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PRE 2010 DOCSDate: Owner: Address City of Fridley, Minn. BUILDING PERMIT /f 9 - � i N° 4348 DING No...le��. Street....._ ......_......._. _............ ....r........... '- Part of Lot .............. -.... ............... ............. -........... -- ... Lot ...........1--3 ........ Block ...............1 .. / .............................. Addition or Sub-Division.—W-1/4 ............... .. . - � Corner Lot ................................... Inside Lot ..... ........................... Setback � .'_t_p_............ Sideyardf V..... C?..y........_........................... _........... Sewer Elevation .. ...................... .................... ..... _..................................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: t G a -- ....._............ Front -® Depth T-- Height 0 Sq. Ft. .74-4_.7 Cu. Ft. /fir... � ......................................................... Front ....................... ... Depth -- ----- ............ Height ........................ Sq. Ft....._.--._.......... Cu. Ft...................... p Type of Construction ......._ ................................ .. Est. Cost _./ .Y....... . ............. 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 s 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 time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PEMM CITY OF FRIDLEY, MINNESOTA' .r. Owners Name Builder Address Address, LOCATION OF BUILDING ' No. SNt'w Street nAyooa Part.of-Lot Lot i 3 Black / Addition or Sub.Div. tI yw- G- . Corner Lot Inside Lot Back Back.: 3 t Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. ' DESCRIPTION OF BUILDING To be used as: Front z Depth_f Y Height / fi Sq. Ft. Cu. Ft. Front ' i `` Depth Height Sq. Ft. Cu.. Ft. — J/ Type of Construction Estimated Cost 7 �� To be completed The undersigned hereby makes application for a permit for the work herein specified,...., agreeing to do all work'in strict accordance with the City Ordinances and ruling of...,,;;. the Department of Buildings,, and hereby declares that all the facts and representa- tions stated in this application are true and correct., ! (' G ' SIGNATURE DATE w (A Schedule of Fee costs can be.found on the Reverse Side.) City of Fridley Application for Dumbing and Gas Fitting Permit r Dept. of Bldgs. Phone SU 4.7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Lova I� €g 12 y zz `a pz � 0O? J w 0 Z z 90 • R � N WATER HTR. GAS TIM az � Base f 1st % 2nd _ 3rd _ 4th • Future Connection Openings I Connected with Sewer e New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RAI Number Fixtures ......................I!L x $1.50 Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 Catch Basin ............................ x 3.25 Water Beater (Up to 200,000 BTL) ...... x 2.00 New Ground Run Old Bldg. x 3.25 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, Annn 19 �?' Owner Kind of Building Used as To be completed about /d e" a Estimated Cost, $ G TOTATOTALOldl!Fluilding Permit No -� Permit No. G� 4 Signe- $ Bye_"--'� $ Business Phone $ ROUGH DEC 21 1959 DEC 2 3 1 FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...................... — x $1.50 S Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........................... TOTAL FEE $� 42 2M 7-59 City of Fridley, Minn. BUILDING PERMIT �2C Date:" Owner:'=w Builder - Address Address OCATION OF BUILDING No. y Street "RAO, Part of t Lot_ Block Addition or Sub -Dion Corner Lot Inside Lot Am!!!!! ' ab2dation, Sideyard Sewer Elevation_ _ Elevation DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Ca Ft. t _ Depth Height ^ Sq. Ft. Cu. Ft. Type of Constructioi_ Est.. To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do Zproposed work in accordance with the description above set forth and in compliance with all provisions of ttancxs of the city of Fridley. In consideration of the payment of a fee of It _ , permit its 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 time upon viola ' of any of the provisions of said ordinances.. Building Inspector NOTICE: Tbls permit does not cover the construction, batallation for wiring, plumbing, Bas heating, sewer or water. Be sure to we the 8uildhng Inspector for separate permits for these Items. _ � I APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builderl�'6'�° Address Address ,7/19-S LOCATION OF BUILDING No. Street Part of Loth , Lot � Block Addition or Subdivisi Corner Lot Inside Lot Setback,.S ide-Yar SEWER ELEVATION FOUNDATION ELEVATION G Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING T be used as- nt � De th .._ ! Sq. Ft. Ft. Front Depth ____Ji eight sq. Ft. Cu. Ft. Type of Constructio -7i_ Estimated Cost 60To 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 ruling of the Department of Build- ings, and hereby declares that,all the facts and representations stated in this application are true and correct. DATE — D - IA , ' SIGNATURE lae4,, � e� (Schedule of Fee Costs can be found on the Reverse.Side). SUBJECT City of Fridley 25644 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ` COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. d, `� r i "';•, CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY __--� L 612-571-3450 910-F15 10/28/97 JOB ADDRESS 5412 Madison Street NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DEscR. 13 1 Lyndale Builders 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda Oslund 5412 Madison Street NE 572-9223 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 j] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (14 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 MOT. 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 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 $1,167 @ $.58 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- 40.25 Fire SC $1.17 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTA FEE $ 2.00 ATUREOFCON.RACT ROR HOR. ED AGENT MATEI EN ROP L VALIDA ED HIS IS YOUR PERMIT /J� 5NATURE B G INSP VVV GATE OF OWNER OF OWNER BUILD IDA I NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �57 ConstructionAddress:d �/ (� �� r 3 �� u 1' 4) Legal Description: Owner Name & Address: ,� N j A D S Lut d 0 s AAI l.� Tel. # Q a 3 Contractor: S (; L11� MN LICENSE# Address: S (4 /V1 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF B PROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA:S� Width Hgt/Ground Sq. Ft. OTHER: I ?1° n Q)i `' ('-� 11V_ r CITY USE ONLY Construction Type:_ Qj, P L q (. C, 0 0 Estimated Cost: $ ll(,, % (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: � `'XPPLICANT: Tel. # CITY USE ONLY Permit Fee $� , as Fee Schedule on Reverse Side Fire Surcharge $ / , / �/ .001 of Permit Valuation (1/10th%) State Surcharge $ ��`; $.50/$1,000 Valuation SAC Charge $ $950 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: %/ 3.2®3 TY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2001 N 131 University Ave NE m idley. MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING. VENTILATION, m 13.572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES a JOB ADDRESSy�� 14 RAT'E SCIIEDULE - D 6 i) 5 &)t rA :sidential Rate TOTAL OWNER rda C 1 =umace BUILDING USED AS AeSiear, CG Shell and Duct Worts, Burner • — %Iso Replacement Furnace $ 30.0.0 $ -D {Side Vent •Fill Out Back} ESTIMATED COST .3 LCSL7. O PERMIT NO. .3as Piping (Needed with new furnace, $10.0.0 $ but not replacement) DESCRIPTION OF FURNACE AND OR'I MRNER Sas Range $ 10.40 $ I Air 10.00 No. of Healing UN its (Steam) Ho Water arm Circle One ) ( ) {W ) Trade Name �Ci rri e -r' Size No. Sas Dryer $ $ BTU mo _ HP MR Air Conditioning • All Sizes $ 25.00 $ Fuel A2ait 6-S Total Connected Load all Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR A3mnmr+dal/Industrial W 1.25% of Value of Appliance or Work $ 0 State Surcharge L) TOTAL FEE $ 30• E INIIR= FEE FOR ANY HEATINGICOO ING/VENTILATION EFMGER/ITIOWAIR CONDITIONING PERMIT IS $25.00 LUS THE $.50 STATE SURCHARGE v _INSPECTION FEE $47.00/Hr `i +ir Conditioners can not be placed in a side yard without ritten permission from adjoining property owner. n Ti. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all Worts 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. HEATIN Signed DATE /-9-0 olz Approved By Rough -in Date Final Date BACKSIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION SEP -20-2001 1453 FROM CITY OF FRIDLEY TO 7576701 P.02i02 COMMON VENT. nNT CONNECTOR AND COMBUSTION AIR VIPWICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from nest, deterioration, obstructions, and Is securely supported and fr+estopped where required. YesKNO ( ) The venting system Is plasticlPVC and meets all current codes and manufacturer specifications Including sizing, length, number of elbows and termination. YeSKNo ( ) The undersigned also verifies that the replacement unit Is a listed assembly. and meets the current codes and manufacturers specifications. This does Include AGA -LAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. YesXNo ( ) The existing combustion air is sized and installed to most the current codes and manufacturer's specifications. Yesx) No ( ) When required to Install a new cmMb rstion air, it will be razed and Installed to meet the current codes and manufacturers specifications. Yes'XNo ( ) When Installing a now venting system, the undersigned hereby verifies that it is a fisted assembly and meats the current codes and manufacturer's speftations. 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 codes. Yes �(No ( ) ADAtiance Tvpp and $izelCommon Vent and Vent Connector tnformatlon Appliance #I Type L i(M(L BTU Input 4 Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Not Appliance #3 Type STU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 .-nt Connector Height ft Length ti Diameter In Type �...._ Applenoe #2 went Connector Height ft Length ft Diameter In Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: 6IC41 Signed S)r o Date TOTAL P.02 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Bath Wash IKIra1 Floor Gatch :Auto. Urinal Tub Shower S;rnk,.; TrayQUEIt„ Drain Ba�.trti Washer NO. RATE TOTAL Effective On January 1, 1997 Gas Mise >s Water Heater Range 1=1Xt......z Gas Elec e JOB ADDRESS_ 7'/ 'A r" New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7,Op Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner �j�✓d s� ® S ( 0 /� Water Heater —Electric $ 7.00 Water Heater — Gas** >< $10.00 10 <v Building Used As --,5—/,v Gas Range** $10.00 Gas Dryer** $10.00 Estimated Cost � �'% `,,� PERMIT NO. Back Flow Preventer Required ( )Yes () No Type_ $15.00 2&4 �` > PLUMBING COMPANY Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY �W tev Approved By / "ter Rough—In Date $ .50 $�61'0 PLUS THE $.50 STATE SURCHARGE TEL N0. Final Date **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.