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PRE 2010 DOCS3� City of Fridley, Minn. 6431 University Ave. N. E.; Minneapolis, Minn. 55 2 BUILDING PERMIT Dater June 15, 1972 Owners _ Vern Dnnnavy Real t -s Inc- Builder Same- Address ateAddress _.7 300._. — _3b.th Avenue N . KX - Address Same 913-2741 LOCATION OF BUILDING No. 1378 _ Street Meadowmoor Drive N.E.Part of Lot Lot _ 1.Q._.:__ _ Block_._.._3...._.._..._..___.......__ Addition or Sub -Division Mearlawmoor, Terrace Corner Lot _._ Inside Lot X _ Setback 3-5-51 . Sideyard - 1-n- 59 S" Elevation ._._.- 889.18 —/1dO"44VJVA,WJ Min. of 3 feet ahove Vater table Wye Top of Footing Cdater Table - 893.8 Apprnw.) DESCRIPTION OF BUILDING To be Used as: Dwelling---.._... Front _32! —_ Depth 214 Height 20t Sq. Ft. 777 6 Cn. Ft15,552, --6�.age ...._.._...... Front1_ L1 Depth 221 Height ent Sq. Ft. --308- Cu. Ft. 2080. Type of Construction Wood Frame Est. Cost .19,584 _To be Completed Sep WATER LOCATION: 9.5' E.of Sewer Service SEWER SERVICE: 48.5' W. of E. property line Stipulation: This permit issued subject to stipulations in Mutual Agreement signed by Vern Donnay Realty, Inc. and dated June 14, 1972. 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 pr&ddons of ordinances of the city of Fridley. /1 f) / „ . 19 St In consideration of the payment of a fee of $44.00 , permit is hereby granted to Vern Donnay Realty Inc. to construct the building or addition as described above. This permit 3s 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 buildiIIgs vi*the city ]units and this permit may be revoked at any time upon violation of any of the provisions of Said ordinances. CTA RENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sura to we the Building Inspector for separate permits for these items. Jr Appleafto for Power Phoft and Heathv% Cooling, Ventilation. it and Air Conditioning S"em and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIS: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AM Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $�U' each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace 6.00 $_ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $50000 .............. 9.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . $10.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ... .......... :...... 3.00 $ Each add. 320 sq. ft. IDR Hot Water ... ........ ... 3.00 $ OIL BURNER—to 3 gal. per hour ... .......... .. 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ..... .:......:........ 5.00 $-1._ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL �? 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures .................. x .75 $ Gas Range to 199,000 .......... s$ SAO $ AIR COI)iDTliON1NG $ FAN HEATING SYSTEM See vee Schedule VENTILATING SYSTEM ALTERATIONS do REPAIRS TOTAL FEE $$ ROUGH FIINAI, eo4z - __ — Dept. of Ridge. Phone 8W-3480 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 Ordinance: and ruling of the Department of Buildings, and hereby declares that an the facts and representations stated in this application are true and correct. IL l A,./ Fridley, Minn- 169. .1.2'i-' Owner Kind of Building Used as To be completed about Estimated Cost, $ Old New uilding Permit No. Permit No. DESCRIPTION OF WOR_ H HEATING or POWER PLANTS --Steam, Hot Wate<Warm Air o_L_ 1ne Trade Name � Size No I � f Capacity Sq.. Ft. E.D.R fam H.P. Total Connected Load—J A6 Hind of Fue BURNER — Trade Name Size No Capaci Sq. Ft. E.DR BTU H.P: Signed&OOL4 Budness ph NRDGIMCK HTG. X AIR-COND. W 7,001 Xenia. Av. S. - 545-1611 Wrlil6apolis, Minn. 55416 (REMARKS -OYER) .,�a City of Fridley 1°" for Cas Dept. of Bldge. Phone S®MMM PARTIAL RATE SCHEDULE PLUMBING FIXTURE FRATES. NO. RATE TOTAL Number Fixtures ................ x 82..00 S Future Fixture Opening ............ x 81.50 $ New 7ixture Old Opening .......... x 81.50 $ Catch Basin ..... ............. x 83.25 S Water Beater 'Up to 99.000 BTU) .... x 83.00 S New Ground Run Old Bldg......... x 83.25 $ Electrk Water Ifoater .............. s 8200 8 GAS FITTING FEES. NO. RATE TOTAL lat 3 Fixtures ...... • • ....... , • • —x$2.W 8 Additional Fixtures .............. x 8 .75 $ Gas Range to 199.000 BTU ............ x 85-0 i State Surcharge $ .50 RE PAM A ALTERATIONS— Cafes to Code _ Description . . . . . . . . . . .... . . ... ..... . • ..... . .. .... .4 TOTAL ri $ - City of Fridley: The undersigned hereby makes application for a permit for the vrork herei, speciffied, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Building% and hereby declares that all the fact and representations stated in this application are true and correct Mdley. Mina Z_Z.► Oeener P Kind of Building Used as Q To be completed aboutZ-- Estimated Cost, $ 41 Ze° ®' ®ld Ne Building Permit No. Permit No. Signed By Business Phune No ROUGH. FIIUAL �� City of Fridley 53_8 -s -9i5.51 /Applicalloe for Phmbbg and Cv= Fhtkg fttmk Dept. of Bldos. Phone 3i®0-34.'30 DESCRIPTION OF WORK Number, Kind and Location of Fixtures O iz S <y Z� pc O ��y?c 6 < y v2 5 < Sy (7 u1 (`f WATER MTR. GA5 ELEC. Base 1st 1 2nd 3rd 4th —Future Conneetlon Openings * Now Fixture, Old Openings Connected with Sewer CUBPOW El 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 $ — Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............... x $2.00 ;- Additional Fixtures .................. x $ .75 $$ Gas Range to 1339,00 BTU ............... 1 x $S.Oo s 5. nn REPAIRS It ALTERATIONS—Refer to Code Description ............................................ TOTAL FEE $ 5.00 (§URCHARGE $_,50 1378 N. E. Meadow Moore Drive 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 aR the tact and representations stated in this application are true and correct Fridley, Minn 11-6-72 19 Owner Vern Donnay Homes Inc. Kind of Building Frames Used as To be completed about Res. 11-13-72 Estimated Cost, $ 10.00 3DWK-New. Building Permit No. Permit No. Sign t Business Phune No ROUGH FINAL RIDS MORTGAGE CORPORATION IDS TOWER P. 0. BOX 534 MINNEAPOLIS, MINN. 55440 May 13, 1974 Mr. Darrel Clark City of Fridley 6431 University Avenue NE Fridley, Minnesota 55432 Re: 1378 Meadowmoor Drive Dear Mr. Clark: DISTRICT MORTGAGE LOAN OFFICE TWIN CITIES - PHONE (612) 372-3040 In our telephone conversation, you indicated that somebody had complained about the appearance of the above property. As I told you, there were shingles missing from the side and rear of the garage since last Fall. To my knowledge, there hasn't been any more extensive damage done for some time. As I am sure you are aware, Vern Donnay Realty, Inc. is the owner of this property and we have a construction mortgage. Any repairs to the building would be their responsibility. I've been informed by Vern Donnay Realty, Inc. that they have sold this property and assuming their loan is approved, it should close in the near future. I am not aware as to how the repairs are to be handled. Very truly yours, R. D. Narum Assistant Vice President RDN:ph A SUBSIDIARY OF INVESTORS DIVERSIFIED SERVICES, INC. E 53-84-S-915.51 City of Fridley Appll=fan fw Pk=hbg cad Gm FWbj �� Dept. of Bldgs. Ph o 3430 DESCRIPTION OF WORK N. E. Meadowmoor�€ Drive f Fi Number, Kind and Location o x res y0 WW 3 � 7 Z + F M ,�1 N .zry 3 O LL R t Y C v Js 3 0< u1 O N � • • N WATER "". GAS tIEC. Base ist Insiall, G s qril 2nd 3rd 4th --t • Future Conacclion Openings e Now Fixture. Old Openings Connected with Sewer � Cesspool ❑ 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 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,080 BTU) . • . • x $3.00 $ New Ground Run Old Bldg...... x $3.25 $ Electric Water Heater ...... ......... s $2.00 $ ZAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures . • ... • • ....... • x $2.00 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199,000 BTU.. x $5.00 $ City of Flridley: 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 6-28-74 19_ Owner Darrel E. Schmidt Kind of Building Frame Used as Res. To be completed about 7-5-74 Estimated Cost, $ 10.00 Old—XXWXBuilding Permit No. P•smit Sig�+P.) • By MINNEGASCO Business Phone No ROUGH REPAIRS !t ALTERATIONS—Refer to Code .50 State Surcharge Description ...... Ipstll, Gas. Grill..................$ 5.00 TOTAL FEE 50 Class 11`A'-" Surcharge .5v CITY Or PRIDLEY APPLICAMN M PWMMNG AND GA9 F -MING PEN41T doh Address /J 7 Uepartment ttf Utiiltjjfij§ City of Fridley Tel. #571-J450 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 correct C-4 � Fridley. Mn. , 19 OWNER �- - GC1L�� st1y ryy� c+s� KIND OF BUILDING USED AS m TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE N N Water Heatei of PLUMBING FIXTURE RATES: NO. RATE m - E 1 ro v PERMIT NO. Number Fixtures x $3.00 $ ani Future Fixture Opening x $2.00 al Company c New Fixture, Old Opening H d $ Catch Basin x $5.00 $ Signed By to U D Pq $5.00 p] 3 A W V] N U W r•C 3 U Water Softener O dS leC New Ground Ran Old Building x $5.00 $ ROUGH INSP. _ Electric Water Heater x $5.00 $ Date GAS FITTING FEES: 1st let 3 fixtures x $3.00 $ Date Additional Fixtures x $1.00 $ Gas Range to 199.000 BTU x $10.00 $ 2nd REPAIRS & ALTERATIONS �! First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ 3rd IS $7.50 PLUS $.50 STATE SUPT=RGE State Surcharge `J $ .50 TOTAL FEE $ 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water doh Address /J 7 Uepartment ttf Utiiltjjfij§ City of Fridley Tel. #571-J450 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 correct C-4 � Fridley. Mn. , 19 OWNER �- - GC1L�� st1y ryy� c+s� KIND OF BUILDING USED AS REINSPECTION FEE ($10.00) TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST PLUMBING FIXTURE RATES: NO. RATE TOTAL - _ OLD NEW BUILDING PERMIT NO. PERMIT NO. Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ Company c New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Signed By Water Heater - to 99,000 BTU x $5.00 $ Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Ran Old Building x $5.00 $ ROUGH INSP. _ Electric Water Heater x $5.00 $ Date GAS FITTING FEES: FINAL INSP. let 3 fixtures x $3.00 $ Date Additional Fixtures x $1.00 $ Gas Range to 199.000 BTU x $10.00 $ APPROVAL FOR PERMIT REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SUPT=RGE State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) 63 -8b -B79001 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. :'_-.ber Fixtures gat=e Fixture Opening New Fixture, Old Opening Catch Basin :cater Heater - to 99,000 BTU 100,000 B_J to 199,000 BTU Water Softener dew Ground han Old Building Electric hater Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Ra:.ge to 199,000 BTU REPAIRS F ALTERATIONS First $100.00 ea :Y: add. $100.00 or fraction RATE $3.00 $2.00 $2.00 $5.00 $5.00 $10.00 $7 If $5.00 $5.00 x $3.00 X $1.00 X $110.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10. on) $5.00 $2.00 TOTAL $ $ Job Address 1378 Meadowmoore Drive 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 Depart-ment of Buildings, and hereby declares that all the facts and roprosontations statod in this application aro true and oerrect Fridley, Mn. 7-2-81 , 19 OWNER ZZ121M KIND OF BUILDING frame USED AS fes. TO BE COMPLETED ABOUT 7-9-81 r ESTIMATED COST 70.0(, OLD - NEW BUILDING PERN.IT NO. PERMIT NO. C� � Company a4d go Signed By M1NNEGASQ0 ROUGH INSP. Date Tel. No. FINAL INSP. 17, -� ^ 03 Date APPROVAL FOR PER4IT 4IJ4,00 MINIMUM FEE FOR ANY PLUMBING PER4IT IS $7.50 PLUS $.50 STATE SURMRGE ? tc q U % 0 Water R ro o+ c w �4,y a+ -I b• Heater u ,.. a _ r- a W x X cc U H .0 C o�o C7 S 0 c w iC ti fd o O !J O w ►+ L a p L` N ro$4 4 O 0 O c.Q O I 7 'V Is 1� N o 9 t11 N N .0 co u a c W a 4 .. y w uma> 0,ro � c`� 0 Ist j ri n 2nd 3rd { -j 1 171, E(R) = F%:ture Connection Opening Connected with Sewer - New Fixture, Old Opening Water --------- ;-� PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. :'_-.ber Fixtures gat=e Fixture Opening New Fixture, Old Opening Catch Basin :cater Heater - to 99,000 BTU 100,000 B_J to 199,000 BTU Water Softener dew Ground han Old Building Electric hater Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Ra:.ge to 199,000 BTU REPAIRS F ALTERATIONS First $100.00 ea :Y: add. $100.00 or fraction RATE $3.00 $2.00 $2.00 $5.00 $5.00 $10.00 $7 If $5.00 $5.00 x $3.00 X $1.00 X $110.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10. on) $5.00 $2.00 TOTAL $ $ Job Address 1378 Meadowmoore Drive 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 Depart-ment of Buildings, and hereby declares that all the facts and roprosontations statod in this application aro true and oerrect Fridley, Mn. 7-2-81 , 19 OWNER ZZ121M KIND OF BUILDING frame USED AS fes. TO BE COMPLETED ABOUT 7-9-81 r ESTIMATED COST 70.0(, OLD - NEW BUILDING PERN.IT NO. PERMIT NO. C� � Company a4d go Signed By M1NNEGASQ0 ROUGH INSP. Date Tel. No. FINAL INSP. 17, -� ^ 03 Date APPROVAL FOR PER4IT 4IJ4,00 MINIMUM FEE FOR ANY PLUMBING PER4IT IS $7.50 PLUS $.50 STATE SURMRGE suBJECT PEi2 City of Fridley 711�1 5 AT THE TOP OF THE TWINS BUILDING PERM � IPT COMMUNITY DEVELOPMENT DIV. _ L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 / NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910415 10/22/91 JOB ADDRESS 1378 Meadowmoor Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 Meadowmoor Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charles Lindman 1378 Meadowmoor Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Storm Sash 10825 Green Brier Rd 546-8160 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 O MOVE ❑ REMOVE 8 DESCRIBE WORK Install windows and reside 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1. STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $15,990 $7.99 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $171,00 Fire SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ,$15.99 PLAN CHECK FEE TOTAL FEE (U i/ $194.98 HEN 0 V LIDATED THIS IS YOUR PERMIT SIGNAT E OF CO RACTOR OR AUTHORIZED AGENT MATE) r j SIGNATURE OF OWNER OF OWNER BUILDER) (DATEI BLDG INS P r)ATE NEW [ ] Effective 1/1/91 ADDN [) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 3 7 19 /Yl e a -,j a-) Moe) f- D Qr e w Legal Description: LOT ( O 1 :ai 3 ,4 lz�° L Owner Name & Address: Ch q 1?) f 5 Z t', -J n. 6 � Tel. # Contractor: SA s y, Tel. # S y G 'Z)60 Address: (v S,? s G ercno 13 4e e 2 2 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: .5 i i ✓`� Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ i s -99,e) ° Ft x $ coos on am*) DATE: (� _ a ( APPLICANT: Tel. # 3-f G l �� Permit Fee Fire Surcharge State Surcharge SAC Charge Driveway Escrow Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ , `i /, ')6 Fee Schedule on Reverse Side $ / � 99 .001 of Permit Valuation (1/10th%) $ ,9 $.50/$1,000 Valuation $ $650 per SAC Unit $ Alt.. "A" or Alt. "B" Above $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $--L9-,-1193 ITN SUBJECT d. City of Fridley 2 7 219 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� r Oy 1 I NUMBER DATE PAGE OF APPROVED BY = 1 "1 CITY HALL FRIDLEY 55432 612-571-3450 7REV 910-F158/17/98 JOB ADDRESS 1378 Meadowmoor Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 3 1Meadowmoorj Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE GregNelson 786-6173 3 •CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Seasons Roofing& Remodelin LLC 793 Uni .A e.NE e 795-9410 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 RX REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (17 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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. OWLG. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1417 $.71 DOES NOT P UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION O ANY STATE OR LOCAL LAW REGULATING CON- 3 THE FOR ANCE OF CONSTRUCTION $48,50 Fire SC $1.42 PLAN CHECK FEE TOTAL FEE �+ 9-17 -7 00 License 5.00 55. SIGNATURE OF CONTRA TOR OR AUTHORIZED AGENT IDATEI ENP OPER Y IDATED T IS YOUR P IT BL )NSP f1A SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI ITN did . . Effective 1/1%98 [ ] la y CITY; OF FRIDLEY r � F . SIN�GLaY AND DUPLEXES R 1 AND R-2 Gt ,1BUTLDING PERMIT APPLICATION dL w 7 _..�!:-uctionAddress:� R i �rscription: ' Mame & Address�-�-�SdYI l 3 ?S ii��•3 (�'�a�1i Tel. #��0 �% %� _ ...... nor: Fou r a6ew a Le-C MN LICENSE #_ � 'Fes: (-r,� . Tel. # Dir"t�rs`G'� Attach to this: application, a Certificate of Survey of the lot, with`the proposed construction drawn on it to scale. . Y DESCRIPTION OF IMPROVEMENT C A1t1+:A:Length , 'Width Height Sq. Ft. GE`A,tEA: Length`}# Width Height Sq. Ft. Czi' AREA: Length _Width H t/Ground Sq. Ft. 1111E R: [inn Type: AV� CL Estimated Cost: $ ) qll q (Fee Schedule on Back). t y Curb Cut Width Needed r 's Ft' `'+ 6 Ft = Ft x FAPPLIC' ANT Tel. # CITY USE ONLY € s r l . i �•(ry r Fee $_ g �. ..Fee Schedule on Reverse Side �urcharge $ ' y001'of Permit Valuation (1/10th%);ger Surcharge$ ;,,�� x:$: $1000 50/$1;000 Valuation ` er SAC Unit SAC Charge r $ �,pt , License Surcharge $y''$5:00 (State Licensed Residential Contractors). �* u :i::VC4'}'ay Escrow $}� r3av`' �(Y ° tin n n n w �_��{Alt.; A or Alt. B Above fi } :oSion Control $ ,$450.00 Conservation Plan Review ` 1 $ Fee'Determined by Engineering r cr Main Charge ` ' $ �r ..Agreement Necessary [ ] Not Necessary [ ] x F { TOTAL ;� t�F $ ,' " , d� `i t 'l, STIPULATIONS Ih 1 l _ SUBJECT P . r City O1 Fridley WRECKING 1823 AT THE TOP OF THE TWINS PERMIT ('3 RECEIPT NO. `v -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. /y 572-3604 � NUMBER REV DATE PAGE OF APPROVED By It ;,� CITY HALL FRIDLEY 55432 --__� L 612-571-3450 910-F15 5/16/01 JOB ADDRESS 1378 Meadowmoor Drive NE - 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 Meadowmoor Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Abdulla Oma$ 1378 Meadowmoor Drive NE 780-4160 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Marshall Adams Bldg & Remodeling 24138 Verdin St, St Francis MN 55070 20186497 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-753-0210 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION 0 ALTERATION 0 REPAIR 0 MOVE] REMOVE 8 DESCRIBE WORK Wreck a 22' x 14' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Clean site of all demolition debris. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,000 $N/A WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUT ORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER ST OR LOCAL LAW REGULATING CON. $20.00 STRUCTIO OR THEA ERFOR A E OF CONSTRUCTION PLAN CHECK FETOTAL F �� $20 0 SIGNATURE OF CON.RACTOROR AUTMOp12EO AGENT IDATEIEN OP R LIDAT 7 S R PERIT BL NSP 3U I DATE SIGNATURE OF OWNER,IF OWNERSUILDERI IDATEI Effective 1/1/01 CITY OF FRIDLEY MOVING [ ] WRECKING [ ] PERMIT APPLICATION 6431 University Ave NE Fridley MN 55432 (7 63) 572-3604 Job Address: !6 Legal Description: �,jf /U C� farms 3 Owner & Address:./-kdJ�� ,d,_ Qtr Tel. # Contractor: � �/, // /�q,�,fj S Tel. #2 4C3-- c>a/d Address: ��// 3 (i�rc�,. SL �j(.,y�G�;� /L%/L State License # d/9 DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Cu. Ft. GARAGE :Length ,ao- Width lir Height Sq . Ft . -36 6 ��?tu . Ft. OTHER: Length Width Height Sq. Ft. Cu. Ft. Estimated Cost $ /6 o6 p1`- Approx. Completion Date CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL UTILITIES FOR DISCONNECTS BEFORE WRECKING/MOVING STRUCTURE. Water Bill Paid: Yes [ ] or Collect [$ Moving Route: ] Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. ALL Moving Wrecking Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. PERMIT FEE: d- 0" eO MINIMUM $20.00 STIPULATIONS: Date Signature Moving Wrecking Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. PERMIT FEE: d- 0" eO MINIMUM $20.00 STIPULATIONS: It/ 7 sueJEcr � I ERMIT NO. ' City of Fridley 31843 AT THE TOP OF THE TWINS B U I L D I N� P E R M I T ` RECEIPT NO. CIV. COMMUNITY r PROTECTIVE INSPECTION SEC. 572-36 avI I � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OFAPPROVED By L 612-571-3450 910415 5/22/01 / / JOB ADDRESS 1378 Meadowmoor Drive NE -. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 Meadowmoor Terrace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Abdulla Omar 1378 Meadowmoor Drive NE 780-4170 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Marshall Adams Building & Remodeling 24138 Verdin St, St Francis MN 55070 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-753-0210 20186497 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW j7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 34' x 24' Addn; a 12' x 24' Addn; and a 22' x 24' Attached Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING SEPARATE PERMITS Before digging call fojr REQUIRED FOR: 30 Utiiit' 10cation,4 WIRING HEATIN4WO02 PLUMGINd AND S16 REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TVP 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 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 @ $92,245.44 $46.12 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 CCON— STRUCTION THE ERFO M NCE OF CONSTRUCTION PLAN CHECK FEE TOT�01 FEE - J aoZ d Licen$5. 1,088.10 5 Ar E F CONrRACTOA OR AUTHORIZED AGENT I MATE, HE PR F' VALID T THIS IS YOUR PERMIT BL G INSP 11 QATE S-GNATURE OF OWNER,60WNER BUILDER, (DATE, It/ 7 s/7/off N9W Effective 1/1/2001 ADDN CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 3 7 g iw�nar�- ��-- F�•�l Legal Description: lad' 13 1 nck 3 ,ydar�iv,crc �N-�r�r� Owner Name & Address: A64oII4 /J�r---- 6mac Tel. # ]S(b - ,l/)o Contractor:LIA.QS,4/411 AQRMS 13„; /d, -,,,s t kca ak/,Ag MN LICENSE # 9o:4- J% y57 Address: AAF t 3 e vc„d",- 54-. :51. FiTel. # 7A 3 -Xj- 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 3 Al Width a` -I Heigh Sq. Ft. 416 GARAGE AREA: Length A.2. Width Height _ Sq. Ft. C v Length 1 c9, Width 9.4 Hgt/G•round Sq. Ft. a Fl ti I 3 7 �3 OTHER: COS-( At ✓:duly 0 -/LIF Construction Type: R F- Modem -i Estimated Cost: $ ��S� 7y Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $/`/, '�S' Fee Schedule on Reverse Side $ 9a• .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $1150 per SAC Unit $ S, 0® $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 [ ] Land P/arming /lI C,875-90nvy Ofs wE LoydS"►y y moms /117.7. .WSTesfi�y ENGINEERING, INC. Aiwvts Qwl b Mluurrpnl SUmel d-6066 Engineers Sur vecyor5 certificate of surveire: _ �: p { ��►r�ir� f. ; �� :� �.� Y T� sc. MEADOWMDOR DRIVE /VoR TH 14 D N 14 Nkl'jSo 1378' 32 M LOT 30 , 75 N� O NNX. �..� dlel< r � / oAENbr,CS IRON DENOTES 07I'Z17Y e ZWA/NAGC .EAS,CIVENr ,Lor �o Bt 0CK 3 ACADOWIVOOR 4,9RAcz COUNTY OF . AV,<A /ben* cew y fW hko a o kw and wmd nrpmj&Wof M ire swwy qr*e de� q('& 4*w Awjv" I&W,wd of Ar /atAn grso do� , AAnrai , wad d/ visible wavy& n&* , if y, fma or rrAmid And. As swwyed by Im Mks _dor, FEB A'D. r�4. SUB UQ8AN MCWNEER/NCI , INC. Fn�►mers fr Sur rt Sc�iiE / 40' jy - Effective On January 1, 2001 ,TY OF FRIDLEY INSPECTION DIViSION 131 University Ave NE -idley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 53-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES J06 ADDRESS I �J� � ►'per �' RATE SCHEDULEhl- OWNE residential Rale TOTAL BUILDING USED AS Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 $`= PERMIT NO. ESTIMATED COST (Side Vent •Fill Out Back) • Gas Piping (Needed with new furnace. $ 10.00 $ pESCR1P710N OF FURNACE AND OR BURN but not replacement)I±R Gas Range $ 10.00 $. _____ No. of Heating Units • � Circle One (Steam) (Hot Water)� r A O $ 10.00 $ Trade Name Size No. ` 33 Gas Dryer BTU HP EDR "Air Conditioning • All Sizes $ 25.00 $ Fuel Burner ?rade Name Size No. fi\� •C�. Total Connected load All Others/Repairs & Alterations (LIST ON BACK) $ BTU HP EDR 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work 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 $47.00/1 -Ir "Air Conditioners can not be placed in a side yard without wriRen permission from adjoining property owner. $ .50 $ 1.M 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 staled in this application are true and correct. DATE BLAINE HTe. A!C ELECT. INC. {ama tIoNTRAL AVE. I.E. HEATING CO Rough -In Date Final Date l /(® /b/ 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. Ye4 No( ) 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 manufacturer's specifications. This does include AGA -LAMA 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 VN.o ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yeso 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 -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. YesPNo ( ) 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 ( ) A20111ance Tyrie and Size/Common Vent and Vent Connectorinformation Appliance #1 Type BTU input s 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) BLAINE HTG. A/C ELECT, INC. HEATING CO: 131MCENTRALMN M3o4N.E. Signed By: Date : ' rAW G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 November 26, 2001 Mr. Abdalla Omar 1378 Meadowmoor Dr NE Fridley, MN 55432 Re: Final Inspection at 1378 Meadowmoor Dr NE Contractor: Blaine Heating AC Electric Inc and James Anderson Plumbing Dear Mr. Omar: Permits were issued on August 2, 2001 and September 10, 2001 to install a furnace and four plumbing fixtures at your address. According to the State Plumbing Code and Uniform Mechanical Code, final inspections shall be conducted on the work authorized by these permits. As of this date, no final inspections have been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Codes. We will keep your permits open for another 30 days and if we do not hear from you within this time to set up the inspections, we will expire the permits and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely CITY OF FRIDLEY INSPECTION DIV. 5431 University Ave NE Pridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL W0 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. 9//0 , 2001 Owner liN U� l7(,� V 1 •t1��/Z�U�I ' l Building Used Estimated Cost & ' PERMIT PLUMBING Reinspection Fee $47.00/Hr SIGNED Blt/ TEL N0. c7 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date 1-1 .01 State Surcharge S .50 MINIM M FEE R ANY PLUMBINGIGAS PERMIT IS $20.00 TOTAL FEE $ c �'- %,-(b PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE New Fixtures I $ 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 W0 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. 9//0 , 2001 Owner liN U� l7(,� V 1 •t1��/Z�U�I ' l Building Used Estimated Cost & ' PERMIT PLUMBING Reinspection Fee $47.00/Hr SIGNED Blt/ TEL N0. c7 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date 1-1 .01 State Surcharge S .50 MINIM M FEE R ANY PLUMBINGIGAS PERMIT IS $20.00 TOTAL FEE $ c �'- %,-(b PLUS THE S.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 manufacturer's specifications. Yes( ) No( ) When required to install a new combustion air, it wiil be sized and installed To meet the current codes and manufacturer's specifications. Yes O No ( 1 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 OF FRIDLEY PERMIT NO.: 200401476 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004 572-3604 FAX: (763)571-1287 ADDRESS : 1378 MEADOWMOOR DR NE PIN : 123024120090 LEGAL DESC : MEADOWMOOR TERRACE : LOT 10 BLOCK 3 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER OMAR ADBALLA N & ABDALA FAIZA 1378 MEADOWMOOR DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date. ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 117431 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building PLUMBING Permit NO.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE O YOUR E-MAIL ADDRESS �/ SITE�- THISAPPLICANT IS: ❑OWNERpNTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: wvsIA 14 i;(114 t (Pj C STATE LICENSE # ':5 O,1l 2 EXP DATE p\ 7-- t � . r ADDRESS: l L �® +� �^ (b CrfY2`7� W 1A LK- I�IZ STATE �ZI � SUBMIT A COPY OF STATE YOUR LICENSE W T11 s�� PHONE�L,O �%'3 �® �/� q FAX / 7�'� O APPLICATION ❑ TOWNHOUSE PERMIT TYPE GLE FAMILY ❑ TWO FAMILY TYPE OF WORK: ❑ NEW .REPLACEMENT DETAILED DESCRIPTION OF WORK 1MA 1 h PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) (A-, Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _ _FLOOR GAS PIPING a&m cmucEjm) _ SWIMMING POOL —WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK _WATER CLOSET _BACKFLOW PREV. ($15) _ _ _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER Permit Fee $ S . Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ 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; that the work will be in accordance with the approved plan in the case of all work which enquires review and approval of plans. Z ® L I I I �' SIGNATURE OF APPLICANT V `Wyhi`� PRINT NAME' DATn "PL'" )? _.. Vi:..2 . D 1 OR$. ,:., .,iisvT�CACT. C City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.- Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date A ^ DATE" YOUR E-MAIL ADDRESS SITE ADDRESS / 3 'z k' �,a 0.64) M daa- �?rk2 THIS APPLICANT IS: O OWNER AN PROPERTY NAME: STATE IP OWNER/ADDRESS: TENANT PHONE: CONTRACTOR NAME: ✓ Y!7 / STATE LICENSE # i i 2 .�S" � Z EXP DATE " � / r '3 SUBMIT A COPY OF YOUR STATE , ADDRESS ' C/' E _ �!�' CITY / X'lG ��'' � STATT[r ZIP LICENSE WITH PHONE j 4—> =i_S✓-.7 FAX APPLICATION . " — PERMIT TYPE *SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW > EPLACEMENT ll DETAILED DESCRIPTION OF WORK ' PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor !1.05 = FOR:PROIECTS WHERE LABOR EXCEEDS$500JEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERENOTED..FI RJRES -,(INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINKILAV _FLOOR DRAINS _ SHOWER _ WATER PIPING _ —GAS PIPING (NEED clry=Nz) _ SWIMMING POOL _ WATER SOM NER ($35) —BATHTUB CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER -A, Permit Fee $. O ® Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $lL State Surcharge = $ .50 Total = $ 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; that the work will be in accordance with the quires r view and approval of plans. approved plan in the case of all wo which requires SIGNATURE OF APPLICANT PRINT NAME ATE SIGNATURE gg , �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 )1 Building Inspections 763-572-3604 763-502-4977 FAX DATE 10 .l <�–V SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: DET, 7 PLUMBING Permit No.: 2_(;6 Ci -d (41 RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEYeT EFFECTIVE 2-19-09 YOUR E -M/ IL ADDRESS o"- C V b . ❑ OWNER ADDRESS: CITY STATE ZIP STATE LICENSE #_ STATE BOND # ADDRESS: 5� PHONE ❑ SINGLE FAMILY ❑ NEW ON OF WORK h I )' ( \-',, -n h 0 31;)- ❑ TWO FAMILY ❑ REPLACEMENT FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. $35.50. _ BATH SINKILAV _FLOOR DRAINS —BATHTUB _ GAS PIPING (NEED CITY LIC) _ CLOTHES WASHER _ KITCHEN SINK _ DISHWASHER LAUNDRY TRAY ❑ TOWNHOUSE EXP DATE EXP DATE �9 STATE. V ZIP FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE _ SHOWER _ SWIMMING POOL WATER CLOSET _WATER HEATER ($35) WATER METER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED _ WATER PIPING _ WATER SOFTNER ($ _ BACKFLOW PREV. 3 FOR IRRIGATION OTHER I hereby apply for a plumbing permit and 1 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 1 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 cas of all work which requires review and approval of plans. SIGNATURE OF APPLICANT - - RINT NAME i�l ^� v ` `tel DATE ` G City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977