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AF - 42525_ . City of Fridley, M,� 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: _._.._December 26, 1972 Owner: ....Aarrel_ �1,_ _.�.�r�._.�y.g14p34.?€�?t .�.Q...._.._. Builder __�.am�_ _.... Address _..�.�Q1.....�.�.5?.Q�.�y.711_.B9Lt.��.Y_��5�.___.._____----._ Address ..:_.SamP , __ . � ', • �� LOCATION OF BUILDING No. .....55�5_.._.___.__.__. Street .__Eas_t_�avarian._.Pass�,T,.�� part of Lot Lot -----.-4-•---------------..... Block _._----- 4-----._.__-----•-------------...----- Addition or Sub-Division .__��.�'.1d.t�._�L4��...T.H.._ rd Addition Corner Lot ..._ ..............._._....._ Inside Lot __._X_..._.__.._._.._.._ Setback ..._____.��_._,.._ Sideyard Sewer Elevation -----------------------------•-----..__.___-----._.._.._..__--------_._._ Foundation IIevation -- DESCRIPTION OF BUILDtNG To be Usea as: 1200' __T.a'1n7x�1.Dxts.e---..--•---- Front __.2.4.� _. Depth ----2� �--._ Height __2& �...... Sq. F� �.fi0.0 � CU. Fk 1,5.�.6QQ� _..!CSrag�.- ............................ Front .._.1S1_�.a.'_ Depth _22.!_._ Height ___1L1.!_.. Sq. Ft. _...23.1� Cu. F't. ...�.�,.310� Type of Construction _....Wood_.Frame __�,__ Est. Cost ��0�010___._.�__„__.. To be Completed l�ear Stipula tions : SS/�� (c, In cansideration of the issuance to me of a pernut to construet the building described above, I agree tQ do 'Ehe proposed work in accordance with the description above set and in compliance with all pmvisions ot Ordinances of the city of Fridley. 10.01 St e Surcharge In consideration of the payment of a fee of $_.3,8....O.Q.��.r.., permit is hereby granted to rrp 7 A_ Fa rr Dev . .W._.._......._.__.._._.._ ......................_......._ to construct the building or addition as described above. This permit is granted upoA the express condition that the person to whom it is granted and his agents, employees and worl�nen, in alI WoTk done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinanc�8 Ol` �'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bu31t13IIgt8 vyithin the city Iimits and this permit may be revoked a upon viola ' n of any of the provisians of 88�d ordinances. . % Buildin8 Inspector nARRF.T. ('T.ARK � NOTICE: This psrmit doea not cover the eonsfruetion, installation for wiring, plumbing, gas heating, sswer or water. 8� sun To sM fhs Building Inspeetor for separate permifs fo� these items. ► � c �APPLICATIOt�I FOR RESIDE�ti'I'I�IL, FlL'�'rf2�TI0tl, OR AllllITIOi� BUILDING P�F�1IT' CITY OF FRIDLEY, �IIN�'�'�SOTA O�r�it�t' S N!�,.'�� :�I�ffl��rt/ /�? �iarN .�✓rv<J�. C'o. �3U�LD�t : SQ � E'. x'�DD�.cSS: S9�/ .�f'oa�tlryr+ 1E3/vc�• AllBR�SS: S�dn� NO:. Ss3s ST�EE=: .�Qs� ��U�Gt'e�i�ts7 /"��.sS Lt3'� ' `� BLG�CK : '¢ A�DI i ZON : -thotS�ir.�sr� i�/or�i %�/'y. ,,3 �1 /�ml�/i �i o mt Cfl�,?�T�'R L�T: iIdSID� ZOT: d� SETB.�CK: SID�1'A.�D:�_�_ I�p�� icant �Ltach to this foxrs r�o C��tific�L�s o� Sur��y oi Lo� :.�d pro�qsec� puilding location drawn on �has� ��r�ifi�a��s. � ➢ESCRIPTION OF �3UILDING �o �3e U�ad As : �a�.�a �ous�, ��on� : .�'`� � �Qpth : .�Z� � H��oh� : ..�..�ei� /.ZOt� Sc�uar� �'e�t: C,�� Cubic �se�: /.�. �'ne7� (�9:'d�e� C�''r� ' .�i'TOit�: /�i.a�' �.'ep�.i3: e� `� � HY1.�is".; /�' S�uax� ;net; �a/ Cubic s.��: ��/fl �.�P� of ��nst:�uci.ion: �'idc�� f �.�� s?��.,a��d �� $ %o .�O/�.a�3 . ,:—�,_ . . To �� resnp�a�t�d: %�� 7.3 �n� und�T;�i�;�2d 'nex�by s�'.�t�� polira�i�n zo.L a p�:r�zZ �o� �hp �aox_!{ ��x�� so�c�.L�,�,d, uor��in3 Lo �o �.11 ?�o�r!� i� �s��:i��. ��cco:��:�c� �a:�� .°n._ �C:z.2y gr �'�3,d' �y �:°dirz��3 ard �u1-? �n�;� of th� �a?�.��,*�t o� .�u? id��:�, a-�� z��;7y dvcl��;� Lz�a� all �� aL�� .�� rzpr�3�n��ions ��Xr�d i:z rx`�i ��;�nl-� cai _?n �.-� s �� nd cox�ec r . - � . /.Z — � G 7•L „� „a '�' "�d � � t �: � x �1�',.�" . (5�=� � �a�r�=� Side :; ar ��cidi ::i�n�'i. inf�J.i:i:3"t�.17C1. � � �- 7 - 7 5 � �� ,�.� Number Fixtures � x$2.00 Q, d� Future Fixtures x $1.50 New Fixture-Old Open. x $1.50 Catch Bgstn x $3.25 Water Heater-99,000 BT[T / x $3.00 ,u� Ground Run Old BZdg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: lst 3 Fixtures ^�_ x$2.00 0�• d d —r., Additional Fixtures x $ .75 __� Gas Range-199,000 BTU x �$5.00 Repairs & Alterationa See Descrf ption ; Code State Surcharge .50 TOTAL FEE $ �. S G The undersigned hereby makea application for a permit for �he work herein specified� agreeing to do all work in strict acco�dance with the City Ordinancea and rulin �f the Department o� �uildinge, and hereby declare that �11'the facta and repxeeentatione atated in this �pplication are true and correct. �/�/�3 Date ► . /tpp�[ca�ion 1�or'o�v�sr lta�ts and �a�g, Cooling, Y�nh'tt�tioe. R�tdg�lios a�d A� Condttioni�g S�a�s aid D�vic�s P,�RTtl�1L tL4TE SCHEDULE �� : �� . � �� . . ��Q.� _ Reptacemertt of Pltsnace 6.00 � Repairs dE Alterations--up to f,S00.00 g pp =-- -__ - Repairs dc Alteration� tach add. f500.OQ . 3(Kl S-_._ _ __ _ MLCiI. W1�ll1t �Ilt Furnace SheU � Dtu.K Wark to 190,000 B1V !�l:i �R:a. eii,000 B�rtl . . . . . . . Rep�e�t of lh�rnace Repairs dc Atterations--up to �.00 Repairs dL Alttrations each add. 5500.OQ STEAM or HOT WATER SYSTEI[ Furnace Shet1 bc Lines-to 400 sq. !t. F.DR Steam F�rnace Shett d: Line.-to 640 sq, it. EDR Fiot Water Each add. 200 aq. tt. EDR Steam �. Each adcl. 320 sq. ft. EDR Hot Water .SIOW �O' `7% 3.W i 6.00 = 8.00 �_ 3.00 � __ _ 520.00 S -- _ . _ ._ 20.00 S- - - -------- 3.(Nl = - - -- 3.00 i------ QIL BDRI�iER-to 3 8aL Per hour 6.0� _.___ _� ,_ over 3 ga3. per hour-See lree Schedule _ �'iA8 agR1i�R t up to 198,OOQ BTU) 6.06 j�i � o�er 193�OOiQ BTU E� F« 8el»dul� GAS �ITTIlfG F£i�: 1�0 RATE 1'O?1►L l st 3 F�xtures xj 200 S-_� � Add'etioesai lixtures — x •76 i--- -- Gas Fisa�e to 19�.00� si 6.OP = — �Ilt 4 r� !� �Tf'!E�! � xc.ica.�ra�s � �►�ns ,. � �a.- 3 � � � Fw tc� � �.��- ��-,-� � ,►L rs6 i .d�. �i � B l� St7 n.�. � s�aa.. rs.a.,. eea-�eo • ,, . i� ` cicy or �ar�: The undersigned hereby makes application for a Dermit for the worf� herd�: specified, agreeing to do all work in strict accordaace with the City Ordiaancer and ruling of Che DepartmFnt of Buildings, and hereby declues that aIl t� fad€ and representatiuns stated in this application are true and correct. F1�idley, Minn___.— - ------�,1� _ � f � � ��,J� /l �1M`flPT --� .�-i!`��-'F.�E-- �r st�l / L�! „�� . Kind of Huilding _ �Jsed ag --- -��y.�G ' --- _ `°' j -- - ✓ To be completed about _ ---.-- _---^-_ . Estimated Ca�t, S _ _ ._. - ----- ----- ---- Uld-Neyv. Building Permit No. ___ P�rmit No. �OQ� D'ACNPTIOI� OF 1�IOM FIE�►1'ING or POWL�A PL.AN15-�team, Hot Wa4r, Warm Alr-No Trade Name.� z�^�� g� ��//��3-//� Capacity��11�1%�' __ 3q. !t E.D.R HT(1 g,g Tota] Connected I.o�d lUnd ot ZLe BURNEH - Trade Nae+e_ g{� Np GD�tY 89. !t E.D R B1V $� t�w►ais-oveM + - - � � � <.�.�. _ _�i�, _ . ��i . . / � '}�., ;,a" sm ,�, r �,t !' � �...,.a a�i ,'r..+g '.n h.,w...,{. ra , ` �'. �+°°.,...„.,.°,!-.�y� � � ...�'�.� f,+ ��'.' r,..�.'t,� n ,,�. �$-x ;, $ � ra ?" °`� r.4 S`^ ... �% R �n'l, � a ��«a_:d�sw�se:.,a: a�5s e�"�ar,cs"„»vr rf a�u.::i'�t� ,ei-v� a�e�:.,�awu, � �F'r < s� �, .cc. ��$ t .,.,. �-.aa*^� -;�!!a � .� a.. �w�tffii.- .� irGtll#b'sC�biB'Wm' �i'.o`�.++s�r+o�vm�Y4va'arwaa•K� �t;,:.,m':i:� �awa d�"r�r�"5.� v i��a`� ��i��a;�i �a1�i '��i� ��'@�� T� ��.� 1�R�3°I3'i' ��s�.° .�6<'r': �S'�.' 1'�`l'19�I. ��ce ��:e?I �'r. .r`,�°�ri �a�� . . . �20.EA�1 � Rc�aiacese.€�at ci �,�mar�e 6.OJ � Fepai*t fir /�ltcratiuns----up to �.§OS.Oe� 6 OC $ _ Rc�airs c°a Altc�r�ati�+�s euch add. .",5t30.Q0 . 3(YJ � &��i. �r�.�.r"3.,�1 � fizrnace Shell � I3t:c4 �lork to I�,�CO BTU c�.,h sdd. CS3,(�t24 3'i'tI . . .. R,�p?ac�meYS4 at Flirna��:c Re�uirg & �!terataons—vp La $500.40 itzysairs 6c �lteratfor.s each add. $�e't0.00 . aia oo $ 3.W S 6.c)0 E 6.00 � 3.i� � �TE.,LM or XOT i�T�'i'�R �3'�iE�" r"�.trr:ace Shetl �c Liaes--to 400 sq. it. �'.1?R Steam 4/0.� $ Furnace Shell �c Lir.�--t� S40 sq. ft. EDR Hot Wster 20.00 $, Each add Z00 sq. ft. ��R S'etim A.()t) � E:�tcA add. 320 sq. ft. EDR Hot Wster 3.00 b OIL BDRriEP.—to 3 gaL p�r hour S.4p a over 3 gal. per hour�ee lree Schedule — wa43 �I3'�t"e�1i (,uD tn T��J� ,•'c �TiT) �.(,ii} $ s;4°�z I33.0 .�' Sa"i.1 Sse Fcao �Se;�edul• �� FI'i?1;dG r'°�l::i: �i0 R.4.'Y'E TO'rAL lst 3 Fyxtures ____ x$ 20Q E Additionai Flztures _ __ x ,7b $_.�. ._._.._ Gas Ran,e A 1�.�� x� 5 QU i i1FIt C+��°Yi3�LT w�� s� �i�.:�'$�:.'�°Wi� ffiYi? i �:� �TiL�'P�£� �Y3��0 �Y.i i�F�,.J�'�'IO?&� b� �P�i�.� ' Roua� �� - r 22.2! State Sur.charge .50 $ � � _ Bn Sme F�v ��2a � TOT.I�I. E'� � j D .�� I:�pt. off ��. �h� ��-3��.� / '►- �„ Cfty o4 �#dley: The undessigned hereby makes ap�iic�a±ion 1er a�r.nit fc�r ttye tao;k nere�r.` speciited. abre�ein� to de aII work in stzict accordar.ce with the Ci4y O:�t:sa�anss�= and r?z'ing of the Depattm.rn2 of Lvi�dir.gs, ,;.r;ci har�e�y d�el�r� that aII t€�s f��'.� and repres�ntativns staEed in this appllcation ure tne an$ ccrrect. fl idley, NFian.��,��.,,s�,�- � ,s„1�� !�� r ! tlwner L� d/}/L��/T�� Di1Sh� �-- Kind of Ataiiding ' �1se8 ae , �-%/.�,.-.��i�..�i _ To 1�e completecj about � � -- EstimaterJ Casz, $ %/r�r � OId--N� Buiiding Permit No. -_----- _ P•rmit No. �% _ a° s. rt f� 5/ HF.ATTNG or POWER FI,AI�—ut,��m, F%t Waies, Wartn Air—Ido .. Trade N3me v =__ c,�y� �o s (�/ /� �7 � � Capacisy—� �—� -- Sc&. �'t. E.D.R B'i'U S.P� Tota1 Connected Lo�d � �i �2 _ BURNER — Tr�de Atame_ Size No CaD�dtY — �. Ft �.D.R �T'U F�:. (�@M4RK�OV[Rf , � ��„e.. i _ .,�� ,_i ' ,//. /�_, ' , ,,. .�� . , , � � • 53 -8l�-s -9�5. 51 � C�t�� ricl�y � � a _ a-� • ..,,,,• ' , �ip Y �'si •.�1.�".�i3 �t�'�' ��u��''3ix� C �td �:'z::a i: as�`�y�:� �2i�:�;� . 71c�rt. of Bldrs. i'hon• �-345� . " ' , D�5CRIPTIO:i O:' VIOi1i; 5535 East Bavarian Pass 2�Iu�bar. Y.ia�. and Locc� ca of Fi�?ures I'O��''°' . . . * � N �• O o wwTf4 w7R. v . � 1 N ~ � � � ., ( �" y C .�t � . p Z V z O � U z � �� S � � � 1� � `o �, � ° � It � � 3 U � U � jU U � N G^S tl[C. _ . �� a �� I . Ea�e 1 I st I 2: .'. 3_d 1 4:.`� • Futu:• Coa:.o:•.�.^a Opoai:ir,s a X��a Fi:-h:ro. Old O>oair.r,s � P�.RiIAl. RATE S�H�DULE �ocr�z Cca;yool pLBMBS:iG FIX7L'R£ RATES: • NO. R.;TE TO?AL Nurs:ber i:x.ures . . .. . . . ... . .. . .. x S?.CA S FLture Fixture Ot+caing . . . . . • • , • x 51.50 S�_.. :Cew Fix2u:e Old Openir.g.... ...... . x 51.50 E�.._. Catc!� Basin . . . . . . . . . . . . . . . . . . . . x S3.25 S w a:cr Fieatcr 'Up to 99,000 BTUf •••• x Ss".CO S �• • tiew Crcund Run Old B:dg. ........ . x 53.25 S i:�ctzic Vla;ns He.ataz . . . . . . . . . . . . . . S ,�,2.GJ S :sJS FI7TIYG FE�S: IiO. Ri+TE T07AL Ist 3 Fixtures . . . • • • • • • •• • • . • • • • x S2.00 ; . . Additional F:xttues .. . . . .. . .. . . . . x S .73 3 ' Gas Ranye to 1�A.000 BTU . .... . . . . .. , ' x 35.00 6 . City o1 �-idley: Thc undersigned hereby makes ap�iication for a permit fcr thr a►orlc he:ei specificd� a,^,rec:ng to, do a:l «�crk in s:^c: accc �ar.ce k::h tre Gi� C��.:::n and ruling of the I?epar:mer.t cf �u•�c�'c�, and he:°by declates L�st alt L�e tacc aad represe:�tations sta:ctii in ;i::s 4�plica:ic� are trse :nd correct 'r`ridley, b'.ian 8–�5-75 ?gr-- Owner Darrel A. Farr Developement � Kind of Buildir.g r3�ie • Used as Res . To be completed about 9�2'7� �Es.timated Cost, S � 10.00 __ _ �G�'ew. i3ui.ding Prrmit A'o. P•rait Ho. �� • , Si�,�dL./��...� � , – . By MINNEGASCQ � -- Busincu Ph�ne �o RO'JC3H �xu. .-s'-16 - 7 � � � p.:."PxzRS � aLTERATiONS-Aaf.r so Cod• .50 State Surcharge . DesrripLOn . . . . .�:s�ll Gas. Grill. . .:. . . . . ... . ... . ,� 00 , ' � mru. r�. s 5. 50 • . � • � • �"�R'` �tltCharge .50¢ S . � ' . • lJ1YNPiEGASCO ' . 53-8� � -915.51 � C�i�� ivloy . .... - . �: �-R ,. ,. �. �+ysasr w-i�n -Jr R-''i- '^t .�*�^^i . � . . � . . . �p � ��..a:�:��3 $�21 Piuyi"r...a.a.� �.��a �'� �.:r�,�.� �'`��cos.a� - f?oqt. oi Bld„s. Phon• �-3450 • -- . . D�SCRIPTIO:t O: VlOili; 5535 E. B�rarian Pass Nu�ber, Y.iad as�d IaccSiea of Fi�h:res I'O�`�� . �� : � z '1 �� y � li � � �S � 3 Ea�e 1 st � � w�TE� NT�. N ,� � � O 0 � " t � p Z U Z 0� V 2 � ;� �;; � _ � ,� � �v � � 3 �V � U � IU V � N G�S fl[C. 2rd � I 3:d � t:5 • Fucti::• Con:.o:•.:..^a Opoairuls � X�a Fi:.-h:rt. Old O',J��ir.,s 1 PARTIAL RATE S�NcDULE ��aa: � c��.,�� n pLVMBING FIXTL'RE RATES: NO. RRTE TOTAL Nurr:ber F:xtures . . . . . . . . .. . . . . . . x S2•GO 5 F1�ture F�xture Oi�cning . . • • • • • • • • • x 51.50 S__.. :�ew Fixiu:e 03d Opening. ....... . x 51.50 S—.__. Catch Basin . . . . . . . . . . . . . . . . . . . x 53.25 S V4 a:er Fieatcr 'L'p to 99,000 BTU3 •••• x��.� E • :<ew Grcund Run Old B:dg. . . . .•. . •. . x 53.25 S E:�etzie i�latos Hsataz. . . . . . . . . . . . . . s �",2.00 S__._._._--- :,aL3 FITTI`�G FEES: NO. R:+'iE T07AL Ist 3 Fixtuzes • • • • • • • • • ••• • • • • • • x 32.00 ; . Adciiiional i`:xtures .. . . . .. . .. ... . x $ .75 3 ' Gas R.an?e to iS9.0�0 B;U ...... ..... , 1' x 35.40 6 5•� City of �-idley: Thc undersigned hereby rra.kes a��lication for a pezmit fcr thc arork ?:e:ei specificd, a;;ree:ng to do a:l �ti•c-k ia s:r.c: accc:� a r.; e K:; h t h e C:;� C� C: r.::: e e and ruling of the Dcpartme�t cf Bu �c�'ny�, and he: �by declares L*�:t all L'�e taC: and represe:itations sta;N L� :i:Es appL'cat:c�n are irur :nd eorrect Fridley, y.inn 8-11-75 lg-- Owner Darrel A. Farr Ibvelopement Co. Kind of Buildir.g Fr3mC _ _ Used a� Res. _ To be completed about 8-18�75 - �Estimat�:d Cost. S 10.00 _ ,� � . ]�A'ew. Bui�ding PPrmit T`o. P�rait 2to. lo–��- �� , Signed �G9y��Y � -.--��. . $y MINNEGASCO � -• $usinru Ph.,ne 1�0 ROUCX FIN.�L �/ – �/ ' % � � . p�AiRS ac 1►LTExA72oxs—Asi.z so Cod• .50 State Surcharge " - •D'OL►"Z�'�SjOA •��.��.��.��.�... •... •�....5�� . , � . � ' � � mr,�.i. �� s 5' S° ' � � � • �ass "A" �urchar.ge ,:50� ' �.�. • . , � r �' ��7 Effective Date May 1. 1988 CITY OF FRIDLEY QESIDEhTIAL APPLICATION FOR POWER PLANTS AND NEATING, COOLING, VENTILATION� REFRIGERATiON AND AIR CONDITIONING $YSTEMS AND DEVICES �ATE SCHEDULE ` RATE TO'PAL Furnace Shell and Duct Work, Sur ner (Also replacement furnace) Gas Piping (pipinq needed with new furnace) Gas Range Gas Dryer �� • Air Conditio 'nq (all sizes� All Others/Repairs and Alterations li of Value of Appliance or Work COMMERCIAL/INDUSTRIAL li of Value of Appliance or Work S 2U.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 S /li�� . $ S State Surcharge �� keinspection Fee ($15.d0) Rough Insp. Date Final Insp. � � � Date Approval for Permit __id'�-'=� MINIMUM FEE FOR ANY HEATING PERMIT IS s15.00� PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission fran adjoining neighbor. $ .$� s �.�,�D s 9 Job Addzess �J � S C� ,(�y/�/1//��,., � �/,� Department of Buildingg, 6431 [hiversity Ave. N.E., Fridley. MN 55432 City of Fridley Tel. t571-3450 The undersiqned hereby makes application for a permit for the wrk herein specified agreeing to do all wrk in strict accordance with the City Codes and rulings of the Depart�ent of Buildinga, and hereby declares that all the facts and representations stated in this applicatfon are true and correct. Fridley, Minn. � - � , 19 � � OWNER �f%/L �iLlla.G, / �/'�%i/i ��/� I — KIND OF BUILDING USED AS TO BE ODMPLETED ABOUT A-.T /� -�/ � FSTIMATED COST {� eIS OLD - NEW BUILDING PERMIT N0. PERMIT NO. �� C.T ��' DFSCRIPTION OF FURNACE/StlRNER HEATING or POWER PLANTS, Steam, Hot Water, Wazm Air- No. • Trade Name Size No. Capacity Sq. Pt. EDR STU HP 7bta1 Connected Ioad Kind of Fuel BURNER - Trade Name Si2e No. Capacity Sq. Ft. EDR B1S1 HP Company Signed By SEDGWICK HEATq9ti 8 AIR CO . Tel. t�w. AVE. S0. �1-i1U�711 Fill out back side for stack verification on replacenent furnaces SUBJECT . P E ' c�ty of Fridley 2 2 � 7 7 AT THE TOP OF THE TW INS g � I L D I N G P E R M I T � � RECEIPT NO. � � COMMUNITY DEVEIOPMENT DIV. �p� �%' -1 r � � PROTECTIVE INSPECTION SEC. 1 � �'�'1 � CITY HALL FRIDIEV SS4$2 NUMBEP REV. DATE PAGE OF APPHOVEO BY �""'�" ,�� 612-571-3450 910-F15 8/26/93 / / JOB ADDRESS SS3S East Bavarian Pass NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. 4 4 Innsbruck North Townhouse 3rd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Holly Olson 3 CONTRACTOR MAI� ADORESS Z�P PHONE LICENSE NO. Dicks Fire & Storm 864 19 Ave SE, Minneapolis, MN 55414 781-6170 2481 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII. ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WOHK Reroo� Garage (.Tear-o£�i 9 CHANGE QF USE FROM TO STIPULATIONS �xovi.de smoke detectors as �er LTB.0 1210 adjacent to all sleeping areas and in basement. TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDI710NING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZEO IS NOT COMMENCED WiTHtN 60 DAYS, OR !F CONS7pUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORHECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED $405 $+ 5Q. WITH WHETHER SPECIFIED HEFEIN OF NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $],S.00 Fire SC 5.41 STRUCTION OR 7HE PERFORMANCE OF CONSTRUCTION. PLAN CHECKfEE TOTALFEE License SC $5 0 $20,91 SiGNATUREOFCONTFACiORORAUTHOR�ZEDAGEN7 IDATEI WNE OPE ALiDA7ED THiS IS YOU PEF T � � � SiGNATUFE OF O�NNER i1F OWNEA BUILDEAI iDATE� DG iNS� 1aTE NEW ADDN ALTER [l [l il CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 5/26/93 Consbivction Address: �',S ��' East savarian Pass NE Legal Description: L ''�_ Uwner Name 8t Address: __ Tel. # �aq�� Contractor: Di�ks Fire & sto� (Richard J. willi�ns� MN LICENSE # 24a1 AC�L�tCSS: 864 19 Ave SE, Minneapolis, MN 55414 Tel. # 781--6170 Attach to this application, a Certificate of Survey of the 3� s- a 8 so lot, with d�e proposed conshvction drawn on it to scaie. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Leagth DESCRIPTION OF IMPROVEMENT Width Height Sq. F�. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. OTHER: Reroof Garage � � �� it � (� �� Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: ��aS °� Approx. Comptetion Date: � (Cost on Back) Driveway Curb C�.et Width Neaded: Ft. + 6 Ft = Ft x$ _$, DATE: 8/26/93 APPLICANT: � „ � �,n Tel. # �si-6i�o Permit Fee Fire Surcharge State Surcharge SAC Charge License Sarcharge Driveway Escrow Erosivn Control Park Fee Sewer Main Charge TOTAL $ $. $ $. $. $ $ $, $ $ 1 ��1_�s� Fee Schedute on Reverse Side .001 of Permit Valuation (1/1Qth%) $.SOI$1,000 Valuation $750 psr SAC Unit $5_�0 (Sta.te Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conse�vation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ) STIPULATIONS: � v � SuB�ECT �� city of Fridley 3 o6s2 AT TNE TOP OF TME TWINS g � I L D I N G P E R M I T � � � • � � COMMUNITY DEvEIOPMENT OIV, �� ' PROTECTIVE INSPEC710N SEC. � _ � • -.-- , r ; '; . � _ �"'1 : CITY NALL FRIOLE� SSIJ2 NUMBEN nEV O�TE P�GE O� �vvROVEO S� �""�' �'' 612-571-3450 9t0-F15 2/24/00 / / �oe �ooRESS 5533, 5537, 5539 East Bavarian Pass NE 1 IEGA� �OT NO. BLOCK TRACT Ofi ADDITION SEE ATTACMED oescR. 1,2,3,4 4 Innsbruck North Townhouse 3rd ADdition SHEET 2 PROPERTY OWNER MAIt A00R�S$ ZIP VHONE Various J CONTqACTOR MAI� ADORESS ZIP PMONE LICENSE NO North Central Builders Inc 7401 42 Ave N New Ho e MN 55427 533-6168 3763 � AFiCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE IICENSE NO. 5 ENGINEER MAII. ADORESS , �- Z�F PHONE LICENSE NO 6 USE OF BUILOING Townhouse Buildin 7 CIASS OF WORK � O NEW O ADDITION O ALTERATION � FiEPA1R p MOVE O REMOVE 8 OESCRIBE WORK Reside Townhouse Buildin 9 CHANGEOfUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCV�OAD SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAI, PLUMBING. MEATING, VENTt�ATING OR AIR CONOITIONING 7MIS PENMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING 50. fT CU fT. AUTHORIZED �S NOT COMMENCED WiTHIN 80 OAYS, Oii li CONSTRUCTION OR WORK IS SUSPENpED OR ABAMDONEO :Ofi A PERIOD Of 120 DAYS AT ANV TIME AFTER WOpK IS COMMENCED. NO DWIG. UNITS OFfSTREET PARKING 1 MEREBV CERTIfV THAT I HAVE REAO ANO EXAMINEO TNIS APPLICATION (} STALLS GARAGES ANO KNOW TME SAME TO BE TRUE AN� CORRECI. ALL PROVISIONS Of LAWS VAIUATION SUATAIf AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMP�IEO , WITM WME7MER SPECIFIEO MEREIN OA NOT. TME GRANTING OF A PEFMIT �LS, 797 $9.�FO �OES NOT PRESUME TO GIVE AUTNORITY TO VIOIATE OR CANCEL TME pEqMIT fEE SAC CMARGE PROVISIONS OF ANY OTHER STA7E OR LOCA� �AW REGULATING CON• Q STRUCTION OR THE PERf MANCE OF CONSTiiUCT10N �3O%.ZS F re SC �p1H.SO PLAN GMECK F E TAl FEE Lic se SC . 0 $340.45 S�cw�rupEO�tO C�OAOpAUTM �2EO�GEN� iD�rE� M pq V VA� ED TMIS IS UF1 PEAM�T � -��--�a $�GN�TVAE O� O�NNEA�� ON�NEpBUiIOEA� �O�TE� LOG �NS� ' �14fE sue�ecr PER c�cy of Fridley 31093 AT THE TOP Of TNE TWINS g � I L D I N G P E R M I T i � RECEIPT NO. � � � ; y�� COMMUNITV OEVELOPMENT OIV. r � �� PROTECTIVE INSPECTION SEC. � . . � j /"'1 � Ci7Y MALL FFIOIE� SS��2 NuMBEP pEV O�TE v�GE O: AV� OvEO S� �""'�' �'' 612-571-3450 910-F15 6/27�00 / / J09 ADDRESS � 5533 35 37 39 East Bavarian Pass 1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ASTACME� oescR. 1-4 4 Innsbruck North Townhouse 3rd Addition S►1EET 2 PROPERTY OWNER MAIL AODRESS Z�p PHONE Innsbruck Townhome Association 651-224-5482 J CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock-French Roofing Corp., 2301 E. 25th St., Mpls., NIlV 55406 612-722-7129 4 ARCMITECT OR OESIGNER MAt� ADORESS ZIP PHONE LICENSE NO. 00001423 5 ENGINEER MAIL AOORESS ZIP PHONE LICENSE NO 6 USE OF BUILOING Residential 7 CLASS OF WORK O NEW � ADDITION O ALTERATION [� REPA�Fi O MOVE O REMOVE 8 DESCRIBE WOqK Reroof Townhouse Building (Tear-Off) 9 CHANGE O:USEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit inspectian C�rds Wii{ Be I�al1e� Ta Homeowner To Post TYPEOFCONST. OCCUPANCY GROUP OCCUPANCVLOAD SEPARATE PERMI7S AHE REOUIREO FOii EIECTfi1CAL, PLUMBING, MEATING. VENTI�ATING OR AIR CON01710NING. TMIS PERMI7 BECOMES NULL AND VOIO IF WORK OH CONSTRUCTION ZONING SO. ft CU FT. AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OF IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO fOR A PER100 OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCEO. NO DWIG. UNITS OfFSTqEET PARKING 1 HEAEBV CERTIfV THAT I MAVE pEAO ANO EXAMINEO THIS APPLICATION 4 STA��S GARAGES AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS OF �AWS VA�UATION $URTAX ANO ORpINANCES GOVERNING 7MIS TVPE Of WORK WILI BE COMPl1ED WITM WNE7HER SPECIFIED HEREIN Oii NOT. TME GRANTING OF A PERMIT �S � lO%. 34 ��'/�'�' $2 •SS DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE Oii CANCEI TME pERMIT FEE SAC CMARGE PqOV1510NS OF ANV OTMER STATE Op IOCAI lAW REGUTATING CON• STRUCTION OR THE PERfORMANCE OF CONSTRUCTION $125.ZS Fire SC ��q ��i.HO Pl.AN CHECK F E T A� FEE 132.60 S�GNATUpEO�CON'AACTQAOq�UiNOQ�ZEO�GENT iOATE� EN ROP VA� ED TMIS 1 VOUF EpMI �� S�GN�tU�7E O� O�NNEA�� O�NNEpBU�IDEAi �OATE� �.�$P � �I<<f NEW [j AODN (] �►�.�R II Construction Address: � �egal Description: Owner Name & Address: Contractor: �.� rl ocic_ CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION S �3, 35 B�. 3� °y 3 Effecdve 1I1/2000 612fi72�3604 Bldg Insp ; /l vl �G�SS . . . . . � �ssa� a,-h�rn��. #(�.5 i- aa u � s�1 �� MN LICENSE # LY�DI �a3 N SS�-/o�Tei. # %l�- �12a-�� 'i Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROYEMENT LNING AREA: Length Width Height � Sq. Ft. GARAGE AREA: Length Wdth Height` Sq• Ft _ DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:��.Y� Estimated Cost: $ J� I b�% • 3_� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � 2 _ APPLICANT: ��- �.c�� LO�t'1 Tel.#��a-�aa-71a�''t CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in appllcation Permit Fee $�a5. �S Fee Schedule on Reverse Side Fire Surcharge $ -�� .001 of Permit Valuation (1/10th%) State Surcharge� s�'$ .�$.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] . $��_�,� �,� �� ` �; ��'7 '' l , ; .-._. ,. . • Buildzng i'LUMBING Permit No.. � � _ !� Inspections RESIDENTIAL APPLICATIOl�T Received B�� 763 572-3604 CITY OF FRIDLEY Dat��d. 763-502-4977 FAX EFFECTNE 1-I-OS DATE o Q YOUR E-MAIL ADDRESS SiTE ADDR SS .�� i ��/Y N•t/e�^ �i,{,{I' THIS APPLICANT 1S: ❑ OWNER �ONTR.ACTOR PROPERTY NA1,,�g: A n� ` � ��( ' �W�� ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: GY` r� � w , 1.��, SUBMIT A COPY OF STATE LICENSE # 6;��FC� EXP DATE YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF qDDRESS: 7 oti CITY An�� STA7'E�ZtP �� INSURANCE PHONE 7< —oL(�o� - '�dC'� F,ax �� - �C�d - d�z� 6 PERMTT TYPE � SiNGLE FAMTLY ❑ TWO FAMiLY ❑ TOWNHOUSE TYPE OF WORK: � ��'' �pLACEMENT DETAILED DESCRIPTION OF WORK � PER MS 16B.665 the permit fee is a minimum of �15.U0 or 5% of the tofal cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIX'!'URES: (INDiCATE TOTAL NUMBER OF EACH BELAV�. MINiMUM FE� $15.50. �gqTH SINK/LAV _FIAOR DRAINS _ SHOWER _ WATER PiPiNG BATHTUB GAS PIPING (NEED C1TY LIC) SWIMMING PO�L _ WATER SOFTNER ($35) CLOTHES W ASHER KITCNEN SiNK WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR iRRIGATION — — WATER METER _ OTHER Permit Fee $ �� v. �'�- Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number offixtures @$15.00 x$15.00 =$ TOTAL DUE $�.�� OR Number of fixtures @$35.00 x$35.00 =$ State Suicharge = $ .SO MINIMUM $ l 5.50 (MINIMLIM $] 5.50) Tota] _$ THiS IS AN APPLICATION FOR A PERMIT-NOT VALlD UNT(L PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approvai of plans. SIGI�ATURE OF APPUCANT ��_,��i_��2��UC �/�G�O� PRINT NAME %°-v �%�! vt ��r✓ DATE olC d APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Bt�ilding BUILDING Permit No.: �` �`� l(�35 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da��d� �� 763-502-4977 FAX EFPECTIVE I-1-2010 DATE �'—%+(' ��D YOUR E-MA[L ADDRESS � i' � ^ �' � � , j��.�, SITEADDRESS5s3� �� /3c,�uur�c�.r1 f qS3 r��P��v f�lU l��,� THIS APPLICANT IS: ❑ OWNER ,�lICONTRACTOR PROPERTY OWNER/ NAME: O�� TENANT ADDRESS: %5 E�c�v�►'��ccn �Gt5�S CITY F�rc'�f'%"'�/ STATF�_ZIP PHONE: %ln.>' _ S-�/ —SYi� CONTRACTOR Np�: Cv� u f,`,,�c Cp.ac r'c �c �Hc,. SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE ANDCERTIFICATEOF ADDRESS: y��- �3 �D C.�cic /�i�✓ CITY/v�i,� B%-4�'�o�TATE%2�/IZIP S�5`/1�2. INSURANCE pHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS 0 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE O DECK ❑ SIDING �! OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION J[� MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: S c' S � � ; Y SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING O HOUSE ONLY NUMBER OF SQUARES � NOUSE & GARAGE BASEMENT REMODELiNG SUBMIT: l. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑So�t ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calcutations IN EXISTING OPENINGS �Yes �No LOCATION OF WINDOWS FOR WINDOWS – PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE S[ZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES AHI; BASLll ON VALUATlUN,1NCLUll1NG "1'H�; CU5'1' VN' LABUIt ANll MA"1LK1AL�: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �� D� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surchazge 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 .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridle.y Attach IS AN APPLICATION FOR A PERMIT-NOT VALID UNTTL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be' in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all w rk which requires revi�w and approval of plans. SIGNATURE OF APPLICANT ✓��1 /l-�� PRINT NAME ��' yu �� S�`��`� DATE q`� �(o `+ ID Q 0 � � �� . . � ' . ' . .. . Le �� \� a ,• �� ! ��Il i �� . � �2� �.� � ,�.�__._.�, <� , � t � � \1 fM,. t f�� ) , , ' 'iV1V�t� C � - �' � �L� Nn �ir.a '�'V u�.S - l �' , _ �, : � �� 'a� � � �i�' � ��i v �,r�� p� � � N �� a ��_ r� � �� i � . � �l1/��J �'�k R � _ �� l� Proposal Contract C�eative Conc�ete, Inc. www.creativeconcreteinc.com 922 23rd Avenue NW _ �d� New Brighton, MN 55112 Bryan Stanley � r 1 _ ----------------------------------------------------- Phone: 612-414-7932 ---------�---=�----- �' ��---- �7� 1-------- PROPOSAL SUBMITTED TO PHONE DATE . . __-� � -- _, . , , - -- - < CU �/ �.• _.�.! __�� ,� . ._. ,.. �, , •— �, ,i'-~/`G- r'� .� — , �'�� -- ;? 1 fin_ ��' -� � STREET � F� ��" �� /=. I� C� t/ C.A ✓ f(.� i' "'J I a:l � S CITY / STATE ! ZIP JOB LOCATION 'J We are hereby�submitting estimates and specifications for: ;; �� j � � � C�d�� .' � ; r„ �: � ) ! � �Y �ly � ,L>G� !``' � _� G� o-�7� � �"l U ,, ��" �'l .' f%<� , i j'�'t'.- i . + t � L`� � ' ::% f , '�`. �; , . , r, �; !.�, `, r=�' � f �r� , < / '�_ , �; �� ` - J t ., � .� ��, , ; i . � » -- ; �� r; j ,�-i%: i ! . � c � (..i: t; - . i" % (�..4,i < C1 i,9 r•:, All workmanship is guaranteed against defects. However, we will not guarantee exterior concrete jobs against cracking or color variations due to temperature, humidity, and other environmental conditions. Sod repair not included unless agreed upon in the proposal. � We propose to furnish materials and labor according to the listed specifications for the amount of: _ . � � ,� .-� c�.> . �'%/,� 11'� �.i �- � �"+ � I ✓ Y` ?' � di.'9G! , r'�i. <' / L.v�%'� �'% j� r i i y%��c� dollars($ ✓ l��J r—_ � PAYMENT IS TO BE MADE IN TERMS OF AGREEMENT ABOVE Authorized Signature. Proposal Acceptance I, specifications and prices listed above. agreed upon within this document� Proposal may be withdrawn by Creative Concrete if not accepted within 60 days. , the receiver of work to be completed, agree to t6e I authorize Creative Concrete to complete work as proposed. Payment witl be made as Signature Signature Acceptance Date. **Any alteration from above agreement involving extra cost will be carried out only on written order and will become an extra charge over sod above t6e estimate stated above. Owner to carry fire and other necessary insurance. Creative Concrete provides insurance for company and compaoy-workers. .� r� �- Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: - 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX ��`r�� 1 EFFECTIVE 1-1-2011 DATE I�� r�� I YOUR E-MAIL ADDRESS SITEADDRESS J* 53S Yt�.,var i c�. ►� a�JS - THIS APPLICANT IS: ❑ OWNER L'3CONTRACTOR PROPERTY NAME: OWNER/ �DRESS: �G1 ITY STAT�ZIP�� TENANT PHONE: �I L�S % i` S-l�ir CoNTRACTOR coNrn.a�xnn�: GENTERPOTNT ENERCY sustvIIT A coPY oF corrTAC-r rExsorr: JOANN ZI NKEN YOUR STATE sTarE LicErrsE � 80ND #22013346 EXP DATE �8� 2�� 2011 LtcENSE w�Tx �Dx�ss: 9320 EVERGREEN BLVD SUITE B ciTY COON RAPIDS sTArEMN zu�55433 APPLICATION PxoNE 763-757-6202 F,� 763-757-6701 PERMIT TYPE �SLNGLE FANIILY O TWO FAMII.Y ❑ TOWNHOUSE TYPE OF WORK: ��W �REPLACEMENT C] ALTERATION/REMODEL DETATi,ED DESCRTPTt(?lv' C?F WORK � � FEES ARE BASED ON S] 0.00 PER FI��TL�RE, EYCEPT WHERE NOTED. FIXTLTtES: (I1��ICATE TOTAL NUITBER OF EACH BELOW) PROtiTDE HEAT LOSS CALC'S PER b'L�urU 2006 ASHR?.E HANDBOOK �^ J� Equipment Installed MFG: A (�..Ul.�, MODEL: `\�OPUI=�� SIZ�T 7$ •�� IvtFG: MODEL: SIZEBN MFG: MODEL: SIZEBTU A/C $2�.00 _FIREPLACE (GAS) $I5.00 _GAS RANGFJOVEN $10.00 AIRTO AIREXCHANGEER$15 FIREPLACE �WOOD) $35.00 NEW'GAS GRILL $10.00 BOIiER $3�.00 �FURNACE $3�.00 ^GAS LINtT HTR 510.00 �CHIIriNEY L1NER �10.00 GAS DRYER $10.00 P�OL HEATER $3�.00 �DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 Number of fi��tures @ $10.00 ' x $10.00 = $ ' Number of fi,Ytures @ $I�.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 � x $35.00 = $ 3 5 � «.� State Surcharge = $ 5.00 MINIMUM FEE $40.00) Total = $ Q � THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application fox a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of a ork ich requires revi and approval of plans. SIGNATURE OF APPLICANT � PRINT NAME JOANN ZINKEN DATE �.7 � Ir./ APPROVAL INSPECTORS SI ATURE DATE PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department b431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS �XISTING HOME ❑ MAKE-UP AIR REQUIRED F(JR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Ventin� a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & coolina load per room a. MN Rule 1322, Sec. Nl 104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Desian Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calcnlations.