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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date:....._.._.1_.._........... .................. _....._ - ......... N® 4413 Owner: ........................................ ........... ........... ......... ..... ..... ....... ................. ..... Builder .......�/ � � � .._... Address....._............._......._...._.......---•--..._.._....__...._... .._.... ....................... Address. ........ .............. -........... ................................................... ........................ ..... .... LOCATION OF BUILDING ..... .....No. .............. No....0.....�..�...... Street ....._... ...._. .. _ ........... Part f Lot ---•------------------------_...._. _.. Lot ....................... Block .-..-_... .fP/............... ......_. Addition or Sub -Division .......t....... .............. .............. .._ ........ < I Corner Lot .................................... Inside LotX .................. Setback . �....-...�........ Sideyard ... .Q...:. -O.. - ......................................... Sewer Elevation ................................... _....... _.... ................................ ...................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: ..---'L?r...... - --- c - - Front ..... /' Depth s_ Height �.�..` "'Sq. Ft. ®..�f Cu. Ft.4..A_Y / 6 :............ Front ... . � Depth ..... 9 'H/eight /0.' Sq. Ft. _3..9.. ® Cu. Ft .0 ,0 Type of Cons ction ......._... ----------------------------..------- -- Est. Cosi>��l�.- Q_�� "'ro be Completed...................._................................ In consideration of the issuance to me of a permit to con wilding de5i pec above, a ee to do the proposed work in accordance with the description abov set forth din �qb plia with a ovisions 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 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 upon violation of any of the provisions of said ordinances. Building 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 BUILDING PERMIT CITY -OF ,FRIM -EY, MINNESOTA - Owners? Name Builder CLE R®N, INC. GENERAL. CONTRACTORS Address -" x Address 2500 22nd Ave. 1�T.' Spy 9'9eapolis 10, b ixid. LOCATION OF BUILDING No. t Street en2 M /0& Part of Lot Lot / , Block 1p 'Addition or Sub.Div. Corner YLot Inside Lot j 4ESet Back' - zl_—� Side -Yard' /Q' SEWER"ELEVA`1'ION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and -proposed building location. DESCRIPTION OF BUILDING To be used'as: / *A Front �'� Depth Hea ght� . Ft. Front epth/ Height Sq. Ft.- Cu. Ft. Type of Construction Estimated Cost_ To be completed ., 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'pf the Department of Buildings, and hereby declare t all the facts ela r esenta- tions stated in his aplication are true a corre71 DATE 'SIGNATURE (A Schedule of Fee costs can be found on the Reverhe Side." Application for Power Plants and: Healing, Coding, Ventilation, .Refrigeration 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 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 BTL) ....................... 5.00 $ J 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 ALTERATIONS & REPAIRS TOTAL F= $ ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 a 6 , vld Lo 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. // � Fridley, 1NLn � �� Sq � 194 Owner Kind of Used as n To be completed about Estimated Cost, $ 0 © d Old New. uilding Permit No. '�` i� Permit No. 19 i;� DESCRIPTION OF WORK HEATING orPO PZ.ANTS-ate Hot Wa W�Air—o Trade Nam V Size No G Capacity. Sq. Ft. E.D.R BTU H.P. / Total Connected Load Kind of FuelCts/ BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R I BTU H.P. RAY N. WELTER HEATING CI 4637 CHICAGO AVE. Signed MINNEAPOLIS 7, MINNESOTA By ` ;1 i s �4E 2M 7_59 Business Phone No �"� 1/-- 19 B 6 2 - L(REMARKS -OVER) ,Id'.3® 7zrl AL - SUBJECT P city of Fridley o " 17000 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. r.y _ _ COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/2e9/83 JOB ADDRESS 860 Overton Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roy Loberg 860 Overton Drive N.E. 572-0478 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Grampre-Mueller Construction 5156 - 31st Avenue South 729-5811 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 619" x 2116" Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. WARNING FOR 'WtRMG° ftfdfe digging call local utilities PERMITS REQUIRED SIGNS. AUPRONE - ELECTRIC -GAS Etc, SEPERATE P°I-U{dBING AND HEA TING. REQUIRED BY LAW 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 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 $1,600 $. BO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHO Y TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE LOCAL LAW REGULATING CON - $26.50 TRU ION OR THE PERFORMANCE CONSTRUCTION. PLAN CHECK FEE TOTAL FEE —� $27.30 SIGNATURE OF CONTRACTO THORIZED AGENT )DATE) r WHEN PROPERLY VALIDATED THIS IS YOUP PERMIT BLDG INSP ATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM F014 RESIDENTIAL BUILDING PERMITS (News Alterations, Additions, or Repairs) OWNER: ADDRESS: ® liesega ,u b ie, TEL M0: 5-7 2- y4 Z, BUI LDE Gln <!:]Z7s— ADDRESS: S/Sly-�S sr TEL NO: (& �ZZ Construction location - STRICT NO: 660 STREET: 3 P LOT: BLOCK:ADDITIONS _ Corner Lot: Inside Lot:_ Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square Feets 156 Mbic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction �lw;i�.s rss'�.s®_� Estimated Costa S To Be Cbrapleted: Alt. A Alt. 8 Proposed Driveway 'Width If New Opening Is Desired: S S SEE MVERSE SIDE OF SHEET Zine undersigned hereby makes application for a permit for the work herein specified, agreeing to do -all work bi strict accordance with the City of Fridley Ordi»ances and rulings of the Delxirtmcnt of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNATURE: stipulations: 0 SUBJECT City of Fridley 5459 AT THE TOP OF THE TWINS BUILDING PERMIT ' r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEV 55432 NUMBER REV DATE 9/3/97 PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 860 Overton Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 Brookview Terrace 3rd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roy%Mary Loberg 860 Overton Drive NE 572-0478 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Pat O'Loughlin Northern Sun Builders 772 Mississippi St NE, Fridle , MN 55432 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 572-9249 6526 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (23 Sq) Tear-off; Reside House & Garage; Replace windows IS install egress w n ow In each a room 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code on reroofing. The building wrap must be installed and inspected for the residing. Install smoke detectors to meet the State Building Code. 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 MOT. 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 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 $ 18,000 $9.00 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- STRUCTION OR THE PERFORMANCE OF CONSCTION. TRU --�-�� PLAN CHECK FEE License SC $5.00 TOTAL FEE $294.25 SiGNATUREBF CONT RA OR AUTHORIZED AGENT IDATEI WHEN PROPERLY #_LIDA ED THIS IS YOUR PERMIT 0 BLDG SP r)ATE SIGNATURE OF OWNER OF OWNER BUILDE RI IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT. APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contract Address: Effective 1/l/97 lelex;W Jf-�e A.,� Tel. # -5—,;;;Z— a '�-78 MN LICENSE # 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 % •ek i'�i� – fi'/��✓G/9'� d�Cl G�/� G�r-p /2•'a � ` `P a'°�� �- �,,py"' —�� ��;:,, G !�✓ %G� ��g .sly �'�sa ��-ett eer's+ ltoc,®/ Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: 01 Tel. CITY USE ONLY Permit Fee $ , Z� Fee Schedule on Reverse Side G' . Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 9 eej $.50/$1,000 Valuation SAC Charge $ $950r SAC Unit Pe q / License Surcharge $` c ¢J $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: suejEeT PER City of Fridley 2 9108 AT THE TOP OF THE TWINS BUILDING PERMIT r v ------COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r �� r 1 = I"9 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 3/30/99 JOB ADDRESS 860 Overton Dr NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 6 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roy/MaryRoy/Mary Loberg 860 Overton Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northern Sun Builders 772 Mississippi St NE Fridley, MN 55432 502-9474 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 6526 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (23 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT 13ECOMES 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 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 $1,971 $.98 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- STRUCTION OR HE PERFORMANCE OF CONSTRUCTION f �JG�p PLAN CHECK FEE TOTAL FEE License SC $5.00 1 $70.20 SIGNATURE Of C6<7AACfdAO6_A'ZED AGENT IDATEI WHEN PROPE VALIDATED THIS IS YOUR PERMIT ��� OG #NSP MATE S,GNATURE OF OWNS A,IF OWNER BUILDERI IDATEI NEW [. ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY q ALTER [lj SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Tel. # MN LICENSE Address: `y%--i`�sjas✓'�iov! =J�� - �� Tel. # �f3- �f"a� JV �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 11"ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Le Hgt/Ground 71e Sq. Ft. OTHER. $ c $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ Co$5.00 Construction Type: Driveway Escrow Estimated Cost: $ 70 �! `- 7� Erosion Control $ $450.00 Conservation Plan Review (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE:. APPLICANT: Tel. # TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /, } % .001 of Permit Valuation (1 / 10th %) State Surcharge $ c $.50/$1,000 Valuation SAC Charge $ $1050 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: Date: 12/21/2004 Revision Date: 12/21/2004 Site Information Address 1: Overton Dr. N. E. Address 2: City: fridley County: Anoka Application Information Business Name: R. J. Miller Plumbing Contact Person: Robert J. Miller Office Ph: 763-571-6049 Fax: 763-781-8758 Address 1: City: State: Zip Code: Existing Construction: Pre 1994. Project #: Lot: Block: Subdivision: MN Contractor License #:M1910 Cell Ph: Combustion Appliance Water Heater: Natural Draft Input BTUs: 40,000 Independently Vented Furnace/Boiler. Direct Vent/Sealed Combustion Input BTUs: 56,000 Independently Vented Make -Up Air No Make -Up Air Required by Code Combustion Air Minimum Combustion Air Requirements Met. Applicant Name (print): 9 . M O(eT f — Signature/Date: Code Official (print): Signature/Date: /V e tiv q 4-a T ) 0- .c 1! 4, -r- 1i✓ r -IL k yl 0 G./ jam' #-,I r- or `'t C bos�' o,� Cen/1 SPx� 0 2004 C;enterPoint Rneruv Minneaacco. 2004 Mechanical Code Gnideline%. Pape 1 CITY OF FRWLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PERMIT NO.: 2004-02257 DATE ISSUED: 12/10/2004 ADDRESS 860 OVERTON DR NE PIN 143024110119 LEGAL DESC BROOKVIEW TERRACE 3RD ADD LOT I BLOCK 6 PERMIT TYPE PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS # GAS DRYERS 0 # GAS RANGES # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) # WATER TRMT APPLIANCES 0 APPLICANT RJ MILLER PLUMBING & HEATING 834 40TH AVE NE MINNEAPOLIS, MN 55415 (763) 571-6049 OWNER LOBERG ROY W & MARY M 860 OVERTON DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of 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 Consquction or the performance of construction. Anntftrds- Date . Bldg PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # Visa SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 1 0 300 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.00 0.50 35.50 CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater -Gas"$35.00 Gas Range" $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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 a lication are true and correct. DATE: i , 20 OWNER BUILDING USED ESTIMATED COST i, l PLUMBING COMPANY_ SIGNED BY Approved By Rough -In Date $ .50 PERMIT N �L N0. _ Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST $ OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE i FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT; VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and terminatidn. 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 existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) 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 installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's: specifications. This does include AGA-GAMA Category I Central Fum4ce Vonting 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 PERMIT NO.: 2004-02187 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/29/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 860 OVERTON DR NE y P1 I PIN : 143024110119 LEGAL DESC : BROOKVIEW TERRACE 3RD ADD : LOT 1 BLOCK 6 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2875 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 35.00 G & H HEATING & AIR 11012 ST NW GAS RANGE FEE 0.00 NEW BRIGHTON, MN 55112 GAS DRYER FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL PAID WITH CHECK # 5603 35.50 OWNER LOBERG ROY W & MARY M 860 OVERTON DR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work 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 provisio s of any other state or local law regulating construction or thi perfb2lfance of construction. Applicant Date Bldg In Dat SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION Effective 4/1/2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-572-3604 FAX 763-571-1287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS O V Q_LQNtOV\ RATE SCHEDULE Fee Total Residential Owner_ C3\1 d Furnace Shell and Duct Work, Burner & �, cc, also Replacement Furnace $35.00 $ S, Building Used As Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ ESTIMATED COST a. PERMIT NO t Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER I Gas Dryer $10.00 $ # of Heating U its Circle One (Steam) (Hot Water)arm A ) Trade Name l Cu'1 S ` c� Size No. c�0 *Air Conditioning - AllSizes $25.00 $ BTU 40, QC0 HP n EDR Fuel cc- u"(, Total Connected Load 60 OccD All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Burnerrade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU (W6 O HP EDR Improvement whichever is greater. on work less than $500.00 The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct. State Surcharge $ .50 HEATING CO TOTAL FEE $ Signed Tel # C REINSPECTION FEE $50.00/HOUR - f FAX # � 1— ��� " 27 Date [4�103y *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( No( ) The venting system is plastic/PVC and meets all current codes and manufacturer Yes No( ) 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. Yes ( No ( ) The existing combustion air is sized and installed to meet the current codes Yes `/ No( ) and manufacturer's specifications. (t� When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ((� No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes vz' No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes No ( ) separately as per current codes. Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input 60,C>W 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 V �L Vent Height Diameter 2— 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: Building MECHANICAL Permit No.: --C) Inspections RESIDENTIAL APPLICATION Received $y: 763-572-3604 CITY OF FRIDLEY DaMd;.1 U � 26 i r DATE YOUR E-MAIL ADDRESS SITE ADDRESS ��— THIS APPLICANT IS: ❑ OWNER GIGONTRACTOR PROPERTY NAME:p OWNER/ y�SZlL ADDRESS: 0 V CITY J7 /LCQ,kjL,4STATEL11A &1IP TENANT PHONE: CONTRACTOR COMPANY NAME: i CONTACT PERSON: t L 1M SUBMIT A COPY OF YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE S SLS � S ' ADDRESS: CITY STATE APPLICATION PHONE C -S M G c(2 FAX PERMIT TYPE Q9""" E FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW e4tfPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK jSk 1 " L ` -0 LJ CK'Lp 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: 1 S MODEL.` A ,' 6A SIZE/BTU 2 �� MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU AIC $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 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 = $ Z5, Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Total = $ , S :5-0 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 w ' h requires review and approval of plans. C a P� SIGNATURE OF APPUcAN PRINT NAME \(. ATE y .v ti .�....._. ...«. .. .r,,��•... .^s"�..'.j.".�.,. .... n. F.__eh. +,c� .0 Y/°s, ';''k..FK,.E City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By• 763-572-3604 CITY OF FRIDLEY DabRMDEC 2 2 20 DATE 0 YOUR E-MAIL ADDRESS LA -1 SITE ADDRESS -E V `y1 THIS APPLICANT IS: 13 OWNER ❑C\ONTRACTOR PROPERTY OWNER/ NAME T -l:_ Old TENANT ADDRESS: nCITY STATE ZIP r PHONE: NAME: CONTRACTOR Renewal By Andersen SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE WITH APPLICATION ADDRESS: Roseville, MN 55113 t STATE ZIP PHONE License #20130983 ❑ SINGLE FAMILY/NEI PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ — ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Chu QC� ti �i v I cQ c ` HEIG Ft. SIZE OF IMPROVEMENT LENGTH WIDTH ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIM GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used ❑SI VINYING ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, 13 Aluminum 13 Other ❑ Trim ❑ Fascia ADDITIONS. 1. & PORCHES ct tBMFL* Site Plan/Survey showing the existing structure and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FF.F.c ADV user nwr v•t 17. TOTAL Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge .�.....,,.. t%JUvr& i ivl'1, 11N%,LUU1IVU 1 -HE UUNF OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) 311VALUATION e 14,'RQ4,_. /11r1',11vi .-1 See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Citv of Fridlev Attar 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 v conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not. permit but only an application r a permit work is not to start without a permit; that the work will be in accordance with the approves plan in the case of all work w r uires ew and approval of plans. C n SIGNATURE OF APPLICANT C "" "% NT NAME _ _ ado ay�Gn �� DATE_ /J �c(f 6 Building BUILDING Permit No.: C) Inspections RESIDENTIAL APPLICATION Received By: JV 763-572-3604 CITY OF FRIDLEY Da dQT 2 R n9 763-502-4977 FAX EFFECTIVE 8-19-09 DATEIfIr �I YOUR E-MAIL ADDRESS SITE ADDRESS r THIS APPLICANT IS� ® ❑ OWNER §CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: r� r CITY STATE�ZIP TENANT PHONE: CONTRACTOR NAME: r SUBMIT A COPY STATE LICENSE # :7(a I to EXP DATE 31-6% 12-0K) YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: r2,2 q5- (=* r \-g � VA. CITY STATE 14&IP C. INSURANCE PHONE 7 (D3 -22 - FAX - Ll -09 (1 PROPERTY TYPE )Z -SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH 4ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION' ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 1X -C y - n P V- d V-,.- yr-Cl;�, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT Zy ROOFING NUMBER OF SQUARES -LI ❑ HOUSE ONLY 10 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: —2 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other 13 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ l0 `J00 OCCUPANCY TYPE Permit Fee $ 161a See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3 k G .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ _ Agreement necessary ( ) Non Necessary ( ) Total Due $ i N y, 1 Make checks payable to: City of Fridley Attach Stipulations 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 on site; that the work will be in accordance with the approved plan in the case of all work wires review and approval of plans. SIGNATURE OF APPLICANT - PRINT NAME ­VO4-p- DATE I o 2 O