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PRE 2010 DOCSCity of Fridley, Minn. BUELDING PERMIT Date: ...... - � .- ............ Owner ....................................... Builder Avow.� Address ...................................... Address �.��.�� Awe N® 3869 LOCATION OF BU LDING No. ...<�.�. /.. Street . ..:�' ... .. .. �.. Part of t ....... ... .. ...... . ��yy��rr / .. Lotrl�` .^ Block .............. Ad on or Sub -Division �'! .. .. Corner Lo . y;........ Inside Lot ............ Setback—..��... Sideyard ............. DESCRIPTION OF BUILDING To tLe Used ,. . ... Front . >7.®. Depth3�p:� Height / .. ®_ Sq. Ft. /tl. I .(I Cu. Ft. � 4 Front I.. ® Depth .�1.V: ��r Height . f Sq. Ft.. Cis. Ft. Type of Co coon ................... Fat. Cost. ;7Trn To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth7 in pliance wi1j# all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $.. /.. permit is hereby granted to .................. . ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with - In the city limits and this permit may be revoked at any time upon violation of anyo the provisions of said ordinances. s .... Building, Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspect4r for separate permits for these Items. It N4iND_Ep ING LAND sua.,E,.IENG+�EERs SUR�/.rN AND c -4i �►I„ EYaRS CIVIL 8t. MuNICIpgENOINEERtNQ bet 18 -S6 THAVt_NUE N. SOILS TESTING MINNEAPOLIS LANA CL"NNING 22,MNVN. If otq "t- a�fa J.- __....• _ J�l p •jA Application for Rohrer Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Pho U 4-7470 VP 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 $ NECK. 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 TOTAL 1st 3 Fixtures ...................... x $1.50 $ a Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIA CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARKS: $ See Fee Schedule TOTAL FEE $ 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. Fridley, Minn- Owner inn Owner �e — , 195— Kind of Building 195— Used as 9 To be completed about ltd Estimated Cost, $- 01d Building Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, OVarm Air o r Trade NameSize No Capacity Sq. Ft. E.D.R —o ?; &V R�r� H.P. Total Connected Load U i Kind of Fue BURNER — Trade Name_ Size No Capacity Sq. Ft. E.D.R BTU H.P. S' Byje�� _ r r"' ; CORPORATION 4626 U'7 -'C -;A! E AVENUE NORTH 11 POST 1M-12-58 Business $�QATR �. U . 2, MINNESOTA JAckson 9-9549 D-56 .x.. 'c r, IsL�J�' l�I�QG/��fd�L� ��L. �(�j to 70V .HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS OpffM *NN. Weatherstrips A.S.H.V' . Construction No.. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19— F1.1 ' 1 d)DRoomiLength7 Width / Height II Fl.� Room Length Width Height Wie ws an Doors—Crackaae and Area Windows an oors—Crackage and Area Width Height No. of Lineal it Area No. of pane of pane lights of crack sq. Width Height No. of Lineal f . Area No. of pane of Dane lights of crack sq. ft. 6' &1dL J Coef. Btu Infiltration Glass Coef. Btu Infiltration Infiltration 103/3 9 Glass Int. wall Glass Exp. wall ® Floor Net exp. wall 7 t Int. wall Int. wall Net exp. wall Ceiling / Ceiling IGITO Int. wall Floor -- A--# �j 19 0% - -- --- , ---=— Windows and Doors—Crackage and Area ---- Width Height No. of Lineal it Area No. of pane of pane lights of crack sq. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. f Coef. Btu Infiltration Glass 4 Q1`3 Exp. wall m Infiltration Net exp. wall Int. wall Glass Ceiling ® Floor Exp. wall 2 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pa lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. f Coef. Btu Infiltration Coef. Btu Infiltration ,�'Z IS— Glass Int. wall ® C:) Exp. wall 2 Floor Int. wall Net exp. wall Ceiling / o IGITO Int. wall Ceiling b Floor Total Btu. iced sq. ft. E.D.R. or sq. ins. WA. Leader area No. I of Btu Infiltration Glass Net exp. wall 0 Int. wall Ceiling Floor Total Btu. -7;:i-7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F9_I i -koom I L.enath 3 Width TiHeight Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pa lights of crack sq. ft. Coef. Btu Infiltration 1 Glass 62 - Fsp• wall 2C Net exp. wall 10 1 E-50 Int. wall Ceiling / /� Floor Int. wall Total Btu. ®( Required sq. ft. ED.R. or sq. ins. WA. Leader area 1F1_I X Vfr� Rnnm I rnwth Widthm -5 Height c Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration 62 - Glass ® Exp. wall y 4 Net exp. wall ( �_® Int. wall Ceiling / Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area u SUBJECT PERM14439 City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � �3 I . � CITY HALL FRIDLEY 55432 NUMBERREV. DATE PAGE OF APPROVED BY L"" ,•� 612-560-3450 9t0 -F15 10/24/77 JOB ADDRESS 936 Mississippi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW T -S ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Storage shed 9 CHANGE OF USE FROM TO STIPULATIONS 1. Locate at 4' from property lines 2. Must be attached to a permanent foundation. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 15O ft. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT S q. 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $500.00 .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTALFEE 113 1 $8.00 SIGN URCONT o o �UTHc}iiIZEDAGENT 1DarEt WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT W W, W4,rL-- IVJ2- , /C1,; 2-�/ `% BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) f (DATE) u CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS., OR REPAIRS) OWNER: ��-� 17�Lt�`�i /1 BUILDER: Address: ST Z2 -J' Address: Tel. No. No.. LOT: 3 CORNER LOT: Street: BLOCK: ADDITION: /Overt INSIDE IAT: SETBACK: SIDEYARDS: 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: i S -to, et & Front: �_ Depth: Height: f i Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ `j 00-o o To Be Completed: Proposed Driveway Width If New Opening Is Desired Alt. A Alt. B (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representat' s stated in this application are true and correct. See reverse side for' alditioual information. DATE: SIGNATURE: Stipulations: 7lsL } G, SUBJECT PE NO. City of Fridley 8 3 8 7 72® 4THE TWINS 572-3W4 THE BUILDING PERMIT EI COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. / E 1 = I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-FlS 10/22/98 JOB ADDRESS 936 Mississi pi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1/2 of 3 1 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Valentina Helmin 571-1438 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION kax REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 25 SO 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 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 1 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 $2142 $1.07 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 FiTe .SC $2.14 PLAN CHECK FEE T L FEE ATURE OF CON'RACTOR OR AU O 2E0 A¢ENT IDATEI 7.96 EN Y VALI AT THIS IS Y/DAUB PERMIT WS-GNATURE OF OWNERi6 OWNER BUILDERI (DATE, BL INSD ov PATE NEW ADDN ALTER ConstructionAddress: Legal De Owner IS Contract Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ., Effective 1/1/98 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: Le gth Width Hgt/Ground Sq. Ft. OTHER: �a62'z��Ghr�� ,. (;? 'O -a v - Construction Type: Estimated Cost: $ / ` , (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ sm, �� APP .'�/i/1i��` `:ems �//�tL� - i STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, D $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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 $ IN94,. STIPULATIONS: U 11' v1 I I<IULL ) Il ZA 1 k, = 10N HIV (3431 University Ave Ni- F Ildley, MN 55432 (763)572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NI IMRFR C)I= FIYTI 10C -C Tn oC IAICT Al = r_n �►. r n.. L Ileclive Un Jan 1. 2u02 PLUMBING FIXTURE RATES: New Fixtures Old Opening. New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/ReceMng Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () N( Type NO. RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ -7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 50 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT 1NFO ON BACK SIDE J013 ADDRESS 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 fads and representations stated in this application are true and cotrecL Fall W�, a I M/ w Building Used As Water Bath Estimated Cost �y— PERMIT NO. p �'� c rLL"K Stories Closet Urinal Tub Wash Drink. Floor Catch Auto. Gas GasMlsc. Water Heater FAX # Shower Sink Tray f=ount. Drain Basin Washer Appl, RangeFitt 9t : Elec Basement MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT' IS $20:00,! PLUS THE $.50 STATE SURCHARGE .;..::Gas Floor 1 Floor 2 ...... Floor 3 .. :i.:i.:;.:::.: •; Floor } .. ..:.....:.max PLUMBING FIXTURE RATES: New Fixtures Old Opening. New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/ReceMng Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () N( Type NO. RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ -7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE 50 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT 1NFO ON BACK SIDE J013 ADDRESS 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 fads and representations stated in this application are true and cotrecL Fall W�, a I M/ w Building Used As Estimated Cost �y— PERMIT NO. p �'� c PLUMBING COMPANY SIGNED BY TEL FAX # Approved By o: Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT' IS $20:00,! PLUS THE $.50 STATE SURCHARGE . °-�� THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT. VENT CnNNPCTnR Amn r.QMR1 lSTlnN AIR VIRRIFI CATION ,'- '• When rn la in y-�a an _Y _ n ng,fj-granna, 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 manufacturel's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The axisting cnmhiiatinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a now nimmint intron airitwill be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When installing a now vontinQsYstom, 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 #1 Type Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 HEATING CO: Signed By: Date : rye 11110.E CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR GOWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas'Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/ Industrial 1.25% of Value of Appliance or Work EA 1 ecLive 1JaIIII a ry I, 2UU3 h State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING C oor igned FAX # 71 U�5 e -15-7 - E5%51 Approved By71A Rough -In Date Final Date f FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRES�SI `U: I I I al HIfA OWNER �V ffU4/., Rate TOTAL i BUILDING USED AS $ 30.00 0 $�� tr '' C4- OCC ESTIMATED COST I ,� PERMIT NO. -21 $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heat'"nits I Circle One (Steam) (Hot Water) arm Air) $ 10.00 $ Trade Name I�1� O Size No. BTU -1n. C)0 HP EDR $ 25.00 $ Fuel -i— Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING C oor igned FAX # 71 U�5 e -15-7 - E5%51 Approved By71A Rough -In Date Final Date f FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r-QMMQN VENT, VFNT CQNNFCTnR AND COMBIIRTInN AIR VFRIFICATIoN When rapine—Ann an Pxinfinn .ran _ , 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 (q') No ( ) The venting system is plastictPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. .YeT�) 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 Yes) No ( ) assisted and natural draft appliances. The av nfing rnmht mhnn Air is sized and installed to meet the current codes Yes( NoC) and manufacturers specifications. When required to install - new nnmbuchnn airs it will be sized and installed Yes) No( ) to meet the current codes and manufacturer's specifications. When iostalWigr now yenbnAyytm, 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 Yes No( ) Venting Tables for fan assisted and natural draft appliances. 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 #1 Type r- f n Q c c- BTU Input Vi o ®0 Fan Assisted or Nat Appliance #2 Type 0, /Je-u 4 BTU Input 3-2, so® Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 119 �4040 Common Vent Type e (4-;5 g Vent HeightvZ— Diameter 5- inches Appliance #1 Vent Connector Height ft Length _-�- ft Diameter Y in Type 0 Appliance #2 Vent Connector Height _j_ft Length J—ft Diameter If n Type c_ Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: D Signed By: C 0 CITY OF FRIDLEY PERMIT NO.: 2004-00020 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/08/2004 572-36U4 !''AIL: ADDRESS : 936 MISSISSIPPI ST NE PIN : 133024320032 LEGAL DESC : UNAVAILABLE LOT BLOCK PERMIT TYPE PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT NORTHWOODS MECHANICAL BOX 1085 FOREST LAKE, MN 55025- (651) 257-4951 OWNER HELMIN VALENTINA 936 MISSISSIPPI ST NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 ENTER VALUATION 500 0 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 construction or the performance of construction. lica�\ .1 AnnDate , Bldg Insp. PLBG PERMIT MINIMUM FEE 20.00 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 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTRATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 6061 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 ADDRESS : 936 MISSISSIPPI ST NE PIN : 133024320032 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00021 DATE ISSUED: 01/08/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, RUUD, 70,000 BTU) # A/C UNITS 0 VALUE OF APPL OR WORK #FURNACES # GAS RANGES APPLICANT DEPENDABLE INDOOR AIR QUALITY INC 2619 COON RAPIDS BLV COON RAPIDS, MN 55433-3900 (763)757-5040 OWNER HELMIN VALENTINA 936 MISSISSIPPI ST NE FRIDLEY, MN 55432 I # GAS DRYERS 0 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 cstruction or the performance of construction. AnPAieant T Datel I 1 HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 39220 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0.00 30.00 0.00 0.00 0.00 0.00 0.50 30.50 PER MS 16B.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 f• Permit No.: _ °� C� 3 Building MECHANICAL Inspections RESIDENTIAL APPLICATION Received By: 7.63-572-3604 CITY OF FRIDLEY Date Recd: Z l®G YOUR E-MAIL ADDRESS DATE SITE ADDRESS 13 6 syr /1. - THIS APPLICANT IS: OWNER OCONTRACTOR PROPERTY NAME: aL tfv 57-ef1-e1-V STATE AW ZIPZ ' 6n ST� OWNER/ADDRESS: S -gf CITY TENANT PHONE: b "5 S 3 - S &-d� -7&-3 CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: EXP DATE YOUR STATE STATE LICENSE H CITY STATE ZIP LICENSE WITH ADDRESS: APPLICATION PHONE FAX MNGLE FAMILY [ITWO FAMILY [I TOWNHOUSE PERMIT TYPE b NEW O REPLACEMENT VAALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK 4, -- —W-- J ry PER MS 16B.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 ) Number of fixtures @ $10.00 x $10.00 = $ Labor cost under $00 = $15.00 bor cost between $300 to $500 = cost of labor x .05 = FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: INDICATE TOTAL FOR PROJECTS WHERE LABOR EXCEEDS $500, x $15.00 = $ NUMBER OF EACH BELOW) MODEL: MFG: SIZEIBTU Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: (GAS) $15.00 SIZE/BTU GAS RANGEIOVEN $10.00 A/C $25.00 _FIREPLACE AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 GAS UNIT HTR $10.00 BOILER $35.00 _FURNACE $35.00 HIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $3500 y�VENTII.ATOR $1500 DUCT WORK $10.00 GAS PIPING $10.00 THIS IS AN APPLICATION FOR A PERMITNOT 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 �aH �workh��es view and approval of plans./SIGNATURE OF APPLICANT PRINT NAME A��" G- DATE 3l K 6!%4� City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 $ Number of fixtures @ $10.00 x $10.00 = $ Permit Fee $ 50 Number of fixtures @ $15.00 x $15.00 = $ Surcharge TOTAL DUE $ 50 Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMITNOT 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 �aH �workh��es view and approval of plans./SIGNATURE OF APPLICANT PRINT NAME A��" G- DATE 3l K 6!%4� City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT, RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fue11MC Chapter 7 with MN Amendments b. Natural Gas or propand FGC 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 other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 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 make up air calculations Building „ BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE '3 Z O 6 YOUR E-MAIL ADDRESS SITE ADDRESS 93 6 �'y%rssiSSi�li THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: M cc -, k 14os-End-f--W a TENANT ADDRESS: It CITY En -1101-c,, STATEA/,!,/Z/IP 55y3Z PHONE: -76-3 s'3 �� 3 d�� 7& 3--0-3 -1- �� `i i CONTRACTOR NAME: .001 times the total job valuation STATE LICENSE # EXP DATE $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION pH FAX RISINGLE FAMILY/NEW CONSTRUCTION SIZE SAC Charge PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE }ADDITION ❑ GARAGE/SHED INDOWS R + 6 ft = ft x $20 = $ M BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER $ ❑ SWIMMING OL Fee Determined by Engineering TYPE OF WORK: ❑ NEW ADDITIO Ile �oi MAINTENANCE/REPAIR 21� EMODE G Total Due DESCRIBE WORK BEING DONE: �t F'f is ��z-��f SIZE OF IMPROVEMENT LENGTH / 3 WIDTH HEIGHT 7.6 Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. 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 ❑Yes ❑No LOCATION OF WINDOWS pp OR FOR NEW OPENINGS -DESCRIBE SIZE OF 6 e �! �� t�=6V-ro --c OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED f_ v`C -rS NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDINU 1'tiE CUS'1- UY LAI3Uli AINM Iv1A I ffl'mA ua: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 61fC) OCCUPANCY TYPE Permit Fee $ a See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 00 .001 times the total job valuation Surcharge $ ,'r .0005 x Permit Valuation Minirnum $.50 License Surcharge $ % $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ R + 6 ft = ft x $20 = $ 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 which requires review and approval of plans. SIGNATURE OF APPLICANT '/W PRINT NAME M - 111f 1146AXI- el DATE 31 (� U Op�E cws Z- -_o 13 w 2 pl, I MON , - � Q % C )I A- Building PLUMBING Permit No. a Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd:' D� DATE 7- 21– D6 YOUR E-MAIL ADDRESS SITE ADDRESS 2 36 THIS APPLICANT IS: 0 OWNER ACONTRACTOR PROPERTY NAME: ,'_✓ Ste ey, ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: e ✓✓ 05- cV'_ Pu w b r o, C1 w L STATE LICENSE # 3 (8 of P EXP DATE l a 31 D ^I X 2 4.)X- b� k4 KJZIP53 % SUBMIT A COPY OF YOUR STATE ADDRESS: 17(5 3 3 g9 r^ CITY STATE '07 3 V;?oZ l ? 9 LICENSE WITH PHONE 3 17,5 FAX 74 APPLICATION PERMIT TYPE ;°SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW EPLACEMENr DETAILED DESCRIPTION OF WORK ups C� a S e w w� 9' �'� a ✓ fru 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 X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $l0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _FLOOR �_ BATHTUB _ GAS PIPING (nm cmwCEhrA _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KffeHEN SINK / WATER CLOSET _ BACKFLOW PREV. ($15) _ _(_ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER E r O ber Permit Fee $ Number of fixtures @ 10.00 x $10.00 = $$ um Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ Z=0 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 f approved plan in the case of all work whi�reires review and approval of plans. y /SIGNATURE �� 3 0� e %'�PRINT NAME �V / DATE OF APPLICANT City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections C 7.63-572-3604 DATE C 1 - o . - SITE ADDRESS q J' THIS APPLICANT IS: PROPERTY OWNER/ TENANT MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAILADD RESS i �J 1 Sv I r 1 I v� ❑nOWNER � ONTRACTOR ADDRESS: `_A3k--0 Y d j j S j�,7 f SSI PHONE: --) (,3 . -I 3 a - G a LA a - CONTRACTOR I COMPANY SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: CONTACT PERSON: Permit No. Received By: Date Recd: 9 W ATE I)_ZI* S iia STATE LICENSE # EXP DATE ADDRESS: 13562 CENTRALAVE NE CITY ANOKA STATE a9NZIP 55304 PHONE 763-757-6202 FAX 763-757-6701 SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 16B.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 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) �y � �I MODEL: �� bay SIZEIBTU a7 4-onEquipment Installed MFG: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $100.0 00 BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.OD _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ _,Number of fixtures $10.00 x $10.00 = Surcharge $ s .5011 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ _ Number of fixtures @ $25.00 / x $25.00 = $ aS,6rO Number of fixtures @ $35.00 x $35.00 = $ 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 requires jJreview and approval of plans. SIGNATURE OF APPLIC ter. PRINT NAME ROGER ROF)�011 DATE t9 -®p City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel ]MC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC 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 other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per Mr,T 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 make up air calculations