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PRE 2010 DOCSCity of Fridley Application for Plumbing and Gas Fitting Penna Dept. of Bldgs. Phone SII 4-7470 . a6 d DESCRIPTION OF WORK Los&BozL % �- �'-� 1�� � /� y� ��' Ve Number, Kind and Location of Fixtures /� cJ d qo �e9Z I z Z (9 0 Ig Z ( g O F N WATER HTR. GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ......................IC x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin .... ....................... x 3.25 Water Heater (Up to 200,000 BTU) ...... x 2.00 New Ground Run Old Bldg. ............ x 3.25 TOTAL $ $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ -Gas Range to 200,000 BTU .............. x 2.00 $ P, ',LTERATIONS--Refer to Code �n................................................$ TOTAL FEE $�— City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Nai Fridley, Minn ? r E 19-6 %Y Owner ,o A a /� to " e/ -r Kind of Building /` h+ e' Used as P We �/' To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe By.�i �6•t.9'� Business Phone No- // y 6? 3 - % - (.,-3 o /jy6?3-%-(.� ROUGH � - a 0 - 6 3 FINAL az 2M SUBJECT ADIEVNIIIT NO. City of Fridley 32 0 26 AT THE TOP OF THE TWINS BUILDING PERMIT r R ______ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. 572-3604 IZ/ 5 r IR CJ NUMBER REV DATE PAGE OF APPROVED BY I CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/23/01 10B ADDRESS 7550 Lakeside Rd NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Andco Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jill Dutcher 7550 Lakeside Road NE 763-783-8890 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8826 20268257 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION 0 ALTERATION 1 REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Replace 3 full frame windows within existing openigas 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit Inspection Cards Will Be Mailed To Homeowneo ro Post 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 OWLG. 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 $1.12 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,231 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- F SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 e $2.23 PLAN CHECK FEE TAL FEE Lice C $5. 0 17$91.60 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN P Y VALI A ED"THISY R PE M 6 / SIGNATURE OF OWNER.IF OWNER BUILDER, IOATEI SLOt,NSP JIT �l E NEW[ l Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FANMY AND DUPLEIS R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: p U��► .Yy., Legal Description: Owner. Name & Address: SY k1 Tel. #-103.53• $890 Contractor:. RMA HOME SERVICES INC. MN LICENSE # Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. # Atlanta, GA 30339 Att 763-542-8826 rvey of the lot, BC -20268257 L it to scale. DESCR ON OF IMPROVENIENT LIVING AREA: Length width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. ®TREK: 4cY aM o I i h � U Construction Type: Estimated Cost: $ aLa�j � °per Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: -B--SokSk - (3\ APPLICANT: Tel. # JS • 3k1S • (a0H Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL. $ S3 •as $ T- too CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $1050 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 [ ] STIPULATIONS: -'ec A ap; e--1997 ss. N City of Fridley, Minn.. BUILDING PERMT N® 6376 Date..,? Owner: Builder �! Address Address �C;�:Z OC�j►TI N F B WINGNo. Street Part Lot Z. _ _ Addition or Sub -Division _— Corner Lot . ___ Bl Inside Lot . _ Setback L_ Sideyard _ Z ,X Sewer Mevation _ Foundation Elevation =Used DESCRIPTION OF BUILDING P �/� p Front ! Depth Height Sq. Ft./-L��s Cu. Ft. WQ._� Fron Depth � Height �� Sq. Ft. Cu. Ft. Type of Construction _. L:Q Est. Cdst ���0 �'% be Completed In consideration of 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 compliances with allpr ons of ordinances of the city of Fridley. In consideration of the payment of a fee of $ ., permit is hereby granted to 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 of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ..% _ --- NOTICE: Ible pennh doss not corer the construction, Installation for whfng, plumbing, gas heating, sewer or water. Be sure to we the Building hapeeter for separate permits for thus Items. 7708 Lakeiand Ave. (Brooklyn Park), P. O. Osseo, Minn. Scale a For 7 /'N Registered Professional Engineers and Land Surveyors CERMFICATH OFF SURVEY Zoo. �� Y5:�'1'6r Z tV 7- 2/ 19Z_ 0,:f le Aev z? co 37 'Z NiN ;15% N% Aye /< . -'d Si /�- 33 Ell. Phone HA. 5-2181 s� -3 We hereby certify that tl'iis is a true and correct representation of a survey of the boundaries of the land desc*ri6ed above and of the location of all buildings thereon, and all visible encroachments, if any, from or on said land. As surveyed by me this- -day of--- FilePage -----__Bocik --_._Book-_-`- I CASWELL ENGINEERING CO. Minnesota Ri:.j.stration APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Namgj✓a � ,�`� � Builder Address Address LOCATION OF BUILDING 'No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback_„,- _..Siae-Yard SEWER ELEVATION - FOUNDATION ELEVATION Applicant attach to this form Certificate of survey of 'Lot and proposed building loca o . ��9a DESCRIPTION OF BUILDING To be used as: FrontDepth Height Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 4 GNATUR&L�� (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Minn. BUILDING PERMIT Date: _. May 14, 1968 owner: Leo Heyne Builder Address 7550 Lakeside Rd. Address Same , Same Xo LOCATION OF BUILDING No. _ 755 QStreet _ Lakeside Road _ ____ part of Lot Lot _ 2 _ __ Block 1 Addition or Sub-DivWon ___ Andco Terrace Corner Lot Inside Lot Sewer Elevation Setback ___ Sideyard Foundation Elevation DESCRIPTION OF BUILDING q �a_-2. P, �_' 9'734 To be Used as: Qarage Front 22Depth 24' Height 10Sq. Ft.528 CU. Ft. 5280 Front Depth Height Sq. Ft. — Cu. Ft. Type of Construction Frame Est. Cost_..._._._..._._..___...$1200.00�.....__.. To be Completed In consideration of 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 pliance with all provisions of ordinances of the city of Fridley. ��> In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to Leo Heyne 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 of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair aad moving of buildinsm within the city limits and this permit may be revoked at any time upon violation of of , Vrovisions ii7FWa ordinances. r Clarence Belisle NOTICE: 1W permit does not cover the construction, Installation for wiring, plumbing, pas beefing, sewer or water. Be sun to no the Building Inspector for separate permits for these Meme. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA �4 OWNER'S NAME a B*'ILDER ADDRESS _, nrO LOCATION OF BUILDING s LOTT�LOCK� ADDITION OR SUBDIVISION CORNER LOT,INSIDE LOTSUTBACK* � STDRTWI_% rS SLWE ELEVATION TOP OF FOOTINGi Applicant attach to this .form Two Certificates of Survey of .Lot and proposed bu*lding locatiou. Orawq-.ot _thess Certificates. _ DESCRIPTION OF BUILDING To Sa Ueed. a, Frontes ® DeptkL gh Hei t � Square feet-..-: Cubic Feet ..Front Depth Height Square feet Cubic Feet Type of Construction.. Estimated Coat �� d= ® U 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 ar$d rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and cor ect. DATE SIGNAT ' —l-®��L_ (Schedule of Fee Costs can be found on the Reverse Side). Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................... 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $� each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $� GAS FITTING FEES: NO RATE TOTAL , Warm Air—No- Trade Namp y 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ PAN HEATING SYSTEM See Fee Schedule Sq. Ft. E.D R �ENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE. $ ROUGH FINAL r City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. - -- Ma 5 - 196 Owner Kind Used as To be completed abouty MAY 5 Estimated Cost, $tj �O - Permit No. Permit DESCRIPTION OF WORK HEATING , Warm Air—No- Trade Namp v -0 o 7 Size No- Capacity Capacity Sq. Ft. E.D.R ®®® BTU H.P. Total Connected Loa Rind of Fuel &Z BURNER— Trade Nam Size No / Capacity— Sq. Ft. E.D R BTU H.P. GEO. SMWICK IPTG. & AIR-COND. CO 1001 Xenia AV. S. Minneapolis 16, Minn. Signed C; 4444 Ey <Z 2M Business Pho No (REMARKS—OVER) Windows and Doors—Crackage and Area Width Height No. of Lineal fr —Area No. of pane of pane lights of crack sq. fto ;o 1).S6 A, I HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Infiltration MPNEAPOLIS. MIM. Weatherstrips, A.S.H.VE. Construction No. Exp. wall 4, Insulation Guide J Glass Windows Doors I Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes'—No L No 19— y r 7 7, 7 T, 7 -77 0 Room FLength Width 4- HeHeightRe Ceiling Width Heistht Windows and Doors—Crackage and Area Width Height No. of Lineal fr —Area No. of pane of pane lights of crack sq. fto v 0�� 4- A, I Coef. Btu, Coe(. Btu Infiltration Infiltration Coef. 1 Btu Glass Exp. wall 4, Glass Exp. wall J Glass Net exp. wall 7 41 Int. wall Floor Exp. wall sY Ceiling 3' a y r 7 7, 7 T, 7 -77 Floor Net exp. wall Ceiling Total Btu. � V. -7 & 6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lenffth ; 1 Width e--- Height t Windows and Doors—Crackage and Area aa Width Height No. of Lineal ftArea No. of ane of pane lights of cracksq. ft. 4- A, I Coef. Btu, Infiltration Coef. Btu Infiltration Coef. 1 Btu Infiltration Exp. wall 4, Glass Net exp. wall J Glass 7 7 7 Net exp. wall Floor Exp. wall sY Int. wall Net exp. wall Ceiling Floor Int. wall Ceiling 7,7 k., Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area fFllr'a'' t Rnnm ILencrth Width 14piaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft- Area No. of pane of pane lights qfcrack sq. -Tr Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ",v I Coef. Btu, Infiltration Coef. Btu Infiltration Coef.1 Btu Infiltration Exp. wall 4, Glass Net exp. wall Glass 7 7 7 Net exp. wall Floor Exp. wall sY Int. wall Net exp. wall Ceiling Floor Int. wall Ceiling Floor Total Btu. ;V11 7�- 7 Reauiredlia. ft. E.D.R. or sa. ins. WA. Leader area J ­ Windows and Doors—Crackage and Area Width Height No. of Lineal ft- Area No. of pane of pane lights qfcrack sq. -Tr 7;7, I Coef. Btu, Infiltration Coef. Btu Infiltration Glass v Exp. wall 4, Glass Net exp. wall Exp. wall 7 7 7 Net exp. wall Floor sY Int. wall Ceiling Floor Total Btu.` T,147 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length aF Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No.— of pane of pane lights of crack sq ft. 08 Coef. Btu, Infiltration Glass Exp. wall 4, Net exp. wall Int. wall:_ Ceiling �f �`- tp 7 7 7',,7 7' Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ' Width Height F1.1 Room I Unjzth Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights,, of crack sq. ft. C,,Pef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor - ji Total Btu. � "', ,- P Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I O FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 May 14, 1997 Leo and Darlene Heyne 7550 Lakeside Road Fridley, MN 55432 RE: First Notice of Noncompliance of the Fridley City Code at 7550 Lakeside Road Dear Mr. and Mrs. Heyne: 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 item does not comply with the City Code: • 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 camper topper on blocks in the side yard. We understand that you may have been unaware of this requirement. 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. 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 OF FRIDLEY urt sen -Schneider Code nforcement Officer KJS:Is CE -97-188 Quit Claim Deed. Individual to Corporation. Form No. 28-M. Miller -Davis Co., Minnesota Uniform Conveyancing Blanks (] Us; Nbenture. .Ulnae this .................. i2th ........ ...... day of .... ............. Apr.i1 ................. _........... . 19.. Leo R. Hevne and Darlene Hevne_ (Husband ... and ... Wi..fe) ................................................................. of the County of_ ................... ........ Anoka. ....................................... and State of. ... ............... Mi.nnesiota..................... _........................ , part.l a S.. of the first part, and..............................C........i+....v....o.....f...F.......ri..r.............. llcv.............. ....................... ............................................................. _ _ - ------------------- hunt-cepa.............. _............ _....... _...... _....------------------------------------- - a corporation under the laws of the state of....................Minnesota.................................., party of the second part, Isitneut(b, That the said part.AeS. of the first part, in consideration of the sum of .Qne.....An! ... WIN .... �$ to............................................................in hand paid by the said party of the second part, the receipt whereof is hereby acknowledged, a7®............ hereby Grant, Bargain, Quitclaim, and Convey unto the said party of the second part, its successors and assigns, Forever, all the tract...... or parcel...... of land lying and being . in the County of .................... _..... ...Iokld....................................and State of Minnesota, described as follows, to -wit: A ten foot (10') street and utility easement over the south ten feet of Lot 2, Block 1, Andco Terrace The City of Fridley hereby accepts this easement for street and utility purposes. C SIDNEY C. INMAN City Clerk NO STATE DEED TAX REQUIRED 19AI",YA 0"11117Y rJd1i To jbabe anb to jbolb tije Gallic, Together with all the hcredi.ta.naents and appurtenances there- unto belonging or in anywise appertaining, to the said party of the second part, its successors and assigns.. Forever. 31n zc2mmonp Wberrof, - .The said part............ of the first part ha............ hereunto set .................................. hand...... the day and year first above written. .......... tv ...... . .... ... . .................................. & hd W.- ..................................................................................................................... SUBJECT PER City of Fridley 6 214 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. I m fr _____ COMMUNITY DEVELOPMENT DIV. . PROTECTIVE INSPECTION SEC. r � i I NUMBER REV DATE PAGE OF APPROVED BY = � � CITY HALL FRIDLEY 55432 IL"--A", kj 612-571-3450 910-F15 6/11/98 JOB ADDRESS 7550 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 1 Andco Terrace SHEET 2 PROPERTYOWNER MAILADDRES.5 ZIP PHONE Leo/Darlene Heyne 7550 Lakeside Road NE 784-5034 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof House & Garage 20 SO 2nd Laver 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 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 $1 253 $.62 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- Fire SC $1.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $43.00 PLAN CHECK FEE TOTAL FEE $44.87 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE I WHEN PROPERL ALIDATED THIS IS YOURPIT Xfg S TUBE OF-OWNi IDATEI 81Q6.INSP DATE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 5 Legal Description: Owner Name & Address: e o 4 D4 k ),2 Pj o- 14E yNE Tel. # Zr2(— S O 3 X Contractor: - MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF DIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ DATE: APPLICANT:11,411 Te1. 503 7� TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee . $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: ' SUBJECT - I . City of Fridley 30584 AT THE TOP OF THE TWINS BUILDING PERMIT( IPT NO. _____ COMMUNITY DEVELOPMENT DIV. �>t: - r � PROTECTIVE INSPECTION SEC. V60 � NUMBER REV DATE PAGE OF APPROVED BY --'1 CITY HALL FRIDLEY 55432 ti ----A, 612-571-3450 910-F15 12/15/99 JOB ADDRESS 7550 Lakeside Road NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Andco Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jill Dutcher 7550 Lakeside Road NE 783-8890 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Mon -Ray Inc 801 Boone Ave N, Golden Valley, MN 55427 546-8625 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Ck ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Install one bay window 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Permit Inspection Cams Will Be Mailed . To Homeowner To !�,;v 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 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 OWLG. 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 @ $3,351 $1.68 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $97.25 Frie SC $3.35 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Licens54 $5.00 f107.28 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN ROP ALIDAT THIS I$ Y UR PERMIT �'/L� BIL DW INSP rIArE S-GNATURE OF OWNERJF OWNER BUILDER, IDATEI NEW[ l Effective 5/10/99 ADDN ' [ l CITY OF FRYIILEY ATkit [Xi SINGLE FAMILY AND DUPLEXES IL-1 AND R-2 BUILDING PERMIT APPT.ICATiON Construction Address: 7550 Lakeside Road NE Legal Description: Owner Name & Address: Jill Dutcher 7550 Lakeside Rd NE Tel. # 783-8890 Contractor: MON-RAY, INC 801 Boone Ave. No. MN LICENSE# Address: -Go l den Valley, MN 55427 Tel # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. -l�V44-cuz LIJ10 1 W . D1jk> :Q " LTMG AREA: Length Width Height Sq. Ft. GARAGE AREA: Leno Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grround Sq. Ft. OTTER: INSTALL (1) BAY WINDOW 0005111 546-8625 Construction Type: Residential Estimm wd. Cost: $ 3,351.00 Driveway Curb Cut Width Needed: Ft. + 6 Ft - Ft a $ _ $ DATE: o?- '� �% / "FLICANT: fit Tel. # 546-8625 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcbxje Driveway Escrow Erosion Control Park Fee . Sewer Main Charge CITY USE ONLY $ 97.25 Fee Schedule on Reverse Side $ 3.35 .001 of Permit Valuation (1110th%) $ 1.68 $.501$1,000 Valuation $ $1050 per SAC Unit $ 5.00 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ I Not Necessary [ ) TOTAL $ 107.28 STIPULATIONS: zo/zo'd LL689t7s 0i A31UIdd d0 AM WONA 62:60 666T-LT-Nnf SUBJECT PtRMIT NO. City of Fridley 3268 0 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. -_ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC, 1 � = I "'1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 6/10/02 JOB ADDRESS 7550 Lakeside Road NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 2 1 1 Andco Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jill Dutcher 7550 Lakeside Road NE 612-783-8890 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Harmony Homes Inc 3158 Viking Blvd NE, Wyoming, MN 55092 763-413-1100 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20122139 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION CIX ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Enlarge two existing windows into Egress Windows with window wells 9 CHANGE OF USE FROM TO STIPULATIONS Windows to meet the State Egress Code. 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 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 1 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 @ $2.30 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT $4,585 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 00, PLAN CHECK FEE AL FEE Lice SC $ .00 $123.14 SIGNATURE OF CONTRACTOR OR AUTwORQED AGE NT IDATEI W ENP RLY VALID TO THIS IS V UR/PERMIT SIGNATURE Of OWNER-IF OWNER BUILDER, IDATE) LDG IN O IIAft NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ZKLU L-q(e5'1je— �S' Legal Description: Owner Name & Address. Contractor. Tel. # a(a 237—YZAy MN LICENSE # ay l 11�f 112 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Len Width 1 Hgt/Ground Sq. Ft OTHER: C AVj6V/ ' c� � Construction Type:a JOCK ( _tiYe,sf +� ' Estimated Cost: $ Ddveway'Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: e7 -to'U'- APPLICANT: _ Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] TOTAL $,2,J /4% STIPULATIONS: SUBJECT P City of Fridley k 33364 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ____ - r PROTECTIVE INSPECTION SEC. I � � ®1` NUMBER REV DATE PAGE OF AvaROVED BY CITY HALL FRIDLEY 55432 ".' 763-571-3450 910-F15 3/12/03 JOB ADDRESS 7550 Lakeside Road NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Andco Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jill Dutcher 7550 Lakeside Road NE 763-783-8890 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Envirobate Metro 3301 E 26 St, M ls., MN 55406 612-729-1080 20375791 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 O NEW ❑ ADDITION Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel Basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMS r REWIRED FOR: WIRING, mEATING MIR 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 ISTALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4800 $2.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $111.25 Fire SC $4.80 S ION R HE PERFORMANCE OF CONSTRUCTION os PLAN CHECK4FE TOT FEE Z. Lice $ $123.45 SIGNA RE OF CONTRACTOR OR AUTHORIZED AGENT �DATE� E PROP VALID T THIS IS YOUgERMIT 4 4!SIGNATURE OFOWNEROF OWNERBUiLOERI iDATE, g NSP NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: f 1'sso L.'a"-51;�4r C4 0V Legal Description: Owner Name & Address: d _ &o pe Tel. # 3 _ 7,93 Contractor. Favj-�,6xmaj MN LICENSE # Address: 0 - E,79WhS ice/ , °SI -®1 Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT 04 Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type:, -4k -,,,JL /fid dtmEstimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: DI APPLICANT: Tel. # 1O13�- -.9-1 DTA Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] TOTAL $ Z,-.21� 7550 ME 71 wv SS#3 z 74,3- 763-8890 46P '?IN" 44 21Ae-6 Z�4 ' Dlb,,4 ii -ee;441 Joe rot K*)' oorlo i' Li'l �i� ����� `1 '00�z w CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763)572-3604 FAX: (763) 571-12if7 ADDRESS 7550 LAKESIDE RD NE PIN 123024110128 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-02290 DATE ISSUED: 12/15/2004 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. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2500 APPLICANT ANDERSON HEATING & AIR COND 4347 CENTRAL AVE NE COLUMBIA HEIGHTS, MN 55421 OWNER DUTCHER JILL A 7550 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 HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 24627 SEPARATE PERMITS 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 *Air Conditioning - All Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS' AND DEVICES JOB ADDRESS 65�D &�,I& /iLk Fee Totalz uo Owner k�l�! $35.00 $ 35, PO Building Used As_ /T V IYZ4b $10.00 $ ESTIMATED COSTA J ()D t 00 PERMIT NO t $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $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 Commercial Industrial Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR $ # of Heating Un'# / Circle One (Steam) (Hot Water)=(WarmAir) Trade Name '2 1 Size No.l9/775 9070 $ BTU HP EDR Fuel 4 l r 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. jr�i $ .50 HEATING CO50 #� Signed Tel FAX _1L7V1—&I /'� " /3 _ D # J ®% Date *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL 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. Yes --94' 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 (tv 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 BTU Input 0 SM Fan Assisted or Nat Appliance #2 Type 1°11,P BTU Input -ZA • Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances _;aTaal Btu Input I !�a� Common Vent Type r-P4Jd lis Vent Height /L Diameter inches Appliance #1 Vent Connector Height ft Length — ft Diameter �in Type v Appliance #2 Vent Connector Height Viz -ft Length _Q,,._ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed Ely: I (W -m- m j, , �T wxc" Date : CITY OF FRIDLEY PERMIT NO.: 2004-02232 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/02/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 7550 LAKESIDE RD NE PIN : 123024110128 8 6 2 9 6 LEGAL DESC : UNAVAILABLE : LOT BLOCK. PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 1,237.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. APPLICANT HARMONY HOMES INC (20122134) 3158 VIKING BLVD NE WYOMING, MN 55092- (763)413-1100 OWNER DUTCHER JILL A 7550 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 worl 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 permance of construction. Applicant // / Date Bldg Insp BUILDING PERMIT FEE 47.90 FIRE SURCHARGE 1.24 STATE SURCHARGE, VALUE 0.62 TOTAL 49.76 PAID WITH CHECK # 9752 Z SEPARATE PERMITS REaUIIft FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ J U I Y OF F -MULL -Y CTiecilve 4i u4uu4 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax IR BUILDING PERMIT APPLICATION Construction Address: *251D 6s (e 51Je Ed LE Legal Description: Owner Name & Address: Contractor. LMNG AREA: GARAGE AREA: DECK AREA: OTHER: MN LICENSE # r�b 1,9a 13 y Tel. # 769- 0—llcy Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale., DESCRIPTION OF IMPROVEMENT It Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width ss Hgtt/Ground Sq. Ft Construction Type:--12'Q� Estimated Cost: $��� 2 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: a, APPLICANT: Tel. #Z( 40-8W Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ �� Fee Schedule on Reverse Side Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ 5% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1350 per SAC Unit Eli $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 [ ] TOTAL $ C/9 - qSTIPULATIONS: pUG_22-2005 10, 45 3uilding nspections '63-572-3604 A_M_1L_f_-7 = ADDILESS I 'PUS APPLICANT IS' TE.y &NT SUBMIT A COPY Of YOUR STATE LICZNS& W= APPLICATION PROPERTY TYPE From: 7634344933 Page: 2/3 Date: 1/23/200811:18:18 AM P.02�13 CIT`! OF FR I OLS't' BUILDING Permit No.: , ESIDENTIAL APS" LICATION JVea By: CITY Off` MIDLEY >�a JAN 2 C3 OWMM e" STATE O TWO FAIV.YlN� AADIT ON O BASEMENT FUQSH O DECK DESCRIBE WQRK BEING SQUAi''.1i4 QaAw PROPOSED SIZE:! PROPOSED TWOMT: 1_ndt..'vm ❑ vinyl O Aluminum C Other W_znOwS SNR ZYJSTING pPENINGS *CS QWo OR FOR NEW 0F5MNGS-DFSC=2 SIZE OF OPENLNG CHANGES & �i _ EXP DATE 7"A " A 1.0 !vl f� C FAq x W STR C ION i;U ON ® Q0A0E&7W O ROW CJ TSRAB� 3II.E 13 SIDING 0 OTMM d SW�q POOL Q A=MQN BY.Il�its If I, vA)&9, +J u IIOU$E & GAAACS D A'ITACM GA,ZAGE 17 DETACM GARAGE moiPu O Trim E7 Puna LOCA T ION of wDWWS bA% 1. Existing floor Plan , 2. Propo9ed hoot plan 3, List of &=Wrai members to be used M FOR ;vBW CONSTRtaC ONINCUMING DSM- ADDMUQN3_ 12 Egg= BU= I. Sita �alStsvEy Oro s and proposed Project, 2. Toa soca of c%=uct on pian 3. Energy Cniraulatiet�s T ALL FEES ARE BASED ON VALLTATIONt INCL'ta IN+G Tilly COST OF LABOR A" MATXFUA A : (USING TM 1947 U.B.0 FEE SCMDUL1S) TOTAL. JOB VALUA,TI S �1 OCI.CUPANCY TYI' Permit Pee $ See Back page for Fee Schedule Plan Review S 19�! X _ 65% of Building Permit Pee Surcharge $ /_ (.0005) times the total job valuation -- Mirdm mm $-SO Fire Surcharge S 5,uzy .001 x permit Vahtation (11100%) License Surcharge S $5.00 (State Ueemed Residential Contractors) SAC Charge S _ $14S0 per SAC Unit (Flans to MWCC for determination) Curb Cut Escrow $ft + 6 ft - R x $20 - $ ]erosion Control S $430 Conservation Plan Review Park Fec $ Fee Determined by Engineering Sewer Main Charge S Agee►metlt nece93M ( ) Non Necessary ( ) Tots! Due S 77 FIT Make cheecksa able to: QU of Fridley Attach THIS tS AN APPLICATION FOR k PIMMU NOT VALID Lft4M PROCFSSEO I hereby apply for a building permit and I acknowledge that the infarMatiOn above is complete and accurate; that the Work W111 be in conformance with the ordinances and codes of the City of Fridley and with the Wroesota Construction Codes; that I understand this is not a pormit but only an application for a perntit 84work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all w w and approval of plana. $10 -NATURE OF APPLICANT Mle PR�AtT NAM I�/ �I I:� �ilv DA A r -613— 7t — C" 7 C� Building BUILDING PermitM - Cc _$ " Inspections RESIDENTIAL APPLICA►TIO�f Received ay: 763-572-3604 CITY OF F�]LE'Y Date Recd 763-502-!4977 FAX FFFFCTIVE 1-1-08 DATE P� r p Y01JR E-MAIL ADDRESS A47VV0 ( &k^ (aA r hl • '�� SITE ADDRESS �-� ![�$KJOAid 11.1 , _... .. .. THIS APPLICANT IS: I] OWNER J:ONTRACTOR PROPERTY OWNER/ NAME: z l 1 r ilrltCJ'P—r/ TENANT NATE %1/l ZIP ADL7kEss:7aSt) ( iaimtl� CITY Fr' 1�_ $1$25 per SAC Unit (Plans to MWCC for determination) rHpNF: 7to3-� �3 � $73'903 CONTRACTOR NAME: t '-4C- ae ADDRESS. -_&30 E*ST Mt' 1k %T- crryd�:� STATE PI'OLZtF 3 3 SUBMIT A COPY OF PHONE 7&3-7-10-3100 . - FAZ 7&3-r-10 - -B i O YOUR STATE LICENSE _ �Q C•E�( EX,t)A'I'F STATE L2NSI; Il� � .. MOPERTY TYPE SINGLE FAMILYINEW CONSTRUCTION SIZE Sewer Main Charge O TWO FAMILY/NEW CONSTRUCTION STORIES 1?ERrffT TYPE O ADDITION Q GARAGFlSHED ❑ WINDOWS ;PBA9EMEN'1` RNISII O ROOF ❑ DKAIN TILE $Make ❑ DECK 12 SIDING [3 OTHER ❑ SWIMMING POOL _ C3 NEW HOME CONSTRUCTION ❑ ADDITION ❑ MA1NfENANCFJREPAIR ICKEMODCII ING TYPE OF WORK; 'u�4►` t �'P ° %DESCRIBE E F/ 4 i M i 5'l rlH �r 1� WORK BEING DON/i19 JLF •T ftw# �r44K I L SIZE OF IMPROVEMENT LENGTH WIDTII tISIGHT SQ PT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY BASEP REMODELING SUMMIT: ❑ HOUSE & GARAI.'.R 1, Exing Floor Plan GARAGES ❑ ATTACHED GARAGE 2 ProKsW floor plan o nFTArHRD GARAGE 3 Etat of structural memhen to bo used PROPOSED SIZC: PROPOSED HEIGHT: FOR NLW CONSTRUCTION INCLUDING DECKS, SSUTNG ADDI IYQNS & PQ ❑ Vinyl QSoffit 1 Site Plsn&rvey showing the exleting UniCh roe E3 Aluminum O Trim and prop wfti proj-L 0 Other ❑ Fascia 2 Taw sets of eonstruction plans WINDOWS 3 Energy Calculations IN E71STING OPENINGS QYes E]No LOCATION OF WINDOWS OR I•Z)R NEW OPENING$ -DESCRIBE SIZE OF _ OPENING CHANGE!9 & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS i ^OM d%1V T .DAD AFdn MAT UVAI Q. ALL FEES ARE BAwm Oro VA1,4A'l ItJM, 1l'IC:L+UUu'ly inti N-%" a v� .,r..........,.....r__w._.�_. (USIN(; THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATIONS 00' OCCUPANCY TYPE Permit Fee _$ See Back Page for Fee Schedule Plan Review $� r �/% 65% of Building Permit Fee Fire Surcharge $ "5 . '7� 001 times the total job valuation Surcharge $ S 0005 x Permit Valuation Minimum $ 50 License Surcharge $ 5 : $5.00 (State Liom ed Residential Contactors) SAC Charge $ $1$25 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = _ ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge S Agreement necessmT ( ) Non Necessary ( ) Total Due $Make checks pn able to: Cl of I rldle Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I Imeby apply for a building permit and I acknowledge that Ike information about is complete and awlime; that the work Will be in coofo=oee with the ordinances and codes of the City of Fridley and with the Minn Ia C(mtfruotiOn cr that i m►nd is not a permit but only an a�)licatian fora permit and work is not t0 81ort without a permit on site; that the work will be inla= vcd pl in the c oIINTNAMEffWK I work which requires review and approval of plans. SIGNATURE OF APPLI A . Chf l�R K In l)ATEz 1 �' .DATE APPROVED BY NOTE: SEPARATE PERUM ARE Me TOTCOTZ99L Iva zC;CT Ilia SOOZ/TO/ZO Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: k�j 763-572-3604 CITY OF FRIDLEY Date Recd: -J,-/ `2 763-502-4977FAXEFFECTIVE 1.1-08 �q DATE— C — YOUR E-MAIL ADDRESS d d°i A t� �s✓�'j SITE ADDRESS 7 5C) 1.4k -e-5,4 RAX fv . THIS APPLICANT IS: ❑ OWNER ,VONTRACTOR PROPERTY NAME: ,7'1 1( t,40_ ADDRESS: _' 5-5-0 LA ICe' 5 � E CITY < STATE_t!ftZIP OWNER/ TENANT PHONE: M, ` 7'9,9, ggg6 CONTRACTOR COMPANY NAME: t TK S@t V 1c-- S :17;Le- , NOTE: SEPARATE CITY CONTACT PERSON:'R,'11 LICENSES ARE STATE LICENSE # FM DATE REQUIREDGAS AND HVAC ADDRESS: "q S 4 �;yj `-`t!-e �GTATF&�,_zIP S SUBMIT COPY OF BOND PHONEAND INSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW [3 PLACEMENT 'Ef-ALTERATION/RF.MODEL DETAILED DESCRIPTION OF WORK Q, P e c V aA °(,, r e �'Jlg ! I 5 f e IJ- W 42 -—Or (e -e° V -,-- 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 of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: Q es (C MODEL: 3& V V V SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 A 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 DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ — -W Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 NHNIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the appro lan in the arse of all work which requires review and approval ofplans. SIGNATURE OF APPLICM,(.O PRINT NAME�(�%l. �r� z` DATE APPROVED BY Gu__ DATBV `Z D SEP City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 .expnDz-t� ape of cOW K'� Pef111- 464 OCO-CO'a? Building = OCCUPANCY TYPE BUILDING Permit No.• _ 6050 See Back Page for Fee Schedule Plan Review $ ►.9 65% of Building Permit Fee Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY Date Rec'd: S -,3L -6 DATE J a0 06 YOUR E-MAIL ADDRESS tW O VGeK* Wt p ®e'gE �1� l>!gLL ,I � • �=c)� SITE ADDRESS 2,S'10 / 414k -F -S f d e_ PId k t:' THIS APPLICANT IS: ❑ OWNER ACONTRACTOR PROPERTY OWNER/ NAME: Zr, 11 a+ —[— ADDRESS:%S50- /J�1Gc'9� ?0A,0 CITY RSTAT 4ZIPSW3CA TENANT Park Fee PHONE: 7(03-2-8890 CONTRACTOR NAME: to er 0-44.4- e -Ce- e4:56- 4SESUBMIT $ STATE LICENSE # c20 -WSW? EXP DATE SUBMITA COPY OF YOUR STATE LICENSE ADDRESS:&50 &95;r #JAT14 s'. CITYA✓1t?1Ci4 STAT> KZIP S5303 WITH APPLICATION g PHONE'263 ` /0 —3/ DC -7 / FAX O 3 " a 1® - 3 k) PROPERTY TYPE SINGLE FAMILY ION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR AREMODELING j n DESCRIBE WORK BEING DONE:eXA4AJ14 19�A eA r Fly tg(. O N Fir fn % f 'IcUe— 0010 9 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. Existing Floor Plan 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 ❑ Other ❑ Fascia and proposed project. WINDOWS 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 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 IJ.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ = OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ ►.9 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $5� ®(� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$— $Erosion 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 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 applicatio5 for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work ' h qu' s iew and p val of plan.;. ��yy SIGNATURE OF APPLICAN� PRINT NAME�K JZa Qe-t KA pq..f) DATE 'I ®� ding PLUMBING Permit No. & -ections F RESIDENTIAL APPLICATION Received By:572-3604 CITY OF FRIDLEY Date Rec'd: �- « () 763-502-4977 FAX EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS / [ SITE ADDRE S ?rro h S �v !J t< THIS APPLICANT IS: ❑ OWNER 1131',CONTRACTOR PROPERTY NAME: i ( u�c�er- ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME:S �` STATE LICENA # O r EXP DATE SUBMIT A COPY OF R STATE LICENSE, BOND AND CERTIFICATE OF STATE BOND #EXP DATE ADDRESS:3 7 3 (,_1 ,t N-C_,,­� 9-0-e­ CITY �n ✓u 4 STATE ✓ ZIP INSURANCE . PHONE _%G ?-otS�oL�'YoL� (� FA)W,7 -4S d - oZL PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 11 NEW *'REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 1613.665 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 of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. I BATH SINMAV DRAINS _ SHOWER _ WATER PIPING _FLOOR BATHTUB GAS PIPING (NEED CITY LIC) —SWIMMING POOL —WATER SOFTNER ($35) _ WASHER SINK / WATER CLOSET _BACKFLOW PREV. ($IS) _CLOTHES _KITCHEN DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 (MINIMUM $15.50) (MINIMUM $15.50) Total = $ 3v c THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 pl in the case of I wRr C which requires review and approval of plans. YE DATE ��� G SIGNATURE OF APPLIC T PRINT NAME GY�t,�t/ APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Y] S Sp Lpcees"obe Date: 6/4/2000 Revision Date: 6/4/2008 §ftinformation Address 1: case remodle aridly Address 2: City: County: Application Information Business Name: SWENSON HEATING & AIR COND. INC Contact Person: GREGG SWENSON Office Pit: 763.389.1888 Fax: 763.389.1288 Address 1: 12723 320th Ave Existing Construction. Pre 1994, Project P. Loi: Block: Subdivision: MN Contractor License * Cell Ph: 612.282.7536 City: Princeton State: MN lip Code: 55371 Minimum Mechaniical Code Resauirenwnts Met Will you be replacing or adding a water heater, furnace, or boiler? NO Will you be installing a deoorative solid -fuel appliance? NO Will you be installing an exhaust fan 300 CFM or greater? No You have met the minimum requirements* for make-up air and combustion air as required by the international mechanical code, as adopted by the state of Minnesota with amendments. Applicant Name (print): U--- Signature/Date: Code official (print): Signature/Date: --11N;S pm&E 0.104 C—terPnint Fnerav Minneoaccn. ?.QM MPzhanijmJ f'c�rfr f �1icfel;nea. It IV\Ate v p Cry -ria,, INV tig:Zg:L 800Z/9/9 :ale(] M :abed umoqun :woj:l Pone 1 Building MECHANICAL Permit ND.- 77 Inspections RESIDENTIAL APPLICATION Received By -A 40 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 1-1-08 DATE q� YOUR F -MAIL ADDRESS �re'Qq �l.Je n50n hetet t �` C�tia SITE ADDRESS �% SSO 1Ge 1 Off, 1/ THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME:', LL 7) y t Gh�r ADDRESS: ? SSO LA Y_a S %,� e_ gpt P6 CITY FT, a.N±=, STATEr-AZIP SYs� OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: StR�G r156� 1r1eG-t i✓�S� f' Cb n� a 10�. tiS 1 �C . NOTE: SEPARATE CITY CONTACT PERSON: 6 r!�A� Sw e -n 5 a "o LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS ADDRESS: 12-7 3 3 Z07 W CITY P'r %^CC:Lo/� STATE FM S3� AND HVAC. �Ie. SUBMIT COPY OF BOND pHONE�%3. 3 & 7 ' FAX -7U3 - 3 - l Z 9- k AND INSURANCE PERMIT TYPE XSINGLE FAMILY ❑ TWO FAMILY 13 TOWNHOUSE TYPE OF WORK: O NEW ❑ REPLACEMENT XALTERATIONIREMODEL DETAILED DESCRIPTION OF WORK 13A scme-AZ. F-1 n Li 9 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 of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FDCTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU 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 DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 PERMtT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ SO Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ .50 0 OR Number of fixtures @ $25.00 x $25.00 = $ Number of fxures @ $35.0 35.00 = $ Suc $ 50 NIINIIViM $15.51 $155 $z THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL. PROCESSED I hereby apply for a mechanical 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 Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in rdanfWlffi3he approved plan in the case of all work which requires review and approval of plans. SIGNA ANT . PRINT NAME DATEp� s els® APPROVED BY DA I 11IJ " I_ PLEASE NOTE: SERARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK I City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit NoA to Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: (0' I -a 763-502-4977 FAX EFFECTIVE 1-1-08 1'A, DATE ADDRESS KI't _ 11 JUN 0 � 2000 rg cYOUpR�E--MAIL SITE ADDRESS 1 45 C) L�_D �G 1'/r THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY NAME: ADDRESS: ISS 0 GafL CITY STATI7h ZIP ER/ TOWN PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE STATE LICENSE #�7��.A EXP DATE 531' REQUIRED FOR GASAND �L � DRESS: � In Y`°` CITY fes, 4 STATE IP HVAC. SUBMICOPY OF BOND \3�� PHONE x(0.3 �� 2S FAX AND INSURANCE f�o PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 13 TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKl/)p.✓V�.n PER MS 160.665 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 of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _A/C TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 OOL HEATER $35.00 _CHIMNEY _GAS WORK $10.00 PIPING $10.00 VENTILATOR $15.00 _DUCT _GAS � Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Number fixtures @ $15.00 x $15.00 = $ Surcharge $ .50 of = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ (SE) THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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; at oA will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLIC NT - PRINT NAME �Cr ���I�OI^� DATE —6/- / DA APPROVED BY s r City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 i1 JUN -05-2008 02:17 Inspections 763-572-3604 PM STANDARD WATER CONTROL 763 537 1 BUILDING RESIDENTIAL APPLICATION SPfEADDRESS � � THIS APPLICANT IS; M OVIM =ANT SUBMIT A COPY OF STATE LICOU YOUR STATE LICENSE ADDRESS: WITH APPLICATION I .wram -li_ 0 0 BASEib1M4T P24ISH C3 DECK TYPE OF WORD: f o NEW DESCRIBE WORK BEING SIZE OF DdPROVBM 4T • f ' fit w� •.���► is SMING 0 Vinyl d Ahm1h vm El Other MUM INwasTiPoOPSMGS t3Ycs ONO OR FOR NEW OPIRM09-DESCRM SIZE OF OPEWNG CHANGES & r`" OF FRIDLEY 0 HOUSL A GARAGE C] ATPACHED GARAGE Ca DSPACE30 GARAGE ClSofSt © 2Yist ❑ Pwio. LOCA17ON OF W241DOW S 1882 P.01 +, �'"�` Rweived By: i , -r�� !�� �i — — STATE ZIP TION,MMUbING THE COST OF JW UA.0 FEE SCMULE) -lflabr a 60 nCrniPAxc HEIGHT 1. Exisdag Flaar Pin 2. Propo w floor plan 3. List of 60 wuW mamba to be umd FOR NEW CONSTRUCTION INCLUDING DECKS, ADOM01 S. & ZQKq Eq SIM=, I. Site and � wing the existing sauoames• 2. Two no of oamatructhm p1m 3. Energy Calcubdons ENO Plant Review $ 65% of Building Permit Y;" Fire Surcharge $ .001 times the total job valuation S'Se $ .0005 x Permit Valuation Minimum $.50 License Surcharge S $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Bs=w $ ft + 6 ft = ft x $21- $— EmWon Control $ —�� $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main aunt $ Agreement necessary ( ) Nun Necessary ( ) THIS IS AN APPLICAITM FOR A PE tW-NOT VALID UNTIL. PX=SSED I hereby apply for A building permit and I aclmowle* that the information above is rarvlete and accurate; that the work will be in canfornoance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I undenWmnd this is not a permit but only an application for a permit and work is w to start without a permit; that the work will be in aceardance with the approved Plan in the ease of all work w ' ew app mal of plans. ,, ff�� j /� � ,,r �y SIGNATURE OF APPLICANT . 1 PkW NAb E_1&# (.� �"�rJfs �'ly^ DATE �5 %, .1' Engineering WATER AND SEWER Permit No.: '7,61172-3551 PERMIT* APPLICATION Received By 763-571-1287 faxCITY D l EP 2 200 OF FRIDLEY EFFECTIVE 6/9/09 APPLICTATION DATE: Z 9q YOUR E-MAIL ADDRESS: _ THIS APPLICANT IS: OWNER eONVACT �❑ /pJ� a JOB ADDRESS: 5 3/�" ` NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: `l OWNER/ TENANT ADDRESS: 75- L,a, l4S ` - CITY STA P PHONE: '7%o 9 -- 7,-75' XY10 CONTRACTOR NAME: 64c—j w 4I d- c t or--/ �r.✓, tiC SUBMITA COPY OF YOUR STATE ADDRESS: 91 '1 4 Ca 4 yGti-h.rv, S%I - NC CITY •.� STATE OVI'ZIP ,"S -Yl B' LICENSE WITH PHONE Cel L- dk 9 ' ` *7 I `Y CELLPHONE: W7 �pq APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. NarratLvetwriften description: n; Malo '1'-' VA"' Z ht leo►^, Alcv SL 2. Please attach sketch showing curb line, utility tine, building, etc. with distances. PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 ❑ WATER LINE REPAIR $40 ❑ SEWER LINE REPAIR $40� ❑ ADD STATE SURCHARGE $SO , ❑ SAC CHARGE @ $2000 = OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF /WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application for a permit an i not to start without a permit. ^ Er21 `l�S 1a SIGNATURE OF APPLICANT PRINT NAME: fie.. DATE: 2 APPROVED BY: DATE: COPY G TO: ❑ TILITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ 1 GI EERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287