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PRE 2010 DOCSWW -e' le - City City of Fridley, Minn. N° 7725 BUILDING PERMIT Date: June lye 1965 owner: Jim Raiche Builder Superior Concrete Address 6:-391 Madison St. K. E. Address LOCATION OF BUILDING No _6391 Street Madison Street N. E, part of Lot Lot 20 Block 5 Addition or Sub -Division Christie Add. Corner Lot _ Inside Lot Setback ____ Sideyard Sewer Mention — Foundation Mevation DESCRIPTION OF BUILDING To be Used as: Dett. Garage Front Depth Height Sq. Ft Cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction FrOM Est. Cost 51S452•9D To be Completed Storm damage repair In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with of 1 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ •Oo , permit is hereby granted to superior Concrete to construct the building or addition as described above. This permit is granted upon the express conditionkand perso in, around andddley, Minnesotawithin the city ]innitspermit may be revoked at any tone upon violation of any of the provisions of said ordinances. Allen Jensen Building Inspector NOTICE 7hb pwmk don net eova the condnmdw, hutaih w for Whb& phunWe. Yn heathen tower w water. Be euro to no the Bending b qm for for npartlo pwaft for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS ADDRESS LOCATIONBUILDING 7 No. �� Street Part of Lot LOT e BLOCK ADDITION OR SUBDIVISION,�z, Corner Lot___..6,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. DESCRIPTION OF BUILDING To be used as: 1 Front Deptheighty Sq. Ft. •:.` Cu. Ft. ld Front Depth Height Sq. Ft. ,Cu. Ft. 17 Type of Construction Estimated Cost�.5 Tobe -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 7ridley 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 61-3�G 5 'SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). • f 53-81t-9915-051 City of l=: idloy Applicat$an for Plumbl, Dept. of Bidpa. Phone SSO.3430 DESCRIPTION OF WOr.�P_ Numbsr, KL -id &nd LoerSlen of Fixtures Loea*t^„ 6391 Madison NE p Ic O 1-1 5 I< ,� y a 2, ` p 2 8 1 ■ Z Z S O � u 2 U 7< 7 g Y / i N WAUR HTA. GAS Litt. 9:2 r•. ?. VIM FRY6 ,d rd - - th _ Future Conaocdan Oponings �''aO WI= fla�csaz .� Now Fixture, Old Oyonings Cctapcol Q City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work In strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct, Fridley, Minn 3-10-76 la_ Owner `lames Raiehe Kind of Building frame Used as res. To be completed about 3-17-76 • PARTIAL RATE SCHEDULE Estimated Cost. $ 10.00 'LUMBING FIXTURE RATES: • NO. RATE TOTAL Old-- cI. Building Permit No. Number Fixtures ................ x $2.00 $ Signed Future Fixture Opening ............ x $1.50 $ -. By_ - New Fixture Old Opening.....:...: x $1.50 $__-_..__. Business Phone No Catch Basin .................... x $3.25 $ . Water Iieater 'Up to 99,000 BTU). • • • x $3.00 $ ROUGH New Crourkd Run Old Bldg......... x 1-1.25 $ Electric Water nester, ............ . x $2.00$ FU3AL ^7� . AS FITTING FEES: NO. RJ.TE TOTAL 1st 3 Fixtures x $200 $ Additional Fixtures ................ x $ .75 $ Gas Range to 199.000 BTU ........... x $5.00 S REPLACE PRI ER 5.00 •. AIRS &ALTERATIOXS—Refer to Code t .50 State Surcharge • Dezcriptlon • .... . .. . . .. 1 . . . ...... . .... . . ..... •� ... • Y TOTAL FEE S 5.50 ��„ Class SUrcI1?r e .,,(O SUBJECT PE NO. City of Fridley � 16.7 8 5 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 I I 9/27/82 I JOB ADDRESS 6391 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 20 6 Christie Addition SHEET I 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Judy Dilley 6391 Madison Street N.E. 571-7142 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 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 X S DESCRIBE WORK Remodel kitchen; new cabinets counter, flooring 9 CHANGE OF USE FROM 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 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 $3,000 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTH STAT OR LOCAL LAW REGULATING CON- STR ION OR THE PERFO AN OF CONSTRUCTION. 3$.50 PLAN CHECK FEE TOTAL FEE $40.00 SIGNATURE OF CONTRA VR UTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP I OA1 E SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) I CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PER14ITS (New, Alterations, Additions, or Repairs) OWNER: Ttj D u b i l (ail ADDRESS: M4- 41/k.3 40 /J TEL NO: -!; i / --7 /L z BUILDER: ; L---0 I-+ � . J10 ADDRESS: /j �e t r � � TEL NO: Construction Location( STRITT NO: STREET: ��"_,j �S ` QU .--' LOT: BLOCK: ADDITION: 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 Front: Depth: Height: Square -Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: � i o/J&-Z- k" 7- ` N 4—_ IJ (2�f d,'7, Estimated Cost: $ To Be Obrapleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . The undersigned hereby makes application for a permit for the t:.'ork' 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: 'off - f II SIGNATURE: Stipulations: . SUBJECT ERMI City of Fridley o 18958 AT THE TOP OF THE TWINS BUILDING PERMIT _ COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC. / %�� I r ` CITY HALL FRIDLEY 55432 ,.j NUMBER REV. DATE P AGE OF APPROVED BY 612-571-3450 910-F15 5/15/87 JOB ADDRESS 6391 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 6 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bob/Judy Romig 6391 Madison Street N.E. 571-7142 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Marick Builders Ince 200 W. 88th Street, Bloomington, MN 55420 888-2929 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 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20'' x 141 Deck. 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan 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 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 $2,300 $1.15 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE P OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON - SC OR THE PERFORMANCE OF CONSTRUCTION. $38,5Q 7 SZrl,�`7, PLAN CHECK FEE '-4, TOTAL FEE $ 5.63 $49.28 SIGNATURE OF COTACTOR OR AUTHORIZED T DATE) WHEN PROPE VALIDATED THIS IS YOUR PERMIT BLDG INSP 47 OA TE SiGNATURE OF OWNERIIF OWNER BUILDERI (DATE) NEW [ ] of Fridley Effective 4/1/8,6 ADDN. [ ] j'City 1 R-1 AND R-2 1 ALTER. [ ] Building Permit Application Construction Address: 6-3 1( ff L Legal Description:4 p - Owner Name & Address: �0 `I �dJY RBlvt rat �3°/ i Ilsi�7d rsa�6l..._— Tel. # 57� 7/�0? hL Contractor: Marl Ut �e r4 Tel. # 9 22 --k A A s^. 1 AI n Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Length �D d Width Width Height Hgt/Ground Sq. Sq. Ft. Ft. Corner Lot Insi e Lot [ ]� Ft.®Yd.�Set b ck Type of Construction: T('e died '�- s Approx. Completion Date: 100- Side Yard Setback Estimated Cost: $ a.3 % tj Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 15 I � � Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL APPLICANT: Tel. 001611K CITY II ONLY $ Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ $.50/$1,000 Valuation $ $ 525 per SAC Unit $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: L1,, 301 i Li 0 v Cyt �� r I. LOCATION,! F L County %r �! ip Nymall N Street Address and Show exact location of � (in section gri 9 NEON Section No.^ / Fra%ctionof y ME Date sealed .`J l Well Loca ton or Distance from Road mom T 10 Cable tool 40 Reverse 70 Dr'ven 100 Dug 20 Hollow Rod 50 Air fa Bored 110 6alr. Melded 30 Rotary 40 Jetted C Power Auger am J ►�� 1 na L --r PROPERTY OWNEPS 0�4 if TE I STATE OF MINNESOTA DEPARTMENT OF K&TN ABANDONED WELL RECORD MINNESOTA UNIQUE WELL NO. (leave blank 1f not known) Raga Er or Section No.^ / Fra%ctionof y 4. WELL DEPTH (completed) ft. Date sealed .`J l Well Loca ton or Distance from Road S. DRILLING METHOD (if known) T 10 Cable tool 40 Reverse 70 Dr'ven 100 Dug 20 Hollow Rod 50 Air fa Bored 110 6alr. Melded 30 Rotary 40 Jetted C Power Auger Sketch map of wall location 1n, to ft. 6. OBSTRUCTION Well obstructed 0 Yes No Obstructions removed 0 es 0 No If Obstructions cannot be removed, contact MOM before sealing. Nailing Address if different than property address indicated above y' HARDNESS OF 3. FORMATION LOG ,k COLOR FORMATION FROM TO If not known, toicate formation log from new well or nearby well. , ELEVATION, SOURCE OF DATA - CASINGS REMOYED, CASINGS PERFORATED, ETC. IFFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) XMICIR2wrt IIIc wz2w DI® 1, RISE WDomestic 40 Monitoring so Heat Loop go Irrigation 50 Public 90 Industry 30 Test Well 60 Municipal 100 commercial 70 Air Conditioning 110 S. CASINGS) 10 Black readed 70 6alr. Melded Plas4le 60 /'�— Stainless Stae,;'�� Ia. toLV {\ 1n, to ft. Screened wail froa�� ft. t� // r (I! known) Open Hole from _ ft. to _ ft. 10. STATICIWAT,BR LEVEL below [j above act Date Measured 11. WELLHEAD COMPLETION 10 Pitless Ailepter 40 Fours Buried 6 kr 20 Basement offset 30 Well Pit &-7�D 1 12. &WING INFORMATION I[ -Meat Cement 20 Bentonite 30 ut material (roto u. yds,_ REST SOURCES OANIMATION feet direction Well disinfected before sealing? es 14. PUMP [3 RemovedNot Present Type: 1[I Subemrslble 30 L.S. Turbine go Reciprocating 20 Jet 40 Centrifugal 60 IS. EXISTING WELLS (Please sketch loations of abandoned and active wells in remarks secton r on back.) Other unused wa11(s) on property? C] yes N0 Abandoned: 0 Permanent 0 Temporary sealed 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdtetion and tht art is true to the best of my knowledge and belie Licenses'Bos! 'a ? -i ( License Ali 0 'v CITY OF FRIDLEY INSPECTION DN. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On August 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Cllvv Urinal Shower .Wash r F ,Floor TrayE; FM -Auta Drainw,r Washer + a a Gas a y` Wat@r Heater Ran Gas Stones ;; �t ;-, Elec Basement 1`' ry w g i RU Floor 1 iie .? wl',:.__' _ .�. /� Floor 2 Ii r�ih yiy i �i 6 i j iT k k`_$� Gil 1x �� N Floor 3 k , , r ,; !: �i 1, Floor r u, s a1A i 8, f.i. IFI �I l{�P" is.P LL PLUMBING FIXTURE RATES. NO. RATE TOTAL JOB ADDRESS 3 j I�u.d f`SQ New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4,00 $ 5.00 $ 7.00 $ 7.{X3 $ 7.00 $ 7.00 $10.00 $ 7.00 $10:00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr - ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge 50 64 TOTAL FEE $ 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner v� VIA vt,,soL, Building Used As //a w- �� ,1995 376 EstimatedCost- SQa PERMIT NO. 11-441 PLUMBING COMPANY 1 •,�ZJ�' . F (---- k�! c - SIGNED BY TEL NO._7 `� 7 7? ApprovedS��_v Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $2000 PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 80 INCHES. CITY OF FRIDL.EY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR'POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS (4 >� % l.. j �- rte• HATE SCHEDULE 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. $ _ - repregentations stated in this application m true and correct. (Side Vent — Fill Out Back) LO Gas Piping (Needed with new furnace) $10.00' =- T,1995 ltk`e--` OWNERGas Range Range $10.00: $ BUILDING USED AS Gas Dryer $ 10,00 $ ESTIMATED COST 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.Heatino- nits Circle One (Steam) (Hot Water��Tarmj Trade9Name /,�_�,� ��z Size No. Commercial/Industrial BTU --557/ HP EDR 1.25% of Value of Appliance or Work $,� Fuel_ ,k, 4 4 6 Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. v BTU HP EDR TOTAL FEE � L HEATING COMPANY Ice Lam:., H7� MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $95.60 �I Sign®d Bir — a �4" 1 Tel No. (tl�� 0 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUTBACK SIDE F R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE Remarks: HEATING CO: Signed By: Date: 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 (c)"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 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: HEATING CO: Signed By: Date: U/ SUBJECT PERMIT NO. City of Fridley 32080 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 572-360 4 r PROTECTIVE 4-s CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED BY l 612-571-3450 910-F15 8/13/01 JOB ADDRESS 6391 Madison Street ' 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 6 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Munson, 6391 Madison St., Fridley, MN 55432 763-574-2366 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Exteriors Inc. 8600 Jefferson Hwy, PO Box 266, Osseo, MN 763-391-5514 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. BC - 2877 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK Xp NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside; soffits; fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Reside: Per Section 1402, 1997 Uniform Building Code, requires that a weather -resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions to this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. Soffits & fascia: Ventilation must meet 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 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 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,024.00 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. $8.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $153.25 PLAN CHECK FEE TOTALFEE $165.25 SIGNATURE OF CONCRACTOR OR AUTHORIZED AGENT IDATEI VVH PROPERLY VALIDATED THIS IS YOUR P RMIT S-GNATURE OF OWNERoF OWNER BUILDER, IDATEI L G INSP - FjATt U/ NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2000 612-572-3604 Bldg Insp Legal Description: Owner Name & Address: 82&l�''%'J Tel. Contractor % MN LICENSE # L 7? Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �. • F1 5 Construction Type: Estimated Cost: $ J Driveway C rb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ i DATE: APPLICANT: Tel. # 763 '3V/�S-��r CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application Permit Fee s -/S3 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $1100 per SAC Unit $ $5.00 (State Licensed Residential Contractors) R "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ' e4"1_RZ Effective January 1, 2003 CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 n,� f JOB ADDRESS ( of I 1 r cu , sen 54 • NE RATE SCHEDULE n� OWNER � � / �l unse �J Residential Rate TOTAL / ��5't Furnace Shell and Duct Work, Burner . BUILDING USED AS G'-ej7Lt-e- Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) $ ESTIMATED COST PERMIT NO. l Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ vZ6 0® Fuel 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 Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE $ SSU �arr«r �T-wR 0-';Zq ;Z- To^ DATE 7 -03 CenterPoint Energy Minnegasco MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING C013562 Central Ave NE, Anoka, MN 55304 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed 1- C 763-757=6202 REINSPECTION FEE $47.00/Hr FAX # 763-757-6701 *Air Conditioners can not be placed in a side yard without Approved By _ Rough -In Date Final Date written permission from adjoining property owner. THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When rni"srng n ami inn furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes (X) No ( ) and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (X) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan Yes (X) No ( ) assisted and natural draft appliances. The swintion combi-iginn aw is sized and installed to meet the current codes Yes) No ( ) and manufacturer's specifications. When required to in-starr a DOW cnmhustienLair_ it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (X) No ( ) When installing " �e"'� "0013ius _m, 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 Yes{) No( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes (X) No ( ) separately as per current codes. Annu nre Tying and si7picnmmon Vent and Vent Cnn.,p�ter rnfermatiIIii Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type 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 HEATING CO: Cent erPoint EngrgMi_.��asee 13562 Central Ave NE, Anoka, MN 55304 Signed By: � Date : " 3 �'