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PRE 2010SUBJECT NO. City of Fridley C 19748 AT THE TOP OF THE TWINS BUILDING PERMIT _ r REG T NO. • COMMUNITY DEVELOPMENT DIV. t �y-------t r � � PROTECTIVE INSPECTION SEC. !s 1 � � I /'"1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 111/10/88 JOB ADDRESS 5201 Pierce Street N.E. 1 LEGAL LOT NO. 13 BLOCK 1 TRACT OR ADDITION SEE ATTACHED Marion Hills. DESCR. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Richard Tkaczik Construction Inc. 12323 Gladiola, Coon Rapids 55433 421-9009 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 Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 3715" x 371 Dwelling (A rox. : a 241 x 241 Garage,- and a 151 x 15' Deck - GUARANTEE THE ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS, :rWIS DAIA IS FOR INFORMATION P[JaMSES ONLY, 9 CHANGE OF USE FROM AND PERSONS- USTRG THIS INFORMATION SHOULD STIPULATIONS Variance approve d for 15 foot front yard setback on 6/14/88. Soil tests may be required on old fill. Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. See notations on plan. SEWER LOCATION: Approx. 15` Deep, 28' SW of M.H. (Inv. 1005.8 Service extended 39' toward property line. WYE ELEV: 1003.00 TOP OF FOOTTNG: 1006.00 MINIMUM WATER LOCATION: Extended to lot line near center of lot. Use metal detector to determine stop box location. Should be near surface. W SEPARATE PERMITS RrOUIRED FOR Before digging Call local utilities WONG, HEATING, PLUMBING AND SIGNS, TELEPHONE- ELECTRIC- GAaSEtL REQUIRED BY LAW 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 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 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 $77,150 $38.58 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- $378 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE �. $N/A $966,58 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) r - WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT DATA SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI Pi moi. S. `y,I �. �`• _ FR � :i � psi � � r;'� � �� .� •�:,4+ i t "y 77 ti 1 p } i !��R,� ��' I�riR,�T;j^��+Yy}9 E., }•^. 1 t �•�,rek ,'.. �.'�. � r�" ` ' WC '`,t •3�� } � a y , a r � 1"� �•r��2 Ty�`' 3�"€J :';"W�.iCrr `t;.' �"`scd".. ^c .;. ! :i• ::n'_ - _ s ... i u� �. •.3 $ f i t 4 �.. �89w sYA :$5. �• ,'� s -.. ". � _ � p. g � & „aI -. i •.� w� �C,}� •{ f2 ��r 9 ,IiP � l' qq I 2- '�'t A L�"'g• _ � 7'i l sir . 3�f .• - - 1`4 d"Y FN"�tr ,•1� �9 , .. 2f R {� µrd +. _ I "�.e 4 � L. .. - 1 � d .. .. �� ,.. ... f` �} •i9 A yb'14 _ t 4"L'..y r j - ^ t .. � 0 _ C�-\p' � �`\ a- , - __ v � • � '=`� � MSN. �!' a AU ~ y -- loo.00' . DONALD F PERTINEN 1611 HIGHWAY 10 N E. PLANNING & MINNEAPOLIS. MN 55432 DESIGN, INC. 612 780-1920 DATE: REVISIONS' DRAWN BY: City of Fridley Effective 5/1/88 ADDN [ ] R-1 AMID R-2 AMER [ ] Building Permit Application Construction Address: Legal Descripticn: /. d f -3 -- /3 / N,ghe Owner Name & Address:6�/� Tel. # Contractor: �.r�r-� 7��c� �k C°� �v� yLe� Tel. # Address: /�Z3 2 3 /A J, d /A C° Re 62� 3 — Attach to this application a Certificate cf Survey of the lot, with the proposoed construction drawn on it to scale. DESC RIPTMM OF IM ROVEMW LIYING AREA: Length :5 Width 2, - Height Sq. Ft. GARAGE AREA: Length a2 41� Width o Height -2- sq. Ft. DECK AREA: Length Width /S�f Hgt/Ground �' sq. Ft. �- DEEM. ODrner Lot [ I Inside Lot I,i, Ft. Yd Setback Z:, -r Side Yard Setbacks l� Type of ODnstructicn: Estimated Cost: # /,q6, s rM, ISO Approx. Completion Date: 9d aM .s `f� �.o f Cos ,� Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ Width + 6' See Back Page Mn: % / - 3 5W--APPLICW • s Tel. # NiW * A I I: =iii; Permit Free 3)F. Free Schedule on Reverse Side State Surcharge $ L? $.50/$1,000 valuation SAC Charge $ ��, e4 $550 per SAC Unit Driveway Escrow $ Alt. "A° or Alt. •B" Above Park Flee $ Fee Determined by Engineering Sewer !Main Charge $ Agreement Necessary I I Not Necessary [ 7 TOTAL $ 3I'I ?ULATIC HS: i The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEAR $1 to $500 $15 (Minimum Free is $15 plus surcharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for first $21,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100, 001 to $5001000 $ 639.50 for first $100r000 plus $3.50 for each additional. $1,,000 or fraction thereof, to and including $500,000 $500,001 to 510001,000 $2039.50 for the first $500,000 plus $3 for each additional $1000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. Permits for construction will be issued a minimum of 24 hours f rom the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump -or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 S 10.00 TOTAL s,55 -DO s D S Back Flow Preventer Required. . . Yes ( ) No ( ) Type S 5.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $ . 00 Effective Date May 1, 1988 Job Address��/ Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct e Fridley, Mn. OWNER _ 7�,*,f 0/e< �O/il ST• RIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTI T OLD LDINPERMIT O. PRT . J' �Q / W AgcsoN �� G. /e(Uc_ 1 Company Signed By Tel. No. %s' ?,— 0 Ysj ROUGH INSP. Date FINAL INSP. .7 Al' Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE o •+ +ft+ a Water m -ei NN ci eJ M m ami M w w Heater p O tS si 1�t1 C m O O 8s� O O V1 U C7 RI 00 N 3 Q W V1 W r0 ro� U RI y �trp�� i 3 �p 01 p C7 y� O s lec r l l I k lot ( 1 2nd 3rd 4th (R) r Future Connection Opening Connected with Sewer (') - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump -or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 S 10.00 TOTAL s,55 -DO s D S Back Flow Preventer Required. . . Yes ( ) No ( ) Type S 5.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $ . 00 Effective Date May 1, 1988 Job Address��/ Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct e Fridley, Mn. OWNER _ 7�,*,f 0/e< �O/il ST• RIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTI T OLD LDINPERMIT O. PRT . J' �Q / W AgcsoN �� G. /e(Uc_ 1 Company Signed By Tel. No. %s' ?,— 0 Ysj ROUGH INSP. Date FINAL INSP. .7 Al' Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer • Air,Conditioning (all sizes) All Others/Repairs and Alterations li of Value of Appliance or Work COMMERCIAL/INDUSTRIAL l% of Value of Appliance or Work RATE TOTAL S 20.00 $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ State Surcharge int /W s xeeinspection Fee ($15.00) Rough Insp. Date Final Insp. Date v Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 - PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. $ Job Address Department of Buildings, 6431 University Ave. N.E., Fridley, HN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. — , 19 OWNER KIND OF USED AS TO BE c ESTIMATED COST $ .50 $�v 0 O - NEW H ILDING PERMIT NO. PERMIT NO. I l $ DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water Warm Air - Trade Name Size No. C. Capacity Sq. Ft. EDR STU RP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR STU HP Company67 Signed By Tel. No. Fill out back side for stack verification on replacement furnarps CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes 2. Is free from rust or deterioration Yes ( ) 3. Has no foreign objects lodged within Yes ( ) 4. Is securely supported Yes ( ) No ( ) No No ( ) No S. Meets all current Code requirements for size and total BTU connected Yes () No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Remarks Company _ Signed By Da to Richard Tk.aczik Construction Inc. 12323 GLADIOLA N.W. COON RAPIDS, MN 55433 (612)421-9009 March 17, 1989 City of Fridley: I Pat Finn Sr. of 5202 Pierce St. N.E.-Fridley, Minnesota do not object to the placement of the air conditioner to be installed at 5201 Pierce St. N.E.-Fridley, Minnesta. C CIiYOF FRIDLEY CMC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450 March 24, 1989 RE: 5201 Pierce Street N.E., Fridley, Minnesota To Whom It May Concern: Please be advised that the home at 5201 Pierce Street N.E. (Lot 13, Block 1, Marian Hills) has been inspected and does meet all City Codes, with exception to the completion of the following: 1. Provide a hardsurface driveway by June 15, 1989. 2. Provide sod on front and side yards by June 15, 1989.- 3. Provide permanent front steps, garage steps and slab by June 15, 1989. 4. Cap the brick ledge block along the south wall of the garage by June 15, 1989. 5. Complete the exterior stucco by June 15, 1989. 6. Provide a verifying survey by April 14, 1989. 7. Provide a silt fence at the bottom of the slope for erosion control by April 14, 1989. The home may now be occupied. S' cerely, I i Darrel Clark Chief Building Official s CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 March 18, 1991 Mr. Richard Tkaczik Richard Tkaczik Construction Inc. 12323 Gladiola St NW Coon Rapids, MN 55433 Re: Glazing at 5201 Pierce Street NE, Fridley - Iacarella Residence (SECOND NOTICE) Dear Mr. Tkaczik: A recent field inspection at 5201 Pierce Street to determine if the glazing code violation had been corrected revealed that it had not. The owners report that they have not heard from you either. This matter must be corrected or we will have to refer this matter to our City Attorney for his consideration. We will expect that the problem will have been corrected by April 9, 1991. If you have a problem with this date, please contact me at 571-3450. Your cooperation in this matter will be appreciated. Sincerely, D CLARK Chief Building Official DGC/mh Attach: 1 CC: Carolyn/John Iacarella CITY®F FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1267 February 5, 1991 Mr. Richard Tkaczik Richard Tkaczik construction Inc. 12323 Gladiola St NW Coon Rapids, NAT 55433 Re: Glazing at 5201 Pierce Street NE, Fridley - Iacarella Residence Dear Mr. Tkaczik: On Monday, February 5, 1991, we received a telephone call from Mr. Iacarella asking about the Code as it pertains to safety glazing in their dining/living room. Later that day I visited their home at 5201 Pierce Street for the purpose of determining whether or not the glazing in the dining/living room met the Uniform Building Code Chapter 54 Glazing Requirements. Section 5406, Safety Glazing, reads as follows; 11(a) General. Glazing subject to human impact shall comply with this section. EXCEPTION: Louvered windows or jalousies complying with Section 5405 need not comply with Subsection (c) of this section. (b) Identification. Each light of safety glazing material installed in hazardous locations as defined in Section 5406(d) shall be identified by a label which will specify the labeler, whether the manufacturer or installer, and state that safety glazing material has been utilized in such installation. For additional identification requirements and for limitation on size and use by category classification, see UBC Standard No. 54-2, Part I. Each unit of tampered glass shall be permanently identified by the manufacturer. The identification shall be etched or ceramic fired on the glass and be visible when the unit is glazed. 'Tempered spandrel glass is exempted from permanent labeling but such glass shall be identified by the manufacturer with a removable paper label. (c) Horan Impact Loads. Individual glazed areas in hazardous locations such as those indicated in Section 5406(d) shall pass the test requirements of Part I of UBC Standard No. 5402 or by comparative tests approved by the building official which shall be proved to produce at least equivalent performance. EXCEPTION: Polished wired glass complying with Part II of UBC Standard No. 54-2 may be used in fire assemblies and in location specified in Items Nos. 6 and 7 of Section 5406(d). Plastic glazing used in exterior applications also shall comply with the weathering rem in Part II of UBC Standard No. 54-2. Mr. Ridiard Tkaczik February 5, 1991 Re: Glazing at 5201 Pierce Street NE (d) Hazardous Locations .... 7. Glazing in fixed panels other than those covered by Item 6 which have a glazed area in excess of 9 square feet and the lowest edge is less than 18 inches above the finished floor level or walking surface within 36 inches of such glazing. In lieu of safety glazing, such glazed panels may be protected with a horizontal nimber not less than 1 1/2 inches in width when located between 24 and 36 inches above the walking surface." It is my interpretation, after taking measurements at the home, that the 4 window units including the operating portion of the units are more than 9 square feet and are less than 18 inches above the floor, therefore the glass mist be safety glass or be protected by a horizontal member not less than 1 1/2 inches in width and located between 24 and 36 inches above the walking surface as stated in 5406(d)7. Two of the large units do have cracks and before they are replaced, the method of correction to meet code should be decided. I know that the owners are not going to be satisfied with the protective horizontal member however the City will not dictate the method of correction. Your prompt attention to resolving this matter will be appreciated. Please have the corrections completed within 30 days or inform us as to the reason for any delay in completion. ,...� 4 jib- - • DGC/mh CC: Carolyn/John Iacarella Scherer Bros. I miber Co. 3ITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTI IRF.R TO RF INRTAI I Fn nM FArrM FI nnR Effective On Jan 1, 2000 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** NO. RATE TOTAL . JOB ADDRESS 54NC t', 6WOI✓ 12- --L— $7.00 —L— Gas Dryer** _ Back Flow Preventer Required ( )Yes () No Type $7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 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 annlirntinn nrp true and correct. LLA, JOHN cNi 5201 PIERCE STREET NORTHEAST 20 D 5201 PIERCE FRIDLEY, MN 55421 Owner (763) 571-0128 Building Used As &E61DCAY Ceti. o_o C Estimated Cost PERMIT NO. PLUMBING COMPANY 6I &:OIC PLt)naAJ(4 Reinspection Fee $47.00/Hr SIGNED BYTEL NO.&Z Z7s'/0 55 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ _50 MINIMUM F;EE F ANY PLUMBINGIGAS PERWJ� TOTAL FEE $20•so COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE rel �MM r:71.1111 M - 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** NO. RATE TOTAL . JOB ADDRESS 54NC t', 6WOI✓ 12- --L— $7.00 —L— Gas Dryer** _ Back Flow Preventer Required ( )Yes () No Type $7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 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 annlirntinn nrp true and correct. LLA, JOHN cNi 5201 PIERCE STREET NORTHEAST 20 D 5201 PIERCE FRIDLEY, MN 55421 Owner (763) 571-0128 Building Used As &E61DCAY Ceti. o_o C Estimated Cost PERMIT NO. PLUMBING COMPANY 6I &:OIC PLt)naAJ(4 Reinspection Fee $47.00/Hr SIGNED BYTEL NO.&Z Z7s'/0 55 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ _50 MINIMUM F;EE F ANY PLUMBINGIGAS PERWJ� TOTAL FEE $20•so COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 plastic/PVC 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 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 installinc 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 () 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( Apollance 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 Building MECHANICAL permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY c DATE 07 U tr YOUR E-MAIL ADDRESS SITE ADDRESS S o1.0 1 t �� S� THIS APPLICANT IS: 0 OWNER 'gCONTRACTOR PROPERTY NAME:—Poin at 0 G- l OWNER/ ADDRESS: JaU6 PL4_0.C.t.. St NP- CITY F't21o1 � _STATEI`t0 ZIPLJ TENANT PHONE:'D 63 - S `7 /- 57 3 7 CONTRACTOR COMPANY NAME: Ale - SUBMIT A COPY OF CONTAcr PERSON' YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: ge)-'qo rh " Sr ni C CITY_112 � J.51 ` c_ - STATEa"1°'� ZIP _5,1'11 APPLICATION PHONE '7 6 % T S4 c-)09 FAX PERNHT TYPE 0°SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW -WREPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK : A ZA i 1 (:Z L®'-e-Lvl �- " _ =' FL"' i<' A t - PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. ('This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT W�HgERE NOTED. FIXTURES: (INDICATETOTAL NUMBER OF EACH BELOW) Q, MODEL: G"% 6 v U SMFATU Ct 0 OEM) Equipment Installed MFG: r""""`"'� SIZFJBTU MFG: MODEL: MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00. GAS RANGFJOVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL . 00 _BOILER $35.00 ,FURNACE $35.00 NEW UNIT HTR $100.00 0 CHI MY LNER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 _VEN11LATOR S15.00 Permit Fee $ ° Number of fixtures @ $10-00 x $10.00 $ Surcharge Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ `�� 5 Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 PRINT NAME �) t' 1 IR 44 f3 DATE %4 - d y City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 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 PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Chapter 5 with MN Amendments b. Fuel other than gas TMC 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 u4ed for combustion and make up air calculations Building BUILDING PermitNo.,-bo Inspections RESIDENTIAL APPLICATION Received By:ry 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY ec d� 9AIA `�IV or EFFECTIVE 1.1.2010 DATE YOUR E-MAIL ADDRESS SITE ADDRESS e.1" G�.+ %" THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME:_ {Z6h i�t'0 TENANT ADDRESS: CITY STATE- ZIP PHONE:— HONE CONTRACTOR CONTRACTOR NAME: cIt's Roofing and Siding Inc. SUBMIT A COPY OF STATE LICENSE STATE LICENSE #, 5U 14736 n3on N.v-. DATE Y�Nr� ---- �j -31+ AYOUR AND CERTIFICATE OF ADDRESS: 063) 269-8077 CITY STATE ZIP INSURANCE PHO FAX PROPERTY TYPE INGLE FAMI-L;0NEW CONSTRUCTION SIZE ❑ TW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH N&OOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 'rEsli t- _ ( ke,p-� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES � SE & GARAG BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES IWATTACHED GARAGE 2. Proposed floor pin PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Sofln ADDITIONS -& PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Phm/Survey showing the existing structures ❑ Other ❑ Fascia and Proper 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) 'OTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due Dll�� $ 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) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= 6x$24=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ _ Agreement necessary ( ) Non Necessary ( ) $ a1 Make checks payable to: City of Fridlev Attac 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 w rk whichhwires review and approval of plans. SIGNATURE OF APPLICANT � _ 14-t— PR YNT NA MF . S I G R-, PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK