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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N® 7160 Date: �- Owner: Builder Address Address LOCATION—OF No. z� Street ��� � Y4C- of Lot Block �� Addition or Sub- vision . Corner Lot __—, Inside /Lot Setback � �_ Sideyard � � L5 Sewer Elevation' 7 -� mon IIevation e7 -A2, DESCRIPTION OF" BUILDING Tit Used Front Depth Height L6 Sq. Ft. A cu. Ft. ZFro Depth Height Sq. Ft. . Cu. Ft. l Type of ction Est. =--;—`'Fo be Completed In consideration of the issuance to me of a permit to co the buildhtg descri�r':,Ip=g do the propoced work in accordance with the description above fo in com of ordinances of the city of Fridley. In consideration of the payment of a fee of �, 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, orany part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, constructaton, alteratlon, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violatigs�, of any of the Provisions of said ordinances. rte. _ n Y NOTICE 'fhb pennh does not corer the construcHon, hrstAMon for vririaa, phrmbbrg, gas hesdng, sevar or water. Be sure to we the BWMIng hrsputor for sepm to permits for thus hens. APPLICATION FOR BUII+DING PERMIT CITY OF FR.IDIEY, MINNESOTA CLEMRON, INC.- Owner NC:owner IsName Builder G NFRA CONjRACT(lRS 3619 Benjamin St. N. E. Address Address Uinneapo!is 'a, Alan 1612"1 Alll_�Iffl No. 2� / Street �� Part of Lot Lot S Block z Addition or Subdivision Corner Lot Inside Lot_ Setbackd'�� Side-Yar SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be Completed DESCRIPTION OF BUILDING Sq. Ft. //% S Cu. Ft. s i Sq. Ft. Cu. Ft. FAX 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 repre tation stated in this appligAtion areArue and correct. �'"-� _ _, j,1s /4 _ ME" (A Schedule of Fee Costs can be found on the Reverse Side.) Land Pla piny Land SLCWY�?y Sods Teshi?9 Owl & Mmopul Enymeenfly n a 6875-Rfhj ay 065 A[E. Minnpu�a�s 7l, ENGINEERING, INC.. sUnsef 440" -�- En yineers ti Sur veyors certificate of surTe few - E it M DEYELOPWiF.Ni CO. NOTE ,r 1, Elevoi(one SIlown are eropofza +V 2, Fi�tii• Cleor• tl. 2.9 f�. eboy¢ yrwetd 49 hemse cowners . Cperitrg 71.'1 � el. g,5.o O DENOTES IRON ~! DENnE5 DRAINAGE 4 UTILITY TASEMENT LOT s BLOCK 11 MELODY MANOR 2 -SR ADDITION (Anoka Coun}X / �dy C'!4wy flid flni is o /rae aid awmel rep"" dahm ore surrey oC#jr dv+�s q'!Ar abow shod fad, aid of k ora/f ftadls , l/rrean , wd ed risible waverhmm is , tf mj, fmv or m sod /mad. As sww yal 6y me f/vs dwj - �' Ao r i I A -D. SUB URBAN ENCWNEERIN6 , INC. s /fr Sar a SCALE 1"- 30' Date: May 16, 1972 Owner: J. J. Reis City of Fridley, Mian.. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Builder Quality Construction Co. Address -.`7321 Memory Lane N.E. Address 2001 E. 04th St. Mpls LOCATION OF BUILDING No. __..7321 Street ` Memory Lane part of Lot Lot »5 . _ _ Block — 1 _. Addition or Sub -Division Melody Manor 2nd Corner Lot Inside Lot x Setback . Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Residing_____ Front Depth Height Sq. FL Cu. FL Front Depth Height Sq. Ft. Cu. FL Type of Construction Steel Est. Cost _ 1,980. To be Completed 1 month 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 pli with a'll provisions of ordYnances of the city of Fridley. �• In consideration of the payment of a fee of $ 12.00 permit is hereby granted to Qualtty Construction Co. T 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 ordinanos Of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildlIIgB W *thin ancese. city limits and this permit may be revoked at any time upon violation of any of the provisions of Said 664'�e " Building Inspector Clarence Belisle NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to a" the Building inspector for separate permits for these items. .! APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:e_J . tJ ' ` S BUILDER : ` �', �1 / T �1 sC�S ADDRESS: �� �/ `� i%l fr' i' �✓� /fl ADDRESS : , l �'� �` ! �,; ,� NO • . �oZ STREET: 1 C1, LOT: BLOCK: l CORNER LOT: INSIDE LOT: V .1. TION : O_tW azn_ J oZn� SETBACK: SIDEYARD• Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: ',Q�> Estimated Cost: $ / 9s� To Be Completed: fn 6_La The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: /"L� `�o, /� �� SIGNATURE: M4 (See Reverse Side For Additional Information.) SUBJECT P City of Fridley 0718 61 AT THE TOP OF THE TWINS BUILDING PERMIT i • • COMMUNITY DEVELOPMENT DIV. �----y--- r i PROTECTIVE INSPECTION SEC. d -9Y /"--1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ,'j 612-571-3450 910-F15 6/12/85 JOB ADDRESS 7321 Memory Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Connie Ahrens 7321 Memory Lane N.E. 535-5101 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Covenant Construction Co. 7716 - 67th Avenue North., Brooklyn Park 55428 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 535-5101 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Q ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd layer. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $11788 $.89 WITH WHETHER SPEQUED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT P E TO IVE A RITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE t3 OVISIO NY ER S ATE R LOCAL LAW REGULATING CON- $29.50 ST N THE R RM NCE F CONSTRUCTION. PLAN CHECK FEE TOTALFEE $30.39 ATURE C RORAUTHORIZEDAGENT (DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT I BLDG INSP c GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] ADDN. [ ] ALTER. [ ] Construction Addro Legal Description City of Fridley Effective 4/1/84 �R-1 AND R-2 Building Permit Application Owner Name & Address: ;gzol'e,-e S Tel. 4 S-sS—S10� Contractor Address 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. 1 OTHER: Cz� ll el" -ed- Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ % Approx. Completion Date: -��-�- Alt. A Alt B Proposed Driveway Width If New Opening Is Desi $ $ See Back Page for Explanation DATE: �� "'��57- APPLICANT; L Tel. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations l% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TOTAL Job Address 7321 Memory Lane $ 20.00 $ 20.00 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 KIND OF BUILDING City of Fridley $ 10.00 $ Tel. #571-3450 $ 10.00 $ The undersigned hereby makes application for a permit for the work herein $ 10.00 $ 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. $ 10.00 $ Fridley, Minn. August 17, 19 89. State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Da e Approval for Permit DESCRIPTION OF FURNACE/BURNER *REPLACING FURNACE WITH HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. one ONE CARRIER 58SS08OBC Trade Name Carrier Size No. 58SS080BC NAT. GAS FURNACE AND ONE CARRIER 49BG HUMIDIFIER Capacity Sq. Ft. EDR BTU 80,-00 HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE Attach stack verification form with. replacement furnace permits *Air Conditioners can not be placed in side yard without written permission frau adjoining neighbor. Company , Dependable Heating and A/C Signed By Tel. No. 757-5040 OWNER Connie Ahrens $ Frame KIND OF BUILDING USED AS Residential $ TO BE COMPLETED ABOUT ESTIMATED COST $1700.00 $ .50 20.50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. ! DESCRIPTION OF FURNACE/BURNER *REPLACING FURNACE WITH HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. one ONE CARRIER 58SS08OBC Trade Name Carrier Size No. 58SS080BC NAT. GAS FURNACE AND ONE CARRIER 49BG HUMIDIFIER Capacity Sq. Ft. EDR BTU 80,-00 HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE Attach stack verification form with. replacement furnace permits *Air Conditioners can not be placed in side yard without written permission frau adjoining neighbor. Company , Dependable Heating and A/C Signed By Tel. No. 757-5040 City of Fridley AT THE TOP OF THE TWINS SUBJECTIT BUILDING PERMIT NO. 27290 r `y �_���_ COMMUNITY DEVELOPMENT DIV. r i PROTECTIVE INSPECTION SEC. ` _-_- ��"'f;•� CITY HALL FRIDLEY 55432 L 612-571-3450 RECEIPT NO. �� $/S NUMBER 910-F15 REV DATE 8/lg/98 PAGE OF / / APPROVED BY JOB ADDRESS 7321 Memor Lane NE 1 LEGAL DESCR. LOT NO. 5 BLOCK 1 TRACTOR ADDITION SEE ATTACHED Melody Manor 2nd Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Connie Ahrens - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Golden Hatchet Roof497-4006 20003158 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 IRx REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (23 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1918.20 .96 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- STRUCTIO OR THE PE ORMANCE OFC STRUCTION. / � 4A $62.25 Fire SC 1.92 PLAN CHECK FEE TO L FEE 70.13 /��/ �I�y vie Licen 5.0 SIGNATURE OF CONTRACTORORAUTN ED AGENT IDATEI EN ROP VALIDAT/-THIS I�Sj/,,JJR I gL INSP 1C�• DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI J NEV4 [ l ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 73,2 / /:AZ v ":*w III/ Effective 1/1/98 Legal Description: Owner Name & Address: C�l/1�%��iG-t Tel. Contractor: Z®A? 7c-4 e-7— /-'/!U® y__ MN LICENSE #,,qC-t90-315"Y Address:/-` 0� /� o LIVING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EVIPROVEMENT Tel. # 7 Z �7 oA Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: l ���� Estimated Cost: $ I D . 26 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:,ZZI�5�� Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY $ • 2 5 Fee Schedule on Reverse Side $ 1- t 2 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $ OCA $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 [ ] TOTAL $ D - l STIPULATIONS: SUBJECT - I TNO. ' City of Fridley 11884 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. ' • COMMUNITY DEVELOPMENT DIV. -' >r ------ PROTECTIVE INSPECTION SEC. ` 36U 672 r � � eat( '56? � CITY HALL FRIDLEY 55432 NUMBER NEv DATE PA GE Of APPROVED BY L J` 612-571-3450 910415 6/7/01 / / JOB ADDRESS 7321 Memory Lane NE I LEGALLOT NO. BLOCK TR ACT OR ADDITION SEE ATTACHED DESCR. 5 1 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Connie Ahrens 7321 Memory Lane NE 763-784-1785 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Anderson 350 73 Avenue NE, Fridley, MN 55432 763-502-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20130983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace patio door within existing opening 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OFCONST. 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,319 $1.16 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- $83.25 Fire STRUCTION OR THE PERFORMANCE OF CONSTRUCTION SC $2.32 PLAN CHECK FEE TOT FEE LicenseAC $5.00 $91.73 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN ROP LY ALIDATE THIS IS YOUR PERMIT • ��q SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI Bl INSP - TE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLES R-1 AND R-2 BUILDING PERMIT APPLICATION Constriction Address : , 4 -3;t k Legal Description: Owner Name & Address: (It Tel. #3 •U • I�• %S Contractor:; RENEWAL BY ANDERSON MN LICENSE # 350 -73RD AVE. NE. Address: FRIDLEY, MN. Tel. # Attac. 763/5024777 arvey of the lot, d LICENSE# 20130983 ,n it to scale. LPRNG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: \_ rrnA „ I. UL ' A ... C,. Construction Type: Estimated Cost: $ D 311/0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: S -nU2Se .®1 APPLICANT: Tel. #%Sa�• 345 • U-04 I CITY USE ONLY Permit Fee $ %I • a 5 Fee Schedule on Reverse Side Fire Surcharge $ 2 . 3 a, .001 of Permit Valuation (1/10th%) State Surcharge $ . ► LA $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 0_Cp $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL, $ S TIPLTI.ATIONS: •0 l CITY OF FRIDLEY INSPECTION DIV. ;431 University Ave NE =ridley, Mha 55432 763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 S Jo APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (� 1j�0 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR )Id Opening, New Fixture $10.00 ..:.. ': Urinal i. •:F: :..<- .Shower Wash Ei<:::::r:< Floors::.:=: T ra �:.��•�' � Drain � Auto. �1�1'����. Washer &:r -�`-�.Ir'`. �� Gas Ran a <. Water Heater is Gas Elec Sto ries Basemen t<.``< $10.00 Nater Treating Appliance $35.00 Nater Heater -Electric $35.00 Nater Heater - Gas** $35.00 Floor 1 $10.00 Sas Dryer** $10.00 Sack Flow Preventer Required ( )Yes () No Type $15.00 Floor 2 :::}i:i::: :t:::k'.:'i::%: Floor 3 Floor 4 ?3,; � 1 1vOn(D it 3LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS at.S OW Al d - Jew Fixtures $10.00 )Id Opening, New Fixture $10.00 3eer Dispenser $10.00 Now Off Basin $10.00 ;atch Basin $10.00 lain Water Leader $10.00 Sump/Receiving Tank $10.00 Nater Treating Appliance $35.00 Nater Heater -Electric $35.00 Nater Heater - Gas** $35.00 Sas Range** $10.00 Sas Dryer** $10.00 Sack Flow Preventer Required ( )Yes () No Type $15.00 leinspeclion Fee $50.00/Hr 4LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ __6D TOTAL FEE $ �S The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city odes and rulings of the Buildina Division. and hPrphv ri—Lgres that all the fads and repres AHENS, CONSTANCE and correct. 7321 MEMORY LANE NORTHEAST FRIDLEY, MN 55432 Lot 23 Oq (763) 784-1785 ' 20 OWNER BUILDING USED AS I'SI d11evice ESTIMATED COST q6PERMIT NO. � '�` PLUMBING COMPANY O f' b ` a'VA wvv, bz SIGNED BYWJ11 TEL N0. "l012 $Z%- 0,33 Approved By Rough -In Date Final Date OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A, **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furnace, 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 existinsa combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When required to Install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When Installinsa 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 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 PAX: ( 763) 5 71-IZ57 PERMIT NO.: 04-01050 • DATE ISSUED. 07/07/2004 ADDRESS : 7321 MEMORY IN NE PIN : 113024130005 LEGAL DESC : MELODY MANOR 2ND ADD : LOT 5 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. TOTAL # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 400 # WATER TRMT APPLIANCES 0 APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 F JAI_ AHRENS CONSTANCE H 7321 MEMORY LN 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 worl 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 constrpction or the performance of construction. Bldg InspDate::� L-1 Lo I PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 28580 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building MECHANICAL Permit No:: InspectionsRESIDENTIAL APPLICATION Received Bt 763-572-3604 CITY OF FRIDLEY Da d: � F 763-502-4977 F EFFECTIVE -19-09 DATE �� YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: n O vc0frtm PROPERTY NAME: OWNER/ ADDRESS. CITY STA TENANT — — CONTRACTOR COMPANY NAME: Standard Heating & Pur CorxltUontng SUBMIT A COPY OF CONTACT PERSON:. 130 121yrriouth Ave, itie Not di Minneapolis, MN 55411 34 45 YOUR STATE STATE LICENSE # 612--824,2M DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE IASINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ITYPE OF WORK: I ❑ NEW _x2EPLACEME7NT ❑ ALTERATION/REMODEL I DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: MFG4+./ SIZE/BTU MODEL: SIZE/BTUl �/ MFG: MODEL: SIZEMTU /5A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW NEW GAS GRILL $10.00 BOILER $35.00 FURNACE $35.00 UNIT HTR $10.00 CIIIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 THIS IS AN APPLICATION FOR A PERMrT-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 N Imnesota Construction Codes; that I understand this is not a permit but only p tion for a t work is not to start with t a permit; that the will be in acro ance with the approved plan in the o whi iilre ew and approval of p SIGNATURE OF AP C NAME -► City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC -1 NEW HOMES/ADDITIONS )(EXISTING HOME LJ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel tither than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW 11OMES 4. Heat loss & cooling load per room a. Required on new Construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and mare -up air calculations.