PRE 2010 DOCSCity of Fridley
SUBJECT
PERM
14240
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
REGflPT NO. �.
COMMUNITY DEVELOPMENT DIV.—
r i PROTECTIVE INSPECTION SEC.
'9�
1 1 �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
7/26/77
JOB ADDRESS 1500 North Innsbruck Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
9
Innsbruck North SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Ulmer Construction Inc. 103 East Golden Lake Lane 784-1315
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS 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
X
8 DESCRIBE WORK
a 72' x 54' Dwellingand a 23' x 26' Garage WARNING
#i°te�e dig`inQ call locsl
REQ FOR 1NlRIWC�„ i
9 CHANGE OF USE FROM
JEATING, PLUM -1 D S1IGNS. REQUIRED BY �
STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side
yards. Provide a verifying survey before capping. Provide window or exhaust
fan to outside in furnace room. Provide truss design before capping. Provide
soil borings and/or compaction tests and site inspections shall be required.
Submit mfg. specifications and approval data for elevator before capping.
SERVICES OFF NORTH INNSBRUCK DRIVE
SEWER LOCATION: (Approx. 8' Deep In Street) 89' East of Manhole (E. Inv. 960.00)
WYE ELEV: 962.67 TOP OF FOOTING: 965.90 Minimum
WATER LOCATION: 19.2' East of property line. Approx. 10' East of Sewer Service
DRIVEWAY DEPRESSION COST:.N/A Existing Surmountable Curbing.
TM! CM OP • PMOM. DOES NOT GidARANTEE THE
ACCURACY. OP VMffT LOCATIONS AND ELEVATIG •,
THIS DATA 43 MR *062MATION PURPOSES ONLY AN.)
PERSONS USING R SHOULD VERM THE INfQN"71ON
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
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
R-1
1640 + 554
38,340 Total
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
v
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$50,675
$25.34
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-
S OF CONSTRUCTION.
$153.36
$375.00
RUCTION OR THE PERFORMANCE
PLAN CHECK FEE
TOTAL FEE
$ .34
$592.04
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGEN (DATE)
HEN PROPEIJLY VALIDATED THIS IS Y UR PERMIT
BLDG IN SP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
ities
Etc.
NO
t,L I I UI CK /
APPLICATION FOR RESIDENTIAL BUILDING PERMITS J
CNEW, ALTERATION,, ADDITIONS, OR REPAIRS)
OWIIER: BUILDER: 34�'
Address: Address: ��e�D
Tel. No.
L �
No.: Street:
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: 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:
Front: 7,2-- Depth: ^T Height: L
Square Feet: ��� Cubic Feet:
Z- z S ®-�
Front: 3 Depth: Height: L�
Square Feet: Cubic Feet:
Type of Construction: Estimated Cost:
To Be Completed: Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired � $ $
(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 representations stated in this application
are true and correct. See reverse side for additional information.
DATE: �'1 —�7 SIGNATURE:
dydna .
Stipulations: &AJ O44 •�
A&V J101
d. P.44JiP9- 71ZAO'S
e,,,� 5 _ ate. 3V
pe"
S44 oma! ALM J"A d
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS A;,m HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE -
GRAVITY WARM AIR:
RITE
TOTAL
Job Address hj®O DSP/VF
Far^ace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
7.00
$
$
Department of Buildings
Repairs & Alterations -up to $500.00
City of Fridley
Repairs & Alterations each add. $500.00
4.00
$
Tel. X571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a. permit for the work herein
$12.00
$
specified agreeing to do all work in strict accordance with the City Codes
Furnace Shell & Duct Work to 100,000 BTU
r
4.00
$ L Q
and rulings of the Department of Buildings, and hereby declares that ail the
eac.. add. 50, 000 BTU
7.00
--�+--�
$
facts and representations stated in this application are true and correct.
Replacement of Furnace
Repairs & Alterations -up to $500.00
7.00
$
19_
Repairs & Altera;:ions each add. $500.00
4.00
$
Fridley, Minn.
STEAM OR HOT WATER SYSTEM:
OWNER f �M rg CO SLS T7�FB�' 7'10-d
Boiler & Lines up to 100,000 BTU
$12.00
$
/-
KIND OF BUILDING
each add:.. 50,000 BTU
4.00
$
q�
Boiler only up to 100,000 BTU
7.00
$
USED AS V W E L, 141(.
each addn. 50,000 BTU
6.00
$
'
TO BE COMPLETED ABOUT /997
OIL BURNER- to 3 gal. per hour
$10.00
$��
�
COST /0-700
each add. 3 gal. per hour
10.00
$
ESTIMATED
PERMIT NO.
GAS BURNER- from 1C0,000 BTU to 199,999 BTU
$10.00
$
OLD - NEW BUILDING PERMIT NO.
(over 199,999 BTU see Fee Schedule)
.10,00
$
GAS FITTING FEES:
lst 3 Fixtures x
$ 3.00
$ 3.00
DESCRIPTION OF FURNACE/BURNER
Additional Futures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00
$
HEATING or POWER PLANTS, Steam, Hot Water, WNo.
AIR CONDITIONING
$Trade
Name E-8doxSize No.. � 77—
FAN HEATING SY ST ENS % see Fee Schedule
VENTILATING SYSTEMS ;-
$
$
sq. Ft. EDR BTU 13Z000HP
ALTERATIONS $ REPAIRS %
$
Capacity
_
State Surcharge
$ .50
/
Total Connected Load F/ / ?rind of Fuel �[% fir C?��
TOTAL FEE
$ a
)
BUP.NER - Trade Name /ti tY /� Size No.
®�
?OUGH I�SF. REINSPECTION FEE
Capacity Sq. Ft. EDR BTU HP
Date (.$10.00)
Company f 0 �_
L IDNAL INSP.
Date
Signed By
��5 /�
APPROVAL FOR PERMIT ��1�-
r
Tel. No.
A4`NIMUX FEE FOR ANY HEATING PEP-4IT IS $7.50
P
y
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION
WeatherstripsGA.Suide Construction No.
Windows Doors Reference Out. Wap Int• Wall Ceiling Roof Floor
Yes-�o I Yes—No 19_
Kind
11_I �• ® R.,.tat l�nath / Q/idth fc.� Hainht Ift I F1 pN6v/ p WC Room Length
Wi ws and Doors--Crackage and Area
/
Width Hight No. o ael t . Ara
No. of pans of pane lights of amck sq. ft.
_ �e
-41
Coef.
Btu
Infiltration
Btu
37
Infiltration
Glass
AV
�
✓� � �
Exp. wall If
p
Gan
Net exp. wall,'
Y31
Up. wall,
f el,
Int. wall
06'
y
Ceilings
dE31%!
rd
Floor
_
Ceiling
Tow Btu. 1 //®-00 o
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.1 A J Room I Length Width / Heiaht F
Windows and Doors—Crackage and Area
/
Width Height No. of Lineal -fl. Are
No. of pane of pan. lights of track pe.
yr
141 LL
-41
Coef.
Btu
Ceef.1
Btu
Infiltration's
Infiltration
Glass
Glass
p
Gan
Net exp. wap
Y31
Up. wall,
f el,
�=3
06'
y
Net exp. wall
Int. wall
dE31%!
1
_
Ceiling
s
=71 71
�1-5
Floor
`�` ��6
6
Total Btu. J'O
Required sq. ft. E.D.R. or sq. ins. WA• Leader area
Fl_l-,f016:.P Regie► ILenirth IP Width �` Heitht
Windowsf'and Doors--Crackage alnl Area
11
Width Hight No. of a al n. Ate
No. of pane of pan* lights of ==k sq. it.
e,�°�'
`®777
-41
Coef.
Btu
Cftf.1
Bas
Infiltration's
Infiltration
Glass
Glass
p
Gan
Net exp. wap
Y31
Exp. wap
f el,
�=3
06'
y
Net exp. wall
dE31%!
Net exp. wall
_
lat. wall
Iat. wall
Ceiling
Floor
�''
� E'' J
13L,41�
NUMEAMUS. MM.
Inlrulatiou
How Applied
Width A/ Height
Windows, and Doors—Crackage and Area
11
Width Height No. of Lineal ft. Are
No. of pans of pk • lights of erack etl• IL
e,�°�'
`®777
7-7
Coef.
Btu
Infiltration-
nfiltrationGlaze
Coef.
Btu
Infiltration
Glass
Exp. wap- T
p
Gan
Net exp. wap
Y31
1
zo
�=3
Ev. wall
y
Ceiling�)i
dE31%!
Net exp. wall
Iat. wall
Ceiling
Floor
0�
Total Btu. IICT 4119
Required sq. ft. E.D.R. or sq. ins. WA• Leader area
V1 I d'' .' f' "," -/2.•••... 11 I9_ Qhdrh jez Heaht .4
Windows soil Doors--Craekage and Area
,qq
".ag
width Height No. of Lineal It. Are
No. of pan• of pam of craek sp. ft•
Alights
a, 77 r7L7. 7 ,
IS
Coef.
Btu
Infiltration-
nfiltrationGlaze
Btu
Infiltration
Glass
Exp. wap- T
Glass
Net exp. wap
Y31
1
zo
�=3
Exp. wall
Ceiling�)i
dE31%!
Net exp. wall
Int. wap
Ceiling
Floor
Windows akd Doors—Crackage and Area
Width Hight Na of Lineal tl. Are
No. ofpac. et • lights of crack N• it.
�/ F JT 7 /
IS
Coef.
Btu
Infiltration-
nfiltrationGlaze
Glass
Exp. wap- T
Net exp. wap
Y31
1
zo
Int. wall
Ceiling�)i
dE31%!
Floor
Total Btu. ( :Crrr; c>p II Total Btu. I tllo 14'
Required sq. ft. E.D.R. or sq, ins. WA. Leader area I Required sq. N. E.D.R. or sq. ins. WA. Rader area
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION
Weatherstrips Guide Construction No.
Windows Doors Reference Out. Wap Int. Wall Ceiling I Roof Floor Kind
-
Yes-ITO I a- 0 19_
F1.1 s!0^YVc. Room I Unath ,,'_ Width Heiaht II Fi.� ' ? �' Room lLe
Windows and Doors-Crackye and Area
�7
21
Width Height No. of Lineal tL Area
No. of pane of patio lights of crack sq. IL
c='ild%
7777
7 97 76
Coef. Btu
Infiltration
Glass
C"Ll
Exp. wall °
Infiltration
Net exp. wall a
c'
Int. wall
3 k
Ceiling
" C) 0
Floor
1 otal litu. ? O �- v
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
F1.1 Z,,40) Room I lanath ,' Width - -� Heisht . `
Windows and Doors}-Crackage and Area
�7
21
width Height No. of Llne4tL Are
No. or pane of pane lights of crack on. rL
7777
7 97 76
Btu
C"Ll
Btu
Infiltration
c'
e :
3 k
-
-:
Glue
y
6
,
Exp. wall
777 -6
Int. wall
C5? 0 0
Net exp. wall
Y'VO
S-'
Int. wall
fi
Ceiling
2*
Floor
5
_
Total Btu.
Required sq. h. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors--Crackage and Area
�7
21
Width Height No. of Lineal tL Ana
No. of pane of pane lights of arack sq.
V' f f�it.
J —E1 ---f �4�
Btu
COCO
Btu
Infiltration
c'
e :
3 k
�f k
Glass
i>
6
0 0
Exp. wap
777 -6
Int. wall
C5? 0 0
Net exp. wall
Y'VO
Floor
lot. wan
fi
Ceiling
2*
Floor
5
_
Total Btu. :4110 5� 4
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
131AP
ItrIDVNFAPOLIS. MM.
]pfnlatiOn
How Applied
f- Width 0P Heiaht /f
Windows a"'Doorii-Xvackage and Area
�7
21
width Height IVa of Lineal ft. Apra
No. or pane or Nano lights of crack M. fl.
0 �.�
J —E1 ---f �4�
Btu
Coef.
Btu
Infiltration
c'
�> ,.
�� 61
/'!rcla
Glace
i>
6
0 0
Exp. wall
777 -6
Int. wall
C5? 0 0
Net exp. wall
Y'VO
Floor
Int. wap
fi
Ceiling
2*
Floor
5
_
Total Btu 1 z;*
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F'1_I '',!% = '' Rmm 1 Ianath Al Width '°e Heisht '
Windows and Doors--Crackage and Area
et
Width Height No. of Lineal ft. Area
No. of pane of Was lights of crack sq. ft.
Btu
Infiltration
Stu
Infiltration
Glass
/'!rcla
Exp, wall
Net exp. wall
0 0
Exp. wall
777 -6
Int. wall
Ceiling
Floor
lat. wall
Total Btu. 6
Required sq. ft. E.D.R. or sq. iris. WA. Deader area
FI -1 .0,-A A Rmm I lanath ,1 Width .f',; Height Y
Wiadowa and Door -trackage and Area
99.
Width Height No. of Llnel it. Ana
a of pane of twos, lights of crack sq. IL
Coef.1
Stu
Infiltration
/'!rcla
Glass
0 0
Exp. wall
777 -6
Net exp. wall
lat. wall
Ceiling
Floor
Total Btu. I ;
�.Y ur Fv,,!DLEY
APPLICATION FOR PLUMBING AND GAS PITTING PE MIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin •
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
x
$3.00
$
e
$2.00
$
x
m
$
x
$5.00
U
x
k
d
x
Water
v
x
$7.00
$
x
$5.00
H
a
C
q
b H
W
w
Heater
+i
Wb
A
r-
N
JJ
W
M
0
.9 r
d
1
U
M
0
sa
U o3
o
.
-A
.0•a
41
y
�
N
.i a
O
8
•✓ N
O X
u N
N
m
N
x
'as
to
u
0
m
aq
to
'
o w
y
w
U m
It, 3
0,4c
O
lec
1st
2nd
3rd
4 th
(R) = Future Connection Opening
Connected with Sewer
(•) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin •
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
x
$3.00
$
x
$2.00
$
x
$2.00
$
x
$5.00
$
x
$5.00
$
x
$10.00
$
x
$7.00
$
x
$5.00
$
x
$5.00
$
x •$3.00 $
x $1.00 $
x $10.00 $
$5.00 S
$2.00 $
State Surcharge $ .50
TOTAL FEE $
REINSPECTION FEE
($10.00)
Job Address f �i ! �n'1 � 1-�� /-)."
Department of Buildings
City of Fridley
Tel. #571-3450
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
OWNER
n Fridley, Mn. 42-2 , 19=
KIND OF
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMITNNO.
Company
Signed By
Tel. No.
ROUGH INSP.
/7 Date
FINAL INSP.-
j Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.SO STATE SC 'E
v
0
Q CITY OF FRIDLEY
APPLIQTION FOR PLUMBING AND GAS FINING PERMIT
Job Address A -15-0y
Department of Buildings
City of Fridley
Tel. #571-3450
4) d4i� ��& /&-
The undersigned hereby makes application for a permit for the work hereia
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, Mn. , 19
OAAER
KIND OF • s t
s• AS•. - - s
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
m
PLUMBING FIXTURE RATES:
>.
m
TOTAL
m
PERMIT NO.
o
x
X
d
Water
al
m
m
$
Company
w
a .c+
to
m
o
+-1+
a
w
13'Heater
$
Md
ro
G
N
E.
Catch Basin
a
$5.00
eer.
0a0i
a
Water Heater - to 99,000 BTO_x
s+
$ J� G®
Tel No.
rd
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
8w
$7.00
$
New Ground Run Old Building
x
$5.00
$
ROUGH INSP.
w
�
$5.00
ro
u O
x
.
m ro��
ro
y
N
-Cm
'$3,00
3
$ �OG
ag
rd 14
U
U
w
t
.�
0
3
Q w
rn
w
U ca
3
c�
c
o
as
lec
Raqp
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.SO STATE SURCSARGE
State Surcharge
$ .50
1st
TOTAL FEE
$�
REINSPECTION FEE
($10.00)
2nd
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
Job Address A -15-0y
Department of Buildings
City of Fridley
Tel. #571-3450
4) d4i� ��& /&-
The undersigned hereby makes application for a permit for the work hereia
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, Mn. , 19
OAAER
KIND OF • s t
s• AS•. - - s
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERMIT NO.
Number Fixtures
x
$3.00
Future Fixture Opening
$2.00
$
Company
x
New Fixture, Old Opening
x
$2.00
$
r V
Signed By
1-17-111C NX
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTO_x
$5.00
$ J� G®
Tel No.
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
ROUGH INSP.
Electric Water Heater
x
$5.00
$
Date
GAS FITTING FEES:
FINAL INSP. > ^ ? ^
1st 3 fixtures
_L x
'$3,00
3
$ �OG
Date
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
APPROVAL FOR PERMIT
REPAIRS $ ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.SO STATE SURCSARGE
State Surcharge
$ .50
TOTAL FEE
$�
REINSPECTION FEE
($10.00)
NEW .L ] City of Fridley Effective 4/1/86
ApPN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: 1500 North- Innshruc-k nr; t7A - 'Fridley, -
Legal Description: Lot 2, Block 9, Innsbruck North
Owner Name &
Contractor:
Address:
John and Mary McKendrick and Ear D & ngTel. #
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
GARAGE AREA: Length
DECK AREA: Length
OTHER: Porch A ir
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
134
[4101(Vg•696`(OW - ItQ
Corner Lot [X] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Wooj� FtAynL- Estimated Cost: $ '-
Approx. Completion Date: .(fitjr�-7 10 wv
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. # '57/-el3?2
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
s
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SUBJECT
ffRM4T NO.
City of Fridley4
41
AT THE TOP OF THE TWINS
BUILDING
P E R M I T<__
Ir
RECEIPT NO.
� • ______ COMMUNITY DEVELOPMENT DIV.
1 PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
6/7/95
10B ADDRESS 1500 North Innsbruck Dr NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
9
Innsbruck North
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Kutcher 1500 North Innsbruck Dr NE
574-1500
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (30 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State
Building Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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 IHAVE READ AND EXAMINED THIS APPLICATION
1
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,250
$1.13
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-
Fire SC $2.25
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$54.00
PLAN CHECK FEE
TOTAL FEE
$57.38
SIGN R F ONT UTHOR AGENT (DATEi
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
(R/
NATURE OF N DE ) IDA EI
LD INSP
p
NEW [ ] Effective 1 / 1 /95
ADDN ..... . [ .] CIT. y. -OF- •FRIDLEY . :... :... _..
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Legal Description: ��/��� //��
Owner Name & Address: �D_�.?� -Z ,1� ��� Tel.
Contractor: '� ��� MN LICENSE #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + _ $
DATE: APPLICANT: Tel. d
CITY USE ONLY
Permit Fee $_ /� O Fee Schedule on Reverse Side
Fire Surcharge
$ �- a�^
.001 of Permit Valuation (1/10th%)
State Surcharge
$ L / 3
$.50/$1,000 Valuation
SAC Charge
$
$850 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 INSPECTION DIViSION Effective On January 1, 2001
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 ISCO N _Zn05bruff., Drive,
RATE SCHEDULE RQbf-r I KUf
OWNER
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
Rate TOTAL
BUILDING USED AS Ce5( i'1 "
$ 30.00
ESTIMATED COST' 5Eq] PERMIT NO.
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) Warm Air
$ 10.00 $ Trade Named Size No�►��
BTU HP EDR
$ 25.00 $ 26 -Do Fuel_ N&f fagS i 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
$5s=0
Burner Trade Name Size No.
BTU HP EDR
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.
DATE LO 1131 Q /
Rough -In Date
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verges that the
venting has been examined and is free from rust, deterioration, obstructions,
firestopped where required.
Yes ( No ( )
and is securely supported and
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 :
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX: (763) 571-1287
ADDRESS
: 1500 N INNSBRUCK DR NE
PIN
: 243024420069
LEGAL DESC
: INNSBRUCK NORTH
: LOT 2 BLOCK 9
PERMIT TYPE
: ELECTRICAL
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: ADDITION/ALTERATION
PERMIT NO.: 2004-01786 6p t
DATE ISSUED: 10/05/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114 -
OWNER
DONALD STUDLEY
1500 N INNSBRUCK DR NE
FRIDLEY, MN 55432
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
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 118132
SEYAKAIE YEKMI S REQUIRED FOR WORK OTHER THAN DESURLBED ABOVE.