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PRE 2010 DOCSCity of Fridley, Minn. NO 9472 BUILDING PERMIT Date: Sept. 28, 1967 Owner: Homedale Blddrs Builder Homedale Elders. Address 5217 Wayzata Blvd.. Address Same LOCATION OF BUILDING No. 7486 Street Melody Part of Lot Lot 33 Block 4 Addition or Sub -Division .Melody Manor 4th Adda. Corner Lot — Inside Lot X Setback 35' _ Sideyard Sewer Elevation 883.78 191M99 886.78 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 46' Depth 24' 28/ Height 20 Sq. Ft. 1152 ctL Ft. 23,040 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Fast, Cost ^ $18,-50 To be Completed SEWER LOCATION - 110; East of Manhole WATER LOCATION - 10' East of Sewer In consideration of the issuance to me of a permit to building described above I agree to do the proposed work in accordance with the description above forth and in cam ce with of1 provisions of ordinances of the city of Fridley. $100. '—Sewer Connection Charge In consideration of the payment of a fee of $ 35.00 , permit is hereby granted to Homedale Blders 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 violation of any of the provisions of sssaiid ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does net cover the construction, hoftWen for wiring, plumbing, gas heating, cower or wafer. Be wre to see the Building lnnpecfer for copanft permits for them hens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER - ADDRESS ADDRESS LOCATION OF BUILDING NO. ��% STREET �� PART OF LOT _ LOT 3 BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK `� SIDE y-YARD SEYER ELEVATION P3 ' 7 9 TOP OF FOOTING -7 Applicant attach to this form two certificates of survey of lot and proposed bu'i'l�ing location dr wn on t��hese wo certificates. DESCRIPTION OF BUILDING To be Used as: Front_Depth Height y Sq. Ft._ %/Q.�?/ Cu. Ft. 3 O3a' Front Depth Sq. Ft. Cu. Ft. Height Type of Construction ?��Lrj�iZi Estimated Cost /x,71® To Be Completed The undersigned hereby makes application for.a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley 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. DATE 7 _SIGNATUREol (Schedule of Fee Costs can be found on the Reverse Side). ��;`'✓ f t ' Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and U Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: 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 AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ... .................. 3.00 $ Each add. 320 sq. ft. EDR 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 $ 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 .......... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS 8i REPAIRS TOTAL FEE $ — ROUGH FINAL (REMARKS— Dept. of Bldge. Phone 560-3480 City of Fridley: The undersigned hereby makes application for a permit for the work hereic 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. Fridley, Minn_ ��j 19 — Owner Kind of Building�/� Used as i To be completed about�� Estimated Cost, $ Old— Building Permit No. 7 , Permit No. 6� DESCRIPTION OF WORK HEATING or PO PLAINTS --Steam, Hot Water, arm,- � —No Trade Name— , £� ��i� Size Capacity. Sq. Ft. E.D.R /�� G`� BTU H.P. Total Connected Loa Kind of Fue BURNER — Trade Nam � J Size No.11d!22e5 Capacity Sq. Ft. E.D.R� BTU H.P. signePAY N. WELTER HEATING CO. 4637 CHICAGO AVE. By WINNE a Palle 9. MIN - .E Business Phone No-� �0 City of Fridley Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone 50-3 DESCRIPTION OF WORK Number, Kind and Location of Fixtures I GCi NO. RATE TOTAL Number Fixtures ....... .............. €'BI $ Future Fixture Opening ................ Zai New Fixture Old Opening .............. pz ta�3z O 113 J $ U' z • • WATER HTR. x $3.25 $ yz ; $ GAS FITTING FEES: NO. RATE T��OTppA��L--ll io 3 o 1st 3 Fixtures .... ......... ............. LL o U < U�' •1 (�'� o� 0 O F N GAS ELEC;. Base 1st 2nd 3rd 4th • Future Connection Openings Connected with * New Fixture, Old Openings I 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 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater a $2,00 $ GAS FITTING FEES: NO. RATE T��OTppA��L--ll 1st 3 Fixtures .... ......... ............. — x $2.00 $fid Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description TOTAL FEE 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 qnd correct. Fridley, Minn, Owner Kind of Building Used as To be completed about Estimated Cost, Old—New. Build ROUGH FINAL • a Business Phone No 4101 City of Fridley, Minn. N9 9672 BUILDING PERMIT Date: April 17, 1968 Owners —Gerald Helmer Builder Western Garages Address 7486 Melody Drive Adder 30th & Lyndal,e S._ LOCATION OF BUILDING No. 7486 _Street Melody Drive --- part of Lot Lot — 33 Block _.rteAddition or Sub -Division .._._ M.l ody Mayor 4th Corner Lot .__ Inside Lot —.. X Setback — 15 ' -- Sideyard 51 Sewer Elevation --- Foundation Elevation DESCRIPTION OF BUILDING To be Used as: LGarage Front 20' Depth 22Height 10 Sq. Ft. 440 Cu. Ft 4400 Front Depth Height _ Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost 1200X00 __ To be Completed In consideration of the issuance to me of a permit to co the building cribed above I agree to do the proposed work in accordance with the description above t rt h and in pli nee with ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $-6m ) ., permit is hereby granted Western Garages to construct the build14 or0addition 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, conatructton, alteration, maintenan=palr buildings within the city limits and this permit may be revoked at any.th#e upon vions of said ordinances, GASTERMAM, OFFICIAL NOTICE: Tlds permit does not cover the construction, Instellatton for wiring, phmbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MUMESOTA OWNER'S NAME BUILDER ADDRESS � ADDRESS-10-sT +ZG/t� ` SO MN OF $UILIMIG No. 7LIC to LdT _3 .BLbCK._ �?�ITiON OR StMDIVY$ION�iv T �� CORIMR LOT INSIDE SETBACK IWO SIDEYARD S� SEWER ELEVATION ••'�TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Ce-r,,ei$$cates . DESCRIPTION.. '*' #UILDTI�G t To Be Used As: o� Fronta Depth Heigh f `�J Square feet y � � Cubic Feet Front Depth' .g}stw,,-' Square feet Cubic Feet Type of Construction 414o644 -- Estimated Cost 110.0 To Be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and represents stated is application are true and correct. oe DATE _ _ .�,z/� 4# ,_' _SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). fia / - r 100� City of Fridley Application for Plumbing and Gas fitting Pertnit 879'01 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 74.86 Melody Dr Number, Kind and Location of Fixtures Location y x $2.00 S Future Fixture Opening ................ x $1.50 u, 3 Y o u. Z N U< W �U' °d w �U' o� ? 0 O • F • N WATER HTR. GAS ELEC. Base x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st tonn 1 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I 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 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 Gas Range to 199,000 BTU .............. l x $5.00 $ .00 REPAIRS & ALTERATIONS—Refer to Code 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, blinn.5 Jan 68 19_ Owner Hcimedale Bldrs Kind of Building fr Used as res To be completed about Estimated Cost, $ 5.00 10 Jana Old—New. Building Permit No Permit No. sign -42 B Business Phone N ROUGH Description ........... TOTAL FEE $ 42 CITY -OF FRIDLEY INSPECTION DIV. Effective On January 1;1993 e431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace Gas Piping (Needed with new furnace) 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% of Value of Appliance or Work Rate TOTAL 00 $ 20.00 $ $ 10.00 $- $10.00 $10.00 $ State Surcharge TOTAL FEE$ �4? 0 MINIMUM FEE FOR ANY HEATING/COOL INGNENTILATiON REFRIGERATION/AIR CONDITIONING PERMIT iS 115.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDR 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. r®41993 BUILDING USED AS &�6544A04)cz-, ESTIMATED COST 14W PERMIT NO. No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name K— Size No.96Q BTU V HP EDR ' Fuel Total Connected Load Burner Trade Name LZ Size No.,�l�� BTUHP EDRF HEATING COM Signed By Tel No.� Rough In Date Final Date Approved By =. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: .1. Has been carefully examined Yes (NJ/)' No ( j 2. Is free from rust or deterioration Yes (Vi) No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes (14) No ( ) 5. Meets all current Code requirements for size -and total BTU's connected Yes (41) No ( ) Has total heating BTU's of -_�� ` +6. All other BTU's TOTAL BTU's Remarks List Alterations Beinq Done: RAY N. WELTER HEATING CO. HEATING COMPANY , 45.37 Chicago Ave. SO. MInneap®IIs, NDN 55407-3592 Signed By Date D -m HEAT IHSS CALCLAATIONS Weatherstrips A.S.H.V.E Guide aaddo a Doo Reference a=N0 es= 0 19 -?-,3 P— -Roam I U imvtlt d �I R DEPARTMENT OF INSPECTION Conatmetion No. Out. Wall lat. WaU Ceiling I Roof floor Width Height If F1.1 Windows and Doom—Crackage and Area No. Width Height No. of Lineal ft. of pan of pane llsht■ of crack Area no tt. /0 A & Infiltration ,(; , t En,. wall Infilt-ation '7 ,4V : (✓ Exp. wall . % . j S s/ Coef. Btu Infiltration Glass Ceiling Floor Glass Exp. wall Exp. wall Net exp. wall Net a .p. wall Int. wall _ Int. wall Ceiling Ceiling Floor Floor Total Btu. I _ Required sq. ft. E.D.R. or sq. ins. WA. Leader area Fl.I Room I Lenath Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal It. No. of pane of pane I1gh1e of track Area p. It. ,% /0 A & Infiltration Glass En,. wall Infilt-ation . Coef. Btu Infiltration Exp. wall Ceiling Net exp. wall Floor Int. wall Glass Ceiling Floor Exp. wall Net exp. wall Int. wall Ceiling Floor aUtal Btu. Required sq. ft. E.Q.R. or sq. ins. W.A. Leader area Fl./. C'Room WidtF� Windows and Doors—Crackag d Area Wldt1AHeight No. of Lineal ft. Area No. of pane or pane 116618 of crack oa. It. Btu Infiltration I LJ Glass 611L,Z/ Exp. wall M01 I Net exp. wall .1.764 ZY1141 Int. wall Ceiling Floor Total Btu. P- ; _': ed N. ft. F D.R. or aa_ i ^'..4. I., • a a a Insulation Kind How Applied Room I Length Width bight Windows and Doors—Crackage and Area Width Height Neof Lineal ft. Area No. of pane of pane licit of met p. It. Width I Height Ho. of Lln"I ft. Ana of pane of pane lights of emck eq. ft. Coef.1 Btu Infiltration Glass En,. wall Infilt-ation Net exD. well - - - Glass a Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Total Btu. _ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.I Room I Length Width Heiallt Windows and Doors--Craekage and Ana Width Height. No. of Lineal It. Area No. of pane or pane his of crack SQ. rt. Width I Height Ho. of Lln"I ft. Ana of pane of pane lights of emck eq. ft. Coef. Btu Infiltration Glass Exp. wall Infilt-ation Net tip. wall Glass Int. wall Exp. wall Ceiling Net exp. wall _ Floor Total Btu. Required sq. ft. ED.R. or sq. iris. WA. Leader area Fl.1 Rnnrrt I Lenoth - Width Hei-aht Windows and Doors---Craekage and Ana INC. Width I Height Ho. of Lln"I ft. Ana of pane of pane lights of emck eq. ft. Coef. Btu Infilt-ation Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Iotas rite. - Rrrtutr#4 sq_ ft. F i? I?..,r�.Z Q/_a. f rr. r arca SUBJECT PERMIT NO. City of Fridley -- AT THE TOP OF THE TWINS BUILDING PERMIT255- r? RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r L I PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 I'J 612-571-3450 910-F15 5/25/94 JOB ADDRESS 7486 Melody Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 33 4 Melod Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald Holmer 7486 Melody Drive NE784-0166 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. North Central Builders 740 533-6168 3763 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 ❑x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside dwelling; Reroof dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. If second layer, it can be 2nd layer but not 3rd. Smoke detectors shall be provided adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. 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 ISTALLS 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 470 $7, UM $3.73 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- $99.00 Fire SC $7.47 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $115.20 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI V---PERL VALIDATED THIS IS YOUR PERMIT DATEnZ 9 SiGNATURE OF OWNER OF OWNER BUILDERi IDATEI Prepaid Plan Ctmck Effective 1/1/90 Estimated .Qwt CM or FAMXZY Receipt # 02MERM3" 7nwffifid-2c Building Permit APPliftticm Construr-ttion Address Legal Description — TYPE OF WOW [] New [] Addition Alteration -Describe Ae�rr '000, Applicant Signature #533i//68Dat. <--c7,3-?jI *"4+ 5705 �ijofq I I Length, Width Height sq. Ft. # of Stories Sq. Ft. x $ Cost/Sq. Ft. = Valuation Sq. Ft. x $ Cost/Sq- Ft. = Valuation Sq. Ft. x $ C0.st/Sq- Ft. = Valuation 7M VAUJE Building Use Construction 7Mm occupancy Group Air MinditionIM []yes []No Fire Protection Provided_[]Yes []No Performance Bond Amount $- See Reverse for Schedule Received []Yes []NO PeMit Fee . $ 05?f.,0,P See Fee Schedule on Reverse Side Plan Check ,01A0 $ P. In Eamss of Prepaid Amount - See Reverse Side State Surcharge $ 3,23 $-50/$1,000 Valuation (See Sched. for > $1 Million) SAC 09krge4;-C� $ $600 per SAC Unit Park Fee 61;111~ Fee Determined By Engineering Spec. AssesmMentS $, Neoessary Mt NeaWwxy DrivewayEscrw $ •rl X -,sixto/foot TOTAL $ AD[ numat VrIPULMnams C ff.- REYMM sne Y1 7A CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES; APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR nth.... Wash Floor '�'�tG}X'•:'•>::: Auto. Urinal TuE3 Shower Sk` Tray autl*`':` Drain ati'?'` Washer NO. RATE TOTAL 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 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS OU 1.5% of Value of Fixture or Appliance t _ State Surcharge $ .50 TOTAL FEE $ Effective On March 1, 1996 Gas Misc'<« Water Heater Range . yct........ Gas Elec JOB ADDRESS -2 7 f� mv_ AdI61 J The undersigned hereby makes application for 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 Building Used As Estimated Cost 7 5 PERMIT NO._ PLUMBING CO DANY GAVIC & SONS PL! IMBING 12725 NigR@R!! ,- �^ l SIGNED B �� Cli 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 SO INCHES, :1TY OF FRIDLEY INSPECTION DIViSION i;431 university Ave NE =ridley, L4N 55432 APPLICATION FOR POWER PLANTS AND HEATING, C0OLING, VENTILATION, 763) 572.3604 REFRIGERATION MD AIR CONDITIONING SYSTEMS AND DEVICES !!ATEMOLLE tesident'ial Furnace Shelf and Duct Work, Burner - Also Replacement Furnace (Side Vent • Fill Cu; Back) Gas Piping (Needed with neer furnace, but not replacement) Gas Range Gas Dryer *'Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) %, of Value of Appliance or Work ,onnmercial/Industrial 1.257 of Value of Appliance or Work Rate TOTAL $ 30.00 $ 10.00 $--- $10.00 __ $10.00 $10.00 $ $ 25.90 State Surcharge TOTAL FEE .EINSPECTION FEE $47.00/Hr Air Conditioners can not be placed in a side yard without mitten permission from adjoining property owner. Effective On January 1, 2000 . c .. - CC�ty :dEw1��r.�..Aa■�r�..arse�■ BUILDING USED AS ESTIMATED COST _ ?ERMIT NO. �� dE�RIPnO OF FURNACE AND OR"IJR.,y HER No. of Heating Units Circle One (Steam) (Hot Water) (V1arm Air) Trade Riame� _.�_.____- _ Size No. -- - BTU_ HP __ EDR_. FUel—w—____. Total Connecter! Load Burner Trade Name —Size Pio. BTU ..__ HP ��------ EDR The undersigned hereby :Hakes application for a permit for the work herein specified agreeing to do all work in strict accordance with the C'tty Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct DATE_....__....._._.__� T m r Ze-d `thiol COMMON VENT VENT CONNk -LTOR AND COMBUSTION AIR VERIFICATION When replaging an existing immoce, 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 glasticJPVC 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 fisted assembly and meets the current codes and manufacturers specifications: This does include AGA -LAMA Category t Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( No ( ) The exlstnsr combustion aft is sized and installed to meet the current odes and manufacturers specifications. Yes( No( ) When required to Install a new combustion ai&:d will be sized and Installed To meet the current codes and manufacturers specifications. Yes( No( ) When Installi _ as now 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 1 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 Tjtp„® and SIzelCommon Vent and Vent Con Wj Infon Appliance #1 Type BTU Input _ Fan Assisted or Nat Appliance 02 Type _ _.T. BTU Input Fan Assisted or Not , 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 Dight tt Length _ft Diameter _fin Type Appliance #2 Vent Connector Heigh ft Length .ft Diametern Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTI-RATIONS:IOescrlbe) I FORD N MF MWAR, Z0/Z8 ' d S89868L 01 )3lat szi d0 K113 140U BS : Z L 0802-SZ-AON Building LUDING THE COST OF LABOR AND MATERIALS: 19 7UB E S HEDULE) OCCUPANCY TYPE BUILDING $ Permit No.: ;T68-6oX 4 Inspections Plan Review RESIDENTIAL APPLICATION Received By 763-572-3604 Fire Surcharge $ .001 times the total job valuation Surcharge $ CITY OF FRIDLEYn .0005 x Permit Valuation Minimum $.50 'ill IN In inn 763-502-4977 FAX 'S °'; $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-08 Curb Cut Escrow $ DATE • I (' O � YOUR E-MAIL ADDRESS t n �� IN�STE2RlC01ySZ-(?� Ttc�r�1 10 C • CO SITEADDRESS "14'66 Mt� �-1 . $450 Conservation Plan Review THIS APPLICANT IS: ❑ OWNER E CrONTRACTOR $ PROPERTY OWNER/ NAME: rJ L_rra�rL Sewer Main Charge TENANT _ ADDRESS: _7L►®le F-At_-t_z, 4 bra- CITY STATE f t\IZIP Total Due PHONE: 11a3 • -I % q . d I (o4 _ S Make checks savable to: Citv of Fridlev Attach Stiuulations NAME:N,\ ADDRESS: 4-�D \ i\w 't -I -sTE I 1 SCITY,; c71� tS �C STATEkn/ ZIP _41 J. CONTRACTOR SUBMIT A COPY OF PHONE i i D• FAX % -z- YOUR STATE LICENSE STATE LICENSE # 2-0 S1 to EXP DATE PROPERTY TYPE 0.91INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION BIGARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH WIOOF 3M ❑ DRAINTILE ❑ DECK 9'SIDING o t., L -r 499a kF- ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION C<IIAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: IU- rLLK�)Y cZi Sl t�� sy E.X % S -C -t rl< L 1 Ami. -t SIZE OF IMPROVEMENT 2� LENGTH Z- P WIDTH 2 Z HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY -1P �g ® AAL -L4 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: SIDS FOR NEW CONSTRUCTION INCLUDING DECKS, CfVinyl [Koffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum GYFrim �/.j 1°�L% L !9 c EkfriUla 1. Site Plan/Survey showing the existing structures ❑ Other cia -' and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS 0<es ❑No LO�AOF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED�I AwER OF WINDOWS Z - ALL FEES ARE BASED ON VALUATION, (USING THE TOTAL JOB VALUATION $ `� LUDING THE COST OF LABOR AND MATERIALS: 19 7UB E S HEDULE) OCCUPANCY TYPE Permit Fee $ M.15, See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 40 / .0005 x Permit Valuation Minimum $.50 License Surcharge $ 'S °'; $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 $ _ S Make checks savable to: Citv of Fridlev Attach Stiuulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the inallin n 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 Codeunderstand this is not a permit but only an application fora permit and work is not to start without a permit on site; that the work will be in accore with #Wppro the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAMEj�'j , W- Mt.r DATE & • ((v .W APPROVED BY DA I PLEASE NOTE: SIPARATE'PERMITS'ARE REQUIRED OR PLf1MB1NG ELECTRICAL AND MECHANICAL WORK/ 11 From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/26/200612:02:13 PM dta 2\(p.(q� Building OCCUPANCY TYPE BUILDING Permit No.) 0QftQJ!5—q Inspections Plan Review RESIDENTIAL APPLICATION Received ByAll 763-572-3604CITY $ 10.qU.001 OF FRIDLEY DatR m . d DATE VL1CA I C*1 YOUR E-MAIL ADDRESS License Surcharge SITE ADDRESS O . CE9511- -"bl SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow THIS APPLICANT IS: ❑ OWER kONTRACTOR Erosion Control PROPERTY OWNER/ NAME: Slnoucan * atrr ld �U\CY1eli( Park Fee ADDRESS:Sam.y CITY STATE—ZIP TENANT $ PHONE: 1(03 --rls(-1 — 01LaLO Total Due CONTRACTOR NAME: N�*-W VY,.nd AMS SAS %YV!FACA STATE LICENSE # 2LQM12(cFzk EXP DATE �� ,CJI d Tnvi SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:_ w [A 13d. E CIT _C rVMK . A) __STATE ZIP 55=0 WITH APPLICATION PHONE FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED1NDOWS E3 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE?REPAIR INC DESCRIBE WORK BEING DONE: Ynnq 12- wind AM SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. OOFI G ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT' I. Existing Floor Plan GARAGES 13 ATTACHED GARAGE 2• Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of sW crural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. 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 Xes ❑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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION OCCUPANCY TYPE Permit Fee $ L 66 4 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 10.qU.001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 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 $ , 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; that the work will be in accordance with the approved plan in the case of all work w requires review/and approval of plans. ) SIGNATURE OF APPLICANT 9i� PRINT NAME DATE /01;2t'47E77'