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PRE 2010 DOCSBUHMING PERNIff N® 300 { ownellAirea Archite Fridley, Minn., 7 % 18 Builder. ,k !►,_ aid LOCATION OF BUILDING NO, / � I� street �� ` Part of Lo Lot Block Addition or Sub -Division � DSCI�II"1'ION OF BIiMDING Front_�' " Depth Heights S Stories Manner of Construction- 4 To be used as To be completed IJ+� 1£ ted Cost 0 Permit is hereby > to io .m the buildin the above statem . This permit is granted upon the express eon tion that person9=r t is granted, his agents, empl ees and workmen, in all the work done in, around alad upon said bany part th f, shall conform all .respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance,,, repair md moving of buildings within the city limits, and this permit maybe revoked at any time upon violation of an of the provisions of said ordinances. ector of Buildings. AGREENT .AND SWORN STATEMEIM In consideration of the issue and delivery to me by the Inspector of E aildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridle r, and, being first duly sword, I hereby state and say- that the facts stated by ms and contained ft the above permit are true as therein stated. Subscribed and pworn to before me at Fridley, Minnesota, Wo day of A.D. I&U Application for Power Plants and Heating. Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,00 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL / – $ See Fee Schedule g TOTAL FEE $' Dept. of Bldgs. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work hereir specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn- Owner Kind of Building Used as ''Ve'�c To be completed about Estimated Cost, $ �ONew. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS team, Hot Water, Warm Air�No Trade Name ; s` L; Size No. ! ®� C-7 Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fue' r BURNER —Trade Namei �s L1i�No- Capacity =a �� �— Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signed Ke� Byrd i� dam/ /!�'i����a �® ae Business Phone No- PERMIT for Power Plants and Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of_ / H_eating Plants WQJ Dq2 Q.ZAJ to bens lle ltered—repaired Make / OQ v ; Oil fired—, Coal fired—L Gas fired t ; Gas Authorization No. Remarks Approved by Final Inspection 19._ Inspector Permit N° 4881 Fee $ (0.0© Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. . 36 , 1926 Owner1�i, t�i%> ^ OA% Location A21S4 Kind of Building 4-64�Q How Occupied Work to be Commenced—, 19— To be Completed ,19_ Estimated Cost, GO 0®New, Building Permit No. Permission is hereby granted toJJC) . 1 4 N-LIJ—IU � QLD - i t to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications et forth in the approved application for this permit on file in the office j'ice o f the Inspector of Buildings. % ,f' �Q.�Q�2 �✓yi� � • �✓l E9L��� , Inspector of Buildings a 2 2M 11'57 V CITY OF FRIDLEY Effective Date May 1. ]gas APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 1QPCTnP_1CTT1T. RATE TO'PAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $_ 20.00 Gas Piping 0 6,,/Le- 7$ 10.00 $ C � c (piping needed with nerftrnurnace)/ Gas Range $ 10.00 $ Gas Dryer $ 10.00 • Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations It of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1• of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. DateQ Final Insp. 1/ —ZS_ Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 - PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. S Job Address ���� -�!✓ ��v'7/i t Department of Buildings# 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Tel. 0571-3450 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. /7 Fridley, Minn. , 19��2 OWNER KIND OF BUILDING C IC USED AS TO BE COMPLETED ABOUT OI ESTIMATED COST OLD/- NEW BUILDING PERMIT NO. PERMIT NO. / V CO 3� DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water,No. tm Air= Trade Name-r"/G�`L Site No. 117- 61 fir- G 5 Capacity Sq. Ft. EDR BTU ��� ��� HP Total Connected load Kind of Fuel BURNER - Trade Name Site No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. Mo.� Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes 2. Is free from rust or deterioration Yes ( ) 3. Has no foreign objects lodged within Yes ( ) 4. Is securely supported Yes ( ) 5. Meets all current Code requirements for size and total BTU connected 6. Has Total heating BTU's of t j 0 La All other BTU's TOTAL 7 � / c Rema rks No ( ) No ( ) No ( ) No ( ) Yes ( ) No ( ) Company J Lam_e r C L t� ZtC-� (� Signed By Date �/ C� SUBJECT City of Fridley (zP2 3 9 2 7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO.�J COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC,/ CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE Of APPROVED BY 612-571-3450 910-F15 12/20/95 / / JOB ADDRESS 1245 Norton Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 7 Auditor's Sub 489 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leslie Moore 1245 Norton Avenue NE 574-2591 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Creative Design & Finish Inc 1815 Oregon Ave S. St Louis Park 55426 544-3906 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5557 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 1p ALTERATION REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House; Install windows; add insulation 9 CHANGE OF USE FROM TO STIPULATIONS See notations on bid sheet. Replacement bedroom windows must meet the State Egress Code. UNderlayment on reroofing must meet 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 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 1STALLS 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 $5,745 $2.87 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 $112.25 Fire SC $5.75 PLAN CHECK FEE TOTALFEE License SC $5.00 $125.87 SIGNATURE OF CONTRACTOR OR AUTPPGRIZED AGENT MATE) jV WHEN ROP LY VALIDATED THIS IS YOUR PERMIT FjDG INSP "/ DATE SIGNATURE OF OWNER SIF OWNER BUILDERI IDATEI NEW [ ] Effective 8/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2� Building Permit Application Construction Address:,�,�_– Legal Description: — Owner Name & Address: G �� ����� Tel. # Contractor: C�7Z%77 4= MN LICENSE # % ���✓v-�S�ue si,e Tel. #�/ 3 Address:. �/� U � � 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:` Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:Cost: Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: i 2 APPLICANT: Tel. # Vkv-w- 9��Zo -9/ k / CITY USE ONLY Permit Fee $ Z. J Fee Schedule on Reverse Side Fire Surcharge $ 1' - .001 of Permit Valuation (1/10th%) State Surcharge $ Z, 7 $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ CO $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: BID SHEET F95-04 Leslie Moore 1245 Norton Avenue NE Fridley, MN 55432 #574-2591 Contractor !8!b 0,� �� Sa 5L 1 a..:. E,1o.Y�, M. ss w6 _ � ��1....d.d•& �n..ytS57 Contractor's Signature S-1 LIVING ROOM $ ! 3 ZS- a. install window replacement, vinyl* framed, welded or mechanical corners of owner's choice, insulated glass (min U .40), screen, weatherstripping (no vinyl permitted), lock -ins device and hardware. Benda or equal. Set into existing openings. Reuse trim and casing. owner's choice of color. (4 DH) S-2 KITCHEN Installwindow replacement. Refer to spec S-1 a. (3 DH) -,�b. Redo flooring. Install new vinyl sheet floor covering over structural grade underlayment. Congoleutn or equal. $20.00 sq yd installed allowance. Owner's choice of color and pattern Edging of floor covering shall be covered (confirm material and finish with owner). S-3 BATHROOM rv,I(Xv-) 6 j $ 2- 0,- a. Install window replacement. Refer to spec S -t a. (1 nH) A S-4 OTHER ROOMS USED FOR LIVING AND HALLS Dining Room install window replacement. Refer to C ep spec S-1 a. (3 DH) Hallway/bedroom S__Ceyo b. Install window replacement. Refer to spec S-1 a. (2 DH) North bedroom --- - - --- -- $ 10f-% c. Install window replacement. Refer to spec S-1 a. (2 DII/CO),-One window shall meet egress code requirements. Confirm location with owner. West bedroom /l,; $ 20,-d. Install window replacement. Refer to spec S-1 a (L OH) Werk does not include glass block window. New window shall meet egress code requirements. Laundry room 5.- e. Install new steel insulated exterior door, prehung unit, six panel or light of owner's choice, new threshold, weatherstripping and hardware. Cactlegate or equal. Reuse casing Apply painter's finish to new wood frarning. Key alike to other door. Supply owner with 2 keys. 04W=: Install deadbolt as locking device, Schlage or equal. Key alike to other doors. Supply owner r with 2 keys. S '75'- S-6 BUILDING EXT)=.RIOR - rn;�SVia. Install new storm/screen door for north entry (ofi laundry room), solid core, baked enamel prefinished aluminum, with weatherstripping, self -storing corm and screen inserts, hardware and locking device for complete assembly. Benada or equal. Owners choice: of color. ;;{� 21�• ` b. Install new storm/screen door for east entry (off kitchen). Refer to spec S-6 a. ro:; y i i fbf Leslie Moore - page 2 of 3 S L�r� -mac. Tear -off shingles of roofing down to bare wood (garage and house) Haul away debris Replace rntten boards. Specify separate board replacement cost per sq ft. S..? , 2 .7 . Install ice and water shield/starter and metal drip edge along roof where gutters and ribbon boWs are installed Replace plumbing jars. Roof vents shall be checked and if damaged, shall be replaced. Install new 0 LV 240# 3 -tab asphalt shingles, laid over one layer nonperforated. Type 15 felt Certainteed or equal. Ridge shall be laid "Boston" style. Owner's choice of color. Cover entire cave area of house and garage with .0l 9 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Apply aerated material to vented soffit area and ensure soffit venfing that is open to attic area for unobstructed air flow. Owner's choice of color. S �3aZ e. Cover entire trim area around windows and doors of house and garage (includes overhead door) with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Owner's choice of color. rni �S 2&c -I f. Install new gutters and downspouts along south roof edge of house (front) and east side of garage roof, baked enamel prefirnshed aluminum. Alcoa or equal. Gutters shall be S" seamless, secured to roof edge 36" or less on center and pitched. Downspouts shall be 2"0" corrugated, secured to wall and with an installed extension, extending a minimum 60" out from downspout. Owner's choice of coloi: Confirm location with owner. S-7 HEATXNG AND PLUMBING S '2 5a a. Vent laundry tub. $Sa b. Vent latchen sink- 4. tion: Repair damaged surfaces caused by venting work. S__ S_S?i c. Vent bathroom fixtures. tion: Repair damaged surfaces caused by venting work. S 11/0, _ S Jct d. Replace undersized water supply piping between main and water heater with new. Se. Install back flow preventer to exterior faucet, self -draining. S -5D•' f. Remove two fuel oil tanks in ground from north side of house. Abandonment shall meet State regulations. PS U n iA t: j It%At l S-8 GENERAL HEALTH AND SAFETY ^:4/ Slow attic with insulation, Ui. listed, to meet R-38. Seal all thereto b) -passes prior to insulation work Weatherstrip and insulate access panel. Instkd air chutes for so t veittngs install additional roof and soffit ventilation as needed to meet State energy code requirements. S J 30, -b. Complete fire separation wall between garage as ou . ape joints. S 3 i` c. instalLif-c10 erto fire door separating house and garage. S Ji 7 . " d. Install wood, Douglas Fir, guardrail alp ng open side of basement steps. Owner to finish wood.. Confirm design with owner. ( 3 l"=.3'? ) e. Replace cracked glazing in basement window with new. Y S-9 ELECTRICAL ' a. Install 20 amp wall receptacle for window air conditioning unit in living room. Confirm location with owner. S b. Install 20 amp wall receptacle at counter and protect wall receptacles within 60" of kitchen sink with GFI. S ya c. Install wall receptacle in bathroom, protected by GFT. SZ r—d. Correct problem of wobbly fanlight fixture in dining; room. S 3 e. Install 20 amp laundry wall receptacle. S n S -- f. Code wiring to water heater. S 70 g. Code basement wiring- open junction box at ceili'flgin- well room and hanging ceiling light fixture. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH Fi nnR Effective On March 1, 1996 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 • L'C� Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 _ Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ ��•� JOB ADDRESS 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. Owner Building Used As Estimated Cost .PLUMBING COMPANY SIGNED BY 3- 1 11996 r7 FIX, Approved ByRough—In Date Final Date f�i' MINIMUM FE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE / S'yrIII/' "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 • FAX (612) 571-1287 March 6, 1996 S. McClanahan and Leslie Moore 1245 Norton Avenue N.E. Fridley, MN 55432 RE: First Notice of Noncompliance at 1245 Norton Avenue N.E. Dear Property Owners: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent inspection of the property at 1245 Norton Avenue N.E. revealed that not all Code requirements are presently being met. Listed below are items which do not comply with the City Code: 1. Fridley City Code requires that all vehicles must be currently licensed/street operable and kept on a hard surface parking area if they are stored outside. I observed two vehicles which do not meet all these requirements. Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or shortly after March 22, 1996, to determine compliance. If you have questions or would like to discuss this violation, please contact me at 572- 3595. Thank you for your cooperation! Sincerely, Kurt Jensen -Schneider Code Enforcement Officer KJS:Is CE -96-61 V 0 SUBJECT P RMIT NIA City of Fridley 33585 AT THE TOP OF THE TWINS ?BUILDING PERMIT RECEIPT I f ` E ' COMMUNITY DEVELOPMENT DIV. a: ------ SEC. r I PROTECTIVE INSPECTION I ; NUMBERDATE PAGE O: APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 f7i 6/9/03 10B ADDRESS 1245 Norton Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 7 Auditor's Subdivision X689 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kelly Madson 1245 Norton Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northwest Exteriors Inc 6500 Walker St, St Louis Park, MN 55426 952-926-8663 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2026450 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION I REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows within existing openings; Soffit/fascia/trim 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCYLOAD 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 AN RRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDIN GOVERNING TH TV E OF WORK WILL BE COMPLIED $8,500 $4.25 WITH WHET ERS ECIFIED HEREI OR OT THE GRANTING OF A PERMIT DOES NOT PRESU E TO GIVE THO ITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION OF NY OTHER -,SAT OR LOCAL LAW