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AF - 47415� a * �.�:_ ,�"�` � . . . � a - �` - . .. . . , . ._... ,- � . � � � �� . � . . . . . . - . ,.z' - . . . . . _ . .. :. �• . . . . _ _. . :-�. ' _ . . , _ . . ,.. . ,.., • �' ..- �� . ... ..., . ,�. . _�, � �''' .:. :': . - .•-_. .��. .; ,... .. . . , . . . . . . .. . . .. _ ... , . . �,.. . . ,.. . ,� . : , , , , . . . .., . ,� : , .,.�. � . � � � . _ ..;� . . ��: . . � ' -....� . :.. . ,.. . . . .... �. . .:,. � . . . . . .. � . . . �.: . -. .. . �.,. �.:� _,' ., � � , �' . .. . . _ .. , . . . . .:� .. . . �: � . . .. �� .3� . . . :.. � „ �. � � . '� ,:a- ..:.. . . . . . . . . . : , ...:� . ; '�.-. . ' .,�'.; . �.: � '` 's .> ,.'... � . � ':, Aag�tst :I4, 19fi$ ' 4 . , . . . . .. . np y 6 - .� .r'... Y � _ - : . , � -` _ . AOyYl �LikGt�,fC GO• i . : .. �. _ _. , � . � ;. : _:. ; . `51-%%i11 �i8� I�.E • ' ._ : ' " � ., : , .< Fridley � �tia�u�r�rta : . ,. i. < � �.�� - ._ . aea�t Si�r t � < ,: Ths house �►t 6520'Jackaoct Se. N. E. is `ia vi�i3aCiq�a af tts� ' - .- � � City Blectriaal Coda.. The Cacle ca1Ze for B-Single pole, 1��0 Ampr ,; ,. 1-4fl Amp, 1-38:Amp, 2 pole breskers in plac� in the p��l._ P4ease. put in these br�akers. Also 1 Dishwasher for which tbe fe� is : � �° $3.OD. Your prompt att�ntion to thia would be appreciated. - .: . Your.s very truiy, ' . _ : : Leonard 8ich�iller • � . - . ; ` . ' �lectrisal Tnepactor � < "': :LE/bke .� , .. , _ .... - ', � .... t: , r . - ;. _ N . _, .y , : �; , . . � . � . . - k . - �., ' �. : .. . ' " ,ty ;.:. ' ' ' ., . ... .,. . �. .. _ .� . � .. . . . .. . .-�. .. iti :�. -, ..� ` ��::. ' - � :.� .. e i . . . . _ �... , ' . _ . . : . .. -i . . . . � � . . �� • • City of Fridley, Minn. BUILDING PERMIT Date: _ A.pril 23, 1968��_ ___.____._� pwner: _ _ _ Ronald Smith Builder _._..__Smith &.Anderson N� Address ._.__._..912 40th_Ave ._N... E . __ _ _ _.__ _ Address ._..__ 912 40th Ave . N . E . �/�%iA�`' 96$�) LOCATION OF BUILDING No. _.. 65 20 .---- Stx�eet _.__.!f acks on S t_. N. E...._......_...._._.___.-----.._. Part of Lot _._.._._..._.. �.._.._..S .�� _of l�lock _.�._.__...__..._._..__...__._ Addition or Sub-Division _.._. �Clover Leaf Adda. �__.__.._____ i Corner Lot ..__......_.._...__ Inside Lot ....._.._.._._..._..._--••-----_. ... deyard __._..r..._..�._._._._._ X . Setback ...._..--•--_. _. 5_._._._ Si Sewer Elevatioa ._.. Ft...._ t Q.---Z.'.....d e ep.�.._..._.._.._. _. __. _._ Top of Footing -~3' above sewer DESCRIPTION OF BUILDING To be vsed as: DwellinQ _._._,,,,,, �t _.!+6�._ Depth _. 26�._ Height ..__20'.._.. �. � _11�6 � �, 23,920 -�-a.�..a..S..�..____.._._._..__ Front —20 � Depth _.. 2? �.� I�eight _._1 ��.._ Sq. Ft _. 440 � F•t, 4400 Ty�e of Construction ----_..�rame ._....._._.._._._.. Es� Cost _.__..�.21.�_000_....._......_ To be Coinpleted _Ju_..1�.'..15, 1968 SEWER LOCATIOR - Saddle WATER LOCATION - Tap in the Street In consideration of the issuance to me of a permit to construct the building described above I agree to do th� proposed work in accordance with the description above set forth and in compliance witt► a'll pravisions o! ordinanoes of the city of Fridley. _��''�.t ` �� - $100.00 Sewer Connection Charge Ea cou�siideration of the payment of a fee of ��42 . 00 _.._.., permit is hereby granted to Smith & Anders on ^�_..T to constxuct the building or addition as descrlbed above. Thispe rmit is 8rauted upoa� the express condition that the person to whom it is granted and his agents, employees and workmen, in all vno�rk done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinancea o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the dty limits and this permit may be revoked a t a�y time upoz�y�olation of any of the provisians of aaid ordinances. . // _ s u Official � Gasterland NOTICE: 'Ihfs p�rmh doa nof eowr th� construeNon, inshlidion fo� wirin�. PhnnbinY. oa� h�aNno, wwK or wat�r. d� wn fo a� f6� Buildias Insp�cro� fo� ap�raf� p�rmks fo� fh�» IfNns. .. , . � - �! . �- �, • • . : : � , 2 3 9' 20 _ � �vd �8�3aD � �/ d z,� g� . �.i1.L. . . •'.,. ... t2C{f��-�� APPI;ICATYON ROR B'tJI�.DIN�: �'E�tktlT CI1`X OF ;F&,I�,BY; :I�I�SO�A . ;.,: ' . . t� � ��-� � � �� . (� � • • � Y • ...E'r.• . . . , . s. . . ti ., . . . ,. . .f4WNER'S �iAl�__�i�£.�� .S��.a� ` f�, _,�UiLDTB__�� .; �.�.�:+�`.C1��s�,•� ,,i/C. ADDRESS�..�� L�-� .�.L�•�,�..� _.. `�DDRESS��/� �i��y.,,� �. • ; .; . _ , . � . LOCA:TION QF $UI�.nIL�G ,. �.� � : �o. ,�s _ c� �s��r � �� ' J - - LOT�•�� BLOGK__ U ADb��IO� = OR� S�BDIVIS i014 ��!�'�„_, �,e�� CORtdER LOT � INSIDE I,OT_�,��SET$ACK._'j ;L�._..SIDEYARD,�,� ' - .� ' ;`�' � SEWER ELEVATION_:: ��" TOP OF FOOTING APPlica�nt attach eo .tbis form 15�vo.:.Cezti�i,cates o�' �'o�vey of �ot .and ��oposed building .lo,catioa drawn on these Certiff,�atee. � _. , � a�.� � . • . , .,'DESCR�PTION OF BUILD!�NG : To Be Used As: . . �} � . .: , : d./CL%��,.C1N � . F=ot1t��;�,_,rD�ptb� . i�igk.t � �O � _ . . Square feet i� yt = Cub1c F�eet �_, � a�i Z � '_ //� �(tlr� Froat s� � Depth � 2 Height -��,i� Square feeC Cubic Feet '� � Tqpe of Coastruction �� i,�,�L,,�,i Estimated Gost �,�� To Be Canpleted �� r S' �_ � �� The undexsigned hereby makes applicatiou for a permit for the work herein specified, sgreeing to do all work ia sCrict accordaace with the City of Fridley Ordiaaaces and ruliags of the Department of Buildiags, and hereby declares that all the facta and representatioas stated in this applicatiaa are true and correct. DATE _� � _.._ � .z--�� SIGNATURS_ ��' i- ��' _ _ _ . .. (Schedule of Fee Costs can be found oa the Reverse Sidej. �ldv S,C.C, � � -Q,�'��-� - • / � oa /�z� �_ . . _ • K. " i � City of Fridiey Applic�crtion fot� P'h�mbing and Gos Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK � Number, Kind and Locaiioa of Fixiures Localion Gi s s� O tp vi � N N W W Z . • WATER HTR. 'f�' F S �� Sue> ZZ �c p<Z UZ OS�! � �n U' Z Y < � `� � Z <� � p � � oC t� S c `2 d` Z `� a R N GAS ELEC. � 3 � .6 N 3 H C LL N LL O O m< 3 (9 � C9 �n (9 O Base � � I � l ist I 1 / I 2nd 3rd 4th • Future Conaect€on Openiags * New Fixture, Old Opettiags PARTIAL RATE SCHEDULE Sewer � Cesspool j� PLUMBING FIXTURE RATES: NO. RA'1"E TOTAQo, Number F`ixtures . . . . . . . . . . . . . . . . . . . . . . �_ x $2.00 $ I 4 � Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening . . . . . . . . . . . . . x $1.50 $ Catch Basin ..... ............. ... x $3.25 $ 00 Water Heater (Up to 99,000 BTiJ) . . . . . .� x $3.00 $ 3• New Ground Run Old Bldg . . . . . . . . . . . . . x $325 $ IIectric Water Heater z$2,pp s GAS FITTING FEEB: NO. RA.TE TOTAL Od lst 3 Fixtures .......................... � x$2.00 $—�_ Additional Fixtures . . . . . . . . . . . . . . . . . . . . x $ .75 � Gas Range to 199,OW BTLT . . . . . . . . . . . . . . x $5.00 � REPAIR3 & ALTERATIONS—Refer to Code Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL FEE � S� City of Fridley: � l��. l�'"� The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares bhat all the fact and representations stated in this application are true and correct. Fridley, Minn '��rn� � � , 19 � � Owner �J 1 CT �'�-� Kind of Building Used as To be completed about Estimated Cost, $ Old New. uilding Permit No �� d� Permit No. ROUGFi FINAL ,✓/ " 30 " �o � a�o 4 2 Signe By Busines ane No _ July :1D, 1969 . : -�, : � . .;. - Sarith And Anderson �ot��tructian Co, ' 9 i 2-$C�th ,�venue: N.�. , = �olumbi� Hei.ghts, Minneeota Itear Sire: . , Mr. Etoriald 8crimshaw, . owner of 652fl Jacksc�n Street N.'�� , wae �.a. our a€fioe o� July 10, 1969. ge ha8 a oamplaint on the vent above the hood nf tt�s kitcshen . stnve. Th3,s vent he.� not be�n ex�Gended throu�h the ro�f of the t�ot�se. Thie it� i:n violsctiar� of Section 9Ci6 of th� Uniform �.iilding Code that ettttee, "�ent� $ha12 ext�nd above the roof �urfaae, through a fls�hing, $nd terminate in a lieted vent cap; ins�all�d ix� acaordanoe with i.ts 2i�eting and the manufaoturer' � U inatruc�tion� ." _ Mr. Sorimshaw also had a aomplaint on hi� �1.u�inum etorme'e�nd �areene. Fleass see that these u�atter8 are takex� car� of by� Ju2y 2i ,'19b9. IF you hsve any que�tions, pleaee f�el f�se tQ aail me at 5�-345�• �� ` '; Thank y�u. . CLAAII�'C� BELISL� � .: ' Buildir� Zns�ator : CB/cth , < . , � h �_�. :,: . - .� --- � . . . . . . . . , � . . . � . . � . . . , . . . _. a . . OUSE HEATING TEST RECORD ADDRESS �� APT. F OOR TY SUBU OCCUPANT OWNE HEAT LOSS DATE HTG. INST. GAS C0. METER BA SOLD BY INSTALLED BY Elsetrical Work By Gaa Line By TYPE OF HEAT GA FA � STEAM SPACE HTR. UNIT HTR. OTHER GA ESI /� � CONVERSION MAKE ° �Yd �� MAKE OF BURNER Model Modsl Serial � � Max. BTU Rating INPUT B MAKE OF FURNACE Model C TROLS s� THERMOSTAT �� Hsat Plug V��t Sizs Yalve 1J KlND OF LINER ZE NONE Limit �� Draft Hood Regularor Limit Setting � Filters Size Numbsr Fan Setting ,�.e�0"�� Chimnsy Loeation Inside �f Outside Pilot Type Chimney Construetion Pilot Make � Pilot Model $moke Bomb —Wiring � Pilot Timing � Draft 0 Tsst Tap �� L.W. Cut Off � Door Prossure Lightiny Inst.<"/ Pressure J��^ ere?e t CO2 � '`'� ate Tested �� Z'�'� InpuT CFH Pj�Gfilt �- � mpany Testing – Staek Temp. Percent CO �.�� Name of Tester Form 235 App�cation �or'owtr MaiMs and Hsol�Mg. Cooling. Yentitotioe� RfiEig�r�oliou a�d Air Conditioning Sxst�n�s dnd Devic�s PARTtAI RATE SCHEDULE liRAt►?TY WARM AIR: !lJ1TE TOTAL Furnace Shell & Dact Work . . . . . . . . . . . . . . . . . a10.00 i Replacement of F1�rnace . . . . . . . . 6.00 � Repairs & Alterations—up to =b00.00 6.00 a�_-- -__— • Repafrs dc NteraUons each add. 5500.00 , g.pp j`_ __,__ KECH. WAR1�t �IR P1u'nace SheA E� DuM Woric to 1l0,000 BT[T .._... . .. a10.04 �_ each add. A0,000 BTtT ............. ... .... .. 3.W i RepLcement of F�rnace . . . 6.00 � Repairs dc Alterations—up ta �500.00 6.00 ; Repairs & Alterations each add. ;500.00 3.00 i STEA� or HOT iNATEA SYSTEII Ftirnace Shetl & Liaes—to 400 sq. tt. EDii Steam $10.00 $ __ __ FLrnace Shell & Line—to 640 sq. ft. EDR Hot Water 20.00 a_ Each add. 200 sq. ft. EDR Steam g,(� �..__ ___ _`_ Each add. 320 sq. ft. EDR Hot Water 3.pp s-- OIL BURNEA—to 3 gal, per hour g,pp a , over 3 gal. per hour�ee Fee Schedule GAS SIIRItEA (up to 199.000 HTU) _ 6.00 j a►er 199,000 BT[J Se. F�. Sehdul� GAS FITTING FEEB: lf0 AATE TOTAL lat 3 Fixtures . xE 200 S Additional Fixtures .. x .76 i Gas Range to 190.00a si b O� i AIA COlfDI?fOI�I]Ia P]►!f HSJ►TiI�G sTS?E1[ vntrna►t�a s�rsraM ALTtAATiOI(� ! REPAIAs xovvH �trr�r. �/- / - 7 � �.t...., � PN Se�do4 � TO?J1L �E6 � (SURCHARGE $� �' � '` n.pt. o� Hia9.. rh�►. seo-stso �� 'i � city ot Fl�ial�y: The undersi�ed hereby makes application for a permit for the work hereir specified, agreeing to do all work in strict accordattce with the City Ordfnance: and ruling of the Departmeni oi Buildings, and hereby declares that aI� tbe facts and representations stated in this application are true and correct. , Mian � lg _ .- A Owner Kind of Building _______ UseC� ag ------._.___ _ -------- . To be completed about __� 3^ Y 7� 7 Ob Esti ated Cost, a_—.-- --Q.Q —�_ `_ Ol ew. Building Permit No. P�rmit No. �/�;� DESCAIP'i'IOIf OF WORE HEA1"tNG or POWF.ii pI,AN1g_.,gt�earn. got W+�ter, Warm Air—No Trade Name g� N�_ CapacitY— 3q. lrt. E.D.R g� gp Total Connected Load � p= �� BURNER — 1��ade Ns� 3iu No CaWdtY 3q. !'R E.DR BT[J I,�p. �._.��' � �4�?� �`'�, `,� ..� x:y �,� �- , , ..�' �EM��O�M(Rn.�� .,�, �� .' , � „ . �nL,..:.�.. _� , ri'.►Gr� ` B�m� - `� �%l C� G(% - ,�j3 cl o � ,�- . ,� f y � � f �'� � � �" . �: �' i. / I" : 4 -� v J � � �� V � � ` ^ � � V � � � � � \ \ \'� ! �, i k +� 9 :! . :,� r .r'! 4 � . ... � w. t�� [ k ; � ,+� Jr� .r'r � � � r"yF� � � :t H � � .. � . �r�, r �4' ?' % � ,� ,I 1� � i: . . , 53-8��-5-915.51 . ' MiNNEGA5C0 � . • • Cil� G"'fi �'fiC�i�r3�/ A3,�!'sc�a�� i"lc��s� �aw �� s;��;� g`r�:� . Dept. of IItdQn. i'hon� 3E0-34S0 .. . D�SCRIPTtaN OF �":OR:: � 6520 N. E. �ackson Street ?Iumba:, fiind and Locc..K�a of Fixture� I'°u`t�""` - � (Nj WATf� MTII. u, ~ s� � � �'�' Z t, �ii, p Z U Z O� ' V = O � � • �` z � '►� o o � O �o � S � +� 3 U � u a u (� � N � G�S [L[C. � � i + r � M 1; . 1 � . _ .. ___ � Futur� Coassot2i;a OponiruJs N�a FIxturo. Old Opaain�s r 0 Qi�A�i � _ CcsaPaol ('] PARTIAL RATE SCHEDULE City of fl-idley: 'The undersigned hereby makes appllcation for a permit for thr a►oric herei specificd� a�ree:ng to da all w•ork in sirict accordance w�fth the Cit� O:-dir�r.ce and ruling of the Departr�ent of IIuild:ags, and hereby declares that all the facl and representations siated in this applicatioa are true arxi correct iiidley, Mina 7-16-75 �pr Owner Ronald P. Serimshaw ' _ Kind oi Building Frame Used as ' Res. -- To be completed about 7-23-75 _— ^ Estimated Co�t. s i0.00 _ _ . Old--�d4�uitding Permit A'o. P.�mitHo. �`�'3`� .DMBING FIXTURE RAT�3: NO. AATE TOTAL L��"+�`LY � . Signed • Number Ftixtures . . . . . . . . . . . . . . . . ....�_..- x �2.00 3. � B� MINNEGASCO �-� ilawre Fixture Qpening .... ... .... . x S1.50 s _. Y :v'ew Fixture Old Operting. ... .:..... x 51.50 5�.-- 8usin�� PtSVue No Catch Hasin . . . . . . . . . . . . . . . . . . . . x 53.25 S Water i�eater 'lIp to 99.000 BTU>• ••• x 53.00 S . ROUOii tiew Cround Rua O(d Stdg. ....•..:. x�3.25 $ El�ctzic �V�tsr Haatas . . . . . : . . . . . . . . s y2.C4 a._._._...._-� FINAL 'y ` a�'- !' � ' . �l3 FITTING FE£3: NO. ARTE ?OTAL : 1st 3 Fixtures • • • • • • • • • •• • • • • • •• x S2.00 ; . • Additioaal FSxture� .. . . . . ..... ... . x a .�5 S . Gas RsnYe to 199.000 8TU . . ... . . . . .. , ' x 55.00 6 EPJ►IitS �c 11L7EA�lT10NS—R�los !o Cod� , .50 State StlrCharge .Desai�tion .....Inst�ll G�� G��............�..... = K nn � T02.+►L FEE i 5' S� ' . . � Qas� �'R" �urcharge .50� . . . . . r � SUBJECT P E . City of Fridley �� 19 8 7 5 AT THE TOP OF THE TWINS g U 1 L D I N G P E R M I T r ; � REC T NO � • COMMUNITY DEVELOPMENT DIY. � �v------� r � � PROTECTIVE INSPECTION SEC. `� a-o�- S � � , � � /"'i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV � ----�•� �•� 5/5/89 612-571-3450 910-F15 / / JOB ADDRESS 6520 Jackson Street N.E. 1 IEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. S� of 17 Clover Lea� Addition SHEET 2 PROPERTY OWNER MAII AODRESS 21P PHONE Ron Scrimshaw 6520 Jackson 5treet N.E. 571-5810 3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO. George Johnson 5410 Girard Avenue North� Brooklyn Center 566-2351 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION Cj� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroo� Dwelling (25 S uares) � 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys Qrt all nEw roofs or tear-offs and replacement roofs, State Code requires that 2 layers of 15 Ib. felt, m4pped tag�#hec, be instal1ed fo a point .2� �inches �P #fiom axt�rivr watl line, or the use a# Dther appr�red underlayment membrane. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAO VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCEQ WI7HIN 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION �' S7ALLS GARAGES AtJD KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1�25Q $.63 WITH WHE7HER SPECIf1ED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMtTFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 21�00 STRUCTION OR THE PERPORMANCE OF CONSTRUCTION. $ PL N CHECK FEE TOTAL FEE $21.63 SIGNATURE OF CONTRACTOR OR AUiHOFIZED AGENT �DA7Er .. WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT �, ' ...�� SiGNA7UREO:OWNERi1fOWNE�7BU�LDER1 IDATEi BIDG INSp �1�7 � � [ ] � � � �'1'� [ ] Oonstruction Addres�: I�1 AND �2 Building Permit Application � � C� `� � �.s � �"-� �1�� Effective 5/1/88 % ;; �� ! Legal Description: Owner Name & Addrzss: �ii� �CY�'1 S � Q�ti1/ �e1. # � ` ��" Cbntractor: t?`e�f.� � aU �f �i - - Z�e1 • # � ��,� Address: J�/�� `'�'1 Attach to thi.s applicatioa�►, a Gertificate of S�uvey of the lo�t, with the pr+apoe�,ed c�oa�stnictioai drawn ari it to sr,ale. D�(RIPl'IG�T OiF II�VH�[�T� LNII�1G AREA: L�ngth Width iieic�t Sq. Ft. C�iRAG'E ARF�: L,P��gth Width iieight Sq. Ft. DDCR AREA: r� Width Hgt/Grauxl Sq. Ft. o�t: L� %�9.. �rt n�,� cn► � n+i-I--�.e/l� ��.�a� Gbrnax Lvt [ � Inside Iat [ J Ft. Yd Setback Side Yard S cks Zj�pe of Oonstniction: Estimated Cbst: $ Approx. Catq�letion Date: �� ^ '1-�� PY�ed Driveway Width If New openirg Is Desired: Ft. $ $ /� Wi,dth + 6' See Back PageA DATE: �� AP�'L�ICANr: °l Z�1. � , j C'i'1R tTB�E �II,Y �t F� s �I�bG� State Sltzrhazge $ t � � SAC Q�axge $ Drive�ray Fs��aw $ Park Fee $ sewnx rtain criaxge S �,L $ o�1U� �,�,� 3�,0� sriPVr�►TTaJS : . 5��, � Fee Sci�edule aai Reverse Side $.50/$1,000 Valuation $575 per SF�C Unit - Alt. nA�� or Alt. nB'� AbOVe Fee Detennined bY �J��r'� �t ��Y I 7 � N��tiY L J (�c',�—� I�,C� 3� -Z � __--- �l,�d SUBJECT IT NO. City of Fridley ` 2 717 5 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T i� � �` COMMUNI7Y DEVELOPMENT DIV. %�j r � ~ � PqOTECTIVE INSPECTION SEC. '1�1 � � � � �"'1 • CITY HALL FRIDIE� 55432 NUMBER REV OATE PAGE OF APPqOVEO BV �'""�" �'' 612-571-3450 910-Ft 5 8/ 13 / 98 / / JOB ADDRESS 6520 Jackson St NE 1 LEGAL' LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DE$CR. S� of 17 Clover Leaf Addition sHeer 2 PROPERTV OWNER MAII AOORESS 11P ' PHONE Ronald Scrimsaw 571-5810 3 CONTRACTOR MAI� ADORESS Z�P PHONE UCENSE NO. Town & Countr Roofin 9403 Minnesota Ln N Ma le Grove 55349 545-4233 2009282 4 ARCHI7ECT OR DESIGNER MAIL ADORESS Z!P pHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUIIDING 'd n ial 7 CLASS OF WORK ❑ NEW � AODITION O AITERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK o house nd ara e 28 S Tea -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAO SEPARATE PERMITS ARE REQUtRED FOR ELECTRlCAL. PLUM8ING. FIEATING, VENTILATING OR AIR CONDITIONING. 7HIS PERMIT BECOMES NULI AIVD VOIQ IF WORK OR CONSTRUCTION ZONING S�. PT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ON WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 1Qp DAVS A7 ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I FIAVE READ AND EXAMINE� THIS APP�ICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO COfiFEC7. ALL PROVISIONS OF LAWS VAlUAT10N SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE G ANTI OF A PERMIT ].. 16 DOES NOT PRESUME TO GIVE AUTMORITY TO AT O CANCEL TNE pERMIT FEE SAC CHARGE PROVISIONS OF ANY MER STATE OR LO REG LATING CON- STRUCTION R TH P FORMANCE OF C ION. � Fire SC 2.33 �� PLAN CHECK FEE TOTAL FEE 8 .2 � S�GNA7UA CONTRA OA n r Ai DAG T �DATEi WNEN PROPERIV ALIDATEO THIS IS YOUR PERMIT S�GNAT E FOWNEAi�F WNEABURDER� IDATE� � �/�� Bl0 �NSP r�47E AUG-13-1998 ...... � � ADDN I l �-T� [ l __ _ _._ _ _ 08�42 FROM CITY OF FRIDLEY TO CITY OF �'RIDLEY SINGLE FAMII.Y AND DUPLEXES R i AND R-2 BLJYLDING PERNIIT APPLICATION 8589320 P.01/02 r.�cwuvC u uya .��7�. CoasituCCionAddress: l,G SZ.(� �rA C Y�� ,�j`��. Legal Descripdon: Owner Namc & Address: � �\ �l Y.c- ; ,m��► � (0 520 �aclr� Tcl. � �'11— 5 �L� Connactor: "� ►.v r� �� (� �� 1,Zr�o��►na MN I.ICENSE �_apoq28c�. Address:_ 4(`l� (� j�'1V1 t?Sp�1�4 �.-„v� ��, n1.� �� rnvW Tci. �( R l ��5 ='Z] Z33 � ��'tC _ _ ''T� LIVING AREA: GARAGE AREA: DECK AR,EA: o�x: Attach to this application, a Ceitificate of Su�ii�+�f the lot, with the proposed cons�ction drawn on it to scale. riESCR�'Y'YON OF ID�ROVEMENT L,cn,�th i Width Height Sq. Ft. _ i,ength . W�th Height Sq. �t. Len � Width Hgc/Grouad Sq. Ft. 0 - �FF � ► v � Consttucaon Type:�� stimated Cost: �- - o�� (Fee Schedule on Back) Driveway G�rb Giu Width Nceded: Ft. + Ft = Ft x$ = S nA�: a��ic : � T�. ��► � 5�[ S-yo�3� Permit Fce $ .�� Fee Scheduk on R,e.werse Side Fire Suncharge $ .001 of Permit Valuation (1/lOth%) State Surcharge $ ,_ l. /�,� $.SO/51,000 Valuation SAC Cbarge $,__ 51000 per SAC Uait L�,cens� Surc�harge $ � 55.00 (State Licensod R�esideatial ContracWrs) Driveway Fs�roa $ Alt. "A" or Al� "B" Above Erosioa Contral $ a450.00 C.anxtvadou Plan Review Parlc Fee $ Fee Deterrmined bY �8��8 S�vuer Main Charge $ Agrecm�cnt Neccssary [] Not Necessary [] TOTAL • STIPULATIONS: $ c-�. �? � � �. CITY OF FRIDLEY INSPECTION DIViSION 6431. University Ave NE : � � �� t' '1'� � �J°� : �� Fridley, MN 55432 APPUCATION FOR POWER PLANTS AND NEATING, COOLING, VENTILATtON, 763•572•3604 REFRIGERATiON AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE , –s . —�-- Residential Furnace She(t and Duct Wo�k, Burner • Also Replacement Furnace (Side Vent � Fili Out Back) Gas Piping (Needed with new furnace, but not repiacement) GasRange Gas Dryer '�Air Conditioning - All Sizes All Others/Repairs & Alterations (LlS7 ON BACK) 1% oi Value ot Appliance or Work Commercial/Industrial 1.25qo oi Value ot Appliance or Work f:Fi��a��Jl $ 30.00 $ 10.00 $ 10.U0 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATlNG/COOLING/VENTILATIi REFRIGERATlON/A!R CONDlTlONlNG PERMIT IS a25.00 PLU5 THE $.50 STATE SURCHARGE REIMSPECTtpM FEE $47.00/Mr 'Air Conditioners can not be placed in a side yard without wi�tten permission irom adjoining property owner. ; $ �� $ $ $ $��. $ � � $_�0 � 55.� Ettective On January 1, 2001 JOB ADDRESS_� LpJ��D �G4C�SO1� ��" �� OWNER 9�" � C C.l�/ YY1 ��-� BUII.DING USED AS-- ��1�� . ESTIMATED COST J� • �U PERMIT.NO. � � ��- � DESCRIPTION pF FURNACE �1ND OR BURN�R No. of Heating Units � ( Circte One (Steam) (Not Water) ( arm ir} Trade Name � Size No. �' d 7 �; BTU ��j HF' EDR Fuei l�(• �• Tota) Connected Load Burner firade Name Size No. BTU HP EDR ' � The undersigned hereby makes application for a permit for the work herein specified agreeing to do aN work in strict accordance with the City Codes an rulings ot the Building Oivision, and hereby decla�es that alt the facts and representations stated in fhis application are true and correct. � DA�'E � �l Z �� BLAINE HTf3. A/C ELECT. INC. 13562 VEN7RAL Ail�. �1.E. HEATING CO eun�_JUN_&6,� Sig�ed T ��" $ � �C�� TEL # � � �J1 tU �1 v Approved By�_ Rough-In Date Final CK SIOE MUST�E FILLED IN ON V D COMBUSTION AIR VERIFICATION CON � � �r COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When repiacin� an ezistins� turance, the undecsigned hereby verif'�es that the venting has been examined and is free from n�st, deterioratian. obstructio�s. Yes� No and is securely supported and firestopped where required. i � The venting system is plastiGPVC and meets a11 current codes and manufacturer speciftcatio�s including sizing, tength, number of elbows and tertninatian. Yes � Nc () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes a�d manufacturers specifications. This does inctude AGA-GAMA Category 1 Central Fumace Venting Tables for fan Yes � No () assisted and natural draft appliances. The existin�f combustion air is sized and installed to meet the cuRent codes Yes No (? and manufa�turer's specifications. When requi�ed to instaU a new aombustion a�it will be sized and installed Yes �� No to meet the current codes anc� manufacturers speafications. � � � �\ When installins� a new ventinq svstem, the undersigned hereby verifies that � it is a(isted assembly and meets the current codes and manufacture�s � . speciftcations. This does include AGA-GAMA Category I Centrai Fumace Yes No () Venting Tables for fan assisted and na#ural draft app(iances. `�.� / ts the common vent and vent connectors sized and installed correctly after an appfiance has been removed from the cammon vent and vented separatety as per current codes. Yes ( No ( ) A liance T e and SizelCommon Vent and Vent Co�nectorinformation Appliance #1 Type BTU tnput � Fan Assisted or Nat /�� Appliance #2 Type _ BTU Input �_ Fan Assisted or Nat_� Appliance #3 Type _ BTU Input _____,_,_, Fan Assisted or Nat _+ Totai Appliances _ Total Btu Input . Common Vent Type Vent Height Diameter � inches Appiiance #1 VeM Connector Height ft Length _ ft Diameter � in Type•_,,.,,,�,. Appliance #2 Vent Connecto� Height ft Length _ it Diameter _, in �ype =_,. Appliance #3 Vent Connector Height ft �ength ___ ft Diameter � n Type �_. � � .. ``=� ALTERATIONS: (Describel � � � %� . BLAINE HT�3. A/C ELECT.. INC. 13582 vENTRAL ��N.E. . = ��: HEATING CO: � �. Signed By: � Date : �7 `� ��' t_, . , � _ CITYOF FRtDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 14, 2003 Mr. Ron Scrimshaw 6520 Jackson Street NE Fridley, MN 55432 Re: Final Inspection at 6520 Jackson Street NE Contractor: Blaine Heating AC Electric Inc Dear Mr. Scrimshaw: A mechanical permit was issued on July 19, 2001 to install a fumace and air conditioner at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this pernvt. As of this date the inspection has not been requested. The pernlit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspecdon, we will mark the perniit "no inspection called for by homeowner after notification" 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/mh .., Building Inspections 763-572-3604 �i D�J %� `-'i %��, BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE �I �"� I` G} � YOUR E-MAIL ADDRESS SITE ADDRESS � J �/ iZ /�(C. %�SC7� � f /V� � �I�%/'� �' ��J , /LI �% S � �%� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR ❑ OWNER - 12v� SUBMIT A COPY OF STATE YOUR STATE LICENSE �DD1ti WITH APPLICATION pHONE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: 4ILY/NF Y/NEW ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMM C 0 � Permit No.: e� �f'!—� i 7 Received By: rt e _��%GGU%/�1 STAT'�"�Lenr. i� � � /� r J / s�i �%1/. � / DESCRIBE WORK BEING DONE: �p ��-�/�� Q SIZE OF IMPROVEMENT R OFIN NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS .�Yes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTAI.LED DJ7' ❑ HOUSE ONLY O HOUSE & GARAGE ❑ ATTACHED GARAGE O DETACHED GARAGE OSoffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS � v ❑ DRAIN TILE �' °��l�G� /D G�l�D L� � HEIGHT BASEMENT REMODELING SUBMiT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS_ 8c PORCHES SUBMI� 1. Site Pian/Survey showing the existing structures and proposed project. 2. Two seu of construction plans ' 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 199'7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �`, Cp// . Dl> OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Surchazge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge $ E� $ $ $ $ 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) $1550 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 payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I�hereby apply for a building permit and I aclrnowledge 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 which requires review and approval of plans. SIGNATURE OF APPLICANT �� S(�✓ PRINT NAME ��1� �I,v�v v� f1 � DATE /'�� ' �% Building Inspections 763-572-3604 763-502-4977 FAX DATE �_.._. �_ SITE ADDRE SS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING ROOFIIVG NUMBER OF SQUARES _ GARAGES PROPOSED S1ZE: PROPOSED HEIGHT: SIDING ❑ Vinyl O Aluminum ❑ Other BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-I-09 YOUR E-MAIL ADDRESS ❑ OWNER �CONTRACTOR Permit No.:l Received By• Dat��R�e�dn n � 8 2�09 tvaNtE: - � r ADDRESS: � � CITY STATE ZIP PHONE:T�� — NAME: STATE LICENSE # EXP DATE ADDRESS: CITY STATE ZIP, PHONE ❑ SINGLE FAMILYMEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ S[DING ❑ SWIMMING FAX SIZE STORIES ❑ WMDOWS ❑ DRAIN TILE ❑ OTHER ❑ NEW HOME CONSTRUCTION O ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING WINDOWS IN EXISTING OPENINGS ❑Yes �No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED O HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE F7' BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of swctural members W be used FaR NEW CONSTRUCTION INCLUDING DECKS, So�t ADDITIONS. & AORCHES SUBMIT: Trim 1• Site Plan/Survey showing the existing swcwres Fascia and proposed project. 2. Two sets of conswction plans 3. Energy Calculations LOCATION OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) AL JOB VALUATION $�OCX� � OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dae �IIi�:.� - �� 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$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks pavable to: Citv of Fridlev Attach THIS TS 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 1 understand this is r►ot a petmit 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 work whi re uires review and approval of plans. . SIGNATURE OF APPLICANT �/� ....�C_w,l�Yl/, z��j�?'�1�NAME DATE r b" V