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PRE 2010 DOCSSUBJECT PERMIT NO. City of Fridley 290 AT THE TOP OF THE TWINS BU IL DING PERMIT • r � NO. • COMMUNITY DEVELOPMENT DIV. ;RECEIPT r PROTECTIVE INSPECTION SEC. / 'l NUMBER REV.16722/73 PAGE OF APPROVED BY "t CITY HALL FRIDLEY 55432 L---'�"� ,'1 612-560-3450 910-F15 JOB ADDRESS 273 Longfellow Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17, ] $ 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred S. Yesnes, Inc. 6600 Dupont Avenue North, Mpls. 566-8510 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct S 32' x 24' & 25'6" Dwelling and No Garage 9 CHANGE OF USE FROM TO STIPULATIONS �r�C���¢������(�C���(�� Provide a verifying survey before cappi Provide a gravel or similar type driveway. SEWER LOCATION: 65' West of Manhole (Inv. 848.23) Wye Elevation: 848.00 Top of Footing: 851.00 Minimum WATER LOCATION: 10' East of Sewer Service SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SINS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 jt -1 816 15 936 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. $13,779.84 6.89 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- 30.00 275.00 STRUCTION OR THE PERFO MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 311.89 SIGNATUREFCONT CTOR OR AUTHORIZED AGENT (DATE) WH N PR E THIS S OPERMIT h jq�jIDAD jl 17 1IF-j BLDG )NSP DATE SIGNATURE OF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA l !�J OWNER'S NAME :- r"O S. 4 SA/jQ._Z�UC,_BUILDER: Q S. ADDRESS: 6600 ADDRESS :- 6 4_ C:) V ' 4 NO:. owl 7 3 STREET: 16-1-s v 74 -Ar loff LOT: iff BLOCK: ADDITION•wAfY CORNER LOT: INSIDE LOT: V SETBACK: SIDEYARD:% '0 41e Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: fie- Front • 2' Depth:— �7J Height : Square Feet: Cubic Feet: d �`% •P _ —Front: Depth : Height: Square Feet; Cubic Feet: Type of Construction:Estimated Cost:_$ To Be Completed: &M=- NO V4 1-97 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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: _ %� SIGNATURE • ° � grAI2, (See Reverse Side For Additional Information.) (I :i �' v�. ,rte' -. w . _' s ' Id, ® IP marls C-Tou ..2 3) 61S, (1� - 2 sI o 0 ze /�0 )P- �..City of TFHCHm r 3LI;�d�CS Pea.9mit No . AT TK TOP QP TH'I TWINS 1 j PLiJi'°9Ll1'!G PERMIT �,PPLICATiud I0. r ------- COUNVWITY oEVEELO9WENT VIN, � I � PaoTCCTtva t%��'SCT1ap+4 v3ts'P, V" CITY MALL FRIDL4Y MQ2 NUi�fia+� F �v. DATIE PAOE w OvPRov o ®Y .J 01z-GQQ-3-kQ 101 0 ?. 15 73 1 1 800 Job Address 2-73 Owner Address Phone �ss Contractor Phone a" 5 S 30 ' S`/5 vao Kind of Building Us Completion Date st�mate ost 71) } Plumbing; Fixture Rates; NO. RATE TOTAL I II I J Number Fixtures $2.00 /a,00 x _3 ! Future Fixtures 3 x $1.50 �-D I I I i I 1 1� t� I 3oNval saol _._ New Fixture -Old Open. a x $1.50 ,ddb i Catch Bain x $3.25 XIS + Water 'Neater -99, 000 BTU x $3.00 3• o a I I I •7SIWI-- � - •sao, Ground Run Old Bldg. x $3.25 —� t +� •MNlval M I — Elec. `later Heater x $2.00 — SNISVS� I X "�1VJI ira •c4 I � I � •° Gas Fitting Fares I I + Pi eNlvaol '0 aoo,d o 1st 3 Fixtures x $2.00 a.o d ..___--� ,O u sa3MOHS Qal— I I Additional Fixtu' res x $ .75 � •1Nnoe � I ;a L MNtaa I m r 199 0 �. r. Gas R^rbe--.. $ 00 BTTJ $5.00 scall I ~) ^ repairs_ & Alterationss.. o i n See — 1 SMNISI--I I ; Description:Code , �a SN19V9� State Surcharge .50 �I �I I 1 I s®nl1 TOTAL FEE $ The undersigned hereby makes application for a per-mit j s,"Nitl°i ' I + for the work herein specified, agreeing to do all work s13so,o J 0 in strict accordance with the City Ordinances and ruling – N317MI� �� ! of the Department of Buildings, and hereby declare that all the facts and representations stated in this -,, are true and correct. lapplication 5 i' xbai ure g Date a , 7-76'/� - T° �-:e aa' 41�%i' � Y i r',.:b�*. i 6::tii • � S )t � 1 ., �'4 s 'rVY.,''-. 3 rv*r,� °`.moi, s �i'4�:' a.� .4 ~• 2. � a{ %;• �, & Aa � .:.Y 4` i�S - Mei l.. i%atJL ;'i'. ��'. '�' :?' '.a<� fMA72719 WARM AIR: M79 TOTAL Shell & Dust 17ork ... ... ..... .. $10.00 $ r Replacement of Twasee ... 0.00 Repairs & Alterations—up to x.00 6.00 $-- -- — Repairs & Alterations each add. $600.00 3.00 Shell & Duct Worlk to 120,000 BTU ... .. . ..010.W $_ Al) each aid. 60,000 FM ............... .... S.W 5 of Furnace 4.00 $ Repairs A Alterations—up to $M.00 &00 f Repairs & Alterations each add. $M.00 3.00 $ fflc. . • r't. ' _Jj�lr,A, 7urnace Shell & Lines to 400 2y. ft. EDR Steam $10.00 $ Furnace Sheil & Line—to 640 sq. ft. EDR Hot pater 10.00 $_ Each add. 300 sq. ft. EDR steam 3.0" $... Each add. 320 sq. ft. MR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour over 3 gal. per hour --See Fee Schedule GAB S (up to IS%000 BTU) LOD $_� ower 199,000 YM B.. Fee scbedule GAB FINING FEE& NO RATE TOYAj. Ist 3 Fixtures x:3:00 $ Additional Fixtures x .75 $ Gas Range to 199,000 s$ &00 $ AIR CONDITIONIXG FAN HEATING STSTM TEM 2.ATMCI STSTEM ALTERATIONS iit REPAIRS Is" PM adudds,r TOTAL. ru of BUIp. Phoma 5004M City of Findley: The underslaned hereby makes applicstaon for a permit ffor the wolt gels: specified, geeing to do all work in strict AEcordanem with the Cid ordhm=w and ruling of the Department of Buildings, and hereby decA B th an tie Inc-,_m re and representations stated in this application atrw Kind Used as To be completed aboukJ_ __ C Estimat .e iding tit leo. Permit No.��e%5�� DESCIUMICK or MOM HPATING or• Trade Name. imlZ �;Bol we' — sbe '0 U Capacity--- Sq. FL • :; AM9.fay _vm NY O Total Connected Lon -d r 4' Kind of BURNER — Trade Size No— Capacity— Capacity Sq. Ft E.D R- BTO NP ROUGH rum Od ° � gIMAR6f—OYtRI City of Fridley SUBJECT PER ® 297 AT THE TOP OF THE TWINS BUILDING PERMIT r • COMMUNITY DEVELOPMENT DIV. r 1 � PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 612-560-3450 RECEIPT NO. 1�J% /� NUMBERDATE 910-F15 REV. 5-30-75 PAGE OF APPROVED BY JOB ADDRESS 273 Longfellow Street N.E., Fridley, Minnesota 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 17-18 6 Spring Brook Park SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Steve Anderson, 273 Longfellow St. N.E., Fridley, Minnesota 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residence 7 CLASS OF WORK ❑ NEW EX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS TE P�Jl1Ss IRE�IRE� °p V4jRtNG. R�►N , n;GNes P�-� SING call cocat 1VG, Uwed;g��n�tE�,�g�C - �Etc. 0-0 . SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Redwood THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R,-1 168 1,008 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $300.00 SURTAX .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PERMIT FEE $5.00 SAC CHARGE PLAN CHECK FEE TOTAL FEE $5.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 5-30-75 BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 0 ': Of I APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: ��✓E / �',�Y BUILDER: ADDRESS:- 773 W6.J ADDRESS: NO:. L' STREET LS . �- t LOT: t7- fB BLOCK: ADDITION:�C� CORNER LOT: INSIDE LOT: X SETBACK: SIDEYARD: Applicant attach to this form.Two Certificate. of Su rel of Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: OC -CK- Front: 14- / Depth: iV' Height: Square Feet: Cubic Feet: Front: Depth: Height: 0 f Square Fee�t, ; Cubic Feet: Type of Construction:C- 6,0 Estimated Cost: $ `�®® To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. L4�DATE: SIGNATURE• (See Reverse Side For Additional Information.) 0 16 City of Fridley AT THE TOP OF THE TWINS SUBJECT D I D I G''k"IT P . 13'71. D L R EIPT NO. 16U• COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. � 1 = � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ,'j 612-560-3450 910-F15 8/23/76 JOB ADDRESS 273 Longfellow Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17,15 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steven P. Anderson 273 Longfellow Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Schultz Construction 3544 Indiana Avenue, R,obbi.nsdale 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 (j NEW ❑ ON ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. � 6 � WARNING Before digging can iocal utilities TELEPHONE - ELECTRIC - GAS Etc. EPERATE PERMITS REQ RED F WIRING, REQUIRED BY LAWEATING, PLUMBING AND . . --IMPORTANT, N0TIFY THE FRIOLEy DTVI ENGR . REGARDING RI:MVA CURB AND Ar ^+ REP SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYP Y fW% OUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. t'jyjood Frame 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 R-1 576 5760 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 (S)TALS GARAGES S AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISION)PER VA TI N SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE D $ 2 4 $2.13 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OFT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLAT OR CAE p RMIT F E SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULAT 3.04 STRUCTION OR THE PERFORMANCE OF CONSTRUCTI N. PLAN CHECK FEE TOTAL FEE $25.17 SIG TURE CONTRA96 ORO AU HORIZED AGENT rEl/IfJHEN PROPERLY VA�ATTED THIS IS YOUR PERMIT / .. 0. BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE I CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT A) OWNER'S NAME • a` `� �� ' `_ � Sd � BUILDER: © ti S � f'L u\ a vu ADDRESS :�73 dor. +�-� . , ADDRESS : 3S L rive . ws NO:. -�� STREET: L 6—a, -,3 S i . LOT: BLOCK: b ADDITION: CORNER LOT: INSIDE LOT:SETBACK:' SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: v �--- Front: Depth: c'�-Y Height• Square Feet: -�) 7 6 Cubic Feet: —,)'/(0 U Front: Depth: Height: /0 Square Feet; Cubic Feet: Type � ooX to:• 5/o of Construction: !� Estimated Cost: $ i To Be Completed: o, h S 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: q- a3- �('I- SIGNATURE,: (See Reverse Side For Additional Information.) a3 °� 3 WILLIAM A. CARLSON, PRES. CERTIFICATE OF SURVEY 2324 WEST t Loth STREET 889-2084 55431 6 AiILSON INQ .. aatso� SURVEY FOR: LAND SURVEYORS FRED S. YESNESr INC. Tensed, Insured $ Bonded - 0 r a� 2 If G / t I ti SO -4) - LEGAL nESCRIPTION: LOTS 17 AND lPt BLOCK Ff SPRING BROOK PARK. 'qE HEREBY CERTIFY THAT ON.THE 29TH DAY OF NOVEMBER* 1973. WE. LOCATED THE BUILDING ON THE ABOVE DESCRIBED PROPERTY AND THAT THE ABOVE' REPP.ESENTAT ION IS TRUE AND CORRECT, ^4 1 NN. REG, No. 5648� December 28, 1977 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571-3450 Mr. Steven Anderson 273 Longfellow Street N.E. Fridley, Mn. 55432 Re: Building Permit #13716 For a Detached Garage Dear Mr. Anderson: Please be advised that your building permit to build a garage, that was issued August 23, 1976, has now expired. If you should decide to build the garage in the future, you will need to obtain a new permit. If you have any questions, please call me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh CC: City Assessor Lill SUBJECT - PERM City of Fridley 752 AT THE TOP OF THE TWINS BUILDING PERMIT RE T • _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �--'3 CITY HALL FRIDLEY 55432 I.J NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 273 Longfellow 1 LEGAL DescR. LOT NO. 17-18 BLOCK 6 TRACT OR ADDITION SEE ATTACHED Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark J. Wocken 273 Longfellow 784-8004 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 CX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WO tans,t6FGt-i;Law44L x2.4,-g&r&ge Construct a 27' x 13' Attached Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. * Owner changed his plan from a detached garage to an attached garage on June 3, 1982. Changes in the amount of the permit are ed b ow ut no refund was made to the owner. I SEPERATE PERMITS REQUIRED FOR WIRING, NEATI?lG, PLUMBING AND SIGN& SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. wood frame 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 Wf- 351 -5-766- 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 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 5x44$-�8 $3615: WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $l. $] DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PE MIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 515-.59 $44.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE -59,74 $46.31 SIGNATURE CONTRACTOR OR THORIZEDAGENT IDATEI, N PROPER Y VALIDATED THIS IS YOUR PERMIT V� -�'� SiGNAT EO 111FWNER UILDERI IDATEI BLDG INSP DATE Lill CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDLNTIAL BUILDIIIG PER14ITS (Nevi, Alterations, Additions, or Repairs) OWNER: --T &jnrg A/ BUILDER: 9ARY 23Ekb6-0-50IJ ADDRESS: a7.? k0"6FEL(-0W ADDRESS: L sA c TEL N0: _ 7? Al— 800 / TEL NO: Construction Location . STRI=T NO: oZ STREET: L, 00 G F C LCA W LOT: °� I$ BLOCK: i� ADDITION: 5 FR 9 06 3Q00 %< -P- e t<, Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION GM-A(bc Front: y Depth: ay Height: Square. Feet: ��7�� Cubic Feet: tr7� Front: Depth: Height: Square -Feet: Cubic Feet: 4ype of Construction: Estimated Cost: To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ * $ SEE REVERSE SIDE OF SHEET Tile 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 arq true arV4 correct. D,%TE: l� ��� 6 SIGNATUM: Stipulations: a' w WILLIAM A. CARLSON. PRES. CERTIFICATE OF SURVEY 2324 WEST 110th STREET , 888•2084 — - 55431soma , - am.soM "IURVEY FOR: LAND SURVEYORS FRED S. YESNESt INC. Licensed, Insured & Bonded 3e 1.3� �Fa - - 60.0 - Q� LEGAL nESCR 1 PT I ON: LOTS 17 AND 1F?, BLOCK 69 SPRING BROOK PARK. "IE HEREBY CERTIFY THAT ON -THE, 29TH DAY OF NOVEMBERS 19739 WE LOCATED THE BUILDING ON THE ABOVE DESCRIBED PROPERTY AND THAT THE ABOVE -REPRESENTATION IS TRUE AND CORRECT. iINN. REG. No. 5648 a 0 Ac ac ,fL CI IYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 July 24, 1986 PW86-130 Mr. Mark Wocken 273 Longfellow Street Fridley, MN 55432 Dear Mr. Wocken: The City of Fridley will be seal -coating your street on about August 10th of this year. Your driveway approach does not meet City standards and will have to be redone prior to that time. The charge for removing and replacing the existing concrete curb and gutter is $13.50 a lineal foot. To do yours correctly will necessitate removal and replacement of eighteen lineal foot of curb and gutter. Please escrow the money at City Hall by Friday August 1, 1986. The City will do any bituminous patching necessary at no cost to you. If you have any questions, please oontact me at 571-3450. Sincerely, Jon Thompson Engineering Department JT/Irk GNOE ERIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 July 24, 1986 PW86-130 Ms. Sue Hazelton 166 IAngfelloa Street Fridley, MN 55432 Dear Ms. Hazelton The City of Fridley will be seal -coating your street on about August 10th of this year. Your driveway approach does not meet City standards and will have to be redone prior to that time. The charge for removing and replacing the existing concrete curb and gutter is $13.50 a lineal foot. To do yours correctly will necessitate removal and replacement of sixteen lineal foot of curb and gutter. Please escrow the money at City Hall by Friday August 1, 1986. The City will do any bituminous patching necessary at no cost to you. If you have any questions, please contact me at 571-3450. Sincerely, Jon Thompson Engineering Department JT/mk i ^ ' °rT'.�'!' a, ate. �n�+..e.�s}.r^-.�„�F�"�-�wy,�Owre'q��,?dd•.. SUBJECT P_ NO. City of Fridley (9� ,� 64 AT THE TOP OF THE TWINS BUILDING PERMIT r REC� N O. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; � NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/2/94 JOB ADDRESS 273 Longfellow Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17,18 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ren Luehring 273 Longfellow Street NE 780-1458 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO First Choice Exteriors 2405 Annapolis Ln N 4240, Plymouth 55441 553-1918 4266 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 J7 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Rebuild 12' x 14' Deck; Reside Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. 8ef0re d?gginq 0,,►l for all Uti�ity L ons 454-0002 REQUIRE® 13Y LAS 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. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $13,500 @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6.75 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 - $153.00 Fire SIC $13.50 CTION OR THE ERF ANCE OF CONSTRUCTION A PLAN CHECK FEE TOTALFEE 1� _ License SC $5.00 $178.25 SIGNATURE OF CONTRACT OR AUTNO IIZED AGENT IDATEI WHEN PROPEVV VALIDATED THIS IS YOUR PERMIT S.GNATUREOF OWNEROF OWNER BUILDER) IDATEI EILDJ6 INSP DATE NEW [ ] Effective 1/i/94 ADDN CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 3 L o &.jq -ro A c%.) Dam_ ����.La �z Legal Description: Owner Name & Address: 0 fir'" i �q Tel. # 7 rO — NX Contractor: MN LICENSE # Y d & P Address: yaws 1�h�«,/�� L,� d q® lily /Lf<) Tel. #, �5�3�? -1 p /C� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Len % Width i i ` HgdGround Sq. Ft. OTHER: , �- S �-'Sc Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: AQ�k o Rx*."'iw Estimated Cost: $ 3 �' _Approx. Completion Date: (Cost on Back) _ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: /0 - d X APPLICANT: CM USE ONLY Permit Fee $ /`) 3. Fee Schedule on Reverse Side Tel. # 5-,5-3 -/f /O' Fire Surcharge $ /3,10 ..001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ _ $800 per SAC Unit License Surcharge $ . C $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ , o . .2S STIPULATIONS: , CITY OF FRIDLEY INSPECTION DIV. � L,�,jj� � Effective On Jan 1, 2000 3431 University Ave NE � ( pSp Ridley, MN 55432 �'0o APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON FACH F10()R PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE Water Heater - Gas" Gas Range*" Gas Dryer'* Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance (2�%3 toA)G� &�6aJ � lu L TOTAL JOB ADDRESS_ �ttE- i -s &ZOIE IZ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts .and representations stated in this application are true and correct. LUEHRING, TERESA/KEN , 20 I 273 LONGFELLOW STREET N.E. FRIDLEY, MN 55432 Owner_ (763) 780-1458 Building Used Asi=�IflJO Cetd Estimated Cost PERMIT NO. PLUMBING COMPANY OI '=m PLO Nei (7-Z SIGNED BY TEL . Approved By,0eCLj/_ Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE 4R ANY PLUMBING/GAS PERMIT IS TOTAL FEE $M-� PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE N -k e • • _-tom • PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric NO. RATE Water Heater - Gas" Gas Range*" Gas Dryer'* Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance (2�%3 toA)G� &�6aJ � lu L TOTAL JOB ADDRESS_ �ttE- i -s &ZOIE IZ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts .and representations stated in this application are true and correct. LUEHRING, TERESA/KEN , 20 I 273 LONGFELLOW STREET N.E. FRIDLEY, MN 55432 Owner_ (763) 780-1458 Building Used Asi=�IflJO Cetd Estimated Cost PERMIT NO. PLUMBING COMPANY OI '=m PLO Nei (7-Z SIGNED BY TEL . Approved By,0eCLj/_ Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE 4R ANY PLUMBING/GAS PERMIT IS TOTAL FEE $M-� PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE N COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting' system is plastic/PVC and meets all current codes and manufacturer specifications :including sizing, length, number of elbows and termination. Yes () No(,) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air. it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No.( ) When Installina a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I.Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance;has been removed from.the common vent and vented separately as: per current codes. Yes( ) No ( Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input 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 : CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 14, 2003 Ken & Teresa Luebring 273 Longfellow St NE Fridley, MN 55432 Re: Final Inspection at 273 Longfellow St NE Contractor: Norblom Plumbing Co Dear Ken & Teresa Luehring: A plumbing permit was issued on July 12, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh Effective January 1, 2UO3 CITYOF9'FRIDLEY INSPECTION DIViSION ` ��j 6 31 University Ave NE I�� a j`4 l Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB AD U OWNER ]��-L\�inr1 Rate TOTAL BUILDING USED AS,IAO,0�G,� $ 30.00 $ 10.00 $ 10.00 $ 10.00 Vii; 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air.Conditioners can not be placed in a side yard without written permission from adjoining property owner. $J ESTIMATED COST 2'8 ist-o(,D PERMIT NO. 0360 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU lip EDR Fuel - Total Connected Load Burner Trade Name Size No._ $ BTU HP ED $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and $25dbo representations stated in this application are true and correct. DATE -1112:3b HEATING CO NORTHERN HEATING & AIR CONnITIONING, INC Signed // TEL # 7& 3 " 3.)-,3 - 7 7 FAX # 6 r S Approved By Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED C`nMMnN VENT <r=NT CONNFGTQR ANn r-QMRlIST]nN AIR VFRIFICA3I0N when rplan"nn an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( No ( ) The avichnn rnmhi ommnn air is sized and installed to meet the current codes and manufacturer's specifications. Yes (} No ( ) When required to install a npu cnmhu5 len airs It will be sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When ingdallong a now ventinaiyc pm, 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( ) A ipfl nne Jygm and so7piGemmnn V nt and Vent C_nnnanter 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 _ Tota! 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 HEATING CO: Signed By: NORTHERN HEATING & AIR CONDITIONING, INC. Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 REPRINTED ON 4/27/2004 ADDRESS : 273 LONGFELLOW ST NE PIN : 033024420068 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N' 2004-00596 DATE ISSUED: 04/27/2004 VALUATION : $ 2,815.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL AIR CONDITIONER # A/C UNITS 1 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT NORTHERN HEATING & AIR CONDITIONING 9431 ALPINE DR NW RAMSEY, MN 55303- (763)323-7597 OWNER LUEHRING KENNETH S & TERESA A 273 LONGFELLOW ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 25.50 PAID WITH CHECK # 09724 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT NO.: 2004-02058 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/30/2004 .1 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 273 LONGFELLOW ST NE R6243 PIN : 033024420068 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 300 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 35.00 NORTHERN HEATING & AIR CONDITIONING 9431 ALPINE DR NW GAS RANGE FEE 0.00 RAMSEY, MN 55303- GAS DRYER FEE 0.00 (763) 323-7597 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 10244 0.50 35.50 OWNER LUEHRING KENNETH S & TERESA A 273 LONGFELLOW ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to f any other state or local law violate or cancel the provisio7err" regulating construction or thfoa of construction. Applicant Date Bldg Insp /AM —Dot�/j /jq� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS L- q RATE SCHEDULE Effective On Jan , 2002 W4 �� Residential Rate TOTAL OWNER Furnace Shell and Duct Work, Burner . Also Replacement Furnace BUILDING USED AS (Side Vent - Fill Out Back) $ 30.00 $� ESTIMATED COST PERMIT Gas Piping (Needed with new furnace, $ 10.00 $ NO. but not replacement) DESCRIPr10N OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heating Units_ Circle One (Steam) (Hot Water) ( arm Air Trade Name-Lgap" Size No(3e PO(oo BTU rIDy, 00 Q HP EDR *Air Conditioning . All Sizes $ 25.00 $ Fuel w1cL I G Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU _ HP EDR Commercial/Industrial 1.25/0 of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 r� b The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE_ 11"IZ-04 HEATING CO NORTHERN HEATING & AIR CONDITIONING, INC Signed TEL #IV3- �3--jam-7 FAX #. 1,103-3�3--]5G5 7;74X -_t"3a3 -- 7S -9s Approved By1[T Rough -In Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT_ VENT CQNNFQTnR ANn r'nMBIISTInN AIR VFRIFI ATIM When ra la _ing an existing f iri anrP, 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 plasticlPVC 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (�) No( ) The existing comb ,c ion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( No (l When required to install a new combustion airrit will be sized and installed to meet the current codes and manufacturer's specifications. Yes ()q No ( ) When installing a new v -n ing syntam, 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 M 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 (y) No ( ) Apprliannp Tyner and Size/Common Vent and Vent onn ctor Information Appliance #1 Type _�Jt\cLe P BTU Input C Q QoQ Fan Assisted or Nate Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances _� Total Btu Input ino,QQd Common Vent Type(_�4& s Vent Height `'' L-)() 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 A TFRATInNS• ( c rih 1MU HEATING CO: NOPERN HEATING R AIR CONDITIONING, INC. / / `Signed By: Date : 1///Z./d ` T i Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec d: 4:763-502-4977 FAX EFFECTIVE 1-1-2010 DATE YOUR L DRESS SITE ADDRESS THIS APPLICANT IS: ^DWNER DCONTRACTOR PROPERTY NAME: l' e Y STATE WlftZIP�� �J ENANRT ADDRESS: PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE DINGLE FAMILY ' D TWO FAMILY D TOWNHOUSE TYPE OF WORK: ❑NEW {REPLACEMENT Z DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _ _FLOOR PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB —GAS CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER -*\ 4 j, N41 4 �� �`x(v� � � `fx3 � S �+`� q*. .� i. ✓6� y s s �^�� €-i f M'aie£ y"(� �Y#� L Z `C",^k THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME Y DATE, City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977