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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N° _- 45'72 Date:.. -4 r Owner:r, Builder Address _..�_°j� .�°_ k''!��,/ Address ....... :. w ..._..._.._.....__.. _ _ a ___._.._.._.._..._._.___.... LO TON OF BUILDING /._ _ . IVo.._.°'�._. Street °� ...... ..._._.._._ Part of Lot _._....... _...... Lot .....:................ _ Block ..... _........ ....... -... _................. Addition or Sub -Division .......... r- ' � ..' .._ ...........All... ..._........ ...... Corner Lot ..._ . ................... _....... Inside Lot ....._ .:: .............. Setback ..... ._ �.......... Sideyard ....._.:........................................... _.._.. Sewer Elevation ........ ...___..._....__._.___._.._..._......_..._..__....___. Foundation Elevation DESCRIPTION OF BUILDING To Used as: I-'r_ont -/ r _ ._.. Depth ._.:. :.' Height ... _4Q.. Sq. Ft.. z-vcu...._------------------.................._.......•......ont Depth ......... Height................. !..40 Sq. Ft. ............. ........ Cu. Ft. ..... ---•---.......... Type of Construction . �1;l ............ Est. Cost..��j ... �.'To be Completed ............... ................. _. ............... CAUTION THIS PERMIT DOES NOT AUTHORIZE VIOLAT- ION OF ANY PRIVATLAND COVENANTS AND BUILDING RESTRICTIONS. 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 all provisions of ordinances of the city of Fridley. ' 04 In consideration of the payment of a fee of $..s'r ---, 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 violatiof any of the provisions of said ordinances. , . n .0 01 Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas hosting, sower or water. Be sure to see the Building Inspector for separate permits for those hems. a, 4 W, e - APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner s Name us � ^ /C A.1 v V �7 � OL e 'der s� � Address cclfe, Address LOCATION OF c No. =_f�,Streetf Fart of Lot ®r 4 cp/ a y -/.s- Lot _ Block Addition or -Sub.Div. �� /�/ �a 7. Corner Lot Inside Lot�Set Back .3 - Side -Yard Z SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To used as: �� E 7j1Z C Front Depth He3Bht,�' Sq. Ft. 9 ( ` Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction � 0- # /), &- Estimated Cost -7 S� To be 7-4/0 U 3 C.) / f dK C"" 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 fa s and presenta- tions stated in his apflication are true and corre DATE SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) � I . TO INSTALLER OF WIRING t9sa IINNESOT,q STATE BOARD - r aveeoe• St' Paul BOp ELECT Dat,_ RICITY property �' / AU- 5'7703 SERIAL NO Q Addre /�- O' YC . No Sec fond_ ang Tow A=-Certif Master Electrid /%�� _� County Winer Type of structur - - Power SuPPfier Occupant p J y. To the Owner, Lessee, CORRECTIO ! vested in me Mester Electrician or Occu IV ORDER by atatuta, You and Pant of the Penalty of said law to each of you upon whom above described comply withi / ; ; this order shall bsrpremises.a @urhe e, to the authority — days as follows: Y ordared // /7 �� 2✓ Pr i- h? • under P ✓ Y s'e •,, IJ U G -c rte r v 4t �/7 � r rtificate or corres 'r of this order, pondence referring Sign and return to'isto this correction y pector upon cotorder must bear the serial pliance. lnape<►or ♦ s ! ! Z' Ll >l Addr .fr / ' Tow r`! c f �� s>> c' ?f �� /�` /�f i 1 C� j- �� mac. iI �/c•%� �� X/' % f / _ . �� `� l � / �� • .moi !? c i % .. City of Fridley Application for Plumbing and Gas Fitting Pent DESCRIPTION OF WORK Number, Kind and Location of Fixtures qq 07 NO. RATE yyZ Number Fixtures ......................�� x $1.50 /� $- d' Future Fixture Opening ................ Fz �a Z Z_ p J C7 Z Water Heater (Up to 200,000 BTU) ...... 2- x 2.00 WATER HTR. New Ground Run Old Bldg . ............ x 3.25 $ 3U GAS FITTING FEES: dg 1st 3 Fixtures ............... ........... a� � p—S31— o� x .50 Qj LLC Gas Range to 200,000 BTU .............. x 2.00 $ N GAS ELEG m Base / Z 1st / 2nd _ 3rd 4th • Future Connection Openings Connected with I Sewer � New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................