AF - 42984Caty of Fridley, Minn.
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: __....._._I���.�mh��_..2..6.,......1272 __�.__
�
�11859 �
Ownex: -----J�a�r.x'e1.�_A......F.a,�r.�.e:u.e.Lczp.m�n.t.�.o..._ Builder _...�ame_.._.._
Address -----,��_Q�,.._.�.r0ek�..y.n....B_Q111.a.jZc�.r.zl.___....__.._.._---_.._ Address �._.S.am,�.._.__. ---
LOCATION OF BUILDING
No. .---.,�.5.G.7..---------..... Street •-------F..�..s �_..�r�Y.�]...�.11...P_3�..�I..E..,:____ Part of Lot
Lot ...-------4----_.._..---__.. Block .......------ 2--------..._.._......------------- Addition or Sub-Division •_----InnBhrnsk NnY.t1t..T.Ii. 3x� .Ad�-� tion
Corner Lot .---.--.•-.---•---._.------ Inside Lot ...___� ...------..-_-•.------_-- Setback .__.....__� __._.._ Sideyard
5ewer Elevation ....._---------...---------.:.----------••_-----------____._--------••---_ Foundation Elevation .__ .----.=------
DESCRIPTION OF BUILbING
To be Used as: 1200'
Tow�house.---------------- Front _._24 �--- Depth ..._.24.'_._.._ Height _�C_�_..__ Sq. F� �.44..'_.,_. Cu. Ft r15.�.6,.Qp �
_.. Gar ag e_---._ --•-------�------- Front _1 �._5 �_ Depth _.._ 22 __ Height •-_ 10 �----.. Sq. Ft. ....�.�.1_'._... Cu. F� � 1 0�
Type of Construction __..Ir�o.o.cL..Fxame.....__.._.. Est. Cost _..__$�20Y.O.lA.__.....�_...__-• To be Completed 1 vear
Stipulations : s�"�� �: �
In consideration of the issuance to me of a permit to construct the building described above, I agree to d0
thg proposed work in accordance with the description ab9�e^-se� forth and in compliance�with all provisians oE
Ordinances of the city of F'ridley. / ) m l/ /
10.01
In consideration of the payment of a fee of $._._._�.,.D.Q_........., permit is hereby granted to D�.�.ie� A. Farr Devel.
_�.._........____._.._..._ .....................__._.._.__ 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 wOTk
done in, around and upon said building, or any part thereof, shall conform in all respects •to the orclinalaces of
�'ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of built�iII$8
vyithin the city limits and this perniit may be revoked time upon violation of any of the provisions of said
ordinances.
Buildin8 1'pBpeCtOr
DARREL CT.ARK
NOTICE:
This permit does not cover the eonsfruetion, installafion for wiring, piumbing, gas heating, sswer or water. Be sun fo sa�
ths Building Inspectac fo� separate permits for these ifems.
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r�PPLICATIOti FOR RESIDENTIAL, �L4 �;F,A�'I0�',
OK allllI �'IO;� BUILDING �'�Rt�1I�t'
CITY OF FRIDLEY, �IIhNESOT[�
o=�r��'s rra:�� : D�r-�P/ .�F'�r�. ,D��.���. C'�. BIJILD�?2: S�tc� �.
r1.AD�r Ss : �.S'9o/ .QrosaklyYa �' lu�. .AD�R�ss • �' � �'a�
I�O:. 5s:a% ST?'.EE'?': .�Gc's� ��fii>�vi��-i .�R.S�
L�3'S : � BLOCK: Z ADD:�'�I03� : s�l�.fsS6.a-�+�� �/,���/r T•``�• .9 r.'�4���i ��� �'d
CC?'2iiT� LOT: iidSIDE I.OT: � SE�'���: SIDEXA��:—,-.-T,---.-
Ap�licant 4¢tach to this fo� r�o C?�tificate� o� ��z�r:�y o� i,o` u.-�d p�opos�d
buildino location drawn o-n �ha�� Certificat�s. r
�ESCRIPTION 0� BUILDING
�o �e U�ed A� :
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I-i�i�at: ���
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Sr�ua�L ;n��; .�•�d �ubic ^���: �.:�0� ��
i��s� o� �onst�c�ion: ef�tl�r,.�+� ��°'..�.+�� LsfiLr�,t�d i;���: ��<'',� �✓�:�.��. ..
�a ;�� c�P�L���: 7—♦ — 73
a�'ti:� un��?-si.�nad ��arM�y �:?'c�� �t;��Ii�atiion �-��' �. oa�-��.� Ao-� _��_ .aq.-� �.���:w'��
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, City of Fridley
r AT Ti1Q TQp QI TNE TM�INY
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1 �'L-'-"'-� GONwVM�TY pEVE{.O�MCNT OIV,
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Job Address _
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ontractoG���
of Building
omp etian Date
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PLUM� I i�1f PERP1 I T,qPPL I CAT I�iJ
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Aaaress Phone
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Use
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Plumbing Fixture Rates:� N0. RATE TOTAL
Number Fixtures �� x $2.00 �?$ CJ.00
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Bastn x $3.25
Water Heater-99,000 BTU _� x $3.00 ��C�U
Ground Run Old Bldg. x$3.25
Elec. Water Heater x $2.00
Gas Fitting Fees;
lst 3 Fixtures / x $2.00 <�7.�)�
Additional Fixtures x $ .75
Gas Range-199,000 BTU x $5.00
Repairs & Alterations
See
Description: Code
State Surcharge .50
�
i TOTAL FEE $ �?„� .—S�
!The undersigned hereby tnakes application for a permit
�f4r the work herein specified� agreeing to do all work
in strict accordance w ith the City Ordinances and rulin
oi the Department �af �uildings, and hereby declare that
a1l.�the tacta and repxesentationa atated in thia
application are true and coxrect.
ture
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Date
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1KINF(EG�S�O
53-8�-S-91S.51
Ci+y of Fridi+�y
���oe���;� � ��eg �d � � �� P��
Deprt. of Bldya. Phon� 360-3490 -- -
DE3CRIPTION OF WORR
Numlrsr, Kind and Localioa of Fixtu:es I,ocafina 5567 Fa.st Bavarian Pass ld. E.
�'������ �����I�1gz��z(°�I�IZI��•l.�w�T__.__���
3 � N 3� p o � o �� 3 �; � p� V$ � N G�S EIEC.
_ �_•
Base
in
2nd
3rd
4th
• iu�uz� Coaa�clS�oa 4i�oni::Qs
+ N�w Fixlutr, Old Oy�ninys
��
PARTIAL RAT� SCHEDULE
Sow�r ❑
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PLQMBING FIXTURE RATES: .'• NO. RATE TOTAL
Number F`ixtures . . . . . . . . . . . x a2.00 a
F�ature Ftixture Oi�ening . . . . . . . . . . . x 31.50 S --
New Fixture Old Opening . . . . . : . . . . . x a1.50 3�-.__.-
Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 �
Water Heater :L'p to 99,000 BTU� .... x$3.00 $
New Ground Run Old Bldg. ... . x�3.25 $
IIactric Wst�s H�at�s. . . . . . . . . . . . : a2.00 s
;.11S FITTING FE�B: NO. R11TE TOT1lL
1st3Fixtures .••..••..•••••• • xS2.00 i
Additional FYxtures . . . . . . ..... . . . . . x = .7b a
Gas RanQe to 195.000 BTU .. .... ...... �- x 35.00 ; 5. �0
City o1 FYidley:
The undersigned hereby makes application tor a permit for the vsork herei
specified, agrceing to do all work in strict accordance with the Cit,� �rdinance
and ruling oi the Department of Buildings, and hereby declares that aiI the tact
and representations stated in this application are true and rnrrect
10-8-7l�
Fridley, Mian 18_
owner �arrel A, �arr Developement -
Kind ot Building �'rame
Used as Res .
To be completed about �-0-i5-7�!
