AF - 36464sue�ECr PERMIT .
City of Fridley 13219
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
S � ECEIPT NO.
� 1 y__��� COMMUNITV DEVELOPMENT DiV. �
r � � PROTECTIVE INSPECTION SEC.
1 �
�' � /'�'1 � CITY HALL FRVDLEY 55432 NUMBER REV. DATE / PAGE OF �APPROVED BV
----� • •'� 612-560-3450 910-F15 � �2�''��
� �
JOB ADDRESS
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. SHEET
2 PROPERTVOWNER MAILADDRESS ZIP PHONE
Bruce Geske
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Rodne Billman Inc. 1 1 Si
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Sin le Famil Dw li ta
7 CLASSOP WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS
1. Provicle a verification survey��PERATE PERMITS REQtJIRED �E�R WIRlNG�
2. Provide a hard surface Drive.HEATING, PLUMBING ANQ SiGN�.
3. Sod front and side yard.
SEWER: 60' W of MH (Inv. 962.92) WATER: 16.2' N.E. of Sewer Service
Wye Elevation: w/Riser 965.31
Top ��ooting - 967.31 (Minimum)
�`R�` \o�a� �t�C�'����,
�.��ca�� ,GPS SEPERATE PERMITS REQUIR�D FOR WIRING,,
�e{ore a���.E�-E���`C �,P►� HEATING, PLUMBING AND SIGNS.
c` TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPAR��2' E�I�T���ONDITION NG R ELECTRICAL, PLUMBING, HEATING,
VENTILAT �p)FT
THIS PE COMES NULL AND VOID IF WORK OR CONSTRUCTION ZON�NG SQ. FT. CU. FT.
AUTHOAI ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 32 f 336
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WURK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATIOf�t- STA��S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. A�� PROVISIONS OF LAWS VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR 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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � 73.25 325.00
LAN CHECK FEE TOTA� FEE
���-- 423.25
GNATUREO RACTO RAU HORIZ GENT �DaTE� PROPER Y VAI.I ATED THIS S YOUR P RMIT/
L /�G� . J
$' ATUREO E 11 OWNE UIID 1 IDATEI � LDG.INSP D E
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APpLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
. .. ,�.,f. ...y��
OWNER' S NAME ; i � - ,�'���.� BUILDER : ��� ����
� �`. , �``y
ADDRESS: ADDRESS. � �
'�L /_ S' i�r�� .�, t � .��_
`�7 ,��.-� /3� �..��-._ 77'1 � � n
NO : . O �_,,� /�J �. �O �'� � -(�rt � v
STREET: r
LOT : / � BLOCK: / ADDITION :_����,,,�A� 1 �/!y ���`
CORNER LOT; INSIDE LOT: � SETBACK: -�-1� SIDEYARD: �� v '
Applicant attach to this form Zfao Certificates of Survev of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Uaed As ; 1� �l�� ��
� Front :_ � J Depth : 7" � - -� D Height • .� � v�-� �.a— � �
��z� �, 33G �
Square Feet:� y� Cubic Feet•
""`� Frot�t •_ Z. S Depth • 2.�i Height :�$�
/
Square Feet• � Cubic Feet: 7 Z Q
Type of Constxuction: Estimated Cost;_,��g��, °O
�
To Be Completed: ��� / / y`T� �� p� � p�j
----- p =- -- s �
-------
"�� The undersigne ereby makes applicativn for a permit for the work herein
a eeified a reeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulinga of.the Department of Buildings, and hereby
declares that all the facts and representationa stated in this application
axe txve and coxrect.
(� �-��� ��'�/r� "�� �_.�
DAT� : _ / — / � - / �-! � IGNAT[JRE : I ; .
�'`��--=`.:1 ,
�c_
(Se� Revexse Si.de For Additional. Information. +
. •
'��u �o� F�n. 3s' rn ��. r R.�T �aao sc� 6�
�kt� v�o+! s Et'fv w� `T'�+u � OtZ "j'it, v sS Q9 F'�� t� � t'w► SQ E 4
.���.. ?3. L� ?`t� z�•.u� sAC ! 3ZS.o� ?�t'��. 3Z�'.00
BU�LDZNG PER�IIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings sha11, before issuing perniits for the
exection of any building or structure, or for any addition to any existing
building or stxucture, or for any alteration or repairs to any existing
building or st7ructure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set foxth and in
the �anner herein provided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. �rpe 3& 5-$1.85 for
each one thousand cubie feet.
�
ADDITIONAL INFORMATION
��'or t�e puxpose of camputing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average
heigl�t of the raof surface of the main gable of a pitched roof.
For repaixs ox alterations to an existing structure, the fee shall be at the
rate pf $3.00 pex each five hundred dollars ($500.00) or fraction thexeof in
the cost oi all proposed work.
Tn no case shall the fee charged for arcy permit as set fvrth in Section 2 be
less than $5.00,
V�RIFICATION OF FOUNDATTON
NOTE; Permits fox eonatruction will be issued a minim�m of 24 hours fram the
time n� applicat�.on, to allaw for proper xeview oE Che pxoposed structu�e and
af tl�e constxuction site.
A Certified Survey of the lot, showing the location of t'he foundation� once it
has �een constructed, wi11 be required before proceedin� w�.tIt the fraaning,
CERTIFICATE OF OCC�JPANCY
Appli.cation ior a Cexti.ficate of Occupancy sha11 be made ten (10) da.ys prior
t4 the uae or occupancy of any strueture for which a building permit has been
iasued; and said a�xuc�ure shall not be usect or accuFied until a Certificate
of Occupancy ha� been i.seued.
21
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� � Dopt. of $lda=. Phono.SJ�•3450 -.. .
D�3CP.IPTI02i OF V101ii: � _ � ��/��� �
2tum`�ar. Kiad tnd Locr�ien o! Fixti:re� 1"pC3�°°"—�'�"'�"�y
'" waTC� Mr�. City of FYidley:. .
� � t N Z N R , W � � � . � . .
� :g � Z I'� ��� � g��� z°�` � 7 � 7 W • W ws nct. The undersigned hezeby raakes apDllcation for a permit fot th� wozY herei
• � �
S2 � � S� 3� u� u� u$
• y �; ; '^ �; '°` '° specifi�d, a6reeing to do a12 �•o:k ia strict nccor�ar.ce with the Cit,7 Qz�ir.ar.�et
�� I . � � aad ruliag of the Department of �uild:ags; and hereby declares LRat aIl the faci
B9_t . , .
, and representaUons s:ated ia th:s applica�oa are true and correct�
Ist • _... . —
�'ridleY. 9iina / - l � --, lg.Z,?
1r,3 —,_ � -
3: d Owqer _iL�� -� '�""-,n���,'�-�- �--�. .
_. 1 �
4:h Kind oi Buitding ��*�4� -------
' Futu:s Cc�.a:3:.:a Cr,�:�nir�n Coa:.cs::�d vriY:u �/
ueFrsz � Uscd as �����"�-� .
+ N•. Fixwm. Old �Onir�s Cc�pwl � '— , �•
"— , . To be completed about -
PARTlAL RAT� S�HEDULE Est�mased cost, s -- { :----
Old--New. Bui;ding Pern::t Ivo.
' F.:ait No.� /�_ ����i�_
: LII�+lSINC Fl:{TURE RA7£S: bi0. RATE TOTAL ..y
�'� � � � /
I�1111I1bfi F1XtLicS • • • • • • • • • • • � . • . '�.�...' " � X v�.00. S °?����C� • Sl�'2'1� . .
Ftitnre Flxture C)pcning . . . . . . . . . . . . x 51.50 S . _. � • By . '
tiCW iixture Olci .Oyening � � � • • �• � � � • . X 51.54 $..��._... . . BUS3At'SS �'1VAt %i0 � v � � � .L�����
Catch IIasin • . • • . � � � • • • • • � � � � � a • X W.�S ; -'�'
Wate: iteater'l!p to 99.060 BTU).... �...�._.. x�3.00 5 �-�'C
. ;.ew Crouad Run O!d S:dg. . . . .•. . •. . x �.3.25 5—.-----
F.�.6CtSl.0 iia:�r H�d�� � � � � i � � � � � � � • ._ ��.Ci�% s .
�1.5 FIT?SHG FEE3: � NO. RJ,'T'� T07J►L
� �.... x S2.Cn� i "�' L� ��
. 1st3Fix:ures •••••••••••••••••• ,
Additioaal Fixtures .. ...:..... ..... x S.75 S
Gos FtanYe to I99.000 BTU ..,.. ...... , x SS.CO 6----
0
ROUGH'
FINAL '2, " �� ��'.
�.��'PRIRS ic AL?ER1lTI0?iS—P.sf�: to Cod� .50 State Surcharge
. T)e :crJ;.tion . . . : . . . . . . . . . . . . . . ... . . . ... . . . . ... . . . . .� . .
� 1'OTAL FLE �_::1. °= �
. • � ..
. . ... � .
0
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. � � '
•..
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A�CA�OA � rOM/!� �{�5 f�11d H�j, �!!!�f rMh�Of�OA� Rl��1� �%
Ak Condh�ioni�g S�t�n�s and D�vie�s
PARTI/lL IUTE SCMEDULE
l#lt1F:►!T! VI►�,111I�1 AIR: lUiTE TOTlIL
!'tu'nace Stsrll 11e I}uet Work . i1�.00 �
Replaeement of Furnace s.00 �
Repairs d� Alteratioas--up ta sS00.00 600 E._ -__ --
Kepairs dc Alterations each add. f500.00 . 3 W ;— . ._
�LC.N. WAll1�[ Allt
�� sb�t� a� n�uc w�,�x to i�o,000 B'rv
eaeh add. 60�000 B'I'tT . . . . . . .
�PLcemeat of F1�rnace
Repairs d� Atterations--up Eo ;500.00
i%pairs dc Altetations each add, sS00.Op
.ai000 s_.�
3. W i--�—
6.00 =
6.00 �_
3.00 =— -- —
STEADt oz HOT WATBR 8YSTEN
Furnace She11 d� Lines—to 400 sq. ft. F.DR Steam �lO.OQ �.____ __ __
Fwnace Shc�t} ��ne---to 640 sq. ft. EDR Fiot Water 20.00 a_ __ _�__ __
Each add. 200 aq. ft. EDR Steam A,fln �_ ___.
Eacti add. 320 sq. ft. EDR Hot Water 3.00 j_ �____ _
OIL BIIRPIER—to 3 gal. per hour g.pp s___
over 3 gal. per hour—See !'ee Schedule —
Gl18 �OR1fER tup to 199,00p BTU) 6.00 =_✓
oYer 19S.00Q B'f[? SK FN 3eladul�
GA$ FITTIi1G PEEB: Ii0 RATE TOTAL
!st 3 Fixtuses _�—_ xi 200 E—__ �—
AdditMaai Finttues _ — x .76 t-- --
Ga:4 Rang+e to 19�.00G :i 6.Oa i —
� ��� 7�7y,� ��� ,Q1"GC /D ,
ru� asx�� stst��j� �
v�a�.� stsra� � �� ��
u.�rra�s t �xrns ro�ru. � �
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n.rt. � a�as.. �.�, seo-�eo
cicy o� �xat�:
The undersigned hereby makes application for a permit for the work hereic-
specified, agreeing to do al] work in strict accordance with the City Ordivaneef=
and ruling ot the Departm�nt of Buildings, and hereby declares that aIl the fads�
and reuresentatiuns stated in this applicatioa are ttue amd correct.
F�idley, Minn_----1- -- 14 /�7
��.-'-�'-` � -.� �
Owner __ _ �
Kind �i Builc�ing . __ _ _ �m.l %n � �
Use� aQ _ _ �W�J �-'�-� ------ --
To be completed about _ _ __ —_ ._ Li1 _ ) 1 `�
Estima?ed ract, a _ __ ..) ��-!�,! --�-------
)
Uld Nerv. Suilding Permit No. _�__ P•�it No._���`
D'E/CAlPTt01� OF i110l1E
HEATiNG or PO'WEH PLAN'P�-$teara, Aot Wa Warm Air No�.
Trade Hame- ��1S1..L1�!S._L Siu No.,������_
Capacity-------- S9. !'t. E.D.R�tlLD, UO� B1V H P
Total Connected I.wd �_ l�iad oi !1x
� �� U� _ � N. �u ��1, L -.�«�
c�wder sv. �. a.n srv s�
_ _ �"�--�`
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,
$AY� l�i. WELTER �iEATtNG �
ass� cNic,ara a�+E.
g{�,wit _ f/IdoINBAPC]'�A��WINIVE�7'n �,r+anu� O1') c
aT
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560-3450
C�f o r�d'le .
� �
ANOKA COUNTY
6431 UNIVERSI7Y AVENUE NE FRIDLEY, MINNES07A 55432
January T4, 1976
Mr. Ice Comstock
Comstock & Davis
1446 County Rd. J
Mpls., MN �
Re: Sanitary, Water, and Starm Sewer Proje�t #73-A .
Dear Ice,
k�le have received and paid the enclosed bill for time and
material spent in trying to locate sewer and water services
for 1609 Berne Road, the same being Lot 14, Block 1, Innsbruck :
5th Additivn. Accarding to the as-builts we have on record
the utilities were referenced err.oneausly 24 f�. t� the West
of the actual location. �'he sewer wye was determined ta be
at station 2�-76 and not 2+56 as indicated on the plans prepared .
and submitted by your office. The dimension of 16.2 feet
between the sewer servfice and water service was correct. _
Therefore, we are reques�ing re�imbursement from your firm
for the amount on the attached bill due to receiving incorrect
information on the asbuilt p1ans for Project 73-A dated July 1965.
If you would like more information regarding this request,
please feel free to contact me. •:
Sincerely,
, ,.-
� � ������ �
. . /---� ��2...` - t . . . . .
THOMAS A. COLBERT
Assistant City Engineer
TACJas
Enc: 1
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No. 1976 .
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Sold To S � '� � h _ .
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Shipped To� - :
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HOUSE HEATING TEST RECORD
ADDRESS �?� � «R ' APT.
OCCUPANT OWNE�
HEAT LO55 DATE HTG. INST.
SOLD BY INSTALLED
Eleehieal Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. _
G E
MAKE � MAKE OF BURNER _
Model G/ dAodel
Serial r Max. 8TU Ratinq —
INPUT / G G�Od'Q MAKE OF FURNACE
Model
,,�.�� CONTROLS
THERM057 7��L�'' Heot PI g,
Vo Ive
Limit
.
Limit SsHing �
Fon Setting
Pliot Type '
Pilot Makw �
Pilot Model
Pilot Timing
L.W. Cut Of# ' .
Pressure � �
I�uf CFH � 4T_�
Stvek Temp. ...��f�Q—
Form 235
Pereent CO
Peresnt 0
Pareent CO
' r'�
UNIT HTR. OTHER '
CONVERSION
i/
Veot Size .
KIND OF UNER SIZE NON�
Droh Hood -��� y Regutawe
Filters Size Number
Chimney Location Inside____le� Outside '
Chimney Construdion
�F e K
Smoke Bomb Wiring-�
Draft Q� Test Tap Y� .
Door Presswe �ightiny (nst
� � Tested
r �'
�ompany TesTing ° `
Name of Teat�r
.�., _� �.�
���'
' �'" April 20. 1976
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8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
B & H EZect�ic
2516 - 37th Avenue Y1.E.
Minneapolis, Mn. 55421
Re: 1609 Berne Road N.E.
�
Dear Sirs:
A final inspection at the above address on April 20, 1976 noted there
was no ground fault protection provided. Please install this protection
as soon as possible and call for a reinspection of this.
Thank you,
LEONARD EICHMILLER
Electrical Inspector
LE/mh
CI'fY OF FRlDLEY �NSPECTION DIViSION
6431 klniversity Ave NE
Fridfey, MN 5�432 APPLICATIQN FOR F�OWER i�i.ANTS AN� HEATiNG, CDOLiNG, VEN7ILATION,
(763) 572•36Q4 REFRIGERATlCEN AND AIR CQNDI7tONING SYS�ENIS AND DEVICES
FAX (763) 571-I287
RATE SCHEDULE
Residential
Furnace Sheli and Duct Wark, 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 BACKj
1% of Value of Appliance or Work
Commercialtlndustrial
1.25�'Jo of Value of Appliance or Work
Rate "iOTAL
00
$ 30.Cf0 $�_
$ 10.00 $
$ 10.00 $
$ lO.OQ $
$ 25.00 $�
$
$
State Surcharge
TOTAL FEE
�� :� ► . •• ► _ ► •,,
i �l : .► � � �l ► _ i. 1 li
,� � : , :
REINSPECTION FEE $47AQL�Fr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
� .50
� �� 5r�
Effective January 2, 2Q03R
JOB ADDRESS [ C� �� � E Z IV C-. C � 2c�E CC°'��`�
OWNER 1�o�S cr b2�c.� ��s���..
BUlLD1NG USED AS Ho M�
ESTIMATED COST f�ZOc� 6� PERMIT Na. S~ G�
No. of Heating Units�_ Circle One (Steam (Hot Water)� a m A
Trade Name '-cti ��� Siz No. o
BTU 1� c�. avo HP
Fue1 (�r A� c� a s Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
�- C L., E,."',o ,c l-� SZ 6 a Z� 2 Ta �►� S c-. c-�,
The undersign�d hereby makes application for a permit for the work her
specified agreeing to do a!E work in strict accordance with the City Code:
rulings of the Building Division, and hereby declares that all the facts an
representatians stated in this application are true and correct.
DATE �� - Z Z -6 3
HEATING CO �E.s� DE�T•�� H��a,—,.�v r A.�cZ.
Signed TEL # � � Z' 7Z`j� ���1 �
FAX# G'z-- 7Z`'t-�2.d�g
Approved By _ Rough-1n Date Final Date '� 1 �
FILL OUT BACK SIDE FOR STAC�( VERIFICATLQN ON REPLACEMENT FURNAC
�. � tit'tsr.�.vW MUST E3E FIt..1.�D IN WHEN REPLACING FUEL BURNING APPLlAIVCES OR THE
APPUCATi�N WiLL BE RETURNED
�•ii�J•► J ► I ► ♦►► •: t►� •�i: •► � ` ' � •►
.
Whe�"� �tl�laacia: �� �Y���.furaoc�, the ur�dersigned hereby verfies that the
venting has besn e�ined aund is fr�e #rom cust, deteriara6or►, obshucaons,
and is s�cureiy supported and firestapped where required. Yes
The venting system is plas6clPVC and meets a11 cuRent codes and manufacturer
speafications incfuding sizing, fength, number af elbows and termination. Yes
Tha undersigned also verifies that the replacement unit is a listed assembly
and meets #he current codes and manufacturers specificaticros. This does
indude AGA-GAMA Category 1 Central Fumace Venting Tables for fan
assisted and natural draft appliances.
[��
()
Yes ( �yNo { )
Tltie eY;�tir�� cnmenit,en s�r is sizecS and insiaUed ta meet the current codes �
and manufacturers spe�cations. . Yes
Wh�t l�9qUif+�d to in�all a nF.w cemb�stinn air_ it will be sized and installed
to rt�eet the current codes and manufacturers specifications.
When it�tallin�a.���tinp3syStpim, the undersigned hereby veri�ies that
it is�a (isted assembty and meets the current codes and manufacturer's
specfications. This does incfude AGA-GAMA Categary I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
se{�arateiy as per current codes.
Yes
Yes
Yes
Appiiarrce #1 Type �-� BTU Input ir�� avr� Fan Assisted or at
��e
Appliance #2 Type t TU Input . Fan Assisted or Nat
Appliar�ce #3 Type �Input Fan Assisted or Nat
Total Appliances Total Btu tnput
Na ( )
No (1 ,
� `�
s�� .
No ( ) �� �'
�,��
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rr
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� ��S
�,�,�0
�
�
�r�
�
Common Vent Type Vent Height Diameter in�__ ��,� p
L
Appliaric,�e #1 Ver�t Connector Height tt Lengih ft Diameter in Type
App�ance #2 Vent Connector Height ?—ft Length �?—ft Diameter �—in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type (( —y u
�, 5
HEATING CO:
. _• =
Date : `�^ ?_ 2 � t��
,
/
-
_
C[lYOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 30, 2004
Bruce & Lois Geske
1609 Berne Circle NE
Fridley, MN 55421
Re: Final Inspection at 1609 Berne Circle NE
Contractor: Residential Heating & Air
Dear Mr. & Ms. Geske:
A mechanical permit was issued on May 22, 2003 to install a fumace and an air
conditioner at your address. According to the 1991 Uniform Mechanical Code a final
inspection shall be conducted on the work authorized by this permit. As of this date the
inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification and the permit will be expired.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely,
DAVE J�N�iEN
Building Inspector
DJ/mh