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PRE 2010 DOCSCity of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location 9� 0 L O 1 V 6 r= of L. y NO. RATE TOTAL Number Fixtures ...................... — x $2.00 $ • O Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ 0 O x $3.00 $ WATER HTR. x $3.25 $ Base x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st ( 1 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... — x $2.00 $ • O Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ 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. /J Fridley, M�+_�' inn 19 Owner /1r' V.546/AIA L/1 Kind of Building Used as .1-101 To be completed about Estimated Cost, $ BGG O (!5'New. Building Permit No Permit No. Signe V �+ By L4./ Business Phone No_ S 0 ROUGH FINAL 42 Orifi No. of Make Oil fired ; Remarks i Approved by— Final yFinal Inspection, PERMIT for Power Plants and Heating. Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK Plants b JO 144A „Z _roto be installed—altered—repaired fired-, Gas fixed___n_; Gas 19_ _ size 'yam., n Q d7 -U, ; s Inspector s - L-/3 91 Permit AT° - - 4873 Fee CPO Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. h F_ C' , 19_D Owners �°®m _ int r L' eL F - Location -:� O / L O Ala ocal_r9 Lg l Kind of Building rR09M E , How Occupied -/ 1 L'a a -L-L, ►'J G Work to be Commenced—, 19 To be Completed ,19_ Estimated Cost, $ 6/00, 0 () (2�w, Building Permit No. Permission is hereby granted to to install--erect—use the material and devices described in the above statement. This permit is granted upodThe 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 n the specifications s ns forth//�n the approved application for this permit on file in the office of the Inspector of Buildings. rzf ,17 Y A A --y 1 . � YL D a Ruee[L9G(�',fmpector of Buildings 4z 2M 1147 V Original Permit f®r k-LUMBING AND GAS N? 5243 NG S'`/`'k-i" Permit N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for I inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee DFSCRiPTION OF WORK Number. Kind and Location of Fixtures m m to XF m m City of Fridley AeV"'r'&Aj � a 19 2,,) Stories f m o z S m f m Z m Y m> a Z Z # o Z o a U Z r m z m W U J m O m z WATER HTR. 6A8 ELEC. Q J 3 U K 7 a n m F a m z tp Q K 3 F Z O O LL o T J C LL O Q Q U m Q C d' J m_ X E 4. y Q d e a a s O K Basement 1st 2nd 3rd 4th Connected with Sew,er.Cesspool Gas Piping for Openings Permission is hereby granQ-� 9��U Q ) to do the plumbing and gas fitting in the building des ed in the statement hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Owner C�r121LRr 9E'� Location Kind of Buildi"'A'YYc. Used as j,'i "44:2A To be Completed ,19_ Estimated Cost $ 40 -,12 d Old -New. Building Permit No. inspector. Inspector of Buildings. 4Z is►—s�9-v Cit, of Fridley Apprication for Phmbbg aid Gas FNkq Pwredt Dept. of Ridge. Phon* 560-345 DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIBTO RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ J -0-C) New Ground Run Old Bldg. ....... . Electric Water heater . ............ . GAS FITTING FEES: 1st 3 Fixtures Additional Fiztures ................. . Gas Range to 199.000 BTU.. . ... . ... .... REPAIRS & ALTERATIONS—Refer to Code _ x $3.25 $ _ z $2.00 $ NO. RATE TOTAL : $2.00 $ x$.75 $ x $5.00 $ Description.............................................S TOTAL FEE $ r3° U C) 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 Owner Kind of Used as To be completed about Estimated Cost, $,�� G Old—New. Building Permit No. Permit No. Signed By _ Business Phune No ROUGH FINAL i 1, IN �■f+1 Cir l`;�■.■■��C�...�©� mom ■■.■■■■■■EN■■M■.. ■.■■.■■■..■■.■■■- ■ PARTIAL RATE SCHEDULE PLUMBING FIBTO RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ J -0-C) New Ground Run Old Bldg. ....... . Electric Water heater . ............ . GAS FITTING FEES: 1st 3 Fixtures Additional Fiztures ................. . Gas Range to 199.000 BTU.. . ... . ... .... REPAIRS & ALTERATIONS—Refer to Code _ x $3.25 $ _ z $2.00 $ NO. RATE TOTAL : $2.00 $ x$.75 $ x $5.00 $ Description.............................................S TOTAL FEE $ r3° U C) 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 Owner Kind of Used as To be completed about Estimated Cost, $,�� G Old—New. Building Permit No. Permit No. Signed By _ Business Phune No ROUGH FINAL i e4Pplim"i . for Power Plants and HeagWS Cooling. renh-latlOne Rgfdpraftn and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE iRAPITY 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 $-- --- -.�- NECH. WARM AIR I() -,Co 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 &W $ (TEAM 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 31L BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule 6AS BURNER (up to 199,000 BTU) 6.00 over 199,000 BTU See Fee Schedule 'AS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ Z00 $ Additional Fixtures x .75 $ Gas Range to 199,000 X$ &00 $ JR CONDI-1 ZONING 'AN HEATING SYSTEM Sae Fee Schedule rENTILATING SYSTEM $ ►LTERATIONS & REPAIRS TOTAL FEE $—Z-?, _00 ROUGH FINAL __ V Dept. of Bldgs. Phone SO -UM 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 Ordinance: 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, $_ Old—New. Building Permit No. Permit DESCRIPTION OF WORK 10-0 HMTING or POWER PLANTS—Steam, Hot Water, arm Air No Trade Name.-�(v11 eo Size N Capacity Sq. It E.D.R BTU HY Total Connected Load Kind of guev BURNER — Trade Name Size No Capacity Sq. FIL ED R- BTU p (MMARRS-OVER) Budness Phone No Lill Ur rnli,LLy APPLICATION FOR PLUMBING AND GAS FITTING PEWIT — RATE SCHED"! E PLUMBING FIXTURE RATES: NO. RATE « hem 7lxtures S r a m Future Fixtures .. • 3.50 .+ x V S wster • Beer Dispenser — y 4.00 S Blow Off Basin • F' P .ri w Y O ^, e Y a 6. o- c Rain we--!: Leader Heater Y V m r • L • � C •.� • .,C L 'i �C i r c � V 0u Y t CE V � �( S a .Y Y Hot ►tater Beater S 0 p p Baa Rer.ga , � LJ s Las o ✓ �n ✓ m •m I a L Yf V ,y/ S y (O d O State Surcharge I b 3 O ♦v N {. V m < 2 t7 44m l7 O .as �lec' ' I I i 1st 2nd -- 3rd 4th (R) • Future Connection Opening Connected with Sewer (1) • Hew Fixture, Old Opening Mater RATE SCHED"! E PLUMBING FIXTURE RATES: NO. RATE TOTAL hem 7lxtures S 5. CO 5 Future Fixtures S 3.50 S Old Opening, New Fixture S 1.50 S Beer Dispenser — S 4.00 S Blow Off Basin S 5.00 S Catch Basan $ 5.c0 Rain we--!: Leader - 5 —Sco S n..draulie Valve S 5.00 S Sump or Receiving Tank S 5.00 S water Treeting AF;lianee S 7.00 i Hot ►tater Beater S 5.00 S Baa Rer.ga , � LJ s Las ALL OTHERS AND/OR REPAIRS A":O ALTERATIONS 1% of value of Fixture or Appliance ,y/ S y (O d ReinsPection Fee S State Surcharge $ . So (515.00) TOTAL PEE !j S ss S (/ Job Address - Department of Buildings City of Fridley Tel. 1571-3450 The undersigned hereby makes arPlication for &_permit for the work herrin specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department-of-9uildings,-and hereby declares that all the facts and representations. 4ll atedn this Application are true and mrzti ' Fridley, Mn. 19 G /� ----�7 OWNER OCs t� /�r�r�Afd -• - KIND OF BUILDING USED AS - - TO BE COKPLETED ABOUT _ -- --- - OLD - N£W BUILD:NJ PEP -M- NO. P£i;.h!T NO. Company J_At Signed By Tel. No. ^f J k: L_h 1t: P. 4t. FINAL 1NSP. t¢' -- L� , FOR PLr�:7 '11-NIM14 FEE FGk ANY PLUYUIGr, PLXMIT IS $10.00 PLUS THE 5.50 STATE SURCHAMGE N Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and 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 $ MECIL 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 � d GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 0 (2) 1st 3 Fixtures ...................... x$ 2.00 $-9.— Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone 560-3450 city or irricuey: The undersigned hereby makes application for a permit for the work hereir 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, Minn 19 _ Owner V Kind of Building ,� Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. `7 •�'7 DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No.— _ Trade Name �� Size No. 1 Capacity q. Ft. E BTU H.P, Total Connected Loa Kind of Fuel BURNER — Trade Nam Size N�/ Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) <e Business Phone No G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 - (612) 571-3450 - FAX (612) 571-1287 February 22, 1996 Nancy Larue 14648 Embry Path Apple Valley, MN 55124 RE: First Notice of Noncompliance at 201 Longfellow Street N.E., Fridley, Minnesota Dear Ms. Larue: The City of Fridley has established a City Code for the purpose 'of promoting a pleasant. and attractive suburban environment. A recent inspection of the property at 201 Longfellow Street N.E. revealed that not all Code requirements are presently being met. Listed below are items which do not comply with the City Code: 1. Discontinue outside storage of a concrete mixer and assorted contractor goods located in the driveway and yard area. 2. Please be reminded that the City of Fridley does permit home occupations provided all conditions are met (see attached). Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or shortly after March 8, 1996, to determine compliance. If you have questions or would like to discuss this violation, please contact me at 572- 3595. Thank you for your cooperation! Sincerely, Kurt Jensen -Schneider Code Enforcement Officer KJS:Is CE -96-50 FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 November 25, 1996 Nancy Larue 14648 Embry Path Apple Valley, MN 55124 RE: First and Final Notice of Noncompliance of the Fridley City Code at 201 Longfellow Street Dear Ms. Larue: An inspection of the. property at 201 Longfellow Street confirmed that the following items do not comply with City Code: • Please discontinue the outside storage of materials including, but not limited to, a large generator, bricks, buckets, pipe material, two lawn mowers, a dismantled snowmobile and motorcycle, keg, sawhorses, and all other scrap materials or contractor goods. (Boats, trailers, and stacked fifewood are the only materials permitted as outside.storage in the -side or rear .yard.) • Please be reminded that the City of Fridley requires'all rental properties to be licensed. If you are renting this property, contact the Rental Inspection Division at 572-3616 immediately. A final inspection to determine compliance will be conducted on or about December 10, 1996. You should arrange to complete an approved plan for compliance before that date. Should this inspection confirm that this deficiency still exists, legal action will be approved. If corrective action cannot be completed by this time, contact me to coordinate a schedule to complete this requirement. If you have any questions regarding this matter, please contact me at the Fridley Municipal Center, 572-3595. Sincerely, Kurt nsen-Schneider Code Enforcement Officer KJS:ls CE -96-477 susit6t P~T NO. City of Fridley 32557 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. ►v __�___ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. y I , NUMBER REV DATE PAGE OF APPROVED 8r iL ��"'t;.� CITY HALL FRIDLEY 55432 612-571-3450 910415 5/3/02 JOB ADDRESS 201 Longfellow' Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 29,30 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Leo Van Buren 201 Longfellow Street NE 612-743-3336 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 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE R 8 DESCRIBE WORK Construct a 10' x 20' Shed 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WA�, Before %VG di '911 wi 99X11 fog tions 4Q R 2 EDBY LAW 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 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $600 $ 50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $27.45 SITUBE F C NTAA OR AUTHORIZED AGENTF C N'aa Oa AUTHORIZED AGENT (DATEt WHEN PROPERLY BLDG INSP VALIDATED THIS IS YOUR PERMIT 4aTE -G ATURE OF OWNS IIF OWNER BUILDER, MATE, - NEW [ ] CITY OF FRIDLEY Effective 1//2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT A` PPLICA71ON �(. Construction Address: (� ! 1_1 0 io c, z I d "1 , i± Legal Description: Owner Name & Address: Um') c N IzE rj Tel. # Contractor. S z LMN LICENSE # Address: 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: Length Width ('� Hgt/Ground Sq. Ft OTHER: a _� t Z'' ° J (''� '�P CJ Construction Type: L&D cs c&�s AM 2L Estimated Cost: $ � � C) Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ DATE: ��` PPLICANT: Tel. # Call (763) 572-3604 for Permit Fees N ing 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'Engineedng Agreement Necessary [ ] Not Necessary [ ] (� �!�_ TOTAL $ ;z!, STIPULATIONS: t SUBJECT PE �.NQ._.e,__ City of Fridley Q 33525 3 3 5 2 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. i fr------, A�[// "//� r � PROTECTIVE INSPECTION SEC. C;61 / NUMBER REV DATE PAGE OF APPROVED 8Y i CITY HALL FRIDLEY 55432 ---- �.� L j:\ 763-571-3450 910-F15 5/16/03 / 10B ADDRESS 201 Longfellow Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29,30 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leo Van Buren 201 Longfellow Street NE 612-743-3336 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same a 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 Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Restucco house 9 CHANGEOFUSEFROM TO STIPULATIONS 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 @@ @ $ WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT $500 •50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $24.50 SIG TURE OF CO)7RACTORItkAUTHORIZEDAGENr DATE, WHENPROPERLY VALIDATED THIS IS YO R PERMIT LOG INSO fIA IE SIGNATURE OF OVVNER.IF OWNER BUILDER. IDAiEJn I t NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 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: �N u YN-�, `i l / U C" :S + Legal Description: Owner Name & Address: V--0 y /Q --0,)'R - r, F' \lu Tel. # 6 I a` , 7`13 `3.336 Contractor. S F I MN LICENSE # Address: 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: LengthWidth Hgt/Ground Sq. Ft. OTHER: 3.—+ CA C C 0 Construction Type: ST4 < C_ U Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. 6 FtIn = DATE: - 0:1z) Call (763) 572-3604 for Permit Fees if call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ $ ® S' #1-�i a -��3 -3336 in application. Fax to 763-5714287 if using credit card and we will CITY USE ONLY - 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 [ ] FA SUBJECT a City of Fridley 33057 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. `; ------ 572-3609 r PROTECTIVE INSPECTION SEC. I � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55152 763-571-3450 910 -FIS 9/9/02 10B ADDRESS 201 Longfellow Street NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29,30 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leo Van Buren 201 Longfellow Street NE 612-743-3336 J CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same a 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 1 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (8 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 $858 $.50 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- 35.70 Fire SC $.86 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $37.06 SGArUREO CON-RA{Tp OR AUTNORIjEO AGENT iOATE� EN RO AL A D THIS IS YOUR PERMIT 1r SZNATURE OF OWNER off OWNER BUILOE Ri iDATE, FA 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: Legal Description: Owner Name & Address: t D f, P'a -f'j Tel. # Contractor. MN LICENSE # Address: 1 1 o syyc.� > S '� Tel. # �-� rr 7�/ SB 3 6 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: Length Width Hgt/Ground Sq. Ft OTHER: K O 0-3— T210 Q 5 'Z— - � ►_i L_ Construction Type: e� (kD6 �r�N - Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: , Gam- APPLICANT:A Tel. # C 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. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ -�� `90 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 [ ] STIPULATIONS: &4 19-7,311 SUBJECT City of Fridley 4064-,, AT THE TOP OF THE TWINS BUILDING PERMIT r `RECEIPT NO. � • _ COMMUNITY DEVELOPMENT DIV. r E PROTECTIVE INSPECTION SEC. zj E NUMBER REV DATE PAGE Of APPROVED BY i CITY HALL FRIDLEY 55432 763-571-3450 910-F15 12/29/03 JOB ADDRESS 201 Longfellow Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 29,30 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nancy LaRue 201 Longfellow Street NE 763-783-7412 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO North Central Builders Inc 7401 42 Ave N, New Hope, MN 55428 763-533-6168 d 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 WORN ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House 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. .; nnai inspection Cards Will Be Mailed oeown r To 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 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 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 $3305 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1.65 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE icerise SC $5.00 $107.20 SIGNATURE OF CONTRACTOR OR AUTNORiZED AGENT iDATEo MEN PROPERLY VALIDATED THIS IS YOUR PERMUIT IAVOG -NSP MATE $-GNATURE OF OWNER. -F OWNER BUILDER, iDATE, NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 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: D I 1JN (, FELLD w �T6 e r Legal Description: Owner Name & Address: fi A) C V C— Tel. # %L3— 7 F3- 79/D,q Contractor: 0k,TWf/ / r- T1 ,44L / --'o tfes �dV�°• MN LICENSE # &- ,tea 6 5 `0 Address: I/0Q 1 `f I n AyENu It-)a-Tht Tel. # 76 -3- 5' 3 - to l6,? Attach to this application, Aertificate 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: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: ' I D l 0 r- Estimated Cost: $ 3 30 Driveway. Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: 0h,3 L01 APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in ap ication. Fax to 3571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ q7, a5 TOTAL $ 101,20 CITY USE ONLY - 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 [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55932 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES C JOB ADDRESS 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 applicatio are true and correct. Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.Q0 $ *Air Conditioning - All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ Commercial/Industrial r. 1.25% of Value of Appliance or Work $ State Surcharge .50 _ TOTAL FEES' MINIMUM FEE FOR ANY HEATINGICOOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $ 50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On August 1, 1995 OWNER /-'�i'/'' �� _,oz% BUILDING USED AS ESTIMATED COST 135, Gsy) PERMIT NO._C)� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel • —Total Connected Load Burner Trade Name, BTU HP Size No. EDR HEATING COMP Signed By Tel No. '13` , 31 f Approved By ough-In Date Final Date 102 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HIMNEY 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 Dodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done HEATING CO: Signed By: Date: f 6r. ADDRESS: 201 LON LLOW ST NE PERMIT NO. 2005-03017 DATE: 12/22/2005 TIME: 03:30 PM INSPECTOR: DAVE JENSEN INSPECTION TYPE: HEATING FINAL NOTES: 1) Size vent connector and pitch per 2000 I.M.C. 2) Size common vent per 2000 I.M.C. Chapter 5. 3) Provide combustion air or provide Centerpoint Energy Mechanical Code Guidline worksheet 4) Provide min. 3 inch drip leg. STATUS: INSPECTION NOTES: INSPECTOR: 14OV-29-2005 TUE 11:00 AM RAY WELTER HEATING & A.0 FAX N0. 6128252303 a P. 02 FROM :City of Fridley FAx N13. :7635711287 Nov. iB 2= 02.313PM P4 Building MCHANICAL PetmQifiN�.' TWeoons RESMEN'1'LAL APPLICATION � ��.�-...... 763-972-3604 Cny OF FRIDLE " pim'ck VM AOLIRRSY,_., res A"WAKM .4 . SUSlvO'P A COPY OF YOUR STATE Ltc wrm IM& 4;- A YOM -Amm-i DiM7X-15 © TWO FAMO.Y O 7vvVIMM TYPE j,� WOm.11�1E�V► I'1.+![+1Mllut�'Y O AI:tA7it>a11RGD8Z+ DYr6CRiPTION OF WORK PER M81a9 W ibe emit faa is a aaiaimata a1 S1 S.Q0 ar S% of the t9w ad tl . SSOI �� a aapy coR of labor 1 9mpaavaaoM% inoalladaa ar t of t sasidmtisf �cwra� mccbtd'na$ LW w cc* 53tlo - $iS 00. Labor coat batwem $300 so $sw - colt of labor,,,,Y„ X.05 -. Fox M WAM i 424 ism. FM AU Hamra oN SI(.0a M FW= EgCPT VnMEM)M' nr=M: 0WC,ATji=AL 1"ImcrImenom-fX �t at b,gallod A u um- i'7© MM; � AGS =1S ODS au AANGB�PVPN 5la.� —AM EJt ARfaw sis �) t05.OD W ttAs tir+:a�. sla m • ' p� i „��%. Ntuobar of �dnres � s10.ti0 „�, x SID.po � �—�� n r{uplbrr of silxtures S1S.t+0„�.x SIS -00 M It ALAUi3 s Nmbo of fcripm i moo�.r.x 525.00"s . Number ofBxWm $35.00^,x„_ x 535,00 = -s- , .50 rS 2 AN APPIICAnM FORA FMW-OT VAMUNM PhOCStM I ttereb ! 1y ft a bWWjnS pumh ad I aole►mWp that tie ittfonvaaon above it M"Ieft and N=ZW; that *a work wilt be in oanfa m-1 w th0 or4kum wo Wo of the City of Fridley and *M ow mwnw a tra dial tis; that I UNIMM4 this is pats poimit Int 0* an appB;Won Ew a permit =W work it and to Offs t witovt It PO*4 that the work w.11l be In woordaaae WI& dw eppmvad plea In the case of'on w hbb of Alam. StOIVATultBOt+AMJCMr -��.,.:�.°�,�Z:►11 ���r�... City of Fridley Baiwag IU$P dons mpar alit 6431 Uuivel9ty Aveoua NE, Fridloy, UN 55432 7153-572.36114 %A7t• 7fMW-4977 ADDRESS: 201 LONGFELLOW ST NE PERMIT NO. 2005-03017 DATE: 12/22/2005 TIME: 03:30 PM INSPECTION TYPE: HEATING FINAL NOTES: 1) Size vent connector and pitch per 2000 I.M.C. INSPECTOR: DAVE JENSEN 2) Size common vent per 2000 I.M.C. Chapter 5. 3) Provide combustion air or provide Centerpoint Energy Mechanical Code Guidline worksheet. �> p.J� 4) Provide min. 3 inch drip leg. STATUS: INSPECTION NOTES: INSPECTOR: V IS Ca 1Z A Gy' 1Z A Gy' FEB -10-2006 FRI 03:53 PM RAY WELTER HEATING & A.0 FAX N0, 6128252303 P. 01 0 1 1, "cut�r�lheller MUTE Chicago Avenue . Minnoarmlis, M14 55407 V 612-825&867 • Facsimller 612825.293 FACSIMILE TRANSMISSION SHEET PAGE 1 OF DATE: /12006 01 TO: �� � -� � � � X 5 y/ 107 FROM: V�" / ��/ 1'�► / Lerma , V Lw -- FEB -10-2006 FRI 03;53 PM RAY WELTER HEATING & A.0 FAX N0. 6128252303 P. 02 INSTALLATION AND MAINTENANCE INSTRUCTIONS MODEL M LC K THS SYMBOL ON THC NAM13 "M WEANS THE PROQUCT IS LISTED 9Y u�� T. LWM NO. MH 17M (FOR cgMNr;r uNaIS) FLEXIBLE CONNECTOR LISTING No. MH 25730 (FOR VENT CONNECTM) CAUTION: Metal -Fab flexible connector has been designed to property connect Category 1 gas -burning appliances to listed chimney -lining systems or listed Type -13 gas vent. Category 1 appliances operate with a non -positive vent static pressure and with a vent temperature that avoids excessive condensate production in the vent. Appliances burning solid or liquid fuels, or category It, Iq or Iv furnaces, are not to be connected to this flex connector. Metal -Fab product may be installed in unenclosed space between the appliance and the listed masonry chimney system or Type -e gas vent This flexible connector must not pass through any combustible structure such as a wall, ceiling, floor, attic space, or crawl space. Contact local building or fire officials about restrictions and installations in your area_ The flexible connector must not be sized less than that specified in the appliance manufactures instructions. Clearance for Metal -Fab flexible connector to unprotected combustible material Is 1" in open air space and must be in accordance with "Minimum Appliance Clearance" specified In NFPA 211. To properly size the connector, follow the Category 1 venting table now contained in the National Fuel Gas Code (NFPA 54)ANSI Z223.1). While installing flex liner, consideration should be given to the following: (1) make no unnecessary bend (2) make no bends greater than 90 degrees (3) make bends as smooth as possible, with no dips or snags and (4) install with at least a %a per foot rise. INSTALLATION: 1. Determine the length of the connector needed to connect an apownce to, a) inlet of low Y lining system, b) inlet of Type 13 gas vent Tee or 4r ttet is connecting multiple appliances. Mstal-Fab's MAIL, connector WN span a distance of up to 5 ft_ if it is rely to shorten the ovemil length of the connecUr, cut off excess flex fmm the inlet (bottom) end — tieing careful to re -attach tete Inlet sleeve to the shortened length of flex 2. To rAMigure the &Able connector to is proper length, pull and stretch to the required length, being carefu) not to over-stratch the connector. 3. T** bck the Wild (top end of the motor to a) the inlet of the chimney Wng system b) Inlet of the Type -S ges vent syMm or c) irilet and of Type -0 gas vent lee or'i (Sege IFtgum 1 thru 3). Figure 1 caolmoft TCAFKU E Fuawm makay umm FEB -10-2006 FRI 03:53 PM RAY WELTER HEATING & A.0 FAX N0. 6128252303 P. 03 Date: 2/10/2006 Revision Date: 2/10/2006 Existing Construction: Pre 1994. Site information Address 1: 201 Longfellow NE Project #: Address 2: Lot: Block: City: Fridley County: Subdivision: Application Information Business Name: Ray N Welter Htg MN Contractor License #: Contact Person: Office Ph: 612826-6867 Fax: 612825-2303 Cell Ph: Address 1: City: State: Zip Code: Minimum Mechanical Code Requirements Met Will you be replacing or adding a water heater, furnace, or boiler? NO Will you be installing a decorative 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. s Applicant Name (print): 4re i C 5A Signature/pate: 2-0-176 Code official (print): Signature/Date: �kVf- ^'V1 in?f,► ,.-" �Cf9'!o�/.�► �a'�ly1 �l� � i D t/t �! CJS` ,�+ Iv��'�+''r<' TYL Gdcc � i �'-I f j,7 f� �'�'"'L'� I �'1. e Mer.'l" re.�lc�mfe9u,p►r�a�'4.�`- o�ve� nod c��s�. ,N --e. e�i's�-�+�, t��.ec'�"'',c�./ [: e�'ir► Y1 �' 1 %�a' �1JY? J� �.C.. T 6�C %'t�' �A' L ��'' ��/� `rG lad ! ! W414 /oay 0 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page 1 Building Inspections 763-572-3604 DATE -_-A-'2; SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS O OWNA PeONTRACTOR Permit Received By: ATE4&ZIP. STATE LICENSE # 651.365j34n_ EXP DATE 1y� SUBMIT A COPY OF ADDRESS. 3676 �d Rd. #100 CITY STATE ZIP YOUR STATE p� 11�M 55?23-1339 LICENSE WITH PHONE FAX PERMIT 'TYPE J*INGLE FAMILY 13 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK 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) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor x.05= WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL FOR PROJECTS NUMBER OF EACH BELOW) SHOWER _ WATER PIPING _ BATH SINK/LAV FLOOR DRAINS —SHOWER POOL _WATER SOFTNER ($35) _ BATHTUB _GAS PIPING (neo crrrucE^s — W PREV. ($15) WATER CLOSET _ BACKFLO HE _ CLOTS WASHER .—. KITCHEN SINK WATER HEATER ($35) FOR IRRIGATION DISHWASHER — LAUNDRY TRAY WATER METER —OTHER Fee TOTAL DUE $ .50 Nuembr of fixtures @ $10.00 Number of fixtures @ $15.00 Number of fixtures @ $35.00 x$10.00=$ x $15.00 = $ x$35.00=$ State Surcharge = $ 50 Total = $ Z4s 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 ction d this is conformance with the ordinances and codes of the �City workFs not to start with withoutNa permit; that work vvll be mthat accordance �'�' � the not a permit but only an application for a permit approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT - City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977