
612-571-3450 910-F15 4/16/90 � �
JOB ADORESS 1643 B.renner Pass. N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE AT7ACHED
DESCR. ]_ & 7 1 Innsbruck North Townhouse Plat 5 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Sharon Heaton 1643 Brenner Pass N.E. 571-2761
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO
D& P B.uilders Inc. 2370 - 3rd Street N�w „ New B:ri hton, MN 55112 633-8375
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residenti:al
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATtON � REPAIR ❑ MOVE O FiEMOVE
8 DESCRIBE WORK
Repair rotted siding on �rireplace chase
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for ins;pection wi�en cfiase �s open.
TYPEOPCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS AFE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF /20 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT Sl /40.0 S• 7�
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEI THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $33.00
STRUCTION OR THE PERFORMANCE OF CO TRUCTION.
PLAN CHECK fEE TOTAL FEE
},�z,�� � � l6 '�C� $33 .70
SIGNATUFlEOFCONTRACTOAOFlAUTHOAl2EDAGENT IDATE� WHEN PROPERLY VA DATED THIS IS VOUR PERMIT
} � ' � �/ / b
SiGNATURE OF OWNERUF OWNER BU�IDEN� �DA7E� BLDG� iNS� ��4TE
� [ �
ADDN [ ] R-1 AND R-2
�T� [� � Building P�ermit Application
Construction Address: �6 % � � � J'����
Legal Description:
Owner Name & Address:
Effective 5/1/88
�. # 5��� -a 76�
Contractor: �I�- � .1'3�cc-F-'O�� ��C-- Tel . # �-3� �3 �s �
Aadress: �::370 3,2� � 1�� � �%�� ��Lc���v , ��� . s's l / �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING �1REA: Length
C�RA�GE AREA: L�erigth
DECR ARE�: Length
OTf�R: ��
DESCRIPTIOSJ OF
Width
Width
Height
Height
��� �
Sq. Ft.
Sq. Ft.
Sq. F�',.
Corner Lr�t [] Inside Lot [] Ft. Yd SetbaGk Side Yard Setbacks
Type of Construction: Estimated Cost: $ /�{D� `�"
Approx. Campletion Date: �- 02 0- G7G
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
,, idth + 6' See BacJc Page
rar��: ���%� ��� �r�c�ar: .�L.�-anJ �. Tel, # ��-3 -�3 �s�
Fern,.it Fee $ .�-:�.0�
State Surcharge $ '� L�
SAC Chan�e $
Driveway Escrow $
Park Fee $
sewer Main chan�e $
Tar�
STIPUI�ATIONS:
$ �-'�0
CITY USE �II,Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" AUave
Fee Determined bY �91�r'�9
Agree�nent Neoes.s�y [ ] Not NecessaYy [ ]
: �1� � �� ��r�4 �� _�,,i��. � a�
The Chief Building Official shall, before issuing permits for the erection of ar�y
building�or structure, or for any addition to any existing building or structure, or
for any alteration or repair to any existi.rig building or stxucture, upon application
therefore, require the payment by the applicant for such pezmit of fees to the amount
herein belaw set forth and in the manner herein pravided to-wit:
TOTAL VAII.TE
$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
�a��.
$15 (Miniirnun Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for fi.rst $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thexeof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and includirig $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and includirig $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for eac1Z additional
$1,000 or fraction thereof
DRIVEf�Y DEPRESSION E.SCF�7W
(Concrete Ctirb Streets OnlY)
Alternate "A": Remaval and replaceme.nt of curb and gutter only - Driveway width plus
6 feet t]mes $13.50.
Alternate "B": Removal and replaoemeizt of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet time.s $15.75.
1��; �� r: 11 �. �• a� Il��� o M•�I
Permits for construction will be issued a minimiun of 24 hours from the time of
application to allaw for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, shawing the location of the foundation once it has
it has been constructed will be required before proc.eeding with the framirig.
sue�ecr PERMIT NO.
City of Fridley 219 0 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i , RE�EiP�'-ht6�'
� �
� • COMMUtJITY DEVEIOPMENT DIV.
, .�-------. I
r � � PROTECTIVE INSPECTION SEC. �
i �
i �
� A� /"'1 � CITY HALI. FRIDLEv 55432 NUMBER REV OATE PAGE Of APPROVED BV
` .���J \i �.J
612-571-3450 910-F15 6/10/93 � �
JOB ADDRESS 1643 Brenner Pass NE
t LEGAL LOT NO. BLOCK TRACT Ofi ADDITION SEE ATTACHED
DESCR. 1 1 Tnnsbruck North Townhouse Plat S SHEET
2 PROPERTV OWNER MAII ADDRESS ZIP PHONE
Sharon Heaton 1643 Brenner Pass NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
DuAll Services Inc. 636 39th Ave NE, Columbia Heights 55421 788-9411 3178
4 AfiCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW �] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
B DESCRIBE WOFK
Construct a 5'4° x 6!' Deck.�lddition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations: on plan, Install smoke detectors as per UBC 1220 adjacent
to all sleeping a.reas and in basement,
,c
wARaiN�
Before digginq C�II f8P
all utility loc2tiens
4�4•OnO�"�-
REQUIR�b �� ���
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEf110D OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $925 $.47
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $2rJ.QO Fire SC $.93
� PLAN CHECK FEE TOTAL FEE
/ License S $5.00 $31.40
�
SIGNA R CONTR ORORAUTMOFlIZEDAGENT IDATEI NII-� P � VA�IDATED THIS IS YOUR PE MIT
, 6. ��
S�GNATUAE OF OwNEa�iF OWNER BUiLDERI iDATE1. BLDG INSP pFTE
NEW
ADDN
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CITY OF FRtDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 5/26/93
�l g�S
Construction Address: t�`✓ V�° lu �i ��t�S �
Legal Description: � c�-d � 1�1 �C� .�X�� �� nq o�-e-�� (6�1,���•� c� �7 �C l2
awner Name & Address: .�.Y1,��,e-v
�t ' ,
Tel. �
Co�rtractor: � GLU-C ��2JLt,K.��- �,c MN LICENSE # 000 3%'7t�`
Address: �.�6 ' 3 � � !d�"� � � l�v�, %'L� 5 S y2 / Tel. # 7�-�� / /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTiON OF IMPROVEMENT
Width Height
Width Height
�' � ,� �� Wi�l �o r I��/Cii'Oliri(i
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ j Inside Lot [ j Ft. Yd Setback Side Yard Setbacks _
Type of Conshvction: .�d �¢ i e�J Escimated Cost: � T Z5. S°
Approx. Completion Date: (p 30 �j`3
(Cost on Back)
Driveway Curb Cut Width Nceded: Ft. + 6 Ft = Ft x$ _$
DATE: b�� �3 APPLICANT: �� � Tel. #� S� 9� 1/
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TUTAL
ZSe�
� �
$ • `�3
$ �¢`�
$
� ��
$
$
$
$
$ 3lf ¢�
�
t�
Fee Schedule on Reve�rse Side
.001 of Permit Valuation {l/i0th%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary ( ]
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official 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 $500,000
$500,001 to $1,000,000
$I,�00,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 �for fust� $25,000 pl�s $6.50 far each add.itional $1,000
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $100,0(� plus $3.50 for each additional
$1, 000 or fraction thereof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,U00 or fra.ction thereof, to and including $1,000,000
$3539.SQ for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof -
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applicadon 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.
DU ALL SERVICE CONTRACTORS, INC.
"'THERE IS A DIFFERENCE'"
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636 - 39TH AVENUE N.E.
MINNEAPOLIS, MN 55421
TELEPHONE (612) 788-941 1
FAX (612) 788-8007
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LOAD[D 5 CI1[CK[D �V fl[LP ON JOB
��. YES �-: NO
DELIVERED BV DATE DELIVEREO
SCHERER
BROS.
LUMBER
C�.
ACCOUNTINQ
Medbery Yard 4797 Highway 10
Arden Hills, MN 55112 Phone (612) 633-9680
9th Avenue N.E. & Mississippi River
Minneapolis, MN 55413 Phone (612) 379-9633
THIS RECEIPT MUST BE PRESENTED FOR RETURNS AND ADJUSTMENTS
PLEASE READ TERMS ON BACK BEFORE SIGNING
TYPE OF TRANSACTION STORE NAME
STANDARD ORDER WILL CALL � SCHERER BROS
SOLD DU ALL SERVICE CONTRACTR
TO: 636 39TH AVE. NE
COLUMBIA HTS. AIIV 55421
CUST. CODE � SEQ. NO.
DU ALL SERVICE CONTRACTR
W-9600-R
DUAL 11:11 499270 60993 2 51 51 56 11202
REFERENCE NUMBER CUSTOMER ORDER NUMBER
W-9600-R
ITEM NO.
1 04260�2
2 074416
3 074408
4 041800
5 0721212
6 072812
7 8908SJ
8 92GM
ORDERED SHIPPED
156
1
2
24
2
3
4
3
DESCRIPTION
LNFT 2X6 ��2 ROUGH CEDAR
13/12
4X4-16' .40 TTD PINE S4S
4X4- 8' .40 TTD PINE S4S
LNFT 1X8 4�3 ROUGH CEDAR S1S2E KD
2/12
2X12-12' .40 TTD 4�2 PINE S4S
2X8-12' .40 TTD 4�2 PINE S4S
4kJRS 2X8-10-12 SGL JST HANGER/EA
60# SAKRETE GRAVEL MIX
RF(;'D RY __ �'I/ ` J Ci��;��`�'"'! "�WY
UNITS '
_�
156.00 �,
21.33
21.33
16.00
48.00
48.00
4.00
3.00
SHIP DATE
06/09/93
SALESMAN
LOU KIRSCHT
PRICE/UNIT EXTENSION
950.000/MBFT 148.20
610.000/MBFT 13.01
590.000/MBFT 12.58
250.000/MBFT 20.00
700.000/MBFT 33.60
600.000/MBFT 28.80
.490/EACH 1.96
2.950/EACH 8.85
SUB-TOTAL TAx TAX AMOUNT • �
267.00 .00 700 18.69 285.69
Material sFwrtages or damage from delivery stauld be reported within live (5) days a
will be considered as having occured on lhe job sile and rw adjustment will be made.
DU ALL SERVICE CONTRACTORS, INC.
"THERE IS A DIFFERENCE"
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636 - 39TH AVENUE N.E.
MINNEAPOLIS, MN 55421
TELEPHONE (612) 788-9411
FAX (612) 788-8007
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CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Effective On January 1, 1991
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
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
Rate TOTAL
$ 20.00 $
$ 10.00 $
JOB ADDR
U G�a✓Q�
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 ruling of the Building Division, and hereby declares
that all the facts and representations stated in this applicati n are
true and correct. 1 ,199;
OWNE
$ 10.00 $ �.�-�---►�
BUILDING USED AS
$ 10.00 $
ESTIMATED COST Z�� PERMIT NO.
*Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work $
Commercial/Industrial
1% of Value of Appliance or Work
� " ��
� �� � ��'� � � � � � Stat Surcharge
TOTAL FEE
$
� .50_
$ /���
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
DESCRIPTI OF FURNACE AND OR BURNER
..��Zt��J �
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 EDR
HEATING COMPANY / �F- 7�`'
Signed By � Tel No. �7 �D L D�
> �'
Approved By �� Rough-In Date Final Date -� �`��
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
CHIMNEY AND STACR 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 Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
4. Is securely supported Yes () No ()
5. Meets all current Code requirements for
size and total BTU's connected Yes () No ()
6. Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
List Alterations Being Done:
HEATING COMPANY
Signed By
Date
�
sue�ecr PERMIT NO.
