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PRE 2010 DOCSCity of Fridley, Minn. 1 1 6 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT owner: Landyest Development Corp. Builder. Same Address _2-82.$__.=- 5th Avenue South, Mpls Address damp /15-0 4:1 LOCATION OF BUILDING No. — Street -- North Timbel Ridge N . part of Lot See 1502 N Timber Ridge Lot $lo _ —�-- _ _ Addition or Sub -Division Corner Lot _.___-.__..__ _ Inside Lot _ Setback Sideyard Sewer Elevation _ _ .__ _ _ _ __ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Dwelling( Twnhse) Front 38' Depth 29'7k' Height 20' Sq. Ft. 1854' cu. Ft..Zsj0' Front .— Depth Height Sq. Ft. Cu. Ft. Type of Construction Wood Frame Est. Cost 212187 To be Completed 3 months Stipulations: See 1502 North Timber Ridge In consideration of the issuance to me of a permit to const the proposed work in accordance with the description above set Ordinances of the city of Fridley. J 11.00 State e building described above, I and in compliance with all e In consideration of the payment of a fee of $51.25 , permit is hereby granted tq do ns of to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiIIgs ppithin the city limits and this permit may be revoked at any time upon violation of an of the ordinances. ! provisions of said o��++e.��„c�� ssr.--�� -c :r:�s��r• ice--_ ._ NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. P APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNS IS NAM: 1 NO;. . ' ® STREET: I lr�t 6` JG� F�G�� At Al. BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEXARDt Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. ,/ DESCRIPTION OF BUILDING To Be Used As: e %7- Front: 3 -Depth: Z 9 a `r % 4 Height: 2a Square Feet: 18.T'4 Cubic Feet: /Z Front: Depth: Height; Square Feet; Cubic Feet: Type of Construction: 117a4ir.� Estimated Cost: _$ 'tel To Be Completed: -5 /z The undersigned hereby makes application for a permit for the.wprk 14areju specified, agreeing to do all work in sttict accordance with the city of Fridley Ordinances and rulings of the Department of Buildings, and'bereby declares that all the facts and representations ted in this applicatig, are true and correct. 11TR: SIGNATURE: 74 . f (See Reverse Side For Additional Information.) C i-,5 z47 r City of Fridley Application for Plumbing and Gas Fitting Pemit DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: 11 3 0=1 Is C\ x $ $ 07.00 } Z�Z Q.0 Q.0f. 8Z n V� tS o� (�9� W ci t�9 0 z (�90 t R ' N WATER HTR. GAS ELEG Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x $k§@ $ Q- 00 Additional Fixtures .................... x iq9 oou Gas Range to 809,690 BTU .............. x 2--W 1st 1 2nd 3rd 4th • Future Connection Openings o New Fixture, Old Openings Connected with Sewer Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ............... C\ x $ $ 07.00 Future Fixture Opening New Fixture Old Opening .............. x i*@- $ Catch Basin .... ....................... x 3.25 $ 99• e e o, Water Heater (Up to 9601000 BTU) ...... x 2;ft $ 0 0 ew Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x $k§@ $ Q- 00 Additional Fixtures .................... x iq9 oou Gas Range to 809,690 BTU .............. x 2--W REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ 5 u TOTAL FEE $ 0 Dept. of Bldgs. Phone SU 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn- \ 1-- - 19_--�— Owner �z Kind of Building Used as To be completed about Estimated Cost, $ a Old Building Permit No Permit N �v Signed - 1 By Business Phone No 5 e ROUGH q� FINAL a* 42 ' Pla rMAL FZATE S COKEULE e7MA7r 4 wARM AM: MVE ITOT&L nvnaft Shell 8k Duct 7q�;rh .$10.00 $ Replacenmt o4 ramace.. 0,0 Repairs & Alterations --up to 4 .M 6.00 5--- -- - — Repairz & Alterations tesla add. 1,1B00.09 3.00 �L_ :" WAMM am shell do Duct Work to 12cow STU .. each add. 90.000 DTU ............... .... 3.00 Replaccnteat of Purnace 0.00 Reptin A Alterations --up to $M.00 g.00 Rqwirs & Alterations each add. $M.00 3.00 Turnace Shell A Lines—to 400 sq. ft. EDR Steam $10.00 $ ---- reurnace Shell &lire—to "0 sq. ft. EDR Hot Fater 10.00 Each add. 200 sq. ft. EDR Stearn &M Each add. 3120 sq. ft. EDR Hot Water 3.00 $_ _ OIL BURNER—to 3 gaff. per hour &00 3 _ over 3 gal. per hour --fie lee Schedule GAS BURNER cup to IKOW SM LLD $ over 199,000 BTU See Fee embadwe am FITTING Fes. NO RATE TOTAL 1st 3 Fixtures x$ 7.00 $ 2. Additional Fixtures x ,7 $ Gas Range to 199.000 x$ &00 $ AIR CONDITIONIXG 6 In, U U FAN HMTMQ STST M Ore rM Y>671TILATING STSTZM 3 $1f9/ 0 v ALTERATIONS B REPAIRS TOTAL FM $ ROMH rMjM Comm wQ' ms fid, City of Fhd%y: The undersigned hereby makes applicalAon fw a permit Zw the wor2a hereig specified, agreeing to do all work in strict stScordance with tLe City Cprdkmamef and ruling of the Department of Buildings, and hereby declares that all tide 4wL and representations stated in this application are 0Q ail Wit. Kind of Building Used as _ _ h �"`� _. _ _—• . _ To be completed about Estimated Cost, -- )fM Permit MI. DZSCIUMMON ®r wow MATING or team. Hob Wetw4 N* - Trade Name sire 1203-1 0 Capacity—/_/0-,0023Sq Ft. ED R- BTU H.P Total Connected Load �d Ft>e CC/J BURNER — Trade Name size Z40 Capacity—sq. Ft. E.D.R BTO up. (MMAiKS-OVIRI - I JIIII _.�( �✓ A y� 01 SUBJECT P City of Fridley 19591 AT THE TOP OF THE TWINS BUILDING PERMIT r RECE 0. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. "1 /"'1•� CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY i 612-571-3450 910-F15 7/13/88 JOB ADDRESS 1506 .North Timber Ridge 1 LEGAL* LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. N 8 51.7' of W'g of �;; of NE'lg _ of Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joan Kubacki 1506 North Timber Ridge N.E. 574-1061 3 CONTRACTOR MAIL ADDRESS ZIPPHONE .__ ._ LICENSE NO. Irmiter Contractors 127 N. Lexington, St. Paul 55104 222-1539 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 O ADDITION [R ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK New Kitchen Cabinets, New floor, Lighting 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS REQUIRED FOR WIRING, BEATING, PLUMBING AND SIGNS. FOR ELECTRICAL, PLUMBING, TYPE OF CONST. OCCUPANCY--(rf` p , P OpCU7ANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 $8,000 $4.00 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- $99.00 T UCTION OR THE PERFORMANCE OF CONSTRUCTION. 1 /f; �PLAN —41z CHECK FEE TOTALFEE j1Q- er,,.$103.00 SIG TUREOFCONTRACTORORAUTHORIZEDAGENT I ATE) WHEN PROPERLY b - DATED THIS IS YOUR PE MI/ r �T SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) LDG INSP OAT 01 MR I I City of Fridley Effective 5/1/88 AMN 1,1 R-1 AND R-2 AMER Imo' Building Permit Application Construction Address: 15 AV Legal Description: A.). g,�A/ '7 Owner Name & Address: �� a°9 �� Tel. ODntr actor : Tel. Address: / Z /), 6cYrrt-,rrrA) �' f - �sa 6- /0 � �Y le5o Attach to this application, a Certif icate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF II�+II�ROVFi�iTi TG % ;z�� o�ez- P® S T!� eT�r�t wC°W'- fe LIVING AREA: Length Width Height sq. Ft. ow,,D =z- WidLl: 4 f Width -- Height Ski. Ft. : Corner Lot I I Inside Lot I I Ft. Yd Setback Type of Construction: n L ;72Am `--, Approx. Completion Date: _. Hgt/Ground Sq. Ft. Side Yard Setbacks Estimated Cost: 57Y�7) ® Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: 5 $ Width + 6' See Back Page DATE: % id yY APPLICRM: Tel. # CITY USE OILY Permit Flee State Surcharge SAC Charge Driveway F;scrow Park Flee Sewer Main Charge TOTAL StTIFULi UMS: Flee Schedule on Reverse Side $.50/$1,000 Valuation $550 per SAC Unit Alt. "A" or Alt. 'B" Above Flee Determined by Engineering Agreement Necessary I I Not Necessary [ I A '9400 a ac c. �x5 S4 �d nd suejECT PERMIT N0 _ City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT _ RECEIPT NO COMMUNITY DEVELOPMENT DIV , PROTECTIVE INSPECTION SEC -73 -733 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/12/95 JOB ADDRESS 1502,1506,1510,1513,1514,1517,1518,1521,1522,1525,1526,1529 N Timber Ridge 1 LEGAL LOT , i ,T dOWW�n ppN528, 1528, 15 0,15 S Tim er Ri g� ATTACHED DESCR. Various SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Various 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dale Dahl Contractor 451 Maple St NE, Spring Lake Park, MN 784-6353 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential Townhouses 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION? REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO 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 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 1 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 $5,400 $2.70 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. $81.00 Fire SC $5.40 PLAN CHECK FEE TOTALFEE $89.10 SIGNATU FCONTRA OR AUTHORIZED AGENT (DATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT WOE 1. S,GNA URE OF OW NERoF OWNER SUILDER1 IDATEi nd NEW [ ] Effective 1/1/95 "ADDN " [ :] . CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 f�r�y /�� g ildin�Permit A plication ?_t),,771 P Construction Address: Legal Description: CJG Owner Name & Address: ' _ Tel. # Contractor: MN LICENSE # a003G3&1P .Address: G-J5/ AP'A_ 57 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: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of 'Construction: Estimated Cost: $y Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: _ DATE: le r (,�)—q!5 . APPLICANT: Ft. + 6 Ft = Ft x $ Tel. # CITE' USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharged/til' $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: sueutT PE City of Fridley 28704 AT THE TOP OF THE TWINS BUILDING PERMiT I 1572-3goQ4 RECEIPT NO. • ____ CO MUNITY DEVELOPMENT DIV. v r PROTECTIVE INSPECTION SEC. NUM EA REV OATH OF APPROVED BY 1PAGE CITY HALL FRIDLEY 554;2 L 612-571-3450 910-F15 12/3/98 JOB ADDRESS 1502J/1506.)1510- 1 LEGALLOT NO. K TRACTOR ADDITION SEE ATTACHED DESCR.Part nf SPrtinn 13 SHEET 2 PROPERTY OWNER MAIL AODRES$ ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 ' USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION O ALTERATION XX REPAIR, O MOVE O REMOVE 8 DESCRIBE WORK 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with theState Building Code. TYP9 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 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. DWLG. UNITS OFFSTREET PARKING 1 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 $2.48 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4970 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF AN OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TH PERFORMANCE OF CONSTRUCTION Fire SC 4.97 /� PLAN CHECK FEE TOTAL FEE �J�7 0 $112.20 S 514ATURE Of' CONTRA OR OR AUTHORIZED AGENT MATES I WHEN PROPERLY Aawlt/1 _K__P -owd INSP LIDATED THIS IS YOUR PERMIT e, Aa f�All _ S.GNATUREOFOWNERdFOWNER BUILDERI (DATE. NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY (��,�,�/ O� ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �r� BUILDING PERMIT APPLICATION ConstructionAddress: ' =�CJ Legal Description: Owner Name & Address: 06; n Tel. #_r: 6 r-1 '13eli Contractor: MN LICENSE # Address: n of 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: Length Width Hgt/Ground Sq. Ft. OTHER: C_ p -S � Construction Type: Estimated Cost: $_i/'g`? (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `2� �`7 G APPLICANT: �— Tel. # – Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 11c2. c2 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 - APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMRFR nF FIXTI IRFR Tr) RF IM!QTAI 1 s=n nAI Geula n nno Effective On Jan 1, 2000 IS®[P )k)o PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS f -MITE itS d1ZL) e— New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7..00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city. codes and rulings of the Building Division, and hereby declares that all the facts .and representations stated in this application are true and correct. KUBACKI, JOAN / 1506 NORTH TIMBER RIDGE N.E. �d l S , 20 02 - FRIDLEY, MN 55432 (763) 574-1061 Owner _ Building Used As '�Sv1DA=-JU Cz Estimated Cost PERMIT NO. PLUMBING COMPANY rk=M PLO 4j SIGNED B �:� _ TEL NO.6LZ"SZ7 3 Approved By Rough -In Date Final Dat A MINIMUM Mr- 4'UK ANY PLUMBINGIGAS PERMIT IS $20 TOTAL FEE $20.50 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE gym ill _ - • • IS®[P )k)o PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS f -MITE itS d1ZL) e— New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7..00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city. codes and rulings of the Building Division, and hereby declares that all the facts .and representations stated in this application are true and correct. KUBACKI, JOAN / 1506 NORTH TIMBER RIDGE N.E. �d l S , 20 02 - FRIDLEY, MN 55432 (763) 574-1061 Owner _ Building Used As '�Sv1DA=-JU Cz Estimated Cost PERMIT NO. PLUMBING COMPANY rk=M PLO 4j SIGNED B �:� _ TEL NO.6LZ"SZ7 3 Approved By Rough -In Date Final Dat A MINIMUM Mr- 4'UK ANY PLUMBINGIGAS PERMIT IS $20 TOTAL FEE $20.50 PLUS THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing 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. 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. The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. 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(*. ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installina 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 PERM �2004-011 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 07/22/2004 572-36U4 YAX: (7(33) 571-1287 ADDRESS : 1506 N TIMBER RIDGE NE PIN : 133024110101 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK VALUATION : $ 1,092.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. REPLACE AN 1 PX 8' DECK STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE 41.80 GASSEN COMPANY INC FIRE SURCHARGE 1.09 7275 BUSH LAKE RD STATE SURCHARGE, VALUE 0.55 EDINA, MN 55439- LICENSE SURCHARGE 5.00 (952) 522-5575 TOTAL 48.44 PAID WITH CHECK # 24678 OWNER KUBACKI JOAN C 1506 N TIMBER RIDGE 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 conviction qr je-performance of construc)ion.. Bldg Insp Dat le )SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ J ADDN [] ALTER Construction Address: Legal Description: CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R - BUILDING PERMIT APPLICATION "R�WMIR � 110+1- Effective 4/1/2004 (763) 572-3604 Bldg Insp 2 (763) 571-1287 Fax d (2D R39'7� Owner Name & Addr S* Tel. # Contractor. sEe , MN LICENSE# Address: —1,175- Gj 3"' (.e -"t4 J2-0 ZO)&-- , r► ,� Tel. # Tfl Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG.AREA: Length _ Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: -- --- ��S �- - Estimated Cost: $ ' Construction ype: - - �- rivev ay Curb Cut Width Needed: t = Ft x $ _ $ DATE: ® APPLIC Tel. # �� Call (763) 572-3604 for Permit Fees if mailing in applic ion. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Fee $ 0 P . "n Review $ -- Fire Surcharge State Surcharge SAC Charge $ /. $ r License Surcharge Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ STIPULATIONS: Building MECHANICAL Permit No.:,20.01 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DatVEq: // DATE �h/60 7 YOUR E-MAIL ADDRESS SITE ADDRESS 1.-4'02.1 7Z T/' M A44 o' THIS APPLICANT IS: ❑ OWNER PROPERTY 'CCONTRACTOR NAME: �%®Q r� �i Lti Gtr �.C� OWNER/ ADDRESS:A-VmLI A". "?,GLw Al'e CITY STATFI7/i?LIPss ' TENANT PHONE: %100 w.5 7y—/oGei CONTRACTOR COMPANY NAME: G'i-0 h.s9�l�rr� 8 CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: &OP / % L7000�ri`Gh /else CITY `3fi�f/4e�-rl�iC STATFi/�1�,ZIP��i/a APPLICATION PHONE4/'�v? '�'0�9 �c3 �Grb FAX PERMIT TYPE TINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW(REPLACEMENT 11ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU '21VVv 000 MFG: 8 MODEL:C _fW / / SIMBTU MFG: MODEL: SIZE/BTU ✓A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 2PURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMITTEE FOR PR JEt `I!SbVER $500 Permit Fee $ _ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 / x $25.00 = $ Number of fixtures @ $35.00 / x $35.00 = $, Od State Surcharge = $ .50 Total THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this 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 which requires review of plans. �and /approval SIGNATURE OF APPLICANT D/<<zk ( ri/.1�.,liGr+ PRINT NAMED/OI7Vj� G��I�'ilO��f�1�5 DATE_4�"i PLEASE,NOTE: 'SEPARATE.PERMITS ARE REQUIRED F5R BUILDING, ELECTRICAL AND MECHAN)C4LVORK '. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977 107 Q JOB NAME. JOB ADDRESS: Heating TD = 90 F (+70 F indoor -20 F outside) . Cooling TD = 20 F (+75 indoor +95 F outside) HEAT LOSS HEAT GAIN SQ FT COEFF BTUHF SQ FT COEFF BTUH '� "C1;-".--,",: 17 '4Single 33/24 116 Double 0 82 ® 90/74Low E 40 48/39 Other F�4,000 � �� -� � � � x # c 300�. 6� r 12" 3 12" � c % aT`Q, sY t 1 [��..@S(j��l �. tG' 01 9" 4 9" 2 6" 73(o 5 �OO 6" 3 3" 8 3" 4 3" 7 3" .3,6 3 4 10 1-1/2" 4 tib 0" '�3 6 1" 3.5# O 600 Blw grade 1.5 Slab -grade Iin.Ft. 30/Lin. Ft.` m ®v5 , t . F 2 500 SUBTOTAL 11 35`0, 118- SUBTOTAL INFILTRATION: Infiltration CFM = .50 x cubic feet of house divided by 60 .50 x L x W x H / 60 = �00- � Infiltration CFM NOTE:*Additional heating infiltration load should be calculated only if house is loosley constructed Infiltration Infilt. CFM Coeff BTUH Infiltration Infilt. CFM Coeff BTUH * 99 Sensible 22 Latent 24 Attic or crawls ace 10% Attic or crawls ace 10% �� ^' a � s�r�� K ag3'3�' 1 � m •'m m �iYF��,. mr, s.L�� Z� �: 800% Furnace divide b .70 90% Furnace divide b.80��` FURNACE MODEL # JAIR COND. MODEL # / NOTE: Drawing or sketch including location of Condensing unit on back of this form 4/23/2002