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PRE 2010 DOCSING PERMIT Vill ge of Fridley, Minn. N° 2555 Date7 •f• ............ ........... ' Builder a... . Owner / ..... .. Address W �`. �% ..L�'.�?.d ..... ............ Address ........................................ . TION OF BUILDING No. !'., 1....... Street ................ Part of Lot ....................... Lot ..... 17 ..... Block ....Q4.... ... Addition o r Sub -Division Corner Lot ............ Inside Lot .. ......... Setback "Sideyard.'.'r. ........... . To be Used as: �.. Front .0/40.. .................... Front .... Type of Constructio *--q. .... I In consideration of the issuance to the proposed work in accordance with ordinances of the village of Fridley. OF BUILDING a / Depth 974.... Height ..... Sq. Ft.,� 40.7? . Cu. Ft........ . Depth �........ Height ......... Sq. Ft......... Cum. ,Fyt......... Cosa?ryw.. � ........ To be Completed of a permit to construct the building described above, I agree to do description above set forth and in compliance with all provisions of skerati n of the paymentof fee of $. ,�!!�... , permit is hereby granted to ";••; ..... .. to construct a building or addition as described above. This permit is granted upon the express condition that the person t 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, nstruction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit ma be revoked at any time upon viol of any of the provisions of said ordinances.. I - z _. G Building Inspector NOTICE: This permit does not cover the nstruction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the uliding Inspector for separate permits for these Items. City of Fridley, Minn.. N° 8488 BUILDING PERMIT 4:# Z 6 Pe v o: MIEWT 01Y•� •• I. • • H. NXgaard Builder SusselLumber• Address 6361 Madison St. X.E. Address 1850 QQW Ave. s, St. Paul LOCATION OF BUILDING No 6361 Street Mali Qon Street N.R. _ Part of Lot Lot 17 __ Block _ ___6 _ Addition or Sub -Division Chri stie Add; tion Corner Lot — Inside Lot Setback Sideyard Sewer Elevation __ _ — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Det. Garage Front 301Depth 2 t Height 10 t Sq. Ft. 720 Cu. Ft. 1, 200 (Patio) Front Depth Height Sq. Ft. Cu. Ft. Type of Construction E'er Est. Cost 02.,'M -DQ__._..__ To be Completed 90 d 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 pDrth and in compliance with adl provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of permit is hereby granted to S'lassel Ulabor Con 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 regardinng 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. NOTICE: Ibb perp& den net cover the eondrudlon, In talFation for whfng, phmhteg, on heating, awer or weer. 8e sun to ae tin &aiding kgmtor for sepmft pwndit for thea Mena. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA, OWNER'S NAME 'tC h n BUILDER, SF/SS ADDRESS &361 Add�;'6.,7 T� y ADDRESS{�'� d Ate. - 11r� LOCATION OF BUILDING NO, STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front 0-0 Depth`_Height / Sq. Ft. ,,� Cu. Ft. U c' Front Depth Height Sq. Ft. Cu. Ft. Type of Construction F -ane Estimated Cost ra ® 4,-V ex - To be completed 90 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_ 0 ZZ,6 .Y' SIGNATURE (;+ (Schedule of Fee Costs can be found on.the Reverse Side). Ap -051,1, City of Fridley APP icaflon for Pkmbbg and Gat Fhtkg Pomb Dept. of Bldgs. Phone 9®0-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures 110 02 x $3.28 $ Water Heater (Up to 89,000 BTU) .... x $3.00 ; New Ground Run Old Bldg......... IDA Electric Wates Heater .............. s $2.00 vJ GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures ............... , 1 x $200 $—s�--00 Additional Fixtures ......... _....... x $ .78 $ Gas Range to 190.000 HT U ... ,............ x $8.00 $ Replace (1) gas grill 3.00 HWATERMTA. ELEC. Base t TOTAL FEE $ 5.00 1st 2nd 3rd 4th • Futnra Conned Openinps * New Fixture, Old OpeningsCesspool Com w!!h Sawa ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 New Fixture Old Opening .......... x $1.50 $ City of Fridley: r 53-84-S915.51 The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do all work in strict accordance with the CitF Ordinance and ruling of the Department of Buildings, and hereby declares that a& the fact and representations stated in this application are true and correct. Fridley, w.n July 21. 1972 „ 19, owner John Nygaard Kind of Building frMe Used as ---residence To be completed about duly 25. 1972 Estimated Cost, $ Old $New. Building Permit No. Permit No. Signe/. 94 By -- Business PhuJ4 EGASCO Catch Basin .................... x $3.28 $ Water Heater (Up to 89,000 BTU) .... x $3.00 ; New Ground Run Old Bldg......... x $3.28 $ ROUGH Electric Wates Heater .............. s $2.00 vJ GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures ............... , 1 x $200 $—s�--00 Additional Fixtures ......... _....... x $ .78 $ Gas Range to 190.000 HT U ... ,............ x $8.00 $ Replace (1) gas grill 3.00 REPAIRS, 8r ALTERATION&—Refer to Code Claw "AEP SUrCharge .50¢ Description .............................................. t TOTAL FEE $ 5.00 orifi PERMIT for Power ants and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants to be installed--altered—repaired Make Oil fired—,- Coal fired ; Gas fired ; Gas Authorization No. Remarks P Approved by. Final Inspection Date , 19____ Inspector Permit N° 4607 Fee $ g.00 Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., Oj ' t , 19.�L2 Owner Ct 0-M Location Kind of Buildi How Occupied Work to be Commenced—,19— To ommenced ,19_To be Completed C 't--4---e-�� ,19 Estimated Cost, $ 1,29400 Old New, Building Permit No. Permission is hereby granted to } e (?-f) • to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person tow om it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mened shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein name , and to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings. InsPector of Buildings 42 2M 1147 v SUBJECT N - of Fridley 5.2 3 AT THE TOP OF THE TWINS BUILDING PERM I KIE! rpCity T N � • ______ COMMUNITY DEVELOPMENT DIV. i IL INSPECTION SEC. �9 r � � PROTECTIVE / / CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/4/79 JOB ADDRESS 6361 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 6 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terence Rising 6361 Madison Street N.E. 571-7607 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 ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install f ire lace F 9 CHANGE OF USE FROM TO -,STIPULATIONS Unit must be 3 feet from combustibles SEPERATE PEJMI-r,s REQUIRED FOR vvlPi � HEATING, PLUMBING AND SIGNS. 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,000 $.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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTAL FEE $8.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOPR PERMIT 13LDG INSP TE SiGNA UOF.ER tIF OWN ER LDERI (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL -BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: �ry6 ES1. � ADDRESS: ! l&i910i�ou� TEL NO: _� - p BUILDER: ADDRESS: TEL NO: Construction Location STREET NO: ,3(p STREET: t111 pjsp 'n2 S> _ LOT: 7 BLOCK: �_ ADDITION: CH -,e /,f te fe- Corner Lot: Inside Lot: �� Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION 5� ,0-C e-(5�' i�a�D, w6- F,ac Front: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Th Be Completed: 2 /%o Proposed Driveway Width If New Opening Is Desired: Estimated Cost: $ 1 �® Alt. A Alt. B SEE REVERSE SIDE OF SHEET 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: - /- g SIGNATURE: Stipulations: UA, r M (3 ST- 9'SE of Fridley suBIEcr PEW16 67 6 AT THE TOP OF THE TWINS BUILDING PERMIT rpCity • COMMUNITY DEVELOPMENT DIV. �,:------. PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO. 6701 NUMBER 910-F15 REV. DATE 7/13/82 PAGE OF APPROVED BY JOB ADDRESS 6361 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 6 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terence Rising 6361 Madison Street N.E. 571-7607 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 RKKIRKNIMM Residential 7 CLASS OF WORK ❑ NEW OX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 14' Deck 9 CHANGE OF USE FROM TO h STIPULATIONS bass sEPERATE PERMITS REQUIRED FOR ` WON dlgtinj call local.. afilit% ` TELEPHONE - ELECTRIC - GAS Etc. "PATING. PLUMBING AND SIGN, RECRARED Sy LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. wood OCCUPANCY GROUP OCCUPANCY LOAD THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $900 SURTAX $.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $16.00 LAN CHECK FEE TOTAL FEE LX$16.50 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER ALIDATED THIS IS YOUR PERMIT BLD.a'•;aSP DATE SIGNATURE OF WNER IIF OWNER BUI I IDATEI 7 CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PERiiITS (Neta, Alterations, Additions, or Repairs) OWNER: A, e BUILDER: ADDRESS: (� % _ _I%i¢,D>So� ADDRESS: TEL R0: ,5 >/ TEL NO: Construction Location - STRITT NO: (;,3 STREET: 1-1,4y/-5® At" LOT: BLOCK: CQ ADDITION: ,gel Sr,,<,/,onr- ,45 Z� Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DEySCRIPTION OF CONSTRUCTION Front: ! Depth: Square. Feet: (V Cubic Feet: Front: H eight : Depth: Height: Square- Feet: Cubic Feet: JC Type of Construction: Estimated Cost: )'90C Zb Be Cbrapleted: ��` �°✓ 7� Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: D/U$ $ SEE REVERSE SIDE OF SHEET 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: �J " Z SIGNATURE: Stipulations: PQl 6. 00 S'� v " 1 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace Gas Piping QSIeeded with new furnace) Gas Range Gas Dryer , Rate TOTAL $ 20.00 $ 20.00 $ 10.00 $ $ 10.00 $ $ 10.00 $ 'Air Conditioning - All Sizes $ 10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE $ 20.50 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS 6361 Madison St NE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 3-27-95 ,1991 OWNER Terry Rising BUILDING USED AS dwelling ESTIMATED COST 1400.00 PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units 1 Circle One (Steam) (Hot Water) (Warm Air) Trade Name TEMPSTAR Size No. NUG5075 BTU 75,000 HP EDR Fuel nai-. ciao Total Connected Load 60,000 Burner Trade Name Size No. BTU HP EDR HEATING COMPANY Blaine Heating,Air Cond & Elec Inc 3562 Central Avenue N.E. Anoka MN Signed By "a'' s Tel No. 757-6200 553@ Approved BY* y Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY 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 Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories CIC Basement Floor 1 Floor 2 Floor 3 Floor 4 Urinal MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR at{j ,I Wash D ,nit'I' li''P Floor1119. Auto. Gas Gas*o Misb -."'.Water: ;Shower Fmk i Tra • Fot,€ Dram0, iUi1i I Washer Ran FiXt., Gas Elec . l a ,P' n ,Jim Iri.rlal r' ,I„ FFFF - ryIr i ,NI�9 �{igii ,I:� a' ' i III !'I I'� I ,i,l° ' �'n �'�A �•'' � �'�'�' . � It I I 'I. �. I!P'Inil PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS &•..j &p f ,oVC4 /svii 'r✓ ' __31/. . New Fixtures $ 7.00 The undersigned hereby makes application for a ppermit'for the work.fierein 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,corrsct..: Catch Basin $ 7.00 Rain Water Leader $ 7.00 / 1995 ; Sump/Receiving Tank $ 7.00 { Water Treating Appliance $10.00 Owner Water Heater —Electric $ 7.00 T_ Water Heater — Gas $10.00 _�_ Building Used As 1 ,I,Q�P� ; /7 .. Gas Range $10.00Cr Gas Dryer $10.00 Estimated Cost, PERMIT NO.. �./ . Back Flow Preventer Required ( )Yes O No Type $5.00 PLUMBING COMPANY , it Reinspection Fee $30.00ry p _ SIGNED BY TEL N0: ALL OTHERS AND/OR REPAIRS AND ALTERATIONS70 1 % of Value of Fixture or Appliance Approved By Rough—In Date Finan Date State Surcharge .50 MINIMUM FEE FO ANY PLUMBING/GAS:'PERMIT IS $16.00: TOTAL FEE PLUS THE $.50 STATE• SURCHARGE CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1387 April 25, 1995 Fignar Plumbing Co 2844 Johnson St NE Minneapolis MN 55418-3056 ` Re: Water Heater Replacement at 6361 Installed March 25, 1995 Dear Sirs: Madison Street NE, Fridley While conducting a furnace replacement inspection at the above address, it was noticed that the water heater was replaced by your firm. In checking our records, we can find no permit application for this project. We are enclosing a permit application for your submittal. I hope you will go through your records and submit permit applications for all work that your firm has completed in the City of Fridley. If you have any questions concerning this matter, please feel free to contact me at 572-3605, between the hours of Noon and 5:00 pm, Monday through Friday. Sincerelya MEL COLLOVA Mechanical Inspector MC/mh ENC: 1 SUBJECT P City of Fridley 27216 AT THE TOP OF THE TWINS BUILDING PERMIT r � IPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.�3� r NUMBER REV DATE PAGE OF APPROVED BY l `•j CITY HALL FRIDLEY 55432 --_- ��"' 1 J` 612-571-3450 - 910-FIS 8/17/98 10B ADDRESS 6361 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 6 Christie SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Rising 571-7607 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tom Walek Construction 3621 Roosevelt St. NE St Anthony,MN 789-9388 4 ARCHITECT OR DESIGNER MAIL ADDRESS 554fW PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Yff REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (20 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 OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $1668 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $.83 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- Fire SC $1.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $54.00 PLAN CHECK FEE TOTAL FEE ��� - ''�--� License $5.00 1$6/Z50 NATUREOF,C.OT OR ORAUTNORIZEDAa NT iDATEi ENP OPER LIDATED NSP HIS IS V UR PERMIT BATE SiGNATU RE OF OWNER OF OWNER BUILDER) iDATEiBLDG NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 t BUILDING PERMIT APPLICATION ConstructionAddress: co Legal Description: ;� / Owner Name & Address: -Q V^� l�k S 1 vi Tel. # Contractor: (6,--�n Lo v1 s} i-tt- f 16 7 MN LICENSE # Address: j / - RO os -e of H- ,1 - 1 i F, Tel. # 2f j - 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 GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: -7P,.-:-i V- - v - . r e -OL) 7(-) 5 Construction Type: Estimated Cost: $, Driveway Curb Cut Width Needed Sq. Ft. Sq. Ft. (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ = $ DATE: - 7 - 'T APPLICANT: WTel. # ?t sa k Permit Fee $ Fire Surcharge $ s State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ �% " . STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 INSPECTION DIVISION 6431 University Ave NE Effective On January 1. 2{}02 Fridley, MN 55432 APPLICATION FOR 0(O VER PLANTS AND HEATING, COOLING, VENTILATION, © (53) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES CL JOB ADDRESS _ � Cco '-1` MATE �,Cx>�I.E as OWNER F3 Residential Rate TOTAL Fumacc Shell and Duct Work, Burner - BUILDING USED AS ee Also Replacement Furnace $ 3fl.{}0 � --- (Side Vent . Fill Out Back) ESTIMATED COST 0cl� PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ Gas Range but not replacement) $10.00 ®0M1PTIOAI OF FURwAc9 AND AR BURNER $ Gas Dryer $10.00 of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 �. Trade Nance Size No. 00 BT{L-----. HP- EDR "Air Conditioning - All Sizes $ 25.€ 0 $� Fuel _.. _ ._ Total Conrrscted Load All fathers/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No, 1% of Value of Appliance or Work $ BTU HP EDR _ Ll merclal/Industrial 1.25' of Valvae of Appliance car Work �► _ _ The undersigned hereL+y rimkes application for a permit for the work herein LL specified agreeing to do all work in strict accordance with the City Codes an 0 State Surcharge $ 50 rulings of the Building Division. and hereby de lar that all the facts and :5 - representations stated in this application are true nd rest. TOTAL FEE DATE 6 Z YUNI FE F ANY HEATINC,l000LI Y I/ TI % Flit /A1 p LAT- HEATING CO /C. y1 A/ ug 'LffS THE $ �i0 STATE SfJRMIMING RE frlilARGE Signed v TEL #-7-!;e3 ��1� % e 7 FAX # 1EINSPECTION FEE $47.00/Hr i� fi Air Conditioners care not be placed in a side yard without Approved BY Rough In Date Final Oat written permission from adjoini rig property owner. FI (}UT BAC SRIF ION (3iV PLA TIE BELOW MUST BE FULLED IN YMEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICAMON WILL BE RETURNED The venting system is plast[c/PVC and meets all current codes and manufacturer spedfications inducing sizing, length, number of elbows and termination. Yes (j No ( ) The undersigned also vemffles that the replacement unit is a listed assemn* and meats the current odes and manufacturers speciPIcadons. This does include AGA -LAMA Cah4M I Ceryl Furnace Venting Tamales for fan a slated and natural dmft appliances. Yes( ) No( , The Is sized and Installed to meet the current codes and manufeeturees spedflcations. Yes( No( } glen required to >i� 1 ! •�� ��ma®., ,it wlll be sized and installed to med the current codes and manufmacturees specifications. Yes( No( ) When iR�ng a now wa,etMa�, the undersigned hereby v;erirfies that it Is a distad assaftly and meets the current codes and rnanufaoturees spedficatlons. This does include AGA-GAIMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( No( ) IS the OOMMon 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( ) y lrmirw �. grad 2a Uncut and Yea=an mar laftZmaitmnn Appliance #1 Type BTU Input _ Fara Assisted or Nat, Appliance ml 2 Type BTU Input_ Farm Assisted or .Nat Appliance #3 Type BTU Inputt Fan Assisted or flat Total Appllances TSI Btu Input Common Vent Type Vent Height- Diameter inches Applanc a #1 Vent Connector Height ft Length „ft Da meter _In Type App1111snce #2 Vent Connector Height ft Length ft Diameter in Type Appliance 03 Vent Conner Height ft Length ft Diameter in Type �, HEATING CO: Date: '0rZe'd L3T8Z21S Cal A3'IQIcid dig ,JAI: 14dd TS: TT za w-6o-snu Building h= I&C BUILDING Permit Fee Permit No.: two Inspections Plan Review RESIDENTIAL APPLICATION Received BA- 763 -572-3604 $ 0of- c, .001 times the total job valuation Surcharge �'s .0005 x Permit Valuation Minimum $.50 License Surcharge CITY OF FRIDLEY Date Rec'dEFFECTIVE 763-502-3604 FAX $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ 1-1-2010 $ $450 Conservation Plan Review DATE - 1 a� - i a YOUR E-MAIL ADDRESS ��a CXLe Y U."C4 q 77-h"oiST - SITE ADDRESS M S i Sin S N. E $ THIS APPLICANT IS: ❑ OWNER EkCONTRACTOR $ S PROPERTY OWNER/ NAME: ti 1St ►^> TENANT I ADDRESS: Vy) A � 5 f lu o CITY r t e STATE"" N ZIP SS� PHONE: –((0!_1>' CONTRACTOR NAME: 14 A, Ejc 'p � � �,% � r� SUBMIT A COPY YOUR STATE LICENSNS E STATE LICENSE # �N EXP D TE - 31 ' i! AND CERTIFICATE OF �j ADDRESS: CITY � STATEbt ZIP$ INSURANCE PHONE k;�: - FAX PROPERTY TYPE JSSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK X SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 13, 2i� 11f1 " SIZE OF IMPROVEMENT GTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES Q HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, "M Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS – PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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 $ h= I&C OCCUPANCY TYPE Permit Fee $ 67- See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 0of- c, .001 times the total job valuation Surcharge �'s .0005 x Permit Valuation Minimum $.50 License Surcharge $ ,S=' 'o,C' $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ S Make checks pavable to: Citv of Fridlev 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 ordin ces and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicati or 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 casehick requires review and approval o s. SIGNATURE OF APPLICANT PRINT NAME !f!o ► � DATE \J)L ��'�O