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PRE 2010 DOCSCRYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 - FAX (763) 571-1287 - TTD/ITY (763) 572-3534 CITY COUNCIL ACTION TAKEN NOTICE January 6, 2009 Sikh Society of Minnesota 5831 University Avenue NE Fridley MN 55432 Dear Sikh Society of Minnesota: On Monday, Monday, January 5, 2009, the Fridley City Council officially approved your one year extension request until January 5, 2010, for Special Use Permit, SP #07-09, to allow the construction of a worship facility in an R-1, single family district, legally described as Part of Lot 11, Auditor's Subdivision #155, generally located at 5350 Monroe Street. Sincerely, Scott Hickok Community Development Director SHrb cc: Special Use Permit File Address File Mary Fitz Stacy Stromberg C-09-01 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7'00 7.00 GRAVITY WAR,.1 AIR: RATE TOTAL Job Address Furnace'Shell & Duct Work $12.00 $ STHa.11 OR HOT KATER SYSTEM: Replacement of Furnace 7.00 7.00 $ $ Department of Buildings Repairs & Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 7.CO $ Tel. #571-3450 MECHANICAL WAR..\I AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7'00 7.00 $ Repairs & Alterdtions-up to $500.00 $ Repairs & Alterations each add. $500.00 4.00 $ STHa.11 OR HOT KATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.CO $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 B;J see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING �) FAN HEATING SYSTEMS VENTILATING SYSTEMS -` ALTERATIONS $ REPAIRS ROUGH INSP. Date FLIM INSP. Date APPROVAL FOR PER.*1IT _/ x $ 3.00 $ x $ 1.00 $ _ x $10.00 $ S See Fee Schedule $ S $ State Surcharge $ .50 TOTAL FEE $S� REINSPECTION FEE (.$10.00) MINL%IUM FEE FOR ANY HEATING PEILMIT IS $7.50 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. / — /3 , 1977 OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT t� ESTIMATED COST � OLD NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air No. Trade Name Size No. O� Capacity Sq. Ft. EDR BTU V HP Total Connected Load 1���. ,/T� Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company . Signed By qq Tel. No. S-' S -3 /01 SUBJECT PERM City of Fridley o 17 6 51 AT THE TOP OF THE TWINS BUILDING PERMIT rp � RECEI COMMUNITY DEVELOPMENT DIV. INSPECTION S C. q �� Cl9 r PROTECTIVE 1 . � CITY HALL FRIDLEY 55A32 NUMBER REV. DATE PAGE OF APPROVED By 612-571-3450 910-F15 8784 JOB ADDRESS 5850 Monroe Str t N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 8 Donna S SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Willie Jones 5850 Monroe Street N.E. 571-7929 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Improvement, Inc.Central Avenue N.E. 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK t2541 9 CHANGE OF USE FROM TO STIPULATIONS East/West rim joist must be tripled or add post. SEPERATE PERMITS REQUIRED FOR WIRING. %MAxION G HEATING, PLUMBING AND SIGNS. Before digging call local utilities Ityp {ONE - ELECTRIC - CAS Etc-tc- REQUIRED BY LA 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 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 $4�4SO $2.23 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $50.50 None CTIO R THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $12.63 $65.36 GNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATE)' (WHEN PROPERLY V ATED THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG VATE /01 NEW [ ] City of Fridley Effective 4/1/84 ADDN. I ] �R-1 AND R-2 ALTER. I ] Building Permit Application Construction Address: 5�95-0 Monleve- 57ZEE7" AR, Legal Description: w Owner Name & Address: V" � l// a �0y� Tel. 0 `� 7 2/ Contractor: �� �/4/�E � � � �C Tel.# 70LX q Address:L Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width _._. Height Sq. Ft. _ - DECK AREA: Length _ Width _ Hgt/Ground Sq. Ft. _ OTHER:'A%L� i� ��� - 2 s - 1z.4RS Q 44 Zkf4�L"ff.Corner Side Yard Set1b�ck Lot Inside Lot [ Yd. Setback Type of Construction: Estimated Cost: $ � f e Approx. Completion Date: G! 577z�m Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE. APPLICANT: /0Og ��• -�'! Tel. # %��� Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Dain Charge TOTAL CITY USE ONLY $ 9b.Fee Schedule on Reverse Side $ �e�i . �i� 25% of Building Permit Fee $ 3 $.50/$1,000 Valuation $ $425 per SAC Unit ' $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a S AG STIPULATIONS• 1 17 SUBJECT P IT City of Fridley 20096 AT THE TOP OF THE TWINS BUILDING PERMIT i R • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. '7, r PROTECTIVE 1 ; i_J CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/5/89 JOB ADDRESS 5850 Monroe Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 8 Donnay's Lakeview Dm Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Deloris Jones 5850 Monroe Street N.E. 571-7020 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. K & D Remodeling 9272 Yucca Lane, Maple Grove 55369 420-6967 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 241 x 12' Deck Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. WARN* G ^` Before digging call for all utility location$ 454-0002 , REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. 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 $2,050 $1.03 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 STRUCTION OR THE PERF RMAN OF CONSTRUCTION. P AN CHECK FEE TOTAL FEE " ft .-1 $55.03 GNATURE OF &ONTRACTOR OR , HORIZED AGENT I ATE WHEN PROPERLY VAL ATED THIS IS YOUR PERMIT li"' SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI - BLDG INSP f1ATE 17 NEW [ ] ADON [ ) ALTER [ ) R-1 AND R-2 Building Permit Application Effective 5/1/88 Construction Address: .5blj O 12-zc d% 1-c ,jf ,z -- Legal Description: 0 T 0 39 -i LA- Owner Name & Address: //� % /� /' S / _ yv S Tel . # ,P Oontractor: Tel. Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. L�BCRTPTIM Cr Til a I I - VEHM LMM AREA: Length Width Height Sq. Ft. GRRAM AREA: Length _ Width Height Sq. Ft. DDCR AREA: length Wiz/ ` Width / Z- Hgt/Ground Sq. Ft. 07M: tyx -/. (;> z Qj Corner Lot [ ] Inside Iat [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ °- Approx. C mpletion Date: - 3a - �i W Proposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back' /Page .ICM DATE: `7 .� 8 APPI: Tel. # �ya2® �' �.74, Permit Fee $ .b State Surcharge $_ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Ctlarge $ S'I'IPUTATIMS: "3,5-06 CTPY UBE QNLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by F3�i rwpri r� Agreement NAY [ J Not Necessary [ ] �4 e- &"L.Is E) 2&O /107 t SIP41ME HEATING HOUSE HEATING TEST RECORD AIR CONDITIONING AND ELECTRIC. INC. ADDRESS AAc:gt4�ja -'O-fE APT, FLOOR CITY SUBURB OCCUPANT Ola&P'M I � A o S OWNER HEAT LOSS DATE HTG. INST. SOLD BY kJC-f- INSTALLED BY 9I®►..>a. C®J Electrical Work ByT4A A, , an Lino By TYPE OF HEAT GA FA HW STEW SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE a"s- MAKE OF BURNER Model i<l►® Soo 6 ® Modal Serial 3q q&) Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS O�er THERMOSTAT Heat.Plug Vent Site `f e Valve KIND OF LINER SIZE NONE Limit Daft Hood Regulator Limit Setting Filters gin'g Number f Fan Setting Chimney Location inside Outside Pilot Type Chimney Construction Pilot Make U 07)3 Pilot Model S t° c- Smoke Bomb Whines Pilot Timing Dab Test Tag v L. W. Cut Off Door Pressure I.iplttinp InsL 4� Pressure Percent CO, Date Tested `7 Input CFH Percent Or Company Testing p s'i IJ',- eStack StackTemp. Percent CO ® C k Name of Tester Form 235 C TY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/I ndustrial 1.25% of Value of Appliance or Work Rate TOTAL $'30.00 $ $10.00 $ $10.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION 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. .50 Effective On January 1, 1997 JOB ADDRESS ; rat "' The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in, strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. 1 L ,1997 OWNER. TY -1 C)ft I_�-(US 5- -7 7 - 7J1 Z 1 BUILDING USED AS LSP tnQ ESTIMATED COST. I q C,0 �� PERMIT NO. E3 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) a ) Trade Name J3 Y14 A Size No. 336ffL, BTU_ i ati Cr3i'> HP EDR Fuel no_J GG S .Total Connected Load Burner Trade Name Size No. BTU HP EDR BLAINE HTG. A/C ELECT., INC. 13562 CENTRAL AVE. N.E. HEATING COMPANY . ANOKA, MN 553n4 Tel No. -7 5j 7:� p ) Approved ByRough-In Date Final Date 11 jlo FILL OUT BACKSIDE r STACK VERIFICATION ON REPLACEMENT FURNA E CEnAEVEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes (�), No ( ) -3. Has no foreign objects lodged within Yes (,r) 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 <o G(adw 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 .(,6 No ( ) Remarks: E.. y List ALTERATIONS Being Done: HEATING CO: Signed By: Date: F SUBJECT City of Fridley 2 6 8T331) AT THE TOP OF THE TWINS BUILDING PERMIT r T N/ RECEIPT O �• COMMUNITY DEVELOPMENT DIV. L _ PROTECTIVE INSPECTION SEC. ?. 461 1 , NUMBER REV DATE PAGE OF APPROVED BY 'j CITY CITY HALL FRIDLEY 55432 L 612-571-3450 910415 7/27/98 JOB ADDRESS 5850 Monroe St NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 8 1 Donna s SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Dolores Jones 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Lennander Co. 523 Central Ave N Osseo 55369 429-2227 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 jp REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (24 S • sidin • windows 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. Call for building wrap inspection before covering. Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of home. 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 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 I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX Fire SC AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $18,498 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- State SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $274.75 PLAN CHECK FEE TOTA EE^ C SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE, EN ROP VALIDAT THIS IS YOUR PERMIT i BL INSP LATE S.GNATURE OF OWNEROF OWNER BUILDERI IDATEI F NEWKA Effective l/ 1/97 ADDN [ CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 3 (D l 3 ConstructionAddress: sg� L&o Y'® s64 - Legal Description: Owner Name & Address: n` Tel. # Contractor: a n Z c/ -P r C 'd - MN LICENSE #C960.39a,-Ik Address • .5d,3 fle-� 4-rci ) (tel -L) ,e • Tel. # 4q5 -,9aa` -2 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEA El\NT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Lengtb Width Hgt/Ground Sq. Ft. OTHER: 0 0 G - 1 4 Construction Type: ted Cost: e (Fee Schedule on Back) " Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: `' APPLICANT: Tel. #_ CITY USE ONLY Permit Fee ��7/ /� - Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ _ $950 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 STIPULATIONS: City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P } 33135 � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 763-571-3450 RECEIPT NO. NUMBER 910-F15 REV DATE 10/4/02 PAGE OF APPROVED Br JOB ADDRESS 5850 Monroe Street NE T LEGALLOT DESCR. NO. 1 BLOCK 8 TRACT OR ADDITION SEE ATTACHED Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dolores Jones 5850 Monroe Street NE 571-7929 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sussel Corporation 654 Transfer Rd, St Paul, MN 55114 651-645-0331 1934 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE REMOVE B DESCRIBE WORK Remove existing detached garage; Construct a 38' x 20' Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Install a hard surface driveway. NON AW AG SEPARATE SERI REQUIRE® FOR: PLUMBBIINd AN®SIGNS SUO11900 an lie J01 IWO 6O1661p ejoleg ONINNYM SEPARATE PERMITS ARE REOUIRED 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $15,557 SURTAX $7'78 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TION OR THE PERFORMANCE OF CONSTRUCTION PERMIT FEE $265.25 SAC CHARGE Fire SC $15.56 /X\1 PLAN CHECK F Lice e C $5.0 TOT L FEE $293.59 NATURE . RACTOA OR AUTHORIZED AGENT iDATE. SSGNATURE OF OWNER..F OWNER BUILDER. iOATE, MEN ROP L VALIDAT D THIS IS YOUR P MIT 04 .NSF' FIAT[ NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 750 A o to r-6,. s --r 0:5-7 Legal Description: Owner Name & Address:Da4e>R *kS _10 V)*,s -�S XS© A,0922,- ST N -W, Tel. # -!S� 2 ' 79"MQ Contractor. S U -CS EZ MN LICENSE # Address: 6!&4 ~Ta211 test-fi�� �� , S'T SPA �r t �'- )1 Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width -P-0 / Height JZ Sq. Ft °/26 Width Sq. Ft Construction Type: W®&O -PP A -5-; Estimated Cost: $ 15- �5_ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: C) �00'2- APPLICANT. Tel. # 464-S^ ZD,3x 7 Call (763) 572.3604 for Permit Fees if mailing In application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CO $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ STIPULATIONS: /8 ✓4 /B /� 17 !¢ /7 !� 2 17 /6 /•s i ZZZ•3 'tn 29 z•''' Z �1�3 ZB 3 vb�IG .yti 5 plot •� .•• s . N 26 . 1 1 •' �' B Z3 •W 23 � . • Z3 B � ZZ 9 - /3 l3 _ /S 44 17 / so �••K pf g /% !� w Bo / G) /a, sq eo so so 30 30 IS 49 z� f)�� :��k' 59TH AVE. N.E. (40 f K!s e 6'�� 1) /f//; ' ►� 1s �s �s .;�+ (� 8 qya ¢ MARIGO TERRACE. (9) n 7 7f ,•y 9089 ' he /8 . (0) . /2 /O AVENUE .... 58TH Bo Bp, eo: • - s 0) �Aa z� .� . -; ` �,,/° •°. 60 9a ({9) �>o) �) (iii (� v 2 5.�� i � � � � ��� 3 x � ��� ••' � �(r) °� c 'ilk (�) 1, IF 'T• �q �� /� oZ .. � PLACE ° �� A no HELENEs) ��, �� O• (�� � 6 y � c -oma' '�) ,6t�) C,G, (�) �4 2 1 � ��� 0 9�� � 'Y N• . /2 s v rZ . 7 01 �, a ;ITY OF FRIDLEY INSPECTION DIV. 431 University Ave NE 'ridley, MN 55432 763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FI)M IRFR TO RF INRTAI i Fn nN i=Aru izi nrw ® .t.," 2 • a TOTAL 0 � $10.00 ' ASF • )Id Opening, New Fixture 54 �® specified agreeing to do all work in strict accordance with the city codes leer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the fads flow Off Basin $10.00 and representations stated in this application are true and correct :atch Basin $10.00 JONES, DOLORES(� ®S Iain Water Leader $10.00 5850 MONROE STREET NORTHEAST 2U iump/Receiving Tank$10.00 FRIDLEY, MN 55432 Vater Treating Appliance $35.00 OWNER (763) 571-7929 Vater Heater -Electric $35.00 Vater Heater - Gas** $35.00 11 BUILDING USED AS Re d eyt� Sas Range** $10.00 Sas Dryer** $10.00 op ESTIMATED COST �� PERMIT NO. lack Flow Preventer Required ( )Yes () No ILUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_ _ �t,�nnn& NA.,%r- Sew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes leer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the fads flow Off Basin $10.00 and representations stated in this application are true and correct :atch Basin $10.00 JONES, DOLORES(� ®S Iain Water Leader $10.00 5850 MONROE STREET NORTHEAST 2U iump/Receiving Tank$10.00 FRIDLEY, MN 55432 Vater Treating Appliance $35.00 OWNER (763) 571-7929 Vater Heater -Electric $35.00 Vater Heater - Gas** $35.00 11 BUILDING USED AS Re d eyt� Sas Range** $10.00 Sas Dryer** $10.00 op ESTIMATED COST �� PERMIT NO. lack Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY NO teinspection Fee $50.00/Hr SIGNED B TEL N0. ('folZ) $Z7-033 kLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ TOTAL FEE MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. :OMBUSTION 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 replacing 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 existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This. does include AGA-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 : From: City of Fndle\, To: 7637542906 Page: 214 Date: ar' 6/200211:00:09 AM 3uilding 1° ECH-4—NICAL Permit No.: rVI inspections SIDENT���.� �,p��,�� ,��g�� !Received Bt 76 3-57%-46047 7- F CITY Off' FLES' � e� El CTIVL-19-0-0 1)ATI- - O - 0 YOUN E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER YCONTRACTOR PROPERTY NAME: DtJ oog-S ,j 6 A U.% ADDRESS: S So pa b n0 -OL tv� CITY F& t,01, STATE&I" "LIP SSu3� OWNERI 'TENANT PHONE: '7 - S7I S 3 CONTRACTOR COMPANY NAME: lv ✓ C" LA SUBMIT A COPY OF CONTACT PERSON: Cdn r e j r P� _FIREPLACE (GAS) $15.00 YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: Y-19 t' CITY Ple-t 0 1`„ STATE^' --ZIP JS til APPLICATION PHONE 7G 5, 7 '-( J t k FAX PERMIT TYPE ANGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW IeIIEPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ✓1 SQA FEES ARE BASED ON $10.00 PER FI)cTURE, E CEM' WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: u V 0 MODEL: UA PL.- 0 1%f SIZE/BTU o1 Tb ✓\ MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _A1RTO AIR EXCHANGEER $ IS _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 $35.00 FURNACE$35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 _GAS GAS PIPING $10.00 VENTILATOR $15.00 .., ........:.......... .....::. ...::::. ...... ........ .....:. THIS IS AN APPLICATION FOILA 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 i5 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. r, SIGNATURE OF APPLICANT C I� A- ✓� PRINTNAME ( jn r t J IPC 10 p DATE PLEASE NOTI? SL FARATE PERMITS r�R:EREQLIIR.ED� FdR BU-lLDIN€ ..ELECTRL�kL i�.ND ME{.HRq�IIC.AL W-ORiL:: ::::: City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, TN4N 55432 763-572-3604 FAX: 763-502-4977 r