AF - 36430�
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City of Fridley, Minn.
BUILDING PERMIT
Date: _.._March 28, 1969 � _ _����
�j�� y���/
N° 10158
Owner: _._Rodney Billman Inc . Same
. Builder _..___..--- _..._.._.__..._....___._._....._..._..__._.._._....._—.
Address ....._.._1.5.1..•--$�..a..3L.er. Lake__Road___...._._..___...---_ Address _._Same
New Brighton, Minnesota Same
LOCATION OF BUILDING
No. _..._1521._....--- Street _._..._...._�erne Road____........._._._-----_....••--••--•--..._.._.... Part of Lot ._._.._._...r_._...__._.._..
1 _ Innsbruck�5th Addn.
Lot ••--._.....2�._...._._---_ Block _.._.._..--••--••-._. .__ _..._... ._. Addition or Sub-Divisian -----.._..•--_•.-_--__....___.__....__.�.�._
�
Corner Lot ._.__.....---•-•---.._.. Inside Lot ..---_.._X.----....._-----_.._ Setback ---.__3 �----••----_........._ Sideyard __._�........___�...._.....__.._..
9 87 . 74 ._...._...�.2D.._7_4__.�Ag�r..�.x.�._..
Sewer Elevatiam ._.._.._._.__..._...._._..._.__._.._._.._....___.----•--....-----..._._
Top of Footing
DESCRIPTION OF BUILDING
To be Used as: 702
Dwelling 55' 26.4' , 20' 1484 28,930
_.__......_...__._._____---.._.__ Front _.._..__._..._.. Depth _..._.__...._ Height .._.__..........._. Sq. F� ._.._.._._.., Cu. F't _..._
__�asage.._._...._.___.._..._.. Frottt2�.'___...._.. Depth 30 .4 �_.. Height ._.._....._�:.� � Sq. Ft. �,.696 ._ Cu. F'� _ 6960
Type of Construction _.._.._.._._Frame..._.___._--- Est. Cost __._.+.��37�_000.....__..---....._ To be Completed ___. _:
SEWER LOCATION - To wye 8.5� South of Manhole
Stubb�� location 10' ( along property line� West of water location.
WATER LOCATION stubbed to the property- a short distance west of hydrant.
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 f rth and in compliance with all provisions of
ordinances of the city of Fridley. �-/� �_ ,
L2-
1_00.00 SewerConnection
�e
--
In cansideration of the payment of a fee of �_..�__ 54 . 00 Rodney Billman, Inc .
, permit is hereby granted to.� —
...._...,.......__...._.._.._.__:._�_... to construct the building or addition as described above. This permit is granted upoa►
the exPress condition that the person to whom it is granted and his agents, employees and worlQnen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o�
Fridley, Minnesflta regarding location, construction, alteration, maintenance, repair and. mo�ving of bufldinSs
within the city ]imits and this permit xnay be revoked at any time upou violation o� of the provisiona of sa�d
ordinances.
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NOTICE:
ih& p�emir doa not �ov� fh� eonsfw�tia�, installdton fe� wieinti. Piumbino. Ou 6uftn�, awK er wat�r. d� wn fo sN
fh� Buildiag Intp�efor h� ap�rat� p�rmits fo� th�» Ihm:.
. , . > 4 �.
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AF'.P�,ICATIOI�i FOR. BUIL�INr PERMTT
U?TY 0� F'RIDI�EY� 9 MI�SOTA
t ��oti� e� �� �uz�;,:�� � �1,�� � !�l�'"���/
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ADDRE�S _ A��R�'SS�� � �� //%/�-�G�C2
/ �� � LC'";A'T�O� 0� �"JIZ,D ':: �,�� �j�� �-�-�.
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T��a o ��s�r�E�� �
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LOT -� o��BLOCK�� A.�DIT.IGI� OP6 SiJ��IVi�IC��T�i J.'I1'[5' /J >�c [,�.C- �
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i;�Er.�`�t I�C�I'
SE°�v� EL�`;°Ai IC?td
IT����I�E �.L�O'I' � SETBACK�_SI���ARD � �
T0� 0�' °'Ou i I?����
Ap�l���t�t az ��.c�h to this �o��r. '1':�,-c r''^��i.ii:�at�^ c�" Su.��re� oi T,ot anu
p_ro�o���'. bui? c�l�^g �.ocatio.�r� ��,Y.a�. or�. �ches•� !:�.Ltz�ic;�,t�:s �
F�ES'�R.��'"I':i�O.�T Cd BT.�TLa�7T1�?(:
'i o �� iT� �� A� : �.-�-t � `'� �L � % 7'
, ��`'` {� E.,✓ ;�," �F"ro�a.+ �T?ey�th _ Z��-r' H g t �' p�{
f,. ' � z� yc�y ..u--� .� � � !�
:..� �qua�^e �"eet 7O 2�"��ev��ubic�� ryt . . � / ',
, F�°o:nt � �.6.�Decs th� �����';_ Height� � U
Squa�e �'F��+� .°{'� - uubic �'��f, L.-.; � � �
Type oi �onstructio.n���.��'�z2-�._ Estla�ated �;o „ � d� �7
�
To Be Completed __� �
� -�� J � � � 'a �`x � ,�
Th� u.ndersigr�.e� hereb,y mak�� application io� a pe�°mzi io.r.^ the �ork
he� ei�. speci�°icd9 agreei�.g to �o all wurk in strict a�cordance �aith th�
�;it,y o�" Fridley Or�inar�c�s a,nd ru�ing� of" th� DGpartnent o F" B�aiZditzg� 9
and h���"by �e�la�es that alI th� :f�cts and rep�esertation.s t�,ted zn
�his ap�? i��.tzorE a,re true a. a�i �oarect o v� �� �_� ��,` /��-_ �---- ��
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DATE -- r�' -' � Si(�NATURE , ` �-�-' , /�
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(Sch�uule of° F'ee �osts car be iou:�d on the R e�°� " de�>
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BUI3�I?�� PEftM�T �'EE �CI�EDLTLE
SECTION 2o The In�p�ctor o.f �uilding� shall, beio:�e is�u�ng per�it�
for� the Esection oi° an,y building o:� struct�.:r�, or for any a�c�ition to any
existing �tructu�^e or buli�.ing9 or for any a.lte�atzon or repairs to any
existi.r.g bui�r�ing or s � ructure 9 upon appli�;�.t �on theref o�^��, �Pr�uirE the
payment b,y the applic�,.:at � o?^ �uch permit oi iee� to t��� amou�zt h�rea..�
below set forth an� in th� ma:�.ner he�ei.ri �Y�ovidcd to�wit:
Uniiorm Building Codeo Typ� 19 2, & 4�$1075 f'or each one trousa;ad
cubic ieet, ox� irac+ion thereof9 in �uch cubical c�ntent�a Type 3 8� 5-
$1050 for each one thouvanci �ubic ieeto
For the purpo�e o�' computi.ng iees ior buil�i.ng permits, the cubical
conte.nt� of any buil�ing or addition to a unifor•m height throughout by
multipl,yi:ng the ground area covered from a point six (6� inches below
+he iloor li.ne of the baseme.nt or the ceilax� to the ave��,ge height of
the upper �ur�iace or to the average height oi the �oof' •suria.ce of the
mai.n gable of a pitched roofe
For repairs or alteratio.r.s to a:n existing �tr�uctu�e, th� fee shall be
at the �ate of $3000 per eacr f�ive hundred �.ollars ($500000� or
iraction thereoi irz the �os� of all proposed worko
In no case sha11 the �ee cha�geel for any permit as set forth i�. Section
2 be les5 than $5000�
NSSSD Co.nnection Chas�ge� based on �ocation - Area 1 or 20
� . . . � �. . . .
. _. ,- �
� � NQ � 4899
��� Permdt far PLUMBING AND GAS FiTTING ��Cr���
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires tliat requeat for I Pe'-n°lt 3�� c�-n I
inspection ahall be phoned in to the plumbing Inapector, 560-3450 giving number of this permit., F� �
DESCRIPTION OF WORS
Number, Kind and Location of Fixtures ,
I{ N
a W 1 J
Stories 1 f N j Z I VI~l Z
4 ° � a � a
3 u I � m� m
Basement
lst
2nd
3rd
4th
� I I � I �
a p� I Y�{ w I tt
z 3
�
3� I o� m o
/
I
U m I 4�� i li I U' Q l9
Connected with Sewer-Cesspool Gas Piping for Openings
_ �.�-, . _
WATER HTR. CLEy Of FTLd�Cy � �/ � 19 r-�
GA3 ELEC.
�LU7EeT �=-2--c. 1- �� �ZY7/1�J
Loca tion C Sa � ,� �'at-�,� .
Permission is h.ereby granted �` �' to do the plumbing and
gas fitting in the building described in the statement ereto attache upon the express condition that
the person to whom this permit is granted, and his agents, empioyees and workmen, in tjee plumbing
or gas �itting of said building shall conform in all respects to ordinances of the City of Fridtey, and
this permit may be reaoked at any time upon the violation of any of the proaisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection
Inspector.
Finallnspection Date
7nspector.
<z IM-6•65-V
�
Kind of Building
Used as
To be Completed S , 19�
Estimated Cost $
Old-New. Building Permit No. �aT �� g
Date
Inspector of Buildings.
Ciiy of Fridley J -;��
APp[ic.alion �or and Gas P�nnit �
�9 �g . �
Dept. of Btd�. Phone 560-3950
DESCRiPTION OF WORR /°(�
Numb�r. Kind aad Locatfoa of Fixfuns Loea� z%� � ��, � � �l`�-C'Tr-�'�
� ,� ��l71 w�rea �R. City of FY'id1Cq:
N y1 i � t
� � � � € � � � � � � s_ � - k� 7 7. 7 '" r k c�s e�EC. The undersi
� � � _ �r z O z
� ; � i � � � ; ,. � ,� � 8 3 � Z ; c� � � � � $ gned hereby makes application tor a permit for the work herei
- - speciiied, agreeing to do all work in strict accordance with the City Ordinance
Ba� Z, _ and ruIiag oi the Department oi Buildfngs� and hereby declares that all the fact
lat � and rePresentations stated in this application are true and conect.
2nd 2. % Z .- — % - r - - FridleY, Minn,_L� - / �/ �g��
3rd - - - - -- -- Owner __�����s`-�-,� �
4thF�• ����a _ _ ___ ___ Kind of Buildi �„
C.o�na�ct�d with n8 � �C-t ��_
• �� I na�c
* New Fixluro, Old Op�nings 8swsr � Used as ��
Cssspool �
To be completed about �� �- � P
PARTIAL RATE SCHEDULE Estimated Cost, a
-- �\l �—
PLIIMHING FIXTURE RATES: NO. AATE TOTAL Old ewj Building Permit No._—�_�� .___Permit No. �pt��
Number Fixtures _�� x $2.00 $� U � Signed _��r�s�i� _L � J'"� -�
Fiiture Fixture Opening _ x $1.50 $ _._ By _ �� ���
--...
New Fixture OId Opening x a1.5U � Business phune No._ • � 2 ��� 3
Catch Basin X $3,25 a
Water Iieater (Up ta 99,000 B1'U) �_ X$3,pp g �, , O C�
New Ground Run Old Bldg. _ x$g,�5 $
IIectrie Water H�at�r z $2.00 :
GAS FITTING FEEB: NO. RATE TOTAL
lst 3 Fixtures ... x g2.00 ; .� , o U
Additional Fixtures . . . . . . . . . . . . . x a .75 �
Gaa Range to 199�000 BTU . . , . , . . . . . . . . . x �5.00 6,
AEPAIRS d� ALTER1lTIONB—Raf�r to Cod�
Description.... .... ....... ................ ..........s
TOTi�L 1�'EE s-j 3,.1� U
ROU(3H
FINAL I� ` / " � �
CIiY OF FRIDL�Y INSPECl'ION D1V.
