The URL can be used to link to this page

AF - 44136City of Fridley, Minn.. BUILDING PERMIT N� 5 s�� .: . .� ,� �` �' �""__ _ . � , � ,� � . .; r ' � - � . .. . , — � �„ �` .,�� ' �� . '��` � . . . � . . � � ._ � „�. _ No. �� . Strcet � � r��-.W.. P of L� ..�:..:.�.._..�:._._ F.�. , , ,, � Lot ....�: ...__.�.__ Block ._.�...� ...___._ Addition or Suh- i• , _ Corner Lot _..__._...._..�.._._ Inside Lot _.._....�.��.._.._ Setback _ ' Sideyard . ..___....._ � • a Sewer Elevation _..._...._.�__..___---._..._._..�_._....�....—•_--._�..._.. Foundation Elevation _._...._. . , , : . ____._ ..___._,:...._.._ . . DESCRtPT10N O� BUILDING , � To Uaed as: � ,. �t ; '� , t Depth j� Hei�ht ,� � Sq. Tt't. � Cu, Ft. �, . t .._.. Degth eight _,�• Sq. Ft. \ G�. . F�; `- � � � , : - Type of Construction ..... __��_. Est. C . o be ComPleted _ , : � �_._. _._ , . � � .�. � � r - . � . _ ;r , ,. , . , ,;., In con$ideration of the issusnee to me of a permit to construci the building de�crib�d above. I agi�ee �a do the Prnposed work in accordaiice with the� descript3�n above set fc�rtl� and• in compliance wit6 ail provL�s tf[ ordinances of the city of Fridiey. . , • � ,�, ..____. ' In consideration of the �Y�� of a Pee ot ��!��., Permit i� hereby granted to. �. • to construct the buflding or 8ddition as described above. Tlz3s permit is gi'�ttted':1�qn ' the express conditfon that tk�epe rson to whom ft is gr�nte�i and his agents, employ�es and vvork�ieo� � a� wWOa�l[ � �done in, around and upan safd building, or any part thereof, shAll conform iti � r�spec�ts to tl�e �� v�Vlth n�the 'city�limfts and�t.hfs1p�er�it�maY be rev k� atranY �me up n vio �tio�n�at�Y oR �m�pra � dE ordinancea - Bt� � , NOTICE: ' , This p�radt dws no� eowr fh� eonstruefien, inNallNioa for wi�.;�biny. Yat iwNaa, � or wM�a M wn f� srr th� buiidin� la�p�etor for HparaN p�emNs foe th�a ihms. ' �� , ` . � t -. —. �,. 0 > OFmer's �ddress gPPLICATION FOR BIIILDTNG P�MIT CITY OF FRiDIEY, MINNESOTg � f.- LOCATION OF BUILDING � � No.___,��,�3treet ' ' Part of Lot Lot�_ Block `�,, Addition or Su'bdivision �,'�,��j„Q�„ �� 11� �,rS Corner Lot Inside Lot `� Setback J'Sp Side-Yard 5� �- ,,��o � SEWER ELEVATION FOIINDA2I4N ELEITATION �pplica.nt attach to this form Certificate of Survey of' Lot and proposed building location. To be used as; ��,�,�,. , u�L_F`ront DESCRIPTION OF BUiLDING .� � / �v�D �'-� '�'`� Sq. Ft. �� — Cu. Ft. �� ln Front,�_��-C� _Depth�„� Height / � Sq. Ft. Cu. Ft. Type of Construction "� /�2 L} I� � Eatimated Cost'� i� D o� To be Completed ,� t4 ri! � P ��I � o a— , The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all Work in strict accordance with the City Qrdina.nces and ruling of the Department of Buildings, and hereby declaxes tha.t all the facts and representations atated in this applica.tion are true and correct. ^ ^ �� o- (A Schedule of Fee Costs can l�e found on the Reverse Side.) � b� h � c c' � � ,� �� L � �. w.. •. `. • � w ,> > , T _� City of Fridiey � App�icatian for P'lumbing and Gas Fitting Perrr�it � D! f Bld Ph SU 4 7470 � DESCRIPTION OF WORK Number, Kind and Location of Fixtures N Y w� . � m Z Y = y Z� Q K 3ti � o� � vi 3� o� Base �St l 2nd 3rd 4th _ • Fniure Costnectioa Openings * New Fixtuze, !f31d Openfngs U�' WATER HTR. VI K Z S� W W ? � � � Q U Z O S „j U' Z =J� ~ j� < y. � Z� a p N GAS EIEC. a� o S� <3 c�< t�� c� o PARTIAL RATE SCHEDULE PLUMBING i'IXTURE RATES: Number F`ixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... ....................... NO. RATE `O x $1.50 — x 1.20 — x 1.00 — x 3.25 Water Heater (Up to 200,000 BTIT) .. ....--,� x 2.00 New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 Sewes Cesspool TOTAi. $ 9. G U � � $ $�1 , U G $ GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures .......................... � x $1.50 $ / • � U Additfonal Fixtures .... ................ x .50 $ Gas Range to 200,000 BTU . ............. x 2.00 � REPAIRS & ALTERATIONS--Refer to Code Description ................................................$ � O TOTAL FEE $� ep . o gs. one Location _� s � �71 / � / � �= City of Fridley: The undersigned hereby makes application for a permit for Lhe work herei specified, agreeing to do all work in strict accordance with the City Ordinancs and ruling of the I3epartment of Buildings, and hereby declares t3�at all the fact and representations stated in this application are true and correct. _ Fridley, Minn ! ` �� , 19� Owner `-t Kind of Building / � Used as To be completed about �O Z Estimated Cost, $ � �� Old�. Building Permit No. ��'7`—� Permit No. �Z a� Signed ��^�-' �� - � / � `-� By �� Business Phone No.,/ ��- 3 s�✓! � D �' ^ � ?961� ROUGH FINAL az 2M � App�icarion �or P�awer Ptants and He�oling. Cooting� Ventilation, Refrigeration and Air Conditianing Systems atrd Device�s , �" PARTIAL RATE SCHEDULE (CRAVITY WARM AIR: AATE TOTAL . Furnace Sheli & Duct Work . . . . . . . . . . . . . . . . . . . . .. . . . . 8.00 $ Replacement of Furnace . . .. . . . . . .. . . . .. . .. . . .. .. . . . . 5.00 � Repairs & Alterations—up to $50Q.40 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $ ME�H. WARM AIR Furnace Shell & Duct Work to 124,000 BTU . . . . . . . . . . . . each add. 60,000 BTiT . . ........... ..... . . .. . Replacement of F�xrnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $506.00 .. ... . .: . . . . . . $.00 $ � 2.00 � r�__. 5.00 $ ' 5.00 $ 2.50 $ � STEAM or HOT WA1'ER SY3TEM Furnace Shell & Lines—to 400 sq. ft. EDft Steam .. ... 8.00 $ Furnace Shell & Lin�-to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR 5team . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—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: NO RATE 1'O�AL lst 3 Fixtures ...................... x $1.50 $ � Additional Fixtures ................. x ,50 $ Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $ :'!��lR CONDITIONIMG � ` FAN HEATING SYSTEM See Fee Schedule `VENTILATING SYSTEM $ ALTERATIONS 8e REPAIBS TOTAL FEE $ '� Roucx FINAL Dept. of Sldgs. Phone SU 4-7470 City of Fridley: 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 fact: and representations stated in this application are true and correct. .. n � Fridle3'� �. �ov 2 9 t96� � i9 _ Owner Kind of Buiiding Used as To be completed about �� 2 9 1962 00 , Estimated Cost, $ ��r� ' O��ew. uilding Permit No. ° Permit No. � G' DESCRIPTION OF WORK HEATING o , , Warm Air—No.___L� � � Trade Nam Size No.,�S� � -lIi J�j Capacity Sq. Ft. E.D.RS� �, BTtT H.P. Total Connected Loa �� ` � Kind of E`ue � BURNER — Trade Nam � Size No. �-��!1 '7 ��O Capacity Sq. Ft. E.D.R��' BT(J H.P. �� GEO. SE ICK HTG. & AIR-COND. CO 9� 1001 X�nia Av. 5. "�� Minneapolis 16, Minn. Signe , sy � ��„� 4 Z 2M 7-39 Business Phan o (REMARKS—OVER) „ „; _ . � � �, . � as� ��9 WEAT LbSS CALCULATIONS DEPARTMENT OF BUILDINCS NItNNEAP'QL.tS. MiNN• Weatheratripa A.S.H.V. , Conatruction No. Insulat�on Guide Windowa Doors Reference Out. Wall Int. Wall Geiling Roof Floor Kind I�bw_ Applied Yes—No I Yes—No 19_ . FI•� 1/A/�r►` Room Length Width / 3 Height f Fl.� (3A7 E{ Room Length '�' Wi�b Heigbt Windows. and Doors—Crackage and Area Windows and Doors—Crackage and Atea Wldth Height No. o[ Ltneal t. Area Width Helght No. ot L1nea1 !t Arq � No. ot pane ot pane lighta ot.crack eq. it. � No. o[ pane ot yane liehta of crsck �*Q. f4 � - .� O g � � � I'� � �'� x H �' Hfl Infiltration Glasa �' (j , Exp. wall % t� Net exp. wall Iat�.11 ,�c r i n e oo� Ceiling Floar j 7' � ' Total Btu. / ) ” ' Required sq. ft. E.D.R. or aq. ins. W.A. Leader area F7.� Room ( Length � Width j� Height Windows'and Doors—Crackage and Area Wtdth HeiBht No. oL Lineal !t. Area N of De.ne ot pane liahts oL crack �Q. ft. 1�l '�4, 1 3b 1�l Btu Infiltration � (� G1aaa Exp. wall t / Nct exp. wall Int. wall Ceiling Floor /,Z � /,� Total Btu. Required sq. ft. E.D.R. or aq. ins. W.A. Leader area Fl. ;;�; ' Room � Length /�:. Width � Hei Windows and Doora—Crackage and Area Wfdth Height No. of Lineal tt. Area No. of Dane ot pane lights ot crack aq. it. 2 2�l 3G� 1 1W � Coef. Btu In&ltration � $ Clasa f Exp. wall a Net exp. wall � { Int. wall Ceiling Floor / � 1'ota! Btu. . Required aq. fi. E.D.R. or sq. ins. W.A. L.eader area Infiltratioa Glaaa Exp. wall '� X Net ezp. wall Int. wall Ceiling Floor Total $tu. Required aq. ft. E.D.R. or aq. in:. W.A. l.eader at�et � .�.I 3 c3�D �m I�As�► la w� �o � Windowa and Doors—Cracicage and Area Wldth He16h[ No. of L1nea1 tt. IkeM Na of Dsns ot pane It[1►ts o! cruk .1t Infiltratioa Glaa: Exp. wall /� X Net ezp. wall Int. wall rloor � i(� � x/EJ /6 r f(p .. i F;` Total Btu. Required aq. ft. E.D.R. or aq. ina. W.A. Lea<kc area / Fl.� � Length Vf1x�h % HeiBht Windowa and Doora--Crackage and Arra Width Sa1i1►t No. o! Lin�al !t Ar�t. No. of Dane ot pan� llghtt o[ Cr�Clc p. ft. 1 g t �Q / � � ,Q . 1 t Coef Btu In6ltration 7 j,�► �, Glaas __ �'i. Q� Exp. wal! Z 5 X� Net exp. wall f (� �„ Int. wa[I Ceiling Floor � K ��"',�r" /� � � Total Btu. Required aq. ft. E.D.R. or sq. ins. QI.A. Leader atea J c .) A � � . ' . . � r � 1 H �... ' �. D-!6 � v �fEAT LOSS CALCULATIONS DEPARIMENT OF BUILDINGS MINNEA�'OI.iS. MII�1M• Weatherstrips A.S.H.V. . Conatruction No. Inaulsqon Guide Windowa Doors Reference Out. Wall Int. Wall Geiling Roof F7oor Kind I�icw. Applied Yes—No ( Yea—No 19_ /Fl.� �� /�, Room Length / Width // Height FI.� Room Length Width Eleight Windows and Doors—Crackage and Area Windows and Doors—Crackage aad Area �Yfdth HeighL No. o[ Llneal ft. Area Wldth HeiBbt No. ot Lineal fL Atea � No. of pane otpane lighta of crack ap. ft. No. ot DBne ot pane lighte of eraek p. LO.� � . � y � � g ao Coef. Bcn Coe#. Btu Infiltration �$ 3 / 4 6 Infiltration Giasa � �'U / a t� Glasa : Exp. wall „Z 5t' / y.2 Eap. wall Net exp. wall /,'�t /� Net exp. wall Int. wall Int. wall � Ceiling Ceiling w""'Flobr - !�<X /�i 3 1 �. � l Floor Total Btu. Total Btu. Required sq. ft. E.D.R. or aq. ins. W.A. Leader area Required aq. ft. E.D.R. or aq. ina. WA. I.esdez area F7.� Room � Length Width Neight �,� �m ( Length Wi�h He�ht Windows and Doora—Crackage and Area Windows and Doora—Crackage and Are� Width Helght No. o[ Llaeal Lt. Ares Wldth Hefaht No. of Lfneal 8. Ana No. ot pane ot pane Il6hts of crnek s4. tt. No. of Dane oi yane 1!`hb o! cruk p. Lt. COtf. B�U In6ltration Infittration Glaas Glaaa Exp. wall Exp. wall Net exp. wall Net ezp. wall Int. wall Int. wall Ceiling Ceiling Floar Floor Total Btu. Total Btu. Requircd sq. ft. E.D.R. or sq. ins. W.A. Leader area Required aq. ft. E.D.R. or sq. ins. WA. L.eader ares Fl. Room � Length Width Height F7,� (�� ,ength �ilid�h Height Windows and Doora—Crackage and Area Windowa and Doora--Crackage aad Area Wldth Height No. ot Lineal tt. Area Width Hei�ht No. of Linwl tt AeiNt No. of yane ot pane Itghte ot crack eq. fA IQo. ot pane ot. paoe tiBht� of craek p, !R. Coef. Btu Coef. Btu In6ltration In&ltration Glasa Glaaa Exp. wall Exp. wall Net exp. wall Net exp. wall Int, wall Int. wall Ceiling Ceiling 1� loor Floar Total Btu. 'fotal Btu. ' Required aq. ft. E.D.R. or aq. ins. W.A. Leader area Required aq. ft. E.D.R. or aq. ina. WA. Leader are; Application f�or Power Plants and Heafing. Cooling. Ventilation� Refrigeration and Air Conditioning Systems ond Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 � RepIacemeni of Furnace ............................. 5.00 � Repairs & Alterations—up to $50d.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alteratians each add. �500.00 . . . . . . . . . . . . . . . 2.50 $ MECH. WARM AIR Furnace Stiell & Duct' Work to 1?A,000 BTIJ . . . . . . . . . . . . each add. 6U,Q00 BTU ....................... Repiacement of Flirnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . Repairs & AIterations each add, $500.00 .............. STEAM or HOT WATER SY$'!'EM Furnace Shell & Lines—to 400 sq. ft. E.DR Steam ...... Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . OIL BURIvER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . : . over 3 gal, per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . GAS FITTING FEES: lst ,3 Fixtures ..................... Additional Fixtures ................. Gas Range to 200,000 BTU . . . . . . . . . . . AIR CONDITIONING FAN HEATING SY3TEM VENTILATING $YSTEM ALTERATIONS & REPAIR$ ROUGH FINAL Depi. of Bldgs. Phone SU City of Fridley: 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 ereby declares that all the facts and representations stated in this a lication e rue and carrect. // I � A F�id�'Y; Minn. . o'�- � , 19 SZ� 8.00 $ Z Q� � Owner _ 5.00 $ Kind of 5.00 $ Used as 2.50 $ � � To be completed about 8.00 $ Estimated Cost, $_�l �� — �--"� . �. 8.00 $ ld— ew. Building Permit No. ��114 Permit No. ��/ t7 2.50 $ 2.50 $ , DESCRIPTION OF WORR 5.00 $ � . � HEATING or POWER PL.ANTS—Steam, Hot Water, Warm Air—No. 5.00 $ V G J f� Trade Name Size No. \ NO RATE TOT� J�" Capacity Sq. Ft. E.D.R. BTLJ H,p, _ x$1.50 $� (~ Total Connected Loa Kind of �zet _ x .50 $ '(/D � � BURNER — Trade Name Size No. _ X z.oa $ � Capacity Sq. Ft. E.D.R. BTU H.P. i See Fee Schedule �„� � � � l' r—A/I TOTAL FEE � � `�' — (REMARKS—OYER) �¢�az 2M Business Phone 9 0 CITY OF FRIDLEY aPPLIC=,T?ON FOR PuWER P!ANTS AND HEATItJG, COOLING, VENTILATION, REFRIGERATION AND AIR COf�DITIONING SYSTEMS AND DEVICES PARTI.aL F�TE SCHEDULE �Ra`: ? T`.� li :R�i :�I .r.: R:\'CI? _ .._r.ace S :ell S Dcct �:ork $12. GO �e�'_�ca:.e::t oi : ,._..a..� 7.Oo = e: s_rs � rl`_�_4..ior.s-�u to $500. JO 7' 00 . :rs 6 :,lter�tior.s eack: add. $SGO_00 4.00 ?i�.CH.a\ I C.aL i•.'.aR�I :\ I R,: r1Y-^•dC2 Si:ell & Duct hork co 100,00C BTC eaca ac,i. S�,G00 E;J n2� =.'.CE:T.B.^.L OL °ll�.^.dCF : e: airs S:.i�err.tion�-u;� co �500. 00 :.e.sirs S Mlterations eacn add. 5�00.00 SI°'c�}: OR Y,JT ��:ITi:R 51"S'ii�.�t: �ozle� � :._..es to i00, GDO 3T0 ea� : ac;y.. y50, C�0 8:., Eo:ier o:�y L? to lOC,COG 5TU esc:, ac3n. 50,000 BTli CIL BliF.\tR- to 3 gal. per hour eac!: a�3. 3 gal. pe= i:our $12.00 4.G0 7.00 7 . C�0 4 . �l � T'OT.1L $ $ S $ / /�/,,�/ �f� �� Job Address �� S( YcJ � G►"I !�"ti�� 'l� - L= ' Department of Buildings City of L'ridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work hereiz g specified agreeing to do all work in strict accordance with tne City Co�'es $� and rulings of the Department of Euildings, ar.d hereby declares t�at all the S"),o b facts and representations stated ir. this application are true ar.d correct. $ $ Fridley, Minn. �� . �9 � oWVER r�,-� �;��, Q tiQ� � � $12.00 $ 4.U0 $ 7.00 $ 6.00 $ $10.00 $ ' 10.00 $ _ GaS SLRX�.r.- °rc� 1C0,000 3:� to 199,999 BTU 510.00 S (O,v� (over 1::,99: °'_:i see Fee Sc'r.ed�lei $ l:.�S .�IiT;�I� �LiS: is� 3 Fixtt:res x$ 3.00 $ ad3i:ior.al Fixtures _ x $ 1.00 $ Gss ::ar..;e to 199,000 BTU • x 510.00 $ ;IR C�\�?T.IJ\�\G S Fa\ 1-:�yTi\ii S1"�ii:};S See Fee Scnedule $ �'E\i ILaT?\� S:'STi:�IS S aLTE2.�TI0\S $ REP.aI RS ) 5 State Surcharqe $ .50 TOiAL FEE $� E2J;i::s Z\SF. Da �e PL�AL I`SP. Date e�PB�,;,'v;+I. c OR PER+:IT �� REI:JS°EC.IC^I FEE ($10.00) :"StiiJ:uM FcE .FOR A:IY HF.ATING PERti:ZT TS $7. 50 � KIND OF BUZLDZ?J�� USED RS ?'O HE COMPLETED T,BOUT �{ ' J � 7� ESTIMATED COST � � OLD - NEW BUILDIP3G PERMIT NO. PE?"dIT NO. 7 L.u�_� DESCRI?'=ION OF FURiJACE/BDkN�R HEATIP�G or POWER PLIINTS, Ste�un, Hot Water, Warm Air- ivo. Trade Name \ � i'E' 0� r9.�1 Size ho. p( Fj ��l � Capacity � O_ f�h�_ Sq. Ft. EIIR BTiJ �'P --�--- /� Total Connected Load ��R ��' �? Kind of Fuel _ /�f �� b� S c_ »_ BURNER - Trade Name Size 10. Capacity Sq. Ft. EDR $T� HP . Company ,�u Signed By • 'Pel. No. O � 7,%/ �.� � �� S � �. b«� 5a.� I r3�.��tio� st : ��;��,�� _ � 7 HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION � {p�p . i�3�T , Mq�;; Weathecatrips A Guide �n�truetion No. j�q� Wiac�ows I Doors Refereace Out. Wall Int. WaU Ceiliag Roof Floor Kind �r #� Yea— o Yes— 0 19_ F1•� ic/p p Room l.engt Width Height � Fl.� Room Length , Wi�h Eie�ht Windows and Doora—Crackage and Ana Window: and Doon--�Crac]tage and Atea �Vidth He1gAt No. ot Lln�al f. Ae�� ' Wldth HNSht No. ot ,Llnql fL Aeyt No, ot ps�e ol pane Ilsht• ot erack p. YQ Na ot pans ot pao� il�ht� ot eracr p.fQ . r. � . , 3b ' � ., N -� b - Coe I�Itration CJasa j Fsp. wal! Net e�p. wap �, Int. wali Ceiling Q ) C Floor Total Btu. Required sq., ft. E.D.R. or aq. iaa. �.A. i..eader atrea �.� �,,; � �A��, w��h a Windows and Doors---Crackage aad Area Wldth 8et`ht No. ot Lln�al tL Ae�a No. ot pane ot pane 11sM� ot crack p: !t. � l.VC� In6ltration / g Glaa - Exp, wa�i t,3(o X I � S � Net eYp. wall ,� •yi.a�aA pu, , Ceiling Floor 1 O ] Total Btu. Required aq. ft. E.D.R. or sq. ins. W.A. l.eader. ares Ft• `} ; o Room � Length J Width i Windowa and Door�Crackage and Area wia�h x.tinc xo. oc �rn�at cc, wna No. ot paee o[ pane 11 hN ot cr�ek �q. tt ' � , �.t N I y t � � y �I'L t lnfiltration �s � � CJass Exp. wi►It � Net ratp. waq Int. wall Ctiliag / Floor �� —� —� Total Btu. Required w. f� E.D.R. or �. ia�. area Btu . %a 0 � In5ltration �a C,lass _,_� F.�cp. waU / �T Net ezp. wall Ia� wall ,1,4 7 � � Ceiling Floor ��_� Total Bta _T�_�.. �� 0 Bcu � �� ' � �� ____---- �■ � ired fq. h. E.D.R, or �q. ias. W.A. Leatkr are: Fl.� �� w�� Windows and Door�—�CJacicagt and Area Wldth He1��4 No. ot Llneal [t. Ar�a No. ot yane ot pae� lf�6ts� o! eraek �q. [L . In6ftration Gls�s �p. «�u Net e:p, wall Int. -wall. Eeiling . Floor Total Bta R«,�;�a �. �. Eu.�. � u,. ��. w.n. t.� �. Fl. Room I Len�c1► Q/idth Windows and Doo»—Cracka�e a� Area ldth NiAt Na Ar�t Na o[naa� of oaa� llrAU a[ ee�ek. �s_ tet �� — .'Z S Net acp. wall Int. wirll ' 1 S (, g Ceiling . � D Floor _.�� Totsl Btu. dL Y Q_ Required W. k. £.D.R. or �q. ia�. WA Leader a�ea . HOUSE HEATING TEST RECORD ADDRESS '�f � uC ��L �vn �� APT. FLOOR CITY SUBURB ��'�r�� OCCUPANT �' � s �" '�a- OWNER 1 � HEAT LOSS DA H?� INST. �� SOLD BY 1'�l� INSTALLED BY Eleetrical Work By Gos Line By � TYPE OF HEAT GA FA L` HW STEAM SPACE HTR. UNIT HTR. OTHER � �� DESIGN CONVERSION MAKE �'i, MAKE OF Bl1RNER Model Model ' Ssria l � 7� b�" � V Max. BTU Rati ng INPUT �� 6� O�'�'' . MAKE OF FURNACE Model CONTROLS � �/ THERMOSTAT /�� Heat Plug �, '� Vsnt Size �� Valve_�� ., KIND OF LINER '�-'��" SIZE NONE Limit �� /� � Drah Hood � "'�^ Regularor � `^' Limit Ssfting �190 Filters Size � al%� J Number � Fan Setting % ��' "/ �' �'� Chimnsy Location Insid� ��Outside Pilot Type �'�+�-�-�+-��A� Chimney Construetion �L�-- Pilot Make '�'��+�-� Pilof Model Smoke Bomb Wiring L' Pilot Timing � r% "��' � Draft Test Tag �" L.W. Cut Off Door Prossure Lighting Inst. C� Pressure �� Pereent CO �~ Y Date Tested �� 2 InpuT CFH t�' � Pereent 02 2`�' Company Testing Staek Temp. �� Pereent CO d Name of Testsr " Form 235 �1 U City of Fridley, Minn. BUILDING PERMIT Date: _.._-----MaY_.._22_,,__ 1968._._.___..._.__..._..__..�.____....._ �T� 9'7 60 Owner: _.._._Donal�d._S�purbeck..__.._..._..._..._.._._._..__ Buiider _.._...Derksen--_B_lders.,.--_Inc_.------..----_--_.._._.._._ H 5251 Buchanan St. N. E. 3605 37th Ave. N. E. Addre�ss .....---.......--�--...-----.._._.•--__.._....__....__..._.._._.---•••-----•------•--....--•----...-----.._. Address _..__.....__._._......._...._......------•---....._...._......_......_.___._._.._._...__.._ LOCATtON OF BUILDING No. ...._5 251..---._..... Street ..-�--------------�-Buchanan----�-_S t-� --- N.�...-E--'�--�------------------.. Part of Lot ....._......._....__.__._.._.._._..._.__.._.._._..._.,. Lot ._.._.-----.1:4....._...__ Block ..---2---_......---- .............------------_. Addition or Sub-Division -.-----.--_-----.-Marion_Hil,ls_._.._._____ CornerLot .....------------•--------_ Inside Lot --------...----•------------------------- Setback ---.._.._--•-•-_--.--------_------.--- Sideyard Sewer Elevatian -------•...-----_.....----•-----...-----_.._..._..-.-•-----_...._-------------_..---._ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Family,.._Room.--..-.----.._.._ Front _..._._�:.4..'_. Depth ....._14�--_ Height ...11.�......_.. Sq. F't. ..196_...._ Cu. Ft _..2056 _..�._._..__........_.�..._..._..__......_ Front __.___.......__ Depth _...--•••---•------• Height ....._............__ Sq. Ft. •---_....._..__. Cu. F� Type of Construction _Frame......._..._....-•-•----._.....--- Est. Cost -----.....,.�35 00.. 00....._........ To be Completed .._._...__..�_.. In consideration of the issuance to me of a permit to construct the building described above, I agree to do th� proposed work in accordance with the description above t forth and '�com liance with all pr 'ons of ordinances of the city of Fridley. . permit is hereby granted to_Derlr.sen �lders . In ca�sideration of the payment of a fee of $._.�5.....QQ._..._......._., ... to construct the building or addition as described above. This permit is'granted upon ...._._,........_...._._.._...-•--•---_._. ._._--- • the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to; the ordinances o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and mavfng of buil�ings within the city limits and this permit may be revoked at any time upon violation of the provisions of sa�d ordinancea i C arence Belisle; � __ • NOTICE: ' This psemft doa not eov�r th� eonstruction, installation foe wirfna, plumbina, qas h� fh� Buildiag In�eeFo� for s�p�nt� parmi►s fo� fh�a fNms. � �w�r or wat�r. M sun to sM APPLTCAT:tQN FaR HU7LD.T.NG PBRMIT . _ ,�, _.. . . . .. CZTY OF FRSDLEY, "MIII�NNESOTf�° � OWNER' S NAM�� . � .....BUILDER _ � `' . _ ADDR�SSc�oZ�� -- - 1�iADRES'S�_� 3 �� /�� /O� • . � • .. . •. . �� ., . . LOCAT�ON OF �UILB�NC� .�.- . NO..��' �_ ._._. STREETs?�� .��._��%%�� -- . - ,1 �, . ` ., .... � . , .. ,� . : LOT_ , __�� BLQCK � ' ADDITION��OK� SUBDi�IISIflN � �' _...�...�_.�..._..� ; . _ . . ..__.._ .. . , . " . . � . .. . .. :.r.1 � 1 . . . . . _ . .. _ . . -. .ry . CORi:�SER LOT 1NSIDE LOT„�„_,SETBACK . •�: ' ' ` SiUE�iAIiD : �.�..�t � . . � _.�;; � � -- ------�-� - SEGIER EL�VAxION TOP OF FOOT�NG Apn�.icant attacla to' this form Two`�+ertifica'tes 't�rf-'Survey� of •Lot� aad pxopoaed , building location draiaii. ou these Certificat��`: �'` ' � - °?'r� : .. • . ' � � - - .,._<, • `. _ . '.• � ,. .,; . . • � DESC�tIPTIbN OF� BUI�,�1'ING .' . . , . -� . •_ .. .. To Be Us ed As : •� • .' r° ,� � . � . _ � � . F�oaC . —��. f- : .. Depth� Heigt�t .. . � "'"" _".,.' . . � . ��• , . �_� Square feet Cubic Feet �� Front � � " j`: . � De�3�"H'' - . Height . �� .i . Square feet �� Cubic Feet -x,-�'��-�'�G ' , . -a,. •� � . �. Type of Constructioa Estimated Cost��,�6�1 To Be Completed The undersigned hereby makes applicatioa for a permit for the wark herein sgecified, agreeing to do all work in atrict accordance with the CiCy of Fridley Ozdinances and rulin�s of the DepartmenC of Buildings, and hereby declares thae all the facts and represen ations stated in this application are true and correct. DATE_ ��o�� _ ,rSIGNATURE � _ ,_ (Sched le of Fee Costs can be found on the Reverse Sidej. �Tr� ; ,, ,..� 1,�:` � �-� 4�oZ ��.3 � � • �. : � rE . .(9:°:' �: BUILDING PERMIT FEE SCHLDL}LE � " SEC'I'IDN 2: . The knspector._o£. Buildings sha��., before f��,�ng permfts for the"� erectiot! o� �hy �uilding or s'Cruc'ture, or for any addition ta anq existing structu�ce o�; �.building, or f�er �any aZteratior► car �epairs to any existirig biii:lding or structure, upon appl�ication th�kefare, requfre Che the payment.by the,;appiicant,.for such.�ermit of.f�es to,the.amount herein below set foxth and in the;manaer herin �xovides� to-wnLt:: . . jJtiffor� . ildin�Code: ��Type �, 2, ��- $1.75 for each one thousand cubic feet, or fractioa thereof, in such cubical contenta .•��p�;� 3 b; -5- $1.50 for each on�e Cheusand cubic feeC. . � ri.i :. ' . _,. �� F�r the� �urpoge��ef c�put��ng �fe�s for building pern�its, the cubical cont�nts �f any building or addition t�.a ua�iform height throughout by a�ltiplyir�g the ground area cov�red fr�m a poirit �e'ix (6) iricties below the iloo�. line •f,Xke basement or the cell�r te:the average height of the uppex surface or t• �tlie �average� heigY►� of the roof surface of the main gable of a pitched roo£. „� . . . . . . . : ..;� �"< � �:�- .. Fer repairs or alterations to an exi�ting atructurey: �k�e ;i?�� at the r�te of $3.0� per� each �ft��►e hundred dollars ($5�0':QO) or fraction thereof i� :the coat •f •all.,pro�osed-.wt�rk� . . . , _ , . • � . . ir� mo._case -shall,;tilie; :�ee c�$rged for .�ny.permit as ,seC farth. in�Section 2 be less`than 5.00,' . . . ., i:�" ... . ....f' . . , " ... , . � . ... . . , ♦ � � � . . . . . . NSSSD C�nnecti� Chargee based on locatien- Area 1 or �. � . • ,. - . , ^,... . .: . . . • • x- � �'"..�fT _. _ _ /D � � � (�.�1:!/ �"� � �� "{� � � / �, "X U �: ,f ,,�, Q , . �� ' � � � �z.. � �, t��.,��. 9�- 7�>�� . ,��Z �"i � �-�-�c�rc�r�c� �1f � c�-4 /�` `-.� __ % �' � (/ �� . /�� `�- E�.-�_ ��z".�.�.- - ��. i�X� r� �� . s� . �. �`v � �� / 2 �� .� 9S� . - 1 � I �� !/ � � � b!! � � � l � � �� `/ J/ � L� ` �f � S � r � t �v n u S ri� �, . � , � � - - ��9 � t� +s. .. . _ `��; ' ., ��.� . .� � � ,� t. _---R—�r�_.._ ..-.... ..... ,._--:_—c-�. . y , � i ,� � ' � " ..�. �+ � � C"7J �-ti�i.. � � `r'; `. : �( (,i�h..� �: �-i.h-t " {� • �, . � �-.�.- .� ri ' :t �1 . � � � W ��.L-v�L�C--Z'.� � Z !T . . � . �..:,. .. . _ � � ... . . � . . . . . _ . . . . . _ 5 ��it {� {� � � �' (1�% �CL.t � 5 i .Q i /fl -- F� �'�' � �i . Q ,i . �j" N " r �.�� '=° ,'�:-�,.._ :e , _.. _ _._ � '' �L' 5�:�.�C.-�..c -cl-i.. y � �_ " —• �' � � 7� 2 _ �; � .{ �AF-k--O�s�^-.s.J • ..Cii. _ 'F'�v (/ � � � •- ` � � �� .� �- � . . .. C , . .. . ?� � .-C...i � i 4/�=- - �� `;� � F �.�f--i S� i -�-�— ,�-� . � ' ..-. --.. -�_, '� _ � . _.� . ' �.-. — � ` �� t l - � .. � _ � . � ! r�' ]� � t _.. �js-:. � �ti�.�,� ri J x :�LG.•�..�- . D � G,i � 7 , � '4 � � � oa �$ �, .� ,�%Gd..[.�1fii�'..Z..;,�- ::S �r. «c.:.-Z.s::rs � � ��'� r � �,t 9 J � �/ � ti f � l� f�-!'--t�-G i-✓Z �� 1 � S � `�i \ � i� v, s� �,x; r �: ?'� (rj �/ ✓LL-c.�s/'' ��i.-+.' �� ui .�,'l�'. , , .� _°L _ " ��-�'��,_, j . % � ! --=�.-�-- . _ �� 1�; �—.-�--�-�� , ; �� .----- -' ��--��"t�� " ��` ` • : (+L�..'-�� .' .�{.C�u�c t�C-2 �- �. _ _ ��-l� �L• -,�, r�}y,L�L.c eJ�'-�-`�� F.Z-<- . _ .. .a�.T ____�.__._-- ! � �.. � �z�,� ��Q;. �% C D w ,�S'��_-_.�' t�� ._a�C- � !�a,�-� i�-f'-� �Y- �y-�e.C--t-St� �r� � C��-. �" � � ;� / �' S7`�,,� > .scyt.� � �-�5�� . '�` - - / %, �.:� _ ///� � �� A`-. � � �jL.. �rL.Cat.�.,. _,,,{.Lri�t._ik.4f <% � �'� ` � �✓N'�-'3/ � /h G � :C-i�4L1 �% ' � / . . �� . ° �IJ,C.�:�.`4� .� .�.c:;��.'� ,� �...�.y� �� i' J ��..s - ' � t �-'`-i-�,/� , r ,•-r...-ct � { ' l`"{'' -f.Y � � �� '� , - // � / ) " `� (��J }� Y � x �'� �� -�.C� �. !� �7,.�C �<� �'-t' �%��_4•'..� 4►� �.,r!:�v _. °. ._ '� � � S � � , �/''"� `3� � � / • O �_ %'Z ` � -�-E---� C' , rf. f � k u�� . j? ��,� .. .� u , . . � ��'�� — �z:-� �.�.� � t�;-��,�.,z.._ � . 3`X� �' , s�_____ _ _ _/L 1 � , �'�^�y �-� �- c-�� -� ��.s�-,--f�-- � - -�% t , z -71`. ,{�G-s'�. � c. � �'� �- �• . .�., a -. = l7� 1 - / I /2 , .— � rY.�`-� �t �` l•: ._� - i +.- �i� (i !�.-G��-�+ � Z�� C C-i..�.c-st�.' - �. F� �>�s S �=-t k� r/ --2 ►-F � � �r a � �f C ii c' Lv � �� ,�+�-�' l — X-��,�/� �s: � . . � - - rL. �-e ��.-�-��-�.-� .�C�!i �. L �--� � �< v� � . - ; �.-� � yL lF' �.; � / ) y s %"l�t � ,S — G �u.��e /- " J� sf �y - � � - �� ttr-�-t.:tu.� l� -� � t i-�' �' ��L - 7 �-'" '' � �� .�e-.cu�c�c..�. � '� �`�-�� . . - �,Li�/�;'��'� 7 -7� ' � � ,�,�.�, �.L �. C- - 2X t t, ".:�s i� , �..`" ' . / _ �� .. _ , � � . -4t -- � - l'..:.,.� �.s�.�4'�-� � � ' ' �= � , � � _ 3 - � �,��-- � �y 4'�_ , � `�4 � � . .. �_ �1-c-.�-�-r �t,�,.—: ' /Sy' . �r .�'�-�-'�` sue�ecr P IT N O. City of Fridley ° 14443 AT THE TOP OF 7HE TWINS B U I L D I N G P E R M` I T r ; � RECEIPT NO. � • COMMUt�IITY DEVELOPMENT DIV. , .� ------ � a3 �, r � � PROTECTIVE INSPECTION SEC. �iJ� 1 � f � A� �"'1 � CITY HALL FRIDLEY 55432 � NUM6ER REV. DATE PAGE � OF . APPROVED BV ` .��J \.i �� . .. . s�2-sso-3a5a g10-F15 10/2b/77 � � JOB ADDRESS 5251 Buchanan Street N. E. 1 L�GAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �-4 2 M3rldri H1�.15 SHEET 2 PROPERTY OWNER MAIL ADORESS 21P PHONE Grace Spurbeck 5251 Buchanan Street 13.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Rite Way Waterproofinq 7337 Lake Drive 786-0550 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N0. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION �I ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install drain tile 9 CHANGE pF USE FROM TO STIPULAT40NS SEPERATE P�k�iTS R��IkEG F�?P VVIRtNG� NEAT�NG, PLUMBliVC; AlVD SiGN�, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE FEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PEFMIT BECOMES NULL AND VOID If WOFK 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 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 �"2 � SOO $�-. 3�• WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANT{NG 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 �AW REGULATING CON- C�1S.00 STRUCTI R THE PERFORMANCE O�STR CTION. � PLAN CHECK FEE TOTAL FEE $16. 31 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT Ion7E� � WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT . � � _ /o -a 6 �, SiGNATUREOF OWNERIIF OWNER BUILDERI IDATEI BLDG �NSP DATE CITY OF FfZIll�EY APPI_IC/�TION FOR RESIDENTIAL BUILDING PER(�1�ITS ifVEW, I�L7ERATION5, ADDITTONS, OR REPAIRS) , � � � 13UILDER: % �Pl.,/f1 � Gt�/`� �F�ii /��i+/ l O� � OWPJ�R: �/E��CC l��t r' �� ,� /� � /'/�i � � Address : ,5�, � � ��n�'/j,q,,lff �/S� /�/ � Address : % 337 ��11 e �j��.' ' e , Tel. No.:�� - Q�� ! � No. : ��.�/ Street: � r � i �u�f/��vA�� ! LOT: /'�j� BLOCY.: _o�` ADDITION: /��lt�i�l�/iI i�-tLL.-� � CORNER LOT: INSIDE LOT: S,?.TBACK: SIDEYARD5: Applicart attach to this foxm 21ao Certificates of Survey of Lot and proposed building location drawn on these Certificates. ^ To Be Used As: DESCRIPTION OF BUILDING Front: Depths Height: ' Square Feet: Cubic I'eet: Front: Depth: Height: Square Feet: Cubic Feet: x'ype of Construction:�/�.S�A�� jP/�i(� 'f'/lt= Estir,iated Cost: $�6� 9 o�j To Be Completed: r �+'� O i✓�/'j Alt. A` Alt. B Proposed Driveway Widtl� If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Depa.rtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse si o additional infozr,�ation. � . DATE: ��_�� SIGNATURE: � Stipulations: �� . (� � /. �/ �----- ��.�i � . 0 � ��%� ��; � � �� % C'��;��b�� f ��L�� % ' � � Effective January F, 2003 �ITY OF FRICILEY INSPECTION D1�JiSlON � 1/�(�� S �� f� ��j`��.c:., �}-�, �431 Univer�ity Ave NE ��.S�j/;�` :. / �/� f �`�,J�Al2c =ri�iley MN 'S5�32 APPLIGATION FOR F01NE P �q � R L4N1'S ANO '753) 5723604 REFRIGERATtOW AND AtR CONDITI P'AX (763) 1571-P287 ,fj�T_E DU�.E 3eside�etial Furnace She:ll anc� Duc# Work, Burner - alsa Replacer�ent Furnace (S+de Vent - �ill Out Backj Gas Piping (;IVeeded with new furnace, but nat replacement) Gas Range Gas �ryer *Air Conditi�ning - AII Sizes Rate $ 3U.00 $14.00 $ 10.00 $ 10.00 $ 25.04 All Oth�ers/F�epairs & Alierations (LIS�' ON BACK cr� l;b oiVa�ue of qppliance or Work t�o .�;Or"+ � �ti r � t-�v�m�r%� f'iC� :ommerciat/Industrial i.25qa of Value af Appliance or Work T4TAL $ D. DO $ $ $ $ $ J ,DG' $ State Surcharge $ .50 TOTAL FEE $ 3�- �� `� AINiMUM FE� FO�t ANY HEATlNG/C,QOLING/YENiILAT14fV J(}�: w 2EFRIGERATIONfAIR CONDtTIbNfNG PERMIT IS 25 00 'LUS TF{E $ 50 STATE SURCHARGE �EINSPECTIdN FEE $47.Q0/Hr Air Conditfor�ers can nat be placed in a side yard without yriiten permission from adjoining property owner. H T[NG, COOLING, YEMTILATION, o ONiNG SYSTEMS �{VD DEVICES � � i � JOB AODRESS 5��% I.3r�� h/�i✓%�.v ,�TrE` / �v m m �W N E R R� c�� /��I .�-� l�' W w BUILDING USED AS__ S'r�5 �0� �IrM � It.si � . �, ESTIMATED COST �; ��"�� v� PERMIT N0. �(:��; � � QESCRIP710N OF FURNACE AND OR Bl1RN,�R � fVo. of Heating Units � Circle One (Steam) (Hot Water}/,�W�a�rm �Ai � Trade Name_ .��T"ro1� Size lVo. 1/S,00��--__�o BTU i i_ � a�> HP 1 EDR � Fuel_ �v.�-� Totaf Connected load � a r Burner Trade Name Size �lo. � BTU KP EDR The undersigned hereby makes application for a permit for the work here specitied agreeing to dfl atl work in strict accordance with the City Codes rulings of t�e Building Qivisian, and hereby declares that all the facts and o representations stated in this applicat+an ars true and correct. aaT� _ �r /t �/0 3 H EATI N G Ct� �1-�� v°ir' /�-j r,� �f�'�j.r�c�_C,.�, Signed __��'�i�^- � �� TEL # '6� %ob -�yj� FAX # Approved By��, Rough•In Date� Finai Date FILL OUT BACK SIDE FOR STAC,I�,VERIFICATION ON REPLA FIt��NT FURiVACE m � � m � � m A \ m � � S0'd �d1Dl THE 8EL4W MUST BE FtlL.ED IN WHEN REPLACING FUEL BURNI(�Ci APPt.IANCES OR 7HE AF�'PUCATtON Wtl.�. 8E RETURNED (_'1 MON VE��NT_(:A[11NFCT�R AND C[�MBI ISTInN ,p�j�j�/F�I�iCAT10N When the undersigned heroby verifies fhat the ventirlg has been examined and is free from rust, dete�oration, obstructior�s, and is seq,�ely supported and fuestopped where required. Yes (J6 No O The Ver14r1g syst�em is plasGdPVC ar�d meets all current codes and manuf��cturer specfications including siting� fength, number of elbows and termination. Yes (�1 Na (} The ur�dersigned also verifies that the r�eplaeement unit is a listed assembl}� and me�s the current oodes and manufac�eue�'s specifications. This does irtdude AGA-GAMA Category f Central Fumace Ve�ting Tables for fan assisteci anci na�,ral drait app�aances. The is sized and instaped to meet ihe curt�nt codes and manufacturer's specifications. �18(1 �QU1�8C� tp jr�N a new cnmhustian ai��;et Wi{� � Sl"L� 2titt� tf15�{6C� to meet the current oodes and manufach�rers specifications. When iq�jpq A�w,�.,t��p �� am, the undetsigned hereby verifies that it is a tisted assembly and meets the current codes and manufacturer's specificaaons. This does ir�Gude AGA-GAMA Category I Central Fumace Ven�ng 7abies tor fan assisted and natural drak appliances. Is the c�mmon vent and vent connectors sized and 'mstaUed comectly after an apptiance has been remaved from the common vent and vented s�aratiely as pe.� current oodes. Yes (� No ( ) Yes(�No( ) Yes (�j No ( ) Yes ('� Na ( Yes (?�No (: ) : r • .. � h" . ♦ � .� 11 11�1 � -./ . � • � i � � :.►1 • 1 � 111 . � 1 ,4ppGance #1 Tj�pe ;=�r,� �c�- BTU Input ii5, o�U ' r Nat AppHancs #2 Type _ks� T�2 �,?�?f`R BTU lnput _ ,� �an Assi:�ted o AppGance �F,3 7ype � Q.�� f�� BTU Input .�5., � Fan Assi:�ted � Tobl Apptiat�es �` Total Btu tnput d o�o Gommon VeJ1t 7ype Gi s�¢ � „ Vent Height I�6 �� Diametei° b`` inches flppGartc.e #1 Veni Connector Height ft Length �t Diameter __in Type �,,,_ Appliance #2 Vent Con�ector Height ft Length n Diameter __in Type App{ia�nc•�e #3 Vent Gon�tor Height ft Length ft Diameter i� Type __ R e�• i f • . ... H��tN� co: �FFa R L��.d�E /� �r } d-f E,r,.., �`t� Gd S�9ned BY= � Date : �'///9,/�,3 �� SBiS@'d S8066BL Ol J,3�QI�1� �0 1,1I� WQ�I� 9S:�T �00Z-zT-f10M _ _ C[TYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 March 30, 2004 Mr. Rick Malark 5251 Buchanan Street NE Fridley, MN 55421 Re: Final Inspection at 5251 Buchanan St NE Contractor: Affordable Air & Heating Co Dear Mr. Malark: A mechanical permit was issued on November 19, 2003 to install a furnace and humidifier 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 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 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 by homeowner after notification and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh City of Fridley � ' 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 � y�� y �� Water and Sewer Permit Application ❑ New Connection �Utility Line Repair/Relocation ❑ Existing �Water and Sewer Connection � Date: (� 5�,�.._ � Job Address: � 2 �' �� c �"+�-�' �''� �'�' ' N 2_._ � Name of Applicant (Plumber): ��5 �"�� 'f _ Name of Property Owner: �� L�- , r�� ^ � -- � Existing Structure Permit # �'� �Q � Z� f��' ,7 .% 3� Permit Type: Sewer Fee: �✓� • `�'� �c� Water Fee: Meter Fee: %� ��' Repair Fee: Relocation: State Surcharge: __„� SAC Charge: Special Assessment Fee: Total: $ Applic�ant Signature: Inspector approval: Water Meter Repair - Weekend & H� Water Connections Permit Sewer Connections Permit Inspection Fee for WateriSewer Line Special Assessments Cost of Water Meter SAC Charge State Surcharge Water Tap 04/04/OS (.�(2 -.S 2!S � Zd'�° 9 $125/hour $50 SSO $40 See En ' eerin See Utili Billin ' $1450 $ .50 See Engineering �� Refere�c�e No. 602-05-0622 �� Request For Service Report City of Fridiey � SBfVIC@ FiBQU�@d _final stewer in�,ec�tinn Department Public Worlrs Location of Service need 5251 Buchanan St NE Owne� or Agent of Property S�e-Gene's Water � Seve= Name of Citizen Date � n / ��s Division Sewer Phone:(H) Address � 6 Details of Request Final sewer repair inspection. Time ��_ Phone:(H) 612-221-8229 Request Taken By: Jeana . ..................__._.: .. .::._:, Department � �w �' � � Person responsible for request x�� r,-��c �rG Title ��_ Action taken (include date � communication with citizen) . . � Q '(� vi �� r \ � f .. �r. 2.' Z T` �c;av� � �,,, •4 �c , _ � (1, , _ � r� �.�',��- � d� , .oc� �- �s��d . Date Clea�ed �p_�O�_, Signature of person clearing request ` Yes / No . � � 3uilding :nspections 163-572-3604 �� ^o� ITE ADDRESS 'H1S APPLICANT I5 PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE BUILDING RESIDENTIAL A.PPLICATION CITY OF FRIDLEY UR E-MAIL ADDRFSS �� .�T j'7/ O OWNER �CONTRACTOR NANIE: ��G�'� �+%�Cf �%1� ADDRESS: �Z. S� �vCf�/fI"N PHONE: � (2 — ?� ` 2 li `�7' �/c crrY �3 STATE LICENSE # Z� � g� Z 6 �XP DATE 3� 3�� ADDRESS: �Z31O C�iiW� ��- �q'i- CITY �ilQ PHONE �012' �39' 7�j� FAX / S2— 73(0- %«� INGLE FAMILY/NEW CONSTRUCTION S1ZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES O ADDTTION ❑ GAR.P.GElSHED O WINDOWS O BASEMENT FINISH /�IROOF D DRAIN TILE � DECK ❑ SIDING ❑ OTi�R ❑ SWIlvA�iING POOL TYPE OF WORK: � ��' � MAINTENANCE/REPAIR �ESCRIBE WORK BEING DONE: � 3IZE OF IIvIPROVEMENT �OOFING �p �TTJMBER OF SQUARES �� JARAGES ?ROPOSED SIZE: ?ROPOSED HETGHT: >IDING � Vinyl � Aluminum � Other WWDOWS N EXISTING OPENINGS ❑Yes ONo JR FOR NEW OPENINGS-DESCRIBE SIZE OF �PENING CHANGES & TYPE OF WINDOW TO BE INSTALLED W Permit No.: oi� " Received By: Date Rec' d: ATE_ZIP. 1/lG� STATL'�!7%LIP ��3 i LENGTH WIDTH HEIGHT ❑ HOUSE & GARAGE �'ATTACHED GARAGE � DETACHED GARAGE �Soffit � � � 3 ❑ Trim ❑ Fascia IACATION OF WINDOWS NUMBER OF BASEMENT REMODELING SUBMIT• 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. 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: (fJSING THE 1997 U.B.0 FEE SCHEDULE) T(1TAT..T(1R VAT.TTATTf1N � ��a OCCUPANCY TYPE Pemut Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ �%,� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ /. ,� (.0005) times the total job valuation — Minimum $.50 $ � .001 x Permit Valuation (l/10°/a) $ � $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) g ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) � _ . Make checks uavable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I 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 permit and ork is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whic e' rev' w and approval of plans. �� SIGNATURE OF APPLICANT PRINT NAME � JD DATE ` �� / Building PLIJMBING Permit r�o.: � j Inspections ��yE�TIAL APPLICATION Received By: , 763-572-3604 CITY OF FR�DLE�' D� Re�'d: ��`�I yL DATE YOUR E-MAIL ADDRESS SiTE ADDRESS THIS APPLICANT LS: 0 OWNER CON MALARK, RICHARD PROPERTY rJp,�,�: 525'� BUCHANAN STREET NORTHEAST �w�� rRIDLEY, MN 55421 TENANT �D�S� (763) 5a1-9131 S7'ATE ZIP PHONE: CONTRACTOR �A,,,�: a��M PLLIMBlN��. SUBMIT A COPY OF -; STATE LIC E7� DATE YOUR STATE �DRESS. c.i'IY STATE ZIP LICENSE WITH pHONE ' ' APPLICATION � _ PERMiT TYPE SWGLE FANIILY ❑ TWO FAMII,Y ❑ TOWNHOUSE TYPE OF W ORK: ❑ � �ttEPtac�' DETAILED DESCRIPTION OF WORK r-�.�1 z ��- w 2t� n-� zt�✓ PER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the tota! cost up to $500.00, whic�hever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixiures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = ` � FCR PR03EGTS VVf;ERE LABOR EXCEEDS 5500, FEES ARE BASED ON S 10.00 PER-FI7ti^TCiRE, FXCEP7' Wf�RE NOTED. FDCTURES: (INDICATE TOTAL NUMBIIt OF EACH BELOV� - BATH SINK/LAV _Fi.00R DRAINS SHOWER _ WATEit PIPING BATHTUB GAS PIPING (NEED r17ruC��j SWD�9VIDQG POOL _ WATER SOFCNER (S3� CLOTHE3 WASHER KITCF�N SINK � WATER CLOSET _BACI{FLOW PREV. ($i� DISHWASi-iER _ LAUNDRY TRAY �WATER HEATER (S35) FOR IRRIGATION — _ WATER N1h�I'ER _ 01i�R Fermit Fee . $ Number of fixtures (a� $10.00 x$I b.00 = S Surch e .50 Number of fixtures Qu `$15.00 x$15.00 = S TOTAL DUE $ Number of fixtures (a3 535.00 � x$35.00 =$ �r� State Surcharga = $ .50 Total = $ �.S��S'i� THIS 1S AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED t hereby apply for a building permit and I aclrnowledge that the information above is complete azid accurate; that the woric will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Consteucti�n Codes; that I understand this is not a permit but only an application for a it and work is not to start without a permit; that the work_ wi31 be in accordance with the approved plan in the case of all 'c requ' s review aad approval of plans. STGTIATURE OF APPLICANT PRINT NAME �� l l �CJY U`U� DA7"E ��7 V�� City of Fridley Building Inspections Department 6431 Ur.iversity Avenue NE, Fridley, MN 55432 763-572-3604 �uilding lnspections 763-572-3604 DA� I I" ��I`� � SITE ADDRESS �5 2-S % THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS GH<✓) S ❑ OWNER �CONTR.ACTOR PROPERTY OWNER/ I NAME: ��IC � TENANT pDDxESS: SrZ S�/ CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE NAME: .� Permit No.: Received By: '� CITY �ic+��-L STATE�LIP �G STATE LICENSE #" 9 Od " , EXP DATE 3.�l v� �DxESS:� Q; �D � S. crrY s�� sTa�r�%iz� � 1d/,� PHONE / %�'/�!' 3 � 7 F /%iE ,6d' GLE FAMIL /NEW CONSTRUCTION SIZE ❑ TWO /NEW CONSTRUCTION STORIES P'ERMIT TYPE I ❑ �DITION ❑ GARAG ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING TYPE OF WORK: I❑ NEW ❑ MAINTENANCE/REPAIR DESCRIBE WORK BEING DONE: .l.Prr��'✓� SIZE OF IMPROVEMENT QWINDOWS ❑ DRAIN TILE ❑ OTHER POOL LENGTH WIDTH HEIGHT Ft. ROOFING O HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBNIIT: GARAGES ❑ ATTACHED GARAGE l. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structurai members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl OSoffit � ADDiTIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ pther ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS�%es ❑No LOCATION OF WINDOWS 3. Eoergy Calculations OR FOR NEW OPENINGS-DESCRIB£ SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LTSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S �. !/O. � OCCUPANCY TYPE Permit Fee Plan Review Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due_ $ �. �lS $ �S, U� $ $ � $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks pavable to: Citv of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-N07 VALID UN7'IL PROCESSED 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 perniit 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 eview'and approval of plans. SIGNATURE OF APPLICANT �/ �� PRINT NAME C/�i�S r�- �� DATE /��5� U7 