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PRE 2010 DOCS59917 City of Fridley, Minna 11411 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT nate: May 4, 1972 oma:—Viewcon, Inc. Builder Same ,Address 5901 Brooklyn Blvd. Address Same LOCATION OF BUILDING No 1558 Street North Oberlin Circle part of Lot Lot 3 Block 7 Addition or Sub -Division Innsbruck North Corner Lot Inside Lot $ Setback _— Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: 1496 Townhouse Front 241 Depth 31' Height 28' Sq. Ft_ _ 744 eu. Ft 20,832 Garage 20 -`10" 440 �6b Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Wood Frame Est Cost — 25, 416.96 To be Completed 10/1/72 Stipulations: 1. Developer agrees he will supply all the materials noted in the letter written by the City Engineer dated 2/22/72 by May 30, 1972. 2. Same as indicated on foundation permit. In consideration of the issuance to me of a permit to the proposed work in accordance with the description abo; ordinances of the city of Fridley. above, I agree to do with all provisions of In consideration of the payment of a fee of $_47. 00Viewcon, Inc. permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiup anthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said Building Inspector NASIM QURESHI NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these hems. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : U_t;'1 .l opz BUILDER:_ �rnt .,iyL Q ADDRESS:- D / ADDRESS: _77 NO:.- /63(3 STREET:_ /V(yttk �T LOT: BLOCK: ADDITION: Al CORNER LOT: INSIDE LOT:_ SETBACK: SIDEYARD:�� Applicant attach to this form Two Certificates of Survey of Lot and proposed building, location drawn on these Certificates. I DESCRIPTION OF BUILDING To Be Used As: & vA n &,c Q _> Front: Depth: / Height: a lq96 Square Feet :r7� q Cubic Feet:_ Front: c:;2 O Depth:____ ;ZQ Height: Square Feet;_ 'V 1(n Cubic Feet:_ O Type of Construction: WOO&j} AAn- Estimated Cost:_ To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: � �� SIGNATURE• (See Reverse Side For Additional Information.) yqoo 1,q91 17-'/'y ��o -2136c288 /a �J /1/.28��� lyS_3 4060,8(9 / 993x0 a0 6OS$ 199-3;2C) I-- +p a fj NORT.N 240 -- 7 7 10 L0.0 20.0 Z1 6 L" /* 0' 140 e4 Ito OBERLIN 14.0 — 1-14-00 -- - — -zoo — --140 140 06 t I 1, 'b IT 6) 'j TTI// Id D 14.0 Z.0 140 1 'Z0.0 Z1 0' 140 06 t I 1, 'b IT 6) 'j TTI// Id D 14.0 Z.0 140 1 'Z0.0 M- 0 0 411 20.0 7c 0 71-d 1 0 1 70 0 jj 12X0 'Cl 0/ 11 12" 11 C ,/ .Ili % /, I I• �'/' / I I f� 11+ C LZ ITI 0 0 CD 140 M- 0 0 411 20.0 7c 0 71-d 1 0 1 70 0 jj 12X0 'Cl 0/ 11 12" 11 C ,/ .Ili % /, I I• �'/' / I I f� 11+ C LZ ITI 0 0 CD City of Fridley AppEcaflon for Plus and Cas RM" Pwmit DESCRIPTION OF WORE Number. Kind and Locafion of Fixtur" m s G_ r iI Z • • MA/E� MTe. Base lrt 2nd 3rd _ 4th f • ruwe Comadloa Openinpa • New Fixture. Old Openings With 8awos � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .............. PL. x $I&% i 7.2 v 0 Future Fixture Opening .... :...... x $1.50 y �—." New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ r� p Water Heater :Up to 99.000 BTU) . • • • x $3.00 i-3 New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. a 32.00 $ GAS FITTING FEES: NO. RATE TOTAL lot 3 Fixtures : $2.00 =_ Additional Fixtures ............... z 3 .75 $ Lias Range to 199.000 BTU ............ x $5.00 $ State Surcharge $ .50 REPAIRS t ALTERATIONS—Rotor to Code Description ......................................... TOTAL FEET Dept. of Bldgs. PhorS60-3/4M LOCSOM d .1f 91 City of Fridley: The undersigned hereby makes application for a permit for the work here:, specified, agreeing to do all work in strict accordance with the Cats Ordinance and ruling of the Department of Buildings. and hereby declares that all the tact and representations stated in this application are true and correct ' �f Fridley. Mina / ee Owner Kind of Building �O Used as To be completed about Estimated Cost. f Old—New. Building Permit No. Permit No. Signed B Business Phune No ' -'Y AR ROUGH Ll Appleallen for Poorer Mints and Heathm Cooiing, Ventilation. RetEigeratl and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone iso -MM GRAVITY WARM AIR: RATE TOTAL Location, 22i2 42. 1214," • i -� Furnace Shell & Duct Work ........................... $10.00 $ City of Fridley: Replacement of Furnace ..... I ....................... 6.00 : The undersigned hereby makes application for a permit for the work herein Repairs & Alterations—up to $500.00 ................. 6.00 $ specified, agreeing to do all work in strict accordance with the City Ordinance. Repairs &Alterations each add. $500.00 ............... 3.00 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECH. WARM AIR Fridley, Minn . IS Z2 - Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ / ® each add. 60,000 BTU ....................... 3.00 $ Owner 1 Replacement of Furnace ............. 6.00 $ Kind of Building Repairs & Alterations—up to $500.00 ................. 6.00 $ �.�s �!tet �� • _.cC�� ^^� Used as 4.� Repairs &Alterations each add: $500:00 3.00 $ To be completed about _ STEAM or HOT WATER SYSTEM �'� � Furnace Shell &Famines—to 400 sq. ft. EDR Steam $10.00 $ Estimated Cost, $—/� Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Q Old—New. Building Permit No. Permit No.� O Each add. 200 sq. ft. EDR Steam ............... :...... 3.00. $ Each add. 320 sq. ft. EDR Hot Water . . . ............ 3.00 $ DESCRIPTION OF WOR_ K OIL BURNER—to 3 gal. per hour ... . ' ... ... . . ..... 6.00 $ HMITING or POWER PLANTS --.Steam, Hot Wafer, Warm Air—No over 3 gal. per hour -wee Fee Schedule °—'— o Trade Name � � Size No- GAS GAS BURNER (up to 199,000 BTU) .................. $ over 199,000 UM See. Fee Schedule Capacity. — Sq. Ft. E.D R- BTU H.P. GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ....... x$ 200 'T)L 4�1 Total Connected Load °��� �J Rind of P9ie Additional Fixtures ................. x .76 $ BURNER —Trade Name Size No Gas Range to 199,000' ........... z$' &w $ Capacity Sq. FL E.D.R- BTU HF. AIR CONDi'IONING $ FAN HEATING SYSTEM See Fee Sckedots VENTILATING SYSTEM A�p ALTERATIONS & REPAIRS TOTAL FEE v� �a By � e ROUGH , ^ f Business Phone No Ir/ FINAL '%" l if ' 7 �,��� REMARKS—uveal .53-8b—s-915.51 :01PZ3 City of Fridley 6u11OECT AT THE TOP OP THE TWIN$ r � . tu-------; COMMOITY DEVELOPMENT DIV, PLUMBING PERMIT APPLICATION MOTECTIVE w1OECT10N OW, CITY HALL FIUOLRY 1160E i.-...�.� `.J 1114-600-3"0 NUMO t Ra V. DATE FA4EOF A OV D By Job Address 910- 18A 1 0 12115Z73 1 .1 800 1558 North Oberlin Circle ner Ad ress p Darrell A. Farr Developement 561-0 81Q Contractor Address MIINNEGASC® ;133 MARQUETTE AV Pe Kind of Building Use Mpts., MINN. Frame Res. Completion Datestimate Cost 11-2-71i 10.00 W c O 0 a� 3 f Plumbing Fixture Rates: NO. I� RATE TOTAL ,! Number Fixtures x $2.00 $ Future Fixtures x $1.50 New Fixture -Old Open. x $1.50 Catch Basin x $3.25 Water Heater -99,000 BTU x $3.00 Ground Run Old Bldg. x $3.25 I Elec. Water Heater x $2.00 j Gas Fitting Fees: it I lst 3 Fixtures x $2.00 Additional Fixtures x $ .75 iGas Range -199,000 BTU 1 x $5.00 5.00 Repairs & Alterations See Description: Code _ State Surcharge Class 0A® Surcharge .5c .50 iTOTAL FEE $ 5.50 !The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and correct. -==p"'. ' Signa rI —� Date f 01 SUBJECT City of Fridley 2 2 9S AT THE TOP OF THE TWINS BUILDING PERMIT r RECE PT NO. `- "_____ COMMUNITY DEVELOPMENT DIV r � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/6/94 JOB ADDRESS 1558 North Oberlin Circle NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 7 1 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Tabor & Sons Inc. 3716 St Francis Blvd Anoka MN 55303 789-1902 20014248 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential Townhouse 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling & Install Gutters 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,036.00 $1.02 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 $ 54.00 Fire SC $2.04 PLAN CHECK FEE TOTAL FEE ���� ���✓� fG ` �c�- g `/ License SC $5.00 1$62.06 SIGNATURE O'F CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPE VALIDATED THIS IS YOUR PERMIT 7 +'B G INSP DATE SIGNATURE OF OWNER,1F OWNER BUILDER) IDATE6 01 NEW [ J ADDN [ J CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 1558'- North Oberlin Circle, Fridley, Mn. Legal Description: Owner Name & Address: Contractor: Tabor and Sons, Inc. Tel. # Effective 1/1/94 MN LICENSE # 20014248 Address: 3716 - St. Francis Blvd., Anoka, Mn. 55303 Tel. # 789-1902 Attach to this application, a Certificate of Survey of the lot, with the proposed constriction 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: Corner Lot [ J Inside Lot [ J Ft. Yd Setback Side Yard Setbacks Type of Construction: cutters -roofing Estimated Cost: $_ 2,036.00 Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 10/3/94 APPLICANT: Tabor and Sons, Inc. Tel. # 789-1902 Permit Fee $ dG CM USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ -.001 of Permit Valuation (1 / 10th %) State Surcharge $ $.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 Pian Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary (J Not Necessary. ( J TOTAL $ D STIPULATIONS: SUBJECT PE City of Fridley 31033 J AT THE TOP OF THE TWINS BUILDING PERMIT ` RECE • COMMUNITY DEVELOPMENT DIV. �------- INSPECTION SEC. 3� 6 9 r PROTECTIVE CITY MALL FRIOLEY 65132 NUMBER REV OAT ¢ PAGE Of APPROVED BY 612-571-3450 9taF15 6/8/00 .O ADDRESS.!.1538,42,46,50,54,58 62 66 No. Oberlin Circle I LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED -DES 1-8 . 7 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL AODRES$ ZIP PHONE Innsbruck Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE • LICENSE NO Garlock -French Roofing Corp. 2301 E. 25th St. ls., M 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential ' 7; CLASS OF WORK O NEW ❑ ADDITION O ALTERATION? REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof Building .9 . CHANGE OF,USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Perm- AeI"'t'" Caft drier Ab Post 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 I OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION R 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 $15,610.00 $7.80 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $265.2S Fire SC 15.61 PLAN CHECK FEE TOTAL EE 2 • 66 SIGNATURE Of CONTRACTOR OA AUTHORIZED AGENT IDATEI N P OPER LIDATED T IS IS YO R PERMIT X- 5 dam, SLOG 50 rIAft S-GNATUREOfOWNER-OF OWNER BUILDER, IOATEI SUBJECT PE City of Fridley 3217 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT N 16 COMMUNITY DEVELOPMENT DIV.,`� j 1 PROTECTIVE INSPECTION SEC. @ Et aa°"14Ei I' CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/19/01 JOB ADDRESS 1538 '- 1566 North Oberlin Circle NE 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-8 7 Innsb' uck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Various 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Columbus Exteriors 2131 111 Lae NW, Coon Rapids, MN 55433 763-757-7530 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING 8 Unit Townhouse 7 CLASS OF WORK O NEW O ADDITION O ALTERATION Cj REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside Building; Soffit/Fascia Window Wrap 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. 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 ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 8 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 $60,625 $30.31 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 R THE PERFORMANCE OF CONSTRUCTION $720.75 Fire SC $60.63 PLAN CHECK FEE OTAL FEE $811.69 SIGNATURE OF CON 7 RACTOR OR AUTHORIZE D AGENT iOATEs H N P P RLY VALID TED THIS IS YOUR PERMIT 1AAJ 1,111" LOG IN$ IIATE SIGNATURE OF OWNER OF OWNER BUILDER; iDATE,�+ CITY OF FRIDLEY PERMIT NO.: 2004-00093 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/22/2004 572-3604 FAX: (763)571-1287 ADDRESS 1558 N OBERLIN CIR NE PIN 243024410036 LEGAL DESC INNSBRUCK NO T H 1 ST ADD LOT 3 BLOCK 7 PERMIT TYPE ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL XCEL ENERGY SAVERS SWITCH # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORP 2300 TERRITORIAL RD ST PAUL, MN 55114-1614 (651) 646-2911 PUPEZA, ANTOINETTE M 1558 N OBERLIN CIR 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 wort 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 Ins p Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 113375 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell a.ndZuct Work, Burner & als ' eplacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Effective 4/1/2.004 1 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS! %6 N. Alin C(rde tFee Total r Owner II $35.00 $ Building Used As001 I' 1 $10.00 $� ESTIMATED COST *QVIVOL- PERMIT NO Gas Range $10.00 Gas Dryer $10.00 *Air Conditioning - All Sizes 25.00 All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater $ DESCRIPTION OF FURNACE AND BURNER $ # of Heating Units_ Circle One (Steam) (Hot Water) Trade arne Size Nd $ BTU EDR _ Fuel �S�Tot�aConnec ed Load 1.25% of Valu df,Appliance or Work (List on Back) $ Minimum Fe4c$39,.00 for Commercial/Industrial/Institutional e„7, a-;.""--, s FrF 70 E ~` P State Surcharge $ L rr __ TOTAL FEE In ki�0 $ R EI NSPECTIL�t F:- 0.00/HOU R *Air Conditionersa'not be placed in side yard without written approval from adjoining property owner - copy to City Burner Trade Name BTU Size No. EDR rm Air) 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 hWGect. OBA: GOLDEN VALLEY HEATING & AIR HEATINGJ',�5782 WEST BROADWAY „®,/ CRYSTAL, MN 55429 FAX Tel # Date JAN I c Z00 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough in Date Final Date 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 ) too 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 Type and meets the current codes and manufacturer's specifications. This does Length _ft include AGA -LAMA Category I Central Furnace Venting Tables for fan Type C —tet" assisted and natural draft appliances. Yes -K No ( ) The existing combustion air,is sized and installed to meet the current codes Type and manufacturer's specifications. Yes Nq ( ) 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 &I-A)&,e BTU Input V,o5r Nat Appliance #2 Type $A/d4,e- 1y�'�r BTU Input Pow Assisted a Appliance #3 Type BTU Input Fan Assisted or at Total Appliances _� Total Btu Input 1301,voa Common Vent Type _� L40vt Vent Height Diameter inches Appliance #1 Vent Connector Height XA� ft Length 3aft Diemeter �in Type a Appliance #2 Vent Connector Height • ft Length _ft Diameter min Type C —tet" Appliance #3 Vent Connector Height ft Length ft Di2meter in Type ALTERATIONS: (Describe) QX HEATING & AIR ING. 5182 WEST BROADWAY HEATINGCO:, r NAM JUL-15-2008 01:00 PMI STANDARD WATER CONTROL 763 537 1082 P.01 DING r uil-4w Receivesi By; 1 s ctxdns RESIDENTIAL APPLICATION 63-572-3604 CITY OF FRIDLEY .. . , nam d. � YOM IW AIL ADDRESS __ TENANT STATE—ZIP,„^ � %� • EXP DATE /+.T/1 lIA COPY OF $TATE i10EN9k-% t CTrX �" STAt YOUR T STATE LICENSE ADriRBSS:,,� •• OP Ad WiTii APPLICATION PHONg CONON FAX P><tOPERTY TYPE In SINGLE FAME.y/1VER► �—�--- TWO FAM YINRW CONBTRLICAION STORIES AMMON Q CMARAGIV IED gynwows PERM[T'TYPE D BASEMENT FINISH 13 ROOF )PkAIN TILE Cl DECK O SIDINO Cl OTHER 13 No FOOL T`Yi►E OF WORK.o NEW �AnDITICIN 0 MAYlVT NANCEJREPARt Cl ItEM009LI3G DESCRIBE'WORK BEING DON>3: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT . Ft. HOUSE MBER OF SQUARES Cl HOUSE it GARAGE NUI. �ipg Plow Plan 13 ATTACH&) GARAGE 2. Proposed floor plan PROPOSED SIZE!— © DETACHED GARAGE 3. List of smwtwa! members to be used PROPOSED HEI=-. FOR N1W CONSTRUCTION INCLUDING DECKS, ff va y1 Dsoffid I. Sl% Pinar -7 shown$ the exams 8=11M13 Alu�um G � and Proposed Project. L3 Other 2. Two Bets of aanatructian plans 3. Energy Calculadops RI=TINGOPENIN09 dyes ON* LOCATION Of W24DOWS OR FOR NEW OPPIM03-DESCMBE SIZE Of OPENING CHANGES & Numm—opwMOWS TYPE OF WINDOW TO BE INSTALLED AUI. FEES ARE BASED ON VALIUATIONI INCLUDING THE COST OF LAHCR AND MATE S. (CTSY1riG ' 19l7'' UX.0 FEE SC MM ICY T YPE TOTAL JOB VALfJATIdN S See Back Page for Fee Schedule Permit Fee Plan Review $ 65% of Building Permit Fee Fire Sumbarge $ .001 two the total job valuation Surcharge $ .0805 x Permit Valuation Minimum $.50 $ 55.00 (State Licensed Residential �ContrMotors) License Surcharge $1550 per SACC Unit (Plans to M'WCC for detecwination) SAC Charge $ Curb Gut Escrow S _ _ R+ 6 it = ft x $21 - S Erasion t scrow $ _ -- _ S450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Change $ Agreement neceamy ( ) Nou Necessary ( ) Togil Dae S e Make checks able to: of Fri Attach Stt aiatiieas no 15 AN A"LYCATM POR A PERMIT -NOT VALID 1.1 PROCESSED I hmby apply for a building permit and I acku the ' e V , is complete and accurate: that the work will be in forinance with the ordinances and codes o os with lite Minnegota Constrwtion Codes; that I undel�nd this is not a oonor but only h application fora start without a permit: that the work will be in aw"dance with the approved Don f plan in the case of all W ! Q �. PRWr NAME TE SIGNATURI~ OF' APPL1 Building PLUMBING Permit No.:bW4DU Inspections RESIDENTIAL APPLICATI®N Received ByrMA 763-572-3604 CITY OF FRIDLEY DaAMP E C 17 20 763-502-4977 FAX EFFECTIVE 2-19-09 DATE i2-/157101 YOUR E-MAIL ADDRESS SITE ADDRESS 1 Ss QW 14 THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY NAME: AV1 `° rlt ,e irV' ONVNER/ ADDRESS: ��i 0 D�l�%yY�! C.{ ✓ CITY E641 �4' STATE/W ZIP TENANT PF7nNA• '�1o�i'K�1 1'�el�i CONTRACTOR NAME: gAVZV gLj Fj a0/llgl /% SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND #EXP DATE CERTIFICATE OF ADDRESS: D Z� D /VI 16yI l l� 31 CITY 6l STATER&ZIP S ?j � INSURANCE PHONE 1 3--b 4' A g q FAX S- 7'7 PERMIT TYPE `[7 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: I 0 NEW [REPLACEMENT DETAILED DESCRIPTION OF WORK - t VV-,- K1 M FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV DRAINS _ WATER PIPING _ _FLOOR GAS PIPING (NEED CITY LIC) —SHOWER _ SWIMMING POOL —WATER SOFINER ($35) —BATHTUB CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT JI/�( %�1+� — PRINT NAME J4 1 bik�- G4 M DATE L' I b D City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977