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Oi � 70 � � �' ', o. �r a r� N . �� a � � � � \° P `\ y A �� g , �� , � � � -�_ _ ♦� � ,� � 1 � � I. ' � ^D � ^A�/ � \ \ V ' \ 1 � 4 � 1 � 4 � � � � � \ �. � � \ \ !�\\ �i < < � �: N O Z `^ Z � � Z O r � V Ea ��a� Z d �W � � N Z � � V I+I• � W O� Z � � � W 0. 0 � f , Fl.� /i`,�i oom � Wiadows and Doo�a—! Width Helght 1 No. of pane ot pane '(/ .7 � J � • In6ltration C,laaa Esp. wall �fo j( � Net esp. wall ' Iat. wall Ceiling Floor 'fotal Btu. -- R'e�recrs�:-ft-E:D:R:�r Fl. Room Windows an oors—I w�acn xe�sne No. ot pane o[ pene � Infiltration Calaas F.xp. wall 3 �' f! Net eap. waU Int. wall Ceiling �loor Total Btu n y y YI f�w -/ ��N�' ��f/V /[ %� YL/ �� — � � 77.�5-�� 7�' OF BUILDINGS NIINNEAP�I.IS. NII1�1N• �. � � Insulation ' s Roof F1oor Kind How Applied / Fl.� , Room Length � Width % Height Windows and Doora—Crackage and Area , Wldth Sefght No. ot Llneal it Area ° I No. ot pane ot Pane Ilghte ot crack eq. tQ I / v ?vo `L �C3- � ` I Infiltration .S Glaaa ----- --- -- Eap. wall f C B' Z Net eap. wall ,� Int. wall l.�l�% Of F1'1 - Ceiling " . ------- --- - Floor O B��G, Total Btu. Required sq. ft. E.D.R. or sq. ins. W.�►sj.eader a i Width Height � � �m ( ],,ength � � Width e aad Area Windows and Doors—Crackage and Area L1nea1 ft. Area Wldth Height No. oL L1nea1 [t. Ares ot crack eq. tt. No. o[ pane of pane ItBhte ot crack eq. tt. / /D � Z'� ?� � � Z �� 'oef. Btu o (,� O .�O �'� I � /D 63� 5 -_ �__ /S i 3 a�a _� 3 90 � Coef. Btu Cflef. Btu i ,� �, ,� � Infiltration �G f /��6 'i 'L u�� `�D O Glasa �'� • D o �08 �p. W8u / 9 fl /.s2 D/ D % go � Net eap. wall /O 3 � Int. waU �' /�3 '1� � 9� Ceiling Floor C �'J� .J rQ '' / 'L Total Btu. 6 � � �— _--- �_—_ - =Reqnue�sq�.-E�D:R:or'sq:ins.'V�►:tea�lzr`�rea°- --_- - i Width �.`�� Height �, Room I Length Width� Height e and Area Windows and Doora—Crackage and Area -, Lineal tt. Area �'� — Wldth HelBdt No. ot Llneal 1Q Ares ol crack eq. ft. 1-��■ /� No. ot csne ot.vane UBhte of crack eQ. [t sq. ft. E.D.R. or aq. ias. W.A. Leader area Btu I I �99v Infilcration ' � �� D Glass Esp. wall S � Net eap. wall Iat. wall ? ` � Q Ceiling Total Btu. w� B� ;o -D , /O V—F� � Required sq. ft. E.D.R. or sq. ins. WA. Leader area t[on of the payment of a fee of $ • � , permit is hereby granted to L. E. Shaw to construct the bufldiag or addition as d�cribed above. Thiap�m� t ia granted upon the express condition that the person to whom ft i�s granted and hia agenta, employees an� worl�uuen, fa all work done in, around and upon said building, or anypa,r� tt►ereo$ shall conform in all reapecta to the ordinaaces oE Fr1d1eY� Minnesota g loc�tion, conatructfon, alteral�on, ma3atenance, repair and movin� of buildiaga wlo�� dty ]imits�an�this permit may be r+evoked at a�y time upon violation of any of the P�v9e�tona oP said �OTIC� T6b p�emU does eot eover t6s eeesleu�i�, te�aqdtee for �rMa�, plumbing, eu huNno, a�w�� er waMr. B� sun to a ho Bnildine le�to� for aparat� p�rmils fo� fh�a iiaem. , ^ > ..,_� �w�Qao,� aAa n Wldth He'. Na. ot pane ot � � � / Z � Infiltration Glaas Eap. wall �f@ ji � Net exp. wa11 Iat. waU Ceiling Floor Total Btu. --Rec�irted`s�ft'� Fl. � Windows and Wldth 1 No. ot Dane � Length � 7 Width' rackage and Area lo. o! Llneal tt• E►T� ghte ot crack e4 t� � / /D :R�-ar Room Infiltration Glaas Exp. wa�l .� x Net eap. wall int. wa�� Ceilin¢ N�nor Teta� Btu �F�,�. e-w�-wr � � 3 � �� j��-, �C �� . %?� 5 (sfi`O"�. d �� OF BUILDINGS .�y�- � Insulation �. /� ° lied Roof F7oor Kind How App ' �m ].,eD� p Width 9 Height / �•� . racka e and Area � Windows and Doors—C S . Wldth HalBht No. oY Llneal iG Area 4„ No. 01 Pepe ot PBne llBbte ot crack eq. ft i / y ?vo `� � % I� Coef. B� In6ltration � � � � �p �'D Glass �. Wau X �' 2 Q � ,� 63 Net esp. wall � : Int. wall _----- ---_- -- - - _ - F-== Ceiling � �S �.� �Q Floor � � 9� Total Btu. der area Required aq. k. E.D.R. or sq. ina. W.�►. Fl. � Room (1-eDs� Width Height Windows and Doora—Crackage and Area w�aen se�sne Ngbia oi cracx arii• No. ot Pane ot pane � / s�, _ 7� ?o� � Coef. Btu � fo ��-�'6 � � �i Infiltration � o 0 2 �� c�0 O Glass �� +�r F�p. wau / % �l i.5 � �o ,3 � / � / �O � Net exp. wall I In�. v,►au ��3 � 2- f� Ceiling �� J-� I Floor � � � y Total Btu. _ , - F � - -- — -- - -=�eqaue�sq: �t: �D:R�or sq. :ins.l�i�: �a�e�r�$-- - Room I Length Width� Height Width �.`�� Height F1. '' I and Area Windows and Doors—Crackage aa ea neal tt. Area Wtdth He16ht No. of Llneal LL Ares � crack e9. tt. ��t �� No. ot psne ot.pane It6bte ot crack ea• tG � o � � Btu I � �'� Infiltration ' � � � O Glasa �, v,►eu � �, � Net eap. wau Int. wall � � Q Ceiling Total Btu. ;oef. Btu � g� �0 io �i� O "�` V �� ►'�%' Lr'.J !� •sq ft E D R or sq ias W.A Leader area y Required sq. k. E.D.R. or sq. ins. WA. Leader ana s � � City of Fridley, inn BUILDING PERMIT Date: � Aug . 2, � 1968 Owner: L . E . Shaw Builder Same Address .�._.��71 Ironton St . N. E. Address Same � 3 7�s/� 1�T� 98 s 0 No. 5 71 Street Lot .�.. 2 26_ B1ock F Corner Lot _ inside r.ot Sewer IIevation LOCATION OF BUILDING Ironton St . N. E. � p� of Lot __._. Addition or Sub-Divisian .Y.._ Riverview Heights Setback .._.—._ Sideyard _.� Foundation IIevation DESCRIPTION OF BUILDING To be Used as: Res id�,n$ Front �.. Depth Height ._._ Sq. Ft, (;u, Ft, Front Depth � I�eight Sq. Ft, Cu, F't, Type of Construction Residing �� ^$1200.00 __ To be Completed In consideration of the i�uance to me of a permft to construct the uildin es above, I agi�ee to do the proposed work in accordance with the descriptton above set�forth with all provlsfona oP orrlinances of the dty oP Fridley. 4 � � In consfderat[on of the payment of a fee oP $ 9. 00 , permit is hereby granted to L. E. Shaw to construct the building or addition as described abave. This rmit is granted upon the expresa condition that the person to whom it is granted and his agents, employees an�workmen, ia all work done in, around and upon said building, or any �art thereof, shall conform in all respects to the ordinance� of FridleY, Minnesota regardin� location, conatructiion, alteration, maiatenance, repair and moving of buildfngs w�thi�► the dtY 7imits and th�s perm3t may be revoked at any time upon violation of any oP the provisions oE Ba�d ordinancea ^ NOTICE: 'I6�s permit de� nof eovsr t6s eemlroelioe, Installafioe for vrir6�g, pWmbtne, ga heatieg, mw�e or rrat�r. B� sun to tN tho Buildlee Inspsete� foe ssparat� p�rmils fo� t6as itfms. � .,,, z APPLIC�T:[0�1 FOR BU7.I.D�1G PERMIT CITY 4F FRIDi.�Y, M.�I3NESOTA s . , •; dWNES' S NAME ` � BIIIZDEB„` .!:_ .. . � ADDIt,�S$��,�:�� :. ..�e �s.� � , _ •l�DDRESS : ._.� ._._ . .,, � . ,� � . • - • � LOC�h'�0�1 OF BUILDI�I6. _ . N0._��,�_STREET ��L��L�/`� � - - -- LOT� ��,�;�+' BLOCi�_,� • � � ADDTTION �lOR SUBDIt�IS?�QN,;�rF•d ��Bl�`�'�` /i/S . . . . : .. ,. . � CORTiER LOT IP�SIDE LOT�_SETBACK � SIDEYARD --___-._._.. SET+I�R ET�EVATION TaP OF FOOTiNG ' >t.•,' - :ri . A�plicaat attach �to Chis•�oim Two Ce�tificat�s.of Sn;xey•of Lqt �ad progoaed building location drawii� oa thess Cei�tificates. ` ;;i;= -. , •, . , . � .. ., • ' . �;�;; _, . � � DESCRIPTION OF :BJTLDING �-• . , . � • ; rt - To Se Used Ass ' " - .. . .. � �ron� � . : �'' ° `�jept6 ' . .,Height - . .. . �. -�;•. r.! ai 'S'R.'� -----�— . . � ' •i: Squsre feet ' ��'�' � Cubic Feet . • �+<, :_ � . . � • Front' � ' . Depth . . � He�ight Square feet ^___ Cubic�Feet . Type of Conattuction oT��-rz.� Estimated Cost �/��-�J< �� To Be Campleted The undersigaed hereby makea applicatioa for a permiC for tbe work herein specified, agree3ng to do all work in atrict accordaace wiCb the City oE Fridley Ordiaances aad rulings of the Depart�enC of Buildit�$s, end herebq declares that a11 the facts and representations stated in this applic9tion are true and correct. DATE _ �- � ,� _SIGNATiJRE - --- - �•----- � (Schedule of Fee Costs caa be found oa the xeverse Side�. �� .�� , v - � �� .�e .. .. ,.. a . . ... ' � ,:.) ` ' . ,'1Lt . .. . . . .. , ... ,y', . . • ' . . ( . . . Q. . �;� .. . . . .. ... ... . , .� . .. . . : BUII.D7.�TG� P�RMIa: FEE SC�iEDVifi '- � . :•, . . . . SECTION 2. The �I�tspectbr' of .Buildin�s shall,. before isauing �permi.ts for �the erection of �ny buildf�►g or 'struc�u��e� or for any addition tu. ang '�• euisting structure or building, or far any �Z.teratian�or�r�pai�s.to,.any =. existing building or erruct�ire� up#�'i'. app�;icat�,oa; thar•efbx�, ' require the , the .payment �.bq th� ap�ilicant for �:suclt �ierm�tt of �ae� to the amount herein � belaw set forth and in the manner heria.prov.ided•.�o-wit: , ., . r .,; . . . , . , . .. Uni� ildin�__Code= Tgpe 1, 2, � 4- ��1.75 for each one thousand cubic. feet, er fractioa thereof, ia such Cubical contq�p�.�... Typa 3 6 5='$I.50rfor each oae theusand cubit� feet .: �.. �•• � � � • � ' � � _ i< , . •'" • �.I � . F�r the �ur�ose ef cn�puting fees�.for building"permite, the cubical contents ef:any buiLding or"addition t� a uttiform h�ight throughouC bq •multiplying the ground area cwered . frem �e� point six (6) inches . below t�ie..�floo: line •f tbe bae��nt' ar. tlie cellar te the average heigh,t 'of�•tt�e' upgar earface or to �he average height of.,the•roof�surfi�ca of tihe main gable.o� a,., �� pitched roof . ..• � - •• � . � , ...;,r . � For repaira or alta�ratiane to an exis�ing st�uctur,e, the fee�shal� be aC:.xhe �ate �of $3.00 per each five 6un�red dollars� '($5,00; QO)� or fraction the�rem# �� in the,. c.ost �f�: all Proposec� i��rk. . . '_' ' , � � . . � � ::. � ' " . . .. ` - . :j '. �. . In no caee shall .the� ��e charged for• any permit as set for��i in � Sectioa 2 be les s thaa $S . 00. -' ' " ' NSS5D C�nnectioa Charges based on locatioa- 1�cea 1 or 2. . - ..� . � r� , �� ='� f t : �� s�+p- d!� .�. � . � � � , V •� � •� o P4 � � . �. . o . � 'Y .• • � • � • N � � • M � w • � • & . o � � , : , � .. . • : . � � � • • C-? � ! � � I � � ' :� ' � . C � � � Q} • � K � �.' Q � Q N i3 � , � . C1' . (D . N � � � . ro � . 6i • b•• . � � n � ►- � �? :� � � '>. � x x �i � � " R � �: u n " � n . � W :�. .. �. ' � E G �� M � �' � " M � � � a x M ti c A � x .,, '� ?f A �q o � °i ] � � :`% � .. �� t�o � a� � c x �o O H '� � h .. " x� : � � M `" -v � � • � � ti • � ? N i A ��°�; �o`s��'M � • • Q �o • tf/ � • • • �p � � . �: : • � tD • "a' � : A ► • �y • yp • . . . ,� $ . . . r"" • • • •, • • • • � • • • • • � • � • • . • . • • • • • • • � • � • • • � • . • • � • • • • • � • • . . . : . . . rn . . � : . . . . : . • • • '• : • • • � • •� • • • • • . . • � _ m N � o � o rC-- x x ►t p x x x x x x � Vi � N � N � W W ►�+ �-' N ,.�0 � c��► � � & � S `�' $ $ b' � A f/► N � W VY 61 d� N U M I �i I O � Q � � � � I � O x � � \ . � r � •. . a• e , . . � � .v'.. � � � . � � � n . .� , � µ• 1� Iw �r� �+ IM 1 � ,.r a iL � h i5totics � � WAi�R '° � �,s � �1 u�cw�s � b NTN �vos a n� .�s�►� x II �� _ � s�� . �. � ,,,� � d �� '� t MK M Oa�Hr. � N H � n a rou�n. � � y1WRi. �+ N I100• � 0 ~ OMiNS � M � «s�H .l,� o A F►j 6,lSINs ^� '� b- � p � �:1TO � ti � wwvez■ o ,O � _ M M �G� � I• , � � � Z � � s N Q < � � �� r! �4NG[ q �� p �� GAS C�'[NI►�GS • � v a �'P Z. � ]!y,_•• ��9 " V� N � � { �$ D �y V W /� u M � � � � � � �� f � ' n j �J � l� a � ° � 5' �' c a.. a " � o � � a � 00 ' n ti �• p �• A � Z G. 0� � � w ',�d g � o � y " � m � . ?7 • � O � 1 � � � � � i n � �o � �� C � w N. � � � p 1 � °' o' v .� � � �J N .'.V° �, ;� r i ~ � a' � � °� w � O ;� p. � C�Jn �' '� H � �° y �' � �. �� : U .� c• n; � � �, o, � � �� ►x7 s� �^ » o �, •� � y a x W � � , � �-� n � � C` C' v� V m p .J. � c:�� r 0 �+ a p � � � ��Q • I .» ro M , � � ro y Y � �� . � �� aN�;� � � � '.�T O A h u n � . � v '� r�K .. � �;• � �o ,� L � . I � � ... w a~ � pD 6� '�'� � � � �i �' :o � � � v � � � .� � �n 1 0 �9 ~ M � �' � qa ��`r y v a '.i � o c''� � : �� i r n • e: a � � � � °a �+ � v, � ' .. � ►3 . m � c} � � �. 1. IOCATi�I OF Y{ll� County Name �n o ka � �,— +..— �„� _ _ � ...�..s,m...�V _ ��--�. � --- __ _ — _ Sl. ��- �it9��td,i�A �RARTMENT OF HEALTH � �'''ABANDOI�D M�1L RECORD .. _. __ ._ +� I ��-0p MiNNFSOTA UNIQUE MEtL [q0. , �� (leave Olenk 1f not known) immsMp Nao� TownsMip N�ber Range Number �Sec - r�et1 E Fridley , or �� 4 5 W Numerical Street A¢ ress and City of we lotetton or Otstance from Road Intersetttan Op1 jt• N. i�. ridley, 1�7n. 55432 Shor exact loeatlon of well j��- �• �`" � 7 �. ��-� = (fn seetton grid rtth `X") � ,�ketch map ot well IouN on M r-- 1 .i. ti - 2. PROPERIY OYNER'S NAME Carolyn Nix E ti R. ' l� 4. IIELL OEPTH (completed) Oate sealed �f y 8/29/89 � 2s ft. .� � �._..._� 1 �, ` `:. � ��i t� � � , �, � �; 1 i� i �� I � � .., , � -- � �-- ,��_r�� - '� i -- — Nailing Address if dtfferent t�an property address Tndlcated above Same 3. FOIIMA?IOM lOG COLOR FORNATION FRON If not known. indleate formation log from new we11 0� nearby well. REM0.RKS. ELEVATION, SOURCE OF OATA - CASIHGS REFt0YE0, 5. DRILLING l�TN00 (tf known) 1� Cabie tooi 4� Reverse 7[J Oriven 10�] Oug T� Ho11oa Rod 5[] Air 8[] Bored ll[] ]� Rotary � Jetted 9� Porer Auger 6. OBSTRUCIIONS Mell obstructad � Tes � No Obstructlons re¢uved � Yes �] No if obstruttions cannot be removed, contact MDH Eefore senling. 7. USE 10 Domestic � Monitoring B� Neat loop 2[j Irrigatton 5� Publit � Indust�y 3Q Test Me11 60 Nuntelpal 1� C000mrctal 7[�A1r CondlNonlnq 110_ 8. CASING(S) ' 1� Black 6� Threeded 7(] � 2[j Gair. 50 Yeltled 3� Plattic 6[� Stalnless Steel TO ___�,�_ +n. co 128 re. tn. to rt. Removed pump and 54ft. 14in. drop pipe, with Jet package. 19e11 located in well pit back yard. .4t one time well served as Community water su�ply. FFICIAL ABANOOItED YEII aECORD (MaY 9e used to� iro0arty tranafer) I�BTt lYlB �II'TB DBSD 9. SCREEN � Scroened wall from _ ft. to _ ft. (If knoxn) (] Open Note from _ ft, to _ ft. 10. STAT C MATEfl LEYEL 1 rt. p eatm+ p esova iand surtace Date Measured 11. YELINEAD CWIPlETION IQ Pitless Adapte� � FounA BuNed 20 Basement oftset 5� 7Y Yeil P1t � 12. GROUTING INFORlIATI�N 1� Neat Ce�nt 2� Bentonite � �rout auurtal N@c1t t,�m12�, 07rc. cu. yds_ Cement 13. NEARE51 SOURCES OF COWTAMINATIOFI _ feet dt�ettlon type Well dlsinfected befo�e sealing? � Yes 14. PUMP � Removed � Not Vresent iype: 1[1 Submeralble 30 L.S. ?urbine � Retiprotatinq 2�Jet 40 CenLrlfugal 60 15. EXISTING WELLS (Please sketeh loeations of sbandoned and aetive re11s tn romarka aectlon or an back.) Other unused r�lt(s) on prope�tyT � Yes �190 Abandoned: ❑ Permanent � Temporary � qot sealed 17. YATER HELL CGNTRACTOIIS CERTIFiCATION This r+eit was seeted unde� my Juriadietion and this �eport is true to the best oP my knowledga and Dalisf. Addresa Siqned Do Neme Nama Lteense No. SUBJECT PE City of Fridley � AT THE TOP OF TME TWINS g U I L D I N G P E R M I T �� r � � RECEIPT NO. � ; y __��_ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �� _ � � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVEO Bv �----� • •�� 612-571-3450 9t0-Ft5 8/27/96 / / 108 ADDRESS 571 Ironton Street NE t LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACHED DESCR. 25,26 F Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carolyn Nix 571 Ironton Street NE 784-3037 3 CON7RACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. First Choice Exteriors 2405 Anna olis Ln N Pl outh MN 55441 553-1918 4266 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION D REPAIR O MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof House (11 S ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZpNING 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 1 HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �907 �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFiMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR E PE FO �OF CONSTRUCTION. $3�F.%.5 Fire .5�.' �.91 PLAN CHECKFEE T07ALFEE License SC $5.00 $41.16 SIGNATUAE OF CON'RACTOA OR AUTNOAiZEO AGENT IDATEI WHEN PNOPEFL ALIOATED THIS IS YOUR PERMIT — ., t - ��/ -� a �-�2 ��.� S�GNATUREOFOWNERi60WNERBUILDERi �DATEi BtD INSP pF7E NEw ADDN ALTER i] [l � ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 Building Permit Application � � l � r°�o � �o ,�, .� 7� Owner Name & Address: �, ,, o Contractor: �v� t`� � �;� ,� � Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: r .� ,U' ;,� � %� i �, � � � �, �� Effective 3 / 1 /96 �� S %'� Tel. # % b' �� °` � � 3 `' _MN LICENSE # �d Co � � Tel. # 5��3 �1 � /� Attach to this application, a Certificate of Survey of tlie lot, with the proposed construction drawn on it to scale. D�SCRIPTION OF IlVIPROVEMENT Length Length "�-�'�� Width Height Width Height Width Hgt/Ground c�S� //S,� %��—�� Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Tyge of Const�uction: "7"�.n�v ��" �j. �P r�,`� Estimated Cost: $ �D%.S� Approx. Completion Date: %— l� — g� (Cost on Back) � Driveway Curb Cut Width Needed: Ft. + 6 t= t x$ _$ DATE: �' o% 7— � c.,, APPLICANT: ,� � Tel. # S�' 3 � 1 �` � � �� w �� CITY USE ONLY Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge Lic�nse Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Gharge TOTAL $ � � %� $ � �/ $ • �� $ � �-v� $ $ $ $ $ � �� Fee Schedule on Reverse Side .001 of Permit Valuaxion (1/lOth%) $.50/$1,(�0 Valuation " $9� per SAC Unit $5.� (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450. (� Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPLTLATIONS: � r=y BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing gernuts for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteraiion or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $SOO,�D00 $500,001 to $1,OOU,O� $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $1� or fraction thereof, to and including $2,OOD $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,Q00 plus $9.00 for each additional $1,000 or fiaction thereof, to and including $50,�0 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,D00 or fraction thereof, to and including $500,� $2887.25 for the first $5�,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,(�0,�0 plus $2.75 for each additional $1,� or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Cbrb Streets Only) Alternaxe "A" : Removal and replacement of curli and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificaxe of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. E- � � A n � � � � a � � � r m � � S v m O � m � c n m � Z cn � D D Z v � r m � � $ a Z � z 0 Z D n X � v m O D r m m � c � � �� o �� ,�� v� � � V s�� D �� v � • � � z � � N � - � Q � � � o � � � z� �a �! Q o� � - u � �+ a � 3 s � -��a�� .� _ -,�� .�$� ��;� �� ,4, `� �$�.' � 3. � - � � � � `$ � � � _��:� „ � � � � � � � v b � lt��l� �II111 � � w � M N M� M M fA M iA M N(A O O O V p V�I V�1 �Jf A�! g g � � � � � � �u � � g � � c � � � � � � � � 0 a �� e � � �; �� ;� � �� W '2 � ��--�V � �.y _ � � �� CP b � �o > > � � n a A • c � � eao � � � � � . � � � ��°o� �so �' �� m � a � g��a �� • � � � � � a � � � � w � � �'��o �� r � � Z � � � m � rn � z 0 � � O D r � � � � O z ('� a � � � � 11 � n n K � � n � ) Q n � : t � � i � � * � D '�+ � � O v � � � 3 0' N� _ y, c� O N � n � � o � 3 � O a a- `o_' m �•'� �• � Qq n cD � a o � �� N � � o � � � � � a � r« � 0 _ � D a � 0 < � � W � 0 C o� � � � a� m � � � 0 v � � m Z � � rn � O Z 'n m rn � �A v O 0 \ 2 � � � � � N V � N c� 0 � N oo� � m a 0 0 � 2 D � z � C� O � eD � � � � f � � � � � � � � m 1 l � 0 -� D r 'n m rn � � � N c � � d oa c� � o � � � tD °, � �i a<i � CD p. C �. .y'► D _, � °—' a�' � n m 0 � 0 � � D � Q o '� �� < fD � a� N � � � �� . 4� -0 N• -v jZo c�' D � � � � O •_► � o � O N �� -� 0 z W D f) � D C7 0 a � �� OC D N N m N � � N � � � � f,� D �t t�D N N O � C � "0 ,-� � G1 cD � -o, cn c� � ?; � m � m n� cn °' � p- � < � c� '� � '�-r � C1 � Q � � � o, � r,. � � n-T�o __ � rt � � �- ? � �« � 3��0 � vS A �" v � v � � � a� � c�o � � t� tfr - � � N r r-� �--� (� cn o 0 0 0 °o o° o° °o °o � m t� tfl �a +� � �,a t� t� � p o a � r 0 � � y � ��? � � n � c�'D � cp� � a �o,a� � '"�' � N Om�oa y � �, fD y _. � L7. rr 0q � � � o � a Q4 c. � �•vo� r+��°_' � S N� p) � _°= o ° � d � � � �'Q.�� s� �. c� � � � � � � A � m a � -* � A ° o c �, � d co � � � � � N (np � � rt � c� cSi � •+: o •+ � �, � � � o m —�.,� �.�m � � n �D � � o N o 'c �, a � m o. � m _ _. W W C � � � � � a m Z �1 c�D 2 � N c� Z 0 v � ��—IZ m C � ° �' O m �, d � � � m � C � � N _� o � n � �. C� � o p � � � � c� � � fD �%% a �� r rv � a�'z� � � � .-. 2 (n O f� � m � 3 D m � � D � m � C� � N � C Q • � m � � --I Z O ( \, w '�Q � W C r v z G� C � m � O Z rn � -D�1 m N c� 2 m v C r m ` O W D 0 0 � (J1 'r'I 61 �C7 N Q_ W '""� f--� � �O =� _ � a �� Z m � �� w D "� N � Z z� m � m C7 � � z � C � a � .o z �v r � � � O fi3 Z m .,� �O � --� � p� � Z � Z� � o � G a D G �z O ON za vz .� v o= Zm Z � � Z �n O m 30 N Z a� v< v "' z < '� �a N � O Z � m n _+ <' � 0 � � v � � � -� � � N O O O COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, 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 Fumace 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 cor�bustion �ir, it wiA be sized and installed To meet the current codes and manufacturers specifications. Yes No ( ) Yes � No ( ) Yes(�No( ) • When installina a new ventina svstem, the undersigned hereby verifies 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. Yes �No () � 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'�(1Vo () Aaaliance Tvae and Size/Common Vent and Vent Connector Infonnation Appliance #1 Type �� "' _��c..� BTU Input Fan Assisted or Nat Appliance #2 Type ,y BTU Input Fan Assisted or Nat Appliance #3 Type BTU In.put Fan Assisted or Nat Total Appliances �� Total Btu Input . a Common Vent Type��;� __ Vent Height f� Diameter,� inches Appliance #1 Vent Connector Height ��ft Length � Diameter Y�� in Type � Appliance #2 Vent Connector, Height L�ft Length l,�' ft Diameter �� in Type �_ Appliance #3 �Vent Connector' Height ft Length ft Diameter in Type ALTERATIONS: (Describel ' • � , �l'. " � �i� ,/i � �� . - . : �/ � ,,, � . - , - -_ _, ,�, _ CI"IYOF FR[DLEY FRIDLEY MUMCIPAL CENTER • 6431 Ul�'IVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 11, 2002 Carolyn Nix 571 Ironton Street NE Fridley, MN 55432 Re: Fnal Inspection at 571 Ironton Street NE Contractors: River City Sheet Metal, Inc. Lee Stull Plumbing Dear Ms. Nix: A mechanical permit and plumbing permit were issued on November 20, 2000, to install a fumace and water heater at your address. According to both the 1991 Uniform Mechanical Code and Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by these permits. As of this date, no final inspections have been called for. The permit fees that were paid cover the inspections to make sure the work was completed according to the Codes. We will keep your permits open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permits'�no inspection called for" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ:Is Building MECHANICAL Inspections �tESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY DATE YOUR E-NWL ADDRESS SITE ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICENSE W1TH APPLICATION PERNIIT TYPE TYPE OF WORK: 0 OWNER OCONTRACTOR i• � , :�.r CCbMPANY NAA�:,s CONTACf PERSON: Pemut No.: Received By: Date Rec'd: 'ATE ZIP STATE LICENSE # i� �1- ��-/�/ `� E3� DATE ADDRESS:�,, �.c�rilfirs P�t&� hLr� C1TY 0[�i( STATE�ZIP��!'J PHONE %�0��-Fda �I 7� ( FAX _7!a 3- � c�i o� � �,7 �cQ I�SINGLE FAMILY ❑ TWO FANIILY O NEW �REPLACEMENT DETAILED DESCRIPTION OF WORK � TOWNHOUSE ❑ ALTERATiON/REMODEL 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 improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost uader $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASID ON $]0.00 PER FIXTURE, EXCEPT W1�RENOTED. FtXTURES: (WDICATE TOTAL NU1viBER OF EACH BELOV� SIZEBTU ��C� Equipment Installed . MFG: ('LLtr f 1 P� MODEL: —�� 5�� —�-- MFG: MODEL: MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 . GAS RHNGFJOVEN 510.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) 535.00 =��T � 010�.� BOII.ER $35.00 �IJRNACE $35.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL iiF.ATER $35 00 DUCT WORK $10.� GAS PIPING $]0.00 VENI�.ATOR $15.00 �� _�-� _ •. ... t, ,. _. .. , :. ..., ._ . .. _ . . _ . M Permit Fee $�•Qf� Number of fixtures @$10.00 x$10.00 = Surcharge $ 0 Number of fixtures @$15.00 x$15.00 =$ TOTAL DLJE $ Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ TI�IIS IS AN APPLICATION FOR A PERM�T-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and aceurate; 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 o all wo k which requires review and approval of pl � � `11d� �✓� U DATE � �I�' (p SIGNATURE OF APPLICANf PRINr NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �. REQUtRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPUCATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTIMG HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTtNG HOMES 1. Combustion Air (S� note below) . a. Oil or solid fuel IMC Cha�ter 7 with MN Amendments b. Natural Gras or Propane/IFGC Chapter 3 wrt`Ti MN Amendmen.fis , 2, Iviake-up Air (See note below) a. IMC Chapter 5 with MN Amendmen.ts 3. Venting a. Gas appliances ]FGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Requir� on new construction IMC 1346.0312 5. Ventilation . a. per MN Energy Coc�e 7670 or 7672 6. Duct Design Per IMC 1346:0603.2 a. ACCA Maaual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be u$ed for comb.ustion and make up ai� calcula.�ions BUll�1� Inspe��tions 763-��2-3604 -o 31TL•' ADD��4S THI3 APPLICANT I3: Oh?�NER/ TEI��iNT From: City of Fadley To: 7536883 Rage: 4/4 Date: 7N 8/200612�:12 PM PLUN.�ING Permit No.:L RESIDEI�TTIAL APl''LICATION �"'� By� PHOIdE: CITY OF FRIDLEY YOUR �B/IAII. ADDRESS � OWNER p�NTRACfOR SUBMIT:ACAPXOF �A��----� D`��m EJ�DATS I YOL� ST'A'i'E ADDRESS:�� f � I f'� C1TY COC L�c��s� wrrx rxor� SS- Fnx �103 - 755- PERII�TP TYPE I ��a'� FAMILY TYPE �C�F WORK: ( $�` DETAILLD DESCRIPTION OF WORK 0 TR►O FAMI[.Y O TOWNHOU3E �'r:�a/ ,:. �f�t,l:! Y� Date Redd: A��Y PER MS I 6B.6b5 the permit fea is a minimnm of $15.� or 5% of the total c+�t ap to $500.0A, whichever is greater, for the improvemerrt, installatiffi or replaceme� of a resideutial fixture, exclud'mg ti� 5xtures. (This shoutd re8ect only the cost of I�bor ) Labor caFfi under $300 =$I5.00. Labor oost between $300 to $5� a cost of labor x.05 = FOR PRO:�.CrS Wf�RE LABOR EXCEFAS $500, kEES ARE BASED ON 510.� PER FIXTURE, EXCEPT WIiERE NOTED. FIXTURES: (IIVDICATE TOTAL IJl7A�BfiR �3F EACH SEI.UVI� SATH SIIVK/LAV FLOOR DRNNS SHOWEA WATER P1PIN(3 BATHTUB CiAS PIPINO lnssn atarucarusa) SWILVANiN6 YOOL WATER 30FTNER i$35i CLOTF[ES�fIASH6R KiTCi�NSINK �UATERCL05EP BACKFI.OW PREV. (SIS) � bISHid� ASl�R _ LAUI�RY TRAY =WATER HEATER (S3� FOR IRRIGATION WATER METER OTi�R TOTAL Fea $ ATumber of fixduea (a7 �l 0.00 x$10.00 =$ ff� .50 Number of fixtures �n, $15.U0 _ x $I5.00 = $ �UE S Aiumber of fixkurea (u� $35.00 � x 535.� �$ 3 5• � State �charge = $ SU Tota1= S 3S, sZ7 THIS IS AN APPLICATION FOR A P�9T NdT VALID UNTIL PR4CE8.4ED I hereby �pply for a bu�mg parmit and 3 actmowTedge that tiie in�ormat�on above �s� - compI-e s�end aac�;�ia�tiie wor7s witt be �t confanne.nce �rith tI� ordir�aaces and codes of the City of Fridley and with the Mirmaaota Constructioa Codesr, that. I uuderstartd this is nai a par�i�it but �ly an application for a permit and work is not to start wit�ut a permit; that the work will � in accord�ce with the approved plan in tha case of all work whi requues review and approval of plena. 31(iNATC`RE OF APPIdCANT / PR1NT N1►ME 7 Q.GtI �l f� DATE� I 0�D (D Cit� of Fridley Building Inspections Degart�ment 6431 University Avenue NE, Fridl�y, NIN 55432 ?63-572-3604 FAX: 763-502-4�977 � � City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 � v `�;'�'f'�% i� �� Mechanicai Permit# �` � . Residential Application , � r� ° � � City of Fridley See Back Side For Reauired Information Date Site The applicant is: (cirlce one Property Owner.� � Owner ( Contract� �� t �� e�> s_ State: i'� YI Cell: Contractor Information " Company Name:_ �unennr �c�at�r,�, na� gF�l�sfr^ Contact Person: 3731 Thi�rctnn qye��e� City: State: Zip: Phone: -tl�.� y��- l �d 1 Cell: Fax: ��- G/o1a-��i�S$ Email: _ MN Bond# & Exp Date Type of Work (circle one): New Detailed Description of work: (�i Alteration/Remodel �ent Installed: MFG:(oc��,rn� Model: C Size/BTU: /`/ •O .�� MFG: Model: Size/BTU: , MFG: Model: Size/BTU: check all that apply: Fireplace (gas) $15.00 New Gas Grill $10.00 : $25.00 Fireplace (wood) $35.00 Gas Unit HTR $10.00 to Air exchanger $15.00 Fumace $35.00 Pool Heater $35.00 ler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 mney Liner $10.00 _Gas Piping $10.00 �t Work $10.00 Gas RanQe/Oven $10.00 Permit Fee $ �i� -Q'� Minimum fee $15 or 5% of cost of improvement Surcharge ,� 0.50 whichever is greater + surcharge Total Due $ o��• j(� Make check payable to Ci of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 Construdion 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 case of all work which requires review and approval of plans. Signature of Approval Ins� Date: �lG' lv� Date: Pi(v Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005