PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N°491
Date:
Omer: j' Builder
Address Address
LQCAT OF UILDING
No. Street T–-- Part of Lot
Lot _ Block Addition or Sub -Division LAC
Corner Lot Inside Lot Setback .r Sideyard
Sewer Elevation : _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To Used as:
Front, epth Height Sq. Ft y Cu. Ft
2 to
Front Depth Height a✓ Sq. Ft Cu. Ft.
Type of nstrnction ——Aq"mA it, Est. __ 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
ordinances of the, city of Fridley.
In consideration of the payment of a fee of $ , permit is hereby granted 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 tone upon violation of any of the provisions of said
ordinances.
ref,i '
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, ewer or water. Be sora to am
the Building inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
CL ON, INC.
Oq Mer Is Name ` � ' J1 Builder GENERAL COMTRACT®
RS
_ s
dress 2-'00 2'2 -ad Address Minneapolis 18, Minn.
LOCATION OF BUILDING
Street Part of Lot
Loot Block '� Addition or Subdivision
0orner Lot Inside Lot etback Side -Yard %® d
S*U ELEVATION FOUNDATION ELE'V'ATION
A�plicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
be used as:
FA
Sq. Ft. ,1�,�� Cu. no
,,eg,Front &ZZDepth Height
Sq. Ft. �� Ou. Ft.
of Construction Estimated Cost
�o be Completed
undersigned hereby makes application for a permit for the work herein specified,
Being to do all work in strict accordance with the City Ordinances and ruling of
Department of Buildings, and hereby declares that the facts and re s to
ted in this applicajAon arVtrue and correct. ��
Schedule of Fee Costs can be found on the Reverse Side.)
U City of Fridley
/
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Location_
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
�NO.
7
6��
Number Fixtures ......................
Zs
N
3
�p
LL
N
J4c
LL
1.20
O�
5<
6 3
(i nd
t9
ci
(�
Z
(7 O
•
F
o
N
WATER HTR.
GAS
ELEC.
Base
L / C-)
Water Heater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE
TOTAJ--
1st 3 Fixtures ..........................
Z x
1st
$—
Additional Fixtures ....................
1
/
$
Gas Range to 200,000 BTU ..............
x
2.00
$
2nd
3rd
4th
• Future Connection Openings I
New Fixture, Old Openings
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
�NO.
RATE
TOTAL
Number Fixtures ......................
t'=' x
$1.50
$—
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
$
Catch Basin ............................
x
3.25
$
L / C-)
Water Heater (Up to 200,000 BTU) ......
x
2.00
$
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE
TOTAJ--
1st 3 Fixtures ..........................
Z x
$1.50
$—
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description .............................
TOTAL FEE $ �S
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, . in - "—/J- / 19&//
Owner 19—
Kind of Building _ � 19
Usedas
To be completed about
Estimated Cost,
Old—New. Building Permit
q —,;2 1-61 6�7/-
11 POST IM -12-58
Appiication for Power Plants and Heating, Coding, Ventilation..ReMgen*ion and
Air Conditioning Systevns and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 3U. 4-7470
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 ............................. $.00 $
Repairs & Alterations—up to $500.00 5.00 $
Repairs & Alterations each add. $500.00 ... I .......... 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam ...................... 2.50 $
Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $
OIL BURNER—to 3 gal. per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ C�
GAS FITTING FEES: NO RATE TOTAL
a.r
1st 3 Fixtures ...................... x $1.50 $
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM �-�/
ALTERATIONS & REPAIRS TOTAL F M
ROUGH
FINAL
CL-"�C-
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, 19�
��?�, r
Owner Ci z n %`, i �"
Kind of Building lz;,-/
Used as
To be completed about
Estimated Cost, $ 4�&f
Permit No.
Permit No. "--( 6-1
DESCRIPTION OF WORK
HEATING or PWER PLANTS—Steam, Hot Wa Warm Air r'/a �_
Trade Name No '4r
Capacity Sq. Ft. E.D.R. ' J zp..L/ BTU H.P.
Af
Total Connected Load O, �/ Kind of FueLLd"k' �
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
- S'lgnedRWELTER EAS i Nr3--C,C
By 4637 CHICAGO AVE.
MINNEAPOLIS 7. MINNESOTA
q , 42 2M 7-59 Business Phone No
(REMARKS -OVER)
9 .
�JHEAT LOSS CALCULATIONS®� j DEPARTMENT OF BUILDINGS Y gas 9 tie
Weatherstrips A.S.H.V.E. Construction No.
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
e%—No—No 19- --� -- – d
o P.00in I Lengt �p %. Width
Height r 4f*
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
se"
Width Height No. of ' � Lineal f . Area
No. of pane of pane lights of crack sq. ft.
ex?
.. yo 0
Coef.
Btu
Infiltration
Coef.
Btu
Infiltration
Glass
Exp. wall 7.f
f
'
Glass
Net exp. wall
v"
loes
Exp. wall 32 X C
Int. wall
Ceiling psi
A
Net exp. wall
Int. wall
117
1
6
Ceiling
00
Iii
Int. wall
Floor
Pf q0
G
Total Btu. -
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
J L-1 I -s 7 o__:: I f _ _.t Vrl:.J&L "10 ,.. ua: L& ete
Windows and Doors--Crackage and Area
f
Width
Width Height No. of Lineal ft. Area
No. of Dane of pane lights of crack sq. ft.
se"
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
.. yo 0
Coef.
Btu
Infiltration
Infiltration
Glass
I
fel
IM
'$1
Glass
Exp. wall 7.f
Exp. wall
/ 17 V,
Glass
Net exp. wall
Net exp. wall
Int. wall
loes
10 " 6
Int. wall
Ceiling psi
A
`'
Ceiling /.#v
Floor
1r�
Floor'
Iii
Int. wall
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area I
if FI:1 RM*_4_ Reem I Lenath 14 w Width 47 _qIeiaht
Windows and Doors—Crackage and Area
f
Width
Width Height No. of Lineal ft. Area
No. of pane ofpane lights of crack sq. ft.
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
.. yo 0
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef.
Btu
Infiltration
Glass
I
fel
IM
'$1
111
4-0
Exp. wall
/ 17 V,
Glass
,'
Net exp. wall
Int. wall
loes
10 " 6
Exp. walls"
Ceiling psi
A
`'
r S_
Floor
Ceiling y
I
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI I-- _N" Rnnm I Lenath
MINNEAPOLIS, MINN.
Insulation
How. Aanlied
I
Width ,tb
Windows and Doors--Crackage and Area
Room I Length( 11*',
Width
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
.. yo 0
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
d
Coef.
Btu
Infiltration
13 e
/ 17 V,
Glass
,'
I .a
10 " 6
Exp. walls"
`'
r S_
Net exp. wall
Ceiling y
Iii
Int. wall
Floor
�+^
G
Ceiling
e
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Io
F1.1
Room I Length( 11*',
Width
Windows andDoors—Crackage and Area
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
.. yo 0
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
d
a
Coef.
Btu
Infiltration
,'
3 r
10 " 6
Glass
`'
r S_
Exp. wall"
Ceiling y
Net exp. wall"
Int. wall
Floor
�+^
G
Ceiling ./
e
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. his. W.A. Leader area I
Fl.L f id j#v, g Room I Length&&
Width
-r HeighK
Windows andDoors—Crackage and Area
Coef.
M
Btu
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
.. yo 0
Infiltration
a
Exp. wall V / . Irk t'
Net exp. wall
Int. wall
Ceiling y
7
Floor
�+^
07
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
adw
GNOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
June 29, 1993
Hugh and Karyn Rohrbacher
7320 Lyric Lane N.E.
Fridley, MN 55432
RE: First Notice of Noncompliance at 7320 Lyric Lane N.E.
Dear Mr. and Mrs. Rohrbacher:
The City of Fridley has established a City Code for the purpose of
promoting a pleasant and attractive suburban environment. A recent
inspection of the property at 7320 Lyric Lane revealed that not all
Code requirements are presently being met. Listed below are items
which do not comply with the City Code:
1. Discontinue outside storage of boat located on the grass in
the front yard. (Fridley Zoning Code does permit storage of
boats in the side or rear yard.)
2. Discontinue outside storage of assorted materials located
along the north side of the garage.
Your prompt attention in correcting this situation would greatly
assist us in helping make Fridley a better place to live. An
inspection will be conducted on or about July 12, 1993, to
determine compliance.
If you have questions or would like to discuss this, please contact
me at 572-3595. Thank you for your cooperation!
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -93-311
AW
GiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
July 13, 1993
Hugh and Karyn Rohrbacher
7320 Lyric Lane N.E.
Fridley, MN 55432
RE: Final Notice of Noncompliance of the Fridley City Code at
7320 Lyric Lane N.E.
Dear Mr. and Mrs. Rohrbacher:
On July 12, 1993, a second inspection of the property at 7320 Lyric
Lane confirmed that the following items still do not comply with
City Code:
1. Discontinue outside storage of assorted materials located
along the north side of the garage and the dirt pile located
in the driveway.
A final inspection to determine compliance will be conducted on or
about July 26, 1993. You should arrange to complete an approved
plan for compliance before that date. Should this inspection
confirm that this deficiency still exists, legal action will be
approved. If corrective action cannot be completed by this time,
contact me to coordinate a schedule to complete this requirement.
If you have any questions regarding this matter, please contact me
at the Fridley Municipal Center, 572-3595.
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -93-348
f
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER . 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
August 30, 1993
Hugh and Karyn Rohrbacher
7320 Lyric Lane N.E.
Fridley, MN 55432
RE: First Notice of Noncompliance at 7320 Lyric Lane N.E.
Dear Mr. and Mrs. Rohrbacher:
The City of Fridley has established a City Code for the purpose of
promoting a pleasant and attractive suburban environment. A recent
inspection of the property at 7320 Lyric Lane N.E. revealed that
not all Code requirements are presently being met. Listed below
is an item which does not comply with the City Code:
1. Fridley City Code requires that all vehicles must be currently
licensed/street operable and kept on a hard surface parking
area if they are stored outside. I observed a vehicle (170 -
CAT) parked near the driveway which does not fully meet these
requirements.
Your prompt attention in correcting this situation would greatly
assist us in helping make Fridley a better place to live. An
inspection will be conducted on or about September 13, 1993, to
determine compliance.
If you have questions or would like to discuss this, please contact
me at 572-3595. Thank you for your cooperation!
Sincerely,
Steven Barg
Code Enforcement Officer
SB:ls
CE -93-441
1,
C11YOF
FRIDLEY
FRIDL% MUStICIPA1�� r1TER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 - (612) 571-3450 - FAX (612) 571-1287
Ug
Hugh and Penny Rohrbacker
7320 Lyric Lane N.E.
Fridley, MN 55432
RE: First Notice of Noncompliance at 7320 Lyric Lane N.E.
Dear Mr. & Mrs. Rohrbacker:
The City of Fridley has established a City Code for the purpose of promoting a pleasant
and attractive suburban environment. A recent inspection of the property at 7320 Lyric
Lane N.E. revealed that not all Code requirements are presently being met. Listed below
are items which do not comply with the City Code:
Discontinue the improper outside storage of two boats, lawn equipment, and tools
located in the driveway and side yard area. (Boats are permitted in the side yard
and rear yard.)
2. Fridley City Code requires that all solid waste must be kept in secured containers
stored in the side yard, rear yard, or garage. I observed numerous open
lawn/refuse bags improperly stored near the southeast corner of the home.
Your prompt attention in correcting this situation would greatly assist us in helping make
Fridley a better place to live. An inspection will be conducted on or shortly after
September 6, 1996, to determine compliance.
If you have questions or would like to discuss this violation, please contact me at 572-
3595. Thank you for your cooperation!
Sincerely,
Kurt Jensen -Schneider
Code Enforcement Officer
KJS:ls
CE -96-298
C./
SUBJECT
PERMIT N
City of Fridley
2 4 ! 4 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
N0.
� • ______ COMMUNITY DEVELOPMENT DIV.
I ~ PROTECTIVE INSPECTION SEC,
54? 7-5-
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEPAGE
OF
APPROVED By
612-571-3450
910-F15
10/30/96
JOB ADDRESS 7320 Lyric Lane NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
4
1 Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce Johnson 7320 Lyric Lane NE
493-3807
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same PO Box 1824, Maple Grove MN 55311
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RmiNKIRM Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (18 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED,
NO. DWLG. UNITS
OFFSTREET PARKING
1
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1'000
$.5O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
$39.00
OF CO TOR OR AUTHORIZED AGENT (DATEI
WHEN PROPERLY LI DATED THIS IS YOUR PERMIT
�LIGNATURE
/U
UL DA I N S P
PATE
iG ATU E OF OW R)I OWN R BUILDER) IDATEI
C./
NEW [) Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: 7
Legal Description:
Owner Name & Address: wiz tJCL Lzi;.,r � Tel. # — U
v r+ ���
Contractor: ��� MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Length
Length
Length
DESCRIPTION OF E%IPROVFAWM
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction:
Approx. Completion Date:
Driveway Curb Cut Width Needed:
DATE: APPLICANT:
Side Yard Setbacks
Estimated Cost: $ /". d �
(Cost on Back)
Ft. + 6 Ft = Ft x $ _
Tel. #
CITY USE ONLY
Permit Fee $ .,S -O Fee Schedule on Reverse Side
Fire Surcharge $ o .001 of Permit Valuation (1/10th%)
State Surcharge $ y Sy $.50/$1,000 Valuation
SAC Charge $ $900 per SAC Unit
License Surcharge $ $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 $ D o
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432
572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
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 (UST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$30.00 $
$10.00 $
$10.00 $
$10.00 $
$ 25.00 $
State Surcharge
TOTAL FEE
UL
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 1999
JOB ADDRESS
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
31alow
OWNER
BUILDING USED AS
ESTIMATED COST /,::� 90 . 00 PERMIT NO. �
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units / Circle One (Steam) (Hot Water) arm Air)
Trade Name l2,,—/- Size No.
BTU A&? ®ate HP EDR
Fuel_�A//C�_f&�_,� Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATING ANY & c c,-2
Signed
Approved By 1A_ Rough—In Date Final Date / L
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO: �c) c o,-) a I /-3 /C- 54
Signed By:
Dater S' S
CHIMNEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes (Vil"No
( )
2.
Is free from rust or deterioration
Yes K)"'No
( )
3.
Has no foreign objects lodged within
Yes (--X) No
( )
4.
Is securely supported
Yes (V�'No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (vJ'*'No
( )
6
Has total heating BTU's of 1 A OOD
All other BTU's J0 (00 0
TOTAL BTU's OL) 0
7.
Has a liner been provided for water heater
Yes (` No
( )
8.
Has combustion air been provided for water heater
Yes VI No
( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO: �c) c o,-) a I /-3 /C- 54
Signed By:
Dater S' S
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST UN' LAWR AND MATERIALS:
ISJ IN TH 997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minneso 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 rdan with the approve an in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLIC T ,� ����O� PRINT NAME;/il%/�/S/� CJoA6�S DATE
APPROVED BY Cl-." DATE
BUILDING
Permit No. — COO
Building
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Da> '& P 0 4 2008
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE ,?.d
YO E-MAIL ADDRESS
SITE ADDRESS
✓
THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR
12
PROPERTY OWNER/
NAME:
CITY
STAT03 _
TENANT
ADDRESS:
_ZIP
PHONE:
NAME:
ADDRESS: CITY
STAT> VZIP� 5
CONTRACTOR
SUBMIT A COPY OF
PHONE!o �3 /— .� 3 — �? FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
INGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE'
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAM TILE
uJ I0
❑ DECK @SING ❑ O
ER
b SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT
cn FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING St
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
2. Proposed floor
GARAGES
WX<ACHED GARAGE
plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List
of structural members to 3e used.
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDMWG
EnOfft
ADDITIONS, & PORCHES SUBMIT:
RrVinyl
I. Site Plan/Survey showing the existing structures
❑ Aluminumfd'T
and proposed project.
❑ Other
ascia
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes
❑No LOCATION OF WINDOWS
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 UN' LAWR AND MATERIALS:
ISJ IN TH 997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minneso 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 rdan with the approve an in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLIC T ,� ����O� PRINT NAME;/il%/�/S/� CJoA6�S DATE
APPROVED BY Cl-." DATE