AF - 41863March 21, 1963
City of Fridley
6431 University Avenue N. E.
Fridley 21, Minnesota
TO WHOM IT MAY CONCERN:
I, ROBERT REEKERS, 6414 East River Road N. E., Fridley,
Minnesota, do hereby agree to connect to city sewer when and if it
becomes available to me.
Rx:�ks
Yours very truly,
i
ROBERT REEKERS
J� ��� �. ��
sua�ecr ERMIT
City of Fridley � � 16183
AT THE TOP OF THE TWINS g � I L D I N G P E R M I
r
� �
� � .
� • COMMUNITY DEVELOPMENT DiV.
' i L _ �
r � � PROTECTIVE INSPECTION SEG �G 9
� ,
i
:' � /���1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
���_� / �.S
612-571-3450 g�0-Ft5 5/14/81 / /
JOB ADDFESS 6414 East River Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2$ AllCl. S1IY1. �2� SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Steven S. Smuder 6414 East Risrer Road N.E. 574-0979
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Resi.dential
7 CLASS OF WORK
❑ NEW OX ADD�TION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14 � x 24' Addi.ti.on ta Dwelling
9 CHANGEQFUSEFROM TO
STIPULATIONS
5EPER,�TE PERMITS RE(�UIRED FOR i�if`R`ifl�G,
H�ATI�N�, Pt.UMBING ANQ SI�NS.
W�#�Htl�G
S��e d��in� catf tocat utilities
TEtEPtiONE - EL�CTRfC - GAS Efi�.
REQUtRE� B�' EAVI/
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� FY'dI110
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITH�N 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 336
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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 $13,500 $6.75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
OOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $81. QO
STRUCTION OR THE PEFFORMANCE OF CONSTRUCTiON.
PLAN CHECK FEE TOTAL FEE
$20.25 $108.00
� si� A�-RACTO RAUT izeon� lOATEI � WHEN PROPERLY VALIDATED THIS 1S YOUR PERMIT
� �� / �.
SiGNATUREOFOWNERiIFOWN RBUILDEPo IDATEI BLOG WSP DPi .
.�,
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CZiY t�E' f'ItIU(_CY •
! !�f'('L1C11'C'Ii7'd f'Oft t.f:SI[)L.i�ITII'�i_ GUILI)If1G P�ftirTTS
�� �
Y��� (iderr, i1ll:er��t.ians, /�dditions, or f:cpairs)
4�< ,�
d1T(�R: �-��vC t�,) �. ��.v i� �f'� �UI LDL-'R . S�-e�� �
n�n�.ess: Cc�r�l ��as� �,vc� �� n��r�css: --
TCL �0: ���y—C`��(��(. TCL (d0: •
� Consi:ruction Location '
. s�r�T r�o. � � I �j s��iu,�:T: ��5 c ��v�2 �,b. . .�
x.o��: �,�_� �LO�c.: �nz�rzo�t : � . S , ��_,
Corner Lot: Inside Lot: �� SetbacY.: Sideyards:
Ap�licant attach to this for.m two Certificates of. Suxv�y of lot and
prop�sed Uuilding loeation clrawn on certificates to sc�le.
RESCRIPTIOit OC' COi�lSTRUC�IOPJ -
� I'rant: j�{ � Depth: � U- � IIeight:
Squar.e. Fcet:^ �,� Clibic Feet:
33�
k'rant: Depth: Height:
Squar.e� T'eet: Cubic I'eet:
�_ .
33G� �l 4t�� I'� �- �3� ����
Type of ConsLruction : C( ��p'�
�v- B�
Estimated Cos �: $�
7b }3e Cbr,�pleted: �� �( - �� � � �
� Alt. A Alt. B
Praposed Drive�•�a�r �vidth If New O}7EI11I7� Is Deszred: $� $
_ . S�� F2�,VEIZS�� SID� OF` SiIEET .
,
�.3ie undexsigned l�ereby :na};e� applic�-�ticn for a perm�.t tcr_ the t:nrk' hereiiz specified,
agrecing to do _a1.1 wor}; in strict accora�nce ���ith ihe City of I'ridley Ordinances and
ruli_ri:�� of iite DeZ�artment. of T31ia.].dings, aizd hercby declares that all tlie facts and
repiesa� t;iti.ens stated iii this «ppli�
D1:T�: ���_ �� SIGN1�`.rUF.P.
SL.iZ�ula�or�s :
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sus�ecT PERMI
City of Fridley 19219
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� .
