PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date:'"' ._ _2_L z
Owner:
Address ____ Address
LOCATION O BUII I G
No.Street apart t _
Lot Block Addition ortub-Division .
Corner Lot _ Inside Lot Setback _SS7— Sideyard
Sewer Elevation
Foundation Elevation
N° 39'7
f
DESCRIPTION OF BUILDING
To Used Front Depth Height#I-JO Sq. Ft/�" Cu. Ft.=O
Front Depth ,s ght Sq. Ft. Cu. Ft.
Type of Construction -�`=�— Est. Cost �– 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
ordiniances of the city of Fridley.
In consideration of the payment of a fee of $ e'*'0 ` G --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 violatio f arty of the provisions of said
ordinances.
wilding Inspector
NOTICE
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sere to see
the Building Inspector for separate penitis for these Items.
OJW4
V
APPLICATION FOR BUILDING PERMIT
CITY OF FR.IDIEY, MINNESOTA
Owner's Name Builder ��O�,cC �-�r psi, o,
Address Address as 0_ .O�4C Cfa
LOCATION OF BUILDING
No. treet e� f Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot v Setbacks Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
I
A / //
Front__:2_/-9' Depth ight
Sq. Ft. Cu. Ft.
Frontes Depth Height
Sq. Ft. Cu. Ft.
Type of Construction /"—�,V,1---1E Estimated Cost
To be Completed
Z'Lz
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 alZthe facts an epresentations
stated in this application are true and correct.
DATE ®�Gf� ` / SIGNATURE
(A Schedule of Fee Co is can be found on the Reverse Side.)
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
Fist 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 FEE $ ®6I�
ROUGH
FINAL
rim I
1
HEATING or POWER PLANTS—Steam, Hot Water, Warm Ak—No
Trade Name Size No-
Capacity/
o Capacity/ ®®• ® ` 0 Sq. Ft. E.D.R BTU H.P.
Total Connected Load^ Kind of Fuel
BURNER —Trade Name . Size No
Capacity Sq. Ft. EM.R BTU H.P.
(REMARKS -OVER)
Signed r
By L' F
42 2M 7-59 Business Phone No
Application for Rawer Plants and: Heating.
Cooling, Ventilation, leh igral�ion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
Dept. of Bldgs. Phone SU. 4-7470
GRAVITY WARM AIR:
RATE TOTAL,
Location
Furnace Shell & Duct Work ..........................
8.00 $
Replacement of Furnace ......... ....................
5.00 $
City of Fridley:
Repairs & Alterations—up to $500.00
5.00 $
The gned lication for a
specified, agreeing g to do all makes
in strict accordance with the Cit 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.
MECIL WARM AIR
Fridley, 11 inn 1p A 14, ® 19 —
_4"ce Shell & Duct Work to 120,000 BTU
8.00 $
............
each add 60,000 BTU ... — .................. 2.00 $ _
Owner
Replacement oP Furnace ..............................
.x.00 $
Kind of Building —12�
Repairs & Alterations—up to $500.00 ... ............
5.00 $
Repairs & Alterations each add. $500.00 .......:.......
2.50 $
Used as
To be completed about
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. IDR Steam, ......
8.00 $
Estimated Cost, $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00 $
O1d�Building Permit No. V Permit No.
Each add. 200 sq. ft. EDR Steam ......................
2.50 $
Each add. 320 sq. ft. EDR Hot Water ..................
2.50 $
DESCRIPTION OF WORK
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
Fist 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 FEE $ ®6I�
ROUGH
FINAL
rim I
1
HEATING or POWER PLANTS—Steam, Hot Water, Warm Ak—No
Trade Name Size No-
Capacity/
o Capacity/ ®®• ® ` 0 Sq. Ft. E.D.R BTU H.P.
Total Connected Load^ Kind of Fuel
BURNER —Trade Name . Size No
Capacity Sq. Ft. EM.R BTU H.P.
(REMARKS -OVER)
Signed r
By L' F
42 2M 7-59 Business Phone No
City of Fridley, Minn.
BUILDING PERMIT N°5627
Date:
Owner; Builder '0
Address _ Address — —
LOCATI N��F BUILDING
No. Street _ Part f Lot
Addition or Sub- on �-•'�'t-��
Corner Lot Inside Lot bac Sideyard
Sewer Elevation — Feimdation Elevation —
DESCRIPTION OF BUILDING
To as:
Front ile Depth Height ,.e Sq. Ft. Cu. Ft.
Depth _ ._ _ _ Heigh�t.�y Sq. Ft. Cu. Ft.
Type of Construction _=!' _ Est. Cost + �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 $-7-= , 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 anypart thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
old theme city limits and this permit may be revoked at any time p 5 viola* of any of the provisions of said
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 FRIDLEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No. 7 Stree �e Part of Lot_
Lot? Block _.Add ion or Subdivision
Z�__:4
Corner Lot Inside Lot Setback Side -Yard,_
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
L—` ont Depth Height ___/'
Sq. Ft. LZ O Cu. Ft. �` O
FrontDepth Height
Sq. Ft. Cu. Ft.
Type of Construction \ Estimated Cosh—�
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 of
the Department of Buildings, and hereby declares that all the facts and representations
stated in this application are true and correct.
DATE ,_ .4"z/ SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Fishing Perndt
DESCRIPTION OF WORK
Number, Kind and Location of es
'��+ I,
Z Z
n
��(�90
a� Z
O
•
(7
Z
•
P
•
N
WATER HTR.
GAS
EIEC
+'
Base
/
f
1st
2nd
3rd
4th
• Future Connection Openings
Connected with
Sewer El
New Fixture, Old Openings
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
^
Number Fixtures ...................... x $1.50 $z®, S�
Future Fixture Opening ................ x 1.20 $�
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... `� x 2.00 $—
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $ 4,
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................
TOTAL FEE $ '
Dept. of Bldgs. Phone SII
Location/7
City of Fridley:
The undersigned hereby makes application for a permit for the work here!
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 faci
and representations stated in this applicatiop'-ore true and correct.
19'�/
Owner
Kind of Building w•
Used as
To be completed abouut %gam
Estimated Cost, $ 1 7 -
Old ew. uilding Permit No �rm�iyt No.
/ ! d�% •
ROUGH g —1®�L�
FINAL
42 2M
$y (�
Business Phone
N° 4970
Original Permit t®r PLUMBING AND GAS FITTING� 5#
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for permit lJ C)
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee
DESCRIPTION OF WORK
Number, Sind and Location of Fixtures
Stories
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F
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3 U
Q
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7
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rc
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(9 K
WATER HTR.
GAS
ELEC.
Basement
1st
2nd
3rd
4th
Connected with Sewer -Cesspool Gas Piping for Openings
..
Permission is hereby granted o a to do the plumbing and
gas fitting in the building described in the state nt hereto attached, upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
Inspector.
u u42 IM -6.66-V
City of Fridley ,19-W
Owner
Location "M % W �
Kind of Building/t-��
Used as
To be Completed ,19_
Estimated Cost $
Old -New. Building Permit No.
Inspector of Buildings.
53-84-S-915.51
City of Fridley
Applicalfon for Pkmbhkg and G= RM" P mt1t
Dept. of Bldoa. Phone, 56044
DESCRIPTION or woRz
Number, Kind and Location of FixtuWes
t�
PARTIAL RATE SCHEDULE
PLDMBIRCZ FIXTURE MT ES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... x $1.50 S
New 7ixture Old Opening .......... x $1,50 $
Catch Basin .................... x $3.25 =-
Water Beater ,,Up to 99,000 BTU) .. • • x $3.00 S
New (around Run Old Bldg.... • .... x $3.25 S
Electak Water Hftte,r.............. a $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures x $2.00 $
Additional P12itum ................ x $ .75 $
Gas Range to 199,000 BTU............ x $5.00 $
State Surcharge $ .50
REPAM A ALTERATIONS —1afer to Codo _
i 1ption . .. , . Install Gas Grill .. M 00
TOTAL 7M 6 5.50
rte..,.«.... 7879 N. E. Pearson WaY
City of Fridley:
The undersigned hereby makes application for a permit for the vrork herei,
specified, agreeing to do 411 work in strict accordance with the Qty Ordinance
and ruling of the Department of Buildings, and hereby declares that all the tact
and representations stated in this application are true and correct
Fridley, Mi,• 5—i5-73 19.
Owner Robert J. Wanzone
Kind of Building Frame
Used as Res •
To be completed about 5-22"73
Estimated Cost, $ 10.00
Old—N uilding Permit No. Permit No.
ROUGH
Fi11TAL lJ "� .
Sign
By •
Business Ph�nGA%
,—
SUBJECT®RMi2891
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
'
r
�
REC
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION
SEC..
� � 1q
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L ,\ 512-880.3450
910-F15
3/27/75
JOB ADDRESS 7879 Pearson Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
17
2
Pearson's Craigway Estates 2nd Addn. SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Robert J. Wanzog 7879 Pearson Way N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Ro al Aluminum Products Inc. 526 - 6th Avenue North
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW Q ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 351-x 12' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REGI iRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 BAYS AT
R-1
420
5040
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,400 3.70
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE SAC CHARGE
PROVISIONS OF ANYOTUER, STATE OR LOCAL LAW RECIULATING CON-
Lw-
STRUCTION OR THE P 0AN E OF7,Z
�r7
PLAN CHECK FEE TOTAL FEE
30.56
Z�SI A UREO CO CTORORAUTHORIZEDAGENT (DATE)
WHEN P 0 E Y IDA D THIS ISYOUR PERMIT
BLDG. WSP DATE <
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESO
OWNER'S NAME: 0 1s V A &Zd O
ADDRESS:
NO:. FC77 STREET:
LOT: BLOCK:
ADDRESS: ' �` Z G
�2_ ADDITION:
CORNER LOT: INSIDE LOT: 14L SETBACK: SIDEYARD:
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:
?0-7�:_Front a� Depth: � 2 Height:
Square Feet: UZ 0 Cubic Feet: 15G Q
Front: Depth: Height:
!'2L
Square Feet; Cubic Feet:
Type of Construction: "_� Estimated Cost: Q G . d
c
To Be Completed: 5� �-7 S� ?
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: SIGNATURE;
(See Reverse Side For Additional Information.)
ner 7.
v
3 a, -
It
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERMIT
PE E 148
r
i.ftQQLT
COMMUNITY DEVELOPMENT DIV.
r V PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
812-580-3450
NO
NUMBER
910-F15
REV.
DATE
8/16/78
PAGE OF
APPROVED BY
JOB ADDRESS 7879 Pearson way
1 LEGAL
DESCR.
LOT
BLOCK
2
TRACT OR ADDITION SEE ATTACHED
Pearson-Craigway Estate 2 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Wanzong 7879 Pearson Way
3 (pNTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
e
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Garage
7 CLASS OF WORK
IX NEW :0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' x 11' Addition to rear of existing garage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
TYPE OF CONST.
Wood/Stucco
OCCUPANCY GROUP
OCCUPANCY LOAD
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
ZONING
SO, FT.
220
CU. FT.
2200
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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$1600.00
SURTAX
.80
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-
$8.80-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$9 60
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WH�PROPEVRY,,�Is YOUR PERMIT
BLDG INSP DATE
SIGNATURE OWNER IIF OW UI DERI IDATEI
0A
GfRLD T.
300 *jRUNSWIC °A E`c LOT SURVEYS COMPANY RAYMOND97 6917 IDAHO
GOLDEN VALLEY, MINN. LAND SI;RVE ORS BROOKLYN PARK, MINN
REGISTERED UNDER LAWS Or STATE Or BUNNESOTA
LICENSED BY ORDINANOE Or CITY or SSINNmAPOLw
6917 (dalto Ave. N. 533.9922
Minneapolis, 'mitinnesola 55-128
INDUSTRIAL - IUDICIAL COMBINING MARE THAN 30 YEARS OF
COMMEPCIAL TOPOGRAPHICAL urbeporo QVIC'ertef irate LAND SURVFYING FXPERIENCE IN THE
CITY LOTS - PLATTING METROPOLITAN AREA
ROBERT WANZONG
0
Invoice No. 2950
F. B. 132-414
0 Denotes Iron
Scale 1" =30'
Lot 17, Block 2, Pearson's Craigaay Estates 2nd Addition
We hereby certify that this is a true and correct represent..
fion of a survey of the boundaries of the above described Signed
lend and the locafion of ail buildings and visible ene►oach- LOT SURVEYS COMPANY
Tents. if any. (torn or on said land.
Surveyed by us this _lltild.y of _l:Lai- 1174.
• CITY OF FRIDLEY
APP1.XCATIO1I FOR RESIDENTIAL BUILDING PERMITS
• (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: (U { � BUILDER: �� I� •''
Address : )�L�lq 0-a r.S®n Gy & y Address:
• �_ Tel. No.
No.: f%� j Street: (J'e �e 1 •S o1� lei �/ Al,
LOT: / / BLOCK: ADDITION: jr 6 n - �° V �o e� FS %e, Ice_
CORNER LOT: I14SIDE IAT: _ SETBACK: (,2 _ SIDEYARDS:
Applicant attach 'to this form two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
• e
DESCRIPTION OF BUILDING
To Be Used As:
lraya� q ,— Front: c� ® Depth: • % Height:
Square Feet: 0 Cubic Feet: CV -4 0 0
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ()60 S �y 0 Estimated Cost: $ •O
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side for additional information,
DATE: L SIGNATURE:
Stipulations:
e �
CITY OF FRIDLEY
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the
*Replacement of Furnace 7.00 $ , ev facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00 7.00 $ 7
Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn.—�� 197
STEAM OR HOT I ATER SYSTEM: OWNER
Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING
each addn. 50,000 BTU 4.00 $
Boiler only up to 100,000 BTU 7.00 $ USED AS
each addn. 50,000 BTU 6.00 $ r
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour $10.00 $
each add. 3 gal. per hour 10.00 $� ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00,140. NEW BUILDING PERMIT NO. PERMIT NO.��
(over 199,999 BTU see Fee Schedule) $
GAS FITTING FEES:
1st 3 Fixtures x $ 3.00 $ Q- DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x $ 1.00 $
Gas Range to 199,000 BTU x $10.00 $ HEATING or POWER PLANTS, Steam, Hot Water Warm Ai No.
AIR CONDITIONING$/ ' 00 Trade Name Size No. CteA d7 A h
FAN HEATING SYSTEMS see Fee schedule $
VENTILATING SYSTEMS
ALTERATIONS & REPAIRS $ capacity sq. Ft. EDR BTU HP
State Surcharge $ .50 Total Connected Load (P � Q'7' 9 Kind of Fuel
TOTAL FEE s'g 4 -go
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP
Date ($10.00)
FINAL INSP. - 3� /"
. Company L]WAIA:�
Date��•
�,,Signed By
APPROVAL FOR PERMIT kQ Tel. No. 'a J5-- Z
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
u12 A IC
Job Address /0 0�
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the
*Replacement of Furnace 7.00 $ , ev facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00 7.00 $ 7
Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn.—�� 197
STEAM OR HOT I ATER SYSTEM: OWNER
Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING
each addn. 50,000 BTU 4.00 $
Boiler only up to 100,000 BTU 7.00 $ USED AS
each addn. 50,000 BTU 6.00 $ r
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour $10.00 $
each add. 3 gal. per hour 10.00 $� ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00,140. NEW BUILDING PERMIT NO. PERMIT NO.��
(over 199,999 BTU see Fee Schedule) $
GAS FITTING FEES:
1st 3 Fixtures x $ 3.00 $ Q- DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x $ 1.00 $
Gas Range to 199,000 BTU x $10.00 $ HEATING or POWER PLANTS, Steam, Hot Water Warm Ai No.
AIR CONDITIONING$/ ' 00 Trade Name Size No. CteA d7 A h
FAN HEATING SYSTEMS see Fee schedule $
VENTILATING SYSTEMS
ALTERATIONS & REPAIRS $ capacity sq. Ft. EDR BTU HP
State Surcharge $ .50 Total Connected Load (P � Q'7' 9 Kind of Fuel
TOTAL FEE s'g 4 -go
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP
Date ($10.00)
FINAL INSP. - 3� /"
. Company L]WAIA:�
Date��•
�,,Signed By
APPROVAL FOR PERMIT kQ Tel. No. 'a J5-- Z
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
CITY OF FRIDLEY
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM.
LOCATION 70 ;7 -VA WmA /& DATEct
OWNER "�.I ADDRESS
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodged within
4. That it is securely supported
5. That it meets all current Code requirements
for size and total BTU connected
6. Total Heating BTU Z4ap 4=22
All Other BTU
TOTAL
REMARKS
HEATING PERMIT #
SIGNED - 0.
Lice see
by /r�'l�r•�.
Address Zh 0 - 12ue A
Telephone �S"-� 3r3
G �
Fridley City License
11
CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999
6431 U ri1y`Ave N E
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Commercial/Industrial
1.25% of Value of Appliance or Work
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.
$ 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.
RICHMOND & SONS ELEC. INC.
HEATING CO // %;�, dba: GOLDEN VALLEY HTG & AIR
CRYSTAL, MN 55429
Signed DA11R
Approved ByRough-In Date Final'Date
FILL OUT BACKSIDETACK VERIFICATION ON REPLACEMENT FURNACE
JOB ADDRESS— /1/V
/'(_GtrJc.LJ V
RATE SCHEDULE
l�
OWNER
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS
Also Replacement Furnace
$ 30.00
$,'0_0
(Side Vent - Fill. Out Back)
ESTIMATED COST
PERMIT N0.
Gas Piping.(Needed with new furnace,
$ 10.00
$
but not replacement)
DESCRIPTION OF FURNACE AND OR BURNER
Gas Range:
$ 10.00
$
�
No. of Heating Units
Circle One (Steam) (Ho ater) arm Air
Gas Dryer
$ 10.00
$
Trade Name
Size No.
BTU
HP `3 EDR
* it Conditioning - All Size
$ 25.00
$C.C/
Fuel
Total donnected Load_
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name
Size No.
1% of Value of Appliance or Work
$
BTU
HP EDR_
Commercial/Industrial
1.25% of Value of Appliance or Work
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.
$ 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.
RICHMOND & SONS ELEC. INC.
HEATING CO // %;�, dba: GOLDEN VALLEY HTG & AIR
CRYSTAL, MN 55429
Signed DA11R
Approved ByRough-In Date Final'Date
FILL OUT BACKSIDETACK VERIFICATION ON REPLACEMENT FURNACE
CHDINEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes O�No ( )
2.
Is free from rust or deterioration
Yes -N
( )
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 V
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:
List ALTERATIONS Being Done:
HEATING CO: S ELEC. INC. ,
Signed By:
dba: GOLDEN VALLEY HTG & AIR
Date: NOV ,Z 1990 CRYO -, r -:-J c- d'
—
612-Gr5-2uo0
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range`*
Urinal
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Wash ?il :<;; Floor:::::.:.: Auto.
.... ower ...... Trav Drain 1.....
Washer
NO. RATE
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 5°/ f Value of Fixture or A liance
TOTAL
JOB ADDRESS
Effective On Jan 1, 2003
Gas
Gas I Elec
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and corre t.
Owner
Building Used
C
Estimated Cos PERMIT NO.
PLUMBING COMPANY
SIGNED B - TEL N0.
A0/_ o pp
Approved By ' Rough -In Date Final Date 4_11
State Surcharge 50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
• APPLICATION WILL BE RETURNED
When rala _i g an exacting furance, 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-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The existing cnmbistinn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to ins air a now rnmhi is inn air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting ay.%_tem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
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:
rA
CIiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
June 2, 2004
Mr. Sean Sullivan
7879 Pearson Way NE
Fridley, MN 55432
Re: Final Inspection at 7879 Pearson Way NE, Fridley
Contractor: Shiloah Water Co.
Dear Mr. Sullivan:
A plumbing permit was issued on March 10, 2003 to install a water softener at your
address. According to Section 4715.2800 of the State Plumbing Code, a final inspection
shall be conducted on the work authorized by this permit. As of this date the inspection
has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Code. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
Sincerely.
DJ/mh.