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AF - 42091City of Fridley, Minn. 4�.,. �- _-- a.. � .. . BUILDING PERMIT n te. �►�..�...1�. lfi�►� �,, -- _ , ° 8780 � � r �. a_ �,: l�n . Lrtia J�sa� suiider _._Yiiil•• i. -�■�•� Aaa�e.s ....�_..�f, �ir�r �r�l x�s• ._.� nd$t'a/� �� Ma L�a �wi� 1�1�►i , - LOCATION OF BUILDING Na .1!�...�.. Sfxeet _�Mt:��[ �ii� �.s. .�.___.._.�_ Part oi Lot � L�ta 1 i p'slock 10 namtton or sub-Divldcn �'� �seWt i'�s� �•t�Mt corner I.ot _._�._..._._ Inaide Lot ...._. . S�etback �____._.._.__....... stdeyard _r___.__ Sewer Elevatlarci �...._._..._.._.......�._._�_____.��.M__._._...... Foundatiaa� Etevattou DESCRIPTtON OF BUILDfN6 To be v.ea a.: � -^.� �' Froait ZZ' DeD� ,._..,,Z3 � Hei�t 20! gq, Fk -�:d�.- Gtt. 8`!. ��=+�-� _....._.�... �..�.._..._._.�.... ,.� �� ..._._._. �. �. ._.._.._...�.� �,� .�,.. Type or constructsan � Eet. cat ' Completed __..._._y._. _..__...._.._._..__._..._..._._ To be __ - , ,��....�..�... In caa�sdderatio� o! thhe issuance to rne of a peririit to cu�struct the imiidin8 &eecribed abow I a�t+�t"b� de :- th� propoaed work in acoordance wltti the descripttou above set forth and in campiiance wlth af I� ad: ordinaaces o! the dty of Fridtey. . . . . . . � . . . . . .4. . . In cansideratlaou o! t%e payment o! a#ee of $...._�.s.�-__.., permit is ha'eby S�ttd � .�.,l.�..� to co�strucc the tbuilding or aaa�tic� ae �escrtt,ed sbon�e. �rhisp� t is �"antetl s��n the expresa condition that thepe to whom it is granted and hia ag�ts, �nployees and w� ig a11: �aR�k. done i�►, around and upon eaid �buildiag, or aa,y thereol, shall c�nlaam in aII x�e�psct�s io t�ha d Fridle�r, Mint�ta lccatic�, aoam�tr�t�c� dtera�o�. :nait�be�sanca, repatt attd a� oi wl�� dty ]iaaiti�a�d th pes�nit may be x+avo�sd at aqy tlaQe upan violatlam o! any: at ffif p�s o! : .�a- � � � NOTICEs _ . 11�b p�endf dea nef eewr fM eaahoalioe, � 1er �. P�Y� N� �r Nw�M N wi�r. /s wN N rN fh� �eit� Inp�alsr for � p�n�ts �oe � haw�. � • - . .g -�- -�-� _ — . ..; ,�... _ APPLICATION FOR BUILDING PERMIT CITY OF FRZD�LEY, MINNESOTA ��'��/�-� _ . OWNER' S NAME BUILDER �%�/ lV � ADDRESS �� ,� �� / /��} �� ADDRESS�/( �w/ C.tit'^� LOCATION OF �UILDiNG N0, � STREET ��:�,v �C /��PART OF LOT iAT��/ ��... BLOCK : 0 ADDITION OR SUBDZVISION �� ,; CORNER LOT INSIDE LOT SETBACK SIDE-YARD � SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this for�an Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUiLDING To be used as; , . � i � � Front �� Depth�Height i Sq. Ft. � � Cu, Ft. -r �-�--- Front Depth Height Sq. Ft. Cu. Ft. Type of Construction_ �.��,,,� � �stimated Coat � �U � To be completed The undersigned hereby makea application for a germit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that a11 the facts and representations stated in this application are true and correct. . DATE � � SIGNATURE �U-°'`� � _. _ > (Schedule of Fee Costs can be found on the Reverse Side). � • � �� ' 5 €�� )i nr A�ril 2�� 19b6 �ir, '�illiata A, Si��1 i.��ill Twin I,ake Av$rane �Siru��a�olis, �I3�.x�ri+�sota► Desr P�r. Sippels B�fore moving the gar�ge an our ��:ilding Pex�zit Atv. x`� i�$�� i.t �r3.11 be �ecessary far you to .�vrnish this o�'fice �rith a certif ica�e of ir�3uranee �or publ3.c 1iab�li.tg. Qther— �i.s�i a lice:�s�d c�ntr3c�s�r �oulsi h�ve t.� do th� n�ovang. �1��, it �i�.l �� r��aa� r ac: "��u �.;:� �;:.�.3.�irr� �� brou,�h� �.'�� '�r� '�' Jr'� a.� �, � i.a� r� � �w'.�a AGJ ps ;�3. *':^�'J;. ':,'.�..;�1'J ��ii�i tir el'�"wlti`47'�� Bt1�.ZC�Ti�j �T49p@C'�rOi' City Qf �'ridley AGREEMENT WITH THE CITY OF FRIDLEY ' .. I, '�� owner of Lot 15, Spring Brook Park 2nd Addition, have requested permission to improve our present private sewer system and understand and agree that we will not object to the City providing City sewer and further I will accept the assessment for said sewer and will also connect to it within 6 months of its completion. BREEN (Own r) � � DA / CHARLES DUr7PHY ��ontra Pu er) TE �i�/ c� �ti�ic�y � . ��i�4�c��o� ��e� Piu��stg �„�d �-� �'ri�e�� P��i� — Aept. of IIldaa. Phon� 3E�0•3450 D£9CRIPTIOti Oi VlO�;f: • ' ,��j }' ?iumbar, Kind and Loce.tfea of Fixlurei I'°�ati"'~ —�r�"` `� � G „ �J � WATf4 NTII. � � y y� � ` z I �' �" z t� '.� p Z 1�j Z p � � • • O IC 3,. 3 Z i3� �� o<�r r� 7�� Z I7 � N GAS [IEC. __� '� � S� S N��. c. �:o �� 33 ul u� 08 Basr 1 st 2nd _ 3rd 4th i • -Fueiu• �oanxsSoa Oponinqs Conr.aeiod ai21n * Now Fixtur�, Old O�yai:zqs S�isos ( Ccsapool ( �...:.. �� ;> , , /.� z /� l� �/. % n /1 ' U City of FYidley: The undersigned hereby znakes aDDlication for a permit tor tl�r vsork heni specificd, a�reeing to do all work in s.rirt ucordance with the Cit� Ox�irana and ruIing of ihe Department of $uiId:ngs, and hereby deciares that aIl the fact and representations stated in this appllcation are true and correM Fridley, Minn _ �'v� D , 19� Owner �' ` Kind oi Buil�ing Used as To be completed about P�RTIAL RATE S�HEDULE Estimated Cost, a Old—New. IIui2ding Permit No. P•rmit No. ��3� ?LQ!rFBTNG FIXTURE RkTES: NO. RATE TOTAL Number Ftixtures . . . . . . . . . . . . . x S2.� S Signed �Lture Fixiure Opcning ........... . x 51.50 S�_. . By -. New Fixture Oid Oyening . . . . . : . . . . . x S1.50 S—.._. __ Busin�•ss P'hune No Catch Basin . . . . . . . . . . . . . . . . . . . . x 53.25 E Water iieater 'l.'p to 99,000 BTUj .••• x$3.00 S . New Ground Run Old Bldg. ......•. x�.3.25 3 ROUOFi Elsctric Wstar Hsataz. . . . . . . . . . . • z $2.G0 = FIPIAL �f , �. ? - 7 �, . :.1.3 FI?TING FEEB: PIO. RATE TOTJ►L lst 3 Fixtures . . • • • • • • • • • • . • • • • • x S2.00 = . Add3tional Fixtures . . . . . . ..... . . . . . x s .75 ; ' Gaa RanYe to 199.000 BTtJ . .... . . . . .. . x �,5.00 4 . REPAIRS � AL7ERJ1'fION3—R.f�r !o Cod• . 50 State Surcharge � • Descriytion . . . . . . . . . . .. . . . , . . . ... . . . ... . . . . ... . ... . .� TOTti. FEE � • , • n SUBJECT P City of Fridley 15 8 0 8 AT THE TOP OF THE TWINS g U I L D 1 N G P E R M i T r ; ',, RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � i L'«'�_', . r � � PROTECTIVE INSPECTION SEC. � � i `-._-�; /'�'1,'� CITY HALL FFIDLEV 55432 NUMBER REV. DATE PAGE OF APPFOVED BY Z 612-571-3450 910-F15 7/1/80 � � JOB ADDRESS 351 Ely Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. [j. � j�'t't].U11d O�S SHEET 2 PROPE(iTY OWNER MAIL ADDRESS 21P PHONE Brian R. Williams 35I Ely Street N.E. 784-2860 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEEfi MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERAiION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct an 18' x 20' Detached Gara e 9 CHANGE QF USE FROM TO STIPULATIONS �$rage must be kept 5' from east property 1ine. Provide a hardsurface driveway. wAR�� SEPER�TE pERMITS RE(�UIRED FOR iNt�it��t -. Before diEpi�� call tac�l utilities ��•�lTl�'�If, Pi.UiW61NC A1V0 S�t�flt$�, �, TEtEPt�p�yE . ELECTRIC - GAS Etc. R�QUIRED gy L,41,,r/ TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC� FY'dIC!@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTlON ZONtNG 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 360 3600 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAqKING � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 7HIS 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 WI�� BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3��.%�..60 $�..59 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S7RUCTION OR THE PERFORMANCE OF CONSTRUCTION. $14.40 NONE PLAN CHECKFEE 70TALFEE NONE 15.99 SIGNATUREOFCONTRACTORORAUTHOR12EDAGENT � IDATEI • WHEN PROPERLY LIOATED THIS IS YOUR PER AIT I ��r.� ! d � SiGNA7Ui7E OF OWNER �IF OWNER BUiLDEA� �DA7E1 BLDG WSP � TE CITY OF FRIDLCY � • A('PI�TC11'{�IOiJ FOR RESTDENT1l11. [�t,�l_[)IhlG f'CRMITS (tdew, Altcrations, Addil;ions, or I;et�airs) Ol�lllEit: �2� r�� (�: C_.C_f {-��YL-s� 11bDRESS: �/ � �� — �'CL �10: '�c�3��- �.`�(�� 0 0 , , �-, •, i3Ui LDER : �,14-,'�1,�� _- -.. _� f�UD(tCSS: • � 7EL idU: • � Construction Location . . s�rru�� t�o :,_.. ��.( s�r�z��T: � S. � 2� 3�' ._ . ____— _ _ _ l LOT: . . � BLOC'i'.: / ADDITION : �C> % / �t,! i(/� �/-�� Corner Lat: Tnsi.de T�ot: SeLbacY: Sidey4rds: Applzcant attach to this farm two Certi�icates of Suxvey of loL- and ' proposed building ].ocation dra�vn on certificates to scale. DESCRIPI"IOf1 OF CONSTRUCTION � . , . ��s�:�.�� F�_ont: � AePth: v�U Height: � /(� � Sqiza�e. I'eet_ �s (� Cubic Feet: `�� Z'rc:.:'� : Depth : H eight: . ,.-�--------- � Square• I'eet.: Cubic Feet: '.i`ype of Caiistruction : f ,( ��, ��% �FdYt � �stimated Cost: $ t . 7b Be d�mpteted: - • Alt. A Alt. B Proposed Driveway S�Tidth T� New Opening Is Desired: $� $.� ' - . S�E REVERSE SIDE OF SSEET . �9ie undex:signed hereby makes applzcation for a permit for the work herein specified, agreeing to do al� work in strict accordance with the Ci.i�y of T'ridley Ordisiances and rulings of tlze Deparime�it of nuildings, an� her.eby dec�.ares that all the facts and represent�tions stated in this application axe true and correc�. , . ° . DI1TE : r% - % -�(� S I GNATU F.E : .�% ,t i �1 _ � .l � ,t S� � Q � /rY1.D Stipulati�ons : � J�-�.��v . �.�� . � !�-�� . � , . sue.iecr PERMIT c�ty of Fridley 3 i 6 2 AT THE TOP OF TNE TWINS g � � L D I N G P E R M I T r � � COMMUNITY DEVEIOPMENT DIV. AECEIPT NO. . ' j V'�"'� , . . r � � PROTECTIVE INSPECTION SEC. � '� i . `___- w,��;'j CITY MAL� FRIOIE� SS132 NUMBEF NEV OATE � PAGE Of APPROVED B� i �� 612-571-3450 9t0-Ft5 1/19/Ol � � �oe nooaESS 351 Ely Street NE t LEGAI LOT NO. BLOCK TRAC7 OR ADDITION SEE ATTACMEO oescR. 4 1 Rottlund Oaks s►+EET 2 PROPERTY OWNER MAIL ADDFESS 2�P PMONE Becky Olson 351 Ely Street NE 786-6809 3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO Ask For Coveralls 2499 Rice St ��150, Roseville, MN 55113 651-486-8086 20075564 a AFiCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS 21P PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WOAK O NEW ❑ ADDITION O ALTERATION (� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (19 Sq) Tear-off; Replace Patio Door 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. ��r�a�t �nspec#io� E��;�� l�I� �� aiie� .� � �A��1,��° '�"� �,��' TYPEOFCONST. OCCUPANCVGROUP OCCUPANCvLOAD SEPARA7E PERMITS ARE RE�UIREO FOii ELECTRICAL, PLUMBING, HEATING, VENTILATING OR Alp CONDITIONING. TNIS PERMIT BECOMES NULL ANO VOIO IF WORK Oq CONSTRUCTION 20NING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUC710N OA WOAK IS SUSPENDED OR ABANDONED fpq A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OFF57itEE7 PARKING I MEREBV CERT�FV THAT I HAVE READ AND E%AMINED THIS APPLICATION 1 STA�LS GAqAGES AND KNOW THE SAME TO BE TpUE AND CORI;ECT. ALl PROVISIONS Of �AWS yq�UqTION SURTAX ANO ORDINANCES GOVERNING TMIS TYPE OP WORK Wlll BE COMP�IED WITH WHETHER SPECIFIEO MEREIN Ofi NOT THE GRANTING Of A PERMIT �3,443 $1. ]2 OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OFi CANCEL THE pEqM1T fEE SAC CNARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUlA11NG CON- STRUCTION OR THE PERFOAMANCE OF CONSTRUCTION �97.25 Fi e SC �.3.�F�i PLAN CHECK f TOT � FEE Lice S $5. 0 107.41 S�GNRIUQE O� CON'AACTOQ O%� AUTHOQ�ZED AGENT IDATEi E PROP � ALIO T TMiS IS VOUF PERMIT � � S�GN4TU�iE O� OWNEQ�� OWNEp BU�LDER� iDATE� Bl G��+So �� TE DE�.-14 �a0� 15 ��S F�'�JM C I T1r' i iF F? 1 DLE'r' TO 6514��i i?�i F. �+3.��4 tVEW ( l apDN [ J CI7"Y OF FfZIpL�I( Eff�ilve •Jl1/700G A.LTER `�j� SINQLE FAMRY AND DUPLEXES R-1 A�i� i�,2 (763) 672-3694 8lci� Insp J BUILDlNG PEI'�Mt7 APPLlCATION Constructian Address: �5 �.egal Description: Owner Nam� & Address; _ Contraatt,r . i��,� �� v- � � �'f � J�/. �. `� � —.. T'el. #� '�(O ' ��/ :� MN L;CENSE #�O SS�o r E1iL.�l �� J� s'E'vL�Q TeL # J�' SS//� Attach to this applicafinn, a CPrtific�te of Sur�ey c,f the lot, with the �Srapc+a�d cons+.r�clion drawn on it to scafa. bESCRtpT10N OF IN�ROVEMENT UYlNG AREA: �ength �N�� —�—,.�—._. _ Height Sq. Ft. GARAG� ARE:4: Length �� `Jlirdttt _ Heigtit � ;",�1- ��, ` — DECK AREA: Ltngth Wl�th ,_„ _ Hgt/Ground Sq. Ft OTHER: L��Qd � G•n, nI1 � „L _ �� r- —,� • ✓i / lJ l9 5�s ,� g.��, � -,,�-� �'� � C�onstruc+:ion Type:-- Estlmat� Cast $ � �5�� . � Driveway Curb �ut Witlth NP�r��c�: Fi. �r 6 rt =_ Ft x� ��'' � =g oa�r�: �� OrJ __ a�PticaNr: �.L�� r �z�e v-a //� r�. � �i.5/ �Pro'-��.G � TY U3E pNLY - Catl (763 72-36�d for p�rmit Fe�s i� mailing in appiication ,� �� oZ 5 Permit Fe� $ Fe2 Schedule on Reverse Sid� Fir� Surcha�rge � „ .U01 of P�rmi; Valu�t;c�r�, (1l1pth°1o) �+�, � State Surcharge $` , $.5p/$�,�pp Valuafiion SAr L�a�e $ $1100 par SAC Unit License Su�charge $ , CJ� $5.Q0 {State UoensPd Residentia! Contractors) Grivevvay �scraw � r�ft. "A" or 41t. ,.B'. Above Erosion Cpntral $. _$450.pQ Gonservatiot� Plan Review Park Fee $ _^ Fee petermined by Engineering Sewcr Main Charge $ _ _ Agreement f�lecess�ry {] Not Ne�cessary [ J TOTFL � � STIPULATION$; /dr% / f � e I ADDRESS IP� I LEGAL DESC PERMIT TYPE PROPERTY TYPE C�NSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-36U4 N'AX: : 351 ELY ST NE : 033024310006 : ROTTLUND OAKS : LOT 4 BLOCK 1 : HEATING : RESIDENTIAL : ADDITION/ALTERATION 571-12t�7 . PERMI O.: 2004-00840 �� __ _. DATE ISSUED: 06/04/2004 � VALUATION : $ 8,015.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. REPLACE A FURNACE (WARM AIR, BRYANT, 80,000 BTUS) # A/C UNITS 1 # FURNACES # GAS DRYERS 0 # GAS RANGES APPLICANT STANDARD HEATING & AIR COND CO 410 WEST LAKE ST MINNEAPOLIS, MN 55408-2998 (612)824-2656 OWNER OLSON REBECCA S 351 ELY ST 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 know the same to be true and correct. All provisions of laws and ordinances governing this type of war� will be complied with whether specified herein or not. The ganting 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/ An 'nl�an�°� � Date , / Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 10526 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 0 0.00 35.00 0.00 0.00 25.00 0.50 60.50 CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 FAX (763) 571-1287 RATE SCHEDULE DIViS10 N APPLICATION FOR POVI/ER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Aiso 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 BACK) 1�'Jo of Value of Appliance or Work Commercial/Industrial 1.25°�0 of Value of Appliance or Work Rate �OTAL�S: �C� ��,� ,dc� �� a $ 10.00 � $ 10.00 $_� $ 10.00 $ $ 25.00 $ ��. � $ �. State Surcharge TOTALFEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION � REfRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Condiiioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 -.�L��.� �/ - . •: OWN BUIL �3o�y Effective January 1, 2003 o��-dC�U`�� ESTIMATED COST �� PERMIT NO DESCRIPTI�N OF FURNACE AND OR BURNER No. of Heating Units�_ Circle One (Steam) (Hot Water) ( a i Trade Name Size No.3SS BTU B HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No ED 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 arr rulings of the Building Division, and hereby declares that all the facts and representations stated in this appli�ation are true and correc . DATE � ! '�� HEATI co �iAI��ARp HEATING 8� A{R CONDITIONING CO3 -- , �10 WEST LAKE STRE � , IVIINN�AP(�LIS, �08-2998 # 612-824� 656 Approved By � Rough-In Date ��,.-�_) Final Date 10 y THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIANCES OR THE � APPLICATION WILL BE RETURNED •��i•► I ► I ► •►► •: !►� •u: �► ! C d •► When n�a _inp an AY �ttna f�ran __, the undersigned hereby verifies that ihe venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. - Yes ( ► No ( ) N /,/� The venting system is plastiGPVC and meets all current codes and manufacturer "� speciflcations 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 Fumace Venting Tables for fan assisted and natural draft appliances. The Yie in� _nmh ��t�nn air is sized and installed to meet the current codes and manufacturers specifications. Whef1 fiBqull'ed t0 inc all a n_�•� cnmh �ction a'r� it will be sized and installed #o meet the current codes and manufacturer's specifications. When jpstallin� a new ventin�3yc em, the undersigned hereby venfies that it 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. 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 No ( ) Yes ( ) No ( ) Yes ( No ( ) Yes()No()1v� Yes ( ) No ( ) jl% � :.. .. - .- .�. .��.� -� ... -� .��- . � .��. .� Appliance #1 Type `� �- BTU Input �° o o�Fan Assisted or Nat ��--- Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Tota! Appliances ___� Total Btu Input,�^ 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 __ � 1�9-5 �� c � �. G�7}2 ft�1Z� HEATING CO: � ��'-d � '� �� Signed By: Date : 3 � 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 : 351 ELY ST NE : 033024310006 : ROTTLUND OAKS : LOT 4 BLOCK 1 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION PERMTT NO.: 2004-00885 �1' v DATE ISSUED: 06/10/2004 � VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. RECONNECT FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT SPARK ELECTRIC 2114 WASHINGTON ST NE MINNEAPOLIS, MN 55418- OWNER OLSON REBECCA S 351 ELY ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becoines 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. Ail 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 coustruction or the performance of construction. Applicant Date Bldg Insp ELEC PERMIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 39888 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 20.00 0.50 20.50 Building PLUMBING Permit No.:�,��lT Inspections - RESIDENTIAL APPLICATION Received By: �� 763-572-3604 CITY OF FRIDLEY �� 9 2007 DATE /O T S YOUR E-MAIL ADDRESS SITE ADD SS Se.u.lL �S D..a�wt�✓ THIS APPLICANT IS: ❑ OWPIER �ONTRACTOR Becky Olson PROPERTY �,�: 351 ELY STREET NORTHEAT ��'�� fwD�ss: Fridley, MN 55432 �� z� TENANT Pxo�: 7637866809 CONTRACTOR N�: SU$MIT A COPY OF STATE LICENSE # C> EXP DATE YOUR STATE ADDRESS• f�� I CITY ' �� /S _STATE��LIP rS�YO� LICENSE WITH p}�p� 7— y033 FAX — APPLICATION -� � PERMIT TYPE �SINGLE FAMILY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: � �W ��PLACEMENT DETAILED DESCRIPTION OF WORK . PER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the total cost up to $500.00; whichever is greater, for the impro�ement, installation or replacement of a residential fixture, excluding the fixtures. (This.should.rEflect only.the cost of tabor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.O5 = 'F4R::PROJEGTS WHERE L?:BOR EXCEEDS�5300;-FEES ARE BASED ON $10.00 PER FIXTURE, EXCEP'i':VJHERE210`I�D:.:F[XT�IR£S�,.(II�FDICA�TE TOTAI, NUMBER OF EACH BEIAVJ} BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING p✓�cmucsxsE) SWIMMING POOL WATER SOFTNER ($35) CLOTHES WASHER KITCHEN StNK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER = LAUNDRY TRAY �WATER H°ATER (S35) FOR IRRIGATION WA; ER METER OTHER Permit Fee $ _ Number of fixtures @ S l 0.00 x$10.00 =$ � Surchar e .50 Number of fixtures (a3 $15.00 x S i 5:00 =$ TOTAL DUE $ Number of fixtures @$35.00 � x$35.00 =� 3S.po _ _ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTtL PROCE53ED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformacrce 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 app ' tion 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 o 1 ork which re ires review and approval of plans. SIGNATURE OF APPLICAN � i�//�— PRINT NAME Jt /VO/b/DN�I DATE Z S�O City of Fridiey Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 rAX: 763-502-49?7 