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AF - 40675SUBJECT P City of Fridley _ 16 8 6 7 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T i � � � • � `L _____ COMMUNITY DEVELOPMENT DIV. ��,�� r � � PROTECTIVE INSPECTION SEC. , ' ; �/�� /"'1 � CITY HALL FRIDLEY 55432 NUMBER� REV. DATE PAGE OF APPROVE� BY �"'"� � ��' 612-571-3450 910-F15 12/7/82 / / JOB ADDRESS 5481 East B'renner Pass NmE. 1 IEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Innsbruc�k North Townhouses Plat 6 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Da.rrel A. Farr Development Corp. 4600 Lake Road, R�bbinsdale 55422 536-9936 3 CONTRACTOR MAILADORESS Z�P PHONE LICENSENO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct an 18' x 28' 'I'oGmhouse 9 CHANGE OF USE FROM TO STIPULATIONS The poured in-place concrete curbing (8-612) to be constructed in the areas marked in yellow on the development plan that was signed by the Da.rrel Farr Development Corp. Construction Supervisor on �cember 7, 1982. A copy of the contract for the curbing work will be filed with the Gity. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. WOOC� FidL�e THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�- ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTfiEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHEFi SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $40,250 yfi2O.�.3 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $2�2.50 $425.00 PLAN CHECK FEE TOTAL FEE �`�[�� f�� 0.63 $748.26 SIGNATUREOFCO_NiRACTOR RAUTHORIZEDAGENT IDATEId ° EN PFi E IOA D THIS IS YOUR PERMIT 4 , // i.ra��r . -1 Z °-i ��Z — SIGNATURE OF OWNE OWNER BUILDERI IDATEI BLDG INSP �ATE l.l I 1 �;' i i;:..•"=1 � APPLICATION FOR RESIDENTIAL BUILDING PER�'IITS � CNEW,,ALTERATIONS, ADDITIONS, OR REPAIRS)_ . - � . � OWt7ER: DARREL A. FARR DEVELOPN�TT CORP. gUILDER:-. S� Address: 4600 LAKE ROAD� Address: �- � R , - - Tel. No.: 536-9936 No.:� 5481 � Street: East Brenner Pass � LOT: 1 •BI�OCK: �2 ADDITION- 6th CORNER LOTs , X ZNSIDE 7AT: S: TBAQC: SIDEYARDS: Applicant attach to this iozm Zt,io Certificates of Survey of Lot and prot�.osed building location drawn on these Certificates. .. . . • '. . . . - , - - . •. �� : - DESCR��IO1V-`OF��UILDING � � . ( � To se osea As: `��,:� - - � � - HOUSE Front: �g Depth: Height: ag . � Square Feets �._ Cubic Feet: •- * .' . Front: Depth: Height: , Square Feet: Clabic Feet: � • • - . � . . • �Type of Constructions WOOD FRAM.E ` Estimated Cost: $�� - ' _ . - -� -Zb Be Completed: APRIL 1983 ' '''� • /Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $' $ - • (SEE REVERSE SIDE OF SHEET) . . . . I The undersigned hereby makes application £or a permit for the work herein ' specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations st�ted in this application are true and correct. See reverse side for additional inf rmation_ �� DATE: o�-- SIGNATURE: Stipulations : . �Cct,w► ; 'Z�l'2. ,S� . �� bn.�3 1� _ Z°�! 3 'Su�, '1'�i ��, 2 �. � SAC �{ 2 S. �CJ h y� g . �G � : ` ,f' �r � ca�rtn �c�.`. r,r� 2 n. uN �T � � �►�y, 28 � 18 = Sd `i� ��• = �' � z�,� r�► � s,r,Y x 3G.26 � �pPEti . z8� �� sv� ,� 3` .z` , (�u �r � �I� u�� uu�tC t� ,., << ,� Ur� i s � � 1� A�M�,� � Z�� a��,I x 7. 3� � 1 i3�18 �{ ,r 3� 2� - � y� �o�l.y� � 8, �� o �i �g 2�,'.0 c} o , 25y. �8 � � 1-�D,�� 3� 70';. �U �8, 2�rs.oY /•J- 3�- 8 r�-�t,� ; � 'Z. 4Z, �'a t�.Q �°•�� -r� 'ZV. �3 gAC 4 tis ,o� - ��8.2� �R p .0 T� 5t�- 32y Y 3C, "i�C � I� ��4 8• Z`� 33,�a�.6$ ns ��, ��?SR��+�, � ,0 2�,�i 8= sc�V x�, s,�� ( v 3G.2G � zs.�,� �8 �l Sy x3C, zc 3 ��. �14 ��,2��.a�f �l. G d) .3 � � (�2,�„� $ � �� t�'c�w► N pe T� �ic �� r�n1�f �.0 2 g,r� Q• sp� x7 S�'� 3�o�'�v S�Y � 36 26 . 1�3 , 2�� a� � � _ . � . � y Y 1� ��(3 i.�c3�. ta �- p!�. � G�(.'�'L. '3�, (• �''�. ,��, �� 21� .00I 52. �� b. 8� �2�.0� r1 oS.� 233. 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O � z 0 H a c� d Q N' \ J 0 � � n 1 , \ �, ^ � i �e 8 M � � M I � t O � M � y �0 � � Q��o � 55�� ' w�� s ~ °u � ` �� M �1 � 4 , oe5 � M « � � M M Q ~ ! b m ''�O +Ci � �.�i C �.�ai �O .ay LLYm� "�� 4 $ 0 m � � m �e�� a ��s � �.�i m y a m� ..�i �p o ° a � �I� � C � � M � � � rr .,ma u�i ..Pi /� O �pC O � �.�i � M ! m q !+ °o c rMr .+ �o �o e � � � a' Oa �"' �w pC O i � a�.: °.a �° $u� � �'`�� m a�+ � a s °� etj3Q M � abt�y s� � 7� 3xT3 •�s�t . T�� g� y�'j saKseM s Dji4��lfi � su�s4g � y�� Q� =�T3 $ Ssa�IS su�3uno3 0� bu�xujsa � 8dvs,L 48B!! B��S O 'O +� O su�eae � � C� O �t us4s � 8 � aT�I=� � or s�asot� � � � �� '� � � +� 'O �O t� � � ea�so3S .�i N n � v �� I � \ � o � � � � � h M � � � $ � � W m � � o �� O � � 0 Z M � \f w � o �� a ;� a � 6 � � � 6 4 � °� 0 0 0 ., � m M N � aw Z� �r � u � y �E �e. OG N � � (V N w� =N �a � o. p O v O � � '� � E" v► � w si► w w tA ��a w tn tA a � c�► w O O o 0 o O o 0 0 0 0 0 0 �y o u+ �n o 0 0 0 0 0 0 0 0 0 � . . . . . . . . . . . . . � �n n� .r • in u► u� �n �n n �n o o m .� .� o m w a� sr► .A w a w w� w w y m w °i e a �J O r t 4 � z N � � F B �; « �i 4 m � � i � � e M 0 M O Y C • � M �,�, .�i [�+ .�i 4 S 8 � � N a 4� M . . i v° •.°+ � i oc~ �� °� .� w e � s s a u o.+ " � M O+� O.� +1 C y � O � � r D � e • ri a � +� � �y x o a+ a e • a > o s+ m � o a "' v-'�i .°. a°° i o n a�c i w• w .°. � °' ++ � a• w e a+ .� w e e� • tn � � �� a c o °0 s� o� i° M � �' Z ~�° w s n a°w a i a°� ° � o •+ a Qs .+ 4 e o .+ +� �O ■ s+ ,+ ■ ■ Q • � .1 • .1 O y � � O O r � • a � $ �. O f0 f0 N OG Ca c0 ! � {7 V' r� .� IK a � sue�ecr PER City of Fridley -17 3 8 0 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � FECEIPT NO. • COMMUNITY DEVELOPMENT DIV. � � ti: ----- � r � � PROTECTIVE INSPECTION SEC. ! 1 � i 1 � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'"'"� � ,'� 612-571-3450 910-F15 1/17/84 � / JOB ADDRESS � 5481 East Brenner Pass N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Tnnsbruck North Townhouse Plat 6 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Darrel A. Farr Develogment Corp. 4600 Lake Rd. Mpls. , NR�i 55422 536-9936 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICEN8E NO. 8 USEOF BUILDING Residential 7.bwnhouse Garage 7 CLASS OP WORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOFK Construct a 10' x 22'.Gar 9 CHANGE pF USE FROM STIPULATIONS TO TYPE OF CONST. OCCUPANCY ( SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. wOOd Fr�1e THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 22� ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT $2,34�. GO OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI N OR HE PERFORMANCE OF CONSTRUCTION. 3S. SO � PLAN CHECK FEE c �� IGNATUR CONTRACTORORAUTHOR12EDAGENT �on7Ei WHEN PROPERLY VALIDAT IDATEI P I OCCUPANr'Y IOAD CU. FT. 22�� OFFSTREET PARKING IGARAGES �`l. �.% SAC CHARGE TOTALFEE $39.67 �� ffective �ug. l, �Q91 �l i�' �T e it��?LL� � �ii'f'L1(:AT1G�1 �O�t Rl:S1l�l�1TIP,� aUILDi�,G P►�r,;�JiS . (Nch•r, �il terat�s�ns, t►dditions, or �c�ai�s) . . ��;I�ER: Darrel A. Farr D�ve ,lonm�nt rv, �3UI�DER� GA1vtF' � v AD�:CSS: 4600 Lake Rd. Mpls., MN 55422 ^DDiiCSS: YEL �D: 536-9936 TEL i�0: � �onst�uction Location S�.�T �p; • 5481 ��; East Brenner Pass E.07': 8 �ZAC�C: 2 AD�ITIO:i: 6th Cozncr a.ot: Ynsicic �ts � �etbacY.: Sideyards: Ap, licant at4.nch to tl�is form t�.�o C�rtificates of Svzvcy of lot and p_opo:,ed building �ocatian dra:+n on eertificates �o �cale. DESCRIPTlO�� OF CO;:STT:UCT10t� Gara�e g�ont: 10 �Pth= 22 H�ight: _�n Squzre �'eeL: �bic Fcet: �ront: �y�th: Height: Square Fc�t: Ctibic I'eet: _ 7�pe �f Co.,�tzuction: Wood Frame Estimated Cost: _S_ 1.�$4n �b Se (br.:pleted: M�� 9$� 11t. A �!1 t. B Propos�d Drivc�+iay Hidth If New' Opening Is Desired: $ S, _ , S�L PiVF.R;L' SIDi �F SiIE�T . 7i�p uncicrsiencd hcreb:• ��l:c:, aPplicztien foz a g>errit fc� the �ork hc�cin sp�cificd, egzccin3 to do.all aork i:, strict accozdincc Hith the Ci�y of T'ridlc�• Ozdi�ianccs �iid zulii�� of tl�e Del�.�rtsnc��t of IIui:c]in�s, and hexcby declares th��t all t)�e facts �nd re}�re�c��iticns sta2cd +n �is applie�tion �ze �ue and sodrect. �`zz: �-/3-8`f sica�n�ru�: dtii�ulAtions : ry . �/�,u sue�ccT P T NO. c�ty of Fridley 310 8 5 AT TME TOP OF TME TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � VV ��..� � �Q /� r � � PROTECTIVE INSPECTION SEC. ,� � 1 i � � �"'1 � CITY MALL FRIOLEr SS�J2 NYMBEa pEv OATE PAGE OF AvvqOVED Bv 1---•�' �•' 612-571-3a50 s�aF�s 6/27/OD / / JOB AOORESS 5471 73 75 77 79 81 East Brenner Pass t IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACNED OESCR. 1-6 2 Innsbruck North Townhouses Plat 6 SMEET 2 PROPERTY OWNER MAIL AODRES$ 21P PMONE Innsbruck Townhome Association 3 CONTRACTOR MAIL ADDiiESS 21P PMONE IICENS N Garlock�French Roofing Corp. 2301 E. 25th St., Mp1s., NIlV 55406 612-722-7129 0�08142 1 AiiCNITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE N0. S ENGINEER MAtL AODRESS ZIP PNONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O AOOITION O ALTERATION [� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof Townhouse Building (Tear Off� 9 CHANGE OF USE fpOM TO STIPULATIONS Underlayment must comply with the State Building Code. u��r��t Inspection C�r�� Will 6� Malied �'o Homeo�ner T�� .'`•�a�� SEPARATE PERMI7S ARE FiE0U1RE0 fOR EIECTRICAI, PIUMBING. MEATIN(i, �PE �F GONST. OCCUPANCY GqOUP OCCUPANCY �OAO VENTILATING OR AIR CONDITIONING. TMIS PERMIT BECOMES NULL ANO V010 If WORK OR CONSTRUCTION =pNING SO. fT CU fT AUTNORIZED IS NOT COMMENCED WITMIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO fOR A PERIOD OF 120 OAYS AT ANV TIME AfTER WORK IS COMMENCED. NO DWLG. UNIiS OFFSTpEET PARKING 1 NEREBY CEiiTIfY TMAT 1 MAVE READ ANO EXAMINEO TMIS APP�ICATION 6 STA�LS GARAGES ANO KNOW TME SAME TO BE TtiUE AND COFRECT. ALL PROVISIONS OF LAW$ yp�UAT10N SURTA7I AND ORDINANCES GOVEqNING TMIS TYPE OF WORK WILL 9E COMPLIED �21 � 6�1. OO �lO. HO WITM WMETMER SPECIFIEO MEREIN OR NOT. TNE GRAN7ING Of A PEqM1T DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TNE pERMI? fEE SAC CMAFGE PROVISIONS OF ANY OTNER STATE Oii LOCAL LAW REGULATING coN• �349.25 Fire .SC �2�..6�J STRUCTIQN OR TME PERFppMANCE Of CONS7RUC710N PLAN GMECK FEE TOTA� FE $38 .68 S�GN�TUQEO�CON't1ACTQAOp�U�MOp�2ED�GENt �D�tE� EN ROPER OATEO T IS VOUR PEpMIT � � � � S�GN��UpE O� OWNBA��t pwNERBWIDEp� � - iD�TE� � � L IhS� flGTt rn G1 O1 .�t O � .� � � .. w W 0 ~ W �.1 � ~ W W � >O VZ 2a i y � OW O� t� y z N � 2 �O � ~ 4� �fl F� z� ao �z �a oz �a , a� O �Li Z (�+J 0 "' � � � � J n. O d � 0 O ti � W �Q 4 W � v, z w y, � n a' � � ;U .� C�o� 0 � A.�C � �� m� t- � -a' c� X Ci � L�{ 1 � �� ,.�,. � C N � j � 4 W � � � �O � .:'. - W � W � 1-� 0 W � � G� Z � J � � � � O Z M- t�J 4 l7 0 � � U � W F- � � i.1,J � Q E � i � � _ .. � � � W J �o � �� y U d � C C a '� m U � ro � � t.3 � FO � c � c � d � 2 �° Z o d ��— z° � � � J � 0 � «� �r �� d p o O O O O � � � O O d9 v� t�Y d9� �.. �a� G �p � � �� m „^x � c a� � � d m C � r � .`� = C� N ... Oii° � � �a `' ii -- _ � ��...m l0 = d �, s � y ? .'c �y � � � � G � � tA �- m l0 �-' �' C. � �ocp N atia c� ra � � H � � O O � N W 1%1 d nu 4 c 'c s 'C7 0 U � � V a .� 'W 0 N � � � 3. � � a 'w = � � da� � Z �, a� � t�`o � F'_ � . �� mm � V Q m Z O ti � V � �� . O � -. :«' O C7 f� r C Q � �� •a, `O a� d � ►`�'. ? t o � C � C C ..,. 14 � y 'i7 d � A t y � w 1��0 � � d +.Ci m 'o" t�,1 L y � N w � � � a`� � '� t�o a�d �m l� � •a wv�%. O � �� m V L O V � � � ' y �O acca � Y � Q, d O C � �° '� 'y :�'c Eja�.. �oo� a � o c � � �.0 � N c �'m c QD � u! O 'y OD .MC :ir � �a ca -dp � o � G•— N � `" OD � °'"� $ � � •L L 1 � � , � � Y � 3 , O C - �a � a �a �`o c � � � .i �' . � � m �N �.i " O�fr �. ta � W N � . � a _ y � . . LI �� O V C9 z d W Y `O . � � � � \ 0 ► � C [i W a 0 �� ca 0 .� � � �° •. m d O a � � O t � �.: . L. A � . . �� . '�.-T, a. a � � " .�o.A . � w � .� a . �. ; � pG �.'•• '; l0 .� _ 'c. � Q .Q 'O ^ � �o , � °c � � c� 1�.1 t�,� C � �„ o z � o c �' O W � � a Q � U w ? � r. u� � � 4 T6 3Jt/d S�1311I� Sd9 a31SdW 8�Z8-BbL-L99 LE �5Z Z00Z/'[9/0T � � CITY OF FRIDLEY 6431 iJNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 ADDRESS : 5481 E BRENNER PASS NE PIN : 243024440188 LEGAL DESC : INNSBRUCK NO T H PLAT 6 : LOT 1 BLOCK 2 PERMIT TYPE PROPERTY TYPE CON5TRUCTION TYPE : HEATING : TOWNHOUSES : ADDITION/ALTERATION �--\ PERNIIT NO.: 2004-015� , DATE ISSUED: 09/14/2004 � VALUATION : $ 6,600.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERNIISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, RWD, 50,000 BTUS) AND AN AIlZ CONDITIONER. # A/C iJNITS 1 # FURNACES 1 # GAS DRYERS APPLICANT CENTERPOINT ENERGY/NIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- ,11:'/�I �1� KOBERNUSZ ARVILLA A 5481 E BRENNER PASS NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or consiruction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this applicarion and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� 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 provisions of any other state or local law regulating construction or the performance of construction. Applicant _ � Date , � � � � _ ��i � ` � . 0 # GAS RANGES FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONII�TG FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 6019 SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 0 35.00 0.00 0.00 25.00 0.50 60.50 G N d�' Z ; o m ~ w � Z W e� � U v W �� ❑ � � �Y � '4 U c� :� � Z W H � � � S � � � Z Q O cn � Z L] g Z . � O U � � .� � d O G � o- Z ¢ O � O Q � °� Q W U � J � Q OWC O . � a 2 C9 � Z � � � �- � � --� m � � � W z J d �y �- � a a LL�„ � u�i a d � � - O � � C � N �� °ca ,� ;�. �o ;sGfiTGt'.J I� � � " a � � � pl � � � � �.t./ � � � � �� 'Jn � l� V � � � W G a � v m 3 0 � m �� ` � � ti� � H � w a 8 � �q J �N U W bo Q � W �' � Q � �o � Z � N � 3yw o CJ .o � � ^ � J � � � �n�f � v o C a� � a t� o� _ �o a� � U n i � '� O �� g � � C �� = m w �a � a� ��m� � o � z � a x � E � m � � a� m m � U � � � � � � � � � � � °o °o, g o ' � � � � � W C G � w � U p � �� F- U C o � � C c � cv � �0 = c°�i N � C � q. '� � � y � � � � R TGiJ.QJ.CJ. r ai t� m a�i �i � c IL : m Z c 'a `a tya c� ua�o c � � C�7 ni z+ a t9 C � � � � � � O �� 3�� U i0 i � � � m c°� � .. •� s � � � � � � _ � �1 � }+ W �Ur�-+ a c a°i''d� t0 � � � � � � � � � � o � ,��c � � z �. � � , � a ; � �a� {y C G y Y� � Y m3o��z H ,p O � � p�.� U 'C � y P4 .�C bp m � ��(1 � C Z `.�j�K1 c a�i ,� �° c� '-� � G p � � �� U z �. � � � � a� d � � F-=- N W RI i N O N � I n � n � � � � � � � o � � �, ,�, � 0 tci � � � c � � a � � � � O � Y � v ` a. � � m �� oa _7 � � o c a°m o 3 � � � /J� �° °�` ti � Q � I N � � @ ,�, � � �103 � � c � o �, p C�' y c� U �� c o > �: a p a��s o a� H a o � G¢. � v � O M � �na�z � �� °� ��a m � � � � u. � � N > > ; E � 7 ��So�o �� ca ocv� .� a � � � U e�i rL �.a�rr r�-� -►n A i i � �o R s w � W � ��a � O � � 1 n � � O x S 0 � W � z O U a N z W � > 0 ;� co a�i � � 0 � '0 � � b� N V c �°. � � v co , a. � d .Q � o� c ,�•, m °' � o a�i ¢ � c 0 ',,.+_ C �� o '� U � � £ a � � 0 i0 c � � � 0 c .� � � � 0 �' � wna�� b�:ii beez-�z-�de . ^_ Z� ' d �d101 FILL IN COMPLETELY FOR REPLACEMEN7 FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTIPJN AIR VERfF1CATlOId When replacin� an existinq fumace, the undersigned hereby ver�es that the venting has been examined and is free from nast, deterioration, obstructi�ns, and is securely supported and itrestopped where required. Yes (� No () The venting system is plastic/PVC and meets al{ current codes and manufacturer speciflcations including sizing, length, number of elbowrs and terrnination. Yes (� No () The undersigned also verifies that the.replacemeni unit is a listed assembly and meets the current codes and manufacturer's specificatians. This do�s include AGA-GAMA Category I Central Fumace Veniing Tables for fan assisted and natural draft applianc.�s. The existin combustion air is sized and installed to meet the current codes and manuf�eturer's spec�cations. - - When required to install a new combustian air. it will be sized and installed to meet the current codes and manuf�ac°turer's spec'rfications. Yes ( � No ( ) Yes ( x� No ( ) Yes � ) No ( ) When installinca a new ventina svstem, the undersigned hereby verifi�s that it is a listed assembly and rr�eets the current codes and manufacturer's specifications. This does include AGA-GAMA Category 1 Central Fumar.e Venting Tables for fan assisted and natural draft app(iances. Yes (� Is the common vent at�d vent connectors sized and installed cflRectly a�ter an appliance has been removed from the c�mmon vent and vented separately as per current codes. No ( ) Yes � ) No ( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information � . Appliance #1 Type �`'"�"" BT�11nPut � Fan flssisted or Nat ��- Appliance #2 Type . t �� BTU Input � Fan Assisted or Nat � Appliance #3 Type BTU lnput Fan Assisted or Nat Total Appliances Tatal Btu lnput � Cvmm� Vent Typ� C.l -`,2j Vent Height �. �: Diameter ,� inches Appliance #1 Vent Connector Height 3 ft Length �ft Diameter �� in Type e 1- b Applianc� #2 Vent Connector Height �_ft Length 3 ft Diameter _ 4! " in Type C 1• tr Appliance #3 Vent Connector Height ft Length ft Diameter in Type CENTERPOIPTT ENERGY MINNEGASCO HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: 1 < ° Date : '7 - / - 6 L/ n �GI/�01'�-�I iGIJ,9J.SL Ol � J,31Q 1�� 0 .111 � WCJM-I S? : T t b00Z-LZ-�IdE!? ' , /w. M � -_..w�� Minnega�o ADDRESS_ �YB i � �/'`�y1q20 S,� OCCUPANT � �a. �'/! lo � HEAT LOSS Yes DATE HTC3. iNSI: SOLD BY CenterPaint En@,�yy M�nnenRSCo Electrical Work By i ` TYPE OF HEAT FA SPAC� HTR. OAS DESIGN MAKE �✓ Model ' ° � Serial � �7 Z � — — -- - -- - NPUT 6'�_ �3 G d CONTROLS Fieat Piug Umit Settin �an Settin d fe� Pilot Type Pilot Make Pilot Model Pilot Timing � �e� PressUre �° s d�. Perc�t COa e Z' nput CFH k�� O�' � � Percent QZ � '• Stack Temo. � � „ Perc�t CO � � HOUSE ii�ATINC TEST RECORD APT. � FLOOR ✓ CITY o'�'�� OWNER e %%_ I� •2�"�t 4��'?s INSTALLED BY CenterPoint Energy Minneaasco Gas Une By �� UNIT HTR. OTHER CONVERSIOl� Vent Size ��___ - KIND OF LIN�R -� SIZE NONE 1 r Draft H�✓e e ct" Regulator��7 /�'it �� Fikers Size `�wZ,`°i fcf Nuenber ♦ Chimney L�aUon Ins(�le Outside Chlmney Constructian � �a 5� � Wiring 2� Test Tag }L Lightlng Inst Date Tested �i % � Company Tesbng t i 4 En r M'nne � Rlame of Tester �,� e.. J ADDRE55 PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57"1-36U4 r'AX: : 5481 E BRENNER PASS NE : 243024440188 : INNSBRUCK NO T H PLAT 6 : LOT 1 BLOCK 2 : ELECTRICAL : TOWNHOUSES CONSTRUCTION TYPE : ADDITION/ALTERATION 571-11ii7 PERMIT NO.: 2004-01594 . q �� DATE ISSUED: 09/14/2004 � VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A FURNACE AND AIR CONDITIONER # 0-100 AMP CIRCUITS 2 # 101+ AMP CIRCUITS 0 APPLICANT CENTERPOINT ENERGY/NIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- OWNER KOBERNLJSZ ARVII.,LA A 5481 E BRENNER PASS NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and laiow the same to be true and correct. All provisions of laws and ordinances governing this type of wor� 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 provisions of any other state or local law regulating conshuction or the performance of construction. Applicant Date Bldg Insp Date ELEC CIRCUIT FEE (0-100 AMPS) ELEC CIRCiJIT FEE (101+ AMPS) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 6019 5�r��i�r; Yr;iuvu�r5 x�t�uuir;ll r�ux w��c ��i�r�x �i�r�N li�5c;��ll ati�vr;. 20.00 0.00 0.50 20.50 Building Inspections 763-572-3604 763-502-4977 FAX DATE -/ / / V/ STI'E ADDRESS � TEIIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICENSE I■ • �./.I�: BUII.DING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR �MAII. ADDRESS PHONE: � � � --�cs23 �� PHONE "�% Ip 3° 7� J� 'I 4'7 0�-� FAX STATE LICENSE # �� E?� DATE PROPERTY TYPE � SINGLE FAMII.Y/NEW CONSTRUCTION SIZE 0 TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑�DITION O GARAGFJSHED WS — ❑ BASEMIIVT FINISH ❑ ROOF DRAIN TII.,E ❑ DECK ❑ SIDIlVG O OTHIIt ❑ SWARMINGPOOL TYPE OF WORK: O NEW HOME CONSTRUCTTON ❑ ADDTITON � MAINTENANCFJREPAIR 0 REMODELING _ DE9CRIBE WORK BIING ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HIIGHT: SIDING ❑ Vinyl ❑ Aluminwn ❑ Ofher wnvnows IN EXISTING OPININGS Yes DAio OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLID NUMBER OF WINDOWS ON VALUATION, INCLUDING THE COST Ol �-��SING THE 1997 UBC FEE SCHEDIILE) r�nr, D ❑ HOUSE ONLY 0 HOUSE 8c GARAGE � ATTACHED GARAGE ❑ DETACHED GA1tAGE l�� HEIGHT Permit No.: Received By: Date �i TE�'�ZIP�� '�n�J � d �� Sn5 � �`� `Y I� BASEI�IENT REMODELING SUBNIIT: 1. , Existing Floor Plan 2. Proposed floor plan 3. List of struchual membecs to be used FOR NEW CONSTRUCTION INCLUDING DECKS, �Sa� ADAITIONS_ 8c PORCHES SUBMIT: ❑ T� 1. Site Plan/Survey showing the existing structures ❑ Fascia � ProP�� P%I� 2. lrvo sets of construclion plans s. ��y ca��tgao�s LOCATION OF WINDOWS Ai"i• TOTAL JOB VALUA' Perrnit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control I Pazk Fee I Sewer Main Charge AND MATF.RiAi.S: $`��, i U See Back Page for Fee Sch�ule $ •—' 65% of Building Permit Fee $ �� .001 times the total job valuation � � 5 O .0005 x Permit Valuation Minimum $.50 $ 5• o c7 $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ e�{ �, p� Make checks payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PIItMIT-NOT VALID UNTIL PROCESSID I�reby apply for a buiid'ing permit and I aclmowledge that the information above is complete and accurate; that the work will- be in conforma�e with the ordinances and codes of tha City of Fridley and wit6 the Minnesota Construcdon Codes; that I understand t6is is not a permit but only an applic�tion for a permit and work is �t to s�t without a permit on site; tbat the wosk will be in acco with the ved plan in the case of all work which requires review and approval of plaos. SIGNATURE OF APPLICANT`"d e PRINT NAME �d L� .1�b01� !. 5 DATE �/� �b APPROVED BY DATE PLEASE NOTE: SEPARATE PERNIITS ARE RE UIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL �VORK