The URL can be used to link to this page

PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N°5 0 2 5 Date: Owner: Builder Address a..z. � Address lafn � or LO TI OF BUILDING No. Street - -1 - — Part of _ Lot-,pBlock _ _ _ .. _ _ Addition or Sub -Division . _ a p - ---1` .� Corner Lot y Inside Lot _ A-� Setback —s L5 —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING ' Front Depth . Height 14 Sq. Ft. Cu. Ft,/�o Front Depth �ght, Sq. Ft Cu. Ft Type of Construction ++L'`r�� Est Cost _..� 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 in compliance with all provisions of ordinances of the city of Fridley. Y 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 f any of the provisions of said ordinances. rf. ,.../' Building Inspector NOTICE: This penult does not cover the construction, Installation for whing, plumbing, gas heating, sewer or water. Be sure to see the BuMg Inspedor for separate permits for these items. O•�aner Is Nan Address 51 APPLICATION FOR BUILDING PERMIT CITY OF FR.IDIEY, MINNESOTA LOCATION OF BUILDING No. Street Part of Lot Lot, i 0 Block , Addition or Subdivision-,5rg�..e /� Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be Aved as: Type of To be Completed DESCRIPTION OF BUILDING li Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. ted Cost 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. DATE -,9Z ® SIGNATURE °y (A Schedule Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley, Minn. BUILDING PERMIT N°s 4 Date: Owner: �� Builder b 7-A�:s Address Address CA ON �2ILDING No. Street " � Part ofot Block Addition or Sub -Division Corner Lot — Inside Lot _ +`"" aback ideyard +s Sewer Elevation _ Folleasition Elevation DESCRIPTION OF BUILDING To PPU as: Front Depth __,'-'Height Sq. Ft Cu. Ftp !� Depth _C��I�� t CZ; -3q. F't. Cu. Ft Type of Construction �"'2 Fit /�4z _ 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 in compliance with a'll provisions 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the dty limits anddts permit may be revoked at any tinge pupa viola of any of the provisions of said ordinances.) NOTICE: 161a permit does not corer the construction, iesteMen for v kb& phmnbtup, Sea heath* nwer or crater. Be sun to an the MIA* Inspector for separate pormlis for thea Bonn. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S ITA14E oS LOCATION OF BUILDING No.zV pL Street 4 , Part of Lot 1• Lot _d Block _Addition or Sub vision -+ Corner Lot Inside Lot Setback Side -Yd SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this.form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front Depth Height ZV Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost I 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 true and correct. DATE oar / (Sebedule of Fee Costs can be found on the Reverse Side). " . .. w ,. . -- ?? City of Fridley Application for Plumbing and Gas Fitting Perm Dept, of Bldgs. Phone SII 4:1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE City of 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. 19& Owner Kind of Building / Used as ` PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures ...................... x $1.50 $—� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x �, �Q�Q � Water Heater (Up to 200,000 BTU) ...... � � xX' Z�z �c p Z �z 5O5� J C�jz�� a Z - • • N WATER HTR. GAS ELEG Base 1st ! 2nd _ 3rd _ 4th • Future Conaectfoa Openings Connected with Sewer New .Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE City of 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. 19& Owner Kind of Building / Used as ` PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures ...................... 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 $---,:' G 6 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL x $1.50 $ x .50 $ x 2.00 $ To be completed about Estimated Cost, $ Old -New. Building Permit No —tea Permit No. Signe ROUGH y ^ I FINAL Description ................................................$ TOTAL FEE $ a 42 2M By Business Phone No- lle-6, Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE 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 U V 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 $0 over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....... . ............... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .A ................... x $1.50 ,, $� Additional Fixtures ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ go® AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 �J 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. Fridley, Owner Kind of Building Used as To be completed about Estimated Cost, $ 019 —Ne wilding Permit No. Permit No. DESCRIPTION OF WORK 196J_ HEATING or POWER PLANTS --Steam Hot Water, Warm Air—No r Trade Nam ,'�()- Size No_ �S Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER —Trade Name �,- Size No Capacity Sq. Ft. E.D.R BTU H.P. Signed (REMARKS -OVER) 2M Business Phone No Compl states there are several rats in the woodpile behind the garage at-.278.Liberty. While I was taking the complaint I observed at least 2 rats in the backyard of 278 Liberty. ATTN: CITY HEALTH INSPECTOR ___� INCIDENT REPORT 81-11010 'FF�IDLEY POLICE DEPARTMENT case # MN0020600 OFFENSE OR INCIDENT ANIMAL COMPLAINT DATE REPORTED TIME REPORTED DAY: S. M T W TH F 2-14-81 DATE OCCURED 154 TIME OCCURED HRD: R — radio C A RlP P — phone PLACE OF OCCURRENCE A — alarm ��`T� GRID 0 I in 97P-1 i hcri-v I (/�7 �% — person NAME OF COMPLAINANTNICImo-Y TIM -- DOB V —visual Marvin Ilallwn M — mail HOME ADDRESS PHONE T — other 9R8 1 i hart/ BUSINESS ADDRESS 780-1325 REPLACEMENT VALUE: PHONE REPORTED BY VALUE OF DAMAGE: ADDRESS VALUE RECOVERED: PHONE OFFICE USE ONLY: OFFICER ASSIGNED SQUAD # ISN UOC UCS ASSISTIN I S ADPAR PPROVAL ENTERED CJRS: ARRESTED/SUSPECT(S) OR DESCRIPTION GL TIME OF ARREST 1. 2. WITNESSES ADDRESS PHONE DOB 1. 2. DETAILS OF INCIDENT: ADDITIONAL REPORTS: Compl states there are several rats in the woodpile behind the garage at-.278.Liberty. While I was taking the complaint I observed at least 2 rats in the backyard of 278 Liberty. ATTN: CITY HEALTH INSPECTOR ___� CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 October 6, 1983 TELEPHONE ( 612)571-3450 Nr. Stan Carey 278 Liberty Street N.E. Fridley, HN 55432 Re: Automobile Body & Repair Shop Home Occupation Dear Hr. Carey: It was brought to the City's attention on October 4, 1983 that you Were operating an automobile body and repair shop home occupation at your residence. Although the City does permit certain home occupations, it should always be remembered that the purpose of a residential area is to provide a living setting away from the noise, signage, clutter or traffic of a commercial district. Therefore, please read the following section of the Fridley City Zoning Code which defines a home occupation. Section 205.03 defines a home occupation as, "Any occupation or profession engaged in by the occupant of a dwelling unit and carried on within the unit and not in an accessory building. Any home occupation shall be clearly incidental and secondary to the principal use of the premises and shall not change the residential character. The following are criteria of home occupations: A. Professional offices, minor repair services, photo or art studios, dressmaking, teaching and similar uses. B. No stock in trade is stored outside the dwelling unit. C. No over the counter retail sales are involved. D. Entrance to the home occupation is gained from within the structure. E. Teaching is to be limited to six (6) or less students at any given time. F. Day care facilities that serve ten (10) or fewer children. G. In addition to spaces required by the°occupant (family), there is no need for more than two (2) additional parking spaces at any given time. H. Employees shall consist of members of the immediate family only.• We are confident in your cooperation on this matter and if any questions or problems arise, please feel free to contact me at 571-3450. Sincerely, STEVEN J. OLSON, R.S. Environmental Officer SJO/mh CITY OF FRIOLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571.3450 F$ December 7, 1983 Mr. Stan E. Carey 278 Liberty Street N.E. Fridley, MN 55432 Be: Home Occupation Dear Mr. Carey: A complaint was received and a subsequent inspection was made of your residence on December 6, 1983• The complainant expressed concern that you may be operating a business out of your garage and also that your wood stove may be operated in an unsafe manner. At the time of our inspection no determination could be made about either concern because no one was home to discuss the matter. I have enclosed the section of our City Code concerning home occupations for your review. If you have any questions about the Code or its interpretation, please call me. If the interpretation is that you are in violation, please bring your property into compliance as soon as possible, certainly not later than January 1, 1984. You can reach me at 571-3450, between the hours of 8:00 a.m. and 5:00 p.m., weekdays. Sincerely, cz: � DARREL G. CLARK Chief Building Official DGC/mh ENC: 1 SUBJECT PER City of Fridley 1750 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEI O. may_______ COMMUNITY DEVELOPMENT DIV. I� r PROTECTIVE INSPECTION SEC. � !L) 1 � i ``j CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY j, ,fes 612-571-3450 910-F15 5/24/84 JOB ADDRESS 278 Liberty Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 49,50 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stan Carey 278 Liberty Street N.E. 784-2444 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS 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 $5500 $.550 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- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TO;AL FE O SI NATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT Q. SIGN TUBE OF OW NER IIF OWNER BUILDER (DATEI -_ BLDG INSP r)AT14 NEW L ] ADDN. [ ] ALTER. Construction Addri Legal Description City of Fridley Effective 4/1/84 �R-1 AND R-2 Building Permit Application Owner Name & Address: �" ' "J'� W Tel. # (' S' Contractor: IV Tel. # Address: 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. 9G d GARAGE AREA: Length Width M Q - Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot GC] Ft. Yd. Setback Side Yard Setback Type of Construction: rl �fl'L Estimated Cost: $ 600 Approx. Completion Date: � I r Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE:JR-iAPPLICANT: Tel. #7W4 " 2IS Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY �Cy Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ /5.,�:_b :ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 431 University Ave NE ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT04 -b� 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash :: •::.:<.:::::::<;::: :l>✓t:>::::::::: ?8 Uj6p-ery �� )LUMBING FIXTURE RATES: NO. RATE- TOTAL JOB ADDRESS 6&A -A& ' aL5, O -W AA4— dew Fixtures ....Urinal........ The undersigned hereby makes application for a permit for the work herein Nd Opening, New Fixture Show r . Tra � Dra'n Auto. t.::::;::;: Washer Gas Range (#SG ?' Water Heater Stories�....' Gas Elec� Basement Iain Water Leader $10.00 278 LIBERTY STREET NORTHEAST _,20 iump/Receiving Tank $10.00 FRIDLEY, MN 55432 Nater Treating Appliance $35.00 OWNER (763) 784-2555 Nater Heater -Electric x Floor 1 Nater Heater - Gas** $35.00 11 BUILDING USED AS Ytg S a e -yG� Sas Range** $10.00 q6 � oto //,1 QQ, ' Dy U / I 3as Dryer** $10.00 ESTIMATED COST PERMIT NO. " ` 3ack Flow Preventer Required ( )Yes () No $15.00 Floor 2 Type Y-� t�i1M lOr Reinspection Fee $50.00/Hr SIGNED BY TEL N9:0, lZ) t327 740.33 %LL OTHERS AND/OR REPAIRS AND ALTERATIONS Em0 1.25% of Value of Fixture or Appliance Floor 3 Approved By Rough -In Date Final Date State Surcharge $ - 6Z MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ �S OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. Flo r 4 ?8 Uj6p-ery �� )LUMBING FIXTURE RATES: NO. RATE- TOTAL JOB ADDRESS 6&A -A& ' aL5, O -W AA4— dew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein Nd Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes 3eer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts 31ow Off Basin $10.00 and representations stated in this application are true and correct. ;atch Basin$10.00 CAREY, KATHLEEN �1/ Y Iain Water Leader $10.00 278 LIBERTY STREET NORTHEAST _,20 iump/Receiving Tank $10.00 FRIDLEY, MN 55432 Nater Treating Appliance $35.00 OWNER (763) 784-2555 Nater Heater -Electric $35.00 Nater Heater - Gas** $35.00 11 BUILDING USED AS Ytg S a e -yG� Sas Range** $10.00 q6 � oto //,1 QQ, ' Dy U / I 3as Dryer** $10.00 ESTIMATED COST PERMIT NO. " ` 3ack Flow Preventer Required ( )Yes () No $15.00 1 ` PLUMBING COMPANY O C ` aW1 Type Y-� t�i1M lOr Reinspection Fee $50.00/Hr SIGNED BY TEL N9:0, lZ) t327 740.33 %LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ - 6Z MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ �S OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 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 () 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 O 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 installina a new ventina 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 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) HEATING CO: Signed By: Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAX: (763) 571-1287 ADDRESS : 278 LIBERTY ST NE PIN : 033024310054 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMITO.: 2004-00811 DATE ISSUED: 06/_0_2-/2004 y VALUATION : $ 400.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 C111,1RI 01 CAREY STANLEY E & KATHLEEN 278 LIBERTY ST NE FRIDLEY, MN 55432 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 # WATER TRMT APPLIANCES 0 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 work 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— I Date., Bldg Insp L -a �- PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 28353 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Frrosion Control Park Pee Sewer Main Charge �+..a..l T%..s See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) ties the total job valuation — Mi IPUM $.50 .001 x Permit Valuation (1/100/0) $5.00 (Stam Licensed Residential Contract=) $1450 per SAC Unit (Plans to MWCC for determination) _fi + 6 fi = fix $20 = $ $450 Cc savatian Plan Review Fee Determined by En&ee1ifte Agreement necessary ( ) Non Necessary ( ) Make check.► Payable to: Cita► of FRid1eY Atta+ THIS is AN APPLICATION FOR A PERMIT NOT VALD UNTIL PROCEZW that the work will be ID I hereby apply for a buildmg permit and I acknowledge that the information aboVe is complete and accmate> conformance with the ordinances and coda of the City of Fridley and with the Mimes= ConstrmtiOn Codes; tlw I understand this is not a permit but only an application for a permit and work is not to start without a 't; tba the work will be in accordance with the approved plan in the of all ork and vai of ians- / q J ///{{{/// n P DATE (y SIGNAT ME OF OF FRIDLF-Y CITY B�,DING.�SIDENTIAL Mrc 1�eronitNo.:Al,ding s .A► 'PLT CAT ION R�Ved BySpec�io 13-572-3604 Cff Y OF I'ItII I Y nate Rea> 6v YOUR E-MAIL AAOR�S E ADDRESS L, e.` S �. /V is APPLICANT W. D 0VMM p ,cTOR EtQI'F•RTY a Iii/ ,.I,gME: k SFAi'� ZII' TENANTAD»' GTTY mom l03 8 � • d SS5" CUNT"MR TtAI + / OF STATE LICENSE � � � S� � SUBWr A COPY ADDRESS. CITY 'OUR STATE LICEIQSE FAX _ wrmAppu+cA.'riON PRom a srz>� ❑ S119= FA—MLYNEW CONMUCTION —E i?IiOPERTY TXT �'TWOFAMILY/NEW ODNSTRUO ON STORIES PEYZW '1 "E 0 1nQN OOF p TILE ❑ BASEMM FAUSH a OTHM s7(K C3 > n SWII+/gma IPOOL TYPE OF WORK: I ►NV—'D ADU MAW7I PNANCFMWAIR ►ESC .M WORK BEW() DOM: .0 Q v � Q `r Cid i%L y L'Tei' - HEIGHT . F'L'. H I.. '��sTH 17E OF AVl1'ROV1:M»T a HOUSE ONLY g=6 SQUARES ❑ HOUSE & GMAM 1. Izxist�P► �' P�°° ❑ ATTACIM GARAGE 2- O DETACHED GARAGE 3. C) Linc vPsanreual mambas to be ROPOSM H&IGHT- --- FORNEW C.C3NMUCi'fON RfLUDINo PEM' „DING ] V m°yr1 �oma�tsv IIST 1. �� Sim PImdS=9 9ftWxz9 tltd lumim Am 1 pdw J ❑ Fasda 2. est t3� ProJ . Two sas of oonsaucaas 3- Energy Calcuiaaioas DOW NCsOPENWGS DYffi @to LOCATION OF WINDOWS 1R FORNEW OMNOSZESCRISg S12E OF WENWG CHANGES & NUMBFdt OP WINDOWS 171M OF WINDOW TO EE TNSTALiED VALUAIMON, INCLUDING TBE COST OF LABQR AND MATERIALS: ALL FEES ARE BASED ON (USMG THE 1997 U.B.0 FEF SCMDULE) ^r rrAL JOB VALUA ION $ � � � � � OCCUPANCY TYPE Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Frrosion Control Park Pee Sewer Main Charge �+..a..l T%..s See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) ties the total job valuation — Mi IPUM $.50 .001 x Permit Valuation (1/100/0) $5.00 (Stam Licensed Residential Contract=) $1450 per SAC Unit (Plans to MWCC for determination) _fi + 6 fi = fix $20 = $ $450 Cc savatian Plan Review Fee Determined by En&ee1ifte Agreement necessary ( ) Non Necessary ( ) Make check.► Payable to: Cita► of FRid1eY Atta+ THIS is AN APPLICATION FOR A PERMIT NOT VALD UNTIL PROCEZW that the work will be ID I hereby apply for a buildmg permit and I acknowledge that the information aboVe is complete and accmate> conformance with the ordinances and coda of the City of Fridley and with the Mimes= ConstrmtiOn Codes; tlw I understand this is not a permit but only an application for a permit and work is not to start without a 't; tba the work will be in accordance with the approved plan in the of all ork and vai of ians- / q J ///{{{/// n P DATE (y SIGNAT ME OF Building PLUMBING Permit N4U�QQ Inspections RESIDENTIAL APPLICATION Received By 763-572-3604 CITY OF FRIDLEY Date Rec'd:-7 DATE YOUR E-MAIL ADDRESS SITE ADDRESS X (5�% l✓ THIS APPLICANT IS:J OWNER OCONTRACTOR PROPERTY NAME: S % e_¢ ENAER/ ADDRESS: ter` �1 G CITY n STATE #J ZIPr PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE AINGLE FAMILY O TWO FAMILY O TOWNHOUSE O NEW REPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK Gi 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (NEw cn7mcrosE) _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK —WATER CLOSET _ BACKFLOW PREY. ($15) _ _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ L Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ j (� TOTAL DUE $ �� -7'�- State Surcharge = $ .50 Total = $ 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 appl ation 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 work which q ' es review and approval of plans. 1 (�f1 SIGNATURE OF APPLICAN PRINT NAME li DATE Efts City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977