PRE 2010 DOCSSUBJECT
PERMIT NO.
City of Fridley
® 12806
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
` ___ ___ COMMUNITY DEVELOPMENT DIV.
Tr
���'�®
r ; PROTECTIVE INSPECTION SEC.
73
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
11/15/74
JOB ADDRESS 1494 Onondaga Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
1
Jim Lund Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Lund Construction, Inc. 2417 - 148th Avenue N.E., Anoka
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS 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
Construct a 24' x 40' Dwellin and a 26' x 22' Garage
9 CHANGE OF USE FROM TO
STIOULATIONS Provide a hard surface driveway. Provide a verifying survey before
capping.
SEWER LOCATION: 138' east of Manhole (Inv. 886.99)
Wye Elev: Including 4' riser = 892.20
Top of Footing: 895.75 Minimum
WATER LOCATION: 10' east of sewer service
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PL1,J1APjIfr,1G AN0 )sGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Hood, Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PAR ING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
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
$24,052
12.03
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 PERFORMANC OF CONSTRUCTION.
$47.00
300.00
/�
PLAN CHECK FEE
TOTAL FEE
1 lc l
359.03
SIGN TUREOFCONTRACTOR ORAUTHORIZEDAGENT IDA E)
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
BLDG INSP DATE
0
QSMVEY
FOR `TG �1.9gti1.- -- ---------------
— ( _ `1 900.7
/ ( % T a
C9o3.0
Eq:cm'n:�i
(9o3i 0 q - ,9^t 7)
_ 4
`
T7. OC
Denotes iron monument
Note: Description invalid until
plat is filed
(900) Denotes Existing Grade
Proposed Top of Foundation- 903.5
Fq-o-3Fj D -.motes Proposed Grade
DESCRIPTION:
Lot 2, Block 1, Proposed JIM LUND ESTATES,
Anoka County, Minnesota
' I hereby certify that this is a true and correct representation of a survey of Jot) No.
,own & Country the boundaries of the above described land and of the location of all buildings, `68
if any, thereon, and all visible encroachments, if any, from or on said land.
Book _Paye .
lti - -_9
Loral J'uiveyrny ® Site Planning As surveyed h•; me this _ _... �% �%._ day of -- --. � ----- 1 "
8tilfi 10ty Av N. 0 94 at Buono Av. N.'t -
gtuokiyn Nark. MN 55428 4®,
Phone 533 7340 Minn. Rcc3. No- __ ��4.. -_- _
rr _
17-00
i +
i
O
O
dam-•
�f'
903
903
®
1 zo
®
6
Proposed
�{ovtC
Q
®
2b
(n
(9031 a 24
Eq:cm'n:�i
(9o3i 0 q - ,9^t 7)
_ 4
`
T7. OC
Denotes iron monument
Note: Description invalid until
plat is filed
(900) Denotes Existing Grade
Proposed Top of Foundation- 903.5
Fq-o-3Fj D -.motes Proposed Grade
DESCRIPTION:
Lot 2, Block 1, Proposed JIM LUND ESTATES,
Anoka County, Minnesota
' I hereby certify that this is a true and correct representation of a survey of Jot) No.
,own & Country the boundaries of the above described land and of the location of all buildings, `68
if any, thereon, and all visible encroachments, if any, from or on said land.
Book _Paye .
lti - -_9
Loral J'uiveyrny ® Site Planning As surveyed h•; me this _ _... �% �%._ day of -- --. � ----- 1 "
8tilfi 10ty Av N. 0 94 at Buono Av. N.'t -
gtuokiyn Nark. MN 55428 4®,
Phone 533 7340 Minn. Rcc3. No- __ ��4.. -_- _
rr _
ze)
z�, ®T
70 r
F9 0?, vZ d
4� 7-T Zdt-,r 4t—, � Ti 6/z
' �', of- Sewer %ge r vjc
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNERS I Ar1E:,TAMES LUND .CQNST..,INC. BUILDER: JAMES LUND. QN T. INC.
ADDRESS: 2417 148t, Ave NE Anoka ADDRESS: 2417 148th Ave NE Anak
NO:. 1484 STREET: Onondaga Street
LOT: 2 BLOCK: 1 ADDITION: JIM LUND ESTATES
W- 121
CORNER LOT: INSIDE LOT: X SETBACK: 46.00 SIDEYARD E- 151
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:
i�.
Single family Front: Z41 Depth: 401 Height:
Dwelling :.j
quare Feet: 9601 Cubic Feet:
Garage cont: 4&1= Depth: 221 Height:
C3—
Square Feed Cubic Feet: =
Type of Construction: Frame Estimated Cost: $ S4,000.00
To Be Completed 2-1-75
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.
DATE: 10-13-74 SI
(See Reverse Side For Additional
o
x,
ek,�iz`"a
Ciiy ®f Fridley
Applicekli for r1ambIng end G= IRMhq
Dept. of Bldsa. Phone, 590-3480
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
ffi��1
x $3.25
$
Water Heater (Up to 99,000 BTU) ....
x $3.00
$
�7
�
`Z
8
$
Q5
Electric Water Beater ..............
OV
w
0
p
•
•
N
WATER NTR.
GAS
[LEC.
Base
!
�,
1st 3 Fixtures .............. • .. • •
f�
=
r
Additional Fixtures ..................
x $ .75
$
Gas Range to 199,000 BTU ... ,.........
x $5.00
6 -
1st
2nd
3rd
4th
• Future, Connection Openings I � � w= Sewer
#
Now Fixture. Old Openings Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ........ ......... x $2.00 $ G -
Future Fixture Opening ........
n B .... f x$1.50
New Fixture Old Opening ........... x $1.50 $
Catch Basin ....................
x $3.25
$
Water Heater (Up to 99,000 BTU) ....
x $3.00
$
New Ground Run Old Bldg. ........
x $3.25
$
Electric Water Beater ..............
a $2.00
$
SAS FITTING FEES:
NO. RATE
TOTAL
�,
1st 3 Fixtures .............. • .. • •
x $2.00-
=
r
Additional Fixtures ..................
x $ .75
$
Gas Range to 199,000 BTU ... ,.........
x $5.00
6 -
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,
Owner
Kind of Building
Used as
19 /
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.
Signed"IL,;_ � r :%
By
Business Phone No
ROUGH
d
REPAIRS & ALTERATIONS—Rotor to Code
.50 State Surcharge
Description .............................................. i
TOTAL FEE S'
kppfted Ion fW Po"rerrl and v`aq.: coang. verfoRafto. R
kir Cand Mr whg Symms and Devi=
GRAVM WARM AM:
IMTZ T07JUL
Furnace Shell & Duct Wont
. $10.00
Replacement of Furnace
6.00
Repairs & Alterations—up to $500.00
6.00.
'Repairs & Alterations each add. 5500.00
300
Furnace Shell & Duct Work to 12.0,000 BTU ..$1000 S - F1
each add.. 60,000 BTU . .. ...... 3.W y
Replacement of Furnace 6.00 $
,Repairs & Alterations --up to $500.00 &00 g
Repairs & Alterations each add. 5500.00 3.00 $
STEAM or NOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. F.DR Steam $10.40 $
Furnace Shell. & Linc- -to 640 sq. ft. EDR Hot Water 10.00 $
Each add. 200 sq. ft. EDR Steam R.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 ZUR=R (UP to 10,0W BTU} b 0tD $ 7 a
over 199.000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures — _ X$ zoo
Additional Fixtures x .75
Gas Range Range tb 199.0W XZ$ 5.00 >B
r =� 1; � ' 'I,PS it s-. +, X •; r,1.aF
7e.
State Surcharge .50
Gas Feo mcbCdab
ToTa L rm s 7S'O
�11
City of Fridley:
The undersigned hereby makes application for a permit for the work herd
specified, agreeing to do all work in strict accordance with the City Ortibmaneev
and ruling of the Department of Buildings, and hereby declares that all the fess,
and representatiuns stated in this application are true and correct.
Owner
Kind of B
Used as
Fridley. Minn
1d r1
To be completed about
Estimated Cast, $ / �S
OlNe . Building Permit No. _—_ Permit No.���
o?"( •S: �_ * - F
EIFA77NG or POWER PZ.ANj%T�S-Steam, Blot Water, Warim Air—No
+�
Trade Name �y�✓�^�r� v° Size
-Capacity—_—.— Sq. rt. E.D.R 2' ®®�14'r[ �� Hip -
Total Connected Load / Mnd at FP w
BURNER — Trade Size No-,_,12®� ?7
capacity- Sq. 7L v D � RTU ffi,S:
(UNA otS-OMS
560-3450
Cif®a11e
ANOKA COUNTY
6439 UNIVERSITY AVENUE NE January 16, 1975 FRIDLEY, MINNESOTA 55432
James Lund Construction, Inc.
2417 - 148th Avenue N.E.
Anoka, Minnesota 55303
Re: Structural. Finals on Homes in
Jim Lund Estates.
Dear Mr. Lund:
You have been requesting finals on the homes built in Jim Lund Estates.
Upon making these inspections, we have noted that there are no door closers
on the door leading from the dwelling unit to the garage.. This is a
requirement of the Building Code and therefore you must install them. Make
sure that they are capable of completely closing the door as some that we
have seen are not capable enough and do not close and latch the door.
This is necessary to keep the integrity of the firewall between the
house and the garage.
We ask for your cooperation in getting these installed on all your
homes prior to your requesting finals and those with people in and already
finaled must be installed on or before February 7, 1975.
Upon your completion of this request, would you please supply us with
the addresses of those installed in the homes that we have already make
finals on so we can reinspect them.
If there are any questions on this matter, please feel free to contact
me at 560-3450.
Sincerely,
DARREL G. CLARK
Community Development Adm.
DGC/mh
iC
SUBJECT
PE
City of Fridley
o 18 9 6 6
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION
r 1 PROTECTIVE SEC.
y
1 �
{ CITY HALL FRIDLEY 55432
NUMBER
REV,
DATEPAGE
OF
APPROVED BY
612-571-3450
910-F15
5/27/87
/ 1 1
DC
JOB ADDRESS 1494 Onondaga Street N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Jim Lund Estates
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Gerald J. Wickman 1494 Onondaga St, N.E. 55432
786-7486
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
s ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAILADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW -N ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove deck and replace Huth. three season porch. C12' by
101).
9 CHANGE OF USE FROM TO
STIPULATIONS
Use treated wood,
Provide colar ties and beam.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
porch.
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
1.20
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,000.00
$ 1.38
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.
$44.50
^�-
PLAN CHECK FEE
TOTALFEE
$11.13.
$57.01
SIGNATURE OF CONTRACTph OWOA THORIZED AGENT (DATE) V
a P
RL VALIDATED
THIS IS YOUR PE MIT
e s ��
WHEPR
SP
a
sX
DATE
SIGNATURE O N RUF OWNER BUILDERI IDA I
iC
NEW [ ]
City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
s
Construction Address
Legal Description: M '" � -/" - -�./
re we Tel. # 7R-%�s
Owner Name & Address:
Contractor: J!4 M4, Tel. # -
Address
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.
pgc�o= AREA: Le5,th
Width Hgt/Ground ( 77 Sq. Ft.
OTHER:
q t� -2 3� 16 910 -1 12� x Iq�®�
Side Yard Setback
Ft. Yd. Setback
Corner Lot [ ] Inside Lot [ ] /�� ��
Type of Construction: b Estimated Cost: $ 90
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width
If New Opening Is
Desired: See Back Page
for Explanation
Tel
DATE:
APPLICANT:
.�"
CITY
USE ONLY
Fee
$ .
Fee Schedule on Reverse
Side
Permit
Check
$
25$ of Building Permit
Fee
Plan
3
$.50/$1,000 Valuation
State Surcharge
$
SAC Charge
$
$525 per SAC Unit
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [
] Not Necessary [ 7
TOTAL
$
STIPULATIONS:
8!f
0?-)°� U
O1 0 oc', ��.J
Tit R. op SURVEV
ICE TORCA
FOR_ TAMES LUND
ESTATES, Ahoka County' Minnesota
i � �� &® �� - I hereby certify that this is a true and crirrect rewsentat{o�1 of a survey 1)f ' :;n4t iiiI
the boundaries of the above destribed land and of.the location of allhtiildings,,:
it any, thereon, and all visible encroachments, it any, front or on said lanri, t�D�
-
Land Serve rn O Site. Planning As surveyed by me this � r.:;. No. day of
y. 9 y
li Civil Engineering
(y�//1� 59'
t?$16 70hh Av. N. If 94 at [iuune Av N.1 -. __ ._. ..._._ _. _ ..f .PL'E'1�c�CGtai- . R�S.4.....� ..._:_ ..,. •
Brouklyn Park,'htN 55428
j
Phone- 5337340 Minn. Rey. No.
C11
C,
M
M
77.0®
Y..) Pj;"e..•.nc�
x
1
V
F
j
o -Denotes
iron•monument:;
Ut+utY .� Qriinagg EgyFrrtnt
'—
RGViSed' O •s'a�1!J
",'. OltnClc'i t CAn
.'
— — — —
,
%74
�
77-00
DESCRIPTIONe
`Lot 2, Block*l, JIM LUND
ESTATES, Ahoka County' Minnesota
i � �� &® �� - I hereby certify that this is a true and crirrect rewsentat{o�1 of a survey 1)f ' :;n4t iiiI
the boundaries of the above destribed land and of.the location of allhtiildings,,:
it any, thereon, and all visible encroachments, it any, front or on said lanri, t�D�
-
Land Serve rn O Site. Planning As surveyed by me this � r.:;. No. day of
y. 9 y
li Civil Engineering
(y�//1� 59'
t?$16 70hh Av. N. If 94 at [iuune Av N.1 -. __ ._. ..._._ _. _ ..f .PL'E'1�c�CGtai- . R�S.4.....� ..._:_ ..,. •
Brouklyn Park,'htN 55428
j
Phone- 5337340 Minn. Rey. No.
City of Fridley�'2
SUBJECT
-
P
7 3'J5
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r� �®
j
eoJC
I . �
",I CITY HALL FRIDLEY 53432
NUMBER
REV
DATE
PAGE OF
APPROVED By
1 612-571-3450
9114415
6/28/02
JOB ADDRESS 1494 Onondaga St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Jim Lund Estates
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Wickman, 1494 Onondaga St NE, Fridley, MN 55432
763-786-7486
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Northern Crest Inc, 7401 Central Ave NE, Fridley, MN 55432 763-792-9564 20098415
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
�l NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Construct 10' x 12' 3-season
8 CHANGEOFUSEFROM TO
STIPULATIONS
REQUIRED FOR.
See notations on plans.
WIRING HEATINAA
1
Per Section 1402, 1997 Uniform Building Code requires that a B'LU IATA S�a
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions to 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 the application guidelines.
Call for inspection of wrap before covering.
WARNING
Ventilation must meet State Building Code.
Before digging call for
all utility locations
450002
TYPE OF CO ST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING.
Cr 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 DWLG. UNITS
OFFSTREET PARKING
I 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
$16,500.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$8.25
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 PERFORMANC $265.25
Fire SC $16.50
OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
�Q
Licens5.00 $2 .00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATE, HE PROP
VALID TED HIS IS YOUR PERMIT
S,GNATURE OF OWNEROF OWNER BUILDER, IOATE, B G ,NSP
_'ATE
NEW []
ADDN []
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/2002
(763) 572-3604 Bldg Insp
NL I
Legal Description:
Owner Name/�& Address: A) ftAc' '7rl Tel. # �6 0
Contractor: Nee -nen 0d-0'5 f" 'thc , MN LICENSE # 2 d ®q V q/ 5 -
Address: llgo( 6eaj 1,9V e` / ' F?Q kf W Tel. # 16 3 - '%fa - 9196 y
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
�6 z 516 16 .-a I /
LIVING AREA: Length Width Height _ Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: �� - S� a- V olti� ���a'�-a s�'� Loi(/Jet` -
0ou a
A^ ( e4s'
"
Construction Type: 0 � Estimated Cost: $ Z ; Too,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE:4—lq-oo- APPLICANT: Tel.#
��LL r 7G 3-% a- 50 G 3
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using cre it card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ C� 06
$ "51 CO
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ ]
$ �D9 "s-, W STIPULATIONS:
W
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement) ltti j(44�
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
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
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.
Effective On May 10, 1999
JOB ADDRESS4�W r�/air�S Gy
OWNER 46 CA s�
TOTAL
BUILDING USED AS�
$ r
ESTIMATED COST PERMIT NO. Zf
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name Size No.
BTU HP EDR
$ Fuel Total Connected Load
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
$ .50 rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are -true and correct.
HEATING MA
Signed
Approved By Rough -In Date
DATE
Final Date '�
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
8. Has combustion air been provided for water heater Yes () No ( )
Remarks:
HEATING CO:
Signed By:
Date:
CHIMNEY AND -STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:
1.
Has been carefully examined
Yes ()
No
( )
2.
Is free from rust or deterioration
Yes
O No
( )
3.
Has no foreign objects lodged within
Yes ()
No
( )
4.
Is securely supported -
Yes (
). No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()
No
( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
8. Has combustion air been provided for water heater Yes () No ( )
Remarks:
HEATING CO:
Signed By:
Date: