Loading...
PRE 2010 DOCS_. .. `viYViti LAV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 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 Water Heater - Gas** Urinal APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash Floor Auto. < ' Shower ia± l <<' Trav I a nt>> Drain IMQ Washer NO. RATE __7 Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type Reinspection Fee $47.00/Hr $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge Effective On Jan 'i, 2002 Gas T> Water Heater Range <:» Gas Elec A�"�TOTAL JOB ADDRESS C�(.tCM 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 orrect. �cJ , 2003 Owner J�'►-t �t 50 Building Used Asib °�/ Estimated Cost lL? PERMIT NO. / PLUMBING COMPANY_(0v0A� C. 14�' SIGNED BY �- TEL NO.Z R2S FAX # /1 Approved By V Rough -In Date Final Date "� " -();)- c MINIMUM FEE IEOR ANY PLUMBING/GAS PERMIT IS TOTAL FEE $ S� 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 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCA71ON WILL BE RETURNED COMMON VFNT, tFNT MN CTOR AND COMBUSTION AIR VERIFICATION When ra In acing an taAstong furaom, 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 (1 No ( ) The venting system is plasticIPVC 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 indude AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The ayosting cnmhuctinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When required to install a new _nmb ,conn airy it will be sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When jpntaffinn a new venting system, the undersigned hereby verifies that it 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( ) 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 #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 HEATING CO: Signed By. Date T41 AC{ THI AN[ VER SUBJECT PER City of Fridley 0 19626 AT THE TOP OF THE TWINS BUILDING PERMIT CEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. n Y i CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROV D BY •-_.�/"'t;`� 612-571-3450 910-F15 8/12/88 JOB ADDRESS 6520 Lucia Lane N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N. 85' C, 5 & N. 85' of E. 14.99' of Lot 6, Lucia Lane Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harris Sonnenberg 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Herb Knutson.Construction 11511 Keisling Blvd., Coon Rapids 55433 422-9416 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 4] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 11 MOVE El REMOVE B DESCRIBE WORK Construct a 461 x 261 Dwelling and a 30' x 20' Garage TELEPHONE - ELECTRIC -GkS Ite. 9 CHANGEQFUSEFROM TO REQUIRED BY LAW STIPULATIONS Provide City with copy of verifying survey before capping. Provide a hard surface driveway. Provide sod in the front and side yards. See notations on, plan-.:,.. SEWER & WATER LOCATIONS: In Same Trench; 169' NNW of 6" valve near centerlrie' of• ' ' Mississippi Street - 110' West of NV corner of 6517 Lucia Lane,.N:E..' DRIVEWAY CURB CUT: 35' x $13.50 = $472.50.. Fill.in:existing curb cut and .replace with new driveway. CITY OF FRIDLEY DOES NOT GUARANTEE THE SEPARATE PERMITS OF UTILITY LOCAtIbNS AND S REQUIRED FOR ELEVATIE7NS, DATA IS FOR INFORMATION PURPOSES ONLY, iAIIRIfYG, HEATENG, PLUMBINGAND SIGNS. PERSONS USING THIS INFORMATION FY IT ON THE SITE, SHOULD 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 '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 $85 $42.58 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ,150 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 TOTALFEE A. $1,169.08 + DW SIGNATUaE OF CON' ACTOR ORAUTHORI DAGENT (DATE) . WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT k��S �,GNARE OF OWNERIIF OWNER BUILDERIIDATEI BLDG INSP f1AT NW [ AWN [ ] AMER [ ] City of Fridley R-1 AMID R-2 Building Permit Application Construction Address:% Z C) v C- a A, (n Legal Descripticn Owner Name & Addri Oontractor /' _ a. - Address : Effective 5/1/88 r Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF IMPROVEMETP LIVING AREA: Length -' Width Height Sq. Ft. GARAGE AREA: Length b Width D Height Sg. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. ODrner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Woco Estimated Cost: $ �� Approx. Completion Date:/ ,t as NeVJ -'? 44726 so bLgj , ti /Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ Width +,•6See Back Page 9 3Q DATE:4Z4l! APPLICANT: � naJ��7 Tel. M MY USE OHI.Y Permit Flee Free Schedule on Reverse Side State Surcharge $.50/$1,000 Valuation SAC Charge $ $550 per SAC Unit Driveway Escrow Alt. "A" or Alt. "B°"Above Park Free $—' Flee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ l Not Necessary [ ] TOTAL ,gJ 1� r.- EXTERIOR ENVELOPE AVERAGE "U" CCUPUTATTON Q OVJT�R - t -- SITE ADDRESS C Ole MAC T+OR eAArFSd41 Gd k S 1 • , DATE /O -/,S• - Zr PHONE Determine working squarefootage of each. 1. Total expo sed wall ares....... d"t 1 S7. Z J sq. ft. x! �' 7. Do 2. Total roof/ceiling. area...... 12.5& _ sq* ft. x .0 3a•66 Total exposed wall area above floor IZ43 a. To tat wall window area ........................................ b. Total door area...........................................some3,� �,7 c. 11b tal slidinLe door area....... .. .............................. 38.0 d. Total fireplace wall area ..................................... °---- ee To tal wall framing, area ( average 10%1) ......................... /07,61 f.. To tal net wall area above floor ............................... g6 g. Tb tal rim joist area.... «�•�?� Total eypobe4. fdundation area 7Sie •4 h. 'total fouiidai;ion door.;rca..................................... i. Total foundation window ar6a (inclu4es sliding doors......... 63-94 j. Total net foundation area above grade ......................... lc4•S ? k. To tal wall framinc; area (average 10%) ........... s .......... • • • -578, 1. Total net wall. ftwiling area... Determine "U" value of each wall se.mont a. 115• y Xfgn —. = 33,7'x, b. 37.7 X1qJo . , 14 c. 3-�.0 X"U" ,4-f d X "Q" f.. 0168P;�---X"U" C'¢3 = 4.66 h — - Xflu " -rig—_ _ �. /04zz- Xflu. V1 .13 k. X8.75 X��n 099 „XIIUII .. • 043 = Z2. , ! q Ta tai. — • ` yam...was...s..�.w..................m.m....s♦ �l.TLi�. have mit the intent of SBC 6006 (c� 2. 3 If iter. #3 is the same as, or less than ,�.tpn , you r ta rah �£S'x, bbd i.! t�, Y - �r.��.i., ;yam'".Lr% .-.L.' .. vu's'.. a'w t_ �Yy;; f `. •'tF.3:t _ �.�'S`. x i R9 F,lr. did i rY •r -'i U4, S e'EFk fo ; 8M►t '•.R�x � �� .gp •+tI1 � ,._,p ,y �iy: My,j., a, -r,",.F�$+./ _ �`."� ' r "t' - �ssy`K'�afi � �e 3..:a `" t ,i .. - � � p � 1'Y$ .1.1 � 3'e,R����O.' � • Y'Rt yt,l .ik. termins 'fit''! vs3urooff usili , egsaent. . _ �*,,�_�, , 'k' �4 -dyes@, -... S� �'�7C•� 1 to',L+er1 lees ti�exiZ! Y4 .live meioei ' �(Qda�1• •e fid: tr • •.r: .f �. i: .. to Hxilding �Ayelopo Desigu �}y� � 4 y+4� ?'s / ' . ,..+ a�j� s'- : _- .: t _ y- ♦� b�, y�'. y� �- lte uB�BtQm W® �1�M�,�W.4,R- + i # of i temp., i 3 axed h . e� be ,reatep. a of items WT 43A 31 � a•91 a•. - - `s e .h t t � 1_ �,-,,���; -. �. ,. �'��'•1Rr :4.1,'4 ,}°�, { �'+- .y-.. .4 . cb s a d- o y it+L�.� � RP : �. • fy`3�+�g. i' �l l . � �;'�'�.. � f �f{ r!• t Ate. A y . 'Y ..,... 7, +@ T wv t_ e �0 e.�, y _ y_ _ •p4''�'.,:-� a •°' , - w CEILING FRAME R 1201 Insulation R 1 -Interior. Air Film .611 -Interior Air Film .21 2 Sheetxoc", •45 2-�r Sheetroek .45 3..3jw ;soft Wood & .&NI, Insul. 31.30 3-12"- Inmilation 38.00 4-Pb~tqrjor Air Film .61 4 -Exterior Air Film .61 Total R 32.97 Tota R 3 Tota1 U .03 Totaf, U .025 rrame vra11 1-Intorior ".ir Film 24" Misetrock 3-.%,,, Soft Wood 4-W32" Iiberbd. Sheathing 5;-7/161, Med. Dense Hdbd. 6 -Exterior Air Film Total R Total U Insulated Wall 1 -Interior Air Film 2-111 Sheetrocl: 3-1" Insulf.tion 4-25/32" Fiberbd. Sheathing .7716" Med. Deese Hdbd. 4Exterior ?..ir Film Total R Total U Rimm Joist 1 oist1 Interior stir Vilm 2-6" Insulation 3-U-" Soft Wood 4-.7116" Med. Dense ]�Idbd. 5 -Exterior Air Fibs Total 8 Total U f 1 -.Cone. Block Uninsulated Total R 2.12 Total U .47 R �• aM .45 6,88 2.06 67 .-1T 10.92 .05 R .68 • 45 19.00 2.06 .67 .1 23*03 *043 g, " .68 19.00 ..1.88 17 r^.� 4Q -�"5 ----�— —47- 1 B Cone. Block Stripping & 3/4" Foam Insulation Total R 7.91. & It, Sheetrreels. Total U .13" a Y MM DOUBT TFC? ,: 2 2.84 7RIP7. �TSUI;7 327 3.06 UNIT s, }' SQ, IT. OF LIGHT AREA UNIT EK 371. OF LIGHT AREA' 12828 5.o6 12036 4.62 12836 6.56 12042 5.41 12$42 7.69 Ito 48 6.20 ' 12048 ' 8.81 7.2060 7.78' ' 11628 2.81 12D72 9.37 1.1.636; '. 3.65 12428 4.31. 1ig42 `; +4.27 12436 5.59 x1848•.,•, 4.90 - 12442 5.55 6.15 12448 7.51 12028 3.56.... 1246v 9.42 44. DOUBLEHUNG WI11DOWS U R Single, -glazed .s5 1.1.8 Doubje••glazp.d , 47 2.12 UNIT..t; �, SQ. FT OF LIGHT AREA UNIT Sg.�"�'!'. OF LIGHT AREA '3-55 32x16 7.11 16X2Q,, 4.44 �. 8.88 3 66 160. :. 5.33 32x24 10. 66 "d� 6.66 32x24/36 13.33 20x16.. `s°� 4.44 36x16 8.00 2o-c2a : 5.55 w 3Cc2o 10.00 �• } - 6.► 36X 24 12.00 0x� 8.33 36x24/36 15.o+0y . 24x1 _; t ' . 5.33'. : 4oxl6 8.88 r r 24x2D ' 6.66 4 40x20 11.11 •.. 8.OQ 40x24 13.33 24x24 a - : 20.00 4Ox24/36 16.66 28x15 ~�� ` `` '' 6.22 48x16 10. - 2ax20 <: , ; `v:7.77 42x20 13.33 28x24' ` ;9-33 48x.24 16.00 28x24/.36 11.654ft2436 20.04 ,. t � , v x• - j � Y � _ Wpm � � y`_ _ � s � xi��`� • ' 4 a 'L ^. § i ' '¢X'i�✓"y 11� � °fir ` .t, q 5, R gg��. yXs 41' � CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ >. FA Future Fixtures b 3.50 o Old Opening, New Fixture k N $ Water $ 4.00 $ Blow Off Basin N 5.00 E-4 S N $ A N AA H qa, 04 $ Hydraulic Valve Heater 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 3 N Hot Water Heater $ a $ ''ll Gas Range $ 10.00 M N of $ 10.00 +ci ALL OTHERS AND/OR REPAIRS AND ALTERATIONS .0 R p 1% of Value of Fixture or Appliance u T5 x Reinspection Fee $ u $ .50 0 TOTAL FEE $ -'5z• 0 W O E) D M a� 3 a w° W r. U, M 9 3 1 V a 3a. kec 1st �. 2nd 3rd 4th (R) Future Connection Opening Connected with Sewer ('►) New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ ''ll Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $ -'5z• 0 Effective Aug. 1, 1981 Job Address —L— 5 Z U L LN Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. O C_�-_ 1 -i , 19( 6 OWNER lZy IJ "k"o yj KIND OF BUILDING 1'-) -F_ry CJ F -iii t- AL USED AS SrH w1 E TO BE COMPLETED ABOUT ESTIMAATTEDD COST / OLD NEW $UILDING PERMIT NO. PERMIT NO. �1 Company w� b d- `�o� h, E �ij L . Signed By Tel. No. 4 7 ROUGH INSP. Date 2� Q FINAL INSP. 11'.7'r �G Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES C) RATE SCHEDULE RESIDENTIAL RATE TOTAL Job Address (`c• Let - Furnace et Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work $ 20.00 $ 20.00 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ to, Tel. #571-3450 $ 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 $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ 10.00 $ Fridley, Minn. l o�Z -t , 19 OWNER Jove �( v�4 w ✓� $ KIND OF BUILDING 2� USED AS State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. ♦l' 170-1 Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. $ TO BE COMPLETED ABOUT 0 a i -56 ESTIMATED COST # [ ds 00 $ .50 OLONEW UILDING PERMIT N0. PERMIT NO. c✓ $ $1/� DESCRIPTION OF FURNACE/BURNER HEATING or POWER ((PLANTS, Steam, Hot Water, arm AiZ- No. 1 Trade Name �1e t` Size No. Capacity CA CDC) Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By / Tel. No. 6 --? 03 Fill out back side for stack verification on replacement furnaces CHIM14EY 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 and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date 0 Ddd HEAT LOSS CALCULATIONS Weatherstrhm 11 "94716•'G' Guide Windows I Doors Reference Yes --No a— o 19._ Windows and DEPARTMENT OF INSPECTION Construction No. Out. Wall 11nt.WsU I Ceiling I Roof I Floor e and Area !Anal ft I I of crack 0 Btu Infiltration Glass 1 1SL S 0 Exp. wall 6 3 % 2— Net e --p. wall Int. wall 6011.&1 /010 Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.1 Room I Lenath Width Heiaht 'Windows and Doors--Craekage and Area, Width Height No. of Lineal ft. Area No. of pane of pane tights of crack q. ft. Width Height No.-ot ,Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Coef.1 Glass bliltration Exp. wall Net exp. wall Glass Int. wall I-- Ceiling Fsp. wall Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area F7_I Rmm I Lenath Millh He6ht Windows and Doors—Crackage and Area W/dtA Height No. of Lineal ft Area No. of pane of pane lights of crack sq. ft Width Height No.-ot ,Lineal ft. Area No. of pane of pane lights of crack sq. ft. Cftef. Btu Infiltration Coef.1 Glass bliltration Elfp. wall Net eup. wall Glass lot. wall I-- Ceiling Fsp. wall Floor NIINNEAPOLiS. MILAN. Insulation Kind How Aanlied Length Width Height Windows and Doors—Crackage and Area Width Height. No. of Lineal ft. Area No. of pane of pane lights of crack W. ft. Width Height No.-ot ,Lineal ft. Area No. of pane of pane lights of crack sq. ft. Btu Infiltration Coef.1 BM bliltration Exp. wall Net imp. wall Glass Z I-- 27 (e b Fsp. wall lob �Z 1 v Net esp. wall Int. wall Ceiling 9(0® 2 j 0 Floor Total Btu. 1 I Z -7 Required sq. ft. E.D.R. or sq. ins. WA. Leafier area Fl.1 Room I Length Width Herold Windows and Doors—Crackage and Area Width Height. No. of Lineal ft. Area No. of pane of pane lights of crack W. ft. Btu Infiltration Glass Exp. wall Net imp. wall Int. -wall Ceiling Floor Total Btu. Required sq. ft. EDJL or sq. itis. WA. Leader area F1.1 Rmm I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal CL Area No. of was of pane lights of crack p. 1t. Coef. Bta Infiltration Glass Eup. wall Net cup. wall Int. wall Ceiling Floor Total Btu. 11 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. header area Required sq. ft. E.D.R. or Sq. ins.. WA. Leader � t 3®® � � I e's, V7 ��2� Ddb HEAT LOSS CALCULATIONS weatherstrips r'"''s''•'�' Guide Windows Doors Reference e;= o es o 19_ F7_I �� Rmnt fl!nath DEPARTMENT OF INSPECTION Construction No. Out. Wall I Int. Wall I Ceiling I Roof I Floor Height Windows and Doors—Crackage and Area and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pave lights of crack sq. tt. No V Height No. of Lineal t Alta of tune of pane lights of crack I so. tt. Coef. Btu Infiltration Coef. Btu Infiltration Exp. wall Coef. Btu Infiltration 1 S 5o I Glass ,S SZ 135 �- Exp. wall 3 ®544 G Net a --p. wall Ift 120 218( 314 47 Int. wall Ceiling Ceiling 20 Floor Total Btu. 120 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Lenath Width Height Windows and Door—Crackage and Area, and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pave lights of crack sq. tt. Width Height No. of Lineal It'Aru No. of pane of pane lights of crack ea. ft. width Height No of Lineal tt. Ana of pane o! pave lights of track sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Exp. wall 1,2 1 -61— Infiltration Glass 1 S 5o I X46 Exp. wall q 6 2(-7 2 (� Net exp. wall Z 218( -Lo Int. wall Ceiling 20 1' (v -cA-'$ Floor Total Btu. 1L(o�j Required sq. ft. E.D.R. or sq. ns. WA. Leader area 1 F1.1 Ream Illnath width FWaht Windows and Doors—Crackage and Area and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pave lights of crack sq. tt. Width Height No. -of Llnul !t Aru No. of pane of pane lights or crack sa. ft. width Height No of Lineal tt. Ana of pane o! pave lights of track sq. ft. Coef. Btu Infiltration Coef.1 Glass t-3 Exp. wall 1,2 1 -61— met met exp. wan Int. wall Floor Total Btu. Rettuired sq. ft. E.D.R. or sq. ins. WA. Leader area I Kind Fl.l d1A.'9,p-Uzw- Room I Length s NDMPOLIS. NDK Insulation How Applied width Heiaht Windows and Doors--Crackage and Area and Doors—Crackage and Area Width Height No. -of Llnul !t Aru No. of pane of pane lights or crack sa. ft. width Height No of Lineal tt. Ana of pane o! pave lights of track sq. ft. Coef.1 Btu Infiltration Coef. Btu Infiltration Glass 1 S 5o I X46 Exp. wall 8. 747 t8 6 f Net exp. wall Z 218( -Lo Int. wall Ceiling 20 1' (v 11 C,- 0 Floor Total Btu. 1SSL Required sq. ft. E.D.R. or sq, ins. WA. Leader area Fl.I too--Itoom I Length Width Heiaht Windows and Doors—Crackage and Ana and Doors—Crackage and Area Width Height. No. of Lineal ft. Area No. of pane of pane lights of crack aQ. ft. width Height No of Lineal tt. Ana of pane o! pave lights of track sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Glass Glass 4 0 0 rLo z Exp. wap Exp. wall 1 gj 0 IS40 Net exp. wall Z 218( -Lo Int. -wall Ceiling 1-2— ZFloor Floor Total Btu. E Required sq. ft. E.DR or sq. ins. WA. Leader area FIM o.� m I [math width Height Windows and Doors—Crackage and Area No. width Height No of Lineal tt. Ana of pane o! pave lights of track sq. ft. Coef. Btu Infiltration Glass 4 0 0 rLo z Exp. wap I, 5 , Net exp. wall Int. waq �. Ceiling I (o Floor I t & � I< Tow WIL 1 I ID Required sq. ft. E.DR or sq. ins.. WA. Leader area {h 1 K L CITYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 November 30, 1988 Herb Knutson Construction 11511 Reisling Boulevard N.W. Coon Rapids, MN 55433 Re: Final Inspection at 6520 Lucia Lane N.E,, Fridley Dear Sirs: A final inspection was conducted on November 29., 1988 of the above address and the following items were noted which.must be completed before the structure can be finalede �D 1. Provide City with copy of the verifying survey by December 30, 1988. 2. Provide sod in the front and side yards by June 16, 1989- 3. Provide a hard surface driveway by June 16, 1989. We will expect the above items to be completed and a reinspection called for by the scheduled date.' If you have any questions on these items, please feel free to contact me at 571-3450.' Sincerely, DARREL G. CLARK Chief Building Official DGC/mh CC: Mr. Harris Sonnenberg 6520 Lucia Lane N.E. GiYOF FItIDLEY CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450 June 22, 1989 Mr. Herb Knutson Herb Knutson Construction P.O. #33082 Coon Rapids, MN 55433 Re: Final Reinspection at 6520 Lucia Lane N.E., Fridley Dear Mr. Knutson: A reinspection was conducted on June 20, 1989 at the above address and the following items were noted as still incomplete: 1. Provide sod in the front and side yards by July 15, 1989. 2. Provide a hard surface driveway by July 15, 1989. We will expect the above items to be completed by the scheduled date when a reinspection will again be conducted to determine compliance. If you have any questions on these items, please feel free to contact me at 572-3602. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh CC: Mr. Harris Sonnenberg 0 NEW C) CITY OF FRIO1_E", ErfecrR-e 1/112001 ADDN (l 6431 University A,,e N€, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER j ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1267 Pax BUILDING PERMIT APPLICATION Construction Address: J Legal Description: Owner Name & Address: 9ELA 0100FINQ & FtEMO®ELINa. I�c./� 2 , Tel. # 7� -4f�b-f�t�i�r Contractor; _ lT:1001 PARK MN SW- 6 MN LICENSE #_ Address: _ ID 4000-10,90 '5 _ G/2 - rYZ5 X© 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. FL GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: �Q Estimated Cost: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE. APPLICANT:Tel. # Call (763) 572-3604 for Permit Fetes if mailing in application. Fax to 763.571-1287 if using credit card and we will call you for card number. ' Permit ree Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL E/T'd 9TE'ON CITY USE ONLY - $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (Stare Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: S31us 9NI3006 d73S Wa£b : 6 S002 ' 02 ' lao CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_ 44 C <dv' tl" ':;-2 c— 'T5' New Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $10.00 and representations stated in this application are true and correct. Catch Basin Rain Water Leader $10.00 $10.00 DATE:%7, 20 �J Sump/Receiving Tank $10.00 ����JJ °-7 VA Water Treating Appliance $35.00 OWNER -4J7 Water Heater -Electric $35.00 Water Heater - Gas** $35.00 BUILDING USED AS 96r, Gas Range" Range** Gas Dryer** $10.00 $10.00 ESTIMATED COST ��� / PERMIT NO. () No Back Flow Preventer Required &6,0 Type �GcScSCs$!rG— (��c $15.00 ��d -7 - Vd'��'� PLUMBING COMPANY_ Reinspection Fee $50.00/Hr SIGNED BY TEL NO. 99 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance �O Approved By Rough -In Date Final Date State Surcharge $ bra MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $� OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 7 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT,; VENT CONNECTOR AND COMBUSTION AIR VERIFICATION V�hen replacina an existing ftjrnace, 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 () N0( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and terminatidn. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly aihd meets the current codes and manufacturer's specifications. This does in6lude AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existina 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 installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 t'AX: (763) 571-1287 ADDRESS 6520 LUCIA IN NE PIN 133024240108 LEGAL DESC LUCIA LANE ADD LOT 6 BLOCK 0 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.=2004-00916�� DATE ISSUED: 06/15/2004 VALUATION : $ 250.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL BACK FLOW PREVENTER ON IRRIGATION SYSTEM. # BACK FLOW PREVENTERS 1 # ELEC WATER HEATERS VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES APPLICANT DUDA LEON PLUMBING SERVICES 208 17 AVE N HOPKINS, MN 55343-7341 (952)933-5636 OWNER DAWN ZIMMER 6520 LUCIA LN NE FRIDLEY, MN 55432 0 # GAS DRYERS 0 # OF NEW FIXTURES 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of 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. AnDlica --, . Date Bldg PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT BACK FLOW PREVENTER TOTAL PAID WITH CHECK # 12504 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 15.00 15.50 52 -go -q7 «08454 Building MECHANICAL Permit No.:A* O Inspections RESIDENTIAL APPLICATION R W"� ItR�'ar 763-572-3604 CITY OF FRTDLEY Date 7 63-502-4977 FAX EFFECTIVE 1.1-09 ^^ ,� S(P 0 9 UrA Q 15D LfO �L. C Dnel DATE YOUR E-MAIL ADDRESS �z SITE ADDRESS Z® 0— THIS APPLICANT IS: DOWNER &ONTRACTOlt PROPERTY NAME ` , OWNER/ ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR COMPANYNAME _-�_41t2- 1AO_U 7=;'L C. NOTE: SEPARATE CITY CONTACT PERSON: LICENSES ARE REQUIRED FOR GASADDRESS: STATE LICENSE # yEX`P DATE a j °.� i'S IV CITY h� STATIZI54 AND HVAC. SUBMIT COPY OF BOND PHONE)(03--157`1",�gU FAX ANDINSURANCE PERMIT TYPE ASINGLEFAMILY 0 TWO FAMILY 1J TOWNHOUSE TYPE OF WORK: O NEW '0XRFBLACEMENT 0 ALTERATIONIREMODEL DETAILED DESCRIPTION OF WO � Ef PER MS 16B.665 the permit fine is a minimum of $15.00 or 56/b of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, exchidmg the fiKhmes. (This should reflect only the cost of labor) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $.500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (AIDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZF/BTU MFG: MODEL: SlZE0BTU MFG: MODEL: SIZESTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGF/OVEN $10.00 ATO AIR EXCHANGEER $15 FI ISPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 IR BOILER $35.00 \/FURNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMT FEE FOR PROJECTS OVER 5500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ suwh tge S 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $_ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Sttrcharge = $ .50 AlIlVIMiJM S15.50 M114BIUM $ISM Total = $ TIM IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I henry apply for a nwcbamcd permit and I aelmwvledge that the mon above is complete and accurate; that the work will be in comae with the cadmaimes and cis of the City of Fridley wid with the Mimmwlm CoWna-Aim that I is mw a pwaA bha only an application for a permit and work is not to start withoat a pemit flift the work aoomdame with � ow in case wad[ which regimes review Mwapproval of plm& `-- ATE — "Oj SIGMA P ICANT APPROVED BY DATE _ °n PLEASE NO TE PERMITS ARE RE UMED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building $ BUILDING Permit No.: I InspectionsRESIDENTIAL $ APPLICATION Received By:� 763-572-3604 $ 1. (p La DW_MA Surcharge $ CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 DATEI 5aT Q 01 YOUR E-MAIL ADDRESS 1Q50X\ac1ALP- e0t2le DC • C.C7Yn SITE ADDRESS 1_0 S a 6 L LA. c 1 GL UGI, i"e SAC Charge THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR $1550 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: _T)Q,vJ (\ j --:L-1 (Y\ 01� ((NOtAn ADDRESS: n CITY STATE ZIP TENANT PHONE: NAME: Renewal By Andersen Park Fee CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West Sewer Main Charge YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 / STATE ZIP WITH APPLICATION PHONE License #20130983 13SINGLE FAMILY/N0 651-264-4777 9 PROPERTY TYPE ❑ TWO FAMILY/NEW C ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT 0 Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT# GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ GARAGE 2. Proposed floor planDETACHED PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structure ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING,THE 1997 U.B.0 FEE SCHEDULE) Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 1. (p La .001 times the total job valuation Surcharge $ $19-3 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5,00 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ (9 9 Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be u conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approve( plan in the case of all work w h re quiresFqview and approval of plans. }� SIGNATURE OF APPLICANT �� PRINT NAME/1 0LCCh�_1I�So 1f�7 DATE Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FRIDLEY Da V9 2 DATE YOUR E-MAIL ADDRESS SITE ADDRESS A=.e DLASI.w THIS APPLICANT IS: O OWNER *ONTRACTOR Dawn zimmemian PROPERTYNAME: 6520 Lucia Lane OWNER/ ADDRESS: Fridley, MN 55432 rATE ZIP TENANT Y� PHONE: 7635717866 CONTRACTOR NAME: STATE LICENSE # CJ EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS;, -2W -r .6ywAekAPe S CITY �' it STATE L)P S'fY09' LICENSE WITH , PHONE % -11,00 FAX Z APPLICATION PERMIT TYPE SINGLE FAMILY 13 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: E3 NEWREPLACEMENT DETAILED DESCRIPTION OF WORK f PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00; whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This -should -reflect only.the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = =•FO"RO.=- S WHERE LABOR EXCEEDS-00;TEES ARE BASED ON $10.00 PER FDn URB,'EX=.. AU EREMT.ED :FtZCTt M,: DMICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ - PIPING _WATER BATHTUB _ GAS PIPING (NEw a rumsk) _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER —KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($I5) DISHWASHER _ LAUNDRY TRAY LwATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $1500 = $ Number of fixtures @ $35.00 --� x $35.00 = $ 36'.0o TOTAL DUE $ State Surcharge = $ .50 Total = $ O THIS IS AN APPLICATION FOR A PERMIT RIOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applic ' n for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case 1 o1 w ' r fres review and approval of plans. / SIGNATURE OF APPLICANT PRINT NAME10, 4V Je /♦'/d/b�0i�:�1 DATE I 24 0 --—'�,e�..-b City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977