6431 University Ave NE
Fridfey, MN 55432 APPLICA710N FOR POWER PLANTS AND HEATiNG, COOLING, VENTliATiON,
572-36Q4 REFRIGERATION �hND AIR CONDITIONING SYSTEMS ANO DEVRCES
RATE SCHEQUL�
Resicientiat
Furnace Shel{ and Duct Work, Bumer --
Also Replacement Furnace
(Side Vent – Fifi �ut Back}
Gas Piping (Needeci with new furnace)
Gas Range
Gas Drye.r
*Air Conditianing – All Sizes
All Others/R�pairs & Alterations (L1ST ON BACKj
1% of Value of Appliance or Work
Gommerciaf/i nciustriai
1% of Value ot Appliance or Work
Effe�tive On January 1, 19�3
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`7'L°
JOB AD4�RESS ��� ���� ���� l.�/� 5G
The undersigned hereby makes application for a permit for the wark herein
Rate TOTAL specified agreeing to do aii work in strict accordance with the City Codes artd
�, �t� n�C. L�`" rulings of the Building Division, and hereby declares that ail the facts and
��:56' $,��'�� representations stated in this application are true and correct.
r^.%~ L � . 1 994
$ 10.00 $
$ 10.00 $
$ 14.00 $
$10,00
State Surcharge
70TAL FEE
$
OWNER �.4 Nif L�^I�E� � �`� d � `I �
BUILDING USED AS
ESTIMAiED COST �� C� PERM17 NO,;���s'�'
� ; � • s�,� •- •�
$ No, of Heating Units � Circle One (Steam) (Hot Water (Warm Air)
Trade Name C�4,�,�/F�,`„ 5ize No.
BTU �t� D HP � EDR �---•
$ Fuel�/,�,-�Q,�� ,�,45 Total Connected Load '%,� d4�}
,50
�� ..
�< —`
%� �� �
MINIMUNf FEE F�R ANY HEATING/CUULtNGIVENTltA710N
REFRIGERATION1AIR_CONDITlONING PERMIT IS 15.00
PLUS._7HE_.�,50._STATE SURCHARGE
REINSPECt10N FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adj�ining praperty owner.
Burner Trade Name � Size No, �
BTU � HP /�" EDR �-
H
�
Appraved By Rough–in Date Final Date
F1LL C7UT BACK SIDE FOR STACK VER{FICATION �N
REPLACEMENT FURNACE
pe-r,� � �x�►� c� � � 1 �1 �� � ; . .
NOTE: ��1 through ��8 required when using a side vent furnace.
CHIIVINFY ANl? STACK VERI�i�ATI4N
The undersigned hereby verifes that the exist�ng chimney or stack:
1. Has heeq carefuily examined Yes { G�No ()
2. is free from �st or cfeterioration
3. Has no foreign object.s lodged within
4. Is securely supported
S_ Meets all c�trrent Cade rc-quirements for size
an€t total B'l['U's cannected
b I-�as t,aial heating BTU's af �,�_ ���� .
Ali oiher BTU's ,/`—��
'TL)TAL BTU's % ��, � � �
-----�.--
7. Has a liner been provided for water heater
$. Has combustian au� been provided �or water heater
Remarl'�cs:
ist ALTERATiC)I'�S Bein�Uc�ne:
HEATING CO:
Signed By:
Date:
Yes ( t� N� ( )
Yes ( ) No ( +�
Yes (VY No i )
Yes { v� Na ( }
Yes (v�No ( }
Yes ( ) No ( )
/o_l � 9�
� oue�e�� - . ...... .....
City of Fridley 3 088 9
A7 THE TOP OF TME TWINS g � �� D I N� P E R M I T
r
; ` RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. � / � �
r � y • � PqOTECTIVE INSPECTION SEC. ���
�
� � �"'1 � CITY MALL FRIOLE� 55132 NUMBEii pEv O�iE P�GE O� �POnOvEO er
�'""�'"� ,'' 612-571-3450 9t0-F15 5/2/00 / `
108 ADDRESS 1521 Berne Circle NE
t LEGAL �OT NO. BLOCK TRACT OR AbDIT10N SEE ATTACHED
DESCR. ZS I. Innsbruck 5th Addition SHEET
2 PRQPERTY OWNER MAIL ADOHES$ ZIP PMONE
Daniel Newman 1521 Berne Circle NE 571-0893
3 CONTRACTOR MAIL ADDRESS 2�P PHONE LtCENSE NO
Aztec Roofing 11583 Rupp Drive, Burnsville, MN 55337 895-0040 20139140
e ARCNITECT OR DESIGNER MAII AOORESS ZIP PNONE LICENSE NO.
5 ENGtNEER
MAIL AODRESS
ZIP PHONE LICENSE NO
6 USE OF BUIlO1NG
Residential
7 CLASS OF WORK
O NEW O ADDITiON ❑ ALTERATION C� REPAIR O MOVE O REMOVE
8 DESCfi18E WORK
Reroof House & Garage with wood shingles, tear-off
9 CHANGE Of USE FROM
STIPUTATIONS
TO
Install per manufacturer's specifications.
SEPARATE PEi:MITS AfiE REOUIRED FOR ELECTfiICAL, PLUMBING, NEATING.
VENTI�ATING OR AIR CONDITIONING
TMIS PEHMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONS7RUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANV TIME AFTEii WOfiK IS COMMENCED. NO DWLG. UNITS
1 MEREBY CERTIfV THAT 1 HAVE REAO ANO E%AMINEO TMIS APPLICATION 1
AND KNOW THE SAME Tp BE TRUE ANO CORRECT. ALl PROVISIONS Of LAWS VA�UATION
ANO OROINANCES GOVERNING TMIS �YPE OF WORK WIIL BE COMPLIED 1 OOO
WITM WMETMER SPECIFIED MEREIN OR NOT. THE GRANTING Of A PERMIT �$�
DOES N07 PRESUME TO GIVE AUTMOFITV TO VIOLA'fE OR CANCEL THE pEFiMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING coN- $293. ZS
STRUCTION OR THE PERFORMANCE OF CONSTFUCTION
^ OLAN CHECK FEE
�O✓l ;5 ' � ` � � Licen
$�GN4TUQE O� CON"asf,TOQ Op AUTHOA�ZED AGENT IOATE� EN (
oCCUanNCr
STA�LS
$5.
OCCUPANCV�OAD
CU FT
G/►RAGES
$9.00
SAC CMARGE
Fire C $18.00
TOTAL E
$ 5.25
IOAT IS IS Y �Ii ,��;�
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S�GtinrUAE Oa OwtiEQ��� OWNEQ BW�DER� �O�TE� B�OG �tiSo �� � r��
�UN-c4-1998
v�w l J
ADDN ( J
�LTER ( J
�onscructionAddress:
i i� a8 FROf� C I TY OF F� I DI.EY Tp
8959962 P.01iO4
ua�w�e... •� ..... �
CITY OF FRIDLEY
S�1GLE FAMILY AND DUPLEXES T2-1 AND R-�iTY OF FRIDLEY
BUILDING PEIZMTT APPLICATION � s43� UNlVERS1TY AVE. N.E.
� FRIDLEY, MN 55432-4384
� a � �EQi✓r �� 2 c1 � �• n,��n�
„egal Destription: �ll
Jwner Name & Address: ��N � E � ���'4''`� Tel. � 6�L' S7�- � 893
�oacractor. � z'{� L �ot��,�^� MN LICfiNSE 1! �fl 13 `� �o
Address: .! � 58 3�w�� �Q; d� �„�e�sd.l�E rh! .J Te1.11 �� L- S?s'-o o yo
--� r
Attach w this apQlicadon, a CeRificate of Survey of the
loc, with the proposcd construction drawn on it to scale.
DESCRTFI'TON OF IMPRO'VEIVIENT
LI'trIl�IG AREA: Length Width Height Sq. Ft.
�ARAG� AREA: I.ength Width Height
DECK AREA: � Width � Hgt/Ground
OTHER: L,ez;�� i� �: ��,� . _ _'�,-` __� S � /� �,
• �-z.-� , ,
$q. FI.
Sq. Ft.
p L� ��>�'� �� C_ � �
:onscruction i`���� ��`���� Estimat�ed Cost: $ ��e�a' ��iL��� .
Ty�� -
(Fee Schedule on Back1
�riveway Gl�rb Cut Width Needed: Ft. + 6 Ft � Ft x$ _$
�ATE: �-� ��? APPLICANT: �(.�C,f-}-C � Tel. � t��� (S��J` '�� � _
�
� �� , � ���,�
'ermit Fee �� � � �
� i�e Surcharge � �� � � ,, .
�tate Surcharge � ��'$ �_ �
�AC Charge �._ $ � \ ^
.icense Surchar�` ��}$
)riveway Escrow $ •
;rosion Concrol $
'ark Fee $
;ewer Main Charge $
��s����� - , , �
TOTAL $ - �
�TIP ULATION S :
�ITY USE ONLX
Fee Schedule on Rcvecse Side
.001 of Pennit Valuation (1/14th�o)
$.50/$1,000 Valuation
$1000 per SAC Unit
$S.QO (State Licensed Residential Contractors)
Alt. "A" or A1t. "B" Above
$450.00 Conservation Plan Revicw
Fee Determincd by Fngineering
Agreement Necessary ( j Not Necessary (]
;I7Y CJ� -FRiDLEY 1NSPECTIt?N D{V.
i431.#�niversityy A�ve NE
'riciley, t�AN 55432
i72-36�
Urinai
�
2
4
PLUl+IIBING FIXTURE RATES:
� �- � - � S C`G
APPLICATlON FOR P�UMBING AND GAS FITTti+1G PERiYII'T
MARK NUMBER OF FIXTURES TO
NO. RATE TOTAL
New Fixtures
()Id Opening. New Fixtune
Beer Dispenser
ataw off Basin
Catcfi 8asin
Rain Water Leader
SumplReceiving T�k
Water Treadng Appliance
Water Heate� -Electric
Water Heater - Gas" �—
Gas Range••
Gas Dryer" ----
gack Flow prevenber ReQuired ()Yes () No
Type
$ 7.00
3 4.00
3 5.00
s 7.00
S 7.04
S 7.00 �
S 7.00
310.00
a 7_00
$10.0o i
s�a.00
$10.00
�15.00
Reins�ection �ee S47.QOIHr
ALL OTHERS AND/OR REPAIRS AND ALTERATiONS
1.596 �f Valus of Fixbure or Appliance
SbtB $U�f�
TOTAL FEE
�-o-drti
__._-_—
1�
s�
ON EACH
-�-
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JOB ADDRESS �S °Z � � E'`�--^� L �
,The utxiersgned hereby makes appiicadon for a permit for 1he watk hereir�
specified agreeing to do a1t work in strict accordance with the c�ty t�odes
and nal'mgs of the Buiid'mg Division, and hereby declares that aN the facts
and representations stated in this application are true and oorr;ed. .
5/ a �'/e� .20_
��� A � IL� � c§�►--1 � �
9utiding Used A� /S � � ,
_ Estimated Cast -� 6 0.� PERM6T N0._� � C'-��
-PLUMBING GOMP�WY � A �o f� nS �.i•� `�-- S c''"
SIGNED
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COUI�USTION AIR SHALL BE PROVIDED PER UMC SECTIUN 504(A) AND TABLE 6-A. COMMION VEt�ITT INFO ON BACK SIDE
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CtiYOF
FRlDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
September 25, 2000
Dan Neuman
1521 Berne Rd NE
Fridley, MN 55421
Re: Final Inspection at 1521 Berne Road NE
Contractor: R A Johnson and Son
Dear Mr. Neuman:
A plumbing permit was issued on May 10, 2000 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 inspeciion 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 this installation will require a new permit.
Any questions can be addressed to me at 763-572-3603.
Sincerely,
DJimh
�ITY OF FRlQI.�Y INSP��TlC}td OIViS10�1 Effe�tive C}n January 1, 2t102
64�1 U niversit}r Rve N E
Fridley, MN 5�5432 APPLICA'FI�11 F4R P�IER RlA�ITS ANQ �fF.�►TI�1G, C(IOlI�1G, VENTEI.ATi(�N�
(�63} �72•3f�4f�4 REFRJGERAT�O�! AND AIR COtt�f�DiTiOMi�i SYSI'F�J[S AND D�ifICES
JCIB ADQRESS I�21 �.IJ� G�� l`�
RATE SCi�EDUL�E �
OWNER D�l`� ��t� tJ�VJ(��1`-�
Resid�niiat
Furnace Shell and [k�ct Work, Bume� •
Also Re{�lace��t Furrjaae
(Side'�ert� • Fl! Out Badt�
Gas Riping (ideeded with new furnace,
b�t nat replac�ment}
Gas Range
Gas Oryer
'�Air �ondifioning - Att Sizes
�lli Ot�ers,�R�aairs & Attera�ions (LIST OIV BACK�
1� af lfatue o# Appliance or Utifork
�amm�iatflrtdustriat
1.2�°�'„ of Value of #ppliance ar Yt+o�k
Rat�e TOTAL
$ 3{}.OQ $
$ 1Q,00 �
$ lUAO $
$ 1U.00 �
$ 2�.Od $ .O�
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State St.�rcharge
BUILQING USED AS �s � ���� - -
ESTI(v��►TED {{Y7ST `�2(d� �%.0O PER�111� N€}. �� �
�s��Tior� o� Fu�acE �o o�BU�u�
Mo. af Heating Ur�its Circ�e �ne (Staam} (Hat V+�ater} {V�tarrn Air)
Trade i�arne ��z� �1a�
BTiJ HP EQR
Fuel Total Gonneeted Ln�ad
Burner Trade Nam� Size Na-
BTU H P EOR
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$ The undersigned hereby makes ap�alication far a permit far #he vaork �terein
specified agreeing to da all work in strict ac�ardance with th� City Cad�s an
S .54 rulir�gs of the Buiiding I�ivisian, and he�by dectares that all the fa�ts and �
r�resentatio�s staf�l in this applicatio� are true ared carrect. °
T0��4L FE� $��.`�
1 ` ` `- ,�- - + : x i. . _. , i F. . � d � .
�a. ' �_ �a.� . ,_ - . , � � . � �, �;�
� e � ' � �i �.ii�
REIfVSPE�TION FEE $�7.0(i�Hr
�Air Ganditioners can nai � placed in a side yard wifhout
writ� p�missicm from acijaining praperty cr�er.
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��Titvc cc� M�� n�c�rt�,�/rc��,
Signed ___�� ` TEL # �1--6�i11 '�u'Z-
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Ap�oued Rough•an Date Fina� aate � a
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C[7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. 1V.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 30, 2004
Mr. Daniel Newman
1521 Berne Circle NE
Fridley, MN 55421
Re: Final Inspection at 1521 Berne Circle NE
Contractor: Max Mechanical
Dear Mr. Newman
A mechanical permit was issued on September 26, 2003 to install an air conditioner at
your address. According to the 1991 Uniform Mechanical Code, a final inspection shall
be conducted on the work authorized by this permit. As of this date the final inspection
has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, the permit will be marked "no
inspection called for by homeowner after notification" and expire the permit.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh