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PRE 2010 DOCSNOTICE. This permit does not cover th'E sewer or water. Be sure to see construction, installation or -alteration for wiring,_plumbing, gas heating, uiiding Inspector for separate- permits forge items. { City of Fridley, Minn. BUILDING PERMIT' N® 3 3 7 0 Date: ... ...... .... ..... ...... Owner .. .. ...,. Builder ... .............................. ss............................................. LOCATION OF BUILDING , No. l.. /$00 Street .... .�%' ..... .. ... ......... Part of Lot ............................... Lot .. ..... Block ..... .......... Addition or Sub -Division........ .. .... . Corner Lot ............ Inside Lot ..,X....... Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be Used as: a>' �® �E &ARA .. Front ./6.7: V Depth ..... - ®Height .l .. sq. Ft cu. F t,`� .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... Brat. Cost.... W..A.?7.... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed 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 $. ..�..., permit is hereby Xted 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. .... _.:.: ..... g Pr �s9 e NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. 97-84-879001 C1 TY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS, FITTING PERUT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 • $ Catch Basin y $5.00 b[ E Water Heater - to 99,000 BTU x 4 a $ 41 o4 •4 w $ Water Softener Water Heater O c 0 P. Croy ++ G ++ C O1 in R N X 41 -4 O 0 O QH O .0 C N E ami U N N3 a W N M $4 O •$3.00 $ Additional Fixtures L W v 1454 w a y r! 54 O a w ,C .i w ed M U w b 9 b 0 $5.00 a e 3as lec $ State Surcharge $ 5o TOTAL FEE $ 8.00 1st 2nd 3rd 4 t`r (R) - Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number 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 Run 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 fraction $2.00 $ State Surcharge $ 5o TOTAL FEE $ 8.00 ur.rre:i•r•••rr,,zr r•rcr. Job Address 5715 NE Quinc f Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for at 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. 6-7-78 , 19 OWNER JORGESON KIND OF BUILDING flame USED AS res, TO BE COMPLETED ABOUT 6-14-78 ESTIMATED COST 20,00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company Signed By MINNEGA GO Tel. No. ROUGH INSP. Date - FINAL INSP. Z/-^ - 2 g Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCHARGE 63-81—LI6051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE e PLUMBING FIXTURE RATES: NO. RATE TOTAL N x $3.00 $ Future Fixture Opening o $ % N $ Water x $5.00 $ :later 'neater - to 99,000 BTU x $5.00 $ sbi c M riW Ny,� q x $7.00 � rd 54 Sew Ground flan Old Building w $ Electric tater Heater Heater $ GAS FITTING FEES:. 1st 3 fixtures x $3.00 -4 .additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 _ $ K C S U ••i X $ 10 U rJ cn U D c w s ••i O c ,, O o m w .N N r1 U w .0 N a ro a s N N .c p asF11c I'St �2nd� 3rd i (R) - Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ :later 'neater - to 99,000 BTU x $5.00 $ 1-0,000 ^o7J to 199,000 BTU x $10.00 $' Hater Softener x $7.00 $ Sew Ground flan Old Building x $5.00 $ Electric tater Heater x $5.00 $ GAS FITTING FEES:. 1st 3 fixtures x $3.00 $ .additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 _ $ State Surcharge $ .50 TOTAL FEE $ 10 REINSPECTION FEE ($10.00) Job Address 5715 NE Quincy Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work hereLn 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. 1-20-81 , 19 OWNER JORGENSON KIND OF BUILDING frame USED AS res 1-27-81 BE COLLETED ABOUT r ESTIMATED COST 50.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. `- company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. I '^ D to APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMAING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE SUBJECT - PERM) O. City of Fridley 1625' 625% AT THE TOP OF THE TWINS BUILDING PERMIT rp COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ,� L 612-571-3450 910-F15 6/23/81 JOB ADDRESS 5715 Quincy Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 6 Donnay's. Lakeview Manor SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Wally Jorgenson 5715 WM Quincy Street N.E. 571-3307 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement Co. 4832 - 21-2 Street N.E. 572-1820 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 fel ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof I Structure 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized valleys. 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 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 $1e 800 $.94 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- $12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $12.94 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) -'�&Ahjj WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT (d /ut is I BLDG INSP I DATE SIGNATURE OF OWNER OF OWNER BUILDER) �1 AT -EI OWNER: ADDRESS: TEL NO: CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) BUILDER: V , zjj/vc- V &ZE ADDRESS: 330 TEL NO: 2— U —T r- • Construction Location STRIMT NO: �J STREET: LOT: BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTIOPN Front: Depth: Height: Square -Feet: Cubic Feet: • Front: Depth: Height: . Square -Feet: Cubic Feet: Type Construction: C% L�? /-�� v of Estimated Cost: $ To Be Ooripleted: ` Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . Me 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 nd representations stated in this application ar true and cor ect. DATE: (� �� SIGNATURE: Stipulations: SUBJECT PE City of Fridley 16 5 5 AT THE TOP OF THE TWINS BUILDING PERMIT RE COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY i 612-571-3450 910-F15 I 5/4/82 JOB ADDRESS 557155 Quincy Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 6 Donnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wallace Jorgensen 5715 Quincy Street N.E. 571-3307 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Leo 0. Sanders 7813 Jackson Street N.E. 786-2860 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 Install drain the 9 CHANGE QF USE FROM TO STIPULATIONS Electrical extension cords can not be used as part of the power source to the pump. SEPERATE PERMITS REQUIRED FOR WtRl"G, HEATfNG, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,000 $1.00 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 PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $32.50 T UCTIO OR THE PERFO A;NCE PLAN CHECK FEE TOTAL FEE r $33.50 SIGNATURE OF CONTR TOR OR AUTHORIZED AGENT fOATE} WHEN PROPEFAY VALIDATED THIS IS YOUR PERMIT S9 BLDG INSP O E SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI OVINER: ADDRESS TEL N0: CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR RESIDENTIAL BUILDING PE•RiiITS (Next, Alterations, Additions, or Repairs) BUILDER: f ADDRESS: , Z F1 TEL NO: % c Construction Location ,l STRIMT NO: 50 JS - STREET: O lAA o u LOT: ® BLOCK: (O ADDITION: t\x) 3�}Cp S U �� C�� I iAAkj,P— Corner Lot: inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: Estimated Cost: 7b Be Cbmpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE MVERSE SIDE OF SHEET 'Zie 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 h eby declares that all the facts and representations stated in this application a�true andrrect. DATESIGNATUFE: Stipulations: II,ITY OF FRIDLEY INSPECT ioN DIV. ;1431 University Ave NE Fridley, MN 55432 763-572-3604 Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR $ 7.00 -'` Wash ,. Auto. LOWower . ;.. Y Washer NO. RATE TOTAL JOB ADDRESS New Factures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas" $10.00 Gas Range" $10.00 Gas Dryer" $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $47.00/1 -Ir ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Effective On Jan 1, 2001 Heater Gas 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 correct. MWIFla.'t Building Estimated Cost PERMIT NO. f Aj/ I PLUMBING COMPANY SIGNED BY TEL N0. Approved By& Rough -In Date Final Date State Surcharge $ .50 OR ANY PLUMBINGIGAS PERMIT IS MINIMUM F�� PERMIT TOTAL FEE $C�. SD iLy;!c THE $.S0 STATE SURCHARGE 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 replacina 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 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 CO: Signed By: Date : Building CHANICAL permit No.: Inspections RESIDENTIAL APPLICATION Received By: 7.63-572-3604 CITY OF FRIDLEY Date Rec'd: DATE A0 D 4 YOUR E-MAIL ADDRESS SITE ADDRESS i S THIS APPLICANT IS: 0 OWNER NGONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY STATE ZIP