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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: ,TUNE 16, 1966 Owner: Bid. HOMEDALE BUILDERS Address Address7000 Humboldt Ave North Minneapolis, Minnesota LOCATION OF BUILDING No. 7505 Street LYRIC LANE N.E. Part of Lot Lot _._. 21 __ Block 3 Addition or Sub.Division BODY MANOR, 4TH ADDITION Corner Lot Inside Lot X Setback 35Sideyard 0' Sewer Mevation 871.50 720WHOMElevation 874.5 TOP OF FOOT_ G DESCRIPTION OF BUILDING To be Used as: DWELLING Front 46 Depth 28/24 Height 18 Sq. Ft. 1156 Cu, FL 20,808 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction FRAME FSt. Cost _ $17, 500.00 To be Completed SEWER LOCATION - 1+43' from Manhole Downstream WATER LOCATION - 1+53' from Manhole In consideration of the issuance to me of a permit to7set the building described above I agree to do the proposed work in accordance with the description ab athand in co Bance with ail provisions of ordinaaoes of the city of Fridley. .11 In consideration of the payment of a fee of 2$ 1.00 ,permit is hereby granted to HOMEDALE BUILDERS. INC. to construct the building or addition as described above. This permit is granted upon the express cwndition that the peon to whom it is granted��aents, empl;a eesnd woania, around and upon said building, or any part therenform 9aall respectsyMinaesta location, conrepairaadwine dty ts permit mayed at any on violation of any of the provisions of said ordinances. WILLIAM H. SANDIN Building Inspector NOTICE M pan& don not wwr the cendrw9an, hutaWen for wMhs phimbieg, gas heedag, ower or wrier. Be eon to ae the Boliding hupwar for apmft permits for thea Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA 41, OWNER'S NAME BUILDER' ��C .�.. ADDRESS ADDRESS LOCATION OF BUILDING NO. STREET 1 PART OF LOT LOT - BLOCK ADDITION OR SUBDIVISION/'/%% CORNER LOT INSIDE L SETBACK j',- SIDE -YARD SEWER ELEVATION ,r 7/, FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTIONN F BUILDING / ` To be used as; ' Front Depth �&2Height Sq. Ft. .5 Cu. Ft. Front Dept ter_ Height *_ Sq. Ft. `Cu. Ft. r ez--aD Type of Construction , �� y���_� Estimated Cost To be completed�/f�C .� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE (Schedule of Fee Costs can be found the Reverse Side). Ci f Fridley tY o 4, Application for Plumbing and Gas F!Mng Permit Dept. of Bldgs. Phone 560-3, DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... —�— x $1.50 $ 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 $- New Ground Run Old Bldg. ............ x 3.25 $ s apZ GAS FITTING FEES: NO. RATE TOTAL ?d� Y $ ! Sy 8 x ` .50 $ �°j W �aS 0 ? 0O R r N WATER HTR. GAS ELEC. 3� �� Base .3 1st 2nd 3rd 4th • Future Connection Openings Connected with e Now Fixture, Old Openings I Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... —�— x $1.50 $ 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 $- New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .............. ........... x $1.50 $ ! Sy Additional Fixtures .................... x ` .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE $ City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings and hereby declares that all the fact and representations stated in this applic are a and correct. � n A9!ridle�Minn j 19_66 Owner Kind of B ing Used as 7 To be completed about Estimated Cost, Old—New. Building Permit ROUGH FINAL Business Phone No -E+ -�--� a 5.2 Application for Power Plants and Heating. Cooling. Ventilation. ReMgeration 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 $ MECIL 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 Furnace Shell & Lines—to 400 sq. ft. IDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Bot 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 $ overti3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 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 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ �� ROUGH FINAL Dept. of Bldgs. Phone 560-3450 9M 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. Owner Kind of Building �✓t� Used as To be completed about Estimated Cost, $ 7 \ c OldrNew',B,(Hlding Permit No. O Permit No� DESCRIPTION OF WORK HEATING or PORM PLANTS --Ste Hot Wa Trade Nam Size No �✓ Capacity. Sq. Ft. E.D.R D Ic H.P. Total Connected Loads (i _ Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OYER) RAY N. WELTER HEATING CO. Signed 8 GAGG-AVE. — By MINNEAPOLIS ?. MINNEGOTA 4 z Business Phone No--��`� l ei6 City of Fridley, Minn.. BUILDING PERMIT Date: — April 28, 1967 Owner: _ Bains Builder Address _ 7505 Lyric Lane Address ,3 -211" M 9208 A. B. C. Blacktop Co. 1308 Main St. N. E. LOCATION OF BUILDING No._ 7505 Street Lyric Lane part of Lot Lot — Z1 __ Block 3 -- Addition or Sub -Division Melody Manor 4th Addn. Corner Lot --- Inside Lot Setback Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Front _ Depth — Height . _ Sq. Ft. Cu. Ft. Front Depth _ _ Height _ _ Sq. Ft. Cu. Ft. Type of ConstructionAsphalt Dtiveway Est Cost $200.00 _ To be Completed May 5, 1967 3" Class 5 stabilizer Minimum 2" Mat 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 fo and in compliance with all provisions of OA of the city of Fridley./> In consideration of the payment of a fee of $1'00 , permit is hereby granted n A • B . C . Blacktop Co. 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 dty limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Xnspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, see heating, sower or water. Be are to ae the Building Inspector for separate permits for these Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME fi/rG' s BUILDER ' �� B G4clrTCS p GC) ADDRESS S�-� - �/P/ c 19 IV Z7 ADDRESS LOCATION OF BUILDING NO. 15-6S STREET yR l G 1 /I A) C-- PART OF LOT ADDITION OR SUBDIVISION W LOT A# BLOCK 3 CORNER LOT INSIDE LOT SETBACK SEWER ELEVATION TOP OF FOOTING SIDE -YARD Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. To be Used as: DESCIPTION OF BUILDING -- Front Sq. Ft. Front Depth Cu. Ft. Depth Height Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost� cry To Be Completed Z-0 � The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE Z ( 2 SIGNATURE (Schedule of Fee Costs can be found 77the Reverse Side). J City of Fridley, Minn. BUILDING PERMIT Owner: Vern F. Barnes Builder Address .Z50SLvxic Lane Address g7L'if-, 'Lor61c,:7, 0,0 urs LOCATION OF BUILDING No. _ 7505 Street Lyric Lane Part of Lot Lot __21 Block 3 Addition or Sub -Division _-Mel oar, Manor Ub Addi ti on Corner Lot Inside Lot __ X Setback 35' _-_._ Sideyard 31 Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Garage. Front _ 241 _ Depth241 Height --8.1— Sq. Ft. 576 Cu. Ft. $74Q— Front _ Depth Height Sq. Ft. Cu. Ft. Type of Constructionramp- Est. Cost To be Completed Mune 15, 1970 Provide hard surface driveway. 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 compliance with of l provisio of ordinances of the city of Fridley. In consideration of the payment of a fee of $_12,.0.0 , permit is hereby granted to All Seaso;pa Builders 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 buil (— within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: INS permit dons not cover the construction, Installation for wbdng, plumbing, gas heating, sewer or water. Be sure to we the Building btgm for for separate permits for these Items. APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS.NAME : VgLf& � S14 0T S BUILDER : ADDRESS: 7J_0. LyelC. 1-4f ADDRESS: 3.30 7 (/elf l9 CSU2 r9VE. NQ. NO:. %S'®,S' STREET: y%/G L,4sVG LOT: CA/ BLOCK: ADDITION: /t f.FLeV Y ..�l�ti o� �/ '- '1440,41. CORNER LOT: INSIDE LOT:_SETBACK: 3s ( SIDEYARD: Applicant attach to this form Two Certificates of Surve9 of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Grew Ue 6QYQ Lo Front: c Depth: ,� Height: 4P Square Feet: 5-7 4 Cubic Feet: 2 (1 Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction:6;7- Estimated Cost: $ L/lJo-v To Be Completed: �vti �' �S l e/ 7 O The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application ' are true and correct. G�� �-- ;eiA r DATE: � � S- — 7 y SIGNATURE (See Reverse Side For Additional Information.) SUBJECT MIT City of Fridley --22786 AT THE TOP OF THE TWINS BUILDING PERMIT i E O. COMMUNITY DEVELOPMENT DIV. I✓ PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 IL"'" NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 8/12/94 JOB ADDRESS 7505 LYRIC LANE NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 21 3 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas/Joan Helm 7505 Lyric Lane NE 786-4530 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION REPAIR ❑ MOVE ❑ REMOVE R❑ 8 DESCRIBE WORK Reroof House & Garage (24 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 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 $1,800 90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT • PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUL CON- $41.00 Fire SC 1.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTI PLAN CHECK FEE TOTAL FEE 7' $43.70 A IDAT CTOR OR A�LDER Sir, REO�OWNE HEN OPERLY ALI TED THIS I R PERMIT _ iNSP QATE SIGNATURE OF R OF OWNER B(DATE,G TRWITA ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: I. ISO I X'#.fk-�`' e.— E Legal Description: LCA % ;-?/ 3 I�/2,1IJe,,2. Effective 1/ 1/94 bA-1 Owner Name & Address: '-�"AS - t` tib.- Tel. # 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: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ( P, L t:2. A ` N_ Ste ' l -E (� J'r-4 P L C S Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks ~ ` CtL.c-f"-'� 1-3 Type of Construction: Estimated Cost: $ tet)0 Approx. Completion Date: (Cos ..OD Back) Driveway t Width Needed: DATE: 12-� APPLIC Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 411"00 Eq Fee Schedule on Reverse Side ..001 of Permit Valuation (1/10th%) $.50/$1,010 Valuation $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 t'AX: (763) 571-1287 ADDRESS : 7505 LYRIC LN NE PIN : 113024120020 LEGAL DESC : MELODY MANOR 4TH ADD : LOT 21 BLOCK 3 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL PERMITO.: 2004-00243 DATE ISSUED: 02/20/2004 VALUATION : $ 6,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER SECTION 310.9.1.2 OF THE 1997 UNIFORM BUILDING CODE WHEN ADDTIONS, ALTERATIONS OR REPAIRS IN EXCESS OF $1,000 ARE MADE TO RESIDENTIAL DWELLINGS. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 11 WINDOWS WITHIN EXISTING OPENINGS. IS APPLICANT A CONTRACTOR? 1 APPLICANT WINDOWS AMERICA OF MN INC (20248265 559 SHOREVIEW PARK R SHOREVIEW, MN 55126- (651)203-0149 OWNER HELM THOMAS E & JOAN C 7505 LYRIC LN NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort 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 regul constrrtion or the performance of construction. ADnl t / Date Bldg BUILDING PERMIT FEE 125.25 FIRE SURCHARGE 6.00 STATE SURCHARGE, VALUE 3.00 LICENSE SURCHARGE 5.00 TOTAL 139.25 PAID WITH CHECK # 9016 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor. 1 Address -65q Effective 1/1/2003 (763) 572-3604 Bldg Insp L� (763) 571-1287 Fax e% O y� Tel. #- A (e 3— 29 — MN LICENSE # 01oa���� f� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: � xls mated Cost: $ 6, Od d Driveway Curb�"Cut Width Needed: Ft. + 6 Ft = Ft x $.=S DATE: o ` APPLICANT: Tel. #� Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ /.25 -2-5 Fee Schedule on Reverse Side Fire Surcharge C 6 • D a .001 of Permit Valuation (1/10th%) State Surcharge $ 3. Da $.50/$1,000 Valuation SAC Charge $ $1275 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. T" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL _-......_ $ .. / 3 , ��. STIPIII ATIONS' .. _ NEW "[ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: L/ Legal Description: 21 Owner Name & Address: �-0/"q, RAJ 14gZ- P-1Tel. # — Contractor. MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction T Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on i1 to 'scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Driveway Curb Cut Width DATE: APPLICANT: Estimated Cost: $. F ZSFtx $ $ af JOCD Tel. # Call (763) 672-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 If using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ Fee Schedule on Reverse Side $ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1450 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ 5700-00 Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 50o'c')o STIPULATIONS: 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 FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE TOTAL $ $ $ $ .50 JOB ADDRESS OWN BUILDING USED A Effective January 1, 2003 (_( ESTIMATED COST T n PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER No. of Heatin Units Circle One (Steam) (Hot Water) ar ir) Trade Nam Size No.��, s BTU ' O HP EDR Fuel 4 x. I Total Connected Load 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 accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and c�rrect.,/ MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION G CO_ GTANDMI) HEATING & AIR CONDITIONING CO- REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 410 WEST LAKE REET PLUS. THE $.50 STATE SURCHARGE ign iy✓IG,.` (MINNEAPOLIS, gg�408-2998 # 612-824 2656 REINSPECTION FEE $47.00/Hr AX *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date 3 uloy written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE 'APPLICATION WILL BE RETURNED When mplasg an existing Branca,, the undersigned hereby verities that the venting has been examined and is free from rust, deterioration, obstructions, and Is securely supported and firestopped where required. Yes (UAo The venting system is plasbc/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (if 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 exieting,c omhus inn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to ins al' a new combusfanairit will be sized and installed to meet the current codes and manufacturers specifications. Yes ( No ( ) When Installing a now mentnaiystem, 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 (0'f4o ( ) Appliance #1 Type l -CL-, BTU Input O as � Fan Assisted or Nat 70V (a- Appliance #2 Type 0 BTU Input 3 SZ: J ° Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input,o Common Vent Type //�/ Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter �"� in Type C— Appliance #2 Vent Connector Height _L_ft Length �- ft Diameter �in Type Ttl�'T Appliance #3 Vent Connector Height ft Length _ ft Diameter in Type _ Al TIERA71C)NS- /Deccof ribel "Iq Ce r-(� I /lie K HEATING CO: 11f &T& Date Signed By: CITY OF FRIDLEY PERMIT NO.: 2004-00244 6431 UNIVERSITY AVENUE NE ' FRIDLEY, MN 55432 DATE ISSUED: 02/20/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 7505 LYRIC LN NE PIN : 113024120020 LEGAL DESC : MELODY MANOR 4TH ADD : LOT 21 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, BRANT, 60,000 BTU'S) # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 30.00 STANDARD HEATING & AIR COND CO 410 WEST LAKE ST GAS RANGE FEE 0.00 MINNEAPOLIS, MN 55408-2998 GAS DRYER FEE 0.00 (612) 824-2656 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 30.50 PAID WITH CHECK # 90012 OWNER HELM THOMAS E & JOAN C 7505 LYRIC LN NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula ' nstruction or the performance of constructi n. Appl�tDate Bldg Insp Da SEPARATE PERMITS D FOR WORK OTHER THAN DESCRIBED ABOVE. Bulidino- I Pi, UMBEING P-,-mir NoAWC'�� ins-7ec-11011s RESiME"TReceived B i63-5 72,-.:,604 I C 17, Y OF F =,, LZ7_ 11DJM: 19 0 /633-10: - 7 7 F_ X .00T I 10 ZFFEC=1 1-1-19 IIDATE YOUR E-MAIL ADDRESS =-ADDRESS LA 6 THIS APPLICANT IS: 0 OWER AONTRACTOR PROPERTY NAME:vw,,& H ADDRESS. %(6 L46C LA qe CITY 1pm STATEP&ZIPR)TZ OVVNMV TE NILN'T PHONE: 1j0 3 – IiN - q5u CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE 9 0e DATE LICENSE. BOND AND STATE BOND 4 EXP DATE CERTIFICATE OF ADDRESS:CITY STATE ZIP INSURANCE PHONE FAX 69 PF RMTT TAPE SINGLE FAMILY El TWO FAMILY 0 TOWNHOUSE TM OF WORM EINEW %R.EPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of S15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the impmvement,,installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 =315,00. Labor cost between 3300 to S500 =cost of labor X.05 = -plus -50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS 5500, FEES ARE BASED ON 310.00 PER FIXTURE, EXCEPT WEERE NOTED. FIXTURES: C]NDICATETCAAL NUMBER OF EACH BELOW). MINIMUM FEB $15-50. _BATIK SINKILAV —FLOORDRAINS ailOWER. —WATERPIPING GAS PIPING (NEED CITY LIC) —SWDWMINGPOOL ..— WATER SOYTNER($35) —BA77iTUB CLOTHES WASHER KITCHEN SINK WATER CLOSET _BAC1CFLOW?REV,($I5) _DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —WATER METER OTM AMM REM Permit Fee S Number of fixtures (a S10.00 x $10.00 = S Surcharare 50 Number of fixtures @ $15.00 x $15.00 = S OR Number offtaures @S325.00 I x$35.00=s TOTAL DUE S State Surcharge= S .50 (Mmqimum S15.50) (MR411AUM315.50) Total =3 :3,47.0 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acimowledge that the information above is complete and accurate; that the worl< will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes: that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site: that the work will be in accordance with the approved plan in the *ase of all work which requires review and approval of plans. SIG-v1AT1jRcnr.wPLICANT PRI NTITIAME, OA7E- PPP OVCD 131' 0.477 EF.R_,-71_17T-'117 -7 F E--'P.E0 IRED 7-0R3. ff ED 11�,l G:..EL Z:, =7 IC; L I E-07ii H I C,' L. --VORI,' , 3-udding Inspect.'oas Dnepar.i en -E JE. 'vil-I `f,: