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PRE 2010 DOCSCity of Fridley SUBJECT PERMIT NO. ®13106 AT THE TOP OF THE TWINS BUILDING PERMIT r ` COMMUNITY DEVELOPMENT DIV. y ------ � r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 "—•� �'J 612-560-3450 RECEIPT NO. l lvJ l �� NUMBER 91D—F15 REV. DATE 7-24-75 PAGE OF APPROVED BY JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. r. 2 1 INNSBRUCK NORM ADDITION SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ROBERT D. DEGARDNER 7950 EAST RIVER ROAD ERTMEY, MTNNE9QTA 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. YPPONE 4 ARCHITECT OR DESIGNER MAIL ADDRESS IP LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING HOUSE AND GARAGE 7 CLASS OF WORK X® NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK HOUSE - 40 x 32 GARAGE 24 x 28 9 CHANGE OF USE FROM TO STIPULATIONS PROVIDE HARDSURFACED DRIVEWAY SOD FRONT & SIDE YARDS n PROVIDE VERIFYING SURVEY SEPM7E PERMITS REQUIRED FOR WIRI SEWER: (APRROX. 9' DEEP) tEATt PLUMBING AND SIGNS, 167' EAST OF M.H. (INV. 939.39) WYE ELEVATION - 940.24 TOP OF FOOTING - 943.24 digging Call local UblitieS Before WATER: 10' E. OF SEWER SERVICE TELEPHONE - ELECTRIC GAS Etc• 57.8' EAST OF HYD. OC,QUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-] 1,280 & 672 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 $70,150 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. PLAN CHECK FEE TOTAL FEE 438.98 GNTUREONTRA TOR OR AUTHORIZED AGENT (DATE) 5I6§624WNAR(IF a EMPRPE I WHY TED THIS IS YOUR PERMIT JULY 24, 1975 BLDG INSP DATE SIOWNER BUILDER) V V (DATE) JG, •APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY,-NIINNESOTA 01.MER'S NME: 6 h -p -t- BUILDER: e0V S7&41C7ii21V ADDRESS • 7,96 PO ce. ADDRESS: NO:. I�� STREET:ho. O AJ ci LOT: BLOCK: C;2- ADDITION: iQ A.) S, fl- CAL 1 CORNER LOT: INSIDE LOT: SETBACK: 633 ` SIDEYAP.D: ( iz a Applicant attach to this 'f ors Two Certificates. -if Survey.of-Lot and. proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: ad Depth: 3k Height: Z �� Square Feet: %Cubic.Feet:`�� • Front:' Depth: Height: Square Feet;_ Cubic Feet: 6 D Type of Construction:�qa�l, y . 'r Estimated Cost: 70 TO -Be Completed: ��•/ � 7c� 90,1!,®0.. The undersigned hereby makes application fora 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: Vt.s` —SIGNATURE: (See Reverse Side For Additional Information.)' Soo 4. 5.1 ,7?� .317p ®r • a %%wvo.,wT --- --- -- — --- ----- - — - - 9z, Sg- SIK- 40 -12Fo_ City of Fridley Applicatsten foto Plct''rnblin'g and Gas FsFf)n3 Pcrablit - Dept: of Bldgs. Phone SM -3450 DESCRIPTION OF WOr%r6 Mumbar; I:iad and LcerHen of Fixtures +— Futu;e• Ccnaoc:l,:a C�alrs•�a -a Haw Firruro. Old oponings Connrcttd vnxn uowas Ces. neo! City of Fridley.. The undersigned hereby makes application for a .Permit for the- ®cork her el specified, agreeing to do all work in strict accordance with the Cit? Ordinance and ruling of the Department of Build:nr-; and hereby declares that alt the fact and representations stated in this application are true and correct' Ridley, Minn �� — / 2 . 19,E Owner ` Kind of Building Used as To be completed about -- PARTIAL RATE SCHEDULE Estimated Cast, s Old --New. 11uilding Permit No. Permit No. LUISING FIXTURE RATES: NO. RATE tl WATt4 $ -� � 2 ` Number Fixtures ..........'...... Future Fixture Opening ........... . x $1.50 N By New Fixture Old Opening x $1.50 $ 2 Basin Basin .................... 0 EE Water Heater !Up to 99.000 BTU).... ____.L__ x $3.00 $ 3-00. '• - ROUGH New Ground Run Old Bldg....:.... x $3.25 S E-'ectrlk Water Heatar. .....:........ •s $2.00 cAS FITTING FEES: NO. RATE TOTAL Ist3Fixtures •••••••••••••••••• x$2.00 = x'00 - Additional Fixtures ..........'..... x S-75 $ Gas Range to 199.000 BTU ..........• x $5.00 L - • P-TTAIRS & ALTERATIONS—Rater to Code .50 State S=dharge - De;cription ............... c ....................... �') • S�� • TOTAL FI:E y 2nd _ 3rd Futu;e• Ccnaoc:l,:a C�alrs•�a -a Haw Firruro. Old oponings Connrcttd vnxn uowas Ces. neo! City of Fridley.. The undersigned hereby makes application for a .Permit for the- ®cork her el specified, agreeing to do all work in strict accordance with the Cit? Ordinance and ruling of the Department of Build:nr-; and hereby declares that alt the fact and representations stated in this application are true and correct' Ridley, Minn �� — / 2 . 19,E Owner ` Kind of Building Used as To be completed about -- PARTIAL RATE SCHEDULE Estimated Cast, s Old --New. 11uilding Permit No. Permit No. LUISING FIXTURE RATES: NO. RATE TOTAL �� x $2.00. $ -� � 2 Signed Number Fixtures ..........'...... Future Fixture Opening ........... . x $1.50 $..:--. By New Fixture Old Opening x $1.50 $ Business Phone No'Catch Basin Basin .................... x $325 $ Water Heater !Up to 99.000 BTU).... ____.L__ x $3.00 $ 3-00. '• - ROUGH New Ground Run Old Bldg....:.... x $3.25 S E-'ectrlk Water Heatar. .....:........ •s $2.00 cAS FITTING FEES: NO. RATE TOTAL Ist3Fixtures •••••••••••••••••• x$2.00 = x'00 - Additional Fixtures ..........'..... x S-75 $ Gas Range to 199.000 BTU ..........• x $5.00 L - • P-TTAIRS & ALTERATIONS—Rater to Code .50 State S=dharge - De;cription ............... c ....................... �') • S�� • TOTAL FI:E y July 6, 1976 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 DeGardner Construction 7950 East River Road N.E. Fridley, Mn. 55432 Re: Final Inspection at 1438 North Danube Road N.E. Dear Mr. DeGardnera TELEPHONE ( 612)571-3450 A final inspection was made on July 2, 1976 of the above address. The following items were noted and must be completed before the construction can be finaled out; 1. Post house numbers by July 15, 1976. 2. Clean construction debris from adjacent vacant lots by July 15,1976. A reinspection will be made on or about July 15, 1976 to determine compliance. If any problems arise that will prevent you from completing these items by that date, please contact us. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh Frees, ,v. CLTY OF PRXMJM 1. APPLICANT! (PGS 2141 511veir 2. 3. FraaN TO: L 4. Address /vek/ erl�Af®r, --� ` �?,)-7r�l Telephone Number RECEIPT # HATE FEE $ 36 f ape or, �¢ PROPERTY OWNER(S) : moo; lome k,�� Name Name 2cg( S��y�d' �� I�r��'' 0400 , As as Street Address Street Address IV,Q MAI 51511 -r)-L City, State Zip Code Office Phone Home Phone City, State Zip Code Office Phone Home Phone IMAL D_ _RTPT= OF PROPERTY M BE ALTERED: Lots Block k 2!Tract �hn s . /V Z �� ��� `► zz/-- 30 -Z -Ll- L42- ©tilt r oD tZ Im city State Zip Code "?f �ia oE" o t 4171 a...M04 f' �_ "' C:^_,� 5. PURPOSE OF LAND ALTERATION=: ® o �� �F Ae � e' � 6. VALUE OF WORK RU BE PIItPMMEDs $ 7. SOURCE AND OOHPOSITION OF FILT : 9. ATPACHMENTS (Information Needed to Properly Evaluate Application) 7he following plans, drawings, calculations, bonds and/or statements will be required by the Public Works Department. Half section map or sketch of property showing all adjacent property indicating the exisiting buildings and/or structures. Grading plan showing exisiting and proposed finished contours and evaluations. _.Drainage plan showing exisiting and proposed drainage structures, stabilization walls, retaining walls, cribbing, dans, or other protective items. _ Calculations for and approximate quantities of excavation and/or f ill required. _ Signed statement from the property owner accepting responsibilty for the operation and granting permission for land alteration/mining operation. _ Statement to be attached to deed advising of potential need for soil tests prior to any construction on lots where additional fill material has been placed. _ Rice Creek Watershed District Approval (If Applicable) _ Soil Borings (if required) _ Other 10. S'PIPULATIONS - READ BEFORE SIGNIIG APPLICATION: a. A surety bond or ceritified check in the amount of $ (58 of value of work to be completed) must be submitted after approval of application and prior to any work commencing. This bond or check is to ensure satisfactory performance and compliance with the below stated stipulations. 7he surety bond or check shall be kept active until the completion of work and/or expiration of permit and can only be released by written notification of the City after a satisfactory final inspection has been performed by City forces. b. All access and street frontage of the land alteration site must be controlled by a fence, a minimum of four (4) feet in height. All entrances must have gates that are capable of being locked. c. Only rock, sand, gravel, dirt, or similar natural earth fill is permitted. No concrete, asphalt, or demolition wastes will be permitted as fill unl P -q -q a demolition landfill permit is first obtained from Anoka County. d. Operations shall be limited to daylight hours and shall not interfere with the health and safety of surrounding residents and the premises shall be maintained at all times so as not to create a nuisance. e. Any explosives used must be done so in accordance with Chapter 212.3, paragraphs d, e, f, g, of the Fridley City Code and any other applicable standard e.g. Federal, State, Industrial, etc. f. At the end of each season's operations and no later than the last day of December each year, the site is to be left in a neat and orderly condition, with maximum slopes of 2:1 with no overhang or vertical banks and with a level bottom. g. On the Friday of each work week, or when required by the City, material from this operation that is found to exist or) City streets shall be cleaned to the City's satisfaction by the applicant. h. Upon completion of land alteration operations, the land must be �? left according to the plans and.contours submitted with this Zi application and planted with suitable vegetation to prevent erosion. i. Upon completion of land alteration operations or expiration of this permit, an inspection by the City will be made of the premises and adjoining streets. Any damage found to have been caused by these operations will be corrected by the applicant upon notification by the City. Applicant's Signature. Date. Property owner's Signa Date: ' 2. Recon ended For Appr Date: APPROVED BY: fC Date: OF -e? PERMIT EXPIRATION DATE: c LAND ALTERATiM FLAN-CEOCKIM FES 50 Cubic yards or less . . . . . . . . . No Fee 51 to 100 cubic yards. . . . . . . . . . . . . $10.00 101 to 1000 cubic yards. . . . . . . . . 0 . 15.00 1001 to 10,000 cubic yards . . . . . . . 0 . 20.00 10,001 to 100,000 cubic yards - $20.00 for the first 10,000 cubic" ards plus $10.00 for each additional 10,000 cubic yards or fraction thereof. 100,001 to 200,000 cubic yards - $110.00 for the first 100,000 cubic yards plus $6.00 for each additional 10,000 cubic yards or fraction thereof. 200,001 cubic yards or more - $170.00 for the first 200,000 cubic yards plus $3.00 for each additional 10,000 cubic yards or fraction thereof. 50 Cubic yards or less . . . . $10.00 51 to 100 cubic yards. . . . . . . . . . . . . . . . . . . . $15.00 101 to 1000 cubic yards - $15.00 for the first 100 cubic yards plus $7.00 for each additional 100 cubic yards or fraction thereof. 1001 to 10,000 cubic yards - $78.00 for the first 1,000 cubic yards plus $6.00 for each additional 1,000 cubic yards or fraction thereof. 10,001 to 100,000 cubic yards - $132.00 for the first 10,000 cubic yards plus $27.00 for each additional 101,000 cubic yards or fraction thereof. 100,001 cubic yards or more - $375.00 for the first 100,000 cubic yards plus $15.00 for each additional 10,000 cubic yards or fraction thereof. 5/1/4/3 RECEIPT 6431 University Ave. N.E. Fridley, Minnesota 55432 Tel. 571-3450 RECEIVED OF Ov $ ADDRESS FOR 5SSdza�d FUND DPT/DIV ACCOUNT AMOUNT GLF PROJ a2 %o Ud w") RICHARD D. PRIBYL Treasurer By 19 &,-,7_ No. 26167 FLATPAKIT ® MOORE BUSINESS FORMS, INC., - N SUBJECTPERMIT N City of Fridley 1992 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT NO. • COMMUNITY DEVELOPMENT DIV. �,,------. INSPECTION SEC. r � � PROTECTIVE i A � CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY ---- L J ` 612-571-3450 910-F15 5/30/89 JOB ADDRESS 1438 North Danube Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 6 2 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Peters 1438 North Danube Road N.E. 572-3870. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Beitler Building Systems 2751 Mississippi St., New Brighton, MN 55112 636-1927 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 J ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 265 s.f. Deck Addition 8 CHANGE OF USE FROM TO STIPULATIONS See plan for stipulations. 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 SQ. 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 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 $1900 $.95 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- $43.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $43.95 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI s WHEN PROPERLY —VALIDATED THIS IS YOUR PERMIT BLDG INSP flAT SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI IST [ ] Effective 5/1/88 ADON [ ] R-1 AND R-2 A= [ ] Building Permit Application COnStruction Address: Legal Description: Owner Name & Address: Contractor: Tel. # s2-2-3970 "I-1 U ,4zj /4-1-/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. ITvIIr- AREA: length Width Height Sq. Ft. GRWM AM' length Width Height Sq. Ft. DF7G',R AREA: Length Width Hgt/Gmz4 Sq. Ft. OTHER• Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ *06 Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: j D % A.C.:Tel. #_(o/9a CITY USE ONLY Permit Fee $ ;41®Q State Surcharge $Ada SAC Change , $ *Mum® Driveway Escrow $ "a" Park Fee - $ Sewer Main Charge $ ®• 70M$ y3, to srIPUTATIOM: Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ,.. 1900 . COO® Y)e .i.- cid U SUBJECT MIT .T-'``-.� City of Fridley 4 L 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. rt. r I PROTECTIVE INSPECTION SEC NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 I.J 612-571-3450 910-F15 12/2/96 JOB ADDRESS 1438 North Danube Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 1 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fay Peters 1438 North Danube Road NE 340-2484 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Restoration 1628 Hwy 10 NE, Spring Lk Park, MN 55432 784-2772 5267 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 Reroof House (23 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 1 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 $1,897 $.95 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AU HORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER ST E OR LOCAL LAW REGULATING CON- STRUCTION OR TH RFORMA E OF CONSTRUCTION PLAN TAL FEE ;CHECK z �_ —6 — LicenFE SC .00 $67.35 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N 7P 0 RLY V LATED THIS IS YOUR LDG P 2PERMIT GATE SIGNATURE OF OWNER OF OWNER BUILOERI IDATEI U NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: e Legal Description: fi��U (Q��� �,A, QP,n%, ,o Owner Name & Address: Contractor: Address: Tel. # MN LICENSE Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Effective 3/1/96 Tel. # `2,8`i - 222 LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length ---- Width H Ground Sq. Ft. OTHER: 7tCt d^��F-�- v►v� i0P /���.4_. 1 "z c Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacj Type of Construction: Estimated Cost: $ Approx. Completion Date: Ci � �- "' 00 (Cost on Back) Driveway C�urbl Cut Width Needed:Ft. + 6 Ft — Ft x = $ DATE: ! d-/ `Z APPLICANT: Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ 's9,s� Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 FR)DLEY INSPEC I ION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMRFR OF FIXTURES TO BE INSTALLED ON EACH FLOOR L-ttectivc: ui i Jai i i. _ kjU:; PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein 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 Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 E200-3 Rain Water Leader $ 7.00 , Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner 12 Jja Mr(�DA Water Heater -Electric. $ 7.00 Water Heater - Gas** •$10.00 Building Used As Gas Range** $10.00 $10.00 Estimated Cost x) PERMIT NO. Gas Dryer*;reventer . Back Flow Required ( )Yes () No aA COMPAN Type $15.00 PLUMBING TEL N0. 6�GJV�—cX11� 1 Reinspection Fee $47.00/Hr SIGNED BY ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By < I Rough -In Date Final Dal State Surcharge �, $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $,,5 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When r�placina an exictine furance, 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The pY�g comhi intinn air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new cnmbistinn air; it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When ins_�nn a new venfinn systam_, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers 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 Si7pcnmman Vent and Vent r_nnnectnr Informatinn 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 HEATING CO: Signed By: Date : CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 25, 2004 Ms. Sabreen Hammad 1438 North Danube Rd NE Fridley, MN 55432 Re: Final Inspection at 1438 North Danube Rd NE, Fridley Contractor: St Croix Valley Ecowater Dear Ms. Hammad: A plumbing permit was issued on November 3, 2003 to install a water softener at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 .�rracS III, ! 1I l:lgff •7l� a y�tall ADDRESS : 1438 N DANUBE RD NE PIN : 243024420012 LEGAL DESC : INNSBRUCK NORTH : LOT 6 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2003-00005 DATE ISSUED: 11/03/2003 VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT ST CROIX VALLEY ECOWATER 573 CORD A #104 HUDSON, WI 54016- (715)386-8667 ' .]i `ISI PETERS DONALD C & FAY 1438 N DANUBE RD NE FRIDLEY, MN 55432 0 # GAS WATER HEATERS 0 # GAS RANGES 0 # WATER TRMT APPLIANCES PLBG PERMIT MQNIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTRATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # ? 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. Applicant Date Bldg Insp Date, SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0 1 20.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 20.50