PRE 2010 DOCSCity of Fridley
AT THE TOP OF TME TWINE
i
r tU-------COMMUNITY VEVELO MENT VIV,
�! PROTECTIVE wfftcrtom a",
CITY HAIL FRIOLgV 01141t
s
100 Pilot Street N. E.
53-84-S-915.51
:T
PLUMBING PERMIT APPLICATION
s
Robert C.
Struif 560-$152
Contractor
MINNEGASCO Address Phone
733 MARQUETTE AVENUMPLS,,,
Kind of Building
Use
MINN.
Frame
Res.
Completion-
Date
stimate ost
10-22-73
10,00 _
alU
; I II
Plumbing Fixture Rates; NO. RATE TOTAL
+
I
W
W
I —f
--
I
1 Number Fixtures x $2.00
Ii_
Future Fixtures x$1.50
svol
I ! I
I ! New Fixture -Old Open. x $1.50
O
? Catch Basin x $3.25
4Y0
�
I
I
Water Heater -99,000 BTU x $3.00
'781M
Ground Run Old Bldg. x $3.25
saa,
,—i
•MHlval
I
I I 1 II
Im
I Elec. Water Heater x $2.00
i
8N18Ve
lO
I
Gas Fitting Fees;
I --
6Nrvaa
I
I
I I
3 c
tloo,dl
I
•0p
04
1st 3 Fixtures x $2.00
C04
83
I
�Z .3
ea7M0"$
I
I
I
A
j
i Additional Fixtures x$
.75
LNnod
I
I
I
i
aNlaol
Gas Range -199,000 BTU x $5.00
a ►.
HSYMI
I
I
I
I
Repairs & Alterations
I See
s>tWI9I
I I
I
I
Description; Install Dryer Code 5.00 I
�
��-tads 'A'Surcharge .5a
fNISYYI
1
I I
I
I
�
a
State Surcharge .50
I
I
I
�
I TOTAL FEE $ 5.50
H1V9I
I
I I
s,vmivnl
!The undersigned hereby makes application for a permit
I
I
I
I
for the work herein specified, agreeing to do all work
Ei39012
in strict accordance with the City Ordinances and rulin
tl71YM
I
I
I
of the Department of Buildings, and hereby declare thatgI
all'the facts and representations stated in this
app�licatiron re true and rrect.
CZO.
ce
e9
sp
'Signature W1 Date
a
City of Fridley
suedEcr
PE
13681
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
ECEIPT NO.
L-__•___ COMMUNITY DEVELOPMENT DIV.
1 PROTECTIVE INSPECTION SEC.
1 �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
� •'1 CITY HALL FRIDLEY 55432
�•""�'� ,'�
612-560-3450
910-F15
$/5/76
JOB ADDRESS 100 Pilot Avenue N.E.
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
9
1
Carlson ' s Summit Manor South Addn. SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Robert Strief 100 Pilot Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
G & M Construction
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
X
8 DESCRIBE WORK
Construct a 18' x 24' Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a hard surface driveway. Front yard setback variance granted
to 24.6 feet by Appeals Commission on July 13, 1976.
..IMPORTANT..,..
NOTIFY THE FRIDLEY
ENGR.
DIVISION REGAROING CURB
R�QIJIRED mR -WIMNG, REMOVAL AND REPLACEMENT
AT
�-r�t� A, p,I� NItT DRIVEWAY OPENINGS.
S
14EAYt'I-vI► pLUMRING 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 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
432
4320
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
$3,196.80
$1.60
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.
$17.28
PLAN CHECK FEE
TOTALFEE
$18.88
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ICDATEII
W�HpEN PROPERLY VALIDATED THIS IS
_�ER
jYOUR CPERMIT
/
BLDG. INSP DATE
IIF OWNER BUILDE (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDITION, OR REPAIR BUILDING PERMIT
OWNER'S NAME: �1� BUILDER: L -
ADDRESS: /w / ✓� ADDRESS:
h�M
LOT: ?
STREET • O�& AV �,
BLOCK: ADDITION: &JA_J�
CORNER LOT: b--' INSIDE LOT: 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: �l
Front: n Depth: Height: y
Square Feet: °y� Cubic Feet: yea o
Front:
Depth: Height:
Square Feet; —Cubic
Cubic Feet:
Type of Construction: wyo41�tV Estimated Cost: $
To Be Completed: •� A740 411-0 .
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.)
a� UaA(0-41 QJL, (0
M
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. R. C. Struif
100 Pilot Avenue N.E.
Fridley, 121 55421
TELEPHONE ( 612)571-3450
Re: Intersection Vision Safety Zone Obstruction at 100 Pilot Avenue N.E.
Dear Mr. Struif:
In order to provide safe passage for vehicular and pedestrian traffic in
the City of Fridley, periodic inspections of street intersections are
conducted. An inspection on June 30, 1981 has determined that the sight
line for the intersection on your property is obstructed and could present
a hazard to traffic.
Section 205.154 of the City Code requires that, "On a corner lot in a
vision safety control zone, nothing shall be erected, placed, planted or
allowed to grow in such a manner as to impede vision..., the vision
safety control zone is described as follows: That area bounded by the
street right of way lines of a corner lot and a straight line joining
points on said right of way lines twenty five (.25) feet from the inter-
section of said right of way lines."
Therefore, the City is requesting you, the property owner, to correct the
following problem and make the City's streets safer for travel. A
reinspection will be conducted on or about July 20, 1981 to determine
compliance. We are confident in your cooperation to correct this matter
and if any questions or problems result from this letter, please contact
me at 571-3450.
The inspection of your lot indicated that the following obstruction is
existing and should be corrected:
Bushes or shrubs growing into sight line - trim down or back to
be less than A feet high
Hedge growing into sight line - trim down or back to be less than
A feet high
Tree branches growing into sight line - trim up
Fence extending into sight line - lower or remove
Sincerely,
?EN.T.OLSON, R.S.
Env it onmen to 1 Officer
cv, q, �
intry
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571.345D
u
in
OBSTRUCTION:
Lot Block Addition
C. s-t-rt?;F-
Property (Mier-..ddress
e� {
RECORD OF COM %FU IQUIONS :
1. Z//0:7 4-7-4101V
2.
sueJEcr
PERM - .
City of Fridley
0 18920
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
j_��s
�
l1 =
�/ ���,� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
•---�
L 612-571-3450
910-F15
5/4/87
JOB ADDRESS 100 Pilot Avenue N.E.
1 LEGAL
LOT N0.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
9
1
Carlson' s Summit Manor
South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Thomas Bukowski 100 Pilot Avenue N.E.
572-1816
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
Reside Dwelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
1
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
VALUATION
SURTAX
AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3,500
$1.75
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-
$44.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$46.25
SI OF CONTRACTOR OR AUTVRIZEDAGENT IDATEI
WHEN PROPERLY A DATED THIS IS YOUR ER ITS
BLDG INSP
AT
SIGNATURE OF O IIF OVVNER B ILDERI IDATEI
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Y/
Construction Address: I 0 0 (/ "C 0
Legal Description:
Tel. #
Owner Name &Address: Thn 6^� 4 S / %J�vC�«•° /d
Tel. 4
Contractor: S%p"
r �
Address:
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:
DESCRIPTION OF IMPROVEMENT
Height q. Ft.
Height Sq. Ft. _
Hgt/Ground Sq. Ft.
Length 3�
Length
—
Length
Width `l
Width �-
Width
Corner Lot [�'`1 Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
��C i�1 o
Type of Construction: S Estimated Cost: $ 3
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: > ^y / APPLICANT: �^ Tel.
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ t4Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$+7� $.50/$1,000 Valuation
$ $525 per SAC Unit
$ Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
3:50()
L9 0c3 Via, S -V
- L/-
,Jv
V
SuBJECT
PERMIT NO.
City of Fridley22446,
AT THE TOP OF THE TWINS
BUILDING PERMIT
REC
COMMUNITY DEVELOPMENT DIV.
_
1 -_
tr
PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
I'J 612-571-3450
910-F15
4/25/94
JOB ADDRESS 100 Pilot Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9
1
Carlson's Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Thomas Bukowski 100 Pilot Avenue NE 572-1816
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 J1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 32' x 12' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide smoke detectors as per UBC 1210 adjacent
to all sleeping areas and in basement.
WA R R F1
Before digging call for
all utility locations
454-0002
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
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
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
]
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1.31
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,622
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$54.00
$2.62 Fire SC.
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
57.93
SIGNAT IDATEI
yy LY V D TED THIS IS YOUFJ PERMIT
�N-TRACTO�AUT�ZED
BLDG INSP qAT
S i RE OF NER0F OAL&LRB I IDATEI
V
NEW ( ( Effective 1/ 1/94
ADDN (] CITY OF FRIDL-EY
ALTER SINGLE FAMILY AND DUPLEXES R -I AND R-2
Building Permit Application
Construction Address: _ �� ' dl -e
Legal Description: --
Owner Name & Address: �h a '� a p Tel. #
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE #
C P"G o i A'11 , �-e y !"1'1; h /') Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length 3%oz ", Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot Pf Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: g- a�� G J Estimated Cost: $ C;CZ -,
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 F _ x $ _ $
DATE: `-� — `l YAPPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
$ C�_ ��
$ 1_31 -
Driveway
-3/
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
SUBJECT
PEFQIT NO.
City of Fridley
0 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
96
r
1 . �
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
8/6/98
JOB ADDRESS 100 Pilot Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9
1
1 Carlson's Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Thomas Bukowski 100 Pilot Ave NE 572-1816
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ak REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 17 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
1417
.71
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.
$48.50
$1.42
PLAN CHECK FEE
TOTAL FEE
SIG1J TUREO�ORORAUTHORIZED AG � 1 ATEI ��j
WHENPROPERLY Y'AJEIDATEP THIS IS Y R PERMIT
0
BLD INSP 4ATE
S,GNATURE OF OWNER OF OWNERBUILDERi tPATEi
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDI G PERMIT APPLICATION ®q�
ConstructionAddress:
Legal Description:
Owner Name & Address: \&'A'_®Q& K ; Tel. # s --
Contractor: -e" `ice MN LICENSE #
Address: �1 _ b �� \) -<- r Tel. # 57-2 61F 'P
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IldPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE -AREA: Length Width Height Sq. Ft.
DECK AREA: Len Width Hgt/Ground Sq. Ft.
r.
OTHER:
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: #
STIPULATIONS:
.K
CITY USE ONLY
Permit Fee
$
'yam ,S�
Fee Schedule on Reverse Side
Fire Surcharge
$ 7T T
.001 of Permit Valuation (1/10th%)
State Surcharge
$
% /
$.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:
.K
CITY OF FRIDLEY INSPECTION DIVISION
6461 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
P
Commercial/Industrial
1.25% of Value of Appliance or Work
Effective On January 1, 2000
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. "�
J— DATE 12,0 l)
HEA'
Sign
MINOR
Approved By '&J, Rough -In Date Final Date 8 iS�Ot)
JOB ADDRESS J� L---.)
OWNER 1 (�l�
Rate
TOTAL
BUILDING USED AS
$ 30.00
$
ESTIMATED COST
_
PERMIT NO. NJ
$ 10.00
$
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00
$
No. of Heating Units
Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00
$
Trade Name
Size No.
BTU
HP EDR
$ 25.00
$
Fuel
Total Connected Load
Burner Trade Name
Size No.
$
BTU
HP EDR
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. "�
J— DATE 12,0 l)
HEA'
Sign
MINOR
Approved By '&J, Rough -In Date Final Date 8 iS�Ot)
C COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
d,
r When replacing an existing furance, the undersigned hereby verges 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 manufacturers specifications. Yes( ) No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING C(
Signed By:
Are
UiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
August 9, 2000
Tom Bukowski
100 Pilot Ave NE
Fridley, MN 55421
Re: Final Inspection at 100 Pilot Ave NE
Contractor: Dave's Appliance Heating and Air, Inc.
Dear Mr. Bukowski:
A mechanical permit was issued on June 12, 2000 for the property located at
100 Pilot Ave NE for an air conditioning unit. According to Section 305(a) of the
1991 Uniform Mechanical Code a final inspection shall be performed on the
mechanical system. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
DAVE/JgNSEN
BuildW Inspector
SUBJECT
City of Fridley
33813
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
III E
L A "',•; CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
--_.
L J` 763-571-3450
910-F15
8/18/03
10B ADDRESS 100 Pilot Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9
1
Carlson' S Summit Manor South Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Tom Bukowski 100 Pilot Avenue NE
572-1816
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Dan Helwig Construction 13180 Red Fox Rd, Rogers, MN
428-4323 20176351
a ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [j REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires
that a weather resistive
barrier be placed over exterior sheathing to protect the
interior wall covering.
Exceptions for this provision would be if sheathing is
an approved weatherproof
panel or when the siding is an approved weather barrier.
Vinyl siding is not
a weatherproof covering unless the manufacturer states
this in their application
guidelines. Call for inspection of wrap before covering
or take pictures. Caulk
and flash all exterior openings.
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
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
@@
@
$1.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,000
DOES NOT PRESUME TO GIVE AUTHORITY TO LATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
SIONS OF ANY OTHER STATE OR LOCAAW REGULATING CON-
rULCTION
$$3.25
Fire SC $3.00
STRUC N OR THE PERF RMA F NS
PLAN CHECK FEE
TOTALFEE
____!7-44_cerpe
SC $5.00
$92.75
�G 4TURE OF N7RACTOR R AUTHORiZEO ADEN iOATE�
_
HEN PROPERLY
JA
G INSP
VALIDATED THIS IS YO R P MIT
��
r)AYE
S-GNATURE OF OWNEROF OWNER BUILDER, iDATE�
-y-� 9.13
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 5714287 Fax
BUILDING PERMIT APPLICATION '
Construction Address: t 0' 40E A/
Legal Description:
—
Owner Name & Address: �JQM �/Gc w s /� r � � � ��, �� Tel. #
Contractor. LArJ OgEC to C o MN LICENSE # c `2 of 7e, 3 Sl
Address: 13 l P 1Zc-2 Iq V Oe -e -f F'a e e-- rS, Tel. # 12--f-
Attach
2--f_
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: r 0
Construction Type:y/�aV' r�/�� Estimated Cost: $ �,, od 0
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
C,
DATE:o/a/o APPLIC Tel. # Z� _ 7-3
Call (763) 572-3604'for Permit Fees if mailing in application. Fax 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $ �-
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]