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PRE 2010 DOCSCity of Fridley, Minn. BUR DING PERMIT N° 6589 73 Date: Owner: Builder re , Address Address No.� Street -rP of Lot _ Lot __ Block _ Addition or Sub -Division Corner Lot _ Inside Lot —_ _ Setback �_ _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T Used as: Front �J� Depth 1� Height Sq. Ft Cu. ' Front Depth Height Sq. Ft i`�' Cu. Ft Type of coon Est. ,� 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 set 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 ordinauoes of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair end moving of buildings within the city limits and this permit may be revoked at any upon violation of any of the provisions of said ordinances. � �, � /tel Building Inspector NOTICE: Ibb psrndt does not cewr the cons. ctlon, hrshlldion for wiring, pk mbing, gas haadng, rawer or water. Be sure to res tho Building hupoetor for soperata permits for there hems, City of Fridley Application for Plumbing and bas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... — x $1.50 Y o 42d C Z G� W °d w Sc ? 0 O • R • N WATER HTR. GAS ELEC. Base x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL_ 1st 3 Fixtures .......................... x $1.50 lJ $ Additional Fixtures .................... • x .50 1st 1 x 2.00 1 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... — x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL_ 1st 3 Fixtures .......................... x $1.50 lJ $ Additional Fixtures .................... • x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Dept. of Bldgs. Phone SU 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. Owner [F Kind of Building Used as To be completed about ,444 Estimated Cost, $.9.e ®� Old—New. Building Permit Permit No. Signe By Business Phone No. kc 7 7 L.-- ROUGH .ROUGH FINAL Description ................................................$ TOTAL FEE � �-420-42 3M Application for Power Plants and Healing. Cooling. Ventilation. ReMgeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or AOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. IDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ FAIR CONDITIONING $ :FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $�D ROUGH FINAL Dent. of Bldca. Phone SII 4-7470 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. I'll Fridley, Minn AUG 1 — 19-0 19 — Owner Kind of Building Used as To be completed about c �— Estimated Cost, $_ w. lding Permit No. Permit No. DESCRIPTION OF WORK HEATING Warm Air—No� Trade NameSize No F-11�5 - Capacity Sq. Ft. E.D.R = BTU H.P. Total Connected Load ��'� Kind of Fuel BURNER — Trade Nam��ag',c �C'� e_ ' Size No Capacity Sq. Ft. E.D.RZ/S ' >/Y -BTU H.P. L'IIoING BEATING & WIR COND. CO. /1 pf 6409 GOODRICH AVE. S. ELL'iNN,rAPOLIS 26, P.SIPIY. She By 42 2M Business Phone No (REMARKS—OVER) • �lQi /.S S - jai J X�y 11- -S� LOSS CALCULATIONS DEPARTMENT OF BUILDINGS 1VIINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Win ows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind Ho Applied es No Yes—No 19.. 1 1 1 "0 " /FII . _ R.,.,,., I i ann►1, A II / FII /9' 4V R-- I I —th f - W elth /X2 NP;aht .0' Windows a Doors—Crackage and Area Width I Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft.,_ % / /9 Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq.ft. .0 /-.5- ,4,O A D a® / .®— I'll—j iq AV Coef. Btu Infiltration Qp Glass .47 �er� Glass Exp. wallNet O Exp. wall Z7y7x Exp. wall La Ceiling Int. wall Net exp. wall ill /X E Aa S o Floor ,� `y / 'P'A -S! l% Ceiling o Floor Y r Floor 4p 'y,X Total Btu. ,f R9 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl.1. A Room I Length��s = Width AO Height .� Windows and Doors—Crackage and Area jo Width I Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft.,_ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ao T 14 Exp. wall ' a Net exp. wall Int. wall Coef.1 Btu Infiltration Infiltration ��' Qp Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Glass ®a Exp. wallNet O Exp. wall Z7y7x exp. wall La Ceiling Int. wall g Floor ,� `y / Ceiling Int. wall o Floor Y r /—/ Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl. / - Room I Length -P WidthZ,,y Height Windows and Doors—Crackage and Area jo Width I Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft.,_ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Glass �O O Exp. wall ' a Net exp. wall Int. wall Coef. Btu Coef. Btu Infiltration j Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Glass Exp. wall Xfl O Exp. wall Z7y7x -J%WQ e2. S Ceiling Net exp. wall g Floor ,� `y / SOS Int. wall �� "ild O Ceiling Floor J ,X Total Btu. per/ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 'T Windows and Doors—Crackage and Area �® Width I Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft.,_ / f> Glass �O O Exp. wall ' a Net exp. wall Int. wall Coef. Btu Infiltration Floor zo j Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area za 11Se Exp. wall Xfl O Net exp. wall Int. wall 11, S Ceiling Floor ,� `y / p '4 /® ,� �� "ild O Total Btu. ,- Required sq. ft. E.D.R. or sq. ins. W.A. Leader area M. Room ( Length ,4 — Width — Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area �o No. of pane of pane lights of crack sq. ft. Windows and Doors—Crackage and Area Infiltration / f> Glass �O O Exp. wall ' a Net exp. wall Int. wall Coef. Btu Ceiling Floor zo �01 oZ Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / FIP. 4" Room I Length 69 Width -, J Height ,Q Windows and Doors—Crackage and Area Width Height of Lineal Area lights of crackk Area No. o�tlig c Noj of pane /pane Coef. Btu Infiltration 2tdJ Glass O SD Exp. wall ZA Xfl 1( Net exp. wall Int. wall 11, / O, j Ceiling Floor p '4 /® A010 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Orignd • PERMIT for Power Plants and Heating. Cool- ing. Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK ]VO. Of ting Plants, to be e ired repaired Oil fired—,- Coal fired—, Gas fired ; Gas Authorization Remarks Approved Final Inspection 19_ Inspector Permit N° 4708 Fee $ f®•60 - Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. 7, 19 A _ n Owner f ) Location Kind of Building -iQ How Occupied Work to be Commenced—, 19— To be Completed o ,19-9-o Estimated Cost, 606 • a C) (SNew, Building Permit No. Permission is hereby granted to1 �? �'-! ,g✓�.C� to install -erect -use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom 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 mentioned 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 named, and to the specifications se forth 'n the approved application for this permit on file in the office of the Inspector of Buildings. , d N , 111 I -A-Z 4-07 � ��1 . e!g L C1U�,,, l�spector of Buildings 42 2Mt1.67v CITY OF FRIDLEY APPI rrATrnN FnR PmmRiNG ANn Gas FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS First $100.00 each add. $100.00 or fraction RATE r. $3.00 x $2.00 X $2.00 :c $5.00 x $5.00 x $10.00 x. $7.00 x $5.00 x $5.00 TOTAL x $3.00 $ X $1.00 $ r. $10.00 $ $5.00 $2.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) o�e�c/ �/.Job Address �9 111-A � ��/'� Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and torr t Fridley, Mn. / Z /vd a '197 OWNER �Q /�i�+�+ /T/�`�/��1 G Aj KIND OF BUILDINGG !il USED AS J/ :�f/ -P■� /�/ h-- Q TO BE COMPLETED ABOUT 12— / ` 7 J_ - ESTIMATED3.0® �COST -- OIC)- NEW BUILDING PERMIT NO. PERMIT NO. L U `ate Companyb L W1 A/1 Signed By •/��/" Tel. No. ROUGH INSP. FINAL INSP. Date Date APPROVAL FOR PERMIT ®� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7,50 Pry N Ny o K o Water u m m Nr�-.c+ N Q 41 w w Heater o 41 r -1N C N E •,q rt g 1.7 $4 N S•I m O (dM E; 0 W < ••i Sa 0 O N rt G .� •.i ,� .0 R 9 3 O .0 0 .14O..0 41 N 1� N N U N N OO •.i 9 O 0 ai mU q y 3 Qw cq W UMQ3 U LD O as lec L 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS First $100.00 each add. $100.00 or fraction RATE r. $3.00 x $2.00 X $2.00 :c $5.00 x $5.00 x $10.00 x. $7.00 x $5.00 x $5.00 TOTAL x $3.00 $ X $1.00 $ r. $10.00 $ $5.00 $2.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) o�e�c/ �/.Job Address �9 111-A � ��/'� Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and torr t Fridley, Mn. / Z /vd a '197 OWNER �Q /�i�+�+ /T/�`�/��1 G Aj KIND OF BUILDINGG !il USED AS J/ :�f/ -P■� /�/ h-- Q TO BE COMPLETED ABOUT 12— / ` 7 J_ - ESTIMATED3.0® �COST -- OIC)- NEW BUILDING PERMIT NO. PERMIT NO. L U `ate Companyb L W1 A/1 Signed By •/��/" Tel. No. ROUGH INSP. FINAL INSP. Date Date APPROVAL FOR PERMIT ®� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7,50 Pry susdEcr PE City of Fridley 0 15.3 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T _ .62 r ECEIPT � 11 `y _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �J r PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/1/79 JOB ADDRESS 5194 Matterhorn Drive N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 5 Innsbruck lst Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Rolan E. Anderson 5194 Matterhorn Drive N.E. 571-7587 3 CONTRACTOR ct..,9.� MAIL ADDRESS ZIP PHONE LICENSE NO. J— O eri 444-14" 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 ' x 14' Shed 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING► PLUMBING AND SIGN& 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 725 $.50 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 RA HC RIZEDA N7 I A7EI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT XGNATjUREOFCON-RACT i spy r �NVIJ�IO SIGNATURE FOWNERU N RBUILDERI IDAT LDG INSP I WE CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: C) "dE Off BUILDER: ADDRESS: &�61VD IADDRESS: TEL NO: 6T- I ��& 2 . TEL NO: f moi• �[�r Q Construction Location STREET NO: d / / STREET:r D LOT: O 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: f� / Depth: Height: Squane Feet: D Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: � �® 1 V-!3 Estimated Cost: $ 4.b Be Completed: kv 9 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 rulings of the Department of Buildings, and hereby declares that all the facts and repr sentatio/ns /s�tate�d in this applica DATE ,(�a,3 /0 ?q SIGNATURE: St' ulations: PLAT OF SURVEY OF PROPERTY OFViiz_? .9 ` 122meze zz- " �i7r�c `��•-�,�� LOCATION .9¢ DESCRIBED AS FOLLOWS CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY I hereby certlty that on fes" !� f 19 f I hereby certify that on /1— %J X919� this survey. plan, or report was prepared by me or under my : this -survey, plan, or report was prepared by me or under my direct supervision nd that I nm a dulyRegistered Land Sur direct supervision and tha I am a duly gistered Land vayor under the of the State ta, Surveyor under t laws of St a, of nneso 1 of SUBJECT PERMI City of Fridley hi 15 9 5 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. �az 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 8/27/80 JOB ADDRESS 5194 Matterhorn Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ 5 Innsbruck 1st Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE R. E. Anderson 5194 Matterhorn Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Foley Company 4448 Nicollet Avenue 823-9045 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 ElREPAIR ElMOVE ❑ REMOVE X 8 DESCRIBE WORK Re-stucco house 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUiREO FOR WONGS HE 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 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 $2,000. $1.00 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- $12.00 STRUCTION TH PERFORNI�NCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE [/�,-�B %�' - $13.00 _J_Z7�1 RE OF Co T CTOROR UT ¢ED AGENT (DATE WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP 9f ��,'� OAT ATU E OF OW NER UFO NER BU�LDER� IDATEI •1i�.w"., ..:.%iWs:.y. - ry-y:-:cea.�uc: —_ "'sr: -a!�..:Jrv,.,.sr�.a l^ Lr.ut.w�._.i.�Yv:.$,�.a�N �/aY.3a�'1,�".__ - u 1„v�-.- .� _ _.�1'+uv'dw aa�..e_._...•1 �a.w _.-_ •_- .s_!.y • CITY OF FRIDLEY • APPLICATION FOR RESIDENTIAL BUILDING PEhMITs ( 4raq., ALT•ERATI.011S., ADDITIONS, OR REPAIRS) �} i OWNER:V G' nUxL'DERs •'' ” Address - Address: ��- Tel. No. D- _ no.Street • TOOT: BLOCK: ADDITION:A�i-- `-COR.NER LOT: _ INSIDE -IAT: SETBACK: SIDEXARDS: z 'Applicant'' attach 'to this form Tzao Certificates of Survey of. -Lot and proposed . building location drawn on these Certificates. DESCRIPTION OF BUILDING -To Be Used As: - - _- Front. Depth:. Height: Square Feet: Cubic..; Feet: 4 FrOnt:' Depth: Height: - Square Feet: Cubic Feet: Type of Construction Estimated Cost: $ �j ®®® N.— • E To Rae. Completed: _ Alt. A Alt. B. '. Proposed Driveway 4idth 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 im strict accordance with the City of is Fridley Ordinances and rulings•of_the Department of Buildings, and hereby declar(• t; that all. the facts and representations stated in this a lication are true and correct. See reverse side for additional informatio DATE: ® % IGNATUI2E: Stipulat• i , • c, 0 • • t p1. r , 1 CiTY.OF FRIDLEY INSPECTION DIVISION , S,�, ,e" „4xJD �/,4,6bEf' 6431 University Ave NE �/� �'�� L"j& � � Pll' �z Fridley, MN 55432 APPLICATION FOR POWER PUNTS AND HEATI�G, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES S JOB ADDRE L RATE SCHEDULE OWNER�%C//1 Rate TOTAL ) d„ BUILDING USED AS Sc $30.00 $ Oro ESTIMATED COST PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) arm Air $ 10.00 $ Trade Name %�/ /VE Size No. BTU k04 0-b-6HP . EDR $ 25.00 $�1J Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 2001 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. E $ .50 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATINIQ CO DATE - 6l -0 t TEL # �� 15W4 �?a-dD 4-611�--ep Approved By #'M Date Final BACK SIDE MUST PE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION 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. YesA No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. Ye When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes p No( ) When installina 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. Ye 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) HEATI CO: Sign By: Date 9- �/ G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 November 9, 2001 Mr. Roland Anderson 5194 Matterhorn Drive NE Fridley, MN 55421 Re: Final Inspection at 5194 Matterhorn Drive NE Contractor: Cronstrom's Heating & Air Conditioning 1► sham zo J NHDuad Hd0 .LndNI ZOO S.Nd02Idd ' ° almsmd ldalsd.L 40 awvN ) -UU MN x dZIS SITU'IId umusd.L ANVdWOD /aKON ?Iaml do CINDI S'ION.Ll�iO� (n i 8).Ln&z 0 '1a(IOw hS 11 IVIiIasIdW A DMU 2Imuo —um Mm 2I Lli RDWS Viva LS — va 0 JWHH dO dd U s1 A____g 1HOM'NDULOd'Id (T— As Qd'IZV.LSNI SS011 vaH 2IdNMO , .LNVdnDDO axOJax ISHI ON IVaR HRIO #jz"Maa -7z, SUBJECT AwERMIT NO... City of Fridley 33462 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 1 1 ♦ V ----- COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ' Q ^ (,�! ®2 r 1 � 1 1 1y�L NUMBER 11Ev oATEPAGE Or AvvaOvEO BY = � -"'1 CITY HALL FRIOLEY 55132 763-571-3450 910-F15 4/23/03 JOB ADDRESS 5194 Matterhorn Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. g 5 1 Innsbruck 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rolan Anderson 5194 Matterhorn Drive NE 612-789-1902 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tabor & Sons Roofing 10547 Terrace Rd, Blaine, MN 55434 612-789-1902 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20014248 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (31 Sq) Tear -off 9 CHANGEOFUSEFROM 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 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 $3,589 $1.79 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. $97.25 Fire SC $3.59 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 1 z PLAN CHECK FEE TAL FEE -D � ��A '�/ d.3-0 L' ns SC $ .00 7$107.63 SIGNaiuRE OF(CONTRACTOR OR AUTHORIZED AGENT iDATEi H P LY VALI TED THIS IS YO PERM OG -N 7t _ S-GNATUAE OF OWNER"6 OWNER BUILDER, tDATEi NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address:/ g /_/ ��G��t�c Dr. *F, Legal Description: Owner N Contract Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel.#�°�a 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 Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: V Estimated Cost: $ 7? 09 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: / r�-� -— Tel. # �/j Call (763) 572-3604 for Permit Fees -if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 1. '219 $ $ l09-(03 CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] Building FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. PLUMBING Permit No. _C08114 Inspections _ BATH SINK/LAV RESIDENTIAL APPLICATION Received By: _- 763-572-3604 —BATHTUB — CLOTHES WASHER _GAS PIPING (NEED CITY LIC) KITCHEN SINK _ —SWIMMING POOL WATER CLOSET W TER SOFTNER ($ 5) KFLOW 763-502-4977 FAX _ _ LAUNDRY TRAY CITY OF FRIDLEY D 'dJ _ WATER METER EFFECTIVE 2-19-09 DATE 7 � a 109 YOUR E-MAIL ADDRESS _ r0 hA (,L j- rj aua• qp�a 0 1, Cc M SITEADDRESS EMLY MATTE=/:z'rf 612 N E -1�'x I THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: L_ /H E /Srd�D C!Z S O TO NANT ADDRESS: / �i Y d-7� j c=_ -/z ff D /Zhf CITY �%2 J L_9-!KSTATF�ZIP !TZ PHONE: 7 � s • 5 ! I - SSS CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND 0 EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE I(SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: bi NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK .. NST /� r� U/�!� -r iZ Oy ly 1�t I /21Z I C=^ —/I 0^C S YS T �M FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. _ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING —BATHTUB — CLOTHES WASHER _GAS PIPING (NEED CITY LIC) KITCHEN SINK _ —SWIMMING POOL WATER CLOSET W TER SOFTNER ($ 5) KFLOW DISHWASHER _ _ LAUNDRY TRAY _ _WATER HEATER ($35) PREY. $11 FOR IRRIGATION _ WATER METER _OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 APPLICANT_g4&w_e PRINT NAMEI_?<QL4NJc. /a-%,.DE7Z1-0A(DATE_`7 q City of Fridley Building Inspections Department 6431 University Avenue NE; Fridley, MN 55432 763-572-3604 FAX: 763-502-4977