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PRE 2010 DOCSCity of Fridley, A inn, BUILDING PERMIT N® 4444 Date: .. ._.......... .- `�..._ - ._ _.__.._......._...._.. Owner: ...-i? .�'t�......_.... - _ ...s......- Builder .........� ._..�...... Address � -." - �-< (�••�..._ Address _..--•---------.. f �......_.............�....................- - --- LOCATION PF BUILDING No........ Street .............. ... .. �......._..... Part f Lot ............. - ... Lot ....._-� . Block .............�.......................... -Addition or Sub-Divisio �-� _.----- CornerLot .......................... _........ Inside Lot ......... ......... Setback .................. - -- . ------------. Sideyard ....._.-------------------•------------------------------------- Sewer Elevation ...... .................... ........_............._.............--•-........_..............••--- Foundation Elevation -------------------- -------------- -------------- -•----•------------------ _...._-- DESCRIPTION OF BUILDING To Used d .... Front ... Depth `... Height . �....... Sq. Ft. 14a- Cu. Ft.02_10A-.`® .... .............. _........... ......._................. lFrant ........................ Depth -- ------- ..... /9Height ........._ ... Sq. Ft......................... Cu. Ft. .................. .._.. Cos" t. Type of Construction ......w./ ... Est. 621.f ...._........ To be Completed --............ ........................... CAUTION THIS PERMIT DOES_ NOT AUTHORIZE VIOLAT- ION OF ANY PRIVATE LAND COVENANTS AND BUILDING RESTRICTIONS. In consideration of the issuance to me of a permit to co5struct the the proposed work in accordance with the description abov set forth/d ordinances of the city of Fridley. i in e, I agigeto do all isisions of 410 � /� VV - In consideration of the payment of a fee of 41 x ....................... 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 buildings within the city limits and this permit may be revoked at any time upo violati, f any of the provisions of said ordinances. �% � / � / Inspector 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 items. P*4 bib. APPLICATION.: FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA. Owners Nage Builder Address A es ?. LOCATION OF BUILDING NO. Street Part. of :Lot Lot Block Addition or Sub. Div. Corner Lot Inside Lot Set Back +° Applibant attach to this form Certificate of Survey of Lot'Andl.;proposed . bnhding location. ' DESCRIPTION OF BUILDING T be used as Front _T Depth height .. 9 . Sq. Ft. _le? . -akQ4& Cu. Ft. Front ___._..__ Depth Height Sq. ' f �,, ' Cu. Ft. 1 rpeof Construction. Estimated Cost To be completed ��-.--- The undersigned•ereby•makes,applica.tion for a permit for the work here31i . specified,.agrdeing--tp 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 tfue• ancl- cor -bet. �' o Si Date �ature (A Schedule of Fee Costs can be found on the Reverse Side) CY, 407 40, r T Application for Power Plants and.. Heating. Cooling, Ventilation, Ashigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ✓ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace . §.00 $ Repairs & Alterations—up to $500.00 ... ` ............ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. IDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM r ALTERATIONS & REPAIRS TOTAL FEE $ d ROUGH— OUGH FINAL— FINAL Dept. Dept. of Bldgs. Phone SU, 4-7470 City of Fridley: 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 declares that all the facts and representations stated in this application are true and correct. n - Fridley, finis 19 Owner Kind of Building n o Used as To be completed about Estimated Cost, $ © a ' Old New. uilding Permit No. Permit No. 7` DESCRIPTION OF WORK HEATING or POWER steam, Hot Wal arm —No� Trade Name 4,/� Size No -Z y Z J Capacity Sq. Ft. E.D.R U BTU _ H.P. Total Connected Loa i Kind of Fuel /Z-" ' e BURNER — Trade Name . Size No Capacity Sq. Ft. E.D.R BTU H.P. 4637 CHCAGO AVE. Signed MINNEAPDLIS 7, MINNESOTA, By _4Lt --- 42 7M 7-59 Business Phone No (REMARKS—OVER) tr , -. tDCP ty,.ul v l v 2 ��1ipi�i� I�„yam.-��..yp'..� �_ !f� P � •1� p F � � �ne�'u:.. .'". ._....,, a ., -J w,��,�..t�.i,x• '.�a ....,�}�..0 ,. �.., .� i,,{ .. ",a.:_,.... ,.Akkn'.S. xb.... ,Cd�� .. .. .., ..... % .d,... ,�.,. f6+dY ,.. ...,._. ., .v� �..-. . u .., .:.r, z,+.., I, .re �';.k._ � . �.,Y .... .i�..., �.. .. L. ,.s,_ . .. <3.:..!.u"9E City of Fridley, Munn.. BUILDING PERMIT Date: — Y'� Owner: Address Builder Address LO OF! UILDING No. Street_ j.--. Part t Lot _ e _ Block _ _ Addition or Sub -Division N Corner Lot Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To sed as: I1� � UWAr•ort ,&— Depth Height �f Sq. Ft. ++u Cu. Ft Front DepthHeight Sq. Ft Cu. Ft Type of Construction M P3. Est' Coor" To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and In compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $", permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the exggndition that the person to whom it is granted and his agents, employees and workmen, in all work done d and upon saiddleesregardingly ts and this permit may be revoked at any time upon volatio of the provisions of said ordinances. �► Fy Inspector 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 Items. 4 Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL Locaffon_x Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ City of Fridley: The undersigned hereby makes application for a permit for the work herein Repairs & Alterations—up to $500.00 .................. 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00" " " " " " 2.50 $ 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 Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations --up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL Owner Kind of Used a., To be completed about a+' (/" z: / - ` ?6 Estimated Cost, $ / 4* Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ti Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity $ See Fee Schedule TOTAL FEE 2M �.��i�MhRKs-evER} - Sq. Ft. E.D.R BTU H.P. "I SUBJECT PERMIT NO. City of Fridley2 2 3 2 7_. AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. _ v PROTECTIVE INSPECTION SEC. yaq CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE Of APPROVED BY 612-571-3450 910-F153/14/94 JOB ADDRESS 841 OVERTON DRIVE NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 5 Brookvie SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Todd Babekuhl 841 Overton - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Squares) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,875 $.94 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $43.00 Fire Sc $1.88 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 45.82 S�4# OFCONTRAC RA�� ORI ED AGE T IDATEI WHEN PROPE L VALIDATED THIS IS YOUR PERMIT LDG INS DATE i SIGNATURE OF NER OF OWNER BUILDERI DATEI NEW [ ] ADDN [ ] ' . CITY OF FRIDLEY ALTER [ ] SINGLE FAMELY'AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: 75V )ve Effective 1/1/94 Legal Description: Owner Name & Address: p�� ,�� �� <-� Tel. Contractor: �„/`1 P f MN LICENSE # . Address: 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/Groundd Sq- Ft. OTHER: a v1,!�9 rlc rg q P -- ( �1 B 1C� �S Sif21 Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Fj-;'Aer4L4.55 Estimated Cost: $ ZB'%� Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $_ _ $ DATE: /�� APPLICANT: Tel. #10 SSS CITY USE ONLY 60 Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ / c95 .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.501$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 Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ) TOTAL $ STIPULATIONS: - / Nw SUBJECT City of Fridley 1684 AT THE TOP OF THE TWINS BUILDING PERMIT o _ COMMUNITY DEVELOPMENT DIV. tr PROTECTIVE INSPECTION SEC. Z1607 9 r NUMBER DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 , 612-571-3450 910415 JREV 7 /98 JOB ADDRESS 841 Overton Dr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 25 5 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jason Holmquist 586-0228 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Viking Home Im ro M 572-1820 4772 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION RI REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (27 Sq) Tear -off House and garage 9 CHANGE OF USE FROM TO STIPULATIONS Building Underlayment must com;I13 eith State Iftri-di7'Yl-g 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 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 2251 $1.12 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 PERFORMANCE OF CONSTRUCTION. $74.75 Fire SC $2.25 PLAN CHECK FEE Al FEE f�2 / W83.12 L-61314TU F CONTRACTOR OR AUTHORIZED AGENT (DATE) PRO VALIDA THIS IS YOUR PERMIT OG INSP f /ATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI / Nw NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: V 7 l 00"n D Legal Description: Owner Name & Address: —JCQ S' Or-) /716 / hn QYJ J� Tel. # Contractor: i r1 MN LICENSE # 2, Address: Tel. # 6-7? — /�� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EM PROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE -AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ® ®F =27/77 2teqi� .17 Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft — Ft x $ _ $ DATE. -2— 2- 7 % APPLICANT• Tel. # c� CITY USE ONL Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge 1 $ $ $ /, i .2- $ 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) 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: $ -W CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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) Gas Range Gas Dryer 0-6 �,��/ 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 JOB ADDRESS 1411 QVe1­-?)r- Effective On January 1, 2002 OWNER -.–s 14-Ap - i TOTAL BUILDING USED AS—,? '► ESTIMATED COST PERMIT NO. - DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name -;.-el Size No. BTU HP EDR $ Fuel ;6u� . 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. DATE –� O� HEATING CO / o-�P V *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. �� /® FILL ®55 e®/ Signed TEL # CL:5_/'�-j FAX # Approved By Rough -In Date Final Date �'� THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED Cnihil QN VFNTVENT ('-*nNNFCTnR AND COMMICTInN AIR VIFIRIFICATION When rr In acin�e an nAnfino Iran _ , 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 plastictPVC 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 -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The ayanting enmhtjsflnn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new cnmhue_#inn airy It will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When onntallula a new ventingiysttemm, 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 #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 _ HEATING CO: Signed By: Date : Building MECHANICAL Permit No.,X05 -Db01 y - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D Mc4AN ® 20 8 763-502-4977 FAX EFFECTIVE 1-1-08 DATE , 09 YOUR E-MAIL ADDRESS ADDRESS U ()%jvt__Pj " L' SITE THIS APPLICANT IS: ❑ OWNER XCONTRACTOR PROPERTY OWNER/ NAME: 5 r A L L k11 �"y (- k)2CITY_ STATE jAA-)ZIP_26j_z_ TENANT ADDRESS: L7'J PHONE: b t Z—('23 b — 2"/y CONTRACTOR COMPANY NAME: � -A� - £ CONTACT PERSON: ),2 c C✓l NOTE: SEPARATE CITY STATE LICENSE # 7 'AL1 0 EXP DATE ` 2� /L�.'iL'�`� Iiyl—f ("'CITY I(r') LV iLO- STATE ZIP 591 LICENSES ARE REQUIRED FOR GAS AND HVAC. DRESS: j4 SUBMIT COPY OF BOND PHONE FAX AND INSURANCE TYPE k�SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE OF WORK: O NEW ❑ REPLACEMENT &f-ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ha '� % Int, LaVad S C's / PER MS 16133.665 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 OR 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)S o J:J MFG: �Al J MODEL: �i�SS�%L. SIZE/BTU ��� Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU 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 UNIT HTR $10.00 -BOILER $35.00 _FURNACE $35.00 _GAS CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 XGAS PIPING $10 00 —VENTILATOR $15.00 It JR, Permit Fee $ Number of fixtures @ $10.00 / x $10.00 = JO $ Number of fixtures @ $15.00 x $15.00 = $ Surcharge .50 TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances I this is not a but only an application for a permit and work is not to and codes of the City of Fridley and with the Minnes nstructio Codes; that understand permit start without a permit; that the work will be n cco a roved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APP L CANT PRINT NAME ",tG'(!DATE 1 APPROVED BY DATE ., City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 From: unknown Page: 213 Date: 11/12/2008 3:41:20 PM Building PLUMBING Permit No.: Inspections RESIDENT IAL APPLICATION Received By: -ty,46 763-572-3604C0 CiTY OF FRIDLEY >�a - 0 ?63-502-4977 FAX EFFECTIVE 1-1.08 jj DATE -4 YOUR E-MAIL ADDRESS SiTE ADDRESS TH I Q—V: jw r� rv—e-, j� • THIS APPLICANT IS: © OWNER CONTRACTOR PROPERTY NAME; 71ri �TtCV OWNER/ ADDRESS: STATa f%ZIP ✓nom TENANT PHONE: -70—A*39-- q 55— 5-CONTRACTOR CONTRACTOR NAME: `^ L'^5' K CIO STATE LICENSE 0 S217— 17 N� EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE. BOND AND STATE BONS] If.7 IS ,5 1O 6XP DATE CERTiF7CATE OF f ADDRESS:CiTY /` OL -1 STA761 ZIP TNSURANCFPR 'UNE ' 6- 5— am FAX '7 PE MIT TYPE �r 1] SINGLE FAMILY O TWO FAMILY OTOWNHOUSE TYPE OF WORK: NEW la REPLACEMI'NT DETAILED DESCRIPTION OF WORT{ &5 PER MS 16B.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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, PEES ARE BASED ON $10,00 PER FIXTURE, EXCEPTWHERE NOTED. FIXTURES: (INDTCATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15,50. BATH SiNK/LAV FLOOR DRAINS SHOWER _ WATER PiPiNG ,j BATT -MR _ GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SiNK T WATER CLOSET , r BACKrT.OW PRF,v, ($1$) _ DISHWASHER ^ LAUNDRY TRAY WATER HEATER f$35) FOR IRRIGATiON _WATER METER —OTHER y;!g ��►� �vg�p�,. ' , � �. � �¢ 1Ali i i� i ; t�i�` { 1 �.€..oy;}�F .:1 ° e1'•, i ifye , ., R � 5W 6 Number of fixtures @ $10.00 .�4- x $10.00 = $ a`I.C7+-1D Permit Fee $ SurehM Number of fixtures t+ $15.00 x $15.00 = $ OR Number of fixtures c@t $35.00 x $35.00 = $_._ TOTAL DUC $ State Surcharge _ $ .50 MINIMUM $15.50 MINIMUM $ I5.50 Total = $ 4. TTnS iS AN APPLICATION FOR A PERMIT•NOT VALID UNTiL PROCESSED I hereby apply for a plumbing permit and T acknowledge that the information above is complotc 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 T 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 w ch requires review and approval of plans. ry SIGNATURE OFAPPLICANT' ..�' _ PRTNT NAME 5004- DATE APPROVED BY DATE Nu}S � t �i � �pw"' ' .} ,�i:p�fy4gyvH� •�y,1� i X11 � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 7£3502-4977 No engineering WATER AND SEWER Permit No.: -G i I 763-572-3551 PERMIT APPLICATIONReceived By:0qV__0 763-571-1287 fax AMAG 0 CITY OF FRIDLEY EFFECTIVE 6/9/09 APPLICTATIONDATE: © YOUR E-MAIL ADDRESS: 6�,�r" ��n�.�- ne.+ _ THIS APPLICANT IS: ❑ OWNER JkCONTRACTOR JOB ADDRESS: _ _ Vii I 01-jeP toa ®r- A/ e- NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: `ror-s:v' Pepe-4-,7. OWNER/ TENANT ADDRESS:_94II Q0Rr4-.n Isr IVP CITY t'►� �'p= �1 �`� STATE,�ZIP,�I� PHONE: -)(63 0 Q 3Q S CONTRACTOR NAME: SUBMITA COPY OF YOUR STATE ADDRESS: CITY�/�.�4� }�,�,9� STATE gA/ ZIPS!6_3ij LICENSE WITH p PHONE CELL PHONE: 1 q % 4 APPLICATION STATE LIC #_ L 41 n STATE BOND: EXP DATE: L pNarrative/written description: i a% /Lx-6 p 2. Please attach sketch showing curb line, utility line, building, etc. with distances. PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 WATER LINE REPAIR $40 40 V ❑ SEWER LINE REPAIR $40 ❑ ADD STATE SURCHARGE " $.50 V ❑ SAC CHARGE @ $2000 = HOW OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application for a permit and work is not to start without a permit. SIGNATURE OF APPLICANT_ / PRINT NAME: Il' tk w i 6\ DATE: 6 - cA n APPROVED BY: `\ DATE: COPY GIVEN TO: ❑ UTILITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINEERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287