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PRE 2010 DOCS,- 221 6 City of Fridley, .Minn. N° 8 671 BUILDING PERMIT Date: FEBRUARY 10, 1966 Owner: FARREL MAIKI Builder WINDOM PARK REALTY Address Address 2246 Johnson S t . N. E. Minneapolis, Minnesota 7520 LOCATION OF BUILDING No. 29 Street Lakeside Road N. E. part of Lot 10, except W. 149.51 Lot ---- Block 2 Addition or Sub -Division . SPRING LAKE PARR LAKESIDE Corner Lot _ Inside Lot — X Setback 35 Sideyard 29 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: 24 HOUSE Front 34 Depth 26 Height n Sq. Ft. 884 Cu. Ft. 21,2 6 � GARAGE Front 22 Depth 22 Height 10 Sq. Ft. 484 Cu. Ft. 4,1840 Type of Construction Frame st. Cost _ $16, 000 To be Completed In consideration of the issuance to me of a permit to construct the building described above 1. agree to the proposed work in accordance with the description above set fo and in ce wlth provislo ordinances oP the city of Fridley. a/�' �, n In consideration of the payment of a fee of $ 27.00 , permit is hereby granted toWINDOM PARR REALTY to construct the building or addition as described above. This permit is granted upon the express onnditiou that the person to whom it is granted and his agents, employees and workmen, in all work dame in, around and upon said building, or any pew thereof, shall conform is all respeota to the ordinances of Lan ces. ALLEN G. JENSEN Building Inspector NOTICE: M psrmb don not serer the aondmcdoe, tastaMm for Wfib4b phmbine, on heathy, $ war w water. Be curs to we the Wdh* Ingae:sr for apmaN permit for thea Nuns. d APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA r OWNER'S NAME % LOCATION OF BUILDING / Street Part of Lot Y9 S K ADDITION OR SUBDIVISION5 J2i' it g ZAL ke fVC'/k LeeS% d q Corner Lot Inside LOT_ /Setback 3 J Side -Yard_ � �% � - . ..SEWER ELEVATTDN FOUNDATION ELEVATION, 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; Sq. Ft.,�4 Cu. Ft. Front ��Depth Height: Sq. Ft. i- Cu. Ft._�� Type of Construction % Estimated Cost o- To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are truea d correct. �Rd`� DAT; �� a �� SIGNATURE �l�l e �. X6'4a-4� V' 1 / (Schedule of Fee Costs can be found on the Reverse Side). C' --L 0 , - SUBJECT Fridley City of Fr 26197 AT THE TOP OF THE TWINS BUILDING P E R M I T i � p COMMUNITY DEVELOPMENT DIV. .: --"--. PROTECTIVE INSPECTION SEC. �� g r 1 � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/10/98 JOB ADDRESS 7520 Lakeside Road NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 10 2 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Farrell Maki 7520 Lakeside Road NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quarve Contracting 8427 Center Dr NE, Spring Lake Park, MN 55432 785-1472 6016 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Rep—lace windows 9 CHANGE OF USE FROM TO STIPULATIONS Replacement windows cannot reduce the clear openable area to be any less than what was existing. Install smoke detectors to meet the State Building Code - in each sleeping area and on each level of the house. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT, CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,450 $1.72 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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. PLAN CHECK FEE 15-00 TOTAL FEE License SC $97.42 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY (DATED THIS IS YOU PERMIT BLD9f INSP TJAIE S)GNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY l(n� ALTER `' [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ?5aQ LfA"S1 d4 Legal Description: Owner Name & Address: Contractor: Address: rre // Tel. # MN LICENSE # 67016 K Tel. # i3'141L Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%1PROVEMENT LIVING AREA: Length Width Height Sq. Ft. _ GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. _ OTHER: Construction Type: &L) lam (,() I nd6 ) S Estimated Cost: $ 3q 6o . 00 (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: APPLICANT: Tel. # CITY USE ONLY $ oZ�> Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $�j , $5.00 (State Licensed Residential Contractors) $ Alt. A or Alt. B Above �l $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 May 14, 1997 Farrel and Winifred Maki 7520 Lakeside Road Fridley, MN 55432 RE: First Notice of Noncompliance of the Fridley City Code at 7520 Lakeside Road Dear Mr. and Mrs. Maki: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent systematic code enforcement inspection of your neighborhood and property revealed that not all Code requirements are presently being met. The following items do not comply with the City Code: • Fridley City Code requires that all solid waste must be kept in secured 32 -gallon containers with tight -fitting lids stored in the side yard (screened from view), rear yard, or garage, except on the day of collection when the containers may be placed up to 3 feet from the front of the garage. A recent inspection revealed two refuse containers along the side of the garage. Fridley City Code exterior storage requirements state that nothing shall be stored in the front yard. All materials shall be kept in a building so as not to be visible from any public right-of-way, except for stacked firewood, boats, and trailers placed in the side yard. A recent inspection revealed a trailer in the front yard, a tractor/ lawnmower next to a shed in the rear yard, and a wheelbarrow. Fridley City Code requires all compost to be fully confined within a fence or an enclosed structure. The City Code also requires compost to be located in the side or rear yard at a distance no less than five (5) feet from adjacent property lines. I observed a pile of unconfined compost. We understand that you may have been unaware of these requirements. Your prompt attention in correcting this situation will greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or shortly after May 28, 1997. Please have your property in compliance at that time. Farrel and Winifred Maki May 14, 1997 Page 2 If you have questions about the systematic code enforcement process or would like to discuss your particular situation, please call me at 572-3595. Thank you for your cooperation! Sincerely, CITY 9F FRIpLEY 1- Ku J e + -Schneider Code Enfor ement Officer KJS:Is CE -97-184 01 SUBJECT PE O. City of Fridley 6 2 3 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. L'_-____ COMMUNITY DEVELOPMENT DIV. ; r PROTECTIVE INSPECTION SEC. J�5­7/ NUMBER REV DATE PAGE OF APPROVED BY 1 ..."1 CITY HALL FRIDLEY 55432 A j 612-571-3450 910-F15 10/22/97 JOB ADDRESS 7520 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 10 2 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Farrel Maki 7520 Lakeside Road NE 784-7413 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Whitetail'Construction 7435 Oakley St NE, Fridley, MN 55432 783-9519 CITY 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C3t REPAIR ❑ MOVE' ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (17 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,417 $.JL WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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 TH PERFORMANC OF CONS R CTION. $48 PLAN CHECK FEE AL FEE Lice s PITY $50.63 SIGNATURE PF CONTRACTOR OR AUTHORIZED AGE IDATEI E P VALI A ED THIS IS YOUR PERMIT w SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI g G INSP MATE 01 NEW [ J Effective 1/1/97 ADDN [ J CITY OF FRIDLEY ALTER ( ) SINGLEFAMILY AND DUPLEXES R-1 AND R -Z �6 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: -414 Owner Name & Address Contractor: 7 Address: "? q� 'd',�5- (P-0) i W, Z' /" r757� LjA,29'4-- Tel. # tl L ('IA 1<7— MN LICENSE # 57T Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length" Width Hgt/Grround Sq. Ft. OTHER: `, CMZ? 1t `-14 Use--t- Construction se--` Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:O 9 APPLICANT: G'CG� Tel. # 79 -,7 `>Tfl"ULATIONS: CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ `7 / $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ - $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above 'rosion Control $ -$450.00 Conservation Plan Review 'ark Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 3 `>Tfl"ULATIONS: If you have any questions concerning this matter, please.feel free to call on us at 571-3450, extension 170. Insp. B p y STEVEN J. OLSON 'R/S. Environmental OEfefcer Community Development Division CITY OF FRIDLEY 6431 University Avenue Northeast NOTICE OF PEON -COMPLIANCE e �Date Gz d ?---7,, — A dress 75Zo �<4&c-rTime of Inspection �, /�%ips An inspection by this Department has indicated that you are in non-compliance with the following checked (x) sections of Chapter 113, Refuse Disposal, of the City Code. You are hereby;notified,to take whatever action ,is necessary. -to correct any violations on or before ^ 142 2 Z Z -F . Failure to comply with this notice may result in legal actiobyie City Prosecutor. ( ) 113.02. Provide sufficient containers for the storage of all refuse (including garbage) accumulated on the premises between collections. ( ) 113.02 All. refuse containers shall be water ltight, have a tight fitting lid, be impervious to insects, rodents, vermin, and absorption of moisture, be fireproof, and not exceed 30 gallons in size (unless otherwisespecifically authorized). 113.02 All refuse shall be stored in approved containers, with the cover in place. ( ) 113.08 Containers shall not.be placed or maintained as.to_interfere with the use of adjoining property. :For the purposes of collection only, the containers may be placed a.maximum of 3 feet in front of the dwelling unit. 113.07 The contents of storage, containers shall be collected at least once every week, or more frequently if necessary. ( ) 113.09 Containers without covers, in poor repair, corroded, or.otherwise defective shall berepaired or replaced. Other + -t\`' .9 7- 4,� 04ea qy �aG If you have any questions concerning this matter, please.feel free to call on us at 571-3450, extension 170. Insp. B p y STEVEN J. OLSON 'R/S. Environmental OEfefcer Community Development Division 01 SUBJECT NO. City of Fridley 29559 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. *16 COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION 7zl d/ CITY HALL FRIDLEY SSA32 NUMBER REV DATE PAGE OF APPROVED BY L J\ 612-571-3450 910 -Fl 5/26/99 JOB ADDRESS 7520 LAKESIDE ROAD NE 1 LEGALL07 NO. BLOCK TRACT OR ADDITION SEE ATTACHED oEscR. PT 10 2 SPRING LAKE PARK LAKESIDE SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Farrel Maki 7520 Lakeside Road NE 784-7413 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION? ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 4' x 8' Portico on Building Entrance 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. t, alk wwPIR06 ` Before digging call for ull utility locations W-0002 REQUIRED BY LAW SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO 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 $600 $ .50 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 $26.55 Fire SC $ .60 PLAN CHECK FEE TO) TA EE $ 7.65 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN 00,RD A D T HIS IS YOUR PERM T SIGNATURE OF OVVNER,IF OWNER BUILDERi IDATEI B G INSP �IAIE 01 NEW [ ] Effective 1/ 1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATIONlam. 6ep V' ConstructionAddress: 7S �t s ��c� yl Legal Description: Owner Name & Address: 7,--4 eer --e Contractor: X00 -c Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # T k Y - 7©I-3 MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width H t/Gro nd Sq. Ft. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ar Estimated Cost: $ 4v 04 ®4 A (Fee Schedule on Back) Ft x $ _ $ DATE: r- - f j APPLICANT: FL 'W' Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: CITY USE ONLY $ XSS Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) Tel. # Xds- "P y"' $ ,` $.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 [ ] $ t77 7 GS� f CERTIFICATE .OF SURVEY MILNER W. CARLEY & ASSOCIATES �- CONSULTING CIVIL ENGINEERS LAND SURVEYORS 1 500 W. HWY. 96 THEATRE BLDG. 314 OAK ST. 18 4TH AVE. S.E. ST. PAUL 12, MINN. MONTICELLO, MINN. SAUK CENTRE, MINN. ST. CLOUD, MINN. ' 484-3301 295-2906 352-3664 251.7751 1 hereby certify that this survey, plan, or report was prepared by me or under my direct supervision and thut,.,l am a duI Registered land Surveyor under the laws of the State of Minnesota. 7. .4•. P11 Reg. No. 7575 Date Nov, 20,_ 1365 tn 75 %z A v E. scala /"= vo, Ln 150.0 M - I 9.89 R y 33' az 35' 4 3Z r Ause- Tv cc R'A 0 0 CX 1y9.99 /y9 /9 R i fy-�•�,�5 ovT i � I s , ,veww O" Lot 10, except the gest 149,5 feet, Block 2, S_'RiING LAIM PATuZ L1ICL3Y1)1:, Anolca Couivb •, Mian. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer l>a,b- r`,-e_Q��� *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr Effective On January 1, 2000 JOB ADDRESS OWNER Fg.',r� TOTAL BUILDING USED ASJ, /I J ESTIMATED COST .2200• cx9 PERMIT N0. 1661 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Ynit Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name :.5L -75D Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE// HEATING CO Alf�-el y r4.Se`d9e *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. - , �; FILL �615do� Rmi Signed /_x=`��a, TEL �Ae' Approved By Rough -In Date Final Date /Y-4:06 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 () 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 Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) 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 ( ) When installing a new venting system, 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 Furnace 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( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type _ Appliance #2 Type _ Appliance #3 Type _ Total Appliances Common Vent Type _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 CO: Signed By: Date ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 7520 LAKESIDE RD NE 123024110059 UNAVAILABLE LOT BLOCK HEATING RESIDENTIAL ADDITION/ALTERATION PERMIT NO.: 2004-02281 DATE ISSUED: 12/14/2004 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. VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS VALUE (FOR MINIMUM CALC) APPLICANT HOME ENERGY CENTER 15200 25 AVE N # 128 PLYMOUTH, MN 55447 (763)476-1990 OWNER MAKI FARREL M & WINIFRED J 7520 LAKESIDE RD NE FRIDLEY, MN 55432 0 # GAS RANGES 0 300 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 wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regul oo truction or the performance of construction. Applicant 7 Date Bldg HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 56185 SEPARATE P FRMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS S eof Fee Total 1� A $35.00 $ 35-c0 $10.00 $ $10.00 $ $10.00 $ *Air Conditioning - All Sizes $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 Owner Building Used As ESTIMATED COST 6P -i l a . PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating UnitsCircle One (Steam) (Hot Water) Trade Name_. 1" Size No. BTU e4b _ O HP EDR Fuel Id/ �-Total Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for CommerciaVindustriaVInstitutional and representations stated in this application are true and correct. Home Energy Center State Surcharge $ .50 HEATING C 1520025 th Ave N #128 TOTAL FEE $; 5 n Plymouth MN 55447 763-476-1990 fax 763-476-1143 REINSPECTION FEE $50.00/HOUR FAX # vac *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FIEL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS. COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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. Y716 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 Furnace Venting Tables for fan assisted and natural draft appliances. Ye () No( ) The existing combustion air is sized and installed to meet the current nodes and manufacturer's specifications. Yes/ No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Ye5,,() No ( ) When installing a new venting system, 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 Furnace 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( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type C- 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) Iffl. N -WAR -0. CITY OF FRIDLEY PERMIT NO.: 2005-00020 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/06/2005 :)"%L -36U4 FAX: 17631571-IZ57 ADDRESS 7520 LAKESIDE RD NE PIN 123024110059 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE.PH: 763-544-3300 # INSPECTIONS 1 APPLICANT STATE SURCHARGE, ELEC FLAT 0.50 HARRISON ELECTRIC INC ELEC PERMIT FEE - MIN (RESI) 20.00 3440 KILMER LANE N TOTAL X0.50 PLYMOUTH, MN 55441- PAID WITH CHECK # 028066 OWNER MAKI FARREL M & WINIFRED J 7520 LAKESIDE RD NE FRIDLEY, MN 55432 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 wort' will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other'state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date J -rAKA l L r1:!KMI IJ KtyUlKhU I'UK WUK& V I HEK THAN DESC;KIBLD ABOVE. Building BUILDING Permit No.:,_7- InspectionsRESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE �j YOUR E-MAIL ADDRESS I�SQY�C1l1Q�1Q C • CGiJ�Y� -- SITE ADDRESS�r�j o�� D rj` .� Q UV. 't . 9 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME:. TENANT ADDRESS:CITY STATE_ZIP PHONE: I (g 3 . NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, N4N 55113 r STATE ZIP WITH APPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/NEI PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4_777 _ ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW 13 ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:'ty Qk Aa �1 p%,«,%, C,S];,ryLLA i �1� Mi I`9• SIZE OF IMPROVEMENT LENGTH WIDTHHEIGHT Ft ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT• GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Other ❑ Trim ADDITIONS 1. & PORCHES SBMIT• Site Plan/Survey showing the existing structur ❑ Fascia and proposed project. WINUMS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS t1LL t r.rla7 I°\A 16A5CL UN JOB V Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due vALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) INS 2. -6-6 a — OCCUPANCY TYPE X63. 51 See Back Page for Fee Schedule $ 65% of Building Permit Fee _$ cd. 3 S .001 times the total job valuation $ . 1 is .0005 x Permit Valuation Minimum $.50 $ OV $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Ql l , Make checks savable to: Citv of Fridlev Attar 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 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 applicati for a pe 't and work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work hick requ' review and approval of plans. SIGNATURE OF APPLiCA04 RINT NAM ��_DATE_ 41'�ns Building UUUUPANUY 7 -YPLL' BUILDING $ j Permit No.;, Orsi � Inspections $ RESIDENTIAL APPLICATION Fire Surcharge Received By: N2-2-00; 763-572-3604 Surcharge CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 DREM440V DATE YOUR E-MAIL ADDRESS SAC Charge SITE ADDRESS 7520 Lakeside rd ne $1550 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER E)CONTRACTOR R + 6 ft = R x $21= $ PROPERTY OWNER/ NAME: Farren Maki $450 Conservation Plan Review ADDRESS: CITY STATE—ZIP TENANT Sewer Main Charge PHONE: Agreement necessary ( ) Non Necessary ( } CONTRACTOR NAME: Cedar Valley Exteriors Make checks payable to: City of Fridley Attach Stipulations STATE LICENSE # 20177285 EXP DATE 3/31/2008 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 1700 93rd lane no CITY Blaine STATE mn;0,55449 WITH APPLICATION PHONE 7637552221 FAX 7637555390 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS D BASEMENT FINISH ❑ROOF ❑ DRAIN TILE ❑ DECK ❑SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: re -roof 198q SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. OR OFING ❑ HOUSE ONLY NUMBER OF SQUARES _ ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2 Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. st. ral mbers to be used List ofnicwme PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMrr: ❑ Aluminum ❑ Trim L Site Plan/Survey showing the existing strictures ❑ Other ❑ Fascia and proposed project 2. Two seas of conomwtion plans WINDOWS IN EXISTING OPENINGS ❑Yes 17No LOCATION OF WINDOWS 3• Energy Calculations 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 OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ AJJ4.UU UUUUPANUY 7 -YPLL' Pennit Fee $ j See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ p"} - .001 times the total job valuation Surcharge $ . l .0005 x Permit Valuation Minimum $.50 License Surcharge $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ R + 6 ft = R x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( } Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMrr-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 applicat_ioG for a dwork is not to start without a permit; that the work will be in accordance with the approved plan in the case of all qu' review and a noval of plans. SIGNATURE OF APPLI PRINT NAME Emily Bernard,,,,,,,-- Building Permit Fee BUILDING ,2 See Back Page for Fee Schedule Permit No. `(D O 7(e 0 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATIONIleRAd B:763-572-3604CITY � 'i7 .001 times the total job valuation Surcharge OF FRIDLEY .0005 x Permit Valuation Minimum $.50 ' 763-502-4977 FAX LJ— $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 1-1-2010 ft + 6 ft = ft x $24 = $ Erosion Control DATE 5— 19 —,Row d� YOUR E-MAIL ADDRESS $450 Conservation Plan Review SITE ADDRESS $ THIS APPLICANT IS: ❑ OWNER,)geONTRACTOR $ PROPERTY OWNER/ II NAME: _�l n n ; & M"' tc_'. $ TENANT ADDRESS: 5120 � k�o,� CITY STATE�'� ZIP .S�3� 'Lt�zlrs;.,,e.e'� h rrI PHONE: / ICJ -P / q (1 `1 —' 19 )3 CONTRACTOR NAME: — 1 ) c SUBMIT A COPY OF YOUR STATE LICENSEy STATE LICENSE # /? ICA EXP DATE 3 — 3) I AND CERTIFICATE OF ADDRESS: i_30/ m%,r . u d i-, A;w CITY %1i ►-1 low STATEI5>` ZIP S INSURANCE PHONE 3 — :3 - , 9 FAX PROPERTY TYPE Q$SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING I°OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR-gREMODELING DESCRIBE WORK BEING DONE: n, o kk �,x d � ��ti 19-%_ 'V SIZE OF IMPROVEMENT L GTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 11 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT• ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ mer ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THF. 1997 U.B.0 FEE SCHEDULE) 'OTAL JOB VALUATION $',e `' OCCUPANCY TYPE Permit Fee $ ,2 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 'i7 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ LJ— $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1. Make checks payable 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 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT��W' d r PRINT NAME "° °�� ill . /lj� `• Ic'a- DATE 5 — 0 — , -�)'Q APPROVED SEC R106.3.1 .�-l;`AfI INSPECTOR �•� c �,teJ C. �, � fi�� 114" � e v'.�.-rr. � � l '; 1 e- � d, w cx l � r '� -� � .U.� cl- ;tl - 31grZ�-PeVA40-1 aowaI� --)Q(', 145 1 L ix� �*p rn £M�� N N % - Zq q , i-' St From: 7634447357 Page: 212 Date: 6/14/201010:41:08 AM FROM :CITY OF FRIDLEY FAX NO. :76357112@7 Jun. 08 2010 0`':01 "�*-. P4. Building __T_ _ PLUMBING - I inspections RESIDENTIAL APPLICATION M 763-572-3604 CITY OF FRIDLEY Date e 763-502-4977 FAX r;rrw-n VE 1. 1.2rj 10 HATE IQ wmikF-MAILADDRESS _ _.GZ1Y_—_ 1.9rmAmm. q .- 7 THW AMICANT 15 0 OWNLK PROPERTY 4; NAME.: OWNRIV _STATF *MNANT cao"—CTOR4ZA--* 91.113Mri A COPY OF ?at -NA 42 ki &'A&2, _�XP DATL- 111SHWAS"M STATE L[CENSE* V0VR STATE UMNSE, ROND AND MT TIFICATIE OF INSURANCE !qTA*MBOND # ADUUMS-_RLQ! 7 FAX_ _z�W .7JS WATER MrT M- MHFR I PERMT TYPE V%CiLe F&MILY Cl TWO FAMIL) TYPE OF woltx. a NEW XRJiPLAC7WNT DETAILED DFqCRIP11ON OF WORK 01 C MS ARE BASED ON SMAD PER I-IMIRE. PXC-M'WIIMr NOTM 11MIRES (TNOICAlt TOTAL. NumuliR or E. tic" RsLow) Mrnml:m,ALL S9 .571 !L-AATH SINXILAV nRATNS WATER P!P1'4* .VrBATHTUD —PLLY.)R C -AS MPTNQ MLD CITY I 1C) M' ING POOL CMIt %-A rFR q0FTNLI(MAS CLOTHM WA%HH1t MHIIN SIWx :V CLOSFT A BACKfL0W,`RFV $"i 111SHWAS"M —LAUNDRY TRAY _WA 11M I TEATER ($35) FOR IKKIGATION 4 WATER MrT M- MHFR I rVq IS AN APPLICATION FOR A PERMITNOT VALID LN,11L PR(' )CMED I hereby apply for a plOmbing permit and I acknowledgi: that the information above is complete and accurate; that the work will tit 111 conformance with the Ordinances and codes of the City of Fridley and with the Minnesota Construction Codes. that I understand this i,, not a parrilt but only An appli n for a perm and work is not to stan without a permit nii site: that the work will be in accordance with the approved plarij in the of I wor ich requires rcvicw and appriwal oi plans. L SIONATURI!, OF A?MjcAlt;r PRINT NAME. City of Fridley Building Inspections Department 6431 University Avenuc M, Fridley, MN 55432 763-572-3604 FAX763-5024977 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY ecid: 763-502-4977 FAX I EFFECTIVE 1-1-2010 �-- DATE Z Z` tl YOUR E-MAIL ADDRESS > > QvP s t S" i-✓ Cr C Ooh . ��►'L SITE ADDRESS %S'7,0 THIS APPLICANT IS: ❑ OWNER keONTRACTOR PROPERTY NAME: OWNER/ p ADDRESS: -7r0 () ,4� K P F' d CITY 'f1 t STA r,ZIP TENANT PHONE: CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: 5_r&,1,r `I YOUR STATE LICENSE WITH STATE LICENSE # EXP DATj ADDRESSZ r��� AJ(- ?d 11X C IVSTAZII� 1 TAY T� APPLICATION PHONE?i -111P . S_A-17 FAX ::Z Lf 13- tQ L( PERMIT TYPE X.SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: [3 NEW 0 REPLACEMENT ";(ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �-dE v f t- d �tid % �p FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. Equipment Installed MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU _A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 :2UCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 �� , Fa v. € � �S "� .���. � • r -`-` a z .� �' `� R a � � �` �. r ra�.Aa2 a 4 �' *- y� - �3Ev1Y' 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 applicatio r 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 alI is re uires review and approval of plans. �^ ` SVM " �.-JDATE � SIGNATURE OF APPLICANT PRINT NAME, APPROVAL INSPECTORS SIGNATURE DATE �J L- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977