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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® s o Q:� Date: Owner: Builder Address Address LO TI F BUILDING No. Street 6� ____3Zart of Lot Lot __ ._ Block Addition or Sub -Divot . Corner Lot Inside`Y.ot Setback Sideyard' Sewer Elevation _ _._ Foundation Elevation DESCRIPTION OF BUILDING Front Depth &eight -" Sq. n #444$0 u. Ft o d. 4-* nt Depth Height 1W Sq. FL . . Cu. Ft. Type of Construction Est - '4V 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 $044-oy 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 maces. city limits and this permit may be revoked at any00_ upon viol of any of the provisions of said NOTICE: M permit don not cover the construction, hm ftWom for wbh* plumbing, gn heatbrg, sourer or meter. Be son to see the Buffdhm hopeder for separate pwaft for thea hens. APPLICATION FOR BUILDING PERMIT t,CITY OF FRIDLEY, MINNESOTA Owner's Name ' Builder 0 Address Address /_ t LOCATION Zlt�' `� No. (n 7�/� Street l� Part of.Lot Lot Block `Y Addition or Subdivision ;VIIL"'-1414�A Corner Lot Inside Lot Setback Side -Yard Ly SEWER ELEVATION; 3 FOUNDATION ELEVATION 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:. Fro Depth Height u Sq. Ft. Cu. Ft, Front Depth Height Sq. Ft. Type of Construction To be Completed I II_ I — Cu. Ft. stimated Cost 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 tht all the facts and representations stato in this application are true anI correct. Y<- , DATE (Schedule of Fee Costs can be found on the Reverse Side. * � M h� F\ 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 ........................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECIL WARM AIR Furnace Shell & Duct Work to 170,000 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 $ 0 -a GAS FITTING FEES: NO RATE TOTAL T L 1st 3 Fixtures ......................�— x $1.50 -$_ !__C 5 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 FEE kOUGH TINAL Dept. of Bldgs. Phone SU 4-7470 ,y %1_0 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, Minn- Ownerx'47" Kind of Building Used as To be completed about Estimated Cost, $-- -�® Old-. Building Permit No. 60 Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Aiir�—No-� Trade Name- Size Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected LoaL_54 Kind of Fue BURNER — Trade ame Size No Capacity Sq. Ft. E BTU H.P. SUBURBAN YEATIRG & SHEET METAL 8419 CENTER DRIVE N. E. Signed MINNEAPOLIS �%NEQ21, MINN., By d%�O�i�id��✓�/ a <z 2M Business Phone No- (REMARKS -OVER) r HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS S.H.V. Weatherstrips A.Guide Construction No. Windows Doors Reference Out. Wall I Int. Wall Ceiling Roof Floor —No No Room I Lenlath'24 Width Heiizhtle -/ A A F1.1 Windows and oors—Crackage and Area Width Height No. of No. of pane of pane lights lineal ft. Area of crack sq. ft. q4r 44F 91 Coef. Btu / la Infiltration Infiltration Net exp. wall O,U Coef. Btu Inc. wall Exp. wall S Ceiling O �I++n��filtration yeas$ Floor Int, wall f el �- Exp. wall ® ; Q Floor Net exp. wall Ceiling Int. wall ® A® Int. wall Ceiling Ceiling Floor (c) Floor Total Btu.', Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I Length & "09i/Width /)_o Height -91/ Windows and Doors---Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights _ of crack eq. ft. y cj� �e '® Coef. Btu Infiltration Glass Exp. wall Infiltration Infiltration Net exp. wall Glass , S Inc. wall Exp. wall S Ceiling / /V' ® v Floor Int, wall Net exp. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area a P1 1 Fl. - �m I Length /if Width /Oie Height moi/ Windows and Doors—Craekage and Area Width Height No. of Lineal ft. Area No. of pane of pane light,, of crack eq. ft. I 01 Coef.1 Btu Infiltration Infiltration Infiltration Glass , S vo Exp. wall S L Net exp. wall D Int, wall Net exp. wall p Ceiling ® ; Q Floor /® Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I /j. 3/issY- Insulation Room 1 Length /L/ Windows and Doors—Crackage and Area Width Height No. of Lineal Lt. Area No. of pane of pane lights of crack sq. ft. I 01 Coef. Btu Infiltration Infiltration W IT3 J - Glass (r S L Exp. wall Exp. wall Net exp. wall p 'v ® ; Int. wall /® Ceiling Int. wall ® �� Floor Ceiling Total Btu. SIC Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 16 i to I D 1 r -....I , . / W/: sl. "/�" ue:..t.. b® Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 01 Coef. Coef.1 Btu Infiltration ®-� Glass Glassd L oLf— Exp. wall Net exp. wall p 'v Net exp. wall /® Ceiling��— Int. wall Floor Ceiling /49 Floor Total Btu. Required sq. ft. E.D.R. or sq. iris. WA. Leader area / 1:1 � e D_..� 1 t _ _�L hO�iW):.rlt. /s % 4re:..r.• Od ..i Windows and Doors—Crackage and Area Width. Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration] t�® Glass — L Exp. wall Net exp. wall p 'v Int. wall Ceiling��— Floor Total Btu. Required sq. ft. E:D.R. or'sq: ins. W.A. Leader area ` r City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs.Phoa U 4-7470 ! DESCRIPTION OF WORK n Number, Kind and Location of Fixtures Location p � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE IOTAIt Number Fixtures .... U , ..................� x $1.50 $� Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x Water Heater (Up to 200,000 BTU) ...... x New Ground Run Old Bldg. ............ x 3.25 $ 2.00 $ v? G d 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—,/ 0-'J�— 4 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $e!� 1� 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. to Fridley, Minn,/ D If /Z 2 19 2 Owner ��'C-6 - Kind of Building FA Used as To be completed about Estimate ost, $ s Ol New. ding Permit No U Perm No. Signe.. By Business Phone No 445- -7 7 ROUGH 1 D FINAL az 2M _ 12 Im it<T1Z e; N �j J w O Z Z �U' • R • N WATER HTR. GAS EIEC W 3 3 o u. �. 0 U 6113 t�9 •� (�9 Sa o Base I �. 1st 1 2nd _ 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings Sewer Cesspool [] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE IOTAIt Number Fixtures .... U , ..................� x $1.50 $� Future Fixture Opening ................ x 1.20 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x Water Heater (Up to 200,000 BTU) ...... x New Ground Run Old Bldg. ............ x 3.25 $ 2.00 $ v? G d 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $—,/ 0-'J�— 4 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $e!� 1� 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. to Fridley, Minn,/ D If /Z 2 19 2 Owner ��'C-6 - Kind of Building FA Used as To be completed about Estimate ost, $ s Ol New. ding Permit No U Perm No. Signe.. By Business Phone No 445- -7 7 ROUGH 1 D FINAL az 2M 3ff=rY� City of Fridley, Minim N° 8 611 BUILDING PERMIT .: fav,7' "'r owner: `Y x 6 .. 1® f .: 1�P.y ...Y , p Y �ya r : r I C Si, a u a)il a e>,e K,Z, Address Address 675Q LOCATION OF BUILDING No. M Street Qaerton 7a` M A.E. Part of Lot Lot 10 _ Block Addition or Sub -Division Meadowlands, lad Corner Lot — Inside Lot Sewer Elevation Setback Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: HMO, _M Front Depth Height Sq. Ft. — Cu. Ft. Front Depth Height Sq. Ft. _ Cu. Ft. Type of Construction Est. Cost 88 s hh - 00 To be Completed Repair of storm damage In consideration of the issuance to me of a permit to construct the building the proposed work in accordance with the description above set fop�h and in c� ordinances of the city of Fridley. ¢�� -7 f I agree to do provisions of In consideration of the payment of a fee of a -if —00 , permit is hereby granted to n� L oyes Q—tM1-0ti0n Go. to construct the building or addition as described above. This permit is granted upon the express condition that theSbull done in, around and upon Fridley,Minnesota reg within the city Iimits antbiat may be revoked at any tune upon violation of any of the provis�lona of said ordinances. NOTIM M permit don not cover the construction, Wailation for VMR& phrmbine, on hating, sowor or wafer. Be sun to see the BulMhm hgwmr for soperab permih for thea Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA S TeP1re_"0 OWNER'S NAME'41. I�. BUILDER 22� �" , ,/�� ��s �'ai� eO ADDRESS_ ADDRESS _ A�6 LOCATION OF BUILDING No, 1,7SZ) Street40 Q! A1 Part of Lot LOT BLOCK ADDITION OR SUBDIVISION Corner Lot Inside LOT Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION 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; Of9lts"'� Type of Construction To be completed Front Depth, Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Estimated Cost :9:" 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_4L /tZ� SIGNATURE (Schedule of Fee Costs can be found on t1 R�erse`S Pe 1 SUBJECT City of Fridley 26145 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. "; d46 / r � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 6/4/98 JOB ADDRESS 6750 Overton Drive NE 1 LEGAL LOT NO, BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10 2 Meadowlands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clarence/Deloris Sauers 6750 Overton Drive NE 572-2554 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 ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building 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 1 ISTALLS 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 $2,085 $1.04 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- Fire SC $2.08 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 PLAN CHECK FEE TOTALFEE 7.87 SIGN RE OF CONTRACTO.W, AUTHOWr740AGENT (DATE, EN ROPE Y ALIDATED/ IS UR IT �„ BLD INSP -HIS t5 z;0 riAiE ATURE OF OWNEROF OWNER BU IDATEI 1 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 a& /45- BUILDING PERMIT APPLICATION �Qlo ConstructionAddress:idlei )nl :z)R Legal Description: Owner Name &Address: �� �: �i✓��- �5 �'' S SAzt ESQ S Tel. # 5? Contractor: ���-- �3t 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 HilPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length_ Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Estimated Cost: $ "j?o (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x / DATE. APPLICANT. Tel. # i CITY USE ONLY Permit Fee $ / %. %S Fee Schedule on Reverse Side Fire Surcharge $ 00 .001 of Permit Valuation (1/10th%) State Surcharge $ �. d $.50/$1,000 Valuation SAC Charge $ $1000 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: W.. Building Permit Fee BUILDING 3 : See Back Page for Fee Schedule Permit Ivo.:q-U Inspections 5, �;7' 00 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: t 763-572-3604 Surcharge CITY OF FRIDLEY LAU .0005 x Permit Valuation Minimum $.50 Date Recd: G� 763-502-4977 FAX 763-502-4977 $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 8-19-09 ft + 6 ft = ft x $22 = $ Erosion Control DATE ® YOUR E-MAIL ADDRESS ZJPi'll 11- Q fy/� Af0m.—f GC/t&/e5 co -- SITE ADDRESS 61 OUf-Dull- /l9 QI^ Sewer Main Charge THIS APPLICANT IS: ❑ OWNER ,CONTRACTOR Total Due PROPERTY OWNER/ NAME: 139AA ' aH14sdL-3 TENANT ADDRESS: S A6N--- CITY STATE ZIP PHONE 61 a - 0 y *7 CONTRACTOR ,� I�937 NAME: law b uL f3 SUBMIT A COPY OF YOUR STATE LICENSEP� STATE LICENSE # q% Z3 EXP DATE AND CERTIFICATE OF ADDRESS: 61eQ VLf AU CITY Petwq STATE&AJ ZIP S'SY3 INSURANCE PHONE 7 63— 57 WO FAX %6 3 - 572" 9c�3 PROPERTY TYPE AXMLQLLE FAMIL EW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TIL ❑ DECK ❑ SIDING POTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR 11REMODELING , DESCRIBE WORK BEING DONE: R4Hw� ZCs'� �G,n4�/ Lt!(SbLC Gc1lN17WS SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: l . 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 I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS XYes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS- ESCRIBE 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 $ D r OCCUPANCY TYPE Permit Fee $, 3 : See Back Page for Fee Schedule Plan Review $ 5, �;7' 00 65% of Building Permit Fee Fire Surcharge $ 001 times the total job valuation Surcharge $ LAU .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 $ M,1A,; G Make checks savable to: Citv of Fridlev 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 fogr 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 ork hic res review and approval of pl s. SIGNATURE OF APPLICANT RINT NAME DATE Building I PLUMBING I Permit No.: Inspections RESIDENTIAL APPLICATION Received B 763-572-3604 CITY OF FRIDLEY Dat 763-502-4977 FAX DATE IQ —29`0 P YOUR E-MAIL ADDRESS SITE ADDRESS–(o-75-0 Dr V$ THIS APPLICANT IS: ❑ OWNER XWeNTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: AILED ADDRESS: CITY STATE ZIP PHONE: K /4 STATE LICENSE # Z9& -?241 =/;)M EXP DATE �/ p STATE BOND # 9 _v 6-7 9 / Fy _/ / EXP DATE ADDRESS:_//�T� �lo� AG-��' CITYA AA(Cs�.4jeL STATE*A-� ZIP y PHONE 6 (r, 3— q197 • 9 c�-. / FAX SINGLE FAMILY ❑ NEW ON OF WORK ❑ TWO FAMILY ❑ TOWNHOUSE BIEPLACEMENT FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. $35.50. BATH SINKILAV DRAINS BATHTUB _FLOOR _ GAS PIPING (NEED CITY LIC) CLOTHES WASHER KITCHEN SINK _ DISHWASHER _ LAUNDRY TRAY w u 0" FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE _ SHOWER _SWIMMING POOL 1 WATER CLOSET _WATER HEATER ($35) WATER METER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED _ WATER PIPING —WATER SOFTNER($ _ BACKFLOW PREV. 3 FOR IRRIGATION OTHER I hereby apply for a plumbing 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 which requires review and approval of plans. SIGNATURE OF APPLICANT � PRINT NAME DATE A?–,79 —®9 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. Inspections RESIDENTIAL APPLICATION Received By:/ 763-572-3604 CITY OF FRIDLEY DR,ec°� t�� uqg 763-502-4977 FAX EFFECTIVE 2-19-09 DATE /_.:. -_ -? T - _: F YOUR E-MAIL ADDRESS SITE ADDRESS &7S'O oozr4-41A? THIS APPLICANT IS: ❑ OWNER TRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: ^ SUBMIT A COPY OF CONTACT PERSON: /In AL2 Li `g p • J YOUR STATE STATE LICENSE # div 3 �Z :t I —PM EXP DATE /2-3/-0? LICENSE WITH ADDRESS: //05-0 2(0 SJ- f✓E CITY SM / ,B,t=L STATE/HajLIP S.3 14, APPLICATION PHONE 7 l0 3 ^ �i � 7 - ,2 0 3 > FAX 'P!"NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE TYPE OF WORK: ❑ NEW 816PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK (� ► H oocf (7 Q•ti4 V e,%,+ — Rei k4 rAg ll.G T ,_e..fl, d 3t --A, IRA- aau..en-F DL.. -k -4o �•� FEES ARE BASED ON $10:00 PER FIXTURE, EXCEPT WHERE'NOT-ED. FIXTURES: (INDICATETOTAL NUMBER OF EACIVOELOWY , ' ,;,% f PROVIDE -MEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 PHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 •, �•'MY/ F.�i 1 i� �}` ''"a Y �k` wig. ww �C1`i'i ij` a�W'•,?k S£' } '� �' ar- Y .�If �"rW�b f2 "tY'a'u' Si`yF Z'' f $f a• :.. ...3-_ k� t3 �h't.r .° V�...ur ._a ... ...,,N - ._. at ,� „ate 6 i.'�� ,�.' �.'' � THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT �—^ ��,r��T PRINT NAME _1'h1-1 �3�R/iJ<N DATE 10 --?'9-C29 APPROVAL INSPECTORS SIGNATURE DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977