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AF - 33387C� • City of Fridley, Mi.nn. BUILDING PERMIT Date: March_ 5 � 1968 �� 962� �/�� Owner: Dalber.g....�u�...l.s��.._..__._..._......_..___.______.._ Builder ....._...._Sa.me..._.......-.----......_---.__...._.--.--. 1121 80th Ave N. E. Same Addre�ss _..__......._••---._......._.__..__._..._._.........._..._.__.........----......_..._----....-•----- Address _...-----_..._..__....._...........__..._.._..._......._......._.._..._._._._.__..______._ LOCATION O� BUILDING No. .------1601._.._..... Street ._.._.._Ononda�a_...._............__....._..._.__..--�---•--•---...-•-•-•----_..... Part of Lot ....._..........----..�.._._.__.__.._......._...._.._.�. Lot •---•--1-�..-----..._.......... Block ....._-••_-1----....._ .............---•-----...... Addition or Sub-Division ....._........_.I?�.l..kl.��g....T�x��.__..._.._....__.�._._ , � � � Corner Lot ----�---_X....._.._.._ Inside Lot ....--••--�----•� ....................�--- Setback -�-----•---�35.------�---------- Sideyard .._..._.._..�..Q.__...&__.�Q..._....._.�_..—.. Sewer Elevatian ....._......__889 . 75.----. _. _. -- -• -. --.-.-------$.� 2_..7..5-----.._..._._..._._._..._ .. . .. .. ... ....._...--��-------�-�--._ Top of Footing DESCRIPTION OF BUILDlNG To be Used as: _House..._.._._ ............._...__ Front �:0_�._......__ Depth _.-•-..24.�_. Height _...._..�.Q.�_. Sq. F� ___.�.�.Q_ Cu. FL _...1�.i2D0 ._Gara�e......_........---- ...__ Front .. �� .-•--- Depth _.___�?.�_.. Height ..._1 � �...._.. Sq. Ft. _.._..440 Cu. F'� _..��k.S?.Q Type of Construction _----F r ame-----_•-•--•-•....._.___.. Est. Cost .......� 14,x 5 00......--.---_........ To be Completed _..._...6 j.�[ 6$ SEWER LOCATION - 63' West of Ma�hole WATER 8��i[,,OCATION - 73' West of Manhole In consideration oP the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in co,�pIiance with alI provisions of ordinances of the city of FridleY• / a /1 // l il �.�_ /n $100.00��wer Connection In consideration of the payment of a fee of $.....__....�....QQ._.., pexznit is hereby granted .... to construct the building or addition as described above. This permit is granted upon ...._._,........_...._._.._...-•--•-•----_._.__. _- - the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances e� Fridley, Minnesota regarding location, construction, alteration, maintenance, re d moving of buil g within the city limits and this permit may be revoked at � time upon vi�� n`of any / ths provisions ofdsalid ordinances. // Gast 0 Official BuiIding � • NOTICE: This p�rmit doss not eowr th� eonsfweNon, inshllation for wiein�, plumbing, oas h�atin�, qw�� or waNr. d� wn to tN fRa euiidiag fnsp�etor fo� s�pani� p�rmNs for th� N�ms. . . AFPI.ICATIOid FOR HUZI.DING PERMIT CITY OF FRIDLEY, MINNESUTA __ � � OWNER'S NAME � _ �-�� B'_7�:I;DER � . r -e 1�� . . ??� ADDRES$ _ � _._.�_._ �_ .... _....�DDRESS�� --�e�^--p�� LOCATION OF �iT�LDIy.'�G � po.�� . , LQT�� BLQCR,w�: ADDLTION OR St38DIVISION -e�, CORt7�R LOT_�_IIvSIDE L ��S::�'BACK �.-� , SIDEYARD_______a"�� . � : SEWER ELEVATION . "� .r5 � � '7`� TOP OF FOOTING �C� �I�. • �I S `' -�c-�s-E-� `� A-c.rA.�c.e-» — � 3 ' �,_;� -sz.L � f�� -�z-o�-s�-�--�� Applicant attach to this.form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. �Z�� .. (�5 �-Z`.-d� - ��3`' Y.r%-a.� e� 7it�-�fz�.�: '� _ DESC&IPTION OP' BUILDING To Be Used As: . � . �,� �,o Front �d____,_: Depth :� fleight��, --- � ., Square feet � (P � �ubic Feet�` • � •'I / 4 Ca� `� �� Front �� -:Depth .�� , . .Heigtit�� Squa feet,l�� CubiC Feet ° _�?� � Type � of .Coa�truction = Estimated Cost �,'�'��d To Be Completed _ `� /� -.-.-._-1_.�1�-- � The undersigned he` by makes applicatioa for a permit for the work hereia specified, agreeing to do all work in strict accordance with the Citq of Fridley Ordinances aad ruliags of the Department of Buildings, and hereby � declares thaC aIl the facts and representatioas stated in this application are true and correct. � DATE _ � _�� SiGNATURE�,.�� _ � _ (Schedule of Fee Costs can be found rnn the Reverse Side). �� , � �� ': ��» �, �. � �., ,�„� ' � � ��A�� I�� . `3� ��,�.,.u�.. �.., ,_ �k � � � ,,.= ��.,,,t ��.�• � ��.�.�� .,. �� ' ' � �U��;i?�1�G PEit�'!Y1' FEE.. �CIiEDUf,E SECTION 2. The Inspector of BuiZdfngs shall, before issuing permits for the erection of �ny building or structure, o� for any addition to any existing structure or building, or for any air�•�ation or repairs to any existing building or structure, upon applicatiou therefare, require the the payuient by the applicant for such permit of fees to the amount herein below set forth and in the manner herin provided to-wit: Uniform Buildin� Code: Type I, 2, fx 4- $1.75 for each one thousand cubic feet, or fractioA thereof, in sueh cubical contents. Type 3� S- $1.50 for esch one thousand cubic feet. For the purp,ose of enmputing fees for building permits, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered fram a point six (b) inches beZaw the f2oa� line of the basement or the cellar to the average height of the upper surface or t� the average height of the roof surface of the main gable of a pitched roof. _ FAr repairs or alterations �o an existi�g structure, tha fee shall be at the rate of $3.00 per each five hundred dollars ($500.OQ) or fraction thareof in the cost e�f all proposed work. In no case shall the fee charged for any permit as set fa�h in Section 2 be leas than $5.00. NSSSD Connection Charges based on locatia�n- Area 1 or 2. • ` ` � * �, . . _ i � . �.,, 3 � Lond Pla�ni�� [.xk1 Sce�'vr°`/n'y Sor/s T�sirnq C lvt l fr AluRh7�0/ f �JJ�Ik'P^rrR� J �� t��'` Z�L�i'Z 6875 H�ir� *CS ME. ,�l�s 37, ENGINEERING, INC. ��°'° SLhxt 4-0066 Frl yii�eers � Sur vec�ors �ce�tsr,�sc�te of su,�ve ��: T �_. ,_ , F�` ��.. � � C � � t�J � � � W � � � , � � � M � � r.r-- _-- - °� o - — — � �- �....� %, �� to ; o a : � a �l �� , o �.�� ,. � � , �SZ � ��S t � �� _7S . � be r ui Ede rs � n�. NOR"TN � � � � �o � � �,�► �,\ i ��6 � ,� � �Q 1 � -�� ,�..��c��..�� ,.�.. �. � o ,Deno�es Iro� ' Pe — � — .��no�es U�/ �r � Ilrr�inape �osarr�err�' LOT ia �L OCk' t__ DA L f3�RC,� TEQ�7/� CE .� No,ct A C o tJN T Y � l littntby cerf��'y thot lhrs �s a frue n�� arizcf �t� tsentot� � �f' 'a >cr-rty �'fl� bevrwb�aes �l '�1 r a�bvir aEsuyb�d ;a�d, aad n�F � Iocv�ivir q/ aN b�ldrnqs , NitrEOn , sx all ►rcr6/e a,�:roahirrcnts ,, t',�x� , �4arn a- r�.tad fav�d. As wrKC�d � n� !ri'S - d�/ �' - Oc fo�s r' _ � A t7 f9 �3 SUBuRBAN fNG/NEFRJNG, INC. J�G 4'!e / " �iD � rL�us��`�.� ' ti., _ � . _ f � .....�4'rt�. . �� C v QC �� m .� � � _ � ar � � �� 0 � _ �a � F V } � � H � � � �C _ } Cy a� '� �% e` ' Q L 3 � i � 0 •� � 0. 4 � ,., ► ti � M O [) � � a '�' G4 w 0 a A J � W U N W 4 � J � � a � � y � � � �w .� d � � Y o�.�� 3�� U y y Q) N W Y H �+ .}' i"+ •�-� U �3a� � U � � � y w�� o � � � �c°�°q U V � � �+�'�u a N �o ;� �a � .:, a ; '" � � ��o� �w A � � � d � '� �R3 � N tV y � y ��A h aa�o a�i d ��w ,�� hUO� � �� c. o Ew�a�i Nti � U ,� (� � CO �V � H ��. � o 0 o g �o cd cd m � . . 6 : : o 0 0 0 : o � � � � 'C3 `� � co � 3 � � ; � � M a� � � o A �, ;; m � � W i�+ � o � ,, 4 � � Q d � � � 3 � � � � E'�' � a a a ��aaa a � � � 'r � � � N � o �n � G � o � 5 �� $o 0 0 0 0000 o c+i cc co co � � : .' : o O . . C O � : o � � � � ,0 �y ; � fti �° r-� �o �� 6 v � � � o `� a �� " � � � � o � '� � a`°i °' �f �3 3 � � � � � c° . ar�a U � � � � � � 0 U v � H � � 0 z ; .� � �.r � V z ) � L+ a � � � � �� O U d d m E � w o ��.� 0 0 0 0 ooao o�mM � � � � � w � � O H � � y N I � � 3 � E+ °7 x� �, M V o � w � F a� � � 3 dy V] ►�"i x x w w w w c'r � � � 0 0 N M � � w w � 3 0 � w U � a a ` x � 3, b z � �' �' I O � � � z � � � � � o � {�r � � � x .�+� A W� F � z �. � � � � � Y � y u � � � Z Z y U � � � x H U Ey � S � � a � U � y w v � � � � � o� �o ti � a, � � �� M � M � °' w ° z a � CO a O � � � � a � � H F � F � � � 8 a�S�$ � �; � � k k K z � � � � I I I d : .0 U . : N . � w : : � � GQ � �� g y � � x � ,o o� V� s�. f� � �w � � ww x � o a ot9 � ° `�° ra z M � � � � a F � � � � w � � tFrl- � Q �'�°F� 0 � 0 cs ac � z 4 m � � m � �(,Y7 c`�a Q' - w - r - Z - � z �_- � r" ' o � � °`' a v, a � � a� � \ �� m � F � � � � w d � .��. a� a C9 H W W H a N z��' oc�caz w F H O � � � � U E, W a w > a x � a v z u. > 0 1 N Y t W � ti'16 ....:� �... : 4 2 HEAT LOSS CALCULATIONS DEPARTMENT Weatherstrips A.S.H.V.E. Construction 1 Guide Windows I Doors Reference Out. Wall lnt. Wall Ceiling Yes—No Yes—No 19_ ! Fl.� Room �[.ength Width � Height �' Windows and Doors—Crackage and Area �Vldth Helght No. o[ Llneal tt. Area No. ot pane o[ pane lighte � ot crack sq. ft. �" �' I[� � �' m Coef. Btu lnfiltration �' � Glaas ��— Exp. wall Net exp. wall Z � lnt. wall Ceiling / � / � � � Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F7. ' � Room ( Length � p Width J 2 Height Windows and Doors—Crackage and Area Wfd h Height No. o[ Lineal it. Area No. of pane ot pane 1lshte of Crack sa. tt. b �O � . � 3 2 >5,3 i i Coef. Btu In6ltration �,� � � j� Glasa , L Exp. wall Net exp. wall 1 � Int. wall Ceiling U l U v� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room ( Length � Width D Height Windows and Doora—Crackage and Area I Wldth Helght No. o[ Lineai ft. Area No. of pans of eane llehu et cra�� ... �e Infiltration � Glaaa . Exp. wall Net eap. wall Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area �� /D Btu � �5 </ J / 1 . i OF BUILDINGS �l7? � FRIDI.EY, MINII�. �o. Insulation Roof Floor Kind How Applied FI.� m Length Width Heighc Windows and oors—Crackage aad Area Wldth Helght No. ot Llnea! ft. Ar�s �, / No. of pane ot pane Ilghts ot crscic sq. tt. y" i _ Coef. Btu In6ltration � 3 Glaaa . �j ?i F.�cp. wall Nec e:p. wall — Int. wall Ceiling � Floor Total Btu. Z� Required aq. ft. E.D.R. or aq. ina. W.A. I.eackr arca F7.1 Room � Length a—Width // Height Windows and Doora—Crackage and Area Wldth Height No. o! Llaeal tt. Arms No. o[ Dane of yane il[6b ot crack p. tG 2 i , / ll f' . f. Infiltration � G ' ofjj L',�n Glaaa Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required aq. k. E.D.R. or aq. ina. W.A. L.eader aret �.� ` t�� p� w� Windowa and Doorr—Crackage aad Area Width Hei�ht No. of Linsal [t. Ares No ot D�ne ot pan� li�ht� o[ crack p, tt �2 � ��' . � Inhltration Glaaa _� � � F.�cp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. W. ft. E.D.R. or sq. ina. WA. L.eader area 3 �-lS �� 8f �ef. Btu � !,S"ZZ i �� '� � � � �� L:i � � d. a `; C a � �� w 0 W � � � � Q � � � LL � O C � U � C 0 � � o. � � M Q M � � .M aC u+ O o � o O� xa F � a Fr ,d � � W Q M A � � z � � 0 � U .�� w �' a� � '� � �� 3 � �a °' � c�o "U� u H � t/� H w y N O a� � �0 U �� U ,L3 � �b � �� a �� i o�roo ��C� � � N ','p '•^� �sq�� x ti � N ��o� �� 0 '�i � a �,a .� o � y � N �o°0d o 'N '� y :� � 'd �c o � � � � � � � � � ��v a�� . o �g � O � 0 � � � W � � � i W �" O B° w a ; < �� r z .� S9NIN3d0 ! � �� 3JNYL �w �� 6 'lddV �ly sv� w � aaHSVnn � olnv swsve U H71V7 SNIV2l4 aooie 'S11MHS •iNno� •�Niaa � ��,,,,,, SAVMl „� � .� .� HSVM I i �' � S71N�5 O sr,�stie a b Sen1 � � H1VY ` � U X rnNian s�so-r� � �" aaivM � � sauo3S � .d .� t� i� CQ •-N� N M 'W • 'x' \ � � � � Q I z ��+ Y QI � a '� � a � N � a� � U b `� � � d v �� H w O w J 0 W U � W Q � J 1=�—/ Lr a �� M �`�� J �, � �1 z � � � 1 y � � � PO pa � � � 1 \ x � a° z �. � � � O � � O � F� �r F.�j � Ty tf} ER e!} v} d� V} y V1 Vi a 8°� � 8� 8� 8� 8 a � � � � � �, � � � � � SC 5C Sa iC ia M ia �e iC z° °z : � : : . . O � � � � : ep o o : : on � � a1 : : pq A � H ��g °�r �g O a � O �v � � � : � �i � 0 � x k ., GWG k d as'i '�s m W a�i '�'s, ° ��' k � � y � � � ,� � �i k � � F 3 w k � a� � � d �, � � (7 � � f�, � � � Y � ,� � 3 o z "' � �, z z t� z U 3 z� H� d c7 a1 �' D � � f � � : � : � . � b � ci : M • w : a � 0 4 � W q E ° a � � a u � � O�C p 4 � sue�ecr PERMIT NO. City of Fridley 603 AT THE TOP OF THE TWINS g U I L D I N G P E R M{ T • ! � ECEIPT NO. � ` _��_ COMMUi�IITY DEVELOPMENT DIV. r � L �' PROTECTIVE INSPECTION SEC. /' � � / � � /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY � �"—'�'� ,'� 612-560-3450 910-F15 6 21 74 � � JOB ADDRESS 1601 Onondaga Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDiTION SEE ATTACHED DESCR. ].O 1 Dalberg Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Locker 1601 Onondaga Street N.E. 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MA1L ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEEFi MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK C� NEW ❑ ADDITION �J ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK RP�11lOC1Hl old garage into living area and construct a new 24' x 24' Garag 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. SEPERAT� PER,�IITS �.REQk�1REt? FOR YViRING, HEATlNG. Pl.UM6tNG •AND St�NS. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 I HAVE READ AND EXAMINED THIS APP�ICATION ]. STALLS GARAGES AND KNOW THE SAME 70 BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S 4�052 Z.OZ DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $1%.00 PLAN CHECKFEE TOTALFEE �e��G��'��`� 1 �$�X�Ig $17 � OZ SiG UREOFCON'RACTORORAUTHORITEDAGENT (DnTEI WHEN PROPERLY VALIDATED THIS IS YOU.R PERMI -��' A/l .�� co 02/ % SIGNATUFEOFOWNERUFOWNERBUILDERI IDATEI �"��- BLDG INSP � DAT APpLICt�1'ION FOR RESIDENTIAL, ALTERATION, � OR AllDITION BUILDING PER�4IT CITY OF FRIDLEY, �1INNESOTA OWNER' S N1�ME : (O Q r� �O C fCf° V BUILDER: ADDRE5S : J�b1 0. ��,q(a,� S#_ ADDRESS : NO:. ��Ot STREET: Oltos•.�QE .S�', LOT• I� BLOCK: ADDITTON : .� a.l <<ry CORNER LOT: x IN5IDE LOT: SETBACK: SzDEYARD: .. Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. + DESCRIPTION OF BUILDING To Be Used As : � f�0 �! � (� �J/C�'ic�lo E.� //c/'� � i �'r/�/lo �i�� ✓C.C'II�G��. OL� Front: Depth: Height: Square Feet: Cubic Feet: _.� i ' Front • �� Depth • ,�Q � Height : L �;;�,) ! } � Square Feet; Cubic Feet: Type of Construction: Woo1 Fr-A.�.e �stima.ted Cost: $ 3�� • �� ' �,��a.�v To Be Completed: ��r,�, [ 9 �s The undersigned hereby makes applicatian fox a permit ior the work herein specified, agreeing to do all work in stTict accordance with the City of Fridley Ordinances and rulings of the Department o� Buildings, and hereby declares that all the facts and representations stated in this appla.cation are true and correct. DATE : C' ( / � / SIGNATURE : ��2��,. T _ (See Reverse Side For Additional Information.) . : ��' � ,�� ,��-� � �- � � . � �/ " ,�� . � � � , ��;�� BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or stxucture, or for any addition to any existing building or structure, or for any alteration o-r repaixs to any existing building or structure, upon application ther�fore,;r quire th�payment by the applicant for such permit of fees to the apro�,t;l�,e�e'�i� b�.�i t forth and in the manner herein provided to-wit: �; .., i�. �;,...t �T • ' .. n ''�j 1 � �i� l � UNIFORM BUILDING CODE: Type l, 2& 4-$2.15 for each one thousand cubic feet, or fxaction thereoE, in such �:.cub�b,,;�ontet�t's'.� Type 3& 5-�$l r�� for � each one thousand cubic �eet. ` `"�� -"""� r ; r. `,�'� , �; .: •.i ADDITIONAL Ii�FORTIATION �� For the purpose of computing fees for building permits, the cubical contents of anq building or additi.on, is determined by multiplying the ground area covered from a point six {6) inches below the f_loor line of the basement ox the cellar to the average heights of the upper surface or to the average.s• height of the roof surface of the main gable of a pitched roof. For repairs or alterati.ons to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed iaork. �n no case shall the fee char�ged fox any permit a�s set forth in Section 2 be less than $5.00. � ,� b '�" ;�, VERIFICATION OF FOUNllATION , , � v. - ,; � � > �R�, < < �� c_ NOTE: Permits for construction will be issued a minimum of�24 hours from the time of application, to allow for proper review of the proposed stxuctuxe and of the construction site. � • A Certified Survey of the lot, showing the location af the foundation, on.ce it has been constructed, will be required before proceeding `aith the framing. CERTIFICATE OF OCCUPANCY � Application for a Certi�icate of Occupancy shall be ma,de ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occup3.ed until a Certi.ficate • of Occupancy has been issued. ♦ ., r 1 � . . • I, '��`'^ �O►" �`� � , ownex of tlie property l.ocat�ed at �b ll f'�. e� a�ala rt l�v��d l�e� have no ob jection to the CitS- r ' ". allotai.nb the construction of a �Q._t`Q�_°� to be located at� _T �60� owa�..��as'f. _ without� the requixed cer.tiiicatc vs - , su'r.`ve1� L-hat the Cit:y o�-dinarily requires for a11 ncw construction. � S ignect ��' l.l �aar�ss � �2/�-��/ Date � � � '�c"LG' � 1� �>._�zT' _ � � � itness �. , � � . , ' ' • . � Ys . . . . . , ' . . . . ti..':i'� sue�ecr P �• c�cy of Fridley 2�. O 6 6 AT THE TOP OF THE TWINS g U I L D i N G P E R M 1 T ! i � RECEIPT NO. � � � • COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. � , � _." , r , -; � � /"'1 � CITY HALL FRIOLEY 55I32 NUMBEF REV. DA7E PAGE OF APPROVED 8V �'""'�"� ,�� 612-571-3450 910•F15 9/17/91 / / JOB ADDRESS 1601 Qf}��gStreet NE t LEGAL LOT NO. BIOCK TRACT OR ADDITION SEE ATTACHED DESCR. l� Dalb.erg Terrace sHeer 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Robert Locker 1601 Onondaga 5treet NE 786-5415 3 CONTRACTOR MAIL ADORESS ZIP PHONE UCENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 C�ASS OF WORK ❑ NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 32' x 12� Garage Addi:tion 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surfa,ce driveway. DRIVE4JAY CURB. CUT ESCROW: 16� + 6� = 22� x$13,50 =$297.00 WARNING BQfa"re digging call for Ep��TE PERM�TS REQUtRED FpR ail utitity rocations �RI{�iG, HFqTING, PLUMBING AND S� �4-0002 �NS. REQUIRED BY LaW TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTR�CAL, PWMBING, HEATING, . VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES .NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION - OR WORK IS SUSPENDED•OR ABANDONED FOFi A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ^ NO. DWLG. UNITS . OFFSTREET PARKING I HEFEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPUCATION 1- STALIS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS OF LAWS VALUAT�ON SURTAX AND ORDINANCES GOVERN�NG THIS TYPE OF WORK WILL BE COMPLIED $�j, 944 �32 $2 •97 WITH WHETHER SPECIFIEO HEREIN Ofl NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pEqM1T FEE SAC CHARGE PROVISIONS OF ANY O7HER STATE OR LOCAL LAW REGULATING coN- Fi re SC STRUCTION OR THE PERFQRMANCE OF CONSTRUCTION. �S .94 PLAN CHECK FEE TOTAL FEE $89.91 -� DW SIGNATURE OF CONTRACTOA OA AU�HORIZED AGENT �DATEi WHEN PROPERLY VA�� .ATED THIS IS YOUR PERMIT a� . , � ' � r� ,./�,,�,� � - � _.�-C�``� '� - - SiGNATURE OF OWNER OWNER BUI��OERI �DATEI BLDG �NSP FTE � [ I ADCN (� �� ( ] R-1 l�it�ID I�2 Building Permit Applicatian ��a6.�.1Qi lWlCS.7: /� 4' lrs Li. L��h (L,Q�f�t° � • �` • �'j3i �1�1d1: � E�-1l ,r r° � EffeCtfv�e 1,/1,/91 owr�er xam�e � Aaares,s: �.��r-J� � ,�c��r ��c�h�-Y.�a S'r.�-r�� Tel. # �'�'S `��y�J Oartracto�: S��l-� Z�el. # J��: . Pittadi to this applicatirn, a Oertificate of SuYVey of the lvt, with the p�cposed ' n dra�wn an it to scale. 1�-��•: ��M �_, •i- �,��/=r��+'sl I.IPII�IG !�: Ie�th Width Height � Sq. F't. � 11tt�: L�gth ��'-� Width i 2�+ He,ic�t e:S�f Sq. Ft. 3 F . T�CR !�: 7�gth Wi,c3tii,�,-. iigt/Gtvta�d Sq. Ft. O�R: `� X �,�' lr,s i:1� � �� ' � � I �F i. � �--- - Cbrner Lot � Inside Iot [] Ft. Yd Setback :� � Side Yazd Setbacks �O-F � Z�pe of Dasnstructiori: �� F�timated Qost: $" �, -��! �—r " Approx. �leticn Date: .�� !� � �— "L''L.- Pz�q�osed D�iveway Width If New Openirg Is Desirad: � L Ft. $�°��`� $ idth + 6' See Back Page II�Z�: �' - �1� - �l / APPI�CANr: Z�el . # %�` S�4'ls — P�rmit Fee $ (4 C� Fire Suzr2zazge $ State S�rci�arge $ 5AC Q�arqe $ D�riveway Esczvw 5 '�j-�, vd Park Fee $ Sewer' Main Q�arge $ � $ 3�� w4� � _�_ . ii F�ee Sciye3ule an Iaevexse Side .00l x Petmit valuatian (1/loth $) $.50/$1,000 Valuatian $650 per SAC Unit Xlt. "A" G�r Alt. "8" Above Fb2 D�E�l.fled by F.r�i e�r.+,�ri r� ��YY[] ��Y[] sr�vrATTa�s: p ti�v �.� 0�v r..�.,.� �N �,, �f�,c,��.��: ��.�-� S�Q-F ►� � � �� y�� Qfi L �'�05 � y�,r�,, � � � _�1� �►�. � ; , .r�y� * .: _ •:i: � n �e �ief Building Official ehall, befcme issuing petmits for the eraction of any ,;�ding o� �, a� fo� any additian tc any euistin� bu�ildinq a� stn�e, ar for any alteratian aar repa,i.r to anY ��J ��3 ��, L� aPPlicatior► ti�erefoTe, require the PaI'm��t bY the a�pplicant far st� peYmit of feps to the a�oaunt 2�tein belcw set fa�t�i ani in the �ra�er henein p�uiided to-wit: 'IO►I�I+ VAIIJE $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 � � � a. S15 (Minim� F1ae is $15 Plus �a�qe) $15 fa� fitst $500 plus $2 fcar each additianal $100 or fractirn t2�ereof, to at�d including $2, 000 $45 fo� fiist $2,000 plus $9 fos each additianal $1,000 o� ftaCtian thereof, tD at�d inaludirr3 $25, 000 $252 fc� first $25,000 plus $6.50 far� eadl edditianal $1,000 C� f�a�ctiGCi thel^eof, to el�d it�ludii�q $50, 000 $414 . 50 fos first $50, 000 plus $4 . 50 for eac3� additioa�al $1, 000 0�' fractian thet�eof, to and includir�g $100, 000 $639. 50 foY' fi15t $100, 000 plus $3 . 50 for e3Ch additiocial $1,000 or fractian thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 far the first $500,000 plus $3 for each adciitional $1, 000 oor fractian thereof, to ar�d inCludiTg $1, 000, 000 $1,000,001 arid � $3539.50 for the fiist $1,000,000 plus $2 for each additional $1,000 a� fractian thereof �tIV�i7t �SIQ� �CSiOW (Oonc�te Wrb S'tre�ts Or�ly) Altarnate "A": Removal and replac� of a�b ani gutter anly - Driveway width plus 6 feet tim�s $13.50. Alt��nate "B" : Remov�al ar�d replaaanent of an� and gutter ani install a 3 foort wide approadi with 6 ir�di de�th -�iveway width plus 6 feet tizoes 515.75. • _,• .� .. . .�� . �� ,... . Permits for �ian will be isayad a mini.m�aa of 24 hairs fram the time of applicatioc: to allew far p�vper review of the p�v�oserl � arri of the oanstn�ctian site. A nertificate of S�uvey of the lart, shc�rirg the locatien of the fanxiatian ar�e it has it has been wi11 be re> > i red before p�oo�aedirg with the fYa�ing. sue�ecr N O. City of Fridley 25 �01 AT THE TOP OF THE TWINS g � I L D I N G P E R M i T r ; � RECEIP . � ; L _ COMMUNITV OEVELOPMENT DIV. f � � PHOTECTIVE INSPECTION SEC. ��3 / � � ( � ��\ � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE Of APPROVED B� �_.__1l: '.� 612-571-3450 970-Ft5 9/15/97 � � JOB ADDRESS LOT NO. BLOCK TRACT OR ADDITION t LEGAL SEE ATTACHEO DESCR. lO 1 DSZU2Yg T2TTSC2 SHEET 2 PROPER7Y OWNER MAIL ADDHESS ZIP PHONE Bob Locker 1601 Onondaga Street NE 786-5415 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Jayson Lindsay Roofing 2638 Clearview Ave, Mounds View MN 55112 20098263 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 792-1857 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW U ADDITION ❑ ALTERATION j�7 REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House (20 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPEOFCONST. OCCUPANCVGROUP OCCUPANCVIOAD SEPARATE PEfiMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS P�RMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS N07 COMMENCEO WtTHIN 60 OAYS, Ofi IF CONS7RUC710N 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 CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA��S GARAGES AND KNOW 7HE SAME 70 BE TflUE AND CORRECT. ALL PAOYISfONS OF LAWS VALUA710N SUR7AX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT �1,668 �.83 DOES NOT PRESUME TO GIVE AUT ITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISION OF ANY OTHER STA R LOCAL LAW REGULATING coN- �54.00 F� 2 SC � 1. E)% S CTION OR THE PERFORMA E F C NSTRUCTION. PLAN CHECK F T T L FEE 9-��-9% L' e SC $5 0 $61.50 � SiGNAtUAE O CON7RACT OR AUTHORIZED GE T ioniEi HE PtiO VALI D THIS IS R PERMI T— � / ✓ S�GNATUF7E OF pyyNEA ��F OwNER BUiLDER� IDATEI K �� OG �NSP ��4TE NE�'V [ j ADDN ( j ALTER ( ] ConstructionAddress: � Legal DescriPtion: �-p`T Owner Name & Address: Contractor: Address: n��,�� (� �., �. LNING AREA: GARAGE AREA: DECK AREA: OTHER: ' CITY OF FRIDLEY S[NGLE FAMILY AND DUPLE7�ES R-i AND R-2 BUILDING PERMIT APPLICi-1TION � P`.) 0,� G �31�cr� �� Qa1 Effecti��e 1/1/97 � 55�/ �/�3 / ?� ��i�A-C•2 Tel. # 7�� `��il � MN LiCENSE #�� 9 8� 6 3 �_Tel . # %`� � •/ � �' 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPR�JVEI��E\�'I' �'idth rieight VVidth Heiaht Width Hgt/Ground ��5� - /c�i 3q_ F�. Sq. Ft. Sq. Ft. Construction Type: � � d � ��C� ��' Estimated Cost: $ ��j� ( �, �,�°-� (Fee Schedule on Back) Driveway Ctirb C`ut Width Needed: Ft. + 6 Ft =�,, Ft x$ � _$ �ATE: � � _ Permit Fee Fire Surcharge State Surcharge SAC Charge Gicense Surcharge :)riveway Escrow :�rosion Control Yark Fee Sewer Main Charge rrorr� � s�r��ur_n�rto,��s_ Tel. # �Ia�'(8S% CITY USE ONLY $ J� � U Fee Schedule on Reverse Side �_ �% , (c % .001 of Petmit Valuation (i /lOth %) $_ � $.50/$1,000 Valuation $ $950 per SAC Unit $ S �C� $5_00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review � Fee Determined by EngineerinQ $ Agreement Necessary [ ) Not Necessary [ ] � � 1,.�� , � it�<<,u�,vc� ��;�t�irt' FEE SCHLllC'c.t�: '('lie Ctiief I3uilding Off�icial shall, bclore issuing pennits f�r tiie erc;ction oi� any building or structure, or iz�r any addition to any existing building or struciure; or for auy a(teration or repair to any existing buildin� or siruccure, upon application tl�erefore, 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-�vii: ' TOTAL VALUE $1 to $500 $�O1 to $2,000 ��,001 to �25,000 �25,001 to $50,000 �5�,0�1 to $100,000 $1 Q0, 001 to $500, 000 $SQO,QOI to $1,000,000 � FEES $21 (M'uiimum Fee is $21 plus surcharge) $2i for first $500 plus $2_75 for each additiona( $100 or fraction thereof, to and including $2,000 562.25 for first 52,000 plus $12.50 for each additional �i,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 $�0,000 �574.75 for first $SO,OOG plus �6.25 Cor each additionai �1,000 or fraction thereof,, to and including $100;000 .$887.25 for. fust $100,000 plus $5.00 for each addition�►1 $1,000 or fraction thereof,.to and including $500,000 - $2887.25 for -the fiist $500,000 pius . $4:25 for each .additioiral : : - � $i3OQ0 or fraction thereof, to and including $.1,000,000 ` :. -'. $1,000,001 and up $5012.25 for the first $1;000,000 plus $2_75 for eaeh additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCRO�'V (Concrete C�rb Streets Only) Alternate "A"�: Removai and replacement of curb and gutter only - Drivetvay width pius b feet times $13:50. .Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approacl� witti 6 inch depth - Driveway width plus 6 feet times $15:7�: VERIFICATION OF FOUNDATION I'ci�mits for construction will be issued a minimum of 24 hours from the tinic .of application to allow for pro��r r�e:��ie«� oi the pro�osed stiucture and of tlie construction site. �i �'�ertit�icate of Survev <�f tlic lot, si�c�win�, the location of�t}�c f�und<itio;l <�nce il }ias it has (�c�n ��nstt�uct��..' -. ,': i�:� i-�c�t�ir�:;�l 1��1��r-� ;�,-�,��_�•din�� tt�iti�� tl�c t�ra�nii��. � �� .- ��. o � � � Q, S o � �' � � < oa � o � � s rn o � � i m � � T � s o� � � K t o = n � �s < D � � O m � � O � QR 3 7 � � � �'I � � � v N � m z � � n � O z � m m � � 0 0 � _ 0 � � X � � � N j N �• � c ° � o � � m c �m o D O � o v' � � n � o � � o �° iU � � � O � � rt � � � � � � � m � v n�0i m � � v m � � 0 � v � � +�i; ., '� ��'i'. �� 9� 1 ° a�g� � rn � m � zz.i 1 sf ;<� .,� (D � � _ � � � = fl. fl. fD ( � � � � i � 'a � p. i < � � � � i �, �o �o v 3 cD < o��= N � p � m � v � a� — . p — i � <: o i ��.3 � � f �� i �� N - � � f � � � � ; � � � i � � � � � � � o i � � � �-�' ,'r* n n ; - ��,� � � � : � fA rf � Q. � ,.3.t � O ''* � � (D � � I I,n-r 3 � ! � � : p�j Q : � y y i 3 � o D a �� • o � � c < m m � � � m-n m -�Do " m ° v. ��'a � F� 3 (31 -�p O � � v D � o � � � � oa � � o m N.�� v Q o N �� r'• r�i� �' o o � � v � v 0 0 � 0 �t � 0 � a 0 � � Ori D v_� m � � v � v � � N N cn o °o °o � � � � � � � � � C � � C Q � m � _ � � � � °� v �- m o�a fD c z c � v �; � fi� � c � n a �. = o �n "O v = O o � fD � � � m " � � � v Q- 3 r c� ° _ N fl- �p O � � � O � � N O v � � � D � v v � N v � � � o' m�=� 1 � �� c �� .J v ,--�, rn <'�, � �: rn � �� f) �� ` � `�� 0 0 °o °o � � � -_I � � m v O � n� -n c � o � vi � � $: � � c� � � � � � � � — � .��. Q. -� v � � � � m� � 0 � W � 7 m R� � w � 0 0 � v� o C � Q � . fD � -� a� c m a a � � �. i � n N n � a -i m n _ m v r m Ro I°'r+ � -n �- C� W � W � m N � =` c n� 3 a, Q ` ca z � 'f1 o cn u�, '71 � � � � � N � 0 z I�r� m _� v � W w C in � r= �' v F� N Z � � Z "� rn � O Z a n � 7 n 7 � s � : C � � � O ( W C °v ` � C c"'n ' � s �� ..�. � G o � � s � L J � � C S � e � �� 7 D � � 7 r ) D � � �O � Z s � > � ► � 7 O a � �m � � � 7 7 � � � � Z �v �_ 7 � � �Z : � ri n a O 7 j r � Z �� n m � � � 0 Z ?� � o�a �l" � (D � fD \ \ N O O A FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR_AND COMBUSTION AIR VERIFICATION When replacina an existina furnace, 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 combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installinp 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 () 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. No ( ) Yes ( ) No ( ) Appliance Tvpe 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 Tdal 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 u � � ^ �°_ ai�ee �� a F��e �earm a � HEATING CO: �"�091 27pp N. Fairviaw Ave. � Signed By: Date : `�"'x�' """ �s"3 5/ CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 �63) 572-3604 FAX: (7631571-1287 ADDRESS : 1601 ONONDAGA ST NE PIN : 123024140038 LEGAL DESC : DALBERG TERRACE : LOT 10 BLOCK 1 � �.,�� PERMIT O1�I�.�. 2_004-01569 DATE ISSUED: 09/13/2004 ' PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AS PIPING FOR FIREPLACE. # A/C UNITS 0 VALUE OF APPL OR WORK 0 #FURNACES # GAS RANGES APPLICANT FIRESIDE HEARTH & HOME 2700 N FAIRVIEW AVE ROSEVILLE, MN 55113 OWNER LOCKER ROBERT G& SANDRA K 1601 ONONDAGA ST NE FRIDLEY, MN 55432 0 # GAS DRYERS 0 VALUE (FOR MINIMUM CALC) AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate ar cancel the provisions of other state or local law regulating construcf r the perf ance construction. Applicant Date_L Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 607811 SEPARATE PERMITS Ii�EQi�fRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 15.00 0.00 0.00 0.00 0.00 0.00 0.50 15.50 Building Inspections 763-572-3604 .^ MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY _ DATE �'— �y ` c C� YOUR E-MAIL ADDRESS SiTE ADDRESS O THIS APPLICANT IS: D O R 6d'�ONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERNIIT TYPE TYPE OF WORK: ADDRESS: 60 n� CITY Pxox�: i' � 3 - 7RG -- •s �is COMPANY NAME:_ CONTACTPERSON: .r.e Permit No.: �� ` �� Received By:�� Date Rec'd: AT BI1W ZI PSSy3Z. STATE LICENSE # EXP DATE ADDRESS:�i��%L CfS.�S�s�C,!'t� '�'['µ.1 /u� CITY r� STATL� ZI�S'�.� PHONE 7G� J�X-� /cu F�X �J� -7��! - yG9''/ [D3iFIGL£ FAMILY O TWO FAMILY ❑ 1•iEW B-R�PLACEMENT DETAILED DESCRIPTION OF WORK ❑ TOWNHOUSE ❑ ALTERATION/REMODEL Ca�G 4 � f�f /�' �f i_� � PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement o€ a�esidential fixture, excluding the fixtwes. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS W��RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIX'fURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� �r Equipmentlnstalled , MFG: r✓�' MODEi.�SS�AV�Y'�Lb'(5 SIZE/BTLI C NffG: MODEL:J��Y SIZEBTU � MFG: � MODEL: SIZE/BTU ✓A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN 510.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL a10.00 BOILER $35.00 �FURNACE $35.00 _GAS UM'f HTR S 10.00 �CMMNEY LINER $10.00 _GAS DRYER $10.00 _POOL IiEATER $35.00 �DUCT WORK S10.00 GAS PIPING $]0.00 VENTII,ATOR SIS 00 -- a,��r .� .�.+r. r.�t'rr+r�'�"crn �PermitFee,,_ti.',+it�,;iv.a.iv�.._v�_.�...i.....�±su..v . .�.:��_ ...... .-�.... _...,�..... ...,._.:- ....�_.._....__..... _ Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures $15.00 x $15.00 = $ Surcharge $ .50 �° TOTAL DUE $ Number of fixtures @$25.00 I X$25.00 =$ r? . � F Number of fixtures @ $35.00 � x $35.04 = $� State Surcharge = $ .50 Tota1= $ a -� � 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 hut only an application for a permit and work is not to start without a permit; that the work will be i�n accordance with the approved plan in the case of a work which requires review and approval of plans. SIGNATURE OF APPLICANT ��: �� PRINT NAME/1 tGi7Ai+ a/%J -1 t DATE� ��Y' �C� City of Fridley Suilding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ,.. REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDtTIONS �EXISTIMG HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXtSTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropanellFCrC Chapter 3 with MN Amendments � 2. Mak�up Air (See note below) a. ]MC Chapter 5 with MN Amendments 3. Venting 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. Venti.lation a. Per MI�I Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. 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