TENANT n PHONE: CONTRACTOR COMPANY NAME: 1v181 OI e 9 SUBMIT A COPY OF CONTACT PERSON: I�1n . YOUR STATE STATE LICENSE LICENSE WITH ADDRESS: IVINF-59�TE rl Sys CITY STATE ZIP APPLICATION (763) 754-2199 W(763)754-2908 PHONE 9 t6LE FAMILY 0 TWO FAMILY 0 TOWNHOUSE PERMIT TYPE 0 NEW 0#MPLACEMENT 0 ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK PER MS 1613.665 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 fblures. (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 WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Aaa�MODEL: CUAJ)' %AtAt- SIZEBTU Equipment Installed MFG: SIZE/BTU MFG: MODEL: SIZE/BTU /�G; MODEL: GAS RANGE/OVEN $10.00 _AJC $25.00 _FIREPLACE (GAS) $1$35.0 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 ,GAS UNIT HTR $10.00 BOILER $35.00 _FURNACE $35.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENITLATOR $15.00 .....,..... _�..... ,......., _s!.•...:�+:'u'::::c Y-..JJtiYiil2. h:Y5ih"iira'`YI1''i Permit Fee $ �,�`�� Number of fixtures @$10.00 x $10.00 = Number of fixtures @ $15.00 x $15.00 = Surcharge $ 50 $ TOTAL DUE $ �- 0 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. 104 y� SIGNATURE OF APPLICANT, /%/� lig-�/� PRINT NAME 4ehk s AMP DATE ?P 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 HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING 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 IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC 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 used for combustion and make up air calculations _ -- RIVER CITY Ply 02/02 PLUawn®ate f '•° „�• wESMENTIAL APPLICATION 7 dft IOU 1:rldley (F {'f OP&R ^l' IS NOT 0 WNf�IRRf=Ul`19 - AI DIC ED CONMAC TOR I RUST OWARI THE PERWIT. „ COMTRACM crry �/ �� ,' _ 12 mase +►�t� t►13TAf1� o�•wo�rc�'»� t � t�4ar�.kt�. �1 �.,��,,.► �1� _� r' ARE �liD c� �if�0 P� . R'TtA�IEftR NU�u KKnW=t (lND1CATO TOTAL HUMeR OF L CM t�A77i'li3B am pop" ~a* WAm' t= —cLanmWAMER ___JQT*t.(1! 3m1K WAY&R ..__AACKFWN "W. (SIG) �,�U MAtAtSmltRtt L4upOR'Y'F"y Y.WATBR0R (M MR flou"1W>wti �WATER N lEli pettmft f4lo # MRWUM; $In= cw SIP* of cam of *9 lmpmvwwuwwhkftwcr is i''llm Rw4 w $ greater on work Im dw , TOTAL DUE $ „ �� - � � Mf *beaus paysms tax City of Fridley I MGP —RUM V~V MFarldrf%WW mCl^° W ' ! hweby GWfor a oWmbhtq Pomft Benet i ge float ItW Inimt0m a bm Is earrohe ertat Rommm chat ms vom v A bo in oonform mo vft " womalum and cod= of go <' of ftwy mw "mmm hwumsm amoudon ow f wwermw oft f8 not a pomw but Mir an oPk6 m fbr a vw* md+wok !a rpt to est®rt a p umt the ffaf work wN bo ImoMMUM WM +too appftvad pm In the em of aN war& wft rem mlgws" oV pias. MMI! OF APFMUCAJa V- DATU =NATLM6 OP APF0tdCAW S2�b../1�4 ] 1ekas...... TUTAL P-01 11-01-2007 07:45 CASPER MECHANICAL 17636899112 PAGE:2 Building Inspections 7.63-572-3604 CITY OF FRIDLEY DATE d b - 31- 6-7 YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK. O OWNER CONTRACTOR Permit No.. Received By: ADDRESS: CITY r-Gel01.F/ STATE6�J�ZIP=� a PHONE: COMPANY NAME: Q' v Lr�" e 11(L(- t- H� A CONTACT PERSON: _ 111 t s (� USD STATE LICENSE # EXP DATE ADDRESS:Xa90 t-6-14 -2 N(= CITI'�N-t®la STATEA'I�ZIPc4Jt(�� PHONE 7 63^ 7-� Ll' -1'14 g FAX p SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE 0 NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK -1 ) SiA l l Ok--/,G ( s- LE," I -7t PER MS 16B.665 the permit fee is a minimum of 515.00 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 WHERE NOTED. FIXTURES: ONDICATE TOTAL NUMBER OF EACH BELOW) MODEL: ✓G EgWpmcnt Installed MFG: A v_VQ � L• " 6 � � N A bS SIZE/BTU 0 t, n e MFG: MODEL: STZFJBTU MFG: MODEL: SIZE/BTU A/C $25.00_FIREPLACE (GAS) $15-00, GAS RANGEIOVEN $10.00 —AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER 535.00 1_FURNACE $35.00 GAS UNIT HTR $10.00 —CH MgEY LINER $10.00 GAS DRYER $10.00 FOOL HEATER $35.00 GAS PIPING $10 00 VENTILATOR $15.00 DUCT WORD $1[1.00 �"�• ��.�czar..�axr:axw wrv.rivrwa�r+nr.rsca.c� .gF¢_Iffi=..P'i' — Permit Fee $ as,• ®® Number of fixtures @ $10.00 x $10.00 - Surcharge Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ • . 0 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 C/1At,6 PRINT NAME y,I t � )0 � DATE 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 ]MC Chapter 7 with MN Amendments b. Natural Gas or PropanoUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a_ 19C Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a_ Required on new construction ]MC 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 used for combustion and snake up airs calculations 1 n.v 10 P"v Arru4Ar wrr rVRA PERMIT- NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and i acknowledge that the information above is complete and a=ff2te: that the work Wil W in conformance with the ordinances and codes of the City of Fridley and with the Ntinnesota Construction Cottee: that I understand this is not a permit but only an application for a permit and work is not to start withmit a permit; that the wank will be in accordance with the approved plan in the case of all work which requires review and approval of pians. NAME OF APPLICANT C ' , r l.% Q ®, DATE Q (p (9' Please typb or print StGNATURE OF APPLICANT C/ TOTAL P.81 'ao PLUMBING umber RESIDENTIAL APPLICATION BY City Of Fridley '� o 17 NOTE: IF PROPERTY IS NOT OWNERIOCCUP1ED- A UCIENSED CONTRACTOR MUST 013TAIN THE PERMrr. DATE l O ^ V 0 0'7 YOUR E -"L ADDRESS SITE ADDRESS /f 54 0. THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR NAME ��s �d I (& f- � a� ® 0'1 L r) j t n PROPERTY OWNER! TENANT ADDRESS �7/ C � , e .*a "¢ N E CIN PI& I L3I c, STATE LP 3 °L PHONE #_� S -71 - 3 % NAVE ! C t u to 0_4 S4 (Q. 1,_1L4- t LICENSE # CONTRACTOR ADDRESSd&I 'V ® N9 CITY_ LPs. c ,M / td STATE ZIP,i�� a PHONE 0 7 6 S-. FAX# PERMIT TYPE SINGI_E FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORM M NEW REPLACEMENT DETAILED DESCRIPTION OF WORK'-TP)I�a0 (I FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED PIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SWIQq AV -FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Neem City Ucertse) SW M M NG POOL WATER SOFTENER ($34 CLOTHES WASHER KRCHEN SINK WATER CLOSET BACKFLOW PREY. %M DISHWASHER dAUNDRY TRAY WATER HTR (SM FOR IRRIGATION WATER MIs I6tt OTHER Permit Fee $ `As • 6c- MINIMUM: $15.00 or 5°/Y of cost of the Improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ ,gp TC3TAL DUI; $ 3S. 'To Make checks payable to: City of Fridley 1 n.v 10 P"v Arru4Ar wrr rVRA PERMIT- NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and i acknowledge that the information above is complete and a=ff2te: that the work Wil W in conformance with the ordinances and codes of the City of Fridley and with the Ntinnesota Construction Cottee: that I understand this is not a permit but only an application for a permit and work is not to start withmit a permit; that the wank will be in accordance with the approved plan in the case of all work which requires review and approval of pians. NAME OF APPLICANT C ' , r l.% Q ®, DATE Q (p (9' Please typb or print StGNATURE OF APPLICANT C/ TOTAL P.81 Building PLUMBING Permit No. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY e� DATE YOUR E-MAIL ADDRESS SITE ADDRESS C.L. ��- THIS APPLICANT IS: 0CONTRACTOR PROPERTY 1OWNE NAME: d (1 1 C OY'L�c�t�� ADDRESS:CITY (AW STATE -MR ZIPL% OWNER/ TENANT PHONE: -70 G-71 32, CONTRACTOR NAME: A o L:> STATE LICENSE 1t C EXP DATE 1^ 3 � 4t �L6n STATE_ZIP� �(J SUBMIT A COPY OF YOUR STATE ADDRESS: N ® 0 , CITY LICENSE WITH PHONE(? )S) ?) 9 61 -A (2 dP FAX APPLICATION PERMIT TYPE V SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE TYPE OF WORK: 0 NEW (a REPLACEMENT DETAILED DESCRIPTION OF WORK TY1 G; LL) S 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 WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _ _FLOOR _ PIPING (NEEDCHYLICEWE) SWIMMING POOL 5WWATER SOFTNER ($35) —BATHTUB —GAS _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _ _ _ DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _ _WATER WATER METER —OTHER _. ROJI s....r .:. Li1iJ '.$ab0 Permit Fee $ aN. Number of fixtures @ $10.00 f X$10.00=$ - $10.00=$Surchar e 0 Number of fixtures @ $15.00 x $15.00 = $ Surcharge TOTAL DUE $ S® Number of fixtures a $35.00 B x $35.00 = $ State Surcharge = $50 Total = $ - 2 �� 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 1 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 whi h requires review and approval of plans. O l I D�_ SIGNATURE OF APPLICANT " PRINT NAME eJ l If'1°l `�1 +�✓�: DATE d - 1014WO k r vl1 A o UI 1M-6; I ' i rrl , z ► � ° w .' 0;6"JUM . City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977