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PRE 2010 DOCSCity of Fridley r'90 :o for FL—,.A&g endq-2 Dept. of Bldgs. Phone SM -3, DESCRIPTION OF WORN Number, Kind and Loee3fon of Fixtures Location ffi O 11� ? S F 12i�3rS e`i t~ 3 �$J G< z 7j U of Z iglu v V e / • N WATER HTR. GAS ELIC. Base 1st 2nd 3rd 4th .-E • future Connection Openings * New Fixturs, Old Openings Connected with Sswst Closspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .............' .... x $2.00 $ Future Fixture Opening ........... x $1.50 $__ New Fixture Old Opening .....:.... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater :Up to 99,000 BTU) .... x $3.00 $9 910-0 New Ground Run Old Bldg....... •.. x $3.25 $ Electric Water Beater........... s $2.00 S 3AB FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... • • • • • • . x $2.00 $ . Additional Fixtures ................. x $ .75 $ Gas Range to 199.000 BTU .............. x $5.00 $ 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 Fridley, Minn �`l 192-F Owner Kind of Used as S ij ( L t •"" �, 1 �.! Cs To be completed about Estimated Cost, $ 1 &1dNew. Building Permit No. P rmit No. 6, Signed By J �. t • - - Business Phone No 5'3 7' � ROUGH REPAIRS & ALTERATIONS ---Refer to Code .50 State Surcharge . Description ............................................. u TOTAL FEE s3a o 6117 Ur rKLIJLtY 978b -b16051 APPLICATION FOR PWMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL • Ru tuber Fixtures x $3.00 A Future Fixture Opening x $2.00 U New Fixture, Old Opening K n $ Water °� $5.00 • A Water Heater - to 99,000 BTU x $5.00 ►bi H�u [ e $10.00 $ 41rob x $7.00 $ New Ground Pun Old Building Heater •oA 54 $ C x C O ,.4 �hs GAS FITTING FEES: C d 0 o $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x , � $ REPAIRS & ALTERATIONS i W0 g $ ai t y p� v U $ .5o TOTAL FEE w $ 8.00 REzti mM 3 O O as lec 1st ri 1 2nd' 3rd 4th (R) - Future Connection Opening Connected with Sewer (•) a New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL • Ru tuber Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ • Catch Basin x $5.00 • $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Pun Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 - $ each add. $100.00 or traction $2.00 $ State Surcharge $ .5o TOTAL FEE $ 8.00 REzti ;t•t i�,:t yt:E Job Address 6h12 NE Pierce Street '' •' 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 Fridley, Mn. 6-23-78 , 19 OWNER Bialke KIND OF BUILDING frame USED AS res TO BE COMPLETED ABOUT 6-30-78 ESTIMATED COST OLD - NEW BUILDING PERMIT N0. ��- PERMIT NO. Compa Signed By MINNEGASCO Tel. NO. ROUGH INSP. Date FINAL INSP. /,Z Date APPROVAL FOR PERMIT'd, 0/� MINIMUM FEE FOR ANY PLUMBING PERMIT 13 $7.50 PLUS $.50 STATE SURCMRGE SUBJECT City of Fridley 2 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. • ______ COMMUNITY DEVELOPMENT DIV. _ I � PROTECTIVE INSPECTION SEC r NUMBER REV GATE P PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/9/94 J08 ADDRESS 6412 Pierce Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 Moore Lake Highlands 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Rusinak 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Woodland Stoves & Fireplace 1203 Washington - 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 0 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE A 8 DESCRIBE WORK Install a woodburnin stove Vermont Castings, Resolute Aclaim Warnock Hersey ANSI/UL 41481-4737) 9 CHANGE OF USE FROM TO STIPULATIONS Install in accordance with manufacturers requirements which shall be on site during final inspection. Provide smoke detectors adjacent to all sleeping areas and basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,014 $1.00 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 CONSTRUCTION $54.00 Fire SIC $2.01 PLAN CHECK FEE TOTALFEE cense SC $5.00 62.01 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH N Y V DATED THIS IS YOUR PERMIT n/ SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEIBLDG INSP MATE NEW [ ] Effective 1/ 1/94 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address:J l M(S 1A 51A Q k Tel. # S 7 f-- 7 Contractor: o o A /C4 4 It a v e,: o f reQ Ar4MN LICENSE # a S'S a Address: b j l ti a s Alga 7 o h t�'✓ �z y��-Tel. # 3� a^ 64(z f% Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: �N e o � ,,�, / Estimated Cost: $ Zp /q Approx. Completion Date: (Cost on Back) Driveway Cut Width Needed: Ft 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%Q) State Surcharge $ 1610 $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Pian Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessauy [ ] Not Necessary [ ] TOTAL STIPULATIONS: (on SUBJECT - PERMIT City of Fridley 31048 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. 1 COMMUNITY DEVELOPMENT DIV. v ------ �n® r PROTECTIVE INSPECTION SEC. F Q�/ NUMBER REV GATE PAGE OF APPROVED BY _ CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/8/00 JOB ADDRESS 6412 PIERCE ST. NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Moore Lake Hi hlands 1St Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Rusniak 6412 Pi Fridley, MN 55432 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Reroof American Corp. 9508 Lyndale Ave. So. Bloomington 612-888-8400 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20141410 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and arae 23 s tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 1 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 $2,010 $1.01 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 PERFORMAN E OF CONSTRUC ON $83.25/Fire SC $2.01 /7 PLAN CHECK FEE OTAL FEE (/` YOVA4�—®D LicensAC 0 AIS 91.27 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi P LY VA ID B f•. �ySP - ;ED THIS IS;PUR PERMIT gATE S,GNATURE OF OWNER dF OWNER BU40ERi MATEi NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PEERMIT APPLICATION Construction Address: & tllz PleAcLsi. /1! c _ f Legal Description: Owner Name & Address: Contractor:Q �- Address: 9 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/1/2000 612-572-36%4 Bldg Insp o� g� �,001�/ Tel. # MN LICENSE # aMA11V10 9'� Tel. # 61o? -M-AWO U SW,,2d Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTiCN OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Sq. Ft. Construction Type: I&LL ��GtIV' COW 60r—Estimated Cost: $� �® �O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 0 APPLICANT: Tel. #642W -S01190 CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application Permit Fee $ ' - �s� Fee Schedule on Reverse Side Fire Surcharge $ �- 0/ .001 of Permit Valuation (1/10th%) State Surcharge $ ZOO $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ SDU $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 $ 9 . o� STIPULATIONS: CITY OF FRIDLEY PERMIT NO.: 2004-02337 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/29/2004 .3 -36U4 VAX: ADDRESS 6412 PIERCE ST NE PIN 133024310042 LEGAL DESC MOORE LAKE HIGHLANDS 1 ST LOT 7 BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. PH:763-571-7862 # INSPECTIONS 1 APPLICANT GOLDEN VALLEY HEATING & AIR 5182 W BROADWAY CRYSTAL, MN 55429-3591 (763) 535-2000 OWNER RUSINAK JAMES J & RHONDA L 6412 PIERCE ST 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 construction or the performance of construction. Applicant Date Bldg Insp Date STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (RESI) 20.00 TOTAL 20.50 PAID WITH CHECK # 6275 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT NO.: 2004-02338 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/29/2004 r (763) 572-36U4 k -AX: (763) 571-1287 ADDRESS : 6412 PIERCE ST NE PIN : 133024310042 LEGAL DESC : MOORE LAKE HIGHLANDS I ST : LOT 7 BLOCK 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. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2395 APPLICANT GOLDEN VALLEY HEATING & AIR 5182 W BROADWAY CRYSTAL, MN 55429-3591 (763)535-2000 OWNER RUSINAK JAMES J & RHONDA L 6412 PIERCE ST 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 wort 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 re ulag ting cgpstruction or the performance of construction. A�nlic�an}\\\ Date WI HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 6275 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 "'FAX 763=571-1287 -RATE SCHEDULE Residential Furnace Shel "u ork, Bumer & als KeplacementFurnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All ather Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR --_POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES � JOB ADDRESS i Flerccs- - 1 Owner 3:OC7 I•- $35.00 _ $ - Building Used As $10.00 $ ' $10.00 $_- -$10.00- $10.00 . $ $25.00' $ ,o ESTIMATED _ PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units I Circle One (Steam) (Hot Wat Trade Name Size BTU - '70i 6VT)HP EDR FuelTotal Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specked 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/IndustriaVinstitutional and representations statJN%",%W WrPect. DBA: GOLDEN VALLEY HEATING & AIR State Surcharge $ HEATI G 5182 WEST BROADWAY 10 CRYSTAL, MN 55429 TOTAL FEE $ 1 Sign 763.535.2000 Tel # REINSPECTION FEE $50.00/HOUR F # /�Date DEC 1 6 2004 *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 s. 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 termination. Yes O 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 j No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes k/) 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 ventinsa 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( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type � �-t� BTU Input ?®t®®0 n Assiste or Nat Appliance #2 Type w e t��-�� BTU Input 40 0®J Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input .- Common Vent Type e t-rfaSS. 0, Vent Height Appliance #1 Vent Connector Height ft Length ft Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft 'Length ft Diameter inches Diameter;_ in Type Diameter in _ Type Diameter in,, Type ALTERATIONS: (Describe) RICHIVIOND & SONS ELECTRIC INC. / A 9PA: GOLDEN VALLEY WFATimn * Am BROADWAY - HEATING CO: CO: ORDER FOR PAYMENT NO. 'Z - 1-3Y7- 367 Installer of Wiring & W -"kA Air Owner/Occupant reni, 'd ct Job Property Address 6 3/ 2- • A-20- At &-e_ .S?- & C7 Zip Date i' _7-T -!97� Permit No. t -07-x367 Date Filed /7-2-2 —3 rough -in inspection was required. ❑ No access - scheduled inspection. ❑ Fee shortage - see computation. Reinspectlon fee. Fee Computation: 443 (-A., v -g s v A&& jC c - ��.d Qo Please return this order ith your cher in the amount of �' �- ayable to the city/ township by (date) ,-Or Inspector e eaL Arid Q"� Telephone CQ V/- ;?77-;79')% RETURN THIS ORDER WITH PAYMENT TO THE CITY/TOWNSHIP WHERE THE JOB IS LOCATED. RC -02