�� x $1.50 /� $- d' 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) ...... 2- x 2.00 $—L=� New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTALOTA 1st 3 Fixtures ............... ........... —� x $1.50 � p—S31— Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ SSS O� TOTAL FEE $ Dept. of Bldgs. Phone SU 4-7470 / / , Location �C ZZ u 41, iZ -S�;rf I'-/Ae 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 appr n are true and correct. "41-7 1'960' Fridley, Minn 19_ Owner GSSf� E/Z / e /SSA sr/ Kind of Building Used as ��° L " To be completed about // /�� Estimated Cost, $ _ Old—New. Building Permit No �� o� Permit No. 1 SignedLONDON PLUMBING CO. By Business Phone No ROUGH , � � "` FINAL — .450.42 2 2M 7-59 City of Fridley, Minn. BUILDING PERMIT Date: _ Dec. 5, 1967 Owner: _ Roger Curtis Builder Chester Maciaszek Ile -3 g t/'�7 N9 95'74 Address 5460 7th St, N. E. Adm _6380 Quincy St N. E, LOCATION OF BUILDING No. 4,5 71 _____. Street —.. Main S t . N. E. —__ - Part of Lot Lot — 7 _ Block 3 Addition or Sub -Division Rea. of Lot 13, 14, 15 -Plymouth Corner Lot --- Inside Lot _ _ Setback --- Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front _ 2V Depth 26' Height ._.._10 Sq. Ft. 572 Cu. Ft. 5720 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction — Frame Est. Cost �5 00_ _ To be Completed 60 LA— - In consideration of the issuance to me e a permit to cons thy, building i bed with above,I agree to do the proposed work in accordance with the description above set rt jh// dad in Ali ce with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Chester Maciaszek 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 upc7 violation of any of,the provisions of said ordinances. I �/ Official Building IDJREW Jan GWsterl NOTICE. This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sun to as the Building Inspector for separate permits for these hems. • . . APPLICATION FOR BUILDING PERMIT CITY OF,FRIDLEY,-MINNESOTA: OWNER'S NAM 0 Ula T/ S _ B' t:DER �Jfi�S i i4CfLiS Zr� ADDRESS J � 0 7 i -h • _ .. ADDRESS 6 3.F- i1 0611/ /U` 94A/i /__ , LOCATION OF BUILDING NO. YS- I STREET %%4 RERRRA,V&E1fiA1-0c'k /a, r�., ig LOT _ OCR ADDITION OR SUBDIVISION P,��/140 0 if� CORNER LOT INSIDE LOT ✓ SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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 i Front.— Depth Height Square feet 3-2 Cubic Feet 5" 72, Front Depth Height Square feet Cubic Feet Type of Construction _Estimated Cost To Be Completed PA 3/9 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 P , C��! SIGNATURE — w - (Schedule of Fee Costs can be found on the Reverse Side. LOT AND FARM E'.UriVCY!:, CONSTRUCTION SURVEYS M. HALVERSON _ REGISTERED UNDFF? LAWS OF STATE OF MINNESOTA ` ' I PHONE PARKWAY 4-6305 `V ,1 2521 30Tr+ AVE. SO. MINNEAPOLIS G. MINN i SURVEYORS CERTIFICATE TOPOGRAPHICAL PLATTING �II I Z hereby c,ri,if,, tri. -,t tris ?8 ? tr-Le -nd cz,rr!7.-Ct. r—r sent?'t--n of a survey of t'rie of: 1,0t z; Vel -1 (7 J --1'oc*'% 1.I1cfGl. +I } „�}:P. `.F (b1of, "A ll_iG -D1 vmoilths Ano�.n Cr�u1:t 4 . Inn-> � � to -ra o;' tiles I, -)o-1. tlorn of ^ I 1 bu ild inas, thereon and a.11 vi�i�l� �ncroIc'-iAe:�ta, If n.,y, frc,_n or on said land. As .sure y'. _ v Wit' t � tri. ,),i of A -)v11 1;c:'. �J ` r �II I Z hereby c,ri,if,, tri. -,t tris ?8 ? tr-Le -nd cz,rr!7.-Ct. r—r sent?'t--n of a survey of t'rie of: 1,0t z; Vel -1 (7 J --1'oc*'% 1.I1cfGl. +I } „�}:P. `.F (b1of, "A ll_iG -D1 vmoilths Ano�.n Cr�u1:t 4 . Inn-> � � to -ra o;' tiles I, -)o-1. tlorn of ^ I 1 bu ild inas, thereon and a.11 vi�i�l� �ncroIc'-iAe:�ta, If n.,y, frc,_n or on said land. As .sure y'. _ v Wit' t � tri. ,),i of A -)v11 1;c:'. SUBJECT MIT NO. City of Fridley � 15782. AT THE TOP OF THE TWINS B U I L D I N G P E R M I T r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 i---• NUMBER REV. DATE PAGE OF APPROVED BY ��>;.� S 612-571-3450 910-F15 16/16/80 / JOB ADDRESS 4571-73 Main Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 3 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vachuska 4930 Madison Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. C & M Builders 4536 Jefferson Street N.E. 560-7714 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 8 DESCRIBE WORK Reroof Double 9 CHANGE OF USE FROM TO STIPULATIONS Roof can mks be 2nd but not 3rd roof. Install ridged galvanized valleys. 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 2 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 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER RATE OR LOCAL LAW REGULATING CON- STRUCT) OR THE PEP(FORMkI4CE OF CON5TRUCTION. $7.50 �/� 4 �� PLAN CHECK FEE TOTAL FEE '4$8.00 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI ' WHEN PROP)/EEFILY1//y��p,LII/fD/A�TEyD TJ�/�'iAIS/I/S YO()U�R PERMIT `` / '-Lw \ �C 4sC.lL�1A...o' K.J BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY • APPLICATION FOR RESIDLNTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OtdI�ER: _ t� ADDRESS: 6 TEL NO: BUILDER: , (2. � ADDRESS: TEL NO: Construction Location STRFM:T NO: STREET: LOT: `733,LOCI:: ADDITION: Corner Lot: Insiae.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_ nit: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: /000 j- 44 C23 00 Type of ConstructionEstimated Cost: $ To Be Completed: 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 work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and iulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica DATE: to —I 6�-o SIGNATURE: Stipulations: FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 . May 19, 1999 Michael Zachar 4571 Main Street NE Fridley, MN 55421 Re: Final plumbing inspection at 4571 Main Street NE Contractor Fignar Plumbing Co. Dear Mr. Zachar. A plumbing permit was issued on April 10, 1998 for the properly located at 4571 Main Street NE for a new water heater. According to Section 30.5(a) of the 1991 Uniform Plumbing Code a final inspection shall be performed on plumbing systems. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (612) 572-3603. Sincerely, ,6,4, moi, bl- Barry Riesch Building Inspector CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On March 1, 1996 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin - $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 r� 1 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS d.O 1.5% of Value of Fixture or Appliance ad State Surcharge $ .50 //1 r0 TOTAL FEE s cK U - 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. i Owner G .1996 S'16_ Opn Building Used As ]] PERMIT NO. Estimated Cost_ oiJ PLUMBING COMPANY SIGNED BY W/ TEL N0. Approved By Rough—In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. CITY OF FRIDLEY INSPECT QN DIV. 6431 University Ave NE Fridley, MN 55432 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT UADV K111 IKAnr-D nC =1YTI IDDc Tn RG MQTAI i i:n nm 1=Arl4 FI 0f)R Effective On Jan 1, 2001 �•�t�. •,' : y $,'siw:::::: $ 7.00 •:MINN.,! ? r :: •iiT:::.v. xFv��i. $ 4.00 '. +:,=:<::< +Jrj,,ii $ 5.00 D • ::>:. .:Ray:::; i:dATixv::::: "��- Floor < ,..c -;. ,;;, =:B rN•:'T�i+LY'•:F•: Autos,?..:: Gas •. .:»:: ::T:;p �l°✓^.?::: Sr<}?, Cw;.::^• :•�,.,.::. Water Heater A":iii+•'?i;:i: : Gas Elec • x.••"" ` ' Stories E:t U rival R =' T. -:kms.... Shower»; :.. ... Tra f -:<' :.:..:.;.; Drain�itt <q Washer . ..::- Ran a<>: •::il+•YJ.'+i' ::v��Y?.:/'•: •''`•' $15.00 3::•:A.hG /I''ri:: :iti::: .• :??: s::•}• i`•:?$;:;i?`:i :::Y4:;$:::?:vf }� ::: T •ii - :i•:: •:+X:. Basement -•••••• r:;: :.}?,::;^::: i'{i' ?:•:: v'i4:•t:• i:•:::%Y: z. Floor 1 r.. . :::::;;:. ..... :� �'::.::;<: -.- ::•�::;;:::<: ::::........:..:::•+::.: y± :.::. :.�T: •%fii $ii � .?:il::::•:•: :?:?4 �ijijjj? �.. ..........:......:.. Floor 3 y:.:•fi::ti? I r4 F o0 'v:=.''Si:•:• }: is PLUMBING FIXTURE RATES: NO. RATE TOTAL - JOB ADDRESS !1". p 5 7 � M a l t, S4. ,U E New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Gas Range" $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner M0_X 1 n 'P_ Building Used ,/Ay/0 / - , 200/ Estimated Cost /�/ g®� PERMIT NO. PLUMBING COMPANY k)Di,) —Rod4ey _Ceyu.Ciy -? Gt�l a �( —6gs Reinspection Fee $47.00/Hr SIGNED BY � TEL N0. 76' ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved B Rough -In Date Final Date �� ')j State Surcharge $ .50 MINIMUM FE FOR ANY PLUMBINGIGAS PERMIT 1 TOTAL FEE $�''�� PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date: CITY Or FRIDLEY INSPECT iUN DIV. 6431 University Ave NE Fridley, MN 55432 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2001 PLUMBING FIXTURE RATES: 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" NO. RATE TOTAL Gas Dryer** _ Back Flow Preventer Required ( )Yes () No $ 7.00 "' 6Z' $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ '� /' S_b JOBADDRESS c%S73 ! L AIF 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. ®c(,aS .,2061( Owner Ruildina Used As Nf 46'_P Estimated CostS- 760, PERMIT NO. r L PLUMBING COMPANYg�o SIGNED BY �G7---6 I ' 'SEL N0. / Approved By �=- Rough -In Date Final Date '2v COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE MARK NUMBER OF FIXTURES TO BE INSTALLEU UN tAUM t-LUUK r . e 1}i`'•'O::• •-.<'ir.: v:;o."<: :•{155;r :: rir.:..: �rs Wash �/�,:i,-/W: P'vi :i�'i,V r>•�1,�1� Floor S:i:.:.; �;R:::•: i'r: +CIr. Auto. : rb<:.?vY,.::•:.':'s^b}: i..:.ve:iii Gas;::,;>::<.::.: Gas •:....: .; .. .1/.•. Wa er Heater SGr:,. t :. 4:: •:::'.:k.<e>:•i Gas Elec Stories Urinal �:<:� . '#`'�: ShowertftK;: Tra := Drain t11it<. B�iti1:: b:: Washer . .. :. Ran a `` Basement :.:...... ...b.-�:: t.:.. .....:...:.:.......:.. Floor 1 ;.:,:::.::::::: : < < . ::.:....:...<:: r FI00 2 Floor,3 :...::.:.....: :.ter.;.::.:<•:w.b•. Floor 4 PLUMBING FIXTURE RATES: 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" NO. RATE TOTAL Gas Dryer** _ Back Flow Preventer Required ( )Yes () No $ 7.00 "' 6Z' $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ '� /' S_b JOBADDRESS c%S73 ! L AIF 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. ®c(,aS .,2061( Owner Ruildina Used As Nf 46'_P Estimated CostS- 760, PERMIT NO. r L PLUMBING COMPANYg�o SIGNED BY �G7---6 I ' 'SEL N0. / Approved By �=- Rough -In Date Final Date '2v COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type 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 ALTERATIONS: (Describe) HEATING CO: Signed By: _ Date: CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 14, 2003 Mr. M. Zachar 4573 Main Street NE Fridley, MN 55421 Re: Final Inspection at 4573 Main Street NE Contractor: Roto Rooter Service Co Dear Mr. Zachar: A plumbing permit was issued on July 24, 2002 to install three fixtures at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh Building Permit Fee BUILDING Back Page for Fee Schedule Permit No.: 6 d�-w (9 0-7 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $ 1.001 Received Byl,;Ca 763-572-3604 $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY $1825 per SAC Unit (Plans to MWCC for determination) Date Rec'd: 763-502-4977 FAX ft + 6 ft = ft x $21 =$ Erosion Control 4n?�P� $450 Conservation Plan Review Park Fee EFFECTIVE 1-1-08 Fee Determined by Engineering Sewer Main Charge DATE "! YOUR E-MAIL ADDRESS AOASCline. i7G Y $ 1 0'z Make checks payable to: City of Fridley Attach Stipulations o ► L e e SITE ADDRESS 4&W457 MA'Iyi a l d l ey m %pi THIS APPLICANT IS: `OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: 4513 M n Si NE =_EtiJ $ ,! p 1S"T\ATEAkZIP PHONE: '7 b 3 — 5'71 - a 9 g� I+®YV��> to l ool —3 7-0' to / D3 W 0 h F ) NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH idROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:_�pDl�t I VlG SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES //❑ HOUSE ONLY �P -A 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, ❑ 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 OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ N51fiffl T1,7_5See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 1.001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1 0'z Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APP !� a/ �LICANT y ,� PRINT NAME��jhg 0 - DATE S=- D APPROVED BY /' C _ DA; PLEASE NOTE: SEYARATE PERMITS ARE REQUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL