The URL can be used to link to this page

AF - 41947ATTENTION OF: � r _ _ _ _ To Darrel Clark Mervin Herrmann L �� .�., � . . . _ �„p,..._ ..-- J CITY OF FRIDLEY 6431 University N. E. Minneapolis Minn. 55421 612-560-3450 SUBJECT 8080 East R� DATE May 4, 1978 A ire early this morning caused rather extensive damage to the dwelling at the above address. � . _ •C�l+a , _ _ _ __ __ __ _ _ ��.� _ _ _ . _ _ _ SIGNATURE Bob Aldrich REPLY: DATE SIGNATURE REPUER'S COPY - fiETA1N fOR YOUR FILES SUBdECT PERM I . . City of Fridley . 146'74 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � REC . � • COMMUiJITY DEVELOPMENT DIV. , ; y ------, �f .�D a r � � PROTECTIVE INSPECTION SEC. 1 . � �� r'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE � PAGE OF �APPROVEO BY ""� � ,`� 612-560-3450 910-F15 5/5/78 / / JOB ADDRESS g080 East River �ad N. E. 1 LEGAL LOT NO. BLOCK tRACT OR ADDITION SEE ATTACHED DESCR. 6-ZO 9 Spring Brook Park sHeer 2 PROPERTY OWNER MAI� ADDRESS ZIP PHONE Dick Wallace 8080 East River Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. O. R. Anderberg Company 2923 Oakland Avenue, Mpls. 55407 824-2605 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING ReS 1CZ�Y1'tldl 7 CLASS OF WORK ❑ NEW � ADDITION O ALTERATION C� REPAIR ❑ MOVE � REMOVE S DESCRIBE WORK Fire Damage Repair 9 CHANGE QF USE FROM TO STIPULATIONS Provide smoke detector. Contact Fire Department before proceeding. S�'�� PERMITS RE Ul NEI�TING, PL.Ulw81NG AND � ED FOR VYtRl1�,G, �GNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBlNG, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. W�OCZ FY'3ICt2 THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 APP�ICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S� i OOO $2 • rJO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHAAGE PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI OR THf PERF ANCE F CONSTRUCTION. $30.00 f t-7 PLAN CHECK FEE TOTAL FEE � S-J - / S $3 2 . 50 SIGNAT OFC NiRACTORORAUTHO I DAGENT IDATEI � EN PROP LY VALIDATED THIS IS YOUR PERMIT 4 l V V� �� SiGNATUREOFOWNERIIFOWNEFBUILDERI IDATEI �- BLOG iNSP DATE • • CITY 01= �1tIU�CY � . � . • nr��cnriols r-ori ri�:sr��cr��r��ni_ ��1�_UZi�� ('CfZ��fITS , - ' (�'�C:W, I1L1"LIi�TIU(d5, �L�llIT101�S, OR �Cf'AI(ZS) Otti'I7�R: � LCK W �Ll_AC� � T3UILll�l2: v ' � . � � 1.�� Adrlxc�ss: ��j� �.' � UEY�, 1?�, nddre�s: � 1 � �J 0%�I�L14rv1� /�v �, Y''1�'S � �''t°� aL.�� Tel . No . 8�.� -,� (00 S' S5 ¢d'� i I�o. : � �O Street: ��%% �CJ�2 �a�, . LOT ; G-- f 6 BLOCY.: �_ ADDITI OP� : ��sirJ C �,Cd?11� �i�l� COR?QL•'R �OT: IIdSIDE IAT: S::TJ3ACY.: _ SIDEYRRDS: Applicar:i: attach 'L-o L-his foYm 7�ao Certi�icates of Survey of Lot and proposed building locai:ion i:rawn on these Certif:icates. . a DESCRI PTI Oi�d OF BUI LDI �G Ta I3e Used 11s: 2�t �� +l �� 1 �C��LLI ti1 � Front: c�`t"I � Depth :�� I- d Height: � � � Square Feet: Cubic reet: � Front: Depth: � � Height: � Square I'e�t: Cubic Feet: � • � 1 �L 1`�fMnA�E QL- o0 Typ� of Constructien. ��(�Esti.`nated Cost: S' ,�� 7b I3e Co�npleted: �� r — l� � AIt. A Alt. B Prtiposed Drire�aay ��'idth If Isew Opening Ts Desirec3 �_ $ $ ' (SEE Tt�VERSE SIDE OF SHE:ET) The undersigned hereby makes application for a permit for the work herein specified, agreeing ro do all caorl: i.n strict acco�:dance w�.th the City of Fxidlc;� Ordinat�ces and rul.iszgs of the Dec,a.rtment oi Uuilciings, and hereby decl.ax:es Lhat a11 tl�e facts aTid represen�ations stated iri t-lii� applicat:zan are i.rue anci coi-rect. See reverse side r ac7ditional i.n ��:na ian. D11T�: � S— /� STGr1�`�^UP.