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PRE 2010 DOCSDate: MAY 17, 1966 City of Fridley, Minn. X° 8834 Owner: DONALD N. HANSON Builder WEIRLEENGET CONSTRUCTION CO. Address Address 1601 - 127th Avenue N .W. Anoka., Minnesota 4/35 pan crest Minneapolis, Minn. LOCATION OF BUILDING No. 5261 Street LINCOLN STREET N.E. Part of Lot Lot 13 _ Block 1 Addition or Sub -Division HORIZON HEIGHTS Corner Lot _ Inside Lot — X Setback n 35Sideyard 10' and 5' Sewer Elevation 1405.0 —XIMOF&W Elevation 1008.0 TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: DWELLING Front 36 Depth 26 Height 28 Sq. Ft. 936 Cu. Ft. 26,20 ATT. GARAGE Front 24 Depth 24 Height 10 Sq. Ft. 576 Cu. Ft. 5,760 Type of Construction FRAME Est. Cost 420, 000 To be Completed SEWER LOCATION - 88.1' South of Manhole at 53rd Avenue WATER LOCATION - 98.1' South of Manhole at 53rd Avenue 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. / �. a v A X In consideration of the payment of a fee of3$ 2.00 ,permit is hereby granted to WEIRLEENGE CONSTRUCTION CO to construct the building or addition as described above. This permit is granted upon the express c�nditian that the pera�n to whom it is granted and his agents, employces an workmen, in all work. done in, around and upon said building, or any part thereof, shaII conform in all respects to the ordinances of Fridley, Minnesota reg {ng location, construction, alteration, maintenance, repair and maviug of buildings within the city limits nand this permit may be revoked at nay time upon violation of any of the provis�tons of said ordinances. WILLIAM H. SANDIN Building Spector NOTIC& M pumit don nd sorer the aonovedon, IndaWas ftr whino, phmcbhco, on ha hqb aawer or water. Be an to as the tW mhm Ingmbr for "Pardo permlb for thea itW& APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, NINNESOTA OWNER'S NANE BUILDER 1 LOCATION OF BUILDING N0. �� STREET %l r_ -ti �� PART OF LOT LOT L' BLOCK ADDITION OR SUBDIVISION jjggdt�.n�� CORNER LOT INSIDE LOT J--�SEiB ACR id � SIDE -YARD l0 �'�' �� SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certifigatees . lads DESCRIPTION OF BUILDING�«? o f�-- To be used as; i - Front- bepth 4 Height r Sq. Ft. Cu. Ft. --a ✓�--U Front_ rJ` Depth Height lo' 0 Sq. Ft. \-' Cu. Ft. �O Type of Construction Estimated Cost nad o To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE %7% / % -- (Schedule of Fee Costs can be found on the Reverse Side). d d Application for Power Plants and Hurting. 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 $ 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 1st 3 Fixtures ......................�— x $1.50 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $_L4,_� ROUGH FINAL Dept. of Bldgs. Phone 560-3450 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 tlie facts and representations stated in this applicatioU_aK true and correct. Fridley, s Owner Kind of Building Used as / To be completed about Estimated Cost, $_ Permit No. Permit No� (� ' O DESCRIPTION OF WORK HEATING or PO PLANTS—Ste Hot Water�No Trade Nam �' Size No Capacity Sq. Ft. M.R BTU H.P. Total Connected Load � Kind of FuelIf BURNER —Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS—OVER) -BusinessNo CO, ;/ -40 AlRr b-f?A � 0 � 9 Ddb HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S. .V.E. Construction No. Insulation Guide W' ows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How App ' d es No I e No 19_ Fl Room I Len th Width He ht II a Fl_I _ Room I Lenath JD Width C1 Heiaht Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 0 R I L.1L / Width H' ht e g t 0 � Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. �- �- '/ Coef. Btu Infiltration Infiltration Coef.1 Coef. Btu Infiltration 33.91 1 's—E0 1 y,.. ;- Glass 5-0 ®rO Exp. wall 7.1 Exp. wall cD h 0 o Net exp. wall Int. wall Inc. wall v 0 b c� Ceiling / y yj ,,� 14 jo /S'40 Floor y y®� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 0 R I L.1L / Width H' ht Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. . Room I Length Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. I Area No. of Dane of pane lights of crack I sq. ft. � X y 6 -% . pu /_ / la w vf> r° 4 Win ows and Doors—Crackage and Area In ooen & t 0 elg Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane Opens lights of crack sq. ft. Coef. Coef. Btu Infiltration Infiltration Coef.1 Btu Infiltration y 14, 33.91 1 's—E0 1 y,.. Glass Net exp. wall 5-0 ®rO Exp. wall 7.1 0 cD Net exp. wall o J' Inc. wall v 0 � Ceiling Ceiling yj ,,� o Floor 0 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. . Room I Length Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. I Area No. of Dane of pane lights of crack I sq. ft. � X y 6 -% . pu /_ / la w vf> r° 4 Win ows and Doors—Crackage and Area Width HeightNo. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Coef. Btu Infiltration Infiltration Glass 3),139 Glass y 14, -2 1 's—E0 Exp. wall Net exp. wall ii 0 o Net exp. wall Int. wall 7.1 0 cD Ceiling Floor J' Floor v 0 � Total Btu. r 14 Required sq. ft. E.D.R. or sq. ias. W.A. Leader area FI.I —.0 Room I Lenath 4 Width (-� Height F Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. tt. Coef. Btu Infiltration Btu Infiltration Glass 3),139 y 14, Exp. wall Net exp. wall 0 o Inc. wall Ceiling Floor J' Int. wall yrs Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area Height P / Room I Length 12,- Width q Height—Y Coef. Btu Infiltration P %.-St Glass Exp. wall Net exp. wall 4A2 v Int. wall Ceiling , S e 3 Floor X Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. Coef.1 Btu Infiltration 3),139 y 14, Glass Exp. wall y Net exp. wall Int. wall Ceiling yj ,,� o /,0 0 Floor y®� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Original HERMIT for Power lasts and Pleating. Cool- ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants to be installed—altered—repaired Make , Size ; Oil fired—; Coal fired—, Gas fired ; Gas Authorization No. Remarks Approved Final Inspection 19_ Inspector Permit N° 4376 Fee $ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. �9 , 19-46 9 Owner 4 4� d Locai P.?,`a How Work to be Commenced—.: - .2 —9, 19 9 To be Completed / - ? U ,19 Estimated Cost, $ r5--. 6'd Old -New, Building Permit No. Permission is hereby granted to KI—& -r -d-Zd- 1 L• to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the speci ns set forth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings . az 2M 11-67 V . Application for Power Plants and He Cooling, Ventilation Refrigeration pp acing. gRand Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water ........ ......... 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule -00 GAS BURNER (up to 199,000 BTU) ....................... 5.00 $1 / over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL r $ See Fee Schedule TOTAL FEE $-2 Dept. of Bldgs. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work hereit 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, AD= - ZZ 1 Owner Do "/ /y, 1114 1Y3 Kind. of Building 6 , k'LA ems -4 �. / - . be completed .. r Estimated Cost, $-_9 i. rm Old- -New. Building Permit No. -5/5W -7L Permit N DESCRIPTION OF WORK HEATING or POWER PLANTS --.Steam, Hot Wattesr�, •War�Air No0->1-rl- Trade Name Size No Capacity Sq. Ft. E.D.R_ er 1=12 BTU H.P. Total Connected Load Kind of Fue 6 r BURNER — Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS—OVERT By <a jjj1j1AW Phone No- �- 2,- SUBJECT PE20119 City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT ECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. I l1 = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j L 612-571-3450 910-F15 9/19/89 JOB ADDRESS 5261 Lincoln Street N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Rt. 13 Horizon Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Hanson 5261 Lincoln Street N.E. 571-2123 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 l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 1V Storage Shed in Rear Yard 9 CHANGE OF USE FROM TO STIPULATIONS Shed must be three feet from side or rear lot line or off from any easement. Maximum height is 14 ,feet. Shed must be securely anchored to ground by either a slab or tie downs. 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 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 $1,200 $.60 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- $29.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $29..60 SIGNA UREOFCONTRACTO O�IAUTHORIZEDAGENT IDATEI WHEN PROPERLY A (DATED HIS IS YOUR PERMIT BLDG INSP fjAT S4NAT5_U._E:1jOW_N ERIIF OWNE BUILDER; IDATEI NEW UC] ADDN [ ] A'i'm [ ] r R-1 AND R-2 Building Permit Application Effective 5/1/88 Legal Description: o�n,er Name &Address: _17o �� D r) . J- 4 szb t � a, Tel. # Contractor: Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. `LTVW- tAMM:.: � ��` Width Height Sq. Ft. 7 Width 12- Height �_ Sq. Ft. Zqk--) DECK AREA: Length Width Hgt/G MVd Sq. Ft. OTHER: sy�- Corner Lot [ ] Inside Lot [ ] Ft. Type of Construction: zxi FKgAffL> Approx. Cmpletion Date: Yd Setback Side Yard Setbacks Estimated Cost: $ 107 oo. Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page LlA'PE: �- /°j - 81APPLSCANr: ka5� 0 A, Tel. # % CITY USE OI�IIY Permit Fee Fee Schedule an Reverse Side State Surcharge $�( $.50/$1,000 Valuation SAC Charge $ $575 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. 'B" Above Park Fee $ Fee Determined by Ergineeritg Sewer Main Charge $ Arm*+* Necessary [ ] Not Necessary [ ] TOTAL $ A S'I'IPUTATICNS: i acs sao is ai d �i,CN/ M A9V E PUCK TE.L 53 RD Ave. N.E. R• x'5297 20.3 cd C ucj � I I C AI De.#,j arpes I Q*wz a— kz- 1237 -13- - 54 Z ► \ a -127.32 J `n 0 Z J �' 1 4, 7 LEGAL DESCRIPTION: ALL THAT PART OF LOT I?, BLOCK I, HOR12ON'HEIGHTS, .ANOKA COUNT'S A` 1 NNESOTA LYING SOUTHERLY OF THE FOLLOWING DESCRIBED LINE : � 'C`OMM1= 4C I NG AT A POINT ON THE WEST LINE OF SAID LOT . 1 3 DISTANT 90FEET oRO T�4, FROM THE SOUTHWEST CORNER OF SAID LOT 13; THENCE EASTERLY IN A,STR'AIGHT LINE TO A POINT ON THE EAST LINE OF SAID LOT 13 DISTANT '70 FEET NORTH FROM THE SOUTHEAST CORNER OF SAID LOT 13 AND THERE TERMI,NATINW• I hereby comfy that this survey. plea, or report novae prsepR= Dy me or under my direct super- vision and that I am a duly Regater+ed Land Surveyor. ufn t* la of the State of bruin esots. / /E! t1. C. W CI U M AM A5sociATES7 , NC. D,tp - 4-�"4 lee. No , L ktJD 5uRVF-'f 0P -sr kid% /��- o .31;0!)"i,y�-4,• ;Zg��as�0� • r COQ, � 03 CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL RATE TOTAL 1 (� Job Address .-Furnace Shell and Duct Work, �O' Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 Burner (Also replacement furnace) $ 20.00 $ City of Fridley ..Gas Piping $ 10.00 $ � Tel. #571-3450 (piping needed with new furnace) n Gas Range $ 10.00 $ 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 Gas Dryer $ 14.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. ( , 19� All Others/Repairs and Alterations D OWNER o AL D 4iV SON li of Value of Appliance or Work S -N. �t KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS S}� ED FJ tZ li of Value of Appliance or Work $ TO BE COMPLETED ABOUT L ESTIMATED COST State Surcharge $ .50 R 3 C OLD NEW BUILDING PERMIT NO. PERMIT NO. TOTAL !LE Reinspection Fee ($15.00) 77 �/ S./O! DESCRIPTION OF FURNACE/BURNER Rough insp. HEATING or POWER PLANTS, Steam, Hot Water,arm A1r No. Date Trade Name/— Final Insp. �`8 —?--a Date I, Capacity g© /y\ A[/ Sq. Ft. EDR BTU HP Approval for Permit Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 Company PLUS $.50 STATE SURCHARGE Signed By Tel. No. S-2 i —Ny3 *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size ana total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Sianed By Da to 01 J sueJEcr PE City of Fridley 20608 AT THE TOP OF THE TWINS BUILDING P E R M I T r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � 1 = i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/27/90 JOB ADDRESS 5261 Lincoln Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 1 Horizon Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Hanson 5261 Lincoln Street N.E. 571^2123 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof Dwelling 26 ares 9 CHANGE OF USE FROM TO STIPULATIONS Roof can bB 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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 X30.0 $ ,65 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PL N CHECK FEE TOTAL FEE FirIp, SC $1,30 $32.95 T ORAUTHORIZED AGENT IDATEI VALIDAT THIS IS V UR PERMITI\X &19N.AURE�OFN.RA �j�\ '01-Z7-1lJ01SIGNATURE 4ENPIOPEIRLY INSP QA7 F OWNER IIF OWNER BUILD RI IDATEI 01 J NEW [ ] Effective 8/16/90 ADUN [ ] _ --R-1 AND R-2 ALTER [ ] Building Permit Application Legal Description: Owner Name & Address: 72e.2A-j-D N, 14�-kb& J 540*� Tel. Contractor: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVn G AREA: length Width Height Sq. Ft. MOM AREA: length Width Height Sq. Ft. DECK AREA: length Width Hgt/Gr= d Sq. Ft. 07BER: coy In tfj -Iwl- II IKA:1 SQ . Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: —,Q6 LI Estimated cost: $ 130�) Approx. Coupletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: c1- Z 7 - °l 0 APPLICANT:2Tel. # S71 - 7_ I � 3 Permit Fee Fire Surdiarge State Surcharge $ SAC Charge $ Driveway EscrvW $ Park Fee $ Sealer Main Qmrge $ TOTAL $ _30 ,9 sTrPL=CKS : CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th $) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] GMTV OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Frepiace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sim 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 � S O ` �— Effective 4/1,/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES $35.00 $� $10.00 $ $1.0.00 $ $0.00 $ $25.00 $ Commercia Indus-Wo-VInstitutional 225% of value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/insdtutional State Surcharge $ TOTAL FEE $� REINSPECTION FEE $50.00/HOUR *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 REPIACEMENT FURNACE 10B ADDRESS ) QU)1 l° A n J Owner .� �) (�)Y\h'1�� Building Used As ESTIMATED COST_ PERMIT NO # of Heating Units l Circle One (Steam) (Hot Water) arm Alrj) Trade NamSize Na. BTU HP_ EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit far 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. Approved by Rough -in Date Final Date FI COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS at ®, the undersigned hereby verifies ththe Men .�,.,E� co.,o an ®a incs_f_ venting has been examined and is free from rust, deterioration, obstructions, Yes () No( ) and Is securely supported and firestopped where required. The venting system is piastic/l'VC and meets all current codes and manufacturer Yes () No( ) spermcations including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement t unci Is a Hinted This and meets the current odes and m ) include AGA-GAMA Category l Central Furnace Venting Tables for fan Yes { ) No( assisted and natural draft appliances. The ®xi@«ina connbustlion alr is sized and installed to meet the current codes Yes( No { } and manufacturer's specifications. When required to I{.all a ngw combustion air -It will be sized and installed Yes (} No to meet the current codes and manufacturers specifications' When lln�tallin I a n®w venting �Y�t�m.., the undersigned hereby verifies that It is a listed assembly and meetsAGA-GAMA Categhe current codes ory i Centmanufral Furnace No( ) specifications. This does includeYes ( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectorse coed mmon fertit alled and vented iv mer No { ) an appliance has been removed Yes ( ) separately as per current codes• li ce T n iz IC V and V C or I #ion c r BTU input _l___ Fan Assisted or Nat Appliance #1 Type �/� BTU Input _r/-- Fan Assisted or Mat Appliance #2 Type BTU Input _^__ Fan Assisted or Nat Appliance #3 Type Taal Btu Input r t Total Appliances — Common Vent Type Vent Height_._.. Diameter ?,...._ inches �� ft Diameter . 6..In Type __I ft Appliance #1 Vent Connector Heightft Length Dlameter _: „in Type E= Appliance #2 Vent Connector Height _.. ft Diameter in Type Appliance #3 Vent Connector Height= ft Length TETRA OPTS: cri Ir HEATING CO Signed BY.