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PRE 2010 DOCSCity of Fridley SUBJECT P.R 1241 AT THE TOP OF THE TWINS BUILDING PERMIT R EIPT COMMUNITY DEVELOPMENT DIV. v G� � � r , PROTECTIVE INSPECTION SEC. v1 � of CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 12/19/73 JOB ADDRESS 1496 North Innsbruck Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 8 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Kn Swenson 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Springfield Homes 3713 Foss Road N.E. -7-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 JU NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK Construct a 65' x 20' & 26' Dwelling and a 24' x 26' Tuck under Garage 9 CHANGE OF USE FROM TO STIPULATIONS Establish floor of basement elevation from sewer data on permit to provid for slope. Provide a hard surface driveway. Provide a verifying survey before capping. Home Occupation stipulates none outside the family may operate the busine and that no more than 2 cars may be parked on or in fjOf front of the premises other than cars belonging to the family. SEWER LOCATION: 123' South of Manhole on North Innsbruck Drive (Inv. 945.72 Wye E1ev: 946.24 Top of Footing: 949.24 Minimum WATER LOCATION:78' South of Hydrant SEPERATE PERMITS REQUIRED FOR R14% HEATING, PLUMBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 1788-1-624 35,760 Tota 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 $39,354 19.68 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- 67.00 27S.00 STRUCTI N OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE /,�ze, $361.68 SIG ATUREOFCONTRACTO RAUTHORIZEDAGENT (DATE) WHEN PROPERL (DATED THIS IS YOUR PERMIT BLDG. (NSP DATE SIGNATURE OF OWNER (IF OWNER BUILDERI (DATE( APPLICATION FOR RESIDENTIAL, ALTERATION, ` V •� OR ADDITION BUILDING PERMIT / e CITY OF FRIDLLY, MINNESOTA OWNER'S NAME: BUILDER • a lit`ADDRESS: ADDRESS: (J ® C�� STREET : _40 ripk_ ZL& . 6 1 a a LOT: BLOCK: � ADDITION: r2 2 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 2. Applicant attach to this form Two Certificates of Surva of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: CEJ ' Depth: _Height:/`� Square Feet: Cubic Feet: Front • Depth • eight: Square Feet; l� �'! Cubic Feet: Type of Construction:y A 4L, Estimated Cost:a /2 To Be Completed:. The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that -i11 the facts and representations stated in this application are true and corr,•ct. DATE: ������LSIGNATURE: (See Reverse Side For Additional Information.) ,r ` tea, .ati. L t L Land Planning +����1��ji� s 6875. Highway. No. 6$ N. E. nid Surveying- t. • • Minneapolis, Soils Tooting f1141%!-9 Ire Minn. ssas2 Civil Engineering Minn. 784-6066 Monitipal tn9ine1ering Engineers & Surveyors Area Code 612 Certificate of Survey for _SMIMCEIC-L.0' .�6MQs + V NOR T" 1 10 e�a� O ♦ �j7J� y i S �f 0 O y O V 'Oeorfnts shown are aissumed 0, Deno+es imm monump-4 (I)o t0 comtrucfrarl. I01 Wr-Ws ;1W t7ol nI) INNSM C W NOQTH ANovA uarr I -hereby certify that, this is a true and carrot# representation of a survey of the boundaries of the above described land, and of the location of oft buildings, thereon, and all visible encroachments, if any, from or on said lond. As surveyed by me this' -day of Mnv A.D. 10J. n " SUBURBAN ENGINEERING, INC. teed 40 Sngln®arsSu v or* OFF Z7,,o?-S 7— P.p� we V— C ® c -,K 7`,/ 1.2—S d 9 1Y 6, 'Of .5-2_ _yam City of Fridley f AT TNR TOP OP Tft TWINS +"L ------- COMMUNITY DEVELON1IE14T CIY, I i PROTSCTIVI 00ftCTNMI SM. l 0 CITY NAIL iA MY #$O3 4....11.E `.J 443-600-34so SUINICT PLUMBING PERMIT APPLICATION 2� 6/,S79 Job Address - /-11:) is 1 1 1 1 duu 9 �i Owner Address Phone Cont tor A ress Phone Kind of ildings / Use Yds 6a Completion Date -/— 7 I 3IoI� BDeve ',ddv I I IM) ,SMT MNIVUI I rb w BNIBVBI H3 V2 � N lO p ®Ntvaal tloo,d E3 a �O u I saaMONgI Z.3 .3 1Nnca tl HNIMG I I fA SA",L 1I A HSYM SHNMI ---I SNlave I-�, I I. Plumbing Fixture Rates: NO. RATE TOTAL I1 ! Number Fixtures x $2.00 ,42. P Future Fixtures x $1.50 New Fixture -Old Open. x $1.50 i Catch Basin x $3.25 f Water Heater -99,000 BTU �_ x $3.00 Ground Run Old Bldg. x $3.25 I Elec. Water Heater x $2.00 Gas Fitting Fees: lst 3 Fixtures x $2.00 "' Additional Fixtures x $ .75 I Gas Range -199,000 BTU x $5.00 Repairs & Alterations See Description: Code IState Surcharge .50 j TOTAL FEE $ !The undersigned hereby makes application for a permit for the work herein specifiedo agreeing to do all work in strict accordance with the City Ordinances and rulinj of the Department of Buildingsv and hereby declare that all'the facts and representations stated in this applic$tion are true and correct. Date City of Fridley Bt1�dEGY Permit No. AT TK TOP OF THE TWINS 11, r ` HEATING PERMIT APPLICATION L-------; COMMVNITY DEVELOF"RAEHTDIV. PAOTECTIV2 I?ly.ICT" DaPT ( CM MALL FRIDLEY Pa4U �.J �1�-BSO-34F#0 ►ter tigV. DATE PAGE O� b,.....rb�� 910-F17A 0 2/15/73 I'tPPR800 1 1 Job Address ly ' n Address Phone 57 Contractor A res - Phone Kind o Building Use ;-sotimate Comp etion Da e os tt' o �7 go O p ­- r.nAvTTk v1ARm AIR' RATZ TOTAL Heating/Power Plants Furnace Shell &c Duct Work ............. ..$10.00 $ Steam Hot Water arm Air Replacement of Furnace ..... . ..... .. 6.00 qy � Repairs &c Alterations --up to 5500.00 6.00 Trade Name Repairs & Alterations each add. $.500.00 3.00 $—_-- Size No. (4 L CSS' 1 % S�✓ NECIL WAM4 ASR Capacity �p O O Sq. Ft Furnace Shell & Duct Work to 12.0,000 BTU ...... . ..$10.00 $— EDR BTU Ton. each add. 00,000 BTU ........ ' 3.00 S 13, n � � .... ' ' ' ' .. Total Connected L ad Replacement of Furnace . .. ..... 6.00 $ Repairs & Alterations -up to s50o.00 600 Kind of Fuel Repairs &c Alterations each add. $500.00 3.00 $ Burner S`PEA14 or NOT WATER SYSTEM Trade Name Furnace Shell &Lines—to 400 sq. it. FDR Steam @10.00 Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 Size No. Each add. 200 sq. ft. EDR Steam 3.(A $___ _._ Capacity Sq.Ft Each add. 320 sq. ft. EDR i''-iot Water 3.00 $ EDR BTU Ton. OIL BUTT iEFt—to 3 gal, per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 10'3,000 ETU) 5.00 $ e v over U'9,000 BTU See Fe.® Schsdulo GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 200 $_12?_0 0 Additional Fixtures a ,75 $ Gas Range to 1-S9,CC€A AIR COINDITIONIVO FAN HEATI-rG SYSTEM VENTILA T IRG SYSTEM ALTEFIATI0:9S &REPAIRS ROUGH rlNAIJ X$ 5.C* $ ,//I � 0 ,State Surcharge ises Foo ZCh4dttio i— //\\ TO T Sv ,P.L r= $ '7. 560-3450 (:ifty Of 7rdle4y ANOKA COUNTY 6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55421 July 15, 1975 Springfield Homes 3713 Foss Road Minneapolis, Minnesota Attention: Lee Kupcho Re: Hard Surfaced Driveways at: 1496 NO,-th Innsbruck - Mike Swenson 1465 North Danube - Duane Narog Gentlemen: A recent inspection of the North Innsbruck Area brought to our attention that the driveways at the above captioned addresses have not yet been hard surfaced. Please recall that it was a stipulation of the building permits that the driveways be hard surfaced. By hard surfaced, it is intended that it be either blacktop or concrete. Would you please complete the construction of these driveways on or before September 1, 1975. If you have any questions with reference to these matters, please call me at 571-3450. r y truly, Ail DA CLARK Community Development Administrator DC/cs cc: Mr. Mike Swenson Mr. Duane Narog �g CITYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 November 1, 1989 Myron and Donna Swanson 1496 North Innsbruck Drive Fridley, MN 55432 RE: Home Occupation Ordinance Dear Mr. and Mrs. Swanson: In the zoning district where you live, home occupations are permitted as an accessory use, provided certain criteria are met. One of the key requirements (City Code copy enclosed) in defining an acceptable home occupation is as follows: 1. No over-the-counter retail sales are involved. Recently, I received information that you are selling hair care products as part of a beauty salon operating out of your residence. According to previous interpretation by the City Attorney in another case, this practice is permitted to the extent that such sales are restricted to those individuals who receive your professional service by appointment. At the present time, I have no reason to believe that you are in violation of the home occupation ordinance. I am providing this information only so that you are aware of the restrictions, especially concerning retail sales. Please call me at 572-3595 if you have questions or wish to discuss this further. Thanks. Sincerely, Steven Barg Planning Assistant C-89-691 SUBJECT PERMIT NO. City of Fridley 2, 5 AT THE TOP OF THE TWINS ? BUILDING PERMIT 1 RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY i A/'�';•� CITY HALL FRIDLEY 55432 _.-. L J` 612-571-3450 910-F15 10/13/93 JOB ADDRESS 1496 North Innsbruck Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 8 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Swensen 1496 North. Innsbruck Dr NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The American Handyman Can 2835 Central Ave NE, M is 55418 788-2881 3887 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 o REPAIR ❑ MOVE ❑ REMOVE % 8 DESCRIBE WORK Reroo£ Dwelling (28331 Sgs) Tear--off, sheathing, truss & siding repair 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with. the State Building Code. Provide adequate attic ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in the basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $6,500 $3.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $90.00 ,Fire SC $6.50 STRUCTION OR THE PERFORMANCE F CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC S5.00,1 4. 5 SIGNATURE OF CONTRACTOR OR AUTHORIZ AGENT (OATEI w WH ER ALIDATED THIS IS YOUR PERMIT BL G INSP DATE SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FAMILY AND 'DUP1,EXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: Contractor:?;,,, Address: �2 Effective 5/26/93 - 7j�"' Tel. # MN LICENSE #,34f 7 Tel. # 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: LengthJW idth HgtlGro�imd Sq. Ft. OTHER:v� �- O<C'yoU I/Idv��► �� , %e� P1 8, f .O�, /C� moi, 02��� �' Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: f'-- lk6 Estimated Cost: $ 6et�e9 U Approx. Completion Date: 1�9- Z) - 5, (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: %U /,2 - 53 APPLICANTf �' 9�l Tel. Permit Fee $ CITY USE ONLY Fee Schedule on Reverse Side Fire Surcharge $�- ..S C� .001 of Permit Valuation (1/10th%) State Surcharge $ -3- �S $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ 1^10 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ Conservation Plan Review $450.00 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ %�S' STIPULATIONS: ,l SUBJECT City of Fridley 2 2 8 1 5 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir � COMMUNITY DEVELOPMENT DIV r 1 PROTECTIVE INSPECTION SEC*67 CITY HALL FRIDLEY 55432 1[d NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 8/23/94 JOB ADDRESS 1496 North Innsbruck Dr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 I 8 1 Innsbruck NOrth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike/Donna Swenson 1496 North Innsbruck Drive NE 574-1122 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ ❑ NEW % ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE A 8 DESCRIBE WORK Construct a 15'6" x 12' Deck; Remove existing deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1,515 $.76 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- $37.00 Fire SC $1.52 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $39.28 TURE OF CONTRA TOR O TR RIZED AGENT tDA EI _ W • 1 ERLY ALIDATED THIS IS YOUR PE MIT BLDG INSP DATE SIGNATURE OF OWNER OF OWNTR BUILDER) (DATE) ,l NEW [ ] Effective 1/ 1/94 ADDN [ ] CITY OF FRIDLEY a ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AAD R-2 Building Permit Application ConstructionAddress: /4�I6 Legal Description: Owner Name & Address: ` _� �Z� Tel. # Contractor:MN LICENSE # ; Address: %��— Tel. # -r— Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCREMON OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length f $ ` (o '� Width l Hgt/Ground Ft. /. g OTHER: 7� Corner Lot [) inside [ ] Ft. Yd Setback Side Yard Setbacks _ Type of Construction:1Zz� Estimated Cost: $ �s^ s i Approx. Completion Date:� (Cost on Ba k) Driveway Cut Width Needed: Ft. DATE: APPLICANT: _ +6Ft= Ft $ =$. Tel. # Permit Fee $ -3 % 0 ITS USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ ..001 of Permit Valuation (1/10th%) State Surcharge $ 7(0 $.50/$1,000 Valuation SAC Charge $ $800 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 $ c2 STIPULATIONS: Land Planning Ser i��l}'{( �� r Highway f 6875 Hi hwa No. 65 N.E. Land Surveying ( Minneapolis, Soils Testing � ll�blf eWol�, ��jlC. Minn. 55432 Civil Engineering ( Telephone 784-6066 Municipal Engineering Engineers & SurveyorsArea F Area Code 6612 Mortgage Loan Survey for V K ( lA' H0/v,, LOT I -) &Oo4) 8 INNGBRUCK WOR I H Anoka County t Q0 01( k"7� This is a true and correct representation of a survey 'of the bougdaries of the land above described and of the bcation of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest -acquired by the reason of such mortgage. It is understood and agreed CM monumen have been I ced. for the purpose of establishing lot .lines or boundary corners. Dated this�day,of � D.; 19.V SUBURBAN ENGINEERING, INC 07 Ehbinee ' � wSr�'= _ i ,CsV OF FRIDLEY INSPECTION DIV, Effective On January 1, 1993 x6431 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 /'c � !LI IA&L L C RATE SCHEDJJLE 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 Shelf and Duct Work, Burner — 60, rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and cornecL ,193 Gas Piping (Needed with new furnace) $ 10.00 $ /Q �o OWNER Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10,00 $ oq ��� *Air Conditioning — Ali Sizes $10,00 $ ESTIMATED COST PERMIT NO. P � I� DESCRIPTION OF FURNACE AND OR BURNER All Others/Repaim & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Unks_Circle One (Steam) (H=40� Trade Name 1�AAOk Size No. Commercial/Industrial BTU HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load - State Surcharge $ 50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE s, HEATING COMPANY TS / MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS, $15.00 V Signed B Tel No. 45� PLUS THE $.50 STATE SURCHARGE �( REINSPECTION FEE $30.00 a Approved B Hough—In Date Final Date S *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. \� FILL OUT BACK SIDE FOR STACK VERIFICATION ON V� REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( j No ( j 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) S. 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 Remarks List Alterations Being Done: HEATING COMPANY Signed By Date 0 S T R 0 M S 7201 WEST LAKSTREET Width HelBht No. o[ Lineal [t. Area No. of pane of Dane Ughte of crack aq. ft. C R N © ST. LOUIS PARK, MN 55426 Job z® 3 (b (a ads 2- y I HEATING AND AIR CONDITIONING, INC. 920-3800 Q (o �� p'OdU�41 �' `t'S`"' D s6 NEAT LOU CALCULATION! Job Address Weatherstrips A.S. .V. C No. 2 qS,1) Insulation )7 70(o Guideonstruction Reference 77r,T $ Da WindowsI Doors Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied s—No Yes—No 19_ Ye 0 I F1J Room I Length Width Height II Fl.1 1.5 Room ILength Width Height Windows and Doors—Crackage and Area —20 �� I.d' Width HelBht No. o[ Lineal [t. Area No. of pane of Dane Ughte of crack aq. ft. G z�f �� l � �8 4�/�8 1,10 z® 3 (b (a ads 2- y I Coef. Btu c L Coef-1 Btu Infiltration Exp. wall 35 1/ `iL 00-7 Glass 2 qS,1) 60 )7 70(o Exp. wall z uNo 77r,T $ Da N n9 Net exp. wall Net exp. wall Int. wall z I n' 96 F 0 7 -7y Ceiling 1.5 -A 7,/S Floor $ s' ✓ X4 0 Y, Total Btu. I b 2 (0 6.0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I , /3 -/— 4 F1.1 Room I Length Width Height Windows and Doors•--Crackage and Area Width HelBhtNo. of Lineal ft. Area No. of vans of pane lights of crack eq. tt. Area aq. tt. 4�/�8 1,10 6/�i=, z �/ 3V j1,�2- Coef. Btu Infiltration Glass Exp. wall Net exp. wall Infiltration Int. wan Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area R.1 Ranm I Length Width Height Windows and Doors—Crackage and Ana Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack aq. It. Area aq. tt. 4�/�8 1,10 6/�i=, z �/ 3V j1,�2- lCoef.1 Btu Infiltration Glass Exp. wall Net exp. wall Infiltration Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Craekage and Area Width Height No. of Lineal [t. No. of pane of Dane lights of crack Area aq. tt. 4�/�8 1,10 6/�i=, z �/ 3V j1,�2- 7a Infiltration Glass Exp. wall Coef. Btu Infiltration Int. wan Ceiling Glass Exp. wall Net exp. wall Inc. wall Ceiling Floor Total Btu. I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FM Room I Length Width Height 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 Glass Exp. wall Net exp. wall Int. wan Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area I Fl.I Room I Length Width Height Windows and Doonti---Craekage and Area Width Height No. of Lineal ft. Area No. of pane of pane IlBhta of crack W. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wan Int, wan Ceiling Floor 1 otal Utu. Required`sq. ft. E.D.R. or sq. ins. W.A. Leader area CITY Gr FRIDLtr INSPECTION DIVISION �` � �ly � ^ . � 9 L 6431 University Ave NE / `"`�� `-`� Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE f-\ /-. 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 Effective On January 1, 2002 Yxuc k OWNER o I r C.) I 1 `,1/VY Ai'IS0Y l Rate TOTAL �3yy_"\_e BUILDING USED AS $ 30.00 $_ ESTIMATED COST PERMIT NO. AS ` $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ Fuel Total Connected Load 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. $ .50 Burner Trade Name Size No._ BTU HP ED 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 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING Signed FAX # Approved DATE /3' ) Rough -In Date _��s Final Date _� `ivy `012 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, VFNT CONNECTOR AND COMR1ISTION AIR VFRIFICATIoN When ra In acing an exit ono furamp, the undersigned hereby verifies that the venting has been examined and is free from oast, 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 axesting cnmbustinn 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 one alling a new ventipgraystem, 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 C(s)(\ er1Sir BTU Inputs Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances 1 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 : Building $ BUILDING See Back Page for Fee Schedule Permit No.: Zco —®oo/ Inspections RESIDENTIAL APPLICATION Surcharge Received By: 763-572-3604 (.0005) times the total job valuation — Minimum $.50 CITY OF FRIDLEY $ Date Rec'd: DATE YOUR E,/-�MAIL ADDRESS License Surcharge a � E/ /'G e $5.00 (State Licensed Residential Contractors) SITE ADDRESS $ THIS APPLICANT IS: O OWNER ONTRACTOR $ PROPERTY OWNER/ NAME: b'1^, - elft f11-2-1 Erosion Control TENANT ADDRESS:.7 41 q r lA'-'f 1ilC CITY �`° STATI LJ II' Park Fee PHONE: %fe 3 01 - CONTRACTOR NAME:_ eif $ STATE LICENSE H J �EXP DATE Agreement necessary ( ) Non Necessary ( ) SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: h CITY �+ -STATE ZIP`/ WITH APPLICATION PHONE Lrl - 4Wv d FAX PROPERTY TYPE O SINGLE FAMELYMEW CONSTRUCTION SIZE O TWO FAMILYMEW CONSTRUCTION STORIES PERMIT TYPE O ADDITION O GARAGE/SHED O WINDOWS O BASEMENT FINISH PWROOF O DRAIN TILE O DECK O SIDING O OTHER O SWIMMING POOL TYPE OF WORK: ❑ NEW o ADDITION O MAINTENANCE/REPAIR O REMODELING DESCRIBE WORK BEING DONE: 0-rr e SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES. A HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan Proposed floor plan PROPOSED SIZE: O DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT. S[DWG FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit ADDITIONS. & PORCHES SUBMIT: O Aluminum O Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS 3. Epergy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 319.3. l b OCCUPANCY TYPE Permit Fee $ , rA See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ /, y (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ 3119 .001 x Permit Valuation (I/10%) License Surcharge $ aC� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 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 - $ %/j %• D 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 1 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 whico rpquircArevtw and approval of plans. SIGNATURE OF APPLICANT PRINT NAME ��-f" �d7�' DATE__ -' f` 1-01-