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PRE 2010 DOCS/3,9 City of Fridley, Minn. N° 9869 BUILDING PERMIT Date: August 7, 1968 Owner: Miles Lynn Builder ._.__C emron Inc ._ Address Address 4411 Central Ave. N. E. LOCATION OF BUILDING No. 7370 Street — Memory Lane --- Part of Lot Lot -L-- Block 2 Addition or Sub -Division ._ Melody Manor 2nd Addn. Corner Lot .w_ x Inside Lot -- Setback 35' _ Sideyard _ 17' 16' Sewer Elevation ____ X70.39 NNE 873.39 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 3,0' Depth 24' Height 16' Sq. Ft. 144&L Ft. __28..800 Gargge Front 20' Depth 24 1 Height 10' Sq. Ft. _420 Cu. ft 4200 Type of Construction _ Frame Est. Cost — $25,5 00. 00 To be Completed Sewer Location - 60.5' Southwest of Manhole Water Location - 49.5' Southwest of Manhole In consideration of the issuance to me of a permit to cons uilding describe�abq to do the proposed work in accordance with the description above o and p�ons of ordinances of the city of Fridley. 00.00 Sewer Connection In consideration of the payment of a fee of $ 48.00 , permit is hereby granted to Clemron, Inc. 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 said ordinances. Official Building NOTICE: Sh permit don not cover the construction, tmfallation for whine, plumbing, gas hea8ne, sewer or wrier. Be sure to we the Building Inspector for separate permits for then Nome. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ADDRESS ADDRESS LOCATION OF BOILDIN NO.STREET APART OF4 X17 LOT_ BLOCK ADDITION OR SUBDIVISION CORNER LOT SIDE LOT SETBACK, SIDE -YARD f1— 1001- SEWER SEWER ELEVATION P0.3 FOUNDATION ELEVATION f'73.3,9 aJ lug — G 0. S_ , 11'el . u� Applicant attach to this form'fiwo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION AF BUILDING To be sed as: Front DepthZ�—Heigt t Sq. Ft. Cu. Ft. Front — Depth -Pie ----,Height Sq. Ft. Cu. Ft. Type of Construction To be completed �U Estimated Cost���� The undersigned hereby makes application for a permit for the. work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and. hereby declares that all the facts and representations stated in this -application are true and correct. DATE_c'SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). G A City of Fridley Application for Plumbing and G= F'ini'ng Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures N I Number Fixtures ......................—s'�' ►► x $2.00 $ ii ;� Z o� New Fixture Old Opening .............. Z �� Z Seta C4 �6 cog w �Z e� ? Zd coo • F • N WATER HTR. GAS ELEC. Base a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $200 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st 2nd _ 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Cesspospo 0 ol El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................—s'�' ►► 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 $ 3.00 New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $200 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code vofV City of Fridley: 1� 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. �D Fridley, Minn- 19/ Owner CZ CM I?®AJ nL 4w $ Kind of Building 72C-� . Used as To be completed about Estimated Cost, $ d O Old—New. Building Permit No Permit No. 1471-1 signed[\�A ft.. 7 L��t �� i ry C• Business Phone No ROUGH FINAL Description ...................................$ TOTAL FEE $ 42 5. o� az Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam .... . ................. 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TSa`!'AL 1st 3 Fixtures x $1.50 $ Additional Fixtures ................ x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM a ALTERATIONS & REPAIRS LFINAL- See GH Fee Schedule TOTAL FEE Dept. of Bldgs. Phone 560-3450 .ocatien zm� City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Frojey, Minn Kind of Building���� Used as To be ca Estimated Cost, $ O1dBuilding Permit No. �/ d /a Permit No. 4139 DESCRIPTION OF WORK HEATING or POW34 PLANTS -Steam, Hot Water, 0 arm Air No / Trade Name���2Z� �Size No ,1 Capacity Sq. Ft. EM.R BTU . f �'� H.P. Total Connected Load ----=AzoKind of Fue T X� BURNER — Trade Name's Size No Capacity Sq. Ft. E.D.R. BTU H.P. 94AY N. WELTER HEATING CC. Signed 463? E j 188AGE3 AVE. 42 Business Phone No- X��5 4f5�A� (REMARKS -OVER) . D,56 c HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINMN A. -%)LIS. MINN. Weatherstrips Constrwctlon No. Insulation _T -A Guide I __ I How Applied )j�mclows Doors Reference a R �x --No da—No 9___ W,Jtl-, Height Length-,�`17. _rlHeight" ------ Fl. IF,, —R. in Le�t,g,,h r j Windows and Doors—Crackage and Area i I Wd(n-,,,, and and Area Width No. of pane Height of pane lighis of r1k—"2 It, I Btu --- Width llelght No. of pane of pane NoW i lights Cc III us :2 Glass Total Btu. Required sq. ft. Coef. Btu Infiltration Room 1 Width - - Coef. Btu_- Infiltration : i :` ; Glass __ Infiltration R:,77_4_ --!'J"), or sq. fi;. W.A. Le!,&r area �J Exp. wall a/ L Glass Net exp. wall Int. wall Exp. wall Net exp. wall ceilin${ Ne` exp. wall Int. wall Ceiling J Int. wall Floor Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Floor v Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader -area 0;. Room I Length,/:7 ` Width Height Windows and Doors—Crackage and Area, and Area lal-A ft, of ­,tol, Ar a I ft. Btu --- Width llelght No. of pane of pane NoW i lights Cc III us Floor Glass Total Btu. Required sq. ft. Coef. Btu Infiltration Room 1 Width - - Coef. Infiltration : i :` ; Glass Glass - R:,77_4_ --!'J"), or sq. fi;. W.A. Le!,&r area �J Exp. wall a/ L Net exp. wall Int. wall Net exp. wall ceilin${ Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area IFI.IZ j,, %, — Room JLenszth/,/-' Width '* - -' Height -,c Windows and Doors—Crackage and Area, Net exp. wall Width Height No. of No. of pane of pane lights of crack ft. Btu J_ Int. wall Cc III us Floor Glass Total Btu. Required sq. ft. Coef. Btu Infiltration Room 1 Width - - t—Width No of ItI It 1. c' pang ft. _ : i :` ; Glass - R:,77_4_ --!'J"), or sq. fi;. W.A. Le!,&r area �J Exp. wall Net exp. wall Int. wall ceilin${ riour Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. I eader area of r an, I , 11 hts- or crack eq. Coef. Btu Glass _Fxp._W•113 - --Netexp. -waAl Int. wall cellirfx Total Btu. Pequi!-ed s(j. ft. F.D.R. or v.j. -ns. W.A. Lx.-Aer area F J/ i Ruq,ryl I Length Width Height V/ ndows and Doors and Area ffewt rz:, of I Lin it -ft --I A'rea No. 1, r I'a e W t,ane Ight, It I ,q, rt Coef. Btu Infiltration Glass 3. Exp, wall Net exp. wall Coef. Btu J_ Int. wall Cc III us Floor Glass Total Btu. Required sq. ft. E.D.R. Or Sti. K'n'%._W.A._ Leader area 5 11,11-i Room 1 Width Windows and Doors—Crack-age and Area t—Width No of ItI It 1. c' pang ft. a Height,',", Coef. Btu Infiltvation Glass Exp. wall N"! eyp. wali 4 - Total Btu. R:,77_4_ --!'J"), or sq. fi;. W.A. Le!,&r area Ri Room 'Lenstl, jjn" Wit th Height Windows and Doors—Crackage and Ai -ea ', !at,� Height No. ,f pa,- ,f Slane No r f light, Lj,.(,l ft. of crack A rea. q. I(, Coef. Btu Infiltration 1,71,eal ft. of crack —Area sq. ft. Glass Exp. wall Coef. Btu Net -xp. wall Int. wall Coef. Ceding --Infiltration Floor Glass Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width 7 height Windows No. and width e Doors Crackage and Area Area sq. ft. 1i I ht No. of K "f 1) ana lights 1,71,eal ft. of crack —Area sq. ft. Coef. Btu Infiltration Glass Coef. Btu --Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Required sq. ft. E.D.R. fir sq. ins. W.A. Lcader area Net exp. wall Int. wall Cedilig I , 1001 Total Btu. Rt-quircd sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length i Width ,^) � Height W.Indows and Doors—Crackage and Area , ldth No. of pane Height No. of Lineal ft. of pane lights of crack Area sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Required sq. ft. E.D.R. fir sq. ins. W.A. Lcader area SUBJECT PER �46 City of Fridley 'ERMIT 7 1� AT THE TOP OF THE TWINS B U I L D I N P R%IPT N�0. ...... COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 9 5/17/83 JOB ADDRESS 7370 Memory Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I 1 2 melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Willis Lynn 7370 Memory Lane N.E. 786-1974 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 El NEW 0 ADDITION ALTERATION 0 REPAIR 0 MOVE 0 REMOVE x 8 DESCRIBE WORK' Construct a 141 x 201 Addition iDwelling 9 CHANGE OF USE FROM TO it STIPULATIONS Provide Fire Alarms on P'16'th levels. WARNING fturedigging call local' 00100 MEMONE - ELEOMC- 0914: SEPERATE PE OITS REQUIRED FOR WMING REQUIRED .01 LAW, HEATING. PL I�MBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS OE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Al) VENTILATING OR CONDITIONING. THIS PERMIT BEC( MES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NIT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SU 6ENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTE WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CE IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I ISTALLS IGARAGES AND KNOW T E SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDIN CES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $11,100 $5.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT -DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $92.50 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $23.13 $121.18 S GNATU CONT TORO UTHORIZEDAGENT (DATE) Z��Zoy W XHEN PROPERLY ALIDAT R RMIT IS YOUR *(21 IZZ. J�HIS �h I I -i INSP TZ SIGNATURE OF OWNER oF owNJP BUILDER) CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDHIG PERMITS (New. Alterations. Additions. or Repairs) OWNER: _L.t/ / zfi'� ®s L Y" BUILDER: _ iJ CJ(/ /f� �• ADDPJSS: 3 SS: TEL 110: �� q 7 `f TEL N0: Construction Location . STRIST NO: 7S,76 6T1tEiT: s i m AA LOT: t NhOOCi IID ITIOti: GS Corner Lot: Inslac Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOR OF CONSTRUCTION 9"ront: Depth: ? Height: f Square Feet: I & Cubic Feet: Front: Depth: Height: Sare Fest: Cubic Peet: . Type of Construction: Estimated Cost: 2b Be Cbr-pleted: Alt. A Alt. B Proposed Drivmiay Width If New Opening is Desired: $ SEE MVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the work herein specified, Agreeing to 2!b ,all work iJ, strict accordance with the City of Fridley Ordinances end rulings of the Delmxtment of Buildings, and hereby declares that all the facts and representations stated in this application are a and co.-rect. DI1TE: i�' � � <�'� ® 8I GN7►TU:�: Stipulations: 7cA .,S0roe I,' CITY OF FRIDLEY INSPECTION DIV. Etfective On August 1, 1995 rl 643' University Ave NE -� Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT o 572-360x4 MARK NUMBER OF FIXTURES TO SE INSTALLED ON EACH FLOOR Waw Bath :Wash I Floor Catch : Auto. Gag 1IAISc = ^Warier 1 meter Stories ,Closet- Urinal Tub Shower Sink': TM Fount:':': Drain Basin Washer I: Range Fin iGas 'EW m Basement ► : i -� Floor 1 Floor 2 r I Floor 3 Floor 4 __4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS T `°�I, c- rn New Fixtures S 7.00 The undersigned hereby mak©s application for a permit for the work herein J Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Slow Off Basin $ 7.00 and representations slated in this application are true and correct. i Catch Basin $ 7.00 .199600 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Q� qq // Water Treating Appliance $10.00 Owner � �cs�c2 4)i /45 21 � -1 '32 Water Heater -Electric, $ 7.00 Water Heater -Gas**$10:00 7go Building Used Ase sd�,c, Gas Range" $10.00 a Gas Dryer" .$10.00 Estimated Cost � PERMIT NO. Back Flow Preventer Required ( )Yes () No �� A r� Type $15.00 PLUMSING COMPANY �.x Wr ar Reinspection Fee S42.00/Hr SIGNED 8Y !l•Id�+�> t NO.sA' ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or ApplianceA----�=» /l w Approved By Rough -In Date Final Date 00 State Surcharge $ 50'v z MINIMQM FEE OR ANY PLUMBING&AS PERMIT IS In. 0� ���t G TOTAL FEE $ PLUS THE 50 STATE SURCHARGE o .._ 00 **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES. 0 N N Orete►t Test Report for Jabi W "1 1 G ,� � � ry Add7 0 �--- Dale of Insult ° ` _ ` Unit Hi Type of HT. FIA+.._---- H'W-----"" Spm HT...,...._ Mwe Lea! a+q3 Model Sem q 7 M 6 input 1®® Pilot Type Cow w CO2 4. �- PmWre input (FNM S%CkTemp Name OtTester 10- u-�a C,l1� 41, + CPiY OF FF4DLEY INSPECTION DIV. Effective ®n January 1, 1997 6431 University Ave NE Fridley, M 55432 APPMATION FOR POWER PLANTS AMO FEATING� COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDMONM SYSTEMS AND DEVICES JOB ADDRESS '� 3? 0 �'l e �, opt v► � n IL1 e� RATE SCHEl�fLE The undersigned hereby makes application for a pomp for the work herein Residential Rate TOTAL specified agreeing to do alk work in strict accordance VA the Cky Codes and aFumfacse Shell and Duct Wodt, Bumex - rulings of the f3Wng Division, and hereby declares that all the fads and Also Replacemdtt Furnace $ 30.00 $ 33- a representations stated in this application are true and corred.- (Side Vent -Fill W Back) Gas Piping {Needed wNh new furnace} $10.00 $ 16, cep OWNER. Lor n 5 Gas Range $10.00 $ BUILDING USED AS S l t� Gas Dryer $10.60 ' ESTIMATED CC1sT Z.Z o s-- f RrauT NO. 3 5'►9 3 2 `) 'Air Cond t Ang- - Ali Sizes $ 2500 $ DESCRIPTION OF FURNACE AND OR_ R AN OtherstRepaas & Al<erdons (LIST ON BACK} 11% of Value of Appliance or Work $ No. of seating Urts___J,_w Circle One (Stearn) (Hbt Warr) arra ai Trade -Name 4. v? n, o 9 Size No. Commercial/Industrial SIV. oo0 , 4 c® --_ HP EOR 1.25% of Vaiuie of Appliance or Work $ Fuel "� Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. ®TU HIP EM. TOTAL FEE zwro HEsll TNG OO Y -A moA 4 e •�►. c�-P- MINIMUM FEFEE FOR ANY NFATiN C00MN(sIVE"LATIOfV A I TIO IT10NQ P AMTI3 $0.00 Si! wd By 9z Tel No. _ �o - I 1014) PLUS THE $.50 STATE SURCIHARG'E 1 REINSPECTION FFE $42 -OW App!gved 8y Rough-InDate Fatal Date D 'Air Conditioners can not be placed in a side yard without FILL.()UT.BACK WE STACK VERIRCATION ON written permission Irian adjoining Property owner. REPLAf ELME( 3NT R.04ACE r_ r i am N 0 M co N JUL-10-1897 12:12 CITY OF FRIDLE`( 512 571 1287 P.02/02 The undersigned hereby - ver Uft that the •e cisfng chimaey or stack: 1. Has becuefyUy a =dwd . Yes ) No e® ( ) .2. Is, bw from raat'or aiie oratioa Yes ) No { 1 3. Has w forcigm objecd Iod&d'lr t Yes ) No ( ) Is securely supported Yeses) NO ( ) Meets all cuireut Code --dints for size and trotal BTU's connected Yes`(-) No ( ) Has total heating BTU's of AU other BTU's L-9 4 TOTAL BTU's , Inas a Baer bees wovzded. for water beater 'Yes ) No ( ) 8. Has combustion, air been. ffo ded fbr:waW. plieatar Yes .) No ( ) e . 7..1. !'� • u r . :.i J;e:%:n i • S!na 1.,.�' . �: �i:'P(••y 1 '�OJ✓tir r it �' K1. � .'��� •; e � i fi. t }S' � v •5i r � r,. R=m .. .. � �N*' �V.� 9� 7r'.v'i"'..n.. i'ht �. � i! + i �St..d' �. .•'� It ''C .. ka �.,r` eii'�i; :yep y.. ty+2 a+ . •. HEATING CO: Signed By Date: �0-?t�,- Q11 TOTAL P.02 - 1 "T'1 7 SUBJECT City of Fridley 25898 AT THE TOP OF THE TWINS BUILDING PERMIT 1 , NO. COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 4/6/98 JOB ADDRESS 7370 Memory Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Willis Lynn 7370 Memory Lane NE 786-1974 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Roofing 18979 Gladstone Blvd, Maple Grove MN 55311 20010277 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 416-4804 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION I1 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (18 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 $1,127 $.56 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- STRUC N R THE PERFORMAN OF CONSTRUCTION. $40.25 Fire SC $1.13 PLAN CHECK FEE TOTAL FEE t --� - License SC $5.00 $46.94 NATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PRgO�PERL ALIDATED THIS IS YOUR PERMIT �G,a � 4 V BLDr.1 IN SP Y-- 4g — FATE SiGNATURE OF OWNERIIF OWNER BUILDERI IDATEI - 1 "T'1 7 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 l BUILDING PERMIT APPLICATION ConstructionAddress: 7� %C� Re "-k?0 r � I -q •^ 7—' (fr ` d (e 2 Legal Description: Owner Name & Address: l Contractor: Vy l idSC) Address:1 +S / 7'? 6e1&-- ,4 /vd. Tel. # 796 _MN LICENSE #200 16d x.31,1 Tel. # y16 Y' 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: Len th Width /Hgt/Ground Sq. Ft. �-- OTHER: r - f od &L6 C --, Co,(',c—E Construction Type: 9C — D o I Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. 6� Ft = Ft x $ _ $ DATE: Permit Fee $ �S Fire Surcharge $ . State Surcharge $ t S7(,:, SAC Charge $ License Surcharge $� Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ . STIPULATIONS: Tel. # &116 - V?o K CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1,1999 6431 University Ave NE : Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ® ® Lam `b' RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct �,� (Side Vent — Fill Out Back) —� ,19W Gas Piping (Needed with new furnace, $10.00 $ ILS but not replacement) OWNERIOU S rl Gas Range $10.00 $ BUILDING USED AS 1�ZZ&J61fnts_ Gas Dryer $10.00 $ ESTIMATED COST I � "/J � � PERMIT N0. *Air Conditioning — All Sizes $ 25.00 $ `� DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (UST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial - BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. 19I11 Rough—In Date Tel No. _& / 2—Vc) --S —b All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being one: Y HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned. hereby verifies that the existing chimney or stack: L Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No (. ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being one: Y HEATING CO: Signed By: Date: Building PLUMBING Permit No. I�;60 uc -04/6 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-2010 SITE ADDRESS _ THIS APPLICANT IS PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE !(.11114 :ff3VI:V 1 "; 077�x�1 ❑ OWNER 73' PHONE: /e, 3 - ;M 6 -/;r 7? STATE /K"'ZIP NAME: STATE LICENSE # EXP DATE CJ STATE BOND # EXP DATE 12- 3 ADDRESS: �J S �!� 6 r-o"e- 6'', V'_ CI���41 :e2 G Gr, 'STATE Ati ZIP ( L PHONE FAX 11 PERMIT TYPE I SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE II TYPE OF WORK: ❑ NEW kiREPLACEMENT DETAIL DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. _WATER _ BATH SINK/LAV _FLOOR DRAINS SHOWER PIPING —BATHTUB _ GAS PIPING (NEED CITY LIC) _ _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY _ _WATER HEATER ($35) _ FOR IRRIGATION WATER METER OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all wo kwhich requires review and approval of plans. �9 SIGNATURE OF APPLICANT PRINT NAME -F -F A -v/ DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977