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PRE 2010 DOCSCity of Fridley, Minn. WELDING PERMIT Date: ...,/„.. ................. Owner ....................................... Address ...................................... N® 3'783 Builder... Address ............................................. LOCATION OF BUILDING N0.4-3,5-1.. Street . .... Part of t ...... .......... .. . ....... ... .. .. Lot .....:�.... Block ... 4�Z........... Addition or Sub -Division .. ...... Iry Corner Lot ............ Inside Lot .)( ........ Setback .. Si eyard ,%.�................. DESCRIPTION OF BUILDING To b,� Used t` �t/�/—O ” Sq. Ft./® .f&Front Depth z Ht �...... Cu. FtRo0. ........... ......... Front ........Depth ..... HCu. eight ........ Sq. Ft......... Ft. Type of Construction .......... .....• •Est..1t;i: To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed 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. X................................................. oro 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. l NOTICE: -I- r : P. �/. ! ➢ . Building Inspector This This permit does not cover the construction, Installation or alteration for wiringbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. r.;cg4 6A City of Fridley 6 Appiication for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 �+ DESCRIPTION OF WORE Number, Sind and Location of Fixtures 14 Locaffon r 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: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL — x $1.50 $ —/,SO — x .50 $ x 2.00 $ Description ................................................$ �j Xi 1 TOTAL FEE $ < - yL 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, Minn_ RUN 22 1952 , 19 Owner /V A4 Q- 4 A/ T 2 z-�,o2-5 19— Kind 9Kind of Building 1 18— Used as p "/ To be completed about /0-- /'- `s Estimated Cost, $ Old—New. Building Permit No- s2 2Z2 SonedLONDON PLUMBING co. By Business Phone No Connection Permit No . ....................................................... 'JUL 141959 Rough Water Sewer 11 IM -8-58 Meter Deposit Z12 WATER HTR: 3ioJi <� 1: !2Z �a �F N GAS ELEG U2coo Base / 1st 2nd 3rd 4th Future Connedton Openings Connected with New Fixture, Old Openings Sewer Cesspool 0 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: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code NO. RATE TOTAL — x $1.50 $ —/,SO — x .50 $ x 2.00 $ Description ................................................$ �j Xi 1 TOTAL FEE $ < - yL 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, Minn_ RUN 22 1952 , 19 Owner /V A4 Q- 4 A/ T 2 z-�,o2-5 19— Kind 9Kind of Building 1 18— Used as p "/ To be completed about /0-- /'- `s Estimated Cost, $ Old—New. Building Permit No- s2 2Z2 SonedLONDON PLUMBING co. By Business Phone No Connection Permit No . ....................................................... 'JUL 141959 Rough Water Sewer 11 IM -8-58 Meter Deposit SUBJECT P City of Fridley I ir. 12961 y AT THE TOP OF THE TWINS BUILDING PERMIT � R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ����� 1 � ' CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L .... A"r ,'� 612-560-3450 910-F15 5/23/75 JOB ADDRESS 5351 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 2 Temple Terrace 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr. Thom's 5351 Madison Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. John Tapio 7531 Greenfield Street 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 ❑ MOVE ❑ REMOVE S 8 DESCRIBE WORK Construct a 16' x 10' Patio Deck 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AM07.. SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Redwood 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 R-1 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 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. $375.00 .50 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- $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ® PLAN CHECK FEE TOTALFEE %i$5.50 YTUREOF SIG CONTRACTOR o AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT C SIGNATURE OF OWNER (IF OWNER BUILDER) (DATEI BLDG INSP DATE R f APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDI.NG PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME :„ , ��� S BUILDER : ADDRESS: 5-35-/ ADDRESS : NO:. S S �� STREET: LOT: UBLOCK: ADDITION: `2 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attact to this *form.T!wo Certifi.cates.of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: /(o Depth: /O Height 3 2 Square Feet: ,� 0 Cubic.Feet: Front: Depth: Height: . Square Feet; Cubic Feet: Type of Construction: R C P woo p Estimated Cost: $ -3 7 SF O O To Be Completed: 5' 2 9- 7 S 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: ��" :2 3 — 7 S -SIGNATURE: Al1 (See Reverse Side For Additional Information.)' MINDIER ENGINEERS AND 5UgZVEyogs LAND SURbEYINO CIVIL &, MUNIC,pAL ENOIIVgERING SOILS TESTING 6418 -56TH AVENUE N. LANA pLNIIye MINNEAPOLI5 2T, MINN. KE 7- 3637 Clit . M a1� L0VL A/ a S T- L-oT 41 block 2 j Tem'r`1'� WE HERESY CERTIFY THAT THIS IS A TRUE AND CORIZECr REPRE5ENTATIOAS OF A SURVEY LAND ABOVE DESCRIBED AND Or LOCATION OF ALL BUILDINGS, IF AMY, THEREON , AND ALL VISIBLEOF THE DAQIES OF THE IF ANY, FN R ACHMENTS,. FROM OR ON SAID LAND. DATED THIS DI`Yoat.fI.-, er- MINDER ENGINEERING CO., INC. r Ao 17j(o ENC, ►NSER5 AND SURvEYORS _o IrDA U.3 v I y, 1 !row A/ a S T- L-oT 41 block 2 j Tem'r`1'� WE HERESY CERTIFY THAT THIS IS A TRUE AND CORIZECr REPRE5ENTATIOAS OF A SURVEY LAND ABOVE DESCRIBED AND Or LOCATION OF ALL BUILDINGS, IF AMY, THEREON , AND ALL VISIBLEOF THE DAQIES OF THE IF ANY, FN R ACHMENTS,. FROM OR ON SAID LAND. DATED THIS DI`Yoat.fI.-, er- MINDER ENGINEERING CO., INC. r Ao 17j(o ENC, ►NSER5 AND SURvEYORS _o SUBJECT PE City of Fridley o1797"5 AT THE TOP OF THE TWINS BUILDING PERMIT r � REC • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 a JOB ADDRESS � fl\P, 1 rt_ 1 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE X1-3 s3'S I Ply '3 01ra 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 14pV sf 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK pe-Tru 9 CHANGEOFUSEFROM TO STIPULATIONS 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 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 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 SI AT RE OF CONTRACTOR ORAUTHOR�IEDAGENT IDATEI WH PROPE L V I T THIS IS YOUR PERMIT S' L"' 9WCATURE OF 9KVNER IiF OWNER BUILDERI IDATEI ^" BLDG INSP DATE NEW [ ]_ / City of Fridley Effective 4/1/84 ADDN. ICY tR-1 AND R-2 ALTER. 17 Building Permit Application Construction Address: 6 &- 5- Legal Description: Owner Name a Address: Tel. # 6�la - 106,6 Contractor: Tel. # Address: 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 4 Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Leth Width Hgt/Ground Sq. Ft. OTHER: TA—i lc, 4D00V-'_ Ce f Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: W(jUV) FaQ AA Estimated Cost: $ 4K5 610� Approx. Completion Date: MAY /9 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired:c $ See Back Page for Explanation DATE: MA Y 1'4, tqft;_APPLICANT: /✓ Tel. # CITY USE ONLY Permit Fee $ /:s.og Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ �� $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sever Main Charge $ ` �C) Agreement Necessary [ ] Not Necessary TOTAL a [ ] STIPULATIONS: SUBJECT O. City of Fridley F-"19624 AT THE TOP OF THE TWINS BUILDING PERMIT RE NO. • ______ COMMUNITY DEVELOPMENT DIV. r L PROTECTIVE INSPECTION SEC. 1 `� -" -I,� CITY HALL FRIDLEY 55432 , NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 8/11/88 JOB ADDRESS 5351 Madison St. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 Teeple Terrace, Second Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE 5572-1060 Douglas N. & Mary L. 'Ihars, 5351 Madison St. N.E. 55432 427-6834 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 7 CLASS OF WORK ❑ NEW CX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 14 ft. b)y 24 ft. garage addition 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $4x824 $ 2.41 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- $72.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $74.41 S NAT RE OF CONTRACTOR OR AU RIZEDAGENT (DATE) HE P PE LI A WED THIS IS YOUR PERMIT 1 qa UREO OWNER OF OWNER -BUILDER) IDATEI G iNSP DATE NEW ] City of Fridley Effective 5/1/88 AMN [ ] R-1 AND R-2 AMER [ I Building Permit Application Construction Address: -5351 [) a S�nd ��_ � 4 T7 9- 9 Legal Description: !—C1[Z: Lnc1<a _FQy-r,PL� -C R1z,r- a°Ip X10 Q►-t`,0k� Owner Name & Address: -D 0 t � r L A _�-�� �, M A -T 1) n YYN S Tel. # a -7,a - M (� Contr actor : a _ " °� Tel. # qa'3� Address: Attach to this application, a Certif icate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRnTION OF IMPROVEMEW LIVING AREA: Length Width Height Sg. Ft. GARAGE AREA: Length 14 Width Height Sg. Ft. DECK AREA: Length Width */Ground Sg. Ft. DUZEL: ODrner Lot [ I Inside Lot YI Ft. Yd Setback Side Yard Setbacks Type of Construction: G A RACE Estimated Cost: 5 Approx. Completion Date: 1 ?1-16 Proposed Driveway Width If New Opening Is Desired: $ Width + 6' DATE: / l M APPLICANT: Permit Flee $ % % 4 State Surcharge SAC Charge 5 Driveway Escrow 5 Park Fee 5 Sewer Main Charge 5 STIPULATIONS: o4)1, CITY USE ONLY Alt. A Alt. B 5 See Back Page Tel. # 6'7, -/n(� Fee Schedule on Reverse Side $.50/51,000 Valuation $550 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Neoessary [ I Not Neoessary [ ] Lond Plonrnn9 6875 Huhnoy KS W.E. Land SL,rWY; y MImroPnlis 21, so//sTrsfin9 ENGINEERING, INC. Afinnrsola Gal b AAMMiWl Sllnsef 4-6066 En9;neern9 Engineers E Survecyors certificate of sutveT FkP,�.� }" !2 n 1 tt +O ►y N C- , 1 - Ij CY r SCALE 1"=30` GRnr^•E �� 4,�� hereby w/l/y. #ld /h,5 ra a frac and mrrtct repMsenfoNOV7 of a surrey et is hva oties gClk ado,r Asuybed land, and Olit l"Ohon gr'aua�il/lu�s, fheira►� , and W risible ax,wh mh ,,f y, �n err 07506f /and. As surveyed by me 1fys�T_"_ cby g(' ^� i r ,,, G r r A D 19124) SUB UR8M ENGINEERING, INC. 1 Z ;nears £r l40 Surr rs / L L� . • CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEI4S AND DEVICES RATE SCHEDULE QESIDEKTLAL RATE TOTAL Job Address Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ ..7®, R70 Building Inspection Div. 6431 University Ave NE Fridley MN 55432 4 P Y Y Tel. No. 572-3604 Gas Piping $ 10.00 (piping needed with new furnace) Gas Range $ 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 Gas Dryer $ 10.00 $ and rulings of the. Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. * Air Conditioning (all sizes) $ 10.00 $ q19q/ All Others/Repairs and Alterations / OWNER t� �fsr�-, �sL-++�✓Y 18 of Value of Appliance or Work $ KIND OF BUILDING ���`�� 411,' COMMERCIAL/INDUSTRIAL USED AS - lit of Value of Appliance or Work $ TO BE COMPLETED ABOUT ESTIMATED COST State Surcharge S .50 OLD - NEW BUILDING PERMIT NO. PERMIT No. TOTAL FEE $ REINSPECTION FEE $30.00. 8 5-V DESCRIPTION OF FURNACE/BURNER Rough Insp. /SDate � Final Insp. CJ 6 / Date Approval for Permit .�� MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name doL� y J Size No. + Capacity Sq. Ft. EDR BTU ^V 0 HP Total Connected Load Kind of Fuel BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Company Standard Beating LAIC Signed By Tel. No. 824-2656 Fill out back side for stack verification on replacement furnaces STANDARD HEATING & AIR CONDITDONING Co. SERVING THE TWIN CITIES SINCE 1730 HEAT LOSE CALCULATION FOR TKIMS 91191 LL MAIN & 8ASEMENTLENGTH 40 WIDTH 24 HEIGHT 9 WlNDOWS & DOORS - CRACKAGE AND AREA WIDTH HEIGHT NO. LIN FT AREA NO. PANE PANE LIGHTS C�D-..'. SQ FT \ 48 60 1 19.5 23. 3 24 18 2 42 24.5 4 24 24 2 64 42 2 36 80 D 38.7 40 COEFF BTU 128 R.FT INFILTRATION ................. 164.2 20 3284 GLASS .........,...............,.... 130 50 6500 EXP NALL ..............^......^^^^^ 128 NET EXP WALL ...................... 894 13 1b6Zl BELOW GRADE ..... 8 ................ 1024 5 5120 CEILING ............................ 960 15 14400 FLOOR ............~.............., 960 3 288O VENTILATION ..... V ............... 0 O O TOTALBTU ...............^...,.^.^.~..................... yauou ` 410 W. LAKE ST. 1072 PAYN E AVE. MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101-3892 612/824-2656 HEATING AND AIR CONDITIONING CO 2-2449 &"ing The Twin Cities Since 1930' MEIVED ORSAT TEST RECORD ADDRESS— �5(� d-��5�/1� CITY_ OCCUPANT OWNER DATE HTG. INST. INSTALLED BY GAS LINE BY Gc� ii r TYPE OF HEAT: GA FA HW S EAM SPACE HTR. GAS DESIGN MAKE g:-& MAKE MODEL `r �1&a 6 a A 0 / Z�-W MODEL SERIAL -!j/ Z- L a ooh MAX. INPUT MAKE CONTROLS MODEL OCT 10 1991 G1-71 PUbli UNIT HTR. OTHER. CONVERSION OF BURNER BTU RATING OF FURNACE THERMOSTATS � HEAT PLUG (r VENT SIZE VALVE W KIND OF LINER SIZE .s-e"NONE LIMIT e DRAFT HOOD REGU ATOR LIMIT SETTING Z,00 CHIMNEY 'CONSTRUCTION t�f-vo- FAN SETTING MO DRAFTTEST TAG ® �� PILOT TYPE do.- v LIGHTING INST. r z PILOT MAKE (�r•� PILOT MODEL PILOT TIMING:174-4/- ..- PRESSURE PERCENT CO2 (o DATE TESTED %- z- f--� INPUT CFH O PERCENT 02 -10 STACK TEMP.-7!�Eo PERCENT CO Uy&in t NAME OF TESTER SUBJECT PERMIT NO. City of Fridley 24141 AT THE TOP OF THE TWINS BUILDING PERMIT_ RECEIPT NO. • ___-_ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 I = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 5/6/96 JOB ADDRESS 5351 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 2 1 Temple Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doug Thoms 5351 Madison Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Plochocki Construction 29537 F Bpthpl Blvd, rpdar WIN 95011 434-7998 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 ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace front Step (3'6" x 4'6"-," r " run 9 CHANGE OF USE FROM TO STIPULATIONS Front step must meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 1 HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 @ $500 @ $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER aTATE OR LOCAL LAW REGULATING CON- $21.00 Fire SC $.50 STR OR THE PER NC OFC STRUCTION. PLAN CHECK FEE TOTALFEE 22.00 9I ,`NATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALIDATED BL INSP THIS IS YOUR PERMIT�� [C�jJJ DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 3/1/96 ADDN [ ] -CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: T• Legal Description: Owner Name & Address: bl vk Tel. # Contractor: MNLICENSE# Address: Z- 2-S' 37 r5- Blv0- ;Su/I Tel.# `%3 7`--P Attach to this application, a Certificate of Survey of the le6 k't P7 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 Logthh Width Hgt/Ground Sq. Ft. OTHER: l� %lSf/�S !;�� �o �-r� .1 e ,Z, 7 /� ` / %�N .N/ Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 0 rift [.Y' f �� Estimated Cost: $ jn!&D Approx. Completion Date: (Cost on Back) Driveway Curb/Cut Width Needed: ` Ft. +'6 Ft= FIA = $ DATE: (Q APPLICANT: Tel. # CITY USE ONLY Permit Fee $ �/, ®� ,,Fee Schedule on Reverse Side Fire Surcharge $- `� C .001 of Permit Valuation (1/10th%) State Surcharge $ S G' $.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 j ] TOTAL $ �� STIPULATIONS: � C