� � •
� • COMMUNITY DEVELOPMENT DIV.
�' i L �"�� , � ��
r � � PROTECTIVE INSPECTION SEC.
1 � �
i--__ �;/'�'1,,; CITY HALL FRIDLEV 55432 NUMBER i7EV. DATE PAGE OF APPROVED BV
i �� 612-571-3450 910-Ft 5 10/1/87 � �
JOB ADDRESS 6414 East River �3c7..C� N.E.
t LEGAL LO7 NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2$ Auditor's SU�1V1SlOI1 NO. 23 SHEET
2 PROPERTY OWNER MA�L ADDRESS ZIP PHONE
Steven Smuder same 574-0979
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
.Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
ReSidential
7 CLASS OF WOFK
p NEW ❑ ADDITION D ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
1S
8 DESCRIBE WORK
New 30' x 24' Gasa e ^ Remove 14' x 22' Garage
9 CHANGEQFUSEFROM TO
STIPULATIONS
Check for N& S ease,ment.
Need. wreclaing permit on existi.ng garage .
SEPARATE PERMITS ARE FEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTqUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEAIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED 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 WHETHER SPECIFIED HEFiEIN OR NOT. THE GRANTING OF A PERMIT 10 339 �S.I.%
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OP CONSTRUCTION. HF) SO
PLAN CHECKFEE TOTALFEE
$91.67
SIGN E OP CONTRAC OR A� H RIZED A NT ��n7E� �' WHEN PROP R V LI ATE � HIS IS V� R�E� T
�O /-�7
�
SiGNATUAE OF OWNERU NER BUILDERi IDATEI BLDG iNSP qaTE
p� [] City of Fridley Effeetive 4/1/86
ADDN. [ ] �R-1 AND R-2
AI,TER. [ ] Building Permit Application
Construction Addr�
Legal Description
Owner Name & Address: s��� S�`�D�d2� Tel. �:S�?i/'O�r75
Contractor:.s£Z� Tel. � .���
Address: � �1�� �GUEl.c_ �_�.-_- —
Attaeh to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROQEMENT
t�� � �� •
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length �_ Width o2� � Height ,�._ Sq. Ft. �_
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER• l�C�pU�. /�IKL Z �' �iY���� --
�aax � �c.�6�`
Corner Lot [] Inside Lot ["J Ft. Yd. Setback Side Yard Setback
�'
Type of Construction: Estimated Cost: $
� �o33y
Approx. Completion Date: �j`�- � 7
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
�
DATE: ��zZ` �7 APPLICANT
Permit Fee
Plan Check
State Surcharge
SAC Charge
Fark Fee
Sewer Main Charge
TOTAL
� S7 �-D'�! 7
Tel. � �
USE ONLY
',� �
� �
$ ��
$ �- v e/
$
�
$
� �����
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
�ti
�a'� a q, 3a,so
T ��o ��
�v
Agreement Necessary L � Not Necessary []
STIPULATIONS:
�Jt-ip�-- �v 1U iJ �95�w4 �.� �
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� �
COMMUNITY DEVEIOPMENT DIV.
V PROTECTIVE INSPECTION SEC.
� _
� ; ---- .
r , �;
� � �-"1 � CITY HALI FRIDLE� 55432 NUMBEF REV DATE
�""�'� �'� 612-571-3450 910-F15 /10/90
�oe aooRess 6414 East River Road N.E.
1 LEGAL �OT NO. BIOCK TFACT OR ADOITION
DESCR. Pt. 28 Auditor's Subdivision #23
2 PROPERTY OWNER MAIL ADDRESS
Steven/Jeanne Smuder 6414 East River Rraad N.E,
3 CONTRACTOF MAILADDRESS
Same
4 ARCHI7ECT OR DESIGNER MAIL ADORESS
5 ENGINEER MAIL
PAGE Of
� �
20471�
3��7/
APPROVED BV
SEE ATTACHEO
SHEET
574-0979
ZIP PHONE LICENSE NO.
Z�p PHONE IICENSE NO.
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW 0 ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O FiEMOVE
8 DESCRIBE WOHK
Construct a 33! x 16' Addition to Dwellinq _
9 CHANGE OF USE FROM
STIPULATIONS
See notations an plan,
� ������
Before digging cali fo�
al! utiiity locations
454•0002
REQUIRED BY L,AV�
TO
TYPE OF CONST.
SEPARATE PERMITS ARE REOUIFED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNIT
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION �-
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPUEO $28 fSOQ.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $278�00
STRUCTION OR THE PERfOFMANCE OF CONSTRUCTION.
SIGNATURE OF
. _ i
�
OA AUTHOAIZED AGENT IDATEI
u,�o �� � - I b— ��
VER BUiIDERi . �OATE��,_
�
STALLS
CV GROUP OCCUPANCY�OAD
CU. FT.
OFFSTREET PARKING
GARAGES
SURTAX
$14.25
SAC CHARGE
AL FEE
2�2.25
11S IS YOUR PERMIT
i
NE�1 [ ] EffeCtiVe 1/1/90
ADDN � � R-1 P,���
ALTII� [ ) Buildirg Pierinit Application
Construction Addres.s :
t
t�,� �@
Iegal De.scription: OAscT v � (�r � /�v.0__S✓B �3
owner xame & Address: ����11�,�t� 1�- �cr�nJ�1 E�r�r c.�,�F� Tel. #� S7�f -O� �
Contract�or: c��; 'I�e1. #
Address: Co��'� �- �lf.'��C.� �� �-/1`�!'%��Zi
LNII�1G AREA:
GAItAGE AREA:
D�E7CR AR�►:
O't'i��R:
Attach to this application, a Certificate of Survey of the
lot, with the praposed construction drawn on it to scale.
DESCRIP'i'I0�1 OF II�II�'lmVF��i'
i �
Lexigth Width Height �_ Sq. Ft. �_
Iea'�gth Width Height Sq. Ft.
?�exigth Width Hgt/Graund Sq. Ft.
Corner Ic�t [] Inside Lr�t [t� Ft. Yd Setback Side Yard Setbacks
iype of Construction: �pk,tJ � ,�� i.���11 � Estiirtiated Cost: $ ��� � ' �
Approx. ow�letion Date: %-�/
Proposed Driv�way Width If New Opeazirig Is Desired: Ft. $ $
Wi + 6' See Back Page
LIATE: %(j - SU APPLICANr: Tel. # S 7�{�l3� 7Cf —
Permit Fee $ � (��i
State Surcharge $
SAC (�arge $
Driveway E��crow $
Park Fee $
sewer r�tain ct�arqe $
• v�
s�z�ZZOrrs :
$ �, r :t
CITY USE �II,Y
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determi.ned bY �9ineerir�g
Agre�nexit Neoe.ssary [ ] Not Ne:oe.ssaiy [ ]
Q � j k ��; '` ��?'i�
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CITY OF FRIDLEY
APPl.1CATI0N FOR PWMBING AND GAS FITTING PEf�11T
u
u • x
a r, .r
u
Ero � �
O L U
u m u� a
4 � t9 �
COMQCL9d MSCFI
��e. �� c�fi e �Gt�S'CCF e Se w e r
RATE SCHEDULE
PLUMBING FIXTURE RATES: N0.
Nw lixtur��
Futur• iixturs•
Old Op�ning, N�w FiYturs
Be�r Oi�p�nt�r
Blow O[f e��in
Catch Ba�in
Rain Mat�r Laader
Nydr�ulic Valve
Suwp or R�c�ivinq Tank
Mater Tr��ting Appliance
Hot 1later H�at�r
Gas Rang•
Gas Dryer
w Watec
�5 Heater
a7 �
� _
� p as le
Sewer
Water
C �E CLI.t � Gt� 1,
RATE TOTAL
S 5. 00
$ 3.50
5 1. 50
S 4.00
g 5. 00
g 5.00
S 5.00
S 5.00
S 5.00
S 7.00
g 5. 00
5 10.00
g 10.00
5
S
S
5
5
S
S
5
S
5
5
S
S
Back Flow Preventer poqutred. .. Yes O Mo O
Typ° 5 5, uo S
Ef f ective I9ay 1, 199U .
Job Address `t' / /� �QS� ��Ve(/' ��d��
Department of Buildinqs
Cicy uf Fridley
Tel. N571-3450
The undersigned hereby makes applicetion for e perait for the wrk haraLn
specified aqreeing to do all work in strlct eccordance with ths City Coda•
and rulings of the Department of Buildinga, and her�by declnre• that all
the facts and representations stated in thia appllc�tion ere tcua and oorr�ct
Fridley. Mn. % / . 19 7�
owNeR _c��eVe �Gt� 1 �cnr�
KIND OP BUILDING �eS(CkC/�t G �
USED AS
TO BE COMP[,ETED 7—��- 9�
ESTIMJITED OOST I Qj OQc ��
OLD - NEW BUILDING PEAMIT NO. PEfiMIT NO. /��� �
cbmaanY ._ /�6�-T r� ev-U• c0 ,
Signed 8y � J, � �v �S�l f ,
Ta 1. No . �S'�" Z` `/ S� (
ROUGN INSP.
Oate
FINAL INSP. -��— �(.d
Da te
(.r..�' " �
APPROVAL FOR PERMIT
ALL OTHERS 1►NO/OR REPAIRS AND ALTERATIONS
1� of Value of Pitture o� Applisnce 5��� '1INIHUM Ft:[: FOR ANY PLUMBING PERMIT IS s15.00
PLUS THE $.SO STATE SURCHARGE
State Surcharye 5
Reinepection Fee 5
(515.00) TOT.14 FEB g��O
l:ifectivc U�tc J�nuary 1, 1991
CITY OF FRIDLEY
APPLICATION FOR PWMBING AND GAS FITTING PEf7�11T
N T � �4 u x u Water
�a � c� � q � a �. c Heates
�1 ✓ .r [+ N F �,•�(� �0 M ul EA 1+ [1.
4 M � L •^Ci y�, t C C l ~Q U�•Ci O L � U � 4
Q Q •.+ �1 Y1 C M .� 7 p V N a! N N M M L'
w u� �i �i a �i uw° � i u�<s �� � o s la
19� x
2nd
3rd
�th
(R) � FLwr� Conn�ction operti�q Connact�d �ltt� S�w�s
(•) � Nw lixtus�, old Op�ninq ���
RATE SCHEDULE
PLUNBING FIXTUNE RATL:S: N0.
Ntw Pixtures �
Old Openi�g, Nov Fixture
Beer Dispsnaer
elow Off Basin
Catch 8asin
itain Nater Leader
S�wp/A�ceiving Tank
Wates Treating Appliance
Mates Htates - Electric
Mater Heat�r - Gas
Ga• Range
G�s Dryor
8sck Flow Preven[er Required () Yes
TYPe--
ItATF: TOTaL
� 7 .00 � S�/ e �
S �.00 � S
a 5.00 � S
S 7.00 � s
S 7.00 � S
5 �.00 � S
S 7.00 : S
� 10.00 � S
S 7.00 � $
5 10.00 m S
a lo.00 � 5
S 10.00 = g
i ) No
S 5.00 � j
s
ALL OTHERS AND/OR REPJIIRS J1ND ALTERATIONS
i 1• o[ Valu� ot Ftatur• or Applisnce
State Surcharge
,ZBINSPECTION FEE 530.00
TOTAL FEL'
�
5
5-- . —SO�., ,
5� �
Job Addre_:s � � L/
8uildinq Inspection Div. 6431 Univ�rsity Ave NE
Tel. No. 572-360o Fridley MN 55032
The undersiqned hercby makes application for a peceit fo[ tht wo[k herdn
specified aqrecing to do all uork in strict accordance with tht City Codes
and ruling9 0[ ch• De���rcmen[ of euildinqs, and hereby declar�s that •11
che facis and representation� s[ated 1n this aNplicatlon are true and co[re::t.
OMNER
KIND OP BUILDING
r
usen �s �,o � I1 ��„J
1'O 8E COMPLETED ABOUT
� —
ESTItMTED COST �/o10O �
OLD - NE1�i BUILDING PEHMIT NO. PERMIT NO. /4 ��+'� �
���
�� �
Company ,�
Siqnud Dy
Tel. No. S.3.S`" �o?7T
f�OI�GH It7SP.
aace
FItinl. I:lSP. ��� � �/
Gacc
AP'rhOVAL t'OH PEPMIT `�
MIVIMUM FLE FOR A.'�Y' PLU>1!�I�;r,/GAS PERMIT IS $15.00
PLUS THE 5.50 STATE: SL'P.CHARGE
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE
Fridley, MN 55432 APPLICATION F'�R POWER PLANTS AND HEATING� COOLING, VENTIL4TION�
572-3604 REFRIGERATI�:� AND AIR CONDITIONING SYSTEMS AND DEVICES, � �� ,,.� `
RATE SCHEDULE
Residential
Furnace Shell and Duct Wo�k, Burner -
Also Replacement Furnace
..
Gas Piping (N� d�d���� f�C�n�c
� (/A�C�
Gas Range
Gas Dryer
(�<tte TOTAL
a 20.00 � � `
S 1 A.00 S �
JOB ADO
The �ndersigned hereby makes applicatian for a permit for the work
herein specified agreeing to do all work in strict �ccordance with the
city codes and ruling of the Building Division, and hereby declares
that all the facts and rep�esentations stated in this application are
true and correct. ,� ,%� —,/ ,t 991
• I�l����►%L/�/_/fl��
� ��
� � ' �� �
�� . � � � � �`
� �� ! �
4//� ` 'S�
� � � �/ � �
"Air Conditioning - All Sizes $ 1 A.00 $
All Others/Repairs � Aiterations (LIST ON BACK)
19�6 of Value of Appliance or Work $
CommeraaUlndustrial
% of Value of Appliance or Work
�/j1, �/ Z.�C,CT� _
� �
State Surcharge
TOTAL FEE
S��
S .50
s ,�a . °�
MINIMUM FEE FOR ANY HEATING/COOLINGNf�NTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS 515.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTION FEE $30.00
' Air Conditioners can not be placed in a side yarci without
written permission from adjoining property owner.
DESCRIPTION OF 1=URNACE AND OR BURNER
No. of Heating Uni � Circle One (Steam) (Hot Water) arm Air
Trade Name Size No.� � ��L�"�'�S
BTU HP EDR
Fuel� ` � ° Total Connected Load
Burner Trade Name Size No.
BTU Hf� EDR
H ATIN P � ,
E G CO�NY
.
Signed By tel No. 7�� (!� c��
Approved By ���s..L- Rough-In Date Final Date �Z -Z7-�f
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
6���N� AND ELECTRIC! C.
-.. ;.
. ' �.,.�1 .'. �. ..
HOUSE HEATING TEST RECORD
ADDRESS �cI �`f ��I..,�7-" �� ll-F-�1.- %��
OCCUPANT C ��-C � M_ G� �_ �!'�Y
HEAT LOSS OATE HTG. INST. %Z.— 2,iz �/
SOLD BY 'IL-�L t-
Eiectrical Work By � �• / J �
TYPE OF HEAT GA FA �HW TEAM_ SPACEHTR._
� GAS DESIGN
MAKE `�
Model �s � !� l." f� � (e� �%%""S
Serial _',l �� / i� � � � "� %
INPUT ��_�
CO ROLS
THERMOSTAT Heat Plug
Valve �' k. �-
Limit
Limit Setting
Fan Setting '�`,' ✓V�- ,
Pilot Type ���L
Pilot Make
Pilot Model
Pilot Timing �
L. W. Cut Off
Pressure Percent CO, y
Input CFH �"�� Percent O= ���' �
StackTemp. PercentCO �
Form 235
APT. FLOOR CITY � �i �� SUBURB ''—
OWNER � �`�---
INSTALLED BY
Gas Line By
UNIT HTR._ OTHER
CONVERSION'�
MAKE OF BURNER
Idodel
Max. BTU Rating
MAKE OF FURNACE
Model
� �r
vern sue
KIND OF LINER �(.,,.r o 1.- SIZE �� f NONE
Draft Hood i� `S Regulator
Fiiters Size /�s X't--S �t j Number i
Chimney Location Insid,,e1� � Outside
Chimmay Construction •� b1,� C1.� h�y W'; 1... ���
Smoke Bomb
Draft ` �'A �
Door Pressure
Wiring
Test Tag ,�
Lighting Inst. �/.t/1
Date Tested
Company Testing
Name of Tester _� i•�v � ft�r-A'�
CIIY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572- 3604
Effective On January 1, 1993
APPLICATION FOR PLUMBING AND C.,AS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACN FLOOR '
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Biow Off Basin
Catch Basin
Rain Water Leader
Sump/F;eceiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas
Gas Range
NO. RATE
/
Gas Dryer _
Back Flaw Preventer Required ()Yes () No
Type —
$ 7.00
$ 4:00
$ 5.00
$ 7.00
$ 7.00
$ �.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
TOTAL JOB ADDFiESS (o �j/� � '� ✓Q� ��
I �
The undersigned hereby makes application for a permit for the work herein
specified agreeing ta do all wo�k in strict accordance with the city codes
� and rulings of the Buiiding Division, and hereby deciares that all the facts
and representations stated in this application are true and correct.
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND AITERATIONS
1� of Value of Fixture or Appliance , �S�U�
State Surcharge
T07AL FEE
$ .50
g �5-�
.e.� � �3 , � ss�
Owner �f.�(//L =�7Y(,cc�2-/� —
,(
Buiiding Used As ��� a� �•2�
d / l��_l �
Estimated Cost ��a-�� PERMIT NO.
PLUMBING COMPANY �/}?S Ck�l.{-�/� lGr-Yri�1b� � (�j
SIGNEDBY TELNO. �9%��3�5�/
Approved Rough-In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS 515.00
PLUS THE $.50 3TATE SURCHARGE
�
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604 .
._
Residentiai
APPL.ICATION FOR POWER PLANTS AND HEATING, COOLIh1G, VEN7ILATION,
REFRlGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed wfth new furnace)
Gas Range �
Gas Dryer
*Air Conditioning — All Sizes
Ail Others/Repalrs & Alterations (LIST ON 3ACIq
1% of Value of Appliance or Work
Commercial/I ndustrial
1.25% of Value of Appliance or Work
Rate
$ 30,00 $
$ 10.00 $
Effective On March 1, 1996
JOB ADDFlESS_ (�.L.� �QS� �o ✓P.l� �C�
The undersigned hereby makes application ior a p�rmit for the work herein
TOTAL specified agreeing to d� ail work in strict accordance with the City Codes and
rulings nf the Building Qivision, ancl hereby declares that all the facts and
representations stated in this application are true and orrect.
__ _ _._� -- - 991 6
OWNER �eQ,� n� �� �.L�P�I'� �J 7 y 0�I % cI
$10.00 $
$ 10.00 $
$25.00 $ �c�•�
$
$
Stat� Surcharge
TOTAL FEE
BUILDING USED AS_ L���i �
�j 0�
ESTIMATED COST�" PERMIT NO. -��.���
� ; •� � � •: i :
No. of Heating Units_ Gircle One (Steam) (Hot Water) (Warm Afr)
Trad� Name Size No.
BTU _ HP EDR
Fuel � Totai Connected Load
.50 Bumer 7rade Name
$ a5 �� BTU
MINIMUM FEE FOR ANY HEATING[COt�LINGNENTILATION
REFRIGERATION/AIR CONDI710NING I'ERMIT IS $25.00
PLUS THE $.50 STATE 3URCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a sicie yard without
written permission from adjoining property owner.
HEATIN COMPA Y_
Signe
Approved By
FILL OUT E3ACK SID OR
REPLACEMENT FURNACE
HP
.
Size Nn.
EDR
BLAINE HT�. A/C 8� EIECT. INC.
1�562 CENTRAL AVE. N.E.
Rough—In Date
Tel No. ' 1 � I��VLJ
STACK VERiFICATION ON
Final Date ��l �,
��
�
���"
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�63) 572-3604 FAX: (763) 571-1287
: 6414 E RIVER RD NE
: 153024420020
: AUD SUB NO 023 (REV)
: LOT 28 BLOCK
: PLUMBING
: RESIDENTIAL
: ADDITION/ALTERATION
PERMIT NO.. 004-01048
,
DATE ISSUED: 07/07/2004 +
VALUATION : $ 693.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL GAS WATER
HEATER.
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0
# NEW FIXTURES (EXIST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
TIMS QUALITY PLUMBING INC
523 CENTRAL AVE
OSSEO, MN 55369-
(763) 571-0454
OWNER
SMUDER STEVEN S& JEANNE M
6414 E RIVER RD NE
FRIDLEY, MN 55432
0 # GAS WATER HEATERS
0 # GAS RANGES
0 VALUE (FOR MINIMUM CALC)
0
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 know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl�
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 cons ction or the performance of construction.
A�ra�t_ � Date
Bldg Insp
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 8893
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
1
0
693
0.00
0.00
0.00
0.00
0.00
35.00
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0.00
0.00
0.50
35.50
CIiYOF rKiU�.�`Y`,�IV�PECI��ON DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
Urinai
APPLICATION FOR PLUMBING AND GAS FtTTING PERMIT
MARK NUMBER OF FIXTURES TO BE iNSTALLED ON EACH FLOOR
,. Wash pri�l�, �.:� Floor fi�t�h Auto.
�Shower Sii�k.:,,; Tray �QUt1�< : :::<: Drain �a�tn :...: Washer
PLUMBING FIXTURE RATES: NO. RATE
New Fixtures $ 7.00
Oid Opening, New Fixture $ 4.00
Beer Dispenser $ 5.00
Blow Off Basin $ 7.00
Catch Basin $ 7.00
Rain Water Leader $ 7.00
Sump/Receiving Tank $ 7.00
Water Treating Appliance $10.00
Water Heater -Electric $ 7.00
Water Heater - Gas*' $10.00
Gas Range" $10.00
Gas Dryer" , $10.00
Back Flow Preventer Required ()Yes () No
Type $15.00
TOTAL
(�.pa
1_IIG�.IiYC: V11 JG11 1� t.VV�/
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Gas �Ii�SC Water Heater
Ranqe Fix{.: :: .:; Gas Elec
JOB ADDRESS ��� `� �5f ��v�' �oa�-
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.
fo(� � oc,� , 2p_
Owner .,��^�`�— S i'''� uc� e Y
Building Used As 1�pS�de'r^C,�
�� �c�c�� , �l��l��
Estimated Cost �°�� `� PERMIT NO.
PLUMBING COMPANY �� � ����'4'� ����ti v�c. f -i's^�--
Reinspection Fee $47.00/Hr SIGNED BY �°��� TEL NO.�(>;.i �-6" -
AlL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance � 30 0
� Approved By Rough-In Date Final Date
State Surcharge � •50
MINIMUM FEE F R ANY PLUMBINGfGAS PERMIT IS $20.00
TOTAL FEE $� PLUS THE $.50 STATE SURCHARGE
COMB���T{ON AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TASLE 6-A. COMMON VENT INFO ON BACK SIDE
THE BELOW MUST BE F{LLED {N 1NHEN REPLACING FUEL BURN{NG APPLIANCES OR THE
APPLICATION 1MLL BE RETURNED
�•► � : � : � •►
•�,���► � ► i ► •►► •: _►� s�,: _ -
When rs��a �t1Q an Y�c in� f�r� ance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes�No ()
The venting system is plasticlPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No (E�'
The undersigned also veriftes that the replacement unit is a listed assembly .
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances. Yes (tJj No (
'�e pYictina cnmh�ctien �r is sized and installed to meet the current codes
and manufacturers specifications.
When required to �n�ta�� ^ n_t•� cemhuctien airi it will be sized and installed
to meet the current codes and manufacturers specifications.
Yes (� No ( )
Yes ( ) No ( )
�ltv�ec.d�,J hc,5
C�.bus+� �^ �
�,.0 �.
When �� °��� a nP�s� ��pntin�yc pm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
speafica6ons. This does include AGA-GAMA Category i Central Fumace 1•t5cd eW s+, n�
V e n 6 n g T a b l e s f o r f a n a s s i s t e d a n d natural draft a p pliances. Yes O No O V�� 5� 5��--
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes (r�No ()
� . . . . - _._�� ,� . . - . . . . - . . . . - . , . .�� . . �
Appliance #1 Type �I�:x.°�cti ���-=�- BTU Input � � � Fan Assisted o at,
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Totai Appliances __j__ Total Btu input
Common Vent Type G�.SS �. Vent Height Diameter r'�' inches
Appliance #1 Vent Connector Height � ft Length �ft Diameter �in Type C-i �ss C
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ni -rcQa�nnni�• ((�e��r;t,e� ��%[! n �
HEATING CO: � `"�'' s � '�`-�- � ` Q -� �—
Signed By: Date : % - � `�
..
�uilding BUILDING Permit rio.: � `
Inspections RESIDENTIAL APPLICATION Rece' d
763-572-3604 CITY OF FRIDLEY D���'�
763-502-4977 FAX EFFEC�vE i-i-o9
DATE ��I'� YOUR E-MAIL ADDRESS � Si'NLlt�i+� LFO`�N'!�[iI•LQisi _
SITE ADDRESS ��Ly �7 K11�'� fCy'�'j%
THIS APPLICANT IS: �OWNER ❑CONTRACTOR
PROPERTY OWNER/ NAME: VEjJ p,L�,{V �
TENANT ADDRESS: / T � V�' CITY /titD� STATE�/1IZIP �7 � z3 Z
--�
PHONE�%�,� �—,rj ?y�O���
CONTRACTOR NAME: �l'"��
SUBMIT A COPY OF
YOUR STATE LICENSE STATE LICENSE # EXP DATE
AND CERTIFICATE OF ADDRESS: CITY STATE ZIP
INSURANCE PHONE FAX
PROPERTY TYPE �I SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ ASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
�ECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION �ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: �(/ / !'-� /� 1� I7 D�I� �.�Y �1.SDE OF �y(p u„�'
SIZE OF IMPROVEMENT LENGTH .Z � WIDTH � HEIGHT � S FT ��
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
1. Existing F►oor 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 ❑SoffSt 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 Calculations
IN EXISTING OPENINGS �Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FL+'ES AIZE BASED ON VALUATlUN,1NCLUll1NG "1'HE CUS"1' UN' LABUK A1Vll MAIr;KlALS:
(USING H 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �a 3i • � OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
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)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks uavable to: Citv of Fridley Attach
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 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 rk which re ires review and approval of plans.
SIGNATURE OF APPLICANT �CG.P��C/�,� i(i� PRINT NAMEfS%rC�U cS/l�f/li�i'L DATE �(—�—CJ /
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK
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De��gn #:26871 :.:.,..���,..:.��_�..� . �, 8/8/2009
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�** Take this sheet to the Building Materials desk to purchase your materials,
YoG �� ��cted a 1 level deck with:
Pres�t�; e Treated Framing Material Below is a section of the railing style and
4 x 4� raming Posts options you have selected for your deck.
5/4" x�" Pressur� �reated Deck Boards
Po��e�� hootings 8" Tube 4' deep
Prerc�;s�� Gold Combo Drive Screws
Galv�nized Framing Fasteners
* *
Han�'r��� selections:
36" ��i��dle T Railing
2"x�' �;�2" Pressure Treated Spindles, �eveled 1 End
4"x�`��=��" Pressure Treated Utop Notc�ed Railing Posts
5i�;;��: ='� �ssure Treated Plain Handraii
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Spindle placement is approz. 4" apart depending on styie
You may buy all the materials or any part at low cash and carry prices. Because of the wide variable in codes,
Menards cannot guarantee that materials listed will meet your code requirements. Check with your local municipality
for plan compliance and building permit. These plans are suggested designs and material lists only. Some items may vary
from ihose pictured. We do not guarantee the completeness or prices of these s ctures. Tax, labor and delivery not included.
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Illus�ration intend�'��:��=���ow general deck size and shape.
Some options selected may not be shown for picture clarity.
To��y's cost for materials estimated in this design with options:$771,24
, *The base price includes: 40 PSF deck live load, AC2 treated • horizontal 2x6 *�BASE price): $604,85
deck boards, 4z4 posts, 2z8 joists and beams, galvanized framing fasteners, �`*If purchased to ay, you save; $49,88***
AC2 treated 36" Vertical handrail to joist wiihout posts, and premium screws, *�'Monthly B1G Card Payment would be: $21,66***
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Design #:26871 :....: � ::��,,�:�4i�.
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*** Take this sheet to the Building Materials desk to purchase our materials. ***
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� Level 1: 12` x 12'
=- 2' off the ground
= �' Horizontal Decking
2" x fi" .Ini�ts
`— — 2 ft cantileve� n �oists
__�__ = - � 2'' ' _'
-- -- J tilev�r on beams
40 PSF Deck Live Load
1�_' vv��Y
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T����.�'s cos� for materials estimated in this design with options:$171.24
�`The base price includes: 40 PSF deck live load, �C2 treated - horizontal 2z6 * BASE price): $E44.85
deck boards 4�4 posts, 2z8 joists and b�ams, gaEvanized framing fasteners, �"*If purchased to�ay, you save; $49.88***
AC2 treated 36" Vertical handrail to jois� `•rVii�OUY �1sts, and premium screws, �*Monthly B1G Card Payment would be. $21.66�**
Beam Layout for Your Deck
The Scale is 114 :1
' Design# 26871
�v,�rk Length Description
�=_ --- 12� - 2-2x8 2 0
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Joist Layout fcr Your Deck
The Scale is 1l4":1'
Design# 26871
C A
Length
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11'10-1/2"
12'
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,f�=:�,�s to be on 16" centers.
�:r�� �is to be hung from the ledger with joist ��aneers.
��:��is to be toe-nailed to beams with 3-11�" (1.�d) galvanized nails.
H:��;i joists to be fa�e-nailed to joists & led5�rs with 3-112" (16d) galvanized nails.
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Post and Beam Dimension Sheet
Design# 26871
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