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AF - 47731Date Owner _ _ — .� .r,�.--� --- - -- -- .�-= _ :._, J,�..__�-- - - _-- BU�ING PERMIT Vill�.ge of Fridley, Minn. N� 2 3 4 3 �,��,��-� .......................... a �. . . . . . . . . .,��"�„� .�'°i�. . ."'.".�. Builder : :': : . .�. �� . . . . . . . . . . . . . . . . . . . . . . . . . . . �ta�'A'�'�� Address �j�.��`�1 `�: � 'x`z°`�y� .�`'�-� Address . . . . . . . . . . . . .�.. ............................. �� L ATION OF BU(LDING /,�� . No. .�,��':+"...... Street .,°':``.:. ....`.�.��..�......... .. Part of Lot ............. .. , `� � �,,..�..�.:�'.,,��--�..... Loi . .. .. .. . � .. .. . Block .��. �.. . . . . . . .. . Addition or Sub-Division !! .'� . Corner Lot . . . . . . . . . . . . Inside Lot . . . �:` . . . . . . 5etback !�J�►►. , . �!�:"f Sideyard �i� ��'�� . : . . . . . . . . . . . . . . . . DES�CRIPTION OF BUILDiNG To be Used as: � . .°.'.� . . . . .�. . . Front . � . Depth +?�.!� . . Height �1�. � . . . . Sq. Ft. �� . Cu. F't. . . . . . . . . . .... .. .... .. .. .. .. . Front . .. .. .. . Depth . . . .. . Height . .. .. . . .. Sq. Ft. . .. . . .. . Cu. Ft. .. . dfj � .... . ��..�.� { �.... ��p� ..... �? •'!,` Type of Construction Est Cost � . . .. .. .. .. . . To be Completed .. .. .. .. ... .. . ;! In consideration of the issuance to me of a permit to construct the buiiding described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of tlie village of Fridley. ..� ��I �d��of• the p�,yment of a fee of $.��:'. . . . , permit is hereby •granted. t . . . . . . . . . . . . . . . . . . . . . . io construct the building or ad dition as described above. This permit i5 granted upon the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, a3teration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violat of any of the provisions of said ordinances. /� �`' .......::....... Bu4lding Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspeator for separate permits for these ttems. ,,.�., a� r� �r � � �"` Caty of Fridley, inn BUILDING PERMIT nate: J'il-� 7, 1965 ��f N° 8142 ovQaer: IaTareace Holmgren �� Qualitp Homes � Tac. Adare�a 6?26 Jefferson St. N.E. A� 3701 Fremont �ve. 190. LOCATION OF BUILDIWG N�, 6726 s�t Jefferson Street N. E� p� of Lot Lot 6 slock I Addil3on or Sub-Divisiaa� a?-ce Creek Terraca, #!� Corner Lot _ Inaide Lot Sstback Sfdeyard Sewer E1eva13on — Fo�mdation IIevat3on To be vsed as: F'rant Front Type oP Construction DESCRIPTION OF BUILDINf� Depth Height Sq. Ft Depth I�eight Sq. F't. ._... F.�t. Cost �13 � 941 • 00 _ To be Completed Cu. Ft Cu. Fw .'S'tOPIII d8ICi8.g8 T8p8�.P In consideration of the isauance to me of a perm4t to construct the building d�c�ibed above I agree to do the P�Posed work fn acoordance with the d�scription above s�forth and fn com�ce with a'11 provisiona of ordinances oP the dLy of FY3dley. / 1 �� lI i �s In consfderatton oP the paqment of a Pee of �10•� , permit is hereby granted to ��-� �omes� Iac. the esPre�s c:ontlition that the�per sno�t �whom it� �granted and�his agent�employ �ees and w rkmen,�fn all w�ork doae in, around end upon eaid buiid�ing, or anyp� thereof, shall conform in all reapects to the ordinancea of Frl�IIey� Minaesota regarding location, construct�Ton, alteration, maintenance, repafr and mov3ag of buildings wi� dty li�dts and this permit may be revoked at ar�► time upon violation of aay of the P�� oE said �11].en Jensen $„�� NOTIC& '11ds permh doa eot eowr ths eeestivedoe, 6utall�lon tor �rWeg, pinmbteg, �a 6sMlee, ss�ru� or �rtlrr. B� �ma to � Na Buildie� le�ttoe ter ap�rtlr � Por t6�a h�nn. A .,y � ' �- � APP'LICATION FOR BUILDING PERMIT CITY OF FRiDLEY, MINI�ESOTA OWNER i.S NAME L�.��°c�aee Ho�rigr�e� BU'1ZDER _�v.�-i �� i��°n�� , 7an� a ADDRESS b726 �Tef�er�or� ADDRESS �70� F?re�c��,.� .�,��. �14. .. LOCAT�ON OF BUILDING No. Street Part of Lot � LOT 6 BLO�R �� ADDITiON OR SUBDIVISION RCT �`1� Caraer Lot Inside LOT Setback S�de�Yard .�_ _._. SEWER ELEVATION FOURDATIO� �LEVi4TI0N Applicaat attach to this form Two Certificates of Survey of Lot end propo�ed building locatioa drawn on these Certificates. DESCRIPTION OF BUILDING To ba used as : DAMAGES DUE TO �'QRIvAI�Q Front Depth, SeighC Sq. Ft. Cu. Ft. Frcx�t Depth �_Height Sq. FC. Cu. Ft. Type of Cat�atruction Estimated Cast $1a99�.�e�� To be completed The undersigned hereby makes appl�.cation for a permit for the work herein apeci£ier1, agreeiag to do all work in strict accordance with the City of Fridiey Ordinances and rulin�� of the Department of Buildings, and hereby declares that a11 the fact� aud representations stated in this application are true and correct. DATE SIGNATQRE (Schedule of Fee Costs can be found on the Reverse Side). t�e,p�a�e hor�� from ea� u� �� s.w'` � � ti ,- _a'.. �viT.t)ING PERI�T FEE SCNEDtt:.� SLCTION 2. The Inapoctor.,of Buildings shall, before issuing say permit for the ereceion of aay building or atructure, or for any addition to anq existing build- iag or etructura, or for any alterations or �epaiYe to any exiet3n� building or atructure, upon appiication therefore, require the payment by the applicant for 8uch permit of fees to Cbe aimount herein below aet forth and in the manner herein provided to-wit: , � 2.1. For any such permit for the erection of any fire �proof building, other than a�arage, warehouee, factory or grain elevator, or fos the erection of gny fire-proof addition, for similas occupancy, to aay ex3sting buildin�, shall be at Che rate of $1.40 for each one thoueand cubic feet, or fraction tbereof� in such cubi`caI contents. 2:2. For any auch p'ermit for the erection of any fire-proof garage, Warehouse, factorq ar grein elevator, or for the etection of anq f3re-proof addition, for similar occupancy, to ang euistfng building shall be ae the rate of $1.25 for each one thoueand cubic feet, classified as "�ireprcof" by Section 502 of ehe Minneapolia Building Code. � HOIISES . � 2_ 3. For any such permit for the erection of any noa•fireproof�build#.ng, other t6an a garage, warehouee, factory or grain elevator, or any non-fireproof addition, for similar occupancy, to anq exiating building - permit $1.00 for each one thousand cubic feet. GARAGES ..�� 2`.4. For any euch perm3t for the erection of any non-f3reproof garage, warehou.se, factory or �rain elevator, or for tbe erection of aay non-fireproo� additioa, for �imilar occunanc.y, to anq exieting buildiag or �or each auch buildia� or addiCion - ninety cents ($0.90) for each one thousand cubic feet or fraction Chereof, in the cubical contents thereof with the minimum of $4.00. For the� purpose of computing fees for building permiCs, Che cubicai contents - sf anq build3ng-ar-adsiitioa to a-�i£�rm height throughout bq multiply3ng the ground area covered from a point aix (6) inches below the floor line of the basement or cellar to Che average height of the upper eurface or to the avesage height of the roof surface of the main gable of a pitched roof. 2.5. �For repairs or alCerations to an existiag etructure, the fee ahall be aC the rate of $3.QO per each Five Aundred Dollars ($500.00) or £raction thareof in the coet of all propoaed wo�k. 2.6. In no case shal]. the fee charged for any permit aa set forth in Secti n 2 be lese than $4.00.. . � �` • �� .. �°'� - �_ � -� s�e�EC, pE City of Fridley AT TME TOP OF TME TW1NS g u I L D 1 N G P E R M i T �� ;, .� . � `L ___�_ COMMUNITY DEVEIQPMENI DIV. r � � Pi;OTECTIVE INSPECTION SEC. �� ,� l� _ , -__. A��'�'�•� CITY MALL FRIOLE� SS�32 NUMBER REV O�TE P�GE Oi �PVaOVEO Br l �� 612-57�-3450 s�aF�s 9/21/98 / / JOB AODRESS 6726 Jefferson St t LEGAL LOT NO. BLOCK TpACT OR ADDITION SEE ATTACMEO DESCR. ( 1 Rice Creek Terrace - Plat 4 SNEET 2 PROPERTY OWNER MAIL ADOfi�S$ 21P PNONE Jan Redman 571-5558 3 CON7RACTOR MAILADDRESS ZIP PMONE LICENSENO B& B Roofing Service 6760 Ma.dison St Fridle 55432 571-0248 9042 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER qIAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION C� REPAIR O MOVE O REMOVE 8 DESCRIBE WOFiK Reroof house & garage (26S ) Tear-off 9 CHAN(iE OF USE FROM TO STIPULATIONS ' Underlayment� must comply with the State Building Code. SEPARA7E PERMITS ARE REOUIpED FOR ELEC7RICAL, PLUMBING, HEATINa, TYP� OF CONST. OCCUPANCY GROUP OCCUPANCr LOAD VENTILATING OR AIR CONDITIONING. 7HIS PEqMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU FT_ AUTHORIZED IS NOT COMMENCEO VR!ITNIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANqONEO FOR A PERIOD OF 120 DAYS A7 " ANY TIME AFTER WORK IS COMMENCEO. ' NO DWLG. UNITS OFFSTREET PARNING I MEREBV CERTIFY THAT I NAVE FiEAD AND EXAMINEO THIS APPLICATION STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAW$ VALUATION SUR7AJt ANO ORDINANCES GOVERNING THIS TYPE Of WORK WILL �E CpMPLIED $2 � 228, OO �].. ], ], WITH HER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT DO S NOT PRESUME TO GIVE AUTMORI7V TO VIOIATE OR CAMCEL TME pE�MIT FEE SAC CMARGE P OVISIO S Of ANY OTMEF STATE OR LOCAI LAW REGUTATING CON• � $7/{.75 re aS�'i $2.23 TqUCT N OR TME PE ORMANC F ONSTRUCTION PLAN GNECK fEE 10T l EE Licen C $5. $83.09 S�GN4T E OF CON'AACTOA Op A NOA�2E0 AGEN1 ID TE� N P OPE V A IDA D � �S �S Up IT � � I �� S�GNaTUAE O� OWNEA i�� OWNEA BUI�OE�1� IDATE� . ' � BLOG i S� � r��rE » NEw ADDN ALTER [] [l [l ConstructionAddress: � CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERNIIT APPLICATION � � �� Effective 1/1/98 �� r�� Legal Description: ` /� /2 i G Owner Name & Address • �� %%,� Tel. # � �� S�� Contractor: �j� �� Q� //2 �- �// .S MN LICENSE # ��" Address: �p ��O �;�j�%�/_��JY/ � / Tel. # � %/ D`� � Attach to this application, a Certificate of Survey of the ' lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Length Length Length DESCRIPTION OF IlVIPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Typ�� //;� � �� Estimated Cost: $ °'� 2� �,. � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: / Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � $ � � $ . $ �� $ $ �"��D $ $ $ $ �� $ ' CITY USE ONLY Fee Schedule on Reverse Side Tel. # .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � � �� \ BUII.,DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration 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 $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $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 $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1, 0{� or fraction thereof, to and including $100, 000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 � $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "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 $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. ., _ � �SUB�ECT � . City of Fridley 29771 AT THE TOP OF TME TWINS � � I L D I N G P E R M I T r � � O. � `v __�� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTIQN SEC. � �� 1 . � i.-_. `��'��,'� CITY HALL FRIOLE� SS�32 NUM�EA pEV OATE PAGE OF AVCFCVED BY ` J` 612—s»-3450 s�aF�s 6/25/99 � � 10B ADpRESS 6726 e t LEGAL �OT N0. BLOCK TpACT OR AODITION SEE ATTACHED DESCR. 6 1 SMEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PMONE Jan Redman _ 3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO Renewal b Ander 4 ARCHITECT OR DESIGNER MAIL ADDRESS IIP PNONE LICENSE NO 5 ENGINEER MAIL AODRESS 21P PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW ❑ AODITION M$ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re lace 8 windows in home 9 CHANGE OP USE FROM TO STIPULATIONS � Provide smoke detectors in all sleeping rooms and on all levels of the house. �sod ol aauMO�woH ol peileW e8 IIlM � spae� uol�aedsu� �lwaed SEPARA7E PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCr �OAD VENTILATING Op AIR CONDITIONING ?MIS PERMIT BECOMES NULI ANO VOIO IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED V�!ITHIN 80 DAY9, OR IF CONSTpUCT10N OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOO OF 120 DAYS AT ANY TIME Af7ER WOiiK IS COMMENCED. NO. OWLG. UNITS OffSTREET PARKING I HEREBY CERTIFY TNAT I MAVE READ AND �XAMINEO THIS APPLICATION STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PqOVISIONS OF LAWS VA�UATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPL�ED WITH WHETMER SPECIFIED MEREIN OFi NOT. THE GRANTING OF A PEfiMIT %%J2 3 H DOES N07 PRESUME TO GIVE AUTNOFiITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON- STqUCTION OR 7ME PERFORMANCE OF CONSTRUCTION 153 PLAN CNECK FEE TOTAI FEE Lic nse SC 5. 0 169.91 $�GNATUAE OF CON'AACTOA OA AUTMOA�IEO 4GENT IDATEi WMEN PROPE VALIpATED THIS IS Y UR PERMiT p� — '�V c� � � C- I S�GNniUAE O� OwqEQ�� OwtiEp BW�DER� �DATE� B OG �h5� ' qatE Prepai� Plan Check $ Estimated Cost $ Receipt # Effective 1/1/99 CITY OF FRIDLEY R-3, COMN�RCIAL & INDUSTRI�iL BUII,DING PERMTf APPLICATION �\ �'� a�o`� Const�uction P�dress 5 «O-r, s . N . � . �ing . � � r�� Owner & Address �c,.h � ��ed.m�,r� Tel# (o I � • 5�1 • SSS$ c�NTRACIC�R & P.�DDRESS R�.�i,.x�9 bu 'I�rnS.RxS.Q n� .�`SU- 73 � I�c�.� .'N • f.�Y � O� I �i Tel# Ca (a •�• y i i% Architect Reg. # EClc�i n�r Rey. # BUII..DING CONSTRUCTION �' �� TYPE OF WORK [l New `[] _ Additi� � Alteration -Describe �j I D� W ic��l�� '. .._ � ,.,_-- - %n,,. C::•�,. . �� __... (1 I► \_ ,,. .., .,- - —� . OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Tanc�ri-h Width Height Sq. Ft. C1Ii�R �: LiPYl�l Width i%i.ght Sq. Ft . �/y? APPLICANT�CXJ�l� � Tel #(��a-�y•a85�/ Date (9 • o�� • �� va�.uA�oN sq. r't. x$ cost/sq. ri. _�Taluation S ) sq. F't. x$ cC�st/sq. Ft. = vatuation $ ) Sq. Ft. x$ Oost/Sq. Ft. = Valt�ation $ ) _ $ o� TO2AL VP,IlITE � � �� Building Use Construction T�pe Occu�ancy �_ Air Conditi�+' �[] Yes [] No Fire Protection Provided [] Yes ❑ 1� Perfa�nce Bon,c1 �mount $' See Reverse for Schedule Receiv+ed [] Yes' [] No Pezmit Fee $ f � �. ��. L Plan Check $ , Fire 55urchaYge $ _� v % state su.rcha�e $ SAC �5e $ � - C�� Erosion Contiinl $ Park Fee $ S�C . ASSGSS[i�'11t8 $ Driveuray Escrow $ Z10►!'AL $ � , s ��7/�� o,� �� o� �� 6�� See Fee Sched�Lle on Revers� Side Irt Excess of Prepai.d Amo�t - See Reverse Side .001 x Pexmit Valuation (1-/lOth s) $.50/$1,000 Valuation (See Sched,. for > $1 Mi.11ion) $1050 per SAC Unit (Plans to NdniCC for deteYmi.nation} $450.00 Consezvation Plan Review F2e DEte1�iL7S12d By Et1� nc�ari n� A�nt Necessary ❑ Not Necessazy.L] feet x $13.50/foot � �LG �� -�� 5�� ULATIONS � �. C� (,� �,�� ,/��,�� '�a`I $1 to 500 501 to 2,000 2,001 to 25,000 25,001 to 50,004 50,001 to 100,000 10(?,QO1 to 500,000 500,001 to 1,000,�0 1,000,001 and up $1 to 2,OQ0 2,001 to 25,000 25,Q01 to SO,Q00 50,001 to 1Q0,000 1�,001 to 356,000 Over $356,� BUII.DING PERMIT FEE SCHEDULE ,� . . .� $21 (Minimum Fee is $21 plus surcharge) $21 for lst $500 plus $2.75 for each addn'1 $100 or fracrion, to and including $2,000 $62.25 for lst $2,000 plus $12.50 for each addn'1 $1,000 or fraction, to and including $25,000 $349.75 for lst $25,000 plus $9.00 for each addn'1 $1,000 or fraction, to and including $50,000 $574.75 for lst $SO,Ot}0 plus $6.25 for each addn'1 $1,000 or fraction, to and including $100,000 $887.25 for lst $1�,000 plus $5.00 for each add.n'1 $1,000 or fraction, to and including $500,000 $2887.25 for the lst $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to and including $1,000,000 $5012.25 for the lst $1,0(}0,000 plus $2.75 for each addn'1 $1,000 or fraction PREPAID PLAN C�EEC� FEE SCHEDULE $29.25 $29.25 for lst $2,0(� plus $5.85 for each addn'1$1,000 or fracrion, to and including $25,Q00 $163 . 80 for 1 st $25, 000 plus $4.225 for each addn' 1$1, 000 or fraction, to and including $50,000 $269. 43 for 1 st $50, 000 plus $2. 925 for each addn' 1$1, Q00 or fraction, to and including $100,000 $415. 68 for 1 st $100,000 plus $2.275 for each addn' 1$1, 000 or fraction, to and including $356,000 $1,000 (Balance due with issuance of building permit) PERFORMANCE BOND POLICIES When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, water & sanitary sewer servir.es, and storm dra.inage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3% of the building permit value up to a 2 million dollar project or a$60,0� bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects with no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. Reproducible "as-built" drawings of all exterior underground utilities must be submitted to the City Engineering Dept before the project is considered complete and the bond released. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released i�n. October of that year if all improvements are satisfactorily completed. ci � � z Z --I Z O z W n � � v m � � � c � O � � � � m m ! � D v v < o��o O � �o � � o�i � o � ? \ ��-°w N � � C � � N O N -^ v �� o m= -, 'v —+ v � �u p � � O z v� W Gi Gi �� C�� W N� N �� y N c��c c��u m 3 9 ci i�°' i •� .� -� � o 0 .n v � -, -, -, c� � .� -n D � � � N N � � � � W � ._ _+ (D .+, r► N -� � p� � � fp fD � � � � � z' � �' cNp � N � � m D � O. � fD � N � 'C -� � � � � � � � � T � .. � � � . . ., .� m � z 0 I I I�I ( I( I(( I I � � � � � � � � � � � � ,� v, o 0 0 � o V V.i � cn c. v °o °o °o °o °o °o °o °o °o o° °o °o o° � � � C Z � m W v Z � � n 0 � ��l � � � m 3 °: B. � .�r �Q '� m � � W c a � � C N � � � a a � I� � 2• c�D a DA � � � O � O ; � � � � ` � � rS► N � � � 5� �D cQ o'�m`' R � O � � � Z � � O � �Z � ' w L � � N f!� � ' ° o F v►' � a e �' � , Z � - , m , a � . �' n�i . � � m � � a nai -- - -� w � . � � �. �g�� °« m � � � � , O�ro`�� C� � �. : � N i N i N lO '� r c � Z � � .. � m �° . �. z 0 �� u -� O D r r�, u � ' �� '�� i��':� _� i'� � �� I �� cn �l �� C; W � � � o��C .� � Z N � �� r N C rt m _ z� m� � c� � 0 � � d � N O O O COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When reulacing an existinst 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 O No O The vQnting:,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 existins� 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 ( ) No ( ) When installin�t a new ventins� 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 () No () A�pliance Tvae 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 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 ALTERATIONS• (Describe) , � , HEATING Cb: __ Signed By: Date : _ _ C[lYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 4, 2004 Ms. Jan Redman 6726 Jefferson St NE Fridley, MN 55432 Re: Final Inspection at 6726 Jefferson St NE, Fridley Contractor: Norblom Pluimbing Co Dear Ms. Redman: A plumbing permit was issued on August 15, 2003 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this pemut. As of this date the inspection has not been requested. � The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. 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 inspection, we will mark the pemut "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. Sincerely, DJ/mh Building Inspections 763-572-3604 nn��-r v C� SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENAri'I' CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No. Received By: (��6�� Da��:�_0�-.2D� YOURE-MALADDRESS �jSO1,��@Q QQJ.� C.C,[m.� � � �- . �v�_ . �� ❑ OWNER �CONTRpCTOR ADDRESS: � CITY STATE ZIP, PHONE:_�Q � O — S� I ° �S� NAME: STATE LICENSE # ADDRESS: FAMIL Renewal By Andersen 1920 County Road "C" West Roseville, MN 55113 License #20130983 O BASEMENT FINISH O ROOF v O DECK p SIDING NEW - I ❑ M,4tnn DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMFN'r OF SQUARES Rw .Fc PROPOSED SIZE: PROPOSED HEIGHT: u HVUSE ONLY ❑ HOUSE 8t GARAGE 0 ATTACHED GARAGE O DETACHED GARAGE r STATE ZIP. 0 DRAIN TILE ❑ OTHER WIDTH HEIGHT BASE FNT Fru�ppE �. ct rgM T• l. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft SIDING O Virryl �� FOR NEW CONSTRUCTION INCLUDING DECKS, O AIUrtuI1W17 t4DDIT10NS_ �?�R!"[.icc cr to�err. 0 Trim 0 Other i. Site Plen/Survey showin� the existing strucdue ❑ Fascia �d P�Po�d P%l� ��WS 2. Two sets of construction plans [N EXISTING OPEMNGS �Yes ONo LOt;ATION OF WINDOWS 3. Energy Caiculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES A1tE B,�,,SED ON VALUATION, INCLUDIIVG THE COST OF LABpR AND MATERIALS: (USING THF�199�J.B.0 FEE SCHEDULE) Tn�rsr �nov.r.,.......�.a l.. /, r, Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due $ i 39. as $ $ , $ 3.6 $ S, U(� $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.SO $S.QO (State License,ci Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+( ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks p� able to: City of Fridlev ,stt�.• 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 'v conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not ; permit but only an application r a permit d wark is not to start without a permit; that the work will be in accordance with the approves plan in the case of all work w' requires ev' w and approval of plans. SIGNATURE OF APPLICAM PRINT NAME�Q�<<y e v�Gn r� (Q�i�-/J V CJ � DATE �0 6 �y°' Building Inspections 763-572-3604 763-502-4977 FAX DATE SITE ADD S _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 2-19-09 YOUR E-MAIL ADDRESS [e � �'��se.+ S � • ❑ OWNER �CONTRACTOR _ _ _ _ — - -- -- _ - �wnxESS: �e'7.? Le .?G�i'�Fer ssn .S i�. crrY PHONE: %�I,� • ,S �II � SSS �� COMPANY CONTACT; Hame . -� Permit No. Received By: �lJ1�C1 Dat��dS � � 2 8 2�� ii zrn�r�/3� UYi� � ��vv�� .'�"_ _ STATE LICENSE #��80 20�� 2pep EXP DATE ADDRESS: 2700 N. FalWlew AY8• CITY STATE ZIP � ' PHONE 651 /833-2881 FAX PERMIT TYPE �SINGLE FAMILY ❑ TWO FAM[LY TYPE OF WORK: �W 0 REPLACEMENT DETAILED DESCRIPTION OF WORK �+ � TOWNHOUSE ❑ ALTERATION/REMODE�, ►a s�': ��e A�a c e �.,.scr f' ,'ir'��ACI� B�4SED �N $10.� PER FIX'1Y7RE, EXG�PT l�V�iE1�E NQT'EII:'FDfTIJRES: (INDIF:A1'E�iTAL' NUMBER'bFi�l�'��'�.13� °" . ; 1'R4YID��EAT WS$ CALC'S PE1tMANUAL 2006 ASI�2AE-Hi�11FDBOOK. ` - : �;.:;:.- . :,_, _.. _ .: _ . -. . _, _ Equiprt►ent L�stalled. MFG: �. n IO MODEL: ��[ SIZE/BTU � MFG: MODEL: MFG: MODEL: _A/C $25.00 ,�FIREPLACE (GAS) $15.00 __AIItTUAIREXCHANGEER $15 _FIItEPLACE (WOOD) $35.00 BOII.IIt $35.00 FiJKNACE $35.00 CHIMNEY LINER $]0.00 GAS DRYER $10.00 _DUCT WORK $10.00 �GAS PIPING $10.00 SIZF/BTU SIZFJBTU _GAS RANGE/OVEN $tU.� NEW GAS GRi1,L $1{#.UQ � : - : : GAS UN1T HTR $lO.QQ :_ _ P�L }i�EATER $35.Q0 ' _ - VENTILATOR $15.00 - ` : THIS IS AN APPLICATION FOR A PERNIIT-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 conforn�ance 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 k which •equires review and approval of plans. SIGNATURE OF APPLICANT PRRVT NAME /` z✓� n//'�S WC DATE � aJ�' O �� ,... . APPROVAL WSPECTORS SIGNATURE /'S'CV( /1 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 � FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC . a � � � I*TEW HOMES/ADDITIONS D��XIS'FING•I��M�„ . D MAKE-UP AIR .ra;f ,ti�.�;,i .�, . s . . tiy„i��ff i5 ��, ,, . ,.�; REOUIRED FOR NEW/EXISTING HOMES ��d��- r'o.- .v'; . 6y:i�+a'tif.�, :! ��l ledv,"° :�;'b'°..Ni�o��{1e'�.�:.'.. 1. Combustion Air (See note below) b�� j'��' ��' a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Cha.pter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting • � . ° _' _ , ,.a. . Gas a�pliances IFGC, Cha.pter,5 with MN, At�.en�dments.. . _. b, Fuel other than gas I1VIC Cha.pter 8 with MN Amendmerits 4. Hea.t loss & cooling load per room a. MN Rule 1322, Sec. N1104:4.13 5. Ventilation a. Per MN Rule Cha.pter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energ,y Mechanical Code Guidelines software may be used for combustion and make-up air calculations.