The URL can be used to link to this page

PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT Builder Address N° '559 LOC TIO OF BUILDING No. Street _ __ _ Part of t Lot —__ Block - Addition or Sub -Division r' Corner Lot _ Inside Lot �Setback –`_ Sideyard _ "_ ✓ Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To. Used i Front Depth Height Sq. Ft. f __ Cu. Ft Front Depth Height Sq. Ft. Cu. Ft Type of Construction Est Cost+ _ +'��JJ___ =To be Completed _ In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of grdinanoes of the city of Fridley. In consideration of the payment of a fee of $ 051 permit is hereby gran to to construct the building or, addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances Building Inspector NOTICE: This penult door not cover the construction, installation for wiring, plumbing, gas hosting, sewer or water. Be sura to a" the Building hupeetor for separate permits for these hems. 4 APPLICATION FOR .BUILDING PERMIT CITY OF FRIDIZY, MINNESOTA Owner's Name Builder �� '/L Address LOCATION OF BUILDING No. O r Street L /+µms► Part of Lot ,; n Lot Block Addition or Subdivision ' �-r,�• �% Corner Lot Inside Lot L 1 Setback Side -Yard X94 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction 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 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. ,n DATE % SIGNATURE&L w ✓ice-` (A Schedule of Fee Costs can be found on the Reverse Side.) Application for Power Plants and Heating, Cooling, Ventilation, .Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ _ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAIJ 1st 3 Fixtures ...................... Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAIJ 1st 3 Fixtures ...................... x $1.50 $ Z' Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $� ALTERATIONS & REPAIRS TOTAL FEE $ Z s/ ROUGH FINAL Dept. of Bldss. Phone SII 4-7470 5 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, nn_ /�/ ,z_194Z Owner —� Kind of Building /s Used as To be completed about Estimated Cost, $ J �` Ne . Building Permit No. 7—Permit No.- z Zf/ .2 -- DESCRIPTION OF WORK / HEATING or POWER PLANTS—Steam, Hot Water, Warmt/Air—No. Trade Name -!�� `�SizzeNo- SOD Z1 Capacity //S//q. Ft. E.D.R BTU H.P. 7 Total Connected Load '�� Kind of Fuer�� BURNER —Trade Name Size No— Capacity— o Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signe By ' CW<a ZMM 7_59 Business Phone No- X16 9 > 411,R9 A674� HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide ows oo s Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied es No I Yes o 19— I a "' / Fl Room Leng 7 Width Height ' Fl.1 r` 'Room Length / — Width �� Height i Windows aDoors—Crackage and Area it PTS IFY0MANMa �FE2 Height Width V Height No. of Lineal ft. Area No. of pane of pan lights of crack sq. ft. r04-Av- -4,,L C.V. o No. of pane Infiltration lights of crack /�✓ / C Coef.1 Btu iz Glass d . Net exp. wall /Q Btu Exp. wall �— Ceiling FI Floor �f Net exp. wall l / O Int. wall Ceiling /Q Floor Total Btu.` P!� Require .j4qj6. E .R. or sq. ins. W.A. Leader area 11� A i�=� it PTS IFY0MANMa �FE2 Height No. of Lineal ft.MCoef. , , . , No. of pane �i lights of crack Btu Infiltration Glass / 15,0 zlv® Net exp. d . Net exp. wall /Q Btu Infiltration 4vwm Ceiling FI Total Btu. Required sg& E.D.R. or sq. ins. W.A. Leader area o. F1.1 CAIAMM&Rarim I Leni:th %Width / Heigh Windows and Doors—Crackage and Area Width Height No. of Lineal ft.MCoef. No. of pane of pane lights of crack Btu Infiltration Glass / 15,0 zlv® d . Net exp. wall /Q Btu Infiltration Int. wall Ceiling r Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of Dane of pane 11 ht a of crack sq. ft. peCd . -7 , Coef. Btu JCoef.j Btu Infiltration Glass AV 15,0 zlv® Glass Exp. wall d . Net exp. wall /Q / Int. wall Ceiling r Floor �f l / O Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Glass % `�C% V Exp. walL-ge,3 Net exp. wall Int. wall Ceiling Floor /% _11/1,17A5 Total Btu. Required sgr,ft. E.D.R. or sq. ins. W.A. Leader area Fl.l '#OY `�A Room I Length //'_ Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Infiltration Glass 19 16V 47wv Exp. wall Net exp. wall / Int. wall Ceiling 49 Floor �' Q Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.I Room I Length72? Widt101 Heigh / Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass AV 15,0 zlv® Exp. wall Net exp. wall /Q Int. wall Ceiling /® Floor Total Btu. IRequired sq. ft. E.D.R. or sq. ins. WA. Leader area City of Fridley Application for Plumbing and Gas Fitting Porn* Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK 5:;" - Number, Kind and Location of Fixtures Location +� 3U 12 I� Number Fixtures ...................... x $1.50 x Future Fixture Opening ................ ¢ Z S Z New Fixture Old Opening .............. x 1.00 $ Z go • R • N WATER HTR. GAS ELEC. Base x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd _ 4th Future Connection Openings New Fixture, Old Openings Connected with Sewer E] Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $-9-6 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ C;;k - G New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE r� j City of Fridley: The undersigned hereby .makes application for a permit for the work herel 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 ettrue and correct. Fridley, Minnyy` '0�z- & , 19�� Owner , Kind of Building a,_- Used � Used as ✓w To be completed about Estimated Cost, $ Ol New uilding Permit No.—\� Permit No. Signe By Business Phone No. - ROUGH --t" -)- - U t FINAL -4M042 2M SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2 5 2' 88 I COMMUNITY DEVELOPMENT DIV. Q a a ®V 3 PROTECTIVE INSPECTION SEC. i I I 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 1'' 612-571-3450 910-F15 6/3/94 JOB ADDRESS 1081 L de Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 L3mdale Builders SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steve Densmore 1081 Lynde Drive 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 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 ❑ ADDITION ❑ ALTERATION ❑x REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,728 $ 4.36 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $108.00 Fire SC $8.73 PLAN CHECK FEE TOTAL FEE License SC $5.00 $126.09 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIW.N VA DAT THI$ IS VQUR PERMIT_qSIGNATURE BLDG IN;:SLY BATE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] CITY OF FRIDLEY ADDN [ ] ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: C x g� �,, �� svr\-o �- Legal Description: Owner Name & Address: Contractor. Address:` V aAali 5 Effective 1/1/93 Tel. 1/ MN LICENSE 4,e /l -/S Tel. , _ -- CO3-� 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. T OTHER: Comer Lot [ ] Inside Lot [ ] FL Yd Setback Side Yard Setbacks Type of Construction: � C� ► Estimated Cost: Approx. Completion Date: :%0 '( '( Driveway Curb Cut Width Needed: DATE: APPLICANT: Ft. +6Ft= Ft x $ CITY USE ONLY (cost on Back) = $ Tel. # ®C� Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ X 7 .001 of Permit Valuation (1/10th%) State Surcharge $ 1z/, 36 $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ &0 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A' or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: STATE OF MINNESOTA DEPARTMENT OF COMMERCE 133 East Seventh St St. Paul, MN 55101 (612) 296-6319 BUILDING CONTRACTOR ID#0002406 RESIDENTIAL CONTRACTOR CORPORATION Issued: 01/13/92 Expires: 03/31/95 OWEN D COOKE AMER RMDLG INC 8585 N STEMMONS FREEWAY SOUTH TOWER SUITE 102 DALLAS TX 75247-0000 CM -00543 STATE OF MN DEPT. OF COMMERCE v' w 133 East Seventh St _�4'=- � •. St. Paul, MN 55101'= (612) 296-6319 BUILDING CONTRACTOR 3''�•iess• ID#0002406 RESIDENTIAL CONTRACTOR CORPORATION Issued: 01/13/92-03/31/95 OWEN D COOKE AMER RMDLG INC 8585 N STEMMONS FREEWAY SOUTH TOWER SUITE 102 DALLAS TX 75247-0000 X CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 UNversky Ave NE Fr ft"4MN 8543Z'APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572— AEFi�l4ERA�TiON AND AIR CONDITIONING SYSTEM_ S AND DEVICES ? Y Lr, JOB ADDRESS /08/ L 7/V d le- The undersigned hereby makes application for a permit for the work herein Retsiderlrtisi+ Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shea and Duct Work, Burner e ® rulings of the Building Division, and hereby declares that all the facts and Also Aq$acement Furnace y $ 20.00 $ �.D p representations stated in this application are true and corre r Gas Ping {NeeC18d with new furftaCej' $ i0.00 $ OWNER P V g'1 &h HN2 �. t3as Rang® $110.0D $ n E'4 � � BUILDING USED AS l l EN le� A i � d w e ESTIMATED COST -SOD PERMIT NO.. 71' ` ^^Y+E- r� d- X'w 4'1 qH', A a DESCRIPTION QF FUFiNA�E AN OFt BURNER '�,45. 7 w �� eating knits C � t Water - � Appp j oto, of H 9 ..: � _ lrcie rte ,1 arm z - F+C+Atq((t#t` 87J fD7 HP $ D>� t a+tt ■ fi [tea of ark - Fuel Total Connected load fes'gR Y �' i S .{. y s?z �s?. y:;s i f�:, ; 4 ;.tF 5 k9 Ga, tYiE� "4 xgr.; �$}�4. t} ESQ Sum Trade 'rade Name Size No sJ' s :1 kp a R .(�"-e.,7 f.. .yY- �.�, i 'HP Y =W ./• a 7- s4 ,-ry �;- ¢- ALTO Y "1.F Gr & lu , HEATINGCOM. ON i N t tK,.A�' R'� O MIT 15 40 Signed By _ e! TH�,$M ST"A'! BLit + RGE Fey 3 - REINSPECTION FEE 530.00 Approved SaIO Rough—In Date Final Date Air Ccndtloners can nct be phao+ad in a side yard vvithcut FILL OUT BACK SIDE FOR STACK VERIFICATION ON written pemi�sion trot", property owner.: ('. `� REPLACEMENT FURNACE List Alterations Being Done: r CHIMNEY AND SnaK- '=" 74FICATION The undersigned hereby verifies .that the existing chimney or stack: 1. 3 Has been carefully examined Yes ( f No ( ) 2. Is free from rust' or 46teriorat Yes , ( No ( ) 3. Has no foreign objects 1'odged ` **thiin No ( ) 4, Is securely supported ;.`r Yee ( No ( ) 5. Meets all `current Code requireie'nts for size and total BTU's connected 1 Ye$ ( No ( ) 6. Has total heating � All other BTU's �0 "A' fid D _. TOTAL BTU's Q p Remarks N List Alterations Being Done: r ADDRESS OCCUPANT HEAT LOSS' SOLD BY Electrical Work' By TYPE OF HEAT HOUSE HEATING TEST RECORD _DATE HTG. INST. _ GA FA HW STEAM APT. FLOOR CITY SUBURB OWNER _INSTALLED BY Gas Line By _ SPACE HTR. GAS DESIGN MAKE MAKE OF BURNER _ Model Model Serial Max. BTU Rating _ INPUT '� MAKE OF FURNACE Model UNIT HTR. OTHER CONVERSION CONTROLS _ THERMOSTAT,' Heat Plug Vent Size Valve ' KIND OF LINER - -_ SIZE`"- -- NONE Limit Draft Hood Regulator Limit Setting_ Filters Size °" "Number Fan Setting Chimney Location Insido Outside Pilot Type 'k Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure Percent CO2 Date Tested " Input CFH v —Percent 02-�_ Company Testing � Stack Temp. Percent CO Name of Tester ®"'d Form 235 Building AND MATERIALS: BUILDING ([TSING THE 1997 Per mit No.: - Inspections OCCUPANCY TYPE RESIDENTIAL APPLICATION $ Received By: 763-572-3604 $ S CITY OF FRIDLEY Surcharge I Date Rec'd: DATE J' d C 5YOUR E-MAIL ADDRESS 1C-Y�- �C�� 1 �� SITE ADDRESS I o cS 1 Lu Y\CGi-e- l7 ( 1 "-q— License Surcharge THIS APPLICANT IS: 0 OWNER *ONTRACTOR SAC Charge PROPERTY OWNER/ NAME: -'curb Cut Escrow TENANT r�� ADDRESS: d CITY STATE_Z[P $ PHONE: ?ark Fee CONTRACTOR NAME:_ The Home Depot A.H.S. Inc. >ewer Main Charge SUBMIT A COPY OF STATE LIc 3200 Cobb Galleria Pkwy. rota! Due YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHOS 763-542-8826 o SINGLE License #20268257 PROPERTY TYPIC A _ ,o�R>Es PERMIT TYPE 17ADDITION 0 GARAGWHED 0 WINDOWS 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK O SIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: 0 NEW O ADDITION 0 MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: `{ s, yA A � cian o z -A ; -}sem �e SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING 0 HOUSE ONLY NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 0 ATTACHED GARAGE I. Existing Floor Plan PROPOSED SIZE: 0 DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structumal members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 vinyl OSoffit ADDITIONS. & PORCHES SUBMIT: 0 Aluminum O Trim 1. Site Plan/Survey showing the existing structures 0 Other 0 Fascia and proposed project. ' SOWS 2. Two sets of construction plans IN EXISTING OPENINGS OYes 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 rREQ ARE BASED O vALUATIUN, INCLUDING THE COST OF LABOR AND MATERIALS: ([TSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ — OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ S 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation – Minimum $.50 Eire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) -'curb Cut Escrow $ ft + 6 ft = ft x $20 = $ erosion Control $ $450 Conservation Plan Review ?ark Fee $ Fee Determined by Engineering >ewer Main Charge $ i Agreement necessary ( ) Non Necessary ( ) rota! Due $� Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMTr NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in :onformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a >ermit but only an a licatlion for a pe and work is not to start without a permit; that the work will be in accordance with the approved )Ian in the case of all work 'ch requir 'ew and. approval of plans. .IGNATURE OF APPLICANT 0 PRINT NAME ,1!2 e1DA(-VSC&V DATE Building AND MATERIALS: BUILDING (USING THE Permit No.L Inspections 1 OCCUPANCY TYPE RESIDENTIAL APPLICATION $ a , o? Received By: 763-572-3604 $ CITY OF FRIDLEY Surcharge DatRKMdOCT 14 2 I 0 g 0 ell SCA I (di r S O iy) DATE YOUR E-MAIL ADDRESS SITE ADDRESS / b i) 1 SI l ffL o r/y c -1 _ l TfiIS APPLICANT IS: ❑ OWNER 6CONTRACTOR $5.00 (State Licensed Residential Contractors) PROPERTY OWNER/ NAME: SJo Q d 9 $1450 per SAC Unit (Plans to MWCC for determination) ,1 ADDRESS: 0 8 r T CITY ! C STATE—ZIP 55"43 TENANT erosion Control PHONE: 7 i► 3 02 74 2d $450 Conservation Plan Review CONTRACTOR NAME:_ THD At- Home Services, Inc. Jodi m EU t i J b n < STATE LIC 2690 Cumberland Pkwy, Ste 300 q J7 ( 3 q,5 . (, p y 7 SUBMIT A COPY OF Cumberland Office Park YOUR STATE LICENSE ADDRESS CITY STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE Atlanta, GA 30339-3913 ❑ SINGLE Lic# 20268257 Ph. 763/542-8826 r1E PROPERTY TYPE E ❑ TWO FA .ORIES PERMIT TYPE QADDITION ❑ GARAGE(SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTEAANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: W o tx -P! SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDMONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS`E Xes ❑No LOCATION OF WINDOWS 1 / 3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE ,/ SIZE OF G t v / A e L� d. 1 •I 6t G i1 C' r? DPENING CHANGES & � a ^"" �I p,44 (` TYPE OF WINDOW TO BE INSTALLED � - l iid, NUMBER OF WRIDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ S I 1 OCCUPANCY TYPE Permit Fee $ a , o? See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ 07 . g g (.0005) tames the total job valuation - Minimum $.50 Fire Surcharge $ 5.1< .001 x Permit Valuation (1/10%) License Surcharge $ $. D u $5.00 (State Licensed Residential Contractors) 3AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) 7-urb Cut Escrow $ ft + 6 ft = ft x $20 = $ erosion Control $ $450 Conservation Plan Review ?ark Fee Sewer Main Charge Total Due Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMrr-NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in ;onformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a )ermit 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 approved plan in the case of all work whnz�!Z= requires approval of plans. '� /� � /r-) :IGNATURE OF APPLICAN �e PRINT NAME -7(A 1 1 DATE ( �I<YeO 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 RATE SCHEDULE x 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 $ but not replacement) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning - All Sizes, $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ Commercial/industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VE:NTILATION 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. JOB AD OWN L Effective On January 1, 2002 BUILDING USED AS_ S� cyIA ESTIMATED COST :2, C7 PERMIT NQ „'. DESCRIPTION OF FURNACE AND OR BlRNER No. of Heating Units Circle One (Steam)'.. (Hot'1Nater) (Warm Air) Trade Name Size No. . BTU HP EDR Fuel Total Connected Load t' Burner Trade Name Size No. BTU HP EDR The `undersigned hereby makes application for a permit'for the work herein specified agreeing to do all work in strict accordanceanrith the- City Codes an rulings of the Building Division, and hereby declares thifall;the facts and representations stated in this application are true and correct. STANDARD WEST LAKE ITION M MINNEAPOUS, MN S W&2998 DATE d7� 612.8242656 HEATING CO FAX # Approved By Rough -In Date # 1. f �✓' y `lam �S Final Da ^ :PLACEMENT' URNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED commm VFNT, VENT coml;cTOR ANn comusTioN AIR Vmsr.Anm °Men rein acina an -p-.C46%1 rance, the undersigned her* iiy verifies that the >> venting has-been ex, mine)! and. is free from,rost, deterioration -;-obstructions, and is securely supported -and fi estopped where required. Yes O 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 axin±ing comp ,Mien air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new `ombustion Mr. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When ins aur g a new venting nystsm, the undersigned hereby verifies that KIS 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 #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: CITY OF FRIDLEY INSPECTION DIV. ® 0/5 C0 Y-7�Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTAI I m nN FArrw Pi nnQ PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 1O�` �� ►�Ci2 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** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: t 5 20 OWNER C)o BUILDING USED AS �2S ESTIMATED COST 4 MO0 PERMIT NO. $15.00 PLUMBING Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY Approved By Rough -In Date TEL NO. (,Gl 315(ND Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $16.00 or 5% OF COST $ 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 3S.S0 WD FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT: VENT CONNECTOR AND COMBUSTIORAIR VERIFICATION When replacina an existing fornace, 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 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 :