City of Fridley � ...;�6 �
BUILDING PERMIT�__. � �
AT THE TOP OF THE TWINS '" '°
f
; � RECEtPT ND. �
� • COMMUNITY DEVELOPMENT DIV
, �,,-------, ����
r � i PROTECTIVE INSPECTION SEC
i
i
' � /'—�1 � CITY HALL FRIDLEV SS43Z NUMBEA AEV DATE PAGE OF APPROVEO BY
� ""'�"� ��� 612-571-3450 9�0-F15 9/20/94 � �
JOB ADDRESS 1643 Brenner Pass NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ] 1 Innsbruck North Townhouse Plat 5 SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Gittleman Construction Corp 7900 Xerxes Ave, Bloomin ton MN 55431 571-1023
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MA�L ADDfiESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential Townhouse
7 CLASS OF WORK
O NEW ❑ AODITION C7 ALTERATION a_ REPAIR ❑ MOVE ❑ REMOVE
X
B DESCRIBE WORK
Deck Repairs
9 CHANGE OF USE FROM TO
STIPULATIONS
Deck construction including handrail, guardrail, spacing, etc. must comply with the
State Building Code.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPAFATE PERMITS ARE REOUIRED FOfi ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFUCTION ZONING SO. 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
ANV TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTFEET PARKING
I HEREBY CERTIfY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIE� HEREIN OF NOT. THE GRANTING Of A PERMIT �2%O.00 �.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAI LAW REGULATING CON-
STRUCTIO R THE PERFORMANCE OF CONSTRUCTION �LS.00 Fire SC �.L7
� PLAN CHECKFEE TOTALFEE
$15.77
S�GNaruaEOF N7RACTOAOAAUTHORQEDAGENT iDnrE� WHEN PfiOPERLY ALIDATED THIS IS YOUR PERMIT
�� /�7
S�GNAlUREO�OWNEAiiFOWNEABU�LDERI 1OA7E1 BLDG �NSP �1�1E
NEW
ADDN
ALTER
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CITY OF FRI DLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstruclionAddress: I�� �Iz�r...,iti-I�.12 t-'��
Effective 1 / 1 /94
�� �� °�
Legal Description: ' �
,L�.55Q G
Owner Name & Address: It�l �.15 B 2u G K NO 27 !-� �C�v.l hl N OvJ �. "I�el. �f �3I Z So-S
Contractor: C 1�`rL� ��►� til cv►.1 ;T �z-uc.-ri v�l Go 2-F' MN LIC�NSE #
Address: �n v`�� � xE 5,a�l E. �3�0o M I�l C"a`rOr�l � �,,.,Q 3� Tel, !/ �� I� I O Z�
T
Altach to t}�is application� x Certificate of Survey of d�e
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
�THER: .
0
.Length
L,ength
Length
DESCRIPTION OF IMFROVEMENT
Width Height
Widd� Heigl�t
VVidth I-IgUGround
Sq. Ft.
sy. rc.
s�. rt.
Corner Lot [] Iuside Lot [] Ft. Yd Sctback Sicle Yard Selbacks
Type of Construclion: �,G�G {�p,�12S Estimated Cost: $ �� � �27� �71��
Apprvx. Cvmpletion Date: I a- 3 �- 9�F--
(Cas� on Dack)
Driveway Curb Cul Width Needed: Ft. + 6 = Ft x$ _$
UATE: � ! - "��? � ` i APPLICANT: � TeL # S7 ( - I o Z,3
Permit Pee
Fire Surcharge
St��tte Surc�iarge
SAC Charge
License Surcharge
Drive�vay Escrow
Et�osivn Co�iu-ol
Park Fee
Sewer Main Charge
TO"TA L
S"1'1PULA"CIONS:
$
$
$
$_
$--
$
$
$'
$
$
�['TY ILSE Q�I .L�Y
Fee Scheclule on Reverse Side
.001 of Permii Valualion (1l101h�o)
$.50/$1,Q00 Valuation
$8(10 per SAC Unit
$S.QC? (Slate t,icensed �tesiclential Contractors)
Alt. "A" or Alt. "B" Above
$450.Q0 Conservation Plan Review
ree Determined, by Engineering
Agreement Necessary �� Not Necessary �)
SuB�ECT •
City of Fridley 3 0
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
i � RECEIPT NO.
� �• COMMUNITV DEVELOPMENT DIV. �D / q
� � v' � PROTECTIVE INSPECTION SEC. ���
r , ,
� _ �"'1 � CITY NALI FRIOLE� SS�J2 NuMBfR pEV O�TE PAGE O� AvvnOVEO B�
�""�' �'' 612-571-3450 9t0-Ft5 6/27/00 � �
�oe �ooRess 1633, 35 , 37, 39, 41, 43 Brenner Pass
1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. -6 $ 7-12 1 Innsbruck North Townhouse Plat S SHEET
2 PROPERTY OWNER MAIL ADORES$ Z�P PNONE
Innsbruck Townhome Association 651-224-5482
J CONTFACTOR MAII AOORESS ZIP PMONE LICENSE NO
Garlock-French Roofing corp, 2301 E. 25th St., Mpls., MN 55406 612-722-7129 0000142
1 ARCMITECT OR DESIGNER MAII AODRESS ZIP PHONE IICENSE NO.
5 ENGiNEER MAtI ADDRESS ZIP PMONE IICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW O A�DITION O ALTERATION S1 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof Townhouse Building (Tear off)
9 CHANGE Of USE FROM TO
STIPUTATIONS
Underlayment must comply with the State Building Code.
Parmit Inspection Car�s
Will Be Mai18d
To Nomeowner To Post
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYlOAO
SEPARATE PERMITS ARE RE�UtREO FOR ELECTRICAL, PIUMBING, MEATING,
VENTILATING Ofi AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NtNG SO. fT CU iT
AUTHOR12ED IS NOT COMMENCED WITMIN 60 DAVS. OR IF CONSTRUC710N
OR WORK IS SUSPENDED OF ABANDONED fOR A PERIOD OF 1�0 DAVS AT
ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKING
I HEREBV CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 6 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yAlUAT10N SURTA%
AND OpDINANCES GOVEfiNING THIS TYPE OF WOFK WILL BE COMP�IED ]_0.59 �
WITM WHETMER SPECIFIEO MEfiEIN OA NOT THE GRANTING OF A PEiiM1T �21,194. %S �
OOES NOT PRESUME TO GIVE AUTMOiiITY TO VIOLATE OR CANCEL TNE pEqMIT fEE SAC CMARGE
PROVISIpNS OF ANY OTMER STATE OR IOCAL LAW REGUTATING coN- �349 � 25 Fire SC �Z 1. i9
STRUCTION OR THE PERFOFMANCE Of CONSTRUCTION
PLAN CHEGK FEE �OiAL F
$38 . 3
S�GN�TUpEOFCQN'NA(;TOAOQ�UTNOp�ZEO�GENT iD�tE� EN ROO A�IDAT D �S IS Y UR PERMIT y
��V ��V
S�GN�TUAE O� �WNEQ��� OWNEpBU�IOEp� ��ATf� 6. �N$P ���'�t
� V, ,�� ��,y� �� �v, ,,,,V, , From: unknown Page: 2/2 Date: 6/24/2010 4:30:48 PM , ,.`
Building MECHANICAL PermitNo.::�t,i�• � b?�
Inspections RESIDENTIAL APPLICATION eceived B:
763-572-36Q4 LEY ����� �
763-502-4977 FAX CITY OF FRID
EFFEC7'IVE 2• 19-09
UAT8�410 YOUR&MAILADDRGSS dave�davesheatingandair.cotll
SIT� ADDRCSS ��3 BRENNER PASS
TF!(S APPI.ICANT IS ❑ OWNER OCONTRACTOR
PROPERTY Nu,,�g: KRYSTYNA STAFIN
OWiVER/ A���RFG�, �g43 BRENNER PASS ��ry FRIDLEY STATE MN ZIP �2
TENANT T63-502-7822 _._
PHON@:
CONTRAC'1'OR COMPANY NAME: DAVE'S HEATING, AIR 8 ELECTRtC _ _
SUBMl'C A COPY OF CONTACT PERS�N; AMY MADVIG
YOUR STATE STATE I.iCCNSE N EXP DATE
T iCF,NSE WI7'H ADDRESS: �601 37TH AVE NE C1TY COLUMBIA HEIGHTS STp� MN z1P 55421
APpLICATION pHONE 783-7B1-fi901 pAX 763-789-86U5
PERM.IT TYPE �NGLB FAMILY ❑ TWO rAMILY Q TOWNHOUSF.
TYPE OF WORK: � NEW �EPLAC6M5NT � ALTGRATION/REMODEL
L! J
DETAII..ED DESCRIP3'lON OF 1NOR(C REPLACE CENTf2AL AIR WITH LENNOX M#13ACX -024
REFS ARE BASED ON S10.(IQ PCR RIXTURF., F.XCEPT WNERE NOTED. FIXTURES: (INI)ICATF. TOTAL NUMAER OF �ACH BEI.bW)
Equi(finent Installcd MPG; �NNar MODGL: +�x� SIZFJBTU ��!
MFG: MODEL: SIZFlEi7'[J
MfQ: � MODBL: SIZFJFI'l1J
C 525.00 FfRf?PLACB (GAS) SI5.00 GAS RANGGOVEN SI0.0(1
IRTO AIR EXCHANG�ER SIS IRFPLACE (WOOD) 535.00 PfEW OAS GR1LL S10.00
�BOILGR S35.00 �NACG 575.00 �GAS UM'f HTR St0.00
CHIMWEY LINER SI0.00 UA5 DRYGR 510.00 POOL HEATER $35.00
DUCT WORK � 10.0U GAS PI I'ING S 10.00 V EhITI I.ATOR $! 5.00
Number of fixtures @�10.00 x�10.00 = S
Number uf fixlures� $15.00 x$1.5.00 = S__�__�
Number of fixtures Q$25.00 � x$25.00 r$ 25.00
Numbet of fixtures � $35.00 _ x $35.00 = $_
State Sutcharge � $ .50
iNiM[JM FEE 535.50 Totai = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALlA UTITII, PROGf.SSBD
C hereby apply for u ing permit and 1 acknowledge that the infarmation above is complete and accurate; that the wock will be in
conformance with e ord ances and codes of the Ciry of Fridley and with the Minnesota Construction Codes; that 1 understand this is
not a permit but o ly an ap lication for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in t e case 1 work whic , uires r view and approval of plans.
SIGNATURF OF AP .ICANT I'RMT NAM6� _. .. ._ T��S,.}[5��.^I.�
PL,EASE NO'F � SPARATE PER S ARE EtE I D FOR BUiLDING, BLECTRICAL AND CkiAN1CAl. WOR1C
['.itv nf Fridlev
Building Inspections Department
6431. University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
Building MECHANICAL Permit No . �
Inspections R�i SIDENTIAL APPLICATION Recei�ea sy:,�_
763-�72-3604 CITY OF FRIDLEY �� ����
763-502-4977 FAX EFFECTIVE 1-1-2010
DATE �`=� S- �� YOUR E-MAIL ADDRESS
-7
SITEADDRESS � �'-l3 /'�r�.r,n�L / ,n.�.=
THIS APPLICANT IS: ❑ OWNER J�CONTRACTOR
PROPERTY NAME: � �� f, � � % •.,
�WNER/ ADDRESS:, L. 41_i /Z F-u, n: 2 �±1 �� CITY Fr4 r.n I',, STATE�ZIP S� U3.�-
TENANT
PHONE 7G� " r V�- ?!S 1 Z
CONTRACTOR COMPANY NAME: r2t v��- C� �* � i, c.�_ f- �( 2 E }- �
SUBMIT A COPY OF CONTACT PERSON: C� %� �� J /2 tl�J Y�
YOUR STATE STATE LICENSE # EXP DATE
LICENSE WITH ADDRESS: �a- �b �� �� l�'1 �� N� CITY � Q-/O/z- STATFfi�� ZIP SSV �1
APPLICATION pHONE 7 � � "] 3` �� �3 { � �� FAX
PERMIT T'YPE Id' �INGLE FAMILY ❑ TWO FA;�fILY ❑ TOWNHOUSE
TYPE OF WORK• � NEW � REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK J-- r. ;�� � � �.� ,o [��� ,�lc.� �- �� �^ C a �•-f cf� atit c �
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXT'URES: (INDICATE TOTAL NUMBER OF EACH BELOV�
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK �� y,,
Equipment Installed MFG: /% ,� � q MODEL: UJ4��L Z�—� SIZEBTU ��
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
y A/C $25.00 F[REPLACE (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 FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $]0.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Nu�znber of fiz�tuxes @ $10.00 �� x $10.00�= $,' � � � �
Namber af fixtures � $15:00 x $15.00 = �
Number of fixtures � $?5:00 ` x $25.00 $ . '
Number of f �tures � $35.00 x $35.00 — $
State Surcharge — $ .50
� �., <
MINIMUM FEE $35.5Q � Total = �� � �
I'HIS IS AN APPLICATION FOR A PERM[T-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 Conshuction 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.
z`� i. ��s i� - � C���< >��� �ATE G��� 1• l d
SIGNATURE OF APPLICANT �"�, ��?'� / PRINT NAME
APPROVAL INSPFCTORS SIGNATURG �`� '� ��'�---�� DATE � � O
PLEASE I�IOTE: SEPARATE PERMiT ARE REQUIREI} FOR'BUiI:D1NG; ELECTRIC�;��:, , CH�ICAL WORK '
City of Fridley
B�ilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977