REGULATING CON- $167.25 Fire SC $8.50 E PERFOR OF CC�iSTRU TION S nS-GNVAOFCON PLAN CHECK FEE TOTAL FEE ^� 'ice a SC $5.00 $185.00 'RAC DROP AUTHORIZED AGENT tDATE, /WHEN PROPERLY VALIDATED THIS IS YOUR PE MIT S-GNATURE OF 0WNER,1F OWNER BUILDERS -DATES I B DG INSP r)&IE V 0 F®-04-2002 10:25 FROM CITY OF FRIDLEY TO 9529265960 P.O1/02 NEW [ j. CITY OF FRIDLEY Effective 111/2002 ADDN [ l 6431 University Ave NE, Frldlsy, MN 55432 (763) 6723604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �Z�is d Legal Description Owner Name & Address: /11AW W Tel. # Contractor. �� b� r MN LICENSE # gC - ZOZGLOO Address: 6LOV Ltd -C kU2 S�T Tel. it 9S2 - LM rb (03 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on It to scale. DESCRIPTION OP IMPROVEMENT LIVING AREA: Length width _ Height Sq. Ft GARAGE AREA: Length VMM H"ht _ _ 5q. Ft DECK AREA: Length Width HoGround Sq. Ft OTHER: NO Construction Type: Estimated Cost TJ 0-0 Driveway Curb Cut W eed- ed: Ft @ t = Ft x m ffi DATE: (a- S' ®3 APPLIC Tel. # �( Coif (763) 672w1' 604 for Permit Fees if mailing app8catlon or Fax to 763-371.1287 If using credit card and we waI call you for card number. CITY USE ONLY - Permit Fee $ t V17 • -z Fee Schedule on Reverse Side Fire Surcharge $ J-4-0 .001 of Permit Valuation (1110th%) State Surcharge $ 4. $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ ® c) $5,00 (State Licensed Residential Contractors) Driveway Escrow $ AIL "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Pee $ Fee Detemined by Engineering Sewer Main Charge $ Agreement Necessary [ 3 Not Necessary [ ] TOTAL $ 6-° SLTIPuLATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURFS TO RF INRTAI I Fn nM FAr W FI nnR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: 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" -- NO. RATE Gas Dryer-"-' _ BacK Flow Preventer Required( )Yes ( )NO $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 1$10.130 Type $15.00 Remspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE _JA�5 /VULT-®10 HL16- TOTAL JOB ADDRESS NIM Ofs 6W&31✓'e- The undersigned hereby makes application for a permit for the worK herein specified agreeing to do all work in strict accordance witii the city codes and rulings of the wilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. MADSEN, KELLY 1245 NORTON AVENUE NORTHEAST L• ✓ ( ✓ 20_ FRIDLEY, MN 55432 (763)502-0242 Building Used Estimated Cost 400PERMIT NO. 6 CQ PLUMBINGCOMPANY�II2 PLO* �j���a SIGNED BY TEL N0. LZ"SZI `41O 13 Approved By Rough -In Date Final Date $ _50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS S20,00 PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE M�mmn , • • A Fyn i 0 �® PLUMBING FIXTURE RATES: 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" -- NO. RATE Gas Dryer-"-' _ BacK Flow Preventer Required( )Yes ( )NO $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 1$10.130 Type $15.00 Remspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE _JA�5 /VULT-®10 HL16- TOTAL JOB ADDRESS NIM Ofs 6W&31✓'e- The undersigned hereby makes application for a permit for the worK herein specified agreeing to do all work in strict accordance witii the city codes and rulings of the wilding Division, and hereby declares that all the facts and representations stated in this application are true and correct. MADSEN, KELLY 1245 NORTON AVENUE NORTHEAST L• ✓ ( ✓ 20_ FRIDLEY, MN 55432 (763)502-0242 Building Used Estimated Cost 400PERMIT NO. 6 CQ PLUMBINGCOMPANY�II2 PLO* �j���a SIGNED BY TEL N0. LZ"SZI `41O 13 Approved By Rough -In Date Final Date $ _50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS S20,00 PLUS THE 5.50 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 replacing an existing furance, the undersigned hereby verities that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes O 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 existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. (es ( ) 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 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 appliancehas 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 r)iarheter 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 FRIDUY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 '763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1245 NORTON AVE NE PIN : 123024310017 LEGAL DESC : AUD SUB NO 089 LOT 7 BLOCK 0 PARCEL 0 PERMIT TYPE PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATIQN PERMIT NO.: 2004-00019 DATE ISSUED: 01/08/2004 VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 OWNER KELLY MADSEN 1245 NORTON AVE NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS WATER HEATERS 0 0 # GAS RANGES 0 0 # WATER TRMT APPLIANCES 0 PLBG PERMIT MINIMUM FEE 20.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTRATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 27514 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 constrl*tion or the performance of construction. 11= SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.