Estimated Cost, � 10.0�
� :;,-%;
70[&�New. Buitding Permit No. P•rmit No. �L� �.' �
5igne ��� � d�tJ�_
$y "�IINNEGASC� --
Business Phune No
ROUClH
FINAL /e7 -� - 7�
REPAIRS �C 1►L'iERATIOl�i&-R•i•s so Cod. . .50 State 5urcharge
De�criptlon ........................�.....................i
� TOTAL FEE i r � �
, �lass r`A" ��urcharge .:,
%��C�l�dl! �01' f0'�!" � a1Nf �1�1g, CO�pi�Rl�, yl11+1�l�OQ� Rl��f�1'�011 �
I�ir Condieionin� S�tNns and Dfvie�s
P/�R�t�f. RATE SGHEDULE
aa�r*rt wr�►ax �►nt: �utTa rosx�,
rt�rnaee shel� d� n+ut woz�ic ... ��o.oa i
RegTacernent a�f Fiimace &,00 =
Repair4 dF Altcrati.ons---up to =50b.00 g.pp =- -__ --
Regairs dc Alterationr eatch add. f500.OQ . 3(� ;___ . _._
I�fLCN. WJ111i[ Allt
Furnace SI�eIt dc D�u�t Wark to f90,000 BTU
e�lh add. Q�,001? B1'tT . . . . . . . .
R�placem�! txf P�urnace
Rrpairs dc Atterations--up to s500.QQ
I%pairs dc Altesations each add. :500.00
al0 00 i---L�1�' � �
3.W i
6.00 =
6.00 �_
3-00 i— ---
STEAM or HOT WATE'A 8YS'f E�[
i�rnace Shel1 & Lines—to 400 sq. tt. F.DR Steam �20.00 �.-__ __ __
ilunace She11 d� Lin�-to 640 sq. ft. EDR fiot Water 20.00 a _____
Each add. Z00 aq. tt. EDR Steam A.(10 �- -.---
Eacti add. 3Z0 sq. ft. EDR Hot Water 3.00 ;_ _____ _
OIL BIIRI�iLER—to 3 gal. per hour
over 3 gal. per hour�ee 1�'ee Schedule
c�►s atrnxEx �„P co �s,00u szuf
oner 199.000 gTU 8�e F« sdNdul�
G1►8 FIT'rIlIG FEES:
Iat 3 Flxtures _
Ac}ditici►ai lRxtfu^es _
Gas Ran� 10 198.000� _
� .. �. „ �. . �
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:. � , :r
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-:� � t�:
� i�-l�-��
6•00 S..- -- —
6.00 = � , ''T�
1�0 AATE T07AL
- x= Z00 ; _-�•._��
- x .76 i--- --
_ :� 6.OP S _
�r P� feb�
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ctty ot Flidtey:
The undersigned hereby makes appiication for a permit for the worf� herei�
specified, agreeing to do al} work in strict accordancc twith the City Ordinancer�
and ruling ot the Departm�nt af Buildings, and hereby deelates that aIl the fad�
and re�resentativns statc�ci in this applicatioA are true a� correct.
Fridley, Mian_--._ _ � ______y,14 r
OwTfer ---=-�u�`�0�E - �liLtG� 1�1..P�ar-°
Kind �f Building � '/��_�+--.-..c L _
Uset� as _ __ c�!��-��c��.t�
To be eompleted about ---- ---------
Estimated Cast, E .__1�v� '°"� - ------------
Uld—New. Building Permit No. _—_ P�rmit No. �
D�CAIP'l101f OF iIOM
F�A1'ING or PC7WER PLANTg-.�team. Hot Water, Wum Air—No_ �
Trade Ivame �i ����-�/ g� Np,�/!i /C � //d
Capacity--.�/11_�J_ Sq. �'k E.D.R HT(T H.F
Total Connected I.o�d �nd pi �Le � _
BURNEii — Trade Name gise Nlo
C�D�b' 3q. !R E.D-R- B'iV 8�F
��►�ove.t
st�„ � ��, ��-
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�a PUe�r �- ,7r/'/ - �G 3f
sue�ecr "PER .
City of Fridley 2 2 0 71
AT THE TOP OF THE 7WINS g � I L D I N G P E R M I T
; � RECEIPT NO.
� �
� ' COMMUNITY DEVEIOPMENT DIY. G�
r � V � � PROTECTIVE INSPECTION SEC. �� /�
i �
� � /"'1 � CITY HALL FHIDLE� 55432 NUMBER REV. OATE PAGE Of APPROVED BV
�'""� � �'' 612-571-3450 9t0•F15 8/26/93 / /
108 ADDRESS 5567 East Bavarian Pass NE
1 LEGA� LOT NO. BIOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 2 Innsbruck North Townhouse 3rd Addn SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Carol Gardner
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
Dicks Fire & Storm 864 19 Ave SE Minnea olis MN 55414 781^6170 2481
4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO.
5 EhG1NEER MA{L ADURESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reroof Gara e (Tear-af�)
9 CHANGE OF USE FROM TO
STIPULATIONS prQVi.de smoke detectors as per UBC 1210 adjacent to all sleeping areas
and in basement.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF; 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 yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED $480,00 �.SO
WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING 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- $1S. OO Se 48 Fire SC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTiON.
PI.AN CHECK FEE TOTAL FEE
License $5. 0 $2�.98
SIGNATUAE Of CONTRACTOR OA AU�MOF32E0 AGENt IDATEI �W R P VALtDATED TH1S 1S�U I PERM
r �—,.
�Il
� SiGNATUFlE OF OWNEFl iiF OWNEA BUILDEA� iDATEi �� � BLOG �NSP �i TE
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Consbniction Address:
�� DCSCf1�i�lOII: �
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Build.ing Permit Application
East Bavarian Pass NE
��.
Effective 5126193
�-a���
Owner Name &. Address: Tel. �i
Contractor: Di�ks Fire & storm (Richard J. wil�iams) MN LICENSE �t 24s1
At��i'CSS: 864 19 Ave SE, Minneapolis , MN 55414 iCl. # 781�6170
Attach to this application, a Certificate of Survey of the �� 8- 2 880
lot, with the proposed cons�ruction drawn on it to scaie.
DESCRIPTION OF IMPROYEMENT
LIVING AREA: Leaiigth
GARAGE AREA: Length
DECK AREA: Length
OTHER: Reroof Garage (
Width Height Sq- Ft.
Width Height Sq. Ft.
Width HgtlGround Sq. Ft.
Corner Lot [ j Inside Lot [ j Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Side Yard Setbacks
Estimated eosr: S y,� �=
(Cost on Ba.ck) �
Driveway C�rb C�t Widtl� Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 8/26/93 APPLICANT: ����� ��-�YZ�. Tel. # �s1-61�0
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
T4TAL
$
$_
$�
$
$_
$
$
$
$
�P
0
• 1 Y�i��:M!!�
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/ lOth%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.(30
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary ( ]
STIPULATIONS: �
sue�ecr P R NQ..
c�ty of Fr�aley 2 2 0 7 2,
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i � R -EFPT-NO`:"
� �
� ; �_____ COMMUNITY DEVELOPMENT DIV. C� , i
r � � PROTECTIVE INSPECTION SEC. �� l y
� � /"'1 � C1TY HALL FRIDLE� 55432 NUMBER REV. OA(E PAGE OF APPROVEO BV
�""'�"� ,'� 612-571-3450 9t0-F15 8/26/93 / /
JOB ADDRESS 5571 East Bavarian Pass NE
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 2 1 Innsbruck North Townhouse 3rd Addn. SHEET
2 PROPERTY OWNEF MAII ADDRESS ZIP PHONE
Witold Materski
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
Dicks Fire & Storm 864 19 Ave SE Minnea alis MN 5 2481
e ARCHITECT OR DESIGNER MAIL ADDFiESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILpING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION L� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Garage (Tear—o�fi
9 CHANGE QF USE FROM TO
STIPULATIONS provide smoke detectors as per UBC 121Q adjacent to all sleeping areas
and in basement,
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE fiEOUIRED FOR ELECTR�CAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE REAO ANO EXAMINED THIS APPLICATION STALLS GAFAGES
ANO KNOW THE SAME TO BE TRUE AND CORREC7. AlL PROVISIONS OF LAWS VA�UATION SUFTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLiED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $48O.OQ yS, �O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW fiEGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $1S.00 Fire SC $.48 .
PLAN CHECKFEE TOTALFEE
Lieense SC $5.00 20,�8
SIGNATUREOFCON'RACTOAOAAUTHOAIZEDAGENT I�ATE� � WH PE VAI.IDATED THIS IS� yYO P R I
V �'� �
SiGNATURE OF OWNER uF OWNER BU�IDER� �OATEI 4" � BLDG °TE
NE'W
ADDN
AL'TER
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Constivction Address: Z
Lega1 Descriptioa ��'�
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
East Bavarian Pass NE
4wner Name & Address:
COtI�TdCtOf: Dicks Fire & Storm (Richard J. Williams
Effective S/26/93
��� g �
Tel, #
MN LICENSE � 2 4 81
A��s: 864 19 Ave SE, Minneapolis, MN 55414 Tel. # 781�6170
Attach to this application, a Certificate of Survey of the 3 � s- 2 s so
lot, with the proposed constivction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Lertgth
GARAGE AREA: I.ength
DECK AREA: Lengih
QTHER: 1ze roof �a ra
Width Height Sq. F�
Widttt Height Sq. Ft.
Width HgtlGround Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Constiuction: Estimated Cost: ���o �'"
� Approx. Completion Date:
(Cosi an Back)
Driveway Curb Ctiet Width Neoded: Ft. + 6 Ft = Ft x S =�
DATE: 8/26/93 APPLICANT: l.�"�,�,���/ �%�cr�n—r Tel. # 781-6170
Permit Fee
Fire Surcharge
State Surcharge
5AC Charge
License Surcharge
I?riveway Escrow
Erosian Contro!
Park Fee
Sewer Main Charge
TOTAL
$
$
$
$.
$
$
$
$
$
$
�.
Fee Schedu�e on Reverse Side
.001 of Permit Valuation (1lIOth9�)
$.50/$1,OOU Valuation
$750 per SAC Unit
$S.OU {State Lice� Residential Contractors)
Alt. "A" ar Alt_ "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary ( )
STIPULATIONS: �
.
sus�ttr � P
City of Fridley 3 06 8
AT TNE TOP OF TME TWINS g � I L D I N G P E R M I T
; � RECEIPT NO.
� �• COMMUNITY DEVEIOPMENT DIV. �� '
r � V � �� PROTECTIVE INSPECTION SEC. j
1 . .
� � ���'1 � CITY MAL� FRIOIEV SS1�2 NUMBEp NEV OATE PAGE O� APhROVEO B�
�'•"'� � �'� 612-571-3450 9t0-Ft5 2/24/00 � �
J08 AODRESS SS61-5563-5565 st Bavarian Pass NE
1 LEGAL �OT NO. BLOCK TRACT Oii AbDITION SEE ATTACMED
oescA. 1,2,3,4 2 Innsbruck North Townhouse 3rd Addn SHEET
2 PROPEfiTY OWNEq
MAIL ADDRES$ IIP PMONE
Various
J CONTRACTOR MAII AODRESS ZIP PHONE LICENSE NO
North Central Builders Inc 7401 42 Ave N, New Hope, MN 55427 533-6168 3763
a ARCMITECT OR DESIGNER MAII AOORESS 21P PMONE LICENSE N0.
�
5 ENGINEER MAII ADORESS ZIP PMONE LICENSE NO
8 USE OF BUIlO1NG
Townhouse Building
7 CLASS Of WORK
❑ NEW � ADDITION O ALTERATION [� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside 4 Unit Townhouse Building
9 CIiANGE OF USE PROM T�
STIPULATIONS
Call for building wrap before covering.
TYPE OF CONST. OCCUPANCY GROU� OCCUPANCV LOAD
SEPARATE PERMITS ARE REOU�pED FOR EIECTFICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL ANO VOIO If WORK OR CONSTRUCTION ZONING SO. fT CU FT.
AUTMORIZE� IS NOT COMMENCED VjIITHIN 80 DAVS. OF IF CpNSTFUCTION
OF WOftK t5 SUSPENOEO OF ABANDONEO FOR A PEAlOD OF 120 DAYS AT
ANY TIME AfTER WORK IS COMMENCEO. N0. OWLG. UNITS OFFSTiiEET PARKING
I MEREBV CERTiFY TMAT I MAVE pEAO AND EXAMINEO TMIS APP�ICATION �F S7A�LS GAfiAGES
ANO KNOW TME SAME TO BE TFUE ANO CORqECT. ALl PROVISIONS OF LAWS VAlUAT10N SURTA%
ANO OROINANCES GOVERNING TMIS TVPE OF WOfiK WILL 8E COMPLIEO @ r
WITH WMETHER SPECIFIEO HEREIN OA NOT. TNE GRANTING OF A PERMIT W 1H �%9% �9 .�FO
OOES NOt PRESUME 70 GIVE AUTMORITY TO VlOIATE OR CANCEL THE pERM1T fEE SAC CMAfiGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- $307.25 Fir SC �LB.HO
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE TOT �, EE
Z�ay/er� Lice C $5 $340.45
S�GN�TUpE O� C '•CTOp OA A rMOp�ZEO �GENi iDATE� ME P P VALIOA THIS IS VOUR PERMIT
, � ����
S�GNAIUAEO�OWNEP��cOWNEa6U�lDER� I�Aif� Bl �NSV' . f1iTt
�,e,2 l�j��/��
��T�'"flF FRiDLEY INSPECTI4ht DiViSION �,-, ,,
fi431 University Ave NE �;� �j i� �� %� /`f �- v y
@`Fridley, N1N 55432 APPl.ICA � Oilt OR AOWf R PLANT5 AND HEATH►IG, �OQL;ING, VENTti.ATiON,
` 572-36��
'� � RE�'RIGERA�ION AND Al�t CQIIf�1i'�pht�{� SySTEI�S AND aE{►iCES
�
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RA�NE UI.E
Residentiai
Furnace Shel! and Duct Wark, Burner -
Aisv Replacement Furr�ace
{Sid� Yent • Fill 4ut Back}
Gas P1pP�g (Meeded with new furnace,
but not repfacement)
Gas Range
° Gas Qtyer
�`Air Canditiflning - All Sizes
All Qt�rs/Repairs & AlteratFOns {US7 ON BACK�
i%a of V�It� af J4ppliance flr Work
�
J Cornmercialllndustria�
" I.25�y of Value of Appiiart�e or Woric
�
�
�
�
�
V
f2ate TOTAL
� 30.00 $ 3Q f o0
$ 10.40 $
$ 1{}.OQ
$ 1DA0
$ 25.00
State Surcharge
T07A� FEE
0
� F YH ATN / N
RE�Rt�RATtpN/AIR CO t, P 5
� PLUS TH� S 50,�T's'r� c�,�pruaa�r
�
`� REfNSPECTION FEE $47.00/Hr
m
m�Air Conditior�ers can not be placed in a side yarci without
� written permission frorn adJaning �roperty awner.
�
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F'7
�as ����ss .5.5��? E �A�,
�vi�.Q��� usEa
ESTIM�Ai'ED COST
S 4�
fv11�i
Effective On January i � 2i �
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a:
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PERNJIT N�. ��`��%/
D_�SCRIPTtON � FL1Rl�ac„� OR BURNER
$_�
No. of Heating Uni�ts Circle One (Steam} {Hot Water) arm Ai
� Trac� Name Q Size Na
BTU HP EDR
� Ft�el 7'otal Cannected Load
Burrter Trade Name SiPe i�o.
� BTEJ HP EDR
$_-----_
� .5�
� 3�-�D
T�e undersign�d h�reby makes applicatiar� for a permit �or the work here
specif�ed agreeing to da atl war�C in s#ric# accordar�e with the City Codes --_
ruaings af the B�iiding Divisror�, arzd her�eby clecfares ti�tat al� the facts anc
representations s#ated.in this application are true and correct
o�r� � �-O
HEATJ �O �A 2 � �/l'� 1� !V �6- � � ,
Signed o TEL # ���'�33=c�lZ��
,
�
APPr411eC�
Rough-In Daie Final �ate '��`�' ��/ /� F�
�//(� /G�
it`tt tfto�r�ns-r�r�.i ....�...�.�. � �-• --- - - l
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/ �-� � - � �-- - _
� �2�Z � �`7��s ��% ���- ,
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-r ,�5� ' i Lef��q,� � ��r�--�,`��a,�z---
�-1t� id !�� C,e.�%���`�
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t�'d �t�1��1
C�MMON VENT, VFNi CONNECTOR AND CQM�USTICIN A1R VERI�1CATiON
Wh�� re lacin n i'n fu n�e, the undersiQned hereby verifies lhat the
verttir�g has b�en examined and is �ree from rus#, de#�rioratzon, ot�stn�ctia�s,
and is se�ur�iy �upp��{�d and {�restapped where requir�d. Yes (�No ()
The venti�g syst�m is plasticJPVC �nd meets alt current crodes and manufactur�er „�ff i�i
sReC�eaxrrans �ncluding sizing, (eng#h, numl�er of elbows and termination. Yes {) o(�
Th� Gndersign�d alsa ve�es lhat the replacem�nt urtit is a list�d assembly
and meet5 the curre�tt cocies ar�d maRUfac;turet's spe�cat9o��. 'i'his does
6nclucte AGA-GAMA Categary t Gentral Furnar.� Ven#ing Tabl�s for fan
assisted and n�turai draft appRianc�s.
The existinn.comb�rs�ion air is sized and instaNed #o rtleet the cur�nt cades
and manuf�ct�arer's sp�c'�ticaU�ns.
When requir�d to inst�li a new combustiort air. it wili be sizet! �nd in$#a!!e�
To m�ef the cur�ent codes and rnanufacture�'s sp�ccificaban�.
Yes �i No ( }
Yes � Na (
Y�s Qq Na ( )
When inst�llin� a new ventino systert�� the under�igned her�by veriftes t�t�t
it is a iisted assemi�Ey and meets the Curr�nt codes and manuf�cturer'� .
specifications. This daes include I�GA-GAMA Cat�gory � Central Fumac�
'Ven�ir�g T�bf�s fot f�n assisted ant! natura! draft �ppliances. Yes { )
�s the common vent and vent connectqrs siZed a�nd ir�stalled correcNy aRer
an appiianc� has been removeci from the comman vent and ver►#ed f!,
separately as per cearrer�t codes, Y�s i) �( i
Ap,giia�nce Tvo�e and Sixel�mmon V�nt and Vent Connectoe In�or�t�l� 'on
A�a�iiance #9 Type �vR-x�A C�i 9TiJ Inp�t g�i �O , FaR Assisted ar Nat _��
Appliance #� Type �.s�,tT� nl�t�I? BTU Input '��'� �an A�si�ted o� Nat �
Appiiance #3 Typ� BTU lnpu# __,_,�__�, Fan Assisted or Nat �,,,�
Total Applia�ces __ _.._ .. Tatal gtu Input �
Cammer� Vent Type �� 8 Vent hl�ight � S� �i�meter,,,�,,,,,_ inches
Appfiance #9 Vent Connector Ffei�ht _.. fit Lengtt� ft Diameter ,��n Type
Appliance #2 V�r�t Con�ectar H�ight R�,ength ft Diameter,_„in Type
ApplianCe #3 Veni Gonne�#or Meight ft Lengih ft Diameter in Type �
C�
�.� ��-
HEATlNG CQ: �TZ.�. 1�- C� �- M(�" �� �
5igned BY: D�te : ���y B" �
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i�� i e• d �s�q��� � s9 a� J,��Q I�I� �0 1,1 I� wo�� t�s :� i ��0z-0€-n�nr
CITY OF FRIDLEY INSPECTION DIV. ��, Effective On Jan 1, 2000
6431 Universi Ave NE '�
Fridley, MN 55432 �� � ���l�` ���� APPUCATION FOR PLUMBING AND GAS FITTING PERMIT
572-3604 � �1 �t � �
� MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO. RATE
New Fixtures
O!d 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
$ 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 REPAfRS AND ALTERATIONS
1.5% of Value af Fixture or Appliance
State Surcharge
TOTALFEE
TOTAL JOB ADDRESS �`�� � ` - � �ce.�t.,�
$ .50
$ �;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 Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
9� �� ,ZO��
Owner _
Building Used As
Estimated Cost PERMIT NO. ����
PLUMBING COMPANY
SIGNED BY
Approved By
IJ
L s�rv
. � : ._:
Pc (3 G - �Nc .
Final Date t �! 2f� !`1����"
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE