The URL can be used to link to this page

AF - 43051�T° 352. �gila�e of �'�.°Y�i��, l�ann. .y,� . 10� fi��- 3f y�, i,' .'� ; U�� . o�� r��vG� �' -�� f Ow•r_er . ��%��%�"l✓ , � � Architect Frid'_e;�, 1VIinn., , 19�f r �uilcier 1''i.�.�L � f} T F �ULT DING �� No. �0 7� V Street Part of Lot >'�"'� �✓ s Lot ��"'�'�"�'� ? Blaock Addition or Sub-DiVision _ ' S �'✓ � f�."' .:1 ?""�-..�»i�.a '��f _ . . l � . �a . . � _ .. . _ s 8 ! � t�+ � � r - t.o w,� - . - . � Y � r " ��f"�� // ,�s� ,/' } �,n` � �-+ � FT 7� ... ''' � i✓ kF Y�„�+:s� t ,y� d � �.i - r�f ...�a✓ r / „� ��'��F .i�,.}'' i ��.� � ,c� ��,.�f. �'i.+ �7 �P" ��.LL1SJ�� ¢ � ::A..3�,.,£,,�...+� . ' � C . .,�;� - : . �'s ,b"t' �Tt?21Z_.,:" � .. A . �P,i3�11�.s�� :c�E1�11� ^ �� Stories__� ��'Jlaaner of Ccrstruction �� 4 �'�`�'�:�. �:.:a �'"} ; .� `� . � , To �e uced a,s �~� { �J E,� �.�� ,r.�,c� rr`�;.t �s � r ,�.� � ,, �-�.�-K � f , �o be comp?eted > - ��:r�_ Estirnaied Cost ��% �� a� ;,,,> Permit is hereby granted the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon saifl building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regardin� the construction, alterat?on, xs�aintenance, repair and moving of buildings within the city limits, and this permit ma�,` be revoked at any ti�e upon violation of �n3� of the provisions of said . ordinances. � . � . , ' .. . - - d,.., � .. f' � . t r f pector of Buildin��. AlGP,,EEMEIV°�' �.I`d�3 S�FJ�]�R.�T �TATE1vdEN'T In cor�sideration of the i�sue and d�livery to ��.e by the Ynwpector of �uit�i�gs of a+riclle;� c�f the �,bove permit; i hereby agree to do the pro��osec� ��or� i�a. accord�,nce v�ith the description above set fo.rtY� and according to t�e provisions of t�2 �rdinance,� of �'ri�l.ey, a,ncd, }aeing first duly sworn, I�erelay state and say that the facts sta�ec� }�y me and contained in t�.e a�ave �ermit are true as �herein stated. t 1`n �, i��e`� " ✓ , �� Subscribed and sworn to before me at Fridley, 2�iannesota, this- �� . � - ,._, ��'"` � �� ; day of ! .D. 19 ^�' � . -_� , :" �,�-�..�.,,ti:r� �+ , City of Fridley, Minn. BUILDING PERMIT Date: ....�....5. ""'� �� .'"'; f.� ......_.. ............. _....._� - - -��--�--.... �s� � ?� 9 ,�/� Owner: . _.: • _- r, '�"-*�'.,�,' •-- , ,�:'�- �.•` Builder �-• -�. "� �` Address ._ :... . .....,� �'` . 'r � , ° . ��i�'�7 . ...... .... . ,� Address . . ;�-�k:-... N° �, �CATIO F BUILDING � �� .� '� F= ,� � .. - : � . ,.. rro. . . street ..... .° .. . � : � - , ........................._..... -�:.� .-.•- .-� 1.:._ .............. Part of Lot .. . �� Lot ..._ ...... ...i Block ..._,: '�. .._.... Addition or Sub-Division ..�..�w,�:c.��.�.'-.�� , ........._..... ..... .:: . �y '�+'........ �r^ .. .........._ . Corner Lot ....... . :... .... .......... Inside Lot . .. . _ ..... Setback .. ...... .... ................ ........... . . ....... Sideyaxd -� --..........._.......... . � ...... ............. . Sewer Elevation ............................ ............ ... _. ..........:........ Foundation Elevation ...................._. ..............._.. �DESCRIPTION OF BUILDING To be i�sed a�:y� �� f' ,��s�' � � , ,� ��: � � � `�" a� � : ��. i',.� , ,.r'y �-: A <, . � ; :.. . Front �. -;,�! -. De th = • .� � �,. ..Y. ° �,,� �'�. ✓� P f-1,.,r ._..__ Helght ,,,��,�` -- Sq. Ft..:?.1 :..r..--- Cu. Ft. ._._ _....._- _.... : Front De th .. ' _ _� p _.._ � Height S _ ... q. Ft. Cu. F . ..... . . .r ........ . . Type of Construction « '�. � � {"� ,�• � s�" ,�..-�,w,...,.., �,,,,;�.... Est. CosC`� ' � �`{ �' 1 ....... '`�o be Completed _ .. .. . ............. . ... . i� In consid'eration of the issuance to me of a permit to construct the building described above, I a�'� to do the proposed work in accordance with the description above set forth and in compliance with all pravlsions of ordinances of the city of Fridley. `:� !" : In consideration of the payment of a fee of $..... � ______ �---• ----•-- � �-------, Permit is hereby granted to... ._...._..... _...,---- -- °---------°-°------••----�--•--------•�-�--.--....... to construct the building or addition as described above. This permit is gra.n�d upon the express condition that the person to whom it is granted and his agents, employees and workmen, in �1 �'°ork done in, around and upon said building, or any part thereof, shall conform in all respects to the orciinances of Fridley, Minnesota regarding location, construction, alteration, maintenance repair and moving of U�lci�ngs within the city limits and this pexm�t may be revaked at any time upon violation of�any of the provisio�� of said ordinances.. y� / f� %� ' ' € '��.,+' l � __ _ _..__.._ _� ..: _�....k �:_.� __ ��"�uilding =nsP�ctor ' �--�---- ,, � -- %� --- -.___ NOTICE: This permit doea nof cover the construetion, insfallation for wiring, plumbing, gas heating, sewer or water. Be su�6 '�� see the Building Inspeetor for separafs permifs for these ifems. 4 ._ , i —_�Q.�tIZE V1i3LA�f- THIS F .MIT DOES NOT ��AWTS�,�.(� ION OF ANY PRiVATE !.A#�� C � � � � � � ' - - �- � - --,.�.-..,.�..ti.�n � � � / i / / %� � / • I • r , • ` � �� N � � � �� , � � � : / � � / � � ' 11� �:.�/��/.�./i- `��i��.�.L/t •' �: � � ' ' I � . / �%�� .� � /I' / / • • _ ' LOCATION OF BUILDING No. � �`"� Street_, .�ii�� %1 � Part of Lot Aud. Sub. �88, Tha.t paxt of Lot 10 des. as fols Comm � sipt�. on 1�. Line of said Lot Lot � d� At, ��i _�! aBlock Addition or �u iv sion "'"�"�: From .. corner erao ; tb. ii. para].lel with . e of s t 10 to Corner Lot Inside Lot Setback Side-Yard SEWER ELEVATION FOUNDATION ELEIiATION �pplicant attach to this form Certificate of 5urvey of I�ot and proposed buildiug location. To be „used a� : � DESCRIP'I'ION OF BUILDIIdG .�- . � r � Q Sq. Ft. � �� - Cu. Ft. _ Front Depth Height Ft. Cu. Ft � ._.� � Type of Conatruction Estimated Cos ,_T„�,,,_1 To be Completed The undersigned hereby makes applica.tion for a permit for the work herein specified, agreeing to da all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares tha.t all the facta and representations stated in this application are true and correct. DATE • I� �C� SIGNA`TURE - (A Schedule of Fee Coats can be found on the Reverse Side.) r � � � � r ' � � . - — � � � �: a �c �� . . 1 City of Fr�dley `�' A "catio� for P�vmbin and Ga�s Fittin Re�it PP� 9 9 � Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK ,r'` d / .� � �°%��i'°1�'J��4 I3umber, Kind and Lxatian of FixYures Location �,o '�` !�1'% <� I � I�� I Z I Z I� Y I�= I �� < I U � I O� I� a I�= I�? I + I 4 I WAT� 3 � � in 3� o�I u=i a o m<3 C�< C9aS (9'p F NIGAS ELEC. Base lst 2nd 3rd _ 4th • Future Connection Opeaings Connected with I Sewer '� New Fixture, Old Openiags Cesspool � PARTIAL RATE SCHEDULE FLUMBIN'G FIXTURE RATE5: NO. RATE TOTAL Number Fixtures ......... � ...... � x $1.50 $ /• J� Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ..... ...................... Water Heater (Up to 200,000 BTIJ) . . . . . . New Ground Run Old Bldg . . . . . . . . . . . . . GAS FITTING FEES: ist 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU . ..... ........ REPAIRS & ALTERATION3—Refer to Code x 1.20 $ x lA0 $ x 3.25 $ x 2.00 $ x 3.25 $ 130. RATE TOTAL x $1.50 $ x .5U $ x 2.00 � City of Fridley: � The undersigned hereby makes application far 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 t�hat all the facts and representations stated in this application are true and correct. Fridley, Minn , 19 6 d Owner ��'j.r �c �vi> 19—. > Kind of Building ,�'-, f..x3,�-r1.P-=--►" , 19— Used as - � �[ s_+! `e��'_� To be completed about � Estimated Cost, $ Old-1+Fe�. Building Permit No. �� G� �� SignecL ✓d �.,.�"��_-�:__....^- .... By,.:�.�...-a Business Phone No. Description................................................$ TOTAL FEE $ 11 POST 1 M-12-58 City of Fridley, Minn. BUILDING PERMIT Date: __._.._.__....��.��.1...3�.,._ 12.z 1 .._.__.___..._.____ s� N° 10976 Owner: _...�,3L.._�1.tl�.�Qn —•--__.._.._._._..__._._.._ Builder _._Da_y_id��i.---.�a.�'-lor.__._.__......__.._.._.___W_.� Addx�ess .....6428 .Dellwood Driv_e .N.E._ _ _ _ _ �,d�ss _ Box 228 Ax. Rt�k4�_ Osseo _��__� LOCATION OF BUILDING No. _.._Ei..42$.._...._.. Street _._..._....D.�.�,.lTd4QS�---�2�.ii:�_.�...-------.---•--....._.._._..... Part of Lot ....._.._.___.______._—�..—. Lot _..._..._1Q_......._..._ Block _...____.__.....___...._._.._......_.._. Addition or Sub-Division .....�.�.:__....�31.�.....�$�..._............_..........._... Corner Lot ...__-----_.._._.._ Inside Lot Sewer Elevatiari Setback ---_......._ ............._._._.... Sideyard .._...._._ Foundation Elevation ....___..._. DESCRIPTION OF BUILDING To be Used as: •-•-R:e-Shin_gle.---...._ Fmnt _._--•--..._._.__ Depth ...-•--•._....___ Height _._._......_..._ Sq. Ft �___._._._ Cu. Ft .._.__.�__ _-•- ............._....._....._.._.._..__.._._ Front __.___..._..__ Depth __.___._._ Height ._.._....__...__ Sq. Ft. _.._._._...._ Cu. F't. _.._ 7'ype of Construction __.._.._As_phalt._.._..._..._._. Es� Cost ...........�900._00.--..._...... To be Completed _.__.._? days In consideration of the issuance to me of a pernut to construct the building described above, I agree to do th8 proposed work in accordance with the description above set forth d in compliance 'th all pro�visions of ordinances of the city of Fridley. �J�� ""' ,� In ca�sfderation of the payment of a fee of �....._.__�i..,_QQ_..._.._.., permit is hereby granted to_ David M. Tavlor ._.__........_.._._..+_..._�...._....._..__. 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 agenta, employees and workmen, in all work done in, around and upott said building, or any part thereof, shall conform in all respects to the ordinances o� Fridley, Minnesota regarding lceation, construction, alteration, maintenance, repair and moving of buildings within the dty limits and this permit may be revoked at any time upoz� violation of ax�,y of the provisioa�s of safd ordinances. � � � �_� _�� _ � - . � • � ; � � � � � NOTICE: 7Ms p�rmN doa nof eover fh� eonsfrueffon, inMdlation fe� wirin�, plumbtng, oas h�aNn�, »w�e or wN�r. d� wn to tM th� BuiWiap In�p�efor fo� s�p�rN� p�rmits for th�a Ibms. �� APLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : BUILDER: ��'ir/iD /� . %.4 �/L a � ADDRE�S : (p ADDRESS : ,�0 X �a �3 .� , �PT �y, a �S� p . NO •._ � ya � STREET •_ 1��e�C,t Lrne� f�A , �...e I`f .� LOT : � C'� BLOCK: ADDITION : � . �� ' R � CORNER LOT: INSIDE LOT:� SETBACK: SIDEYARD: Appli�ant attach to this form Ttao Certificates of Survey of Lot and proposed building location drawn on these Certificates. HESCRIPTION OF BUILDING To Be Used As: �� -l��cJ�Lf Front: Depth• Height: Square Feet: Cubic Feet: Front; Depth: Height: Square Feet; Cubic Feet: �9' Type of Construction: � $c timated Cost: $�,�� 9d O� To Be Completed: � cQpwi,Q� ' The undersigned hereby makes applicativn for a permit for the work herein specified, agxeeing to do all work in sttict accoxdance 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 txue and correct. DATE : � � ' � �?� SIGNATURE : � �. (See Reverse Side For Additional Informatioa.) ��Dc \ + } , r � �,�� -�� :� �� -.�� er�, � � �. R � �n _ �.�� °��y �� e�� P�RTI�L �TE SC��1L� tiRJ1Y1YX �FARM AIl�: �,A'�LL iQ'1°1�I. !'w�ar�re ShelI & Duct Work . . . . . . . . . . �I0.00 $. Replacemcnt oi itiraace 6.00 �t Repairc & Aitcrations--up to s500.00 g pp � Repairs dc Alterattons each add. 85�0.00 . 3 W � 1ttCii. ikARM AIR �1u-nace Shell & Duct Work to 190,408 BTU eePC� asid. 60,OOQ H'�'tT . .. .. . . .. xepI�cemcnc or FLrr,ace Regaira & AtEe�ations--vp to ;500.00 Rrpairs dc A}tetatioos each add. =500.00 ..S10.OD ; . . 3.W ;.__� s.00 s ro 0 6.00 = 3.0o i STEl1� o: HOT if�A'1'EA SY!lYEDt i�zrr.ace SheiI Sc Lines—to 400 sq. it. F.DR Steem �1p.�J0 S F�unace Shell & Line�—to 640 sq. ft. EDR Fiot Water IO.UO 5. Each add. 200 aQ. tt. EDR Steam R.tl(1 � Eac3s add. 320 sq. ft. EDR Hot V7ater 3.00 S OIL BIIRh"�R--to 3 gaL per hour 6.00 5.�,,.,, over 3 gal. per hour--See �'ee Schedule _ p o GAS BURliER (up to 1�9.OQ0 BTU? 6.OQ ;�.— over 199,O13� B'I'�J S�e F� sch�dul• GAS FxTiIPiG FEEB: Ii0 AATE TOT�1L Ist 3 Flxtvres x� 200 S�.�� Additionai PS�cture�s x .?Q s-- - Gas Range to I99.Oim si 6.OP f St te Su ^ rge � �� v�� 1�IR Co�i�2oI4t14ct �2 � -� i.l�—_ TAl� R�ATIRt� 8YST�lt � Fe� Sc� J�� v�rru.srs�a s'rs� umu�ra�a t �uns �ror�. ts� � ro �- . •�� : FtlQliL � � /l — 7� � � � �c. of �a��. �� o-� � J� Ciiy o! Fridlry: The undersiqned hereby makes application for a permi4 far the svor� 3er�f� specuied, agrc�eing to do all work in stzict accordancc with the City Ord.+a�nce and ru)ing of the Depar,m�nt of Suildin�s, and hereby declar2s that �Il t2ae f�tt and reUresentatiuns stated in this application ase true arsd c�rreci. (.lwner Kind ot �Jsed as To tie completed about � — � � � � `'� �+J �U Estimated Cos� 3 .� U `J Ol New. Building Permit No. --- . P�rmit I�io. �� Tt�It OF WO�tS � or P'UWER PI.ANT�—,Steain, I�o4 Water� Warm Air—No� TYade Name . � � Size No-//7—/dD�/VMA.. Capacity---. _ .!'t. E.D.R- r�� d o� B4'[I �.,p — P TotaI Connected Lo;�d Kind oi fiae BURNER — TYade PEam� Sise No Capacity. t�na�tus—oKR) 3q. !'t. ]S.DR B1'U � � - ' � —�� - �� `, _ � � � �i .' r. �� il� Of �71C��B�/ ♦ APP��cafion Ior Ph�nbing and Gat F�i�q hn�it Dept. of Bldys. Phor►� 590-3450 DESCSIPTION OF WORS �� f� ,/� fi � I I�iumb�r, Kind and Locat�on oi Fixturea �� i N N � � � � � p � �r =� � 8Z �Z °� f � W � !;� � i� � � a� o� � ��'S� �; �4 u� �$ Base Ist 2nd 3rd 4th • Fuxur� Conn�tt�oa Op�nia9s Coaa�cl�d with * ti�w Fixtur�, Old Op�ainqs PARTIAL RAT� SCHEDULE WA7E0. NTII. . . ♦ N GA$ fLEC. Citq oi F�ridley: The undersigned hereby makes application for a permit tor the arork herei specified, agreeing to do all work in strict accordance with the Ci4� Otdinance and ruling of the Department oi Buildings. and hereby declares that all the fact and representations stated in this appllcatioa are true and correct � 1Pridlnv_Minn - - � ^ � �+ _ _ l fl/ � Owner — Kind ot S�w�r � c...�� n PLIIMBING FIXTURE AAT£S: NO. RATE TOTAL Number Flxtures . . . . . . . . . . . . . . . . x a200 S Future Fixture Opening . . . . . . . . . . . x 31.50 $ New Fixtute Old Opening . . . . . . . . . . . x a1.50 s--_- Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 a �a Water Heater ;Up to 99,000 BTU) .••• x a3.00 E� New Ground Run Old Bldg. . . . . . . . . x a3.25 $ F1�ctrle Watu� H�at�r. . . . . . . . . . . s a2.00 = GAS FITTING �E �/ ��I NO. RATE TOTAL st 3 Fixt es • . ��* • • . . � . . . . . . . x 52.00 � Additional Fiztures . . . . . . ..... . . . . . x = .?b i Gas RsaQe to 195.000 BTU . . .... . . . . ... x Sb.00 � . J�b R�PAIRS A� 1►LTERATIOI�b—R�i�s to Cod� Description . . . . . . . . . . ... . . . .. . . .... . . . ... . . .. . ... . ... . � TO'PAI. �'EE i-.�=" Used as To be completed about � ~ � �^ � � � / a�-J d ♦ Estimated Cost, a - Old 1Vew. Buiiding Permit No. Ps�rmit No. tOy (D� Signed By �� _. Business Phune No �' �3 �—C��%�� ROUGH FINlIL 'a~ - � � % � �� r � :� .� � • �... �- �h ; �; .� � _, :�. ��, � � � 9> � ''s '' '� _ w, t �c �� , i° . �z #:, � S : 'Ir �*, s; PARTiAL RATE SC��UQ.E a�,v� �r�,� arR: uan ro�r�z.. . �1.7P1AC@ �Stli �t �it]CZ W6T�C � . . . . . . .� �. ...: .. .�lo.� ai � . Rrptar.ement o4 �rnace 6.pp $ Rcpairs & Altcraticns--up to ;500.00 g pp � Repairs & AlteraUons each add. 8500.OQ . 3 W � liEC.li. WAFiM JsEit flirnace Shetl dc IDuct Work to 1�0,000 BTU . e�ch add. EQ.000 BTU . . . . . . . , Replat�es�eat of Furnace Rrpairs Ec Alterations--up to $500.40 Rcpairs & Alterattons each add. ;500.00 ST£AM o: HOT WATEA SYSTEM F�zr:ace Shell Sc Lines—to 400 sq. ft. F.DR Steem Furnace Shell dc Line--to 640 sq. ft. EDR fiot Water Each add 20p aq. tt. EI�R S?eam Ear.� add. 3Z0 sq. ft. EDR Hot Water OIL SIIAMER—W 3 gaL per hour aver 3 gal. per hour—See r'ee Schedule GAS EURNER CuD to 199,�0 BTU) � ove� 199.OQ0 BTiT Sk Fs� Schadule ..aio 0o t 3.W ; &.00 �� 6.00 ; 3.00 i �... i�-1 •: 3Y a.; ..,. . , •� � '/',� � // ..Y-�..__.__ / . � . .� U` . � +..� city ot I�rfdlcy: The undersigned hereby makes app2lcation for a permit ior the aroris A+erni specified, agreeing to dc all work en strict accordance with the City Qr�ifltante and ruting o! the Departm�nt ot Bvildings, rsd hereby declares that aIl the fad and representatiuns stated in this application are true and correet. c�� Kind o1 �Jsed aa To be completed about, �' —' o'� � ' /,5 510.�JQ S • Estimatc d Cas� S J` (�U –� 20.00 S. pld—New. Building Permit No. -_-- Psrmit No.��J�d' �.O(1 g 3.00 3,�____ _ �N OF WORg 8.00 S.,__,.._.,_.... �-0��0 8.00 t— -�_ GAS FITTING FiEB: 8i0 RA'i'E T07AL :st 3 Fflxtures x$ 200 E°� - a .,.o Additionai Ffxturea x .?6 i_._. _ Gas Range W 199.004 sE 6.l,� : ` a. ,,,. . , i , 'f��..-,. ,:rr : -;�.:� x'. - � t:r t. �� :�... �a- r �. -•�fc. iIIt� // - � ' % � State Surcharge .50 � doe F�o aeleeeiieis . � � �T�� i� HF„A�or POWEi� i'I.ANT3-SLeam, �%t Water, q� A-No- � Trade Name� - �--� Siae No—/J,� ��n!A- Capacity--- — �'t E.D.R r1 d%_ gZ•U H.F Tota2 Connected Load� � � Kind oi F1ie 0 BURNER — Trade Nan�e Siu No Cspacity 9q. !'t. E.D.R 8'd°f) ' � ca�c►.aas—ovEq � a r �_ � � �r . J� �� . =_ / �',/ . � �—_ ��/ .,, , . _ � � � . ,.�,_<:�. ..,,, . SUBJECT N City of Fridley � 16 3 3 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r ; � RECEIPT NO � • COMMUNITY DEVEIOPMENT DIV. ' j ti: - r � � PROTECTIVE INSPECTION SEC. �% 77 � � /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVEO BV � ----�: `.� 612-571-3450 910-F15 8/10/81 / / JOB ADDRESS 6428 Dellwood Drive N.E. t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. P't. �.O AUC�. SUIJ. #88 SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE Raymond Anderson 6428 mellwood Drive N.E. 571-9176 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Pilgrim Remodeling 10091 Pilgrim Way 425-6523 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Resi.dential 7 CLASS OF WORK O NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Aluminum trim and Garage Roof 9 CHANGE QF USE FROM TO STIPU.LATIONS Roof can be 2nd hut not 3rd roof. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHOFiIZED 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 �' STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`2�000 $�.•OO 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� F ANY OTHER STATE OR IOCAL LAW REGULATING CON- $32.50 STR CTIO R THE PERF ANCE OF CONSTRUCTION. PLAN CHECK FEE TO�l�I_F: �0 .i.3 X Si Tu OF ONTRA TORORAUTHOR�ZEDAGENT IDATEI WHEN PROPERIY ALIDATED THIS IS YOUR PERMIT ��i�.;�,,.,��. _+C/� ��^' C`i SiGNATURE OF OWNER IIF OWNER BU�IDERI IOATEI BLDG INSP TE CI7Y OF FRIDLCY Effective Aug. 1, 1981 kPPLIC/1TIa;�I FOft RLSIULi�lTI/t� [3UILDIilG PEf2ijITS (fde►•r, Alter��tions, Additions, or Repairs) Ot•JfdER: r�" � � r /� � � -l;- ; ,> �� Y — ADDRESS : ,�:;. � ' � ,� 1: � ( . t _�_-, t -� �i TEL N0: -- �Y'� -` // - ' ,� / / ; ; � � �UI LDER : ;'� i ,� �� - __� �- � � ADDRESS: j/,i�'�/ , '� � � . ��%.-z,� . TEL td0: !/�S._ !�,_� :�� Cons�:ruction Location STRI�T NO : , �/,% � STREET: ,� �_, f f� _�; z +� �� ' ( / 1 � ��-- � LOT: BLOCK: ADDITION: Corner Lot: Insicle Lot: SetbacY.: Sid�yards: Ap�licant attach to tliis form two Certificates af Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOi� OF COtdSTRUCTIOPd r I'ro nt : Depth : H eight : Square.Feet: Qibic Feet: �'ront : Depth : H eight: Squar.e Feet: C1�bic I'eet: Type of Cor,struction : �� „y-�_ �l�1 � z � Estimated Cost: $-��!;�`!� � �_ .�/ -' f � �� 1'-''�',� , Zb Be O�r,�pleted: �' � ' r �.r :�, , . ; =-/ ° . . Alt. A Alt. B Proposed Drive��ay Width If New Opening Is Desired: $� $ , SE� RF.VER��: SIDE OF SHEET . Zize undersigned hereb�► ma};e� application for a perntit fcr the �:�ork herein specified, agreeing to do.all work iu strict accordance with the City of I'ridley Ordinances aiid rulings of tlle Del�artmei�t of Buildings, and hereby declares that all tl�e facts and representatiens stated :n this application �re true and co;��ect. , '% ,. . D.'ST�: i '� ty�.; . �� ` °�,��" i SIGNATUi2E : �_- �-�---- Stipulations : •:%� � 4_� ,� � < � .. � �-� .� ..�..�-� �, � _:. z �_.. _ CITY OF FRIDLEY FRIDLEY MUNICIPAL CENTE4t • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (61?) 571-1287 DeCember 3, 1990 Raymond Anderson ��'a �' 5.4-3�� Del lwood Drive Fridley, ZIId 55432 RE: Property at 6430 Dellwod Drive Dear Mr. Anderson: On July l, 1990, the City of Fridley began a new program called Systematic Code Enforcement. This program is desiqned to provide fair and equitable code enforcement, improve the City's appearance, and maintain property values by creating a more attractive suburban environment. Under this program, all properties in the City will be inspected approximately once each year to ensure that they are in compliance with the Fridley City Code. A recent inspection of your property revealed that not all Code requirements are presently being met. Listed below are item(s) which do not comply with the Code: 1. Fridley City Code requires that all vehicles must be currently licensed/street operable and kept on a hard surface parking area, or stored in an enclosed structure. Observed two vehicles on your property not on hard surface which are not in compliance with any or all of the above requirements. Your prompt attention in correcting this problem would help us in our effort to improve the City. A reinspection will be conducted on or about December 20, 1990, at which time compliance is anticipated. Please call me at 572-3595 if you have questions or wish to discuss this further. Thanks for your cooperation! Sincerely, Steven Barg Code Enforcement Officer SB:ls C-90-996 _ CiTYOF FRtDLEY FRIDLEY MUIVICIPAL CEIVTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 July 9, 1991 John and Rebeka Chismar 6428 Dellwood Drive N.E. Fridley, MN 55432 Subject: Rental License Application at 6428 - 30 Dellwood Drive N.E., Fridley Dear Mr. and Mrs. Chismar: Recently, you applied for a license to operate a residential rental property at the above-referenced location. We would greatly appreciate your assistance in processing this application by addressing the following questions: l. Are both units presently occupied? 2. How many people are currently living at this address? How many of these are living in each unit? 3. What is the physical arrangement/layout separating the two units? Does anyone have access to the entire structure? Please respond to these questions either in writing or by calling me at 572-3595 as soon as possible. Thanks for your cooperation! Sincerely, Steven Barg Planning Assistant SB/dn C-91-217 CITY OF FR{DLEY iNSPECTiON DIV. Effective On January 1, 1991 6431 University Ave NE Fridley� MN 55432 APPLICATION FOR POWEFi PLANTS AND HEATING� COOLING� VENTIIATiON� 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 Rate TOTAL $ 20.00 $ $ t 0.00 $ $ 10.00 $ Gas Dryer $ 10.Oq $ 'Air Conditioning - All Sizes $�a.��" $ 10.OU $ �• a� 5�t y c n� o.z� All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work � S CommerciaUlndust�ial . 1�/o of Value of Appliance or Work State Surcharge TOTAL FEE /'�'yl,�jyt-' PLUS THE �.50 STATE SURCHARGE REINSPECTION FEE $30.00 $ � .50 �� lS. �Q 'ION � r "Air Conditioners can not be piaced in a side yard without written permissian from adjoining property owner. 3 � �. JOB ADDRESS CL�`t � g � ��( �U� � � The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the ciry codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 5- 1 ,� 9Si�t G7 � OWNER .� C� Y� V� CI'� t S Yn �"1�� BUIIDING USED AS �'�' � 4 ��Jl✓"1��6 � ESTIMATED COST � l3 v D PERMtT NO. �`l�-�� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU � HP EDR Fuel Total Connected Load Burne� Trade Name Size No. BTU �„�� EDR `� C ! 4e.i��, ' c i ��rS�A � ib '�c; i.Yt 4�'8 .•q i�•� itl;{ �� f t�'�` a�" .�, ...�.,. rn qR`*.-.�. HEATING COMPANY 1��'� `"��+��• ��• Signed By. No. ��'1—��-� Approved By �� Rough-In Date Final Date.�,��3 FILL OUT BACK SIDE FQR STACK VERIFICATION ON REPLACEMENT FURNACE � sue�ecr -EftlGfl NO. � City of Fridley 27 5 61 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ` RECEIPT NO. � ` �� COMMUNITY DEVEIOPMENT DIV. �� , j � v � PROTECTIVE INSPECTION SEC. { r , , � f /'�'1 � CITY HALL fRIDLE� SS432 NUMBER REV OATE PAGE Of APVqOVED BY �'""�" ��J 612-571-3450 9t0-F15 � � 9398 JOB ADDRESS 6428 & 6430 Dellwood Drive NE t LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED DESCR. Pt.10(470) Auditor's Subdivision ��'HH SHEET 2 PROPERTY OWNER MAII AODRESS ZIP PHONE Gre Nelson 71 6-6 1 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Seal Guard S stems 9199 Centr - 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK O NEW ❑ ADDITION O ALTERATION �} REPAIR O MOVE O REMOVE 8 DESCRIBE WORK c��'lex Reroof Y�x� Tear-off• Reside 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE Of CONST. OCCUPANCV GROUP OCCUPANCV LOAD SEPARATE PEF;MITS ARE REQUIREO FOR EIECTRICAL, PLUMBING, HEATING, VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTFUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTHUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CEATIFV THAT I HAVE READ ANO EXAM�NED THIS APPIICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORHEC7. ALl PROVISIONS OF LAWS VA�UATION SURTAX AND ORDINANCES GOVERNING THIS TVPE Of WOHK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OA NOT. THE GRANTING OF A PERMIT 6025 3.01 DOES NOT PqESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TNE pERMITFEE SACCHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 12/{. ]S Fire C G.OL PLAN CNECKFEE TOTA EE Lic S 5.0 1 .78 S�GNATUAEOFCONTRACTOAOAAU�HOA�2EOAGENT IDATEi HEN P �LI ATE . S IS R P R IT � / � 'SiGNATUAEOFOWNEA�iFOWNEABUILDEAi �OATE� BIDG NSP ��FTE a`�. �• ADDI�I„ AL'TIIt l 7 � ] - -CTI'��OF FRIDLEY - : - [] SIl�TGLE FAMII.Y AND DUPLEXES R 1 AND R 2 BUILDING PERMIT APPLICATION COI]Strl1Ct10IIAddtCSS: _ Legal Description: Owner Name & Address: Contractor• �Q Address: `1 � qq � �Yl' LIVI�i 1G AREA: GARAGE AREA: DECK AREA: OTHER: 0 . r.uecave u� _ , - �� . - ,��, a . �- /�� i � �,U � Te1.1#/ �I� l 3�ot/ 1pK3 I Nnv �cErrsE # �a�� 3(n ��3 �`7 Tel. # � t '� _ a'i%� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. � DESCRIPTION OF Il�IPROVEMENT Length Width � Height � Sq. Ft. Length Width Height � Sq. Ft. Length Width HgtlGround Sq. Ft. � Construction Type:�Q YDO� ��2Si� Estimated Cost: $ ,, ,� �p, �2 5 - (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x S =$ DATE: �'� APPLICANT: �� j �' Tel. # � �� %L7 b Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL S'TIPULATiONS: CITY USE ONLY $ l 2� •� � Fee Schedule on Reverse Side $ l0-OZ .00I of Permit Valuation (1/lOth�) $ �- � � $.50/$1,000 Valuation $ $1000 per SAC Unit � �J - l? � $5 .00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ �3�-� �ITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 Urinal APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash �3r�i:�c�;:<<:::;::::>:: Floor �a#�`i€�� `�=�= Auto. �'::::::::ik::::i::::i?: `:�>:��: Shower ..... �ir:i�€�:>::::<:: Trav ��€:�'��:::;::�>::: Drain �as�;.;;-«: Washer PLUMBING FIXTURE RATES: _ NO. �YG�-f�'.� �Di��-�'?� Ca'� �� New Fixtures � Ofd Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** —, - Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAtRS AND ALTERATIONS 1.5°/a af Value of Fixture or Appliance State Surcharge TOTAL FEE Effective On Jan 1, 2000 Gas TOTAL JOB ADDRESS_ �l�t� �'s dt,��.5��. F�� $�-� Heater Elec � The undersigned hereby makes appiication for a permit for the work herein specified agreeing to do al! work in strict accordance with the city codes and rulings of the R.uilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. _ SMITH, C.J. � I I� , 20 V I 6430 DELLWOOD DRI'JE N.E. FRIDLEY, MN 55432 Owner _ ��s3) 5o2-s�o6 Building Used As ��fl�Jli (',x,, Estimated Cost �i PERMIT NO. `� l�v PLUM8ING COMPANY OIZC��iI� �L.U!✓IL.il:�fi � SIGNED BY Approved By � TEL N0. Z" - O � Rough-In Date Final Date - /D-�l COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE �ITY OF FRIDLEY INSPECT(ON DN. �431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. R�4TE New Fixtures Old -Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Trea6ng Appliance Water Heater -Electric Water Heater - Gas*' �_ Gas Range"* Gas Dryer'� Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% af Value af Fixture or Appl�ance State Surcharge TOTAL FEE TOTAL JOB ADDRESS �!'i� �"s dt�i�y�"� 0 $� =� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the S.uilding Divisi�n, and hereby declares that all the facts and representations stated in this application are true and correct. SMITH, C.J. � .� /� , � 6430 DELLWOOD DRIVE N.E. 2 FRIDLEY, MN 55432 (763)502-6706 Owner Building Used As �51 �1V C�,+ c, � `�� Q � Estimated Cost PERMIT NO. PLUMBING COMPANY OI�C��I� LU/✓IC�II�G � SIGNED BY Approved By 1��'� L N0. Z" O Rough-In Date Final Date � "�a'�t)� COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE _ _ C[ZYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 6, 2002 Gregory Nelson 6428 Deilwood Drive NE Fridley MN 55432 Re: Paved Driveways Dear Mr. Nelson: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a pubiic nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the Ciry Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jait and/or a$700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy St mberg Planner C-02-53 _ _ CITYOF FIZIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 July 2, 2002 Gregory Nelson 6428 Dellwood Drive NE Fridley MN 55432 Subject: Paved Driveway Reminder Dear Mr. Nelson: This letter is a friendly reminder that afl driveways within the City of Fridley need to be paved by December 31, 2002". As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. For you� convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy S mberg Planner *If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. G02-83 sue�ecr P RNI17 NO: � City of Fridley 3505 AT TME TOP OF THE TWINS g � I L D I N G P E R M I T � � REC � � • � • COMMUNITY OEVELOPMENT DIV. r � � � PiiOTECTIVE INSPECTION SEC. � ��3 � � � � �"'1 � CITY HA�� FRIOIE� SSI�Z NUMBEA NEV DATE PAGE OF APPROVED 8� �""'�� 763-571-3450 9t 0-Ft 5 5/ 12 /03 / / JOB ADORESS 6428-30 Dellwood Drive NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. pt 10 Auditor's Subdivision ��88 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Rob Stolpe 6428 Dellwood Drive NE 763-571-9222 3 CONTRACTOR MAIL ADDRESS Z�P PMONE LICENSE NO Four Seasons Roofin & Sidin Inc 2832 Hedber Dr Minnetonka MN 5 0 � ARCMITEC7 OR OESIGNEfi MAIL AD�RESS ZIP PHONE LICENSE NO. 612-822-0468 20125056 5 ENGINEER MAIL AODiiESS 21P pHONE IICENSE NO 6 USE OF BUI�OING Residential Duplex 7 CIASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE % 8 DESCRIBE WOAK Repair 1 square of roof�r.g 9 CHANGEOFUSEFROM TO STIPULATIONS Ur.derlayment must comply with the State Building Code. TYPE OF GONST OCCUPANCV GROUP OCCUPANCV LOAD SEPAfiATE PERMITS AFiE REOUIqEO FOR ELECTFICAL, PLUM9ING. HEATING, VENTILATING OR AIR CONDITIONING TMIS PEAMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTNOR12E0 IS NOT COMMENCED WITMIN 60 DAVS. OR IF CONSTqUCTION OR WOFK IS SUSPENDED OR ABANDONED fOfi A PERIOD OF 120 DAVS AT ANV TIME AfTER WORK IS COMMENCEO. NO �WLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I MAVE READ AND EXAMINE� THIS APPLICATION 1 STAlLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION SUfiTAX ANO OROINANCES GOVERNING THIS TVPE OF WOfiK WILL BE COMPLIED WITH WHETMER SPECIFIEO MEQEIN OR NOT. THE GRANTING OF A PERMIT �SOO �.SO DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqMIT FEE SAC CHARGE PROVISIONS Of ANY OTHER STATE OR LOCA� LAW REGULATING CON• $23.SO Fire SC �.SO $TRUCTION OF7 TME PERFORMANCE OF CONSTRUCTION PLAN CHECKFEE TOiALfEE 'cer e SC $5.00 $29.50 S�GN�1UpE OF CON"PACTOQ OA oUTMOQ�ZED �GEHT �O�fEr EN PqOPERLY VALIOATEO THIS IS VO Q PER IT � � 3 �� S�GNnruQE O� OwtiEA �� OwrvEa Bw�DEQi �O�TEi l G�hSo r�cr SENT BY: FOUR SEASONS ROOFING & SIDING I; 952 352 9809; MAY-9-03 4:34PM; PAGE 2/2 � �JUL-19-2@02 13:27 FROhI CITY 0� FRIDLEY TO 9523529809 P.01/@4 N� � � CITY O� FRIDLEY Eflective 1/120D2 �dN �� 6431 Unnrersiry Ave NE, Fridiey, MN 55432 (783) STZ�GOt Bldg It�sp ALTER � J SINGLE FAMILY AND DUPLEXES R-t AND R,2 BUILDING PERMITAPPI.ICATION eo�,�tticcion Address: 6�ta g�� I I�, o o d D Y; y e �'r, d � e�r legal Descripbon' ` Owmer Name $, qddress: I�ob STo 1 p e, Tet, ��03 - 5?l -`!z z L Contcador. owr 2 er� a e 4 S i d � n ,Z n� MN LICENSE !� o?o /aSOS(o Address:�?8 3.� Ne d be.r�� n nc�� k4. � mN 353a,� Te1. ��/a � Saa- �6 �` t.lVING AREA; GARAGE AREA: OECK AREq; OTNER: Attach to this appfication, a Ce�tlfccate of Survey of the tot, with the proposed constrvction drawn on it to scale. DESCRIPTION OF lMPROVEMENT �� - �� ________... Height Sq. Ft ��9� ._._,. �dth _, Height Sq_ Ft o,,, .......- . QZ� Construdion Type: R¢.r►tic� e.. aw d reDl t�c.e Roo� Estimated Cost: $ ¢�� Driveway Curb Cut Width Needed: �,Ft + 6 Ft = Ft x g � g DATE; 3 � APPLtCANT; � � Tel. � �o/a' 8.?a -0 �l�- Call (763) 572a60i tor Pertnit F�es if rr�iting in appl"�catio� or Pax to 763-6T1-9ZB7 if using crodit card and ws wHl catl you for aa�! number. Permit Fee FiCe Surcharge � State Surcharge SAC Charge License Surcharge Drtveway Escrow Erosion Contro� Park Fee Sewer Main Charge TOTA� $ ��Z, � �� ffi � S $ �� $ $ $. $ $ �i- ��Z� crrY usE oNLY - Fee Schedute on Reverse Side ' � .001 of Permit Valuatlon (1/10th�) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Lioensed Resider�tial Contradars) Alt. ��A�� or Alt ��B" Above $450.00 Ccnservatian Pl�n Review Fee Detemni�ed by �ngineering Agreement Necessary [ j Nat Necessary [] $TIPULAI'IONS; .� �-,L�� ,`� �: � `� SENT BY: FOUR SEASONS ROOFING & SIDING I; 952 352 9809; 0 To: � --�_ Fa�c; --�. Phone; �� Re; � MAY-9-03 4:34PM; PAGE 1/2 2832 Hedberg Drive Minnetonka, MN 55305 .�hone: (612) 822-0�68 Fax: (9�2) 352-9809 � Fro�; �^�F� --�_ Pa9es• nate: �' ' 9 Q3 CC; Inefuding cover O U�9�t �For R�vi�W ❑ Please Comment � p�oase Repiy Q Hard Copy To Fol1oW • Comm��is: � ! ^ �� . � a `� v 1 I�P � I � �� .,, ,, ` m 1�t � � r CITY OF FRIDLEY INSPECTION DIViSiON 6431 University Ave NE�' ' Fridley, MN 55432 =' APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572•3604 . REFRlGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective January 1, 2003 FAX (763) 571-1287 : . ' ; JOB ADDRESS ��i� �I��UD� ��-�ib 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% of Value of Appliance or Work Commercial/Industrial � 1.25 jo of Value of, Appliance or Work Rate TOTAL ; $ 30.00 $.,�� ' : . "' $ � O�oo $ '..i . � . ... $10.00 $ -� .,;.; . ° ; '-, �.., $ 10.00 $ $ 25.00 $ State Surcharge TOTALFEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.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. $ $ $ � .50 $��'% OWNER �� Sh'►i�, \ BUILDING USED AS �Sic.�r��2 ESTIMATED COST �%1SD< v`a PERMIT N0. !��(c DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_� Circle One (Steam) (Hot Water) arm Ai Trade Name l"�ri �' Size Na�SMT'A v6rYi� BTU �� ci� HP EDR Fuel .�Uaiar✓�! Gt15 Total Connected Load 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. DATE �-�l�d-� � CenterPoint Energy Minnegas�o { ` HEATING C013562 Central Ave NE, Anoka, MN 55304 Signed FAX # 763-757-6701 Approved By _ Rough•In Date 53-'757=6202 ' � c� � Final Date �G� FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE � THE BELOW MUST BE FlLLED IN WHEN REPLACING FUEL BURNING APPUANCES OR THE qppLJCATiON WILL BE RETURNED - .�...,.��c�Tna o �� MBlIST1�N �� •• �, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. The venting system is plastiGPVC and meets ali current codes and manufacturer Specifications including sizing, length, number of elbows and termination. Yes (X► No ( ) Yes (�1 No i ) The undetsigned also verifies that the replacement unit is a listed assembly and meets the cument codes and matrnaufF m ce Venti gcTabl s fo' f noes i n d u d e A G A- G A M A C a t e g o ry I C e n Y e s �) N o () assisted and natural draft appiiances. . .rne • is sized and installed to meet the current codes and manufadurers specfications. �n �u�� , • wi�� be sr�ed and installed to meet the current codes and manufacturer's specifications. � , the undersigned hereby verifies that � is a Gsted assembly and meets the current codes and manufacturer's specifications. Th� dOass s ed andGnaturai d ftaappfances.n�' Fumace Verrting Tabies for fan Is the common vent and vent conned�e commonv en alnd ventedtly after an apptiance has been removed from separately as per cuRent codes. Yes � ) No ( ) Yes � ) No ( ) Yes � ) No ( ) Yes (�) No ( ) � �/1' qppliance #1 Type (� BTU input �, �_ Fan Assisted or Nat BTU Input Fan Assisted or Nat App�� T�e BTU Input Fan Assisted or Nat Appliance #3 Type ._.._ Total Apptiances Total Btu Input �DD Common Vent Type Vent Height Diameter inches qppliance #1 Vent Connector Height ft Length ft Diameter in Type qppliance #2 Vent Connector Height ____ ft Length = Diameter in Type � qppfiartce #3 Vent Connector Height = Length = Diameter in Type � _ 1 • ► ��- • •�- HEATING CO: CenterPoint EnPTQ�= M;TTOn-�-e 13562 Central Ave NE, Anoka, MN 55304 a�rsn Date : �— !�� 3 � �. . � -. � � � _ - . ---(- � Cenl�erPointTM Energy Minnegasco ADDRESS ��7� �2 I I W�� %�" N Fi OCCUPANT C.'T � � _ HEAT LOSS Yes DATE HTG. iNST. 50LD BY CenterPoint EnerQy Minnegasco Electncal Work By S Gv�..P TYPE OF HEAT FA SPACE HTR. r! GAS DESIGN MAKE t-ur�`' e� .` Model � YY( r d\O �– I Z i Serial 4�i0?� J�f �? 1r NPUT �aO. OC1(7 —T CONTROLS Pressure_�� Percent CO2 _�_ nput CFH Percent 02 � Stack Temp. �DO Percent CO 0 HOUSE IiEATING TEST RECORD APT. �FLOOR � CITY �t ol OWNER C�T S V�^�`� INSTALLED BY CenterPoint Ener Minne a o Gas Line By o�^t UNIT HTR. ___ _ _ OTHER CONVERSION � Vent Size � ` KIND OF LINER '✓� SIZE '�j � NONE---�}— Draft Hood `t�vYr� Regulator Filters Size ��i�ZSX i Number � Chimney Location Inside X Outside Chimney Construction �SoNr"� Wiring _� Test Tag 1� Lighting Inst. �C Date Tested Company stin Center ner nne asco Name of Tester '