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AF - 47926`� � �. � City of Fridley, Mirm.. � BUILDING PERMIT Date: _.� December 2�W I969 ____,� y�� 9c� N° 10518 OWl12T: M; ka [] � R�nnnn „�,,,......_..._..� BUIlCi@T _._...�0�'i.C].8L..,F.Z86�G3��--.._-. ..._. W (o �. �Fy C�� ,y� Address ._� tx.eet...N...E..._...___�._ Address .`•814--Sau•tl�--$�tk--�tx�t._._.. 2nd lot south of 1448 Rice �OCATI N OF BUILDING Creek Road (Pa,,f�( �t��,� �q.,�j� No. •-----._._.......___�.__ treet __.._._._.___..._....-�. �L._�--------..._........_.._.._.___ Part of Lot Lot •--.�._,5_.___._....__ Block _......_.�.....___..._._._.._.._..._ Addition or Sub-Division ....PS4�.�.e� H-.�.� N;1 1y Aad� �ion Corner Lcrt _.__....__..._...._ Inside Lot .--.._.--.._.._..�..._.._ Setback _._..__._..._...._.__.__ Sideyard ___ Sewer Elevati� ._._..._._.__._._.._____.___.,._....__..r.._.._.._.____ Foundation IIevation _..._.... DESCRIPTION OF BUILDING To be Used as: I�ot�.11�',rg.._...,......--•__ Front ...53.�._..._.. Depth 28 �&2L+ � Height .._2II'_..._.. Sq. F'L �.�! Cu. FL �.�.�Q � ....._____....___......._.......__ Front _�__._..._ Depth _� Height ._..__..._..__ Sq. Ft _ Cu. F� �pe of Construction ___.._Frame..___...._.....___ Est. Cost $25; 000_.. ._...._.... _ To be Completed ._._Ma_..Y__l� 1969 Provide hardsurfaced driveway. See November 3, 1969 City Council Minutes: "The City Engineex said that he.is conforming with his plat and told Mr. 0'Bannon that he could get one permit to start if he wished under the Ordinance. NOTE: A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding�with the framing. 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 fortt� and in compli�n� wlth all pravisions of ordinances of the city of FrfdleY• �vl � .e� rr7 �l �. S In co�sfideration of the payment of a fee of a�1. 00 __��t is hereby granted to Commercial. Erectors _ to construct the building or addition as described above. Thiape rmit is grauted upo� the express condition that the person to whom it is granted and his agenta, employees and workmen, in all arork done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances afi Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of build;n�s within the dty limits and this permit may be revoked at ar�y time upon� violation of any�of the provlsians of sa�d NOTICE: ihis p�emit dws not wwr tla eonsteueHon, im�all�Na� fer whiny. Pwa�6�Y. Yas h�aNno, s�w�r a� wat�r. N sun to a� 1h� BuiWiag in�p�efor for np�raN p�emks fer f6�a i1Nns. e .. � APPLICATION FOR BUILDING PF�MIT CITY OF FRIDLEY, MINNESOTA OWN�i 'S NAME � �� /Y BUILDF�i�'%J�/�ru��'`� ��1G�� ADDRESS �� %1L�'4' �2�i�� ADDRESS �"�� i� LOCATION OF BUILDING . �Y 7` � NO . STREET ��/L?-y _ .�'��.c..c�, LOT �J BLOCK � ADDITION OR SIIHDIVISION ��dGb'4%�� CORNER LOT � ZNSIDE LOT SEI'BACK �� f SIDEYARD J�`�� SEWII3 ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificatee of Survey of Lot and propoaed buildiz�g location drawn on these Certificatea. DESCRIPTION OF BIIILDING To Be IIeed Ae: �� J w Front �,� Depth �v � ' Height �� fiquare feet �,3 �� Cubic Feet v�� Front Depth Height Sque,xe feet Cubic Feet n �i � � Type of Conetruction To Be C timated Cost Z � �� The underaigned hereby make�l application for a permit for the work herein apecified, agreeing to do all work in etrict accordance with the City of Fridley Ordinances and rulinga of the Department of Buildinga, and hereby declares tha,t all the facts and representations stated in thie application are true and correct. /) DATE � � J/ (Schedule of Fee Coets can be fourid on the Reverse Side.) NOTE: A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before pxoceeding with the framing. J� �,� ....� �-i �°��. " f�� , r�, �, R • � � • - • / / i� J BUILDING PERMIT FEE SCHIDIILE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any axisting structure or building�, or for any alteration or repairs to any exiating building or structure, upo.n application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the ma:zner herein provided to-wit: Uniform Building Code: Type 1, 2, & 4-�1.75 for each one thousand cubic feet, or fraction thereof, i.n such cubical cx�ntents. Type 3& 5- $1.50 for each one thousand cubic feet. For the purpose of computitzg fees for building permits, the cubical contex�ta of any 'building �ag�addition to a uniform heig�rt �thraughout �by ' multiplyi.ng the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average height.of the upper aurface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing atructure, the fee shall be at the rate of �3.00 per each five hundred dollaxs (�500.00) or fraction thereof in the cost of all proposed work. In no case ahall the fee charged for any permit as set forth in Section 2 be leas than $5.00. NSSSD Co.nnection Charg�ea based on location - Area 1 or 2. i ,,.:. � � 1 � +� +�� J � �.�� hy� ; ..,.�.� a � a J�'1` � • . . � � � CITY of FRIDLEY , 6431 Uaiversaty Ave. N. E., Mfaneapolis 21, Miaa. PHONE: SUaset 4-T4TO STOP WORK REMARKS: S 7�p �,,/ d�-� v�7�"' � �/ .,t � / �i � � D }� � v lt � -t- f/ . / ADDRESS a i INSPECTOR DATE 1 Z .T � . F / �, a�d�%y (`� SCHAFER'S SPECIALTIES MPLS. . . � � � N° j� 9007 � Buililing Job Report ADDRE55 ' r,.� % ; , � '� ,� � � . .- ' j / \ _' c> C :' h�C . i .i OWNER �� i� � -T '.- BUILDER DATE TYPE PERMIT NO. DESCRIPTION INSPECTION RECORD DATE REPORT t COMPLETED & APPROVED `,� DATE �,��r..� �� Permit for UMBING AND GAS FI ING N.B. When work covered by thia permit is ready, the Plumbing Ordinance requirea that request for inspection ahall be phoned in to the plumbing Inspector, 560-3450 giving number of thia permit., Storie8 B89emeIIL �St 2nd 3rd 4th Number, Sind and Location of Fixtures Q y y = W WATER HTR. N t J < W Z Z < I ~ W � Z Z I 3 I x I I � O Z F m m Y � a Z� o O< � w Z rc � m d m Z -� � 6� < K � O I J C G G 6 O < LL << GAS I ELEC. 3 U � m t m Vl 3 F � LL N LL O U m K J f W U' < G � � Connected with Sewer-Cesspool Gas Piping for Openings Permission is hereby granted � to do the plumbing arid d gas fitting in the building described in the statement hereto attacked, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of �id building shall conform in all respects to ordiruances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of tice provisions of said ordinances. By Order Of Tlze Inspector Of Buikiings Roughing in Inspection Date rnspector. Finallnspection Date N° 5U83 �-�� IPennit Fee � �S • SO City of Fridley F�gQ�-�-� �-� � , ls �Q. �ZUIICJ' /�/� 1C �. _ �`1S1 J4 Yl� A.� 0 N �� X��Y ��N� Location /'� `�� 1C� �� . Ra l-�.C� Kind of Building_ F��m � Used as U uI t`- L-L-Y1J C� To be Completed �t,� nJ �! , 19,�� Estimated Cost $ /IoC�U. vo O -New. Building Permit Date �nspector. Inspector of Buildings. +: iM��s.v 1 �; � (C � �� ' � O• � O O � � � w � 'a � m � m L � f�i � � � N � _ �� = V � O Y � • � � 0 V C � :� a � _ � = a � a o0 •1 L C a a+ a �� N . O = y L } � � � C ~ � � � � � � W � O � � V • � � � 3 $ � d V 0 � o� ti O , ` � � � � O � U � � � � � .� � � a w � � O S �C � ._ , �, , � •� � .�° � � � a d � � � 0 I � d � U d .o � .� � I � � r� t .� a � � �. � .t � � a' U � U � a � � � �o � � ti � o — 0 �' � � � � � � ` o� O q \ ,,, � � s � � � � a ti 0 � � � � � � � � O a � w �� otiw .��'�r. � �y o � �- ,p w� ,� o � � � T'� � � � y N '� �� C� 'ti ti �� a o �� 'a� O� � O � � � � c�i O � � '.� � R, �, ,� tl •.a � �� °' o ,� � e � a"�'~ � ��w �� c� � o�i '� v� a �, I��' � � � ;� � .s� w � .N � ��o�i 'ti ,� � � o � � � �� .� .� o • �� a . ,� s ,� � o��f ., � � 'd � ` .�, � � � �, � ..� .N � '� � 'N � � � Q � ^ :� o "., ��o o�� , ��s � �, � K°o� o��d� . �.0 .R' ,"C., •,� �� "�0 � �d�� o� �°�'� o� �� O'� �' � � .., � o� ?,•.' � � � �� v R�� .,,o .�� a� w ;��,•N �D �� a, �'� "" O w��,�, � o�� . � '� � � O 0 w d � H � � N a Application �or Power Plants and Heating. Cooling, YeM�ilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . . . . . . $10.00 $ Replacement of Furnace ............................. 6.00 � Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 6.00 $ Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 3.00 $ MECH. WARM AIR �O pO Furnace Sheli & Duct Work to 120,000 BT(T . . . . . . . . . . . . $10.00 $ each add. 60,000 BTIJ .. ........... ..... .. .. . 3.00 � Replacement oP Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 . . . . . . . . . .. . . . . . . 6.00 $ Repairs & Alterations each add. $500.00 . . .. . . . . . . .. .. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR, Steam .... .$10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 3.00 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 3.00 $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER. (up to 199,000 BTU) . . . . . . . . . . � O ............. . b.00 $� over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ....... x$ 2A0 $ � Additional Fixtures . ............... x .?b $ Gas Range to 199,000 . . . . . . . . , x$ b.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL /�/'� �- ` / � See Fee Schadule TOTAL FEE �� Dept. of Bldgs. Phone 560-3450 fi �+ -,' �� City of Fridley: ` The undersigned hereby makes application for a permit for the work hereir. specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. FY�idley, Minn � � � ( , 19�� Owner %��L��l�L_ � ��✓ _ Kind of Building ��1-��'� Used as - _-� w To be completed about Estimated Cost, $ ��' � Oid—New. Building Permit No. Permit No. ry�d �"J DESCRIPTION OF WORK HEATING or POWER PI.ANTS--Steam, Hot Water, Warm Air—No. Trade 1�ame ��' Size No./�� r� °'1� Capacity Sq. Ft. E.D.R. BTU H.P, Total Connected Load 7� �� Kind of Fuel � Tl6(.<� BURNEA — Trade Nam Size No. ��6 -��' � Capacity Sq. Ft. E.D.R BTCT H,p. (REMARKS-OVER) ��E SignecL� ` �%��G��yc:_ By n�� .1F �-=l' %/'.�1-�-c. % Business Phone No- < � � �� y� Original • � PERMfT for Power fants and Heat�ng, Cool- in.g. Ventilation. Re�igeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of � Neu¢cting Plants to insta lterec�--repaired Make , Size �' / ; Oil fired__; Coai fered ; Gas fired �; Gus Authorization No. Remarks _ � � >�l.�t.��t' '1� �%j,,(, �.�� £� I1,c.l.C.IJ �.(1 �-`� � - - (� Ct,� �C,Uir2 oJ�r � Approved Final Inspection Date , 19_ Inspector �3 `�s � P�t N° 4805 Fee � �'7. o p - Of�ice of the Inspector of Bvildings City of Fridley City of Fridley, Minn. o�� , 19� Owner �%�.c.�Z_eJ � ' � rt �--� Location �e�Z �-i�l � /� .� � .�1�v:..Q a Kind of Building ��'Y�Q � How Occupied � Work to be Comrnenced ,19_ To be Completed ,19_ Estimated Cost, $ �-+�•QC� Old ew Building Permit No. Permission is hereby granied to to install—erect—use the material and devices described in the above statement. This permit is grant� upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under tkis permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the ofj`ice of the Inspector of Buildings. , � �d ,( ��li►'11 �vt �'Q,(�(,� , Inspector of Buildings 4: sM � �-a� v ru �� ., �, a ri r- tc� C'�J � � � � cv � �� i_u � a � � 0 :r H ca � N � m m �. i r� N I � a Cii'`l CJF FRi�}1.EY II+FSPECTiON DIV. 643 � ilniv�rsity Ave !�� Fredle}�, MN 55432 572-36pq ��a_,., rE �t,'� i��t� � ,�P�'L�CATJOM FOR POWER P[.,Al�ITS AN€J HEATING, �{}OI.�NG, VENTiLA�'fON, fi�FRtGERAi14N ANa A�R CUNDiTIQN�NG SYS7'EIrAS AN� UEVICES R�sidentiai F�rnace Sheli and Dt�ct Wr�tk, 8urner — A1so �eplacsment Furrtace �Ssde Vent -- Fill put Back} Gas Piping �Needsd with new iurnace} Gas Range �as Oryer *Air Gontiitianmg — A11 Sfzes All 4thers,fRepatrs & Alterations (LlS7 ON BACK} 1°!a ofValue afAppliance flrlNark Commercial/i�dustrial 1259� o# Valus of Appliart�ce or Work Rate 70TAL $ 30.00 $ --------- � �o.oa $ $ �4.t}0 $ $ 70A0 $ $ 25.D4 � � �O St�xe�Surcharge iOTAL FEE E(iective On Marc� i, 19��i ,�os pon�ES;�_�,i��1�-` �c c,� c,,��. T�e u�dersig�4d hereby makes application for a permit ior the wark t�er��n specifiec( agreE�ing ta do aiE work in �frict accordance L�ri#� the City Godes ar rulEngs of ihe Eual�ling pivision, and h�reby deciares thai a!1 the facts and re�reseniations sYated in this ap�lication are true and correct, ��_� 19 �wNER�� ae c q� �C �7 Y� 9 y b°I BU�LDtT�iG ViE�D AS_ ��u@.��1C. ESTIt,AATE� Ct�ST _ i �C.�� • � � PERMfT NO. � � �" �� D�SCFtlPTION QF FURNACE AND OR BisRNER $ Na. of Neating llnits Circle �r�e ;�t�3arna (Not ��+a.er� (V�tarr�; ,�� ; Trad�r Name� Size No. B�V H�' EDR � Fuel '�otat Connected �cad � .5(1 BurnQr Trade Name Size �la, �.�., ,,,.,� B�U _ HP EDR �- , MIN1MUiVi FEE �(?� ANY }.��ATINGjC(}OLIPIGNENTII.AT!{�N RE�R�GERATION�AiR C��IDITIqI�� p�p�T IS 2'�,tm PI..US THE S.SU STATE SURCHAHGE RE�NSPE�TION FEE $42,qpfti� ."Arc Concl�icuters can not be �laced in a side yard witl�out written permtsslon from adjoining prc�perky owner. HEAI"ING C�I++�PAhlY � � CG � Si� `' e1 Na.� g�� t` �P+'�Qd �Y � Rotagh—In Date Final Date " Flll OUT E3ACK SID� F{}H STACK VERIFICATiON OiV REPL{tCEAqENT FURNqC,E �a� SIZ� � f� a r CITY OF FRIDLEY INSPECTION DIV. 6431 Universiry Ave NE Fridley, MIV 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MAf�K NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR $�th ;: Wash Dtin:k Floor G�tcF� ;:; Auto. Urinal Tuk� :.;: Shower Sin'k ! Trav Fou`nt <i Drain !:Bas�n : Washer NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water 7reating Appliance Water Heater -Electric Wffier Heater - Gas** _� Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 __ $15.00 Reinspection Fee $42.o0/Hr ALL OTHERS ANO/OR REPAIRS AND ALTERATIONS 1.5X of Value of Fixture or Appliance State Surcharge .50 JOB ADDRESS Efiedive On January 1, 1999 Gas MiSC ! Water Heater Range Fixt ': Gas Elec �� wy� � Ownr� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. `�Z 3 ,1999 Owner WALLERSTEI�IE, GARY 6244 KERRY LANE FRIDLEY, MN !i5432 Building Used As (612) 574-9409 Estimated Cost �l� � PERMIT NO. � �� PLllMSING COMPANY I� o rb�� `� �`��`'�� SIGNED BY TEL N0. 8�7- �� 33 ��°£ ' �� Approved By Rough-In Date Final Date _/� IS TOTAL FEE $20.50 **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SG� INCHES. l - _ C[1YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 October 9, 2000 Gary Wallersteine 6244 Kerry Lane NE Fridley, MN 55432 Re: Final Inspection at 6244 Kerry Lane NE Contractor: Norblom Piumbing Dear Mr. Wallersteine: A plumbing permit was issued on April 1, 1999, for the above noted address, to install a gas water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on th�s installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVEJENSEN Building Inspector Building Inspections 763-572-3604 763-502-4977 FAX DATE .7/yV� �� SITE ADDRESS _ THIS APPLICANT IS: �ROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMIT TYPE ❑ OWNER BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 n��:�� ADDRESS: PHONE �� YOUR E-MAIL ADDRESS �CONTRACTOR Permit No Received By: Date Rec'd: ATE ZIP c-M S�3I STATE/ � ZIP �.-/ . STATE LICENSE # ZQ'J�I'f � EXP DATE R�SINGLE FAMILY/NEW CONSTRUCTION O TWO FAMILY/NEW CONSTRUCTION ❑ BASEMENT FINISH �ROOF ❑ DECK ❑ SIDING ❑ SWIMM SIZE L L7:r`•1 STORIES TXPE OF WORK: I❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIIt `� REMODELING DESCRIBE WORK BEING DqONE: � .tGC F� TM+}'J I I S�1i SIZE OF IMPROVEMENT (il gitl�/�C LENGTH WIDTH �QU�ING '�1-IOUSE ONLY NUMBER OF SQUARES �� ❑ HOUSE & GARAGE GARAGES PROPOSED SIZE: PROPOSED HEIGHT: �� ❑ Vinyl ❑ Aluminum ❑ Other I�ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS IN EXISTING OPENRVGS OYes �No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST O� (U,�G �HE 1997 UBC FEE SCHEDULE) Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge ❑ DRAIN TILE ❑ OTI-IER HEIGHT F"I' BASEMENT REMODELING SUBMIT: 1. Exisung Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBM[T: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of conshvction plans 3. Energy Calculations AND MATERIALS: '�U a�" !`7 OCCUPANCY � TYPE S 1� $ � . See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ � .a- " .0005 x Permit Valuation Minimum $.50 $ �. O� $5.00 (State Licensed Residential Contractors) $ $1825 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 navable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclamwledge that the infortnation above is complete and accurate; that the work will be in conformance with ihe ordinances and codes of the City of Fridley and with the Minnesota Constructi � that I un this is not a permit but only an application for a pernut and work is not to start without a permit on site; that the work will be in accordance � u of all work which requires review and a proval of plans. SIGNAT O. CANT PRINT NAME,��P_wL�� DATE Z$ APPROVED BY l iS�J� ii�iV �..I/ � DA' Building Inspections 763-572-3604 763-502-4977 FAX DATE � � � � - � � SITE ADDRESS � �.� THIS APPLICANT IS: MECHANICAL Permit No.: RESIDENTIAL APPLICATION Received By: ��_ r 6 ��.� CITY OF FRIDLEY �� i �(li� EFFECTIVE 2-19-09 -' � �� YOU E-MAIL ADDRESS �' �l' �...1 ��t'1 � � i� ❑ OWNER PROPERTY I•tAME: T-� � -�� OWNER/ pDDRESS: �7 c� `-i"`-! � �Y �' �-{ � CITY TENANT n c� PHONE: ��03' S��^'-t�� 1 STATE�ZIP�u 3a CONTRACTOR __ coMpa.NYNa,ME:-----CENTERPOINT-ENERGY--- -__._ __- ---_______------ ---------------. .__ SUBMIT A COPY OF corrTACT PERSON: JOANN ZINKEN YOUR STATE STATE LICENSE # BOND 220133 6 EXP DATE � LICENSE WITH ADD�ss:9320 EVERGREEN BLVD NW SUITE B ciTYC00N RAPIDS sTaTE MN ZIP55433 APPLICATION pHONE 763-757-6202 FAX 763-757-6��1 PERMIT TYPE TYPE OF WORK: �.SINGLE FAMILY � TWO FAMILY ❑ NEW �-REPLACEMENT ❑ TOWNHOUSE ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �1-v�S�cJ�I� �p Lp,� � �c�.,r��. Q� c� �,i � �A�c� � � �� _ _ . FEES ARE BASED ON $]0.00 PER FIXTURE, XCF��E�; WHERE NOTED. EIXTURES: ([ND[CATE TOTAL NUMBER OF E BELOW) Equipment Installed MFG: (� �� MODEL: S�i CYiUC O(�� S1Z TU D MFG: �� MODEL: a� �P \�� SIZEBTU a-�1'1 ��o �C $25.00 _AIR TO AIR EXCHANGEER $15 BOILER $35.00 CHIMNEY LINER $10.00 DUCT WORK $10.00 MFG: MODEL: FIREPLACE (GAS) $15.00 FIREPLACE (WOOD) $35.00 �if�RNACE $35.00 GAS DRYER $10.00 GAS PIPING SI0.00 SIZE/B'I'U _GAS RANGE/OVEN SI0.00 NEW GAS GRILL 510.00 GAS UN[T HTR S 10.00 POOL HEATER $35.00 VENTILATOR S 15.00 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case all work which r uire review and approval of plans. SIGNATURE OF APPLICANT �,��' �� PRINT NAME ROGER HOFFHEIN DATE '7 ' 1`f -�� 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 ❑ NEW HOMES/ADDITIONS �EXISTING HOME 0 MAKE-UP AIR REOUIRED FOR NEW/EXISTING HOMES l. Combustion Air (See note below) 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 Chapter 5 with MN Amendments 3. V enting a. Gas appliances IFGC 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. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building PI,jJM $�NG Pernut No.: ' � �� Inspections RESIDENTIAL APPLICATION Rece�ved B�' �-�' 763-572-3604 CITY OF FRIDLEY �at��ec�� 763-502-4977 FAX EFFECTIVE 7-1-2010 „A.,� 09/13/10 Y�uk�..,�„�,,,,,,�r,ss wnelson@larsonplumbing.com siTe,�nDxESS 6244 Kerry Lane NE_____ ___ _ - _....._. IHIS APPI.ICAhT IS: ❑ OWNF..R �C'nNTRACTOR PROPERTY�n�:........._Rita.. Jo...e....rger ........................................................................ owr�� _ ......... .......... __.._.........._....__..... .._......... TENANT AnnxFSS: 6244 Kerry Lane NE cr� Fridiey sTn� MNb.rr55432 PxorrE: %6-574-9409 CONTRACTOR ,,,�;: Larson Plumbing Inc. SUBMIT A COPY OF YOURSTA'TE STATELICENSEN EXE'DATE I.,ICF.,NSF, BOND AND STATE BOND l� EXP DATE CERTIFICATE OF �D,�ss: 3095 162nd Lane NW CITY Andover srA� MN ztP 55304 n�rsuxa.rrcE Pxor� 763-427-7684 F.� 763-427-9448 PERMIT TYPE Q SINGLE FAI��IILY O TWO FAMII,Y ❑ TOWNHOUSE TYPE OF WORK: � �N' ��-�cEMENT DETAILED DESCRIPTION OF WORK Water Heater Re�lacement FEES ARE BASED OV 510.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BEIAW). MINL�t[Jhi FEE $35.50. BATH Sltv'K�7.AV FI,OOR DRAINS SHOW'F,R WATF.R PIPING SA'PHTUB ' GAS PIPIN(i (NEED C[TY L1C) SW]MI�31N(i I'OOL W.Al'EK SOF7'NER (535) CLOTHES WASHER � KITCHEN SIhI{ VVATER CLOSET BACKFLOW PREV. ($IS) DISHWASHER LAUNDRY TRAY �I WATER HEATER ($35) FOR [RRIGATION UVATF,R MF.T6R OTf�R :ii''r�qiiY�34�.1iT�8'....,� �"�:tit'l.�TlFf'i:' iii[iii �:;<`i�ii+D�ia:li;�'o: Ei� � i;:;i«iiiiiiiiiiiiiiiiiiiiiliiiil;i:ii<iii:: `.:<::::::iiiiiii:iii:iiiii ��i:[<::<i[<':i� i'«ii �i�;:i;ii`;iii53'i!:!!'i;i'E:iEi'iEii:i'iEii:i'iiiiiii:irii'iiiiii:iiiiiiiiii:iii;`i;>%`i`EE;;;iii'iEii;is;'::i';`iiiiiiiiiil;i;;iEi;:i(E"'s'Y2i`:;[E;[[;Eiiii:iiiiEi'iE;iEEiEEiEEiiiii'EiE ;::.:::::' :":. �`Eii�t�A' D�. .:.. � .. ...:::.:.:..::. ...,,,.:,,,. , :.:. ..: . :;::>:.;::>:>::>::>:::::>::>::::<;::::<::;::::. ..: �f :::::2:>C:.�:�33�i1l�i;:::�:::::;�;;Q�:�:I:SL��:��:::::::::::�i::::::X::'��:�:5s��::;�:� ��::::::::�::5::::�:�:�:�::`:::::::':::::::::< :::::::::::::�::`:::i:<::�:::::::::�::::t:;;:;.:::;:::;;:;.:::;::;?::::::::;i:;:::;<::;�::�:::::i::::::::::::t::>::::::::::'::::::`:::::::::::::::::::::€:::::::'::::::::::::::�::::::::::::::::'::':�:'::�:::�::;::::::;::::::'::::::'s:'>;�::::::i:::::'::: ;: L'�11�'Ii�3C3'331....... �S`'!r.:�9... �.-f.t-u.... ..',��.:.::.:::�... � .:.: .�: .;.. .:::..�.�:::::::i�::::i:%r :::.::.....::.::.::.::.::.::.>:.::.::.::.:.:.:..: . ...�:::.s:� �..�...�� :: . . . ..::.: ��:;�:� . . : . :.::....�.�. : �i'�i� Q� �i�,r�s �; S�5 �,:,� x �� S� � ��,� , >:.: : ...:. ;: ; < .::>::::> :::::: ::::::: : �t��e ��Ia�i�� ;> . : �:.,,::,.;,,,;��: > . .. . : >: ;. :.::..::.:::.::.... , :..:. .. '.<::;<:::::.<:::;::;>;::<:::::;: ,; >::::<:::::::::. : ;:>:. �N��1�� t#ik"` S�sta1=;� ,..:>,:,.,::.:: ;.; ;;.. THIS IS AN APPLICATION FOR A PERM[T-NOT VAL.ID iTNTIL PROC,'ESSED I hereby apply for a plwubing pennit and I acknowledge that the inforn�ation above is complete and accurate; that the work v��ll be in conformance with the ordinances and codes of the City of Pridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f'or ermit and ork is not to start without a permit on site; that the work will be in accordance with the approved pl e case 'c equires review and appr v f 1 SIGNATCTREOFAPPLIC PRINTNAME �c%�ae�'�Ulaloniski Dq']'g 09/13/10 APPROVAI, INSPECTORS SIG � JRF. t�; ?:Ei;:i;:i7iiii2°:�:y. ��.�:.�,.,.., .:>�: ,y:: � .. :::..: ...7:..�...;..ik;i!i; �..y; � . � . � . � : :::;A.,�:::,:.:.:::�.:..y.:,��p.,. ��,:�. �..,:,: :,,.,; .:..:,,.::..,..:,.. �.,.. �: � :,:..:..: . :::::....;.. � .::;.. �:}..r�F. ��. �T.:�r�:. � . �,;�'E. � 7. � .;�. � . � .:: �� .: p�.t:�::.��-!.�:;��.r7:.:;;>��:r��:.,�7 .{�'.�:>�7:�..>��v � . � .:::: � ..>.;�.. �.:�.:?. �a/.:�>�;�,�..�> _YN'�.CY�. .. .:�:i.�.7.��'��Jii��J.�.t.i�::: �J.Y��;i'k�:�it�:lA�RAi.a��l:�f...'... . .. :.; . .." A:%Jt7i..ta��Jk"si.i�AJk�1:A�h'1l:F��i'li7Al�AYkRV��✓�k'7ti:'siii;....". % :i;.:3:'<`.'i.7 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977