�:: S�ipulations: �,/ �/f'��A/��(l� � �y� Jr�u �o�r �'�� A--�� . _ � � � �o,.��t �r.�ie �?e��„�,,.Q-�--r— �� `� ' � :��,� � • � �� ., � �z. �� SUBJECT R c�ty of Fridley 18 5 8 6 AT THE TOP OF THE TW {NS g U I L D I N G P E R M I T r ' ' R � � • � • COMMUNITY DEVEIOPMENT DIV. � � � i1: - r � � PROTECTIVE INSPECTION SEC. y,� � . � � `.--- �;/"';,; CITY HALL FRIDLE� 55432 NUMBEH REV. DATE . PAGE Of APPROVED BV i � � 612-571-3450 910-F15 8/11/86 � � JOB ADDRESS g080 East 1 LEGAL LOT NO. BLOCK TRACT OR ADDITIONBrOp]t SEE ATTACHED DESCR. 6—].O 9 Spring �� Park SHEET 2 PROPEFTY OWNER MAIL ADDRESS ZIP PHONE Wallace 8080 East River Rpad N.E. 3 CON7qACTOR MAIL ADORESS Z�P PHONE LICENSE NO. Mr. Siding 10800 Xavis Street N.W., Coon Rapids, 55433 421-8200 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 WORK ❑ NEW ❑ ADDITION _p ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRBE WORK Reside Dwelling and add trim 9 CHANGE QF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTII.ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOFiK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOR4t IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING I HEREBY CERTIFY THAT I 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 HEREIN OR NOT. THE GRANTING OF A PERMIT $4, 950 �2 • 4$ DOES NOT PRESllME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PRO ISIONS O NY OTHER STATE OR LOCAL LAW REGULATING CON- c� TR CTION HE PERFO ANC F CONSTRUCTION. ySO. SO PLAN CHECK FEE TOTAL FEE %� ,� $ 52 . 9$ iGNaru OFCONTRACTOROAAUTHORIZEDAGENT � TEi WHEN PROPERLY V I ATED THIS IS YOUR PERMIT 8 �i SiGNATUAE OP OWNEA UF OWNER BUILDEA� IDATEI �� BLDG �NSP � TE NEW ( � ADDN. [ ] pLT ER . [ � Construction Addre Legal Description: City of Fridley Effective 4/1186 �R-1 ANA R-2 Building Permit Application Ownez Name & Address: Contractor:_ � � �%�� Tel . # '`�°2� ' �UC� Address• � Ut�pp �A�UlS S�� l.�t.e� CDOrJ �.��• aS SS��.3 - LIVING AREA: GARAGE AREA: DECR AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, With the proposed construction draWn on it to scale. pESCRIPTIOA OF IMPROVEMENT Length Width _ Height �._ Sq. Ft. Length Width _ Height Sq. Ft. �_ Length W�dth ___ Hgt/Ground Sq. Ft. ,, �SrD� / 2�M � Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction: �� Estimated Cost: $�95 — Approx. Comp�etion Date: Alt. A Alt B Proposed DriveWay Width If New Opening Is Desired: See Back Page for Explanation DATE: / �_ APPLICANT: �� Tel. � �/" � CITY SE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sexer Main Charge TOTAL STIPULATiONS: $ �. S� $ s �. �� $ $ � - � '� Fee Schedule on Reverse Side 25'� of Building Permit Fee �.50!$1,000 Valuation �475 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( � s�e�ecT PERMIT NO. Cit of Fridle � y y _��8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T -- r — �� RECEIPT NO. � �` COMMUNITY OEVELOPMENT OIV. . j r � L � PROTECTNE INSPECTION SEC �,�� - ( � �'��1 � CITY HAII FRIDLEV 55432 NUMBEA REV OATE PAGE OF APPRO�ED B� �""�� ,�� 612-571-3450 910-F15 11/2/94 / / J08 ADDRESS g080 East River Road NE 1 LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED DESCR. Fj—lO 9 Spring Brook Park SHEET 2 PROPEfiTV OWNER MAIL ADORESS ZIP PHONE Richard Wallace 8080 B� East River Road NE 786-5414 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO. Same 4 ARCHITECT OR DESIGNER MAfL ADORESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WOFiK ❑ NEW ❑ ADDITION ❑ ALTERATION l� REPAIR ❑ MOVE ❑ REMOVE P 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear-off 9 CHANGE OF USE FFiOM TO STIPUlA710NS Underlayment must comply with the State Building Code. TVPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTAICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. fT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, Of; IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI7S OFFS7liEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION 1 STA�LS 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 HEREIN OR NOT. THE GRANTING OF A PERMIT �I�SOO �.75 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR THE PERfORMANCE OF CONSTRUCTION $.3S.00 Fire SC �L.SO PLAN CHECK FEE TOTAL FEE $37.25 S�GNa EOCCON-�nGTOaOA UTHORiZEOAGENT iDnrE� WHEN PfiOP LY VALIDATED THIS IS YOUR PEAMIT � L��.�.t/ �/ - z - 9 � ��;u� ��1a ' �-3�� TUREOFOWNEAi OWNERBUILDERI IOATEi —�' ^ gL G INSP r�47E NEw ADDN ALTER [l [l �� CITY OF FRIDLEY SiNGLE FAMILY AND DUPLEXES R-1 AND R-2 Build'utg Permit Application Effective 1li/94 ��sa � ConshvctionAddress: � SC� E.�i u�-- �A� Fu Dt�.'y Legal Description: e � �.c � P.� Owner Name & Address: ��, �,q �,� �-�-ei �c�-u �,t,� Tel. # 7�6 - 5�-! L� � Contractor: �L � MN LICENSE �` Address: Attach to this appiication, a Certificate of Swvey of the lot, with the pro�sed construction drawn on it to scale. DESCRIPTiON OF IMPROVEMfiNT LIVIATG A1LEA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: ��h Width Hgt/Ground OTHER: �J Z-�lC� .�� F- `f=1 � I �C ' , ,.� � �5,�,2�! � � Tei. # Sq. Ft. Sq. F� Sq. Ft. �1 �c��' Comer Lot [� Ynside Lot [] Ft. Yd Setback Side Yazd Setbacks Type of Constivction: Q� p� F , Estimat�d Cost: $ � � M°° ._- Approx. Completion Date: (Cost on Backj ��.. Driv ay Curb C'�t Width Neecied: Ft. + 6 Ft = t x$ —$ E: ��- 2- �4- APPLICANT: Tel. ��°�, -5¢i�- Ji CITY USE OI�LY _ ' Permit Fee Fire Surcharge State Surcharge SAC Cliarge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �� - �� Fee Schedule on Reverse Side $ /, �Z� .001 of Permit Valuation (lJlt)th%) $ 1 % � $.50/$1,000 Valuation $ $800 per SAC Unit $ $5.00 (Stare Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation P2an Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ `)` � S^ Y � �s�� -�� ;�, �� MEMORANDUM PLA1�iNING DIVISION DATE: March 19, 1997 TO: FILE FROM: Michele McPherson, Planning Assistant SUBJECT: Nonconforming Properties Adjacent to East River Road As a result of Anoka County acquiring additional right-of-way for expansion of East River Road, this property was rendered nonconforming. Please refer to the attached chart which indicates the extent of the nonconformity. MM:Is M-97-137 � EAST RIVER ROAD PROPERTIES AFFECTED BY ANOKA COUNTY RIGHT OF WAY ACQUISITION ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING. USE SETBACK SETBACK SETBACK TYPE 7845 East 97.02 ft 89.1 ft 35 ft front yard yes River Road apartments Apartment 46 ft 38.28 ft 35 ft front yard yes garage 321 79"' Ave. 53 ft 36.3 ft 35 ft front yard yes apartment 7948 East 32.34 ft 17.49 ft 17.5 ft side corner yes River Road 132 28.38 ft 27.06 ft 17.5 ft side comer yes Stonybrook 7950 East 34.65 ft 28.7 ft 17.5 ft side corner yes River Road Garage north 24.75 ft 23.76 ft 35 ft front yard no, before and of above after 8051 East 41.91 ft 30.36 ft 3� ft front yard no, after River Road 305 Liberty 93.06 ft 72.93 ft 17.5 ft side comer yes 440 Ely Street 79.2ft 61.38 ft 17.5 ft side comer yes 8161 Fairmont 93.39 ft 65.01 ft 35 ft front yard yes Circie 450 Hugo 73.92 ft 43.89 ft 17.5 ft side corner yes 8191 East 71.28 ft 40.92 ft 35 ft front yard yes River Road 500 Ironton 55.11 ft 31:15 ft 35 ft front yard no, after : 97 Craig Way 47.5 ft- 23.1 ft: 35 ft front yard no, after 7680 East 37.95 ft 13.5 ft 17.5 ft side comer ` no, after River Road 38.94 ft 23.76 ft 35 ft front 119 Craig Way 63.69 ft 40.92 ft 17.5 ft side corner yes 50.82 36.3 ft 35 ft front 7942 East 49.5 ft 33.3 ft 35 ft front yard no, after River Road ' 8080 East 58.74 ft 33.9 ft 35 ft front yard no, after River Road 8100 East 50. 9 6 ft 50.16 ft 35 ft f�ont yard yes River Road � _ � Laundromat 31.68 ft 1.65 ft 35 ft fron# yard no, after 499 Glencoe 38.28 ft 8.58 ft 35 ft front yard no, after ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING USE SETBACK SETBACK SETBACK TYPE 8164 East 43.56 ft 14.19ft 35 ft front yard no, after River Road 8180 East 37.95 ft 8.58 ft 17.5 ft side corner no, after River Road � 8182 East 38.28 ft 94.19 ft 17.5 ft side corner no, after River Road 8184 East 38.28 ft 14.52 ft 35 ft front yard no, after River Road 8200 East 34.98 ft 9.9 ft 17.5 ft side corner no, before and River Road after 510 Janesville 38.61 ft 12.54 ft 17.5 ft side corner no, after 421/432 39.27 ft 8.58 ft 17.5 ft side corner no, after Ironton 461 Hugo 33.66 ft 3.fi3 ft 17.5 ft side corner no, after Street 8114 Fairmont 36.96 ft 8.58 ft 17.5 ft side corner no, after Circle 8102 Fairmont 33.99 ft 5.61 ft 17.5 ft side corner no, before and Circle 33.99 ft 17.16 ft 35 ft front after 8104 Fairmont 35.31 ft 26.73 ft 35 ft front no, after Circle 8027 Fairmont 21.45 ft 9.9 ft 17.5 ft side comer no, after Circle 46.53 ft 17.16 ft 35 ft front 7899 East 52.8 ft 33 ft 35 ft front no, after River Road 0 ft 20 ft hardsurface 7663 East 64.35 ft 34.65 ft 35 ft front no, after River Road Fire Station 29.7 ft 0 ft 35 ft front no, before and . • after 7701 East 80.19 ft� 62.37 ft 35 ft front yes River Road 8061 Ea�t 90.09 ft 78.54 ft 35 ft front yes River Road a NEW ADDI� AL'C�R �::�C� �`' �� - C� �� [ j CITY OF FRIDLEY Eff�ctive 4/1/2004 [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION �� , n /1 . Construction Address �0� I.. �...1 1"1� � �..' _L' _._" l KL✓ /�-d�v� M� Attach to this application, a Certificate ofi Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width GARAGE AREA: DEC%C AREA: OTHER: Constructi�n Tvc Length Width Length Width Height Height Hgt/Ground � stimated Cost: $ Sq. Ft. Sq. Ft Sq. Ft. ii1 � Driveway Curb Cut Width Needed: F+ 6 Ft = Ft x� _$ DATE: � '.3 �%� APPLICANT: Tel. # � ��0,� Call (7�63) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC �Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sew�r Main Charge TOTAL � 3, �s $ $ Oo $ � .SD $ $ , dl� $ $ � $ $.�a, � CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuaiion (1110th°fo) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Consenration Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � /� �� STIPULATIONS: Building PLUMBING Permit No.: � � Inspections RESIDENTIAL APPLICATION Receivect By: 763-572-3604 CITY OF FRIDLEY Date Rec'a: '�� -U DATE � U� YOUR E-MAIL ADDRESS SITE ADDRESS OC�� -' �. � t�c�C THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY N,qr,jE: %�P�e�:l �j,�,l/�}C�,c�G�e OWNER/ pDDRESS: ��i .- C� � � CITY_ (� _STAT�K�ZIP�3 TENANT ' ~` �� PHONE: ��' "((�SZ-( I Y CONTRACTOR NAME: � SUBMIT A COPY OF STATE LICENSE # �- C.c� � ` _ EXP DATE ,�/ YOUR STATE ADDRESS: ��/ �� CITY STATE'��ZIP�E�> LICENSE WITH pHONE �� 7 �( �/ FAX APPLICATION PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �W PLACEMENT DETAILED DESCRIPTION OF WORK � PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to :�500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the. fixtures: _(This should reflect only the cost .of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECi'��1V#-IERE LABOR EXCEEDS $500, FEES ARE'B;4SEI3 flId $i{}�QO �EIt FI-XTEIFtE;EXGEP3';�HERE N�TED. FIXTURES: (INDI��1�'��'EiTAL " NUMBER OF EACH BELOVI� BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING _BATHTUB GAS PIPING �sEac�rruc�sE) SWIMMING POOL � WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $��!. Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Tota1= $ 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; that the work will be in accordance with the approved plan in the case of all work wh'c e ires review and approval of plans - SIGI3AT[3RE OF APPLICANT PRINT NAME �- c- DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 - — �ITY OF FRIDLEY INSPECTION DIV. Effective Aprit 1, 2004 �431 University Ave NE =ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF �IXTURES TO BE INSTALLE� �N FacN Fi nnR .�L�` 'LUMBING FIXTURE RATES: Jew Fixtures )Id Opening, New Fixture leer Dispenser tlow Off Basin :atch Basin ;ain Water Leader �ump/Receiving Tank Vater Treating Appliance Vater Heater -Electric NO. RATE TOTAL JOB ADDRESS �c.nnn.2 • o�.S o'1,�) yu�i Vater Heater - Gas** �_ �as Range** �as Dryer** �ack Flow Preventer Required ( )Yes ( ) No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.Q0 $35.00 $35.00 $35.00 $10.00 $10.00 � � ��,� � ,,�,�� , 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 fads and representations stated in this application are true and correct. DATE: _ _ �D / _'� , 20�_ OWNER �O� L1iST K'✓CI� IidQG� �S� BUILDING USED AS �SI c�e.vlG� ESTIMATED COST `t f%O ^� PERMIT NO. $15.00 PLUMBING , :einspection Fee $50.00/Hr i,LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance �_ State Surcharge $ •� TOTAL FEE $ �S � SIGNED BY Approved By � � t-'I.�.br� TEL N0. �%f Z� �Z 7 - �033 Rough-In Date Final Date I:OMBUST{ON A{R SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacin� an existins� furnace, 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 plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies 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 Furnace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) When installina a new ventin� svstem, the undersigned hereby verifies that it is a listed assembfy and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () 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. No ( ) No ( ) Yes() No() Appliance Tvqe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total App{iances Tatal Btu lnpu# Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS• (Describel HEATiNG CO: Signed By: Date :