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City of Fridley SUBJECT PER O. 13390 AT THE TOP OF THE TWINS BUILDING PERMIT r � ECEIPT NO. I • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. // / --'I CITY HALL FRIDLEY 55432 ``J NUMBER REV. DATE PAGE OF APPROVED BY ---- 612-560-3450 910-F15 2-27-76 JOB ADDRESS 7519 McKinley Street N.E.- .E.1 1 LEGAL LOT NO. BLOCK TRA CT OR ADDITION SEE ATTACHED DESCR. 4 1 Stinson Boulevard SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Cedar Bay Builders Canyon Lane 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D.W. Construction Inc. 8804 Lexington Avenue 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING XKNKKXNKKIXXPZXXXIKVNIX431 residential 7 CLASS OF WORK CX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct split level (3) — SAN P 9 CHANGE OF USE FROM TO ` :0 STIPULATIONS TELEPHONE - ELECTRIC-GAS Eft 1. Provide a truss design Sewer: (approx. 1�,A;ft� � ��► LAW 2. Provide a verification Survey 12' S. of M.H. In ° 3. Provide a hard surface drive Wye Elev. 893.77 Top of footing 896.77(Minimum) *Take caution not to disturb private property to the South, Recomme obtaining construction easement --Dater: 13' N of sewer service �Iv""oC - Note: The City does not guarantee accuracy in utility ��®k1,aGCM�,PERATE PERMtiViREJ�1R11MG, "'010N �So �Ep�`N N� EATING, PLUMBING AND SIGNS. \ � A�\Ja s, ®pE P REM® SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. wood frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1,008 20,464 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 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 VAL ATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 41,650.00 20.82 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 CON- PERMIT FEE 46.73 SAC CHARGE 350.00 STRUCW OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 417.55 6j (J�' &/ e # 0161W SIGNAT7 C &TRACTOR 6R AUTHOR AGENT (DATE) JSKENVALIDATED THIS I YOUR PERMIT /P}R�OPPEERRLY BLDG iNSP DAT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) id W ♦ f APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT 69,38 CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER: ADDRESS:_ J� _ ;.rte _ _99 NO Is STREET: M) C'1.. v LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: /-- SETBACK--?6' SIDEYARD: Applicant attach to this form Two,Certificates ): Sun.rey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: P 'r Front: Depth: �� Height: Square Feet: /e© Cubic Feet: Front: 2-( Depth: Height: Square Feet;. Cubic Feet: y cu 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 of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE:SIGNATURE: _—Tom (See Reverse Side For Additional Information.) 4(.0!)'- o"20. S2 �;-V. C3 //''��J ('0 � 7'kttf 55 l�"l6_� 560-3450 C�ty o� ¢r�dlety ANOKA COUNTY 6439 UNIVERSITY AVENUE NE March 4, 1976 FRIDLEY, MINNESOTA 55432 D. W. Construction, Inc. 8804 Lexington Avenue New Brighton, Mn. 55112 Re: 7519 -McKinley Street N.E. Dear Sirs: We were out to remove the red tag on the house under construction at 7519 McKinley Street N.E. on March 3, 1976. While there, it was noted that there was no insulation over the exposed footing, therefore the footing and the ground under it must be frozen. It is important that you do not proceed with the block work until the ground has thawed as there more than likely is some heaving in the frozen ground and footing. If you have any questions on this matter, please call me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh GERALD T. COYNE 300 BRUNSWICK AVE. S. GOLDEN' VALLEY, MINN. MINN. REG, NO. 4741 INDUSTRIAL — JUDICIAL COMMERCIAL — TOPOGRAPHICAL CITY LOTS — PLATTING CIW:)AR BAY 3LlI�,e':,iNJ LOT SURVEYS COMPANY LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY 'OF KWNEAPOL 6 5747 W. Broadway Minneapolis, Minnesota 55428 533-9922 #Mrynxs cferttfutttr o — /- 7/7 Lot 4, Block 1, 3TMON BOULEVARD ADDITION N?. We hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land and the location of all builidings and visible encroachments, if any, from or on said land. Surveyed by us this 28th _ day of Janu7.m Iq3� Ia RAYMOND A. PRASCH 6917 IDAHO AVE. N. BROOKLYN PARK, MINN. MINN. REG. NO. 6743 INVOICE NO. %"j 7 2 F. B. NO. SCALE 1" o - 7 O — DENOTES IRON �er.ct. For Zx -ovation :)ri y Before ...... TELEPHONE - ELEETR11C - 614J Etc REQUIRE® BY LAW 0," a--IMPORTANT- s• i�; ,.. N O I1' -T, THE FRIDLEY ENGR. P'DIVISION REGARDING CURB OVAL AND REPLACEMENT ;, , l JAVEWAY. OPENINGS. r �,. �, APS.` f� �`�.q 4,•s"'.� Signed LOT SURVEYS COMPANY r • -x, i� 7 T �z .U� c) 7 - / / o C— - 6 � �, - 7 7 (LfrTy --S au 7'1f � af��fxS6 �T 7-YIC 1,3 1 � , , F 9 -- P07 -f, �, -�e V - CC/), G �' uy • .- --•--- Doprt. of Bldgs. Phone ,S. ---*-34W D�QCaIP"I01T G� V101;� ��"! Xu»i5.:,-lard dna. L'oer.iea of Ftx^s:es I'O`�•"o~ . I City of Pridlcy• . d S 3 { a o ? 7 V .7 W v ►+ wxTf4 WN. cis cue. The undersigned hereby r akes app lca..on for a permit for the -vet here! N i; 1 _ N ; s - a . a = o �„ 0 1 { 3 u u a ; u $ specifi�ed, aecIn- to do all %vc:k in strict acco: dance with t- :e Cid I and ruling of the Department of Buil: ngs, and hereby declares that a:I L`.e fact Ea:r and representations stated in this app`:lcataon are true and correct' _ `` Fridley,, Man 19_• 2a j -- Owner _. 3.d . 4th Kind of Building- • So•aar ❑ Used as t ?{av rmt=v. Old Ctrs=y L's Ccaapaol ❑ -- To be completed about PARTIAL RATE SCHEDULE Estimated cost, $ Old New. BIu':ding Permit No. P.:nit Ir o.f.L__• LMMBI'iG FIXTUP.E RATES: NO. RATE TOTAL x Sig: ed Number Fixtures ................. .,-• _ Fhture Fixture Opening ........... x $1.50 S , -. By `` Business Phone No New Fixture Olid Opening.......... x $j• 50 C2tch Basin • ................... x $3.25 ' •• 1Vatcr Beater 'Up to 99.000 BTUs • • • • x 53.60 S ROUGH New Ground Run Old Bldg....:..:. xS-------- Z.,bc#etc YlatarF.&atLr...... i r® r i:TTI 'G : EE3: NO. RITE Th07AL� • : x $2.00 3— =�=--- '. • , . • Int 3 Fixtures .................. Add!ticaal Fixtures ............... ----- x .75 $ Gas Raait to 13.000 BTU ......... s. x $5.00 .*i , State Surcharge Pr?.V.RS Ic ALTZRATIOHS--Rater to Coda .50 .1k:cri;,',on ...............:........ ,...............F I. S� . TOTAL F'= S i 560.3450 C of 7�dl� ANOKA COUNTY 6431 UNIVERSITY AVENUE NE September 23, 1976 FRIDLEY, MINNESOTA 55432 Mellas Electric Co. Route ##1, Box 266B Wyoming, Mn. 55092 Ree Electrical corrections Dear Sirs: An inspection at 7519 McKinley Street N.E. of the electrical work done noted that there was no ground on the job, there,was no laundry receptacle, and that there was no ground fault interuptero We will expect these correction to be made within a reasonable time and a reinspection called for. If you have any questions on this natter, please feel free to call me at 571-3450° Sincerely, LEONARD EICHMILLER Electrical Inspector LE/mh r'"�ig�,!RR'Pns-a�•.a. •ti'q .+s>+...-n.q ..--ti!ti, p�.,..� �-R�,^..-�.R..� .�rvm� ! „la�,,...r,4,�+.!.�B o°ti.y 3x. di�w1$IYri ift 4.:0 �aa is �a::i �•...�d 2e Ce.as'.�t tt•a•u.:ep.rr�. �Tar�3al v'.a�,p pF�y far �.i�.Kro+r6 aids&$ si � ��+. h7 a�.e. 6 Ir �'R• �9'f��.� U'l lei mYY4r.1 i i V Q.i.61'.+cLt i iv®C PARTIAL RATE SCHEDULE GRAVITir WAMM AIR: RAIM TOTAL F,Mmace Shell & Ihx t work $10.00 � Replacement of Furnace 6.00 P.epai-c & Alterat.ons- up to 5500.00 600 $ Repairs & Alterations each add. $500.00 3:X1 $ KZCFL WARM AIR rurrace Shell & Duct Work to 120,M BTU .$1000 each add. 60,000 BTU 3XX) S Replacement of Furnace 6.00 5 Repairs & Aheratiens--up to $500.00 6.00 g Repairs & Alterations each add. 5500.00 3.00 $ 3TLAM or HOT WATER SYSTLM Pur -ace Shell & Lines --to 400 sq. ft RDR Stearn sio.00 = Furnace Shell Sr Linc—to 640 sq ft. EDR Hot Water 2000 S. Each Add 200 sq. h EDR Siem 3 f3t1 Each add. 320 sq. ft EDR Hot Water 3.00 S OIL BURhZP-to 3 gal. per hour 6.04 S. over 3 gal. per hour --See Fee Schedule GJ1S BVI WER (;:p to L119,0W BTU) 6.00 3� over 253.000 BTU Sae Fee Ekkedvto GAS FITTING FEES: no HATE TOTAL Ist 3 nxtures z$ 200 Si0e< Additional Fixtures � x .75 Gas Range to Lg9.(X0 $$ 5.00 3 GO 'FiLOKlI� 7W?yeq State Surcharge Z, 7 1.1 f Dept. of Bjkq�pjl City of Fridley: The undersigned het specified agrc-cirg to de and ruling of the Depart and repn.,sPntatiuns stair Owner Kind of BuildinZ Used as Tn he completer) about by -makes application for a permit for the work herds 11 work in strict accordance with the City Ord:raacei ent of Buildings, and hereby declares that art the f&cU in this application are true and correctF'ridley, Minn Estimated Cost; $ Old Ivew Building Permit No. __ _ Permit No. W� IDE-Irx-TIT202T OF WORX HEATING or FO FLANM,-Stem, Plot Wa Warm Air No Trade Narne— C a Size No Capacity—__..-_ — Sq.. FL F-D.R g,P Total Connected Load `r' Kind elf rvz BURNER -- TWde Name Size No -11-11"?- 3 Camcity Sq. Ft. E.D R �72 . ) 2-M Emb c2MAatcS-O"i"l RAY N. WELTER HEATING CQ. SLS- 637 Ehie 137 Minneapolis, Minnesota 55407 _ Ph= V-0- z 21, 1977 6,431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571-3450 Mr. Rudy Bayer D. W. Construction Inc. 8804 Lexington Avenue New Brighton, Mn. 55112 Re: Final Inspection at 7519 McKinley Street N.E. Dear Mr. Bayer: A final inspection was made on June 21, 1977 of 7519 McKinley Street N.E. and the following items were noted which must be completed before the structure can be finaled out; 1. Post address on structure by July 1, 1977. 2. Provide door closer on garage door and light by July 1, 1977. 3. Sod or seed the front and side yards by July 15, 1977. We will expect the above items to be completed by the scheduled dates when reinspections will be made to determine compliance. If you have any questions about these items, please feel free to contact me at 571-3450. S' cerely, &S, - i•. -j' DARREL G. CLARK Community Development Adm. DGC/mh CC: Mr. Jack Walters El SUBJECT P City of Fridley :6 � � AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir ' _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. r � � �'--1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/22/95 JOB ADDRESS 7519 McKinley Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Stinson Boulevard Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan/Donna Ossmann 7519 McKinley Street NE 780-5772 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage; Tear -off (21 Sq) 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,575 $.79 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- $37.00 Fire SC $1.58 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $39.37 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT BLD INSP qA E SIGNATURE OF OWNER OF OWNER B ILDERI ID TEI NEW ( ] ADDN (] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: ""7 E; ( Q W, c Effective 1/ 1/95 Legal Description: ' Owner Name & .A,ddress: �� 'Tel. #; .. `'% ,?p--, 7.7 .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 GARAGE AREA: Length ECK AREA: L OTHER: mer Lot [ ] Inside Lot [ 1 Type of Construction: Approx. Completion Date: _ (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ ATE: �a APPLICANT: Tel. # -/,?9-5-7-7 CITY USE ONLY DESCRIPTION OF IMPROVEMENT Ft. Yd Setback Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Side Yard Setbacks Estimated Cost: $ Acl Permit Fee $ % , 06) Fee Schedule on Reverse Side Fire Surcharge $ / , ,q .001 of Permit Valuation (1 / 10th %) State Surcharge $ 29 $.50/$1,000 Valuation SAC Charge $ $850 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 $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES MINIMUM FEE FOR ANY HHEATING/COOLING/VENTILATIONHEATING COMPANY_ , �//e'; REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. '7 8a — � 77 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE JOB ADDRESS '�5 I Q M c �fhLo� RATE SCHEDULE T The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) �j� 7 X1998 Gas ing (Needed with new furnace) $10.00 $ 7r �� -N r �c�ce� OWNERCL_ Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST` 3 O 0 PERMIT NO. *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name K�d� Size No. Commercial/Industrial BTU 15,rev� �,5, HP EDR 1.25% of Value of Appliance or Work $ Fuel ,2,,,& Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR MINIMUM FEE FOR ANY HHEATING/COOLING/VENTILATIONHEATING COMPANY_ , �//e'; REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No. '7 8a — � 77 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHMMY 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 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes No ( ) Yes No ( ) Yes () No ( ) Yes ( ) No ( ) Yes () No ( ) Yes O No ( ) CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2001 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763-572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS_ T5I � kc F RATE SCHEDULE OWNER ,bony-\&- 0 !SS ri. ea -w v\ 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 Pr%Pc"'— 'Sas Rate TOTAL BUILDING USED AS k_Lrr_..._ $ 30.00 $ 10.00 $ 10.00 Gas Dryer -4-t �'�''�.�" $ 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%u of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. ESTIMATED COST O PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Y,,a4 1'igaL:: Total Connected Load Burner Trade Name Size No. $ BTIJ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE &";�o "®/ HEATING CO Signed 06 TEL # ,? `S -P— Approved By Rough -In Date Final Date "; �)( BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When 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_ Appliance #2 Type _ Appliance #3 Type _ Total Appliances Common Vent Type _ BTU Input ' _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 : t C'f fY OF FRIDLEY INSPECTION DIViSION Ltiective January 1, 2003 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 TOTAL $ 30.00 $ 3CL CM $ 10.00 $— $10.00 $10.00 $ $10.00 $- $25.00 $25.00 $.6—ro $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr "Air Conditioners can not be placed in a side yard without Nritten permission from adjoining property owner. $ .50 JOB ADDRESS r)S19 MC..-InLtq S -I f)cr— 11 OWNER IJO`(�11A dSS�rY1Ct1�1 ���-51�1 BUILDING USED AS �e� Jrn ESTIMATED COST 380 ^ 0-6 PERMIT N0. A; V / DESCRIPTION OF FURNACE AND OR BURNER No. of Heatin nits 0 Circle One (Steam) (Hot Water) Warm Air Trade NLtTeSize No. -65 0 6D-0 _ HP EDR Fuel N Total Connected Load Burner Trade Na Size N BTU HP EDR `l &JJL r�lCs 5o f�-N1Coa� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO Signed .--� FAX # 2& Approved By. DATE C� `5 )/®3 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE -is i 9 mC.Kin L* -1 S}-nc,— THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When pe�,113p an exiefing,hiranr& 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 (4 No ( ) The venting system is plasticlPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes lo ( ) 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 -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. YesA No( ) The `g non+.�oo air is sized and Installed to meet the current codes and manufacturer's specifications. Yes (�'No ( ) When regUired t0 incykafl a new-cnmljietrnn MC.jt will be sized and installed to meet the current codes and manufacturer's specifications_ Yes No ( ) When rnntat g a np-w matffing•sytilem, the undersigned hereby Verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA 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 odes. Yes Vf No ( ) Appliance #'I Type f v+wf'c7—' BTU Input WO' 6" Appllance #2 Type �-ar;K BTU Input Appliance *3 Type BTU Input Total Appliances . Total Btu input ice.► a Common Vent Type 11T Vent Height Diameter 'y inches Fan Assisted or Nat 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 n , r �enNs• •nroe�n��e;, td•T•✓,q�c.r� .S HEATING CO: Signed By: Date: `/ "/L `01 TOTAL P.05 Building $a BUILDING See Back Page for Fee Schedule Permit No.: ,,;�OO! Inspections RESIDENTIAL APPLICATION Surcharge Received By: 763-572-3604 (.0005) times the total job valuation — Minimum $.50 CITY OF FRIDLEY Date Rec'd: DATE (�)1 ' 01-9 YOUR E-MAIL RESS `��C O •C�'iYl SITE ADDRESS �� f TG 1Y1 �'elJ� $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME�GI.C1 G .�S Griot In n $ TENANT ADDRESS: 1 CITY STATE_ZIP $ PHONE: 4�W - • oU • S�'� Z. $450 Conservation Plan Review CONTRACTOR NAME:_ RENEWAL, BY .ANDERSEN SUBMIT A COPY OF STATE LICE 1920 COUNTY RD. "C" WEST $ Yoult STATE LICENSE ADDREss:- ROSEVILLE, MN 55113 CITY STATE ZIP WITH APPLICATION PHONE 651-264-4777 N o LICENSE #20130983 Make checks payable to: City of Fridley Attach Stinulations PROPERTY TYPES -)RIES PERMIT TYPE CIADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWID 14NG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �' C�-i HEIGHT Sq. F SIZE OF IMPROVEMENT LENGTH WIDTH ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan 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 structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No 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: TOTAL JOB VALUATION (USING vTHE 1997 B.0 FEE 3 OOOOCCUPANCY TYPE Permit Fee $a o� 3 , A See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ 10, (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ / 3, OCj .001 x Permit Valuation (1/10%) License Surcharge $ �, DO $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 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ at{'�-, �-S'— Make checks payable to: City of Fridley Attach Stinulations 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 Minnesota Construction Codes; that I understand this is not a permit but only an application4a permit and wo not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whi ujre�s review *proval of plans. SIGNATURE OF APPLICANT 01 01 Building BUILDING PermitNo.• `J-00 W Inspections RESIDENTIAL APPLICATION Recei 763-572-3604 CITY OF FRIDLEY Date Ie c DATE �� I I a JO `] YOUR E-MAIL ADDRESS A D SS Yy & h Ul 1 Gcw� CGtS�i �e t SITE ADDRESS -751 g M c k+:- C -P—,, S f IJ -E THIS APPLICANT IS: �XOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: % S/ 9 me- S -t lJ- CITY r -i-3 d (.ms, STATE"° 6 .S5 3 �- PHONE: %&3,7000,6-77�- c.QAIV '7L3 a 1 3a3 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE M SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE b7 -DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: fANEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: r. P (c,,— h1d d e m a SIZE OF IMPROVEMENT LENGTH --)�o WIDTH HEIGHT 3 -)-0 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 ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project VANDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No 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) TOTAL JOB VALUATION $ L } ol., JA . el® OCCUPANCY TYPE Permit Fee $ ON, Q S See Back Page for Fee Schedule Plan Review $ 'al 1 a 1 65% of Building Permit Fee Fire Surcharge $ a .001 times the total job valuation Surcharge $ , .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ j 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 I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT OBJ o-YVY.-n__.�C ejiyyr+-• A--w�RINT NAME O 'vim toyl DATE Building Permit Fee BUILDING Jq'3.aff2 See Back Page for Fee Schedule Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 10. aO. .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ ICM. % 763-502-4977 FAX $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ EFFECTIVE 1-1-09 $ $450 Conservation Plan Review DATE YOUR E-MAIL ADDRESS %L Ge SITE ADDRESS $Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNER CONTRACTOR Make checks gUable to: Ci of Fridle Attach Sti ulations PROPERTY OWNER/ NAME: S A) THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED TENANT ADDRESS: %/ 5A X j /U EE CITY l (J 4-C Y STATE i�1i^�IP � ry PHONE: `7� ;) _ 7 b o _477d _ CONTRACTOR NAME: U) kT-A 0 c L SUBMIT A COPY OF EXP DATE YOUR STATE LICENSE STATE LICENSE # V D '% AND CERTIFICATE OF ADDRESS: NO Uw_ uE CIT/Y__ 3TATEAI�,!M2IP_ INSURANCE PHONE'533--ZolbKFAX PROPERTY TYPE bg SINGLE FAMILY SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAINTILE ❑ DECK KSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION WMAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 0E ,4 -dZ4&e_ /1n SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposal floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIRING FOR NEW CONSTRUCTION INCLUDING DECKS, ADDMONS_ & PORCHES SUBMIT. U'Vinyl 090-ffit ❑ Aluminwn 1. Site Plan/Survey showing the existing structures 13 Other ascia and proposed project. 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 OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ' _ OCCUPANCY TYPE Permit Fee $ Jq'3.aff2 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 10. aO. .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 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 $ Make checks gUable to: Ci of Fridle Attach Sti ulations 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 Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case all ork which reqs it review d approval of pla�ns��.ry l / SIGNATURE OF APPLICANT ( RINT NAME KC � 7 � � DATE I PLEASE NOTE: SEPARATE PERMITS ARE REOMED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK I