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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT No 4131 � v Date: -. ._.. _ .._.... / •... - --...._._ ._ F — --------- ----------- Owner: --------.Owner:...................................... ... _........_...._............_._--- _.._........ .................... Builder ......................................... _....._......._..__.._ Address Address L CATIO.N OF BUILDING No.... _ Street _. �... _. ., !� ` , ..----------- Part of Lot Lot............................-........ Block ..... -....... ............... - ... -................. Addition or Sub -Division ............. ........... - Comer Lot ..... _.......... - ................ Inside Lot - ... _ .............. ..........._..... Setback ....._.............. ....................... Sideyard Sewer Elevation .. .............. ..._............._.._........................_..............---...------......... Foundation Elevation .................. DESCRIPTION OF BUILDING To Pe Used as: /' / ••---............._....... ._.. tent 1....�-- Depth _07.- ®Height L.... ._� Sq. Ft.S/.4.ry _.. Cu. Ft. S .................................................... Front ........................ Depth ........................ Height ........................ Sq. Ft. ....._................. Cu. Ft. ........................ Typeof Construction .................. ......... ...................... _........ Est. Cost.......................................................... To be Completed ..... .............. ........................ ........ In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. ,il;.�l✓°*!.....:Yf.._.._..._...... ................ _.. In consideration of the payment of a fee of $J............, permit is hereby granted to....._............._............._............._......._.. .—__...... ..... .................................. ...._........ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ .. _ .1......_ Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. 4 Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam .................. 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $0 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 _® h GRAVITY WARM AIR: RATE TOTALLfwatinn (072,0 6 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Used as y To be completed about / l Estimated Cost, $ 4o° 6, Old—New. Building Permit No. Permit'No._ DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam/,/ //Hot Water, Warm Air—No Trade Name 10 Of" 20 �L�Size No Capacity / -0 a �a Sq. Ft. Total Connected Load Kind of Fuer BURNER — Trade Name Size No H.P. Capacity Sq. Ft. E.D.R. BTU H.P. QSigne By 42 2M Business Phone No (REMARKS—OVER) e7 52-84-x915.51 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 $ New Ground Run Old Bldg. x $3.25 $ Electric Water Heater = $2.00 $— GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... ■ Additional Fixtures . ... ....... :....... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Gas Dryer 1 5.00 ALTERATIONS—Refer to Coda Description . .............................................$ TOTAL FEE s-5 - 00 ■ ONE N MEN IN No 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 $ New Ground Run Old Bldg. x $3.25 $ Electric Water Heater = $2.00 $— GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures . ... ....... :....... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Gas Dryer 1 5.00 ALTERATIONS—Refer to Coda Description . .............................................$ TOTAL FEE s-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_ 10-1-69 Owner R Helliaksgn Kind of Building frame Used as To be completed about Estimated Cost, $ 10,00 Old—New. Building Permit gyp© P it b L -A ;1 Signe Rv INNEAP®LIS GAS" e0. ROUGH FINAL / b e Business Phone MINNEGASCO 53 -8h -S-915.51 City of Fridley App I9 u11cn 9w Md G -m runk Dept. of Bldg*. Phone 560-3490 DESCRIPTION OF WORK 6220 N. E. Rainbow Drive Plumber, Kind and Location of Fixtures 1'�"` 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 $ New Ground Run Old Bldg. ..... x $3.25 $ Electric Water Heater .............. s $2.00 $ 'WAS FITTING FEES: NO. RATE" TOTAL 1st 3 Fixtures ............ • • • x $2.00 $ Additional Mures .................. 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 herel 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, lyii^n 8-16-74 Owner John L. Holm Kind of Building Frame Res. Used as ' To be completed about 8-23-74 10.00 Estimated Cost, $ ---- Old-99W. Building Permit No. Perm�o. �U Ori. • Signed By MINNEGASC© _ Business Phune No ROUGH FINAL 17' REPAIRS & ALTERATIONS—Rates to Code .50 State Surcharge Install Gas Grill' 5.00 Description ........ .. , .................. $ TOTAL F= 6- 5.50 Class OAS fiarcharp .50g _� �g=I<�ya So ,$J N M WATER MTS. GAS ELEC. (�'J< l�h a� ( 'IV Ira Base Ist In to l Gas Gr 1 2nd 3rd 4th • Future Conneslion Oponines CO with e Now Fixture. Old Openings — ilawor ❑ Ccaspool Cl 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 $ New Ground Run Old Bldg. ..... x $3.25 $ Electric Water Heater .............. s $2.00 $ 'WAS FITTING FEES: NO. RATE" TOTAL 1st 3 Fixtures ............ • • • x $2.00 $ Additional Mures .................. 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 herel 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, lyii^n 8-16-74 Owner John L. Holm Kind of Building Frame Res. Used as ' To be completed about 8-23-74 10.00 Estimated Cost, $ ---- Old-99W. Building Permit No. Perm�o. �U Ori. • Signed By MINNEGASC© _ Business Phune No ROUGH FINAL 17' REPAIRS & ALTERATIONS—Rates to Code .50 State Surcharge Install Gas Grill' 5.00 Description ........ .. , .................. $ TOTAL F= 6- 5.50 Class OAS fiarcharp .50g SUBJECT PE O. City ®f Fridley 1616 4 AT THE TOP OF THE TWINS BUILDING PERMIT r ECEIPT NO. e COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/8/81 JOB ADDRESS 6220 Rainbow Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Sylvan Hills SHEET 2 PROPERTY OWNER MAILADDRESS i ZIP PHONE John Rolm 6220 Rainbow Drive k.E. 571-8584 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 ❑ NEW1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 32' x 16' House Addition 9 CHANGE QF USE FROM TO STIPULATIONS WAM Ie t1$og � low utordes e _ Etc. SEPERATE ARMTS RE FC?R �IRIt�C� LIP � � HEATING. PLl!>1�116HVG AND�SI�i�f By SIGNS. EC lUIRED 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIODIOF 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATjON �20s500. SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $10.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT F E SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 123.00 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.) PLAN CHECK FEE TOTA FEE $30.75 164.00 GNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DDAATTE)�� WHEN PROPERLY VALIDATED THIS IS Y_ODUR" PERMIT tE SIGNATURE OF OWNER -0F OW B ILDER) CITY OF FRIDLEY APPLICAnY4 FOR RESIDENTIAL BUILDING PER4ITS (New, Alterations, Additions, or Repairs) • OWNER: ��2 �r l G BUILDER: ADDRESS: ��f' � Z 0 e ,r ���'�-�r��,�� �.� � ems' ADDRESS: TEL NO: ` l ` i f q- TEL NO: Construction Location STRL•'ET NO: STREET: LOT: BLOCK: 4� ADDITION: 1) 0, 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 6- 4%w Front: a Depth: I1 Height: 00 Square. Feet: -5e'L Cubic Feet: Front: Depth: Height: Square -,Feet: Cubic Feet: Zig s�0•� Type of Construction. e} "� � � � `-�- Estimated Cost: To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . 7.Rie undersigned hereby makes application for a permit for the work* herein specified, agreeing to do•all work in strict accordance with the City of rridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated bi this application -:are true and;to rect. DATE,_ f SIGNATURE: " Stipulations: p a 123 . V 30. f7 lb 0-A* 00 q.06 -ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFOPJ4ATION. This information is required so the BUILDING OFFICIAL can.determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used.; and to assure construction is per approved plans. JOB LOCATION: �✓��^ �_ OWNER/CONTRACTOR: a ADDRESS: PHONE: s_2 F-4 A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area 2. Total door area 3. Total sliding glass door area, e I 4.. Total fireplace wall area 1' 5. Total wall framing area (average .10 0) 6. Total net wall area above floor(average 90%) 7. Total rim joist area Subtotal: Total exposed wall area above floor 8. Total foundation window area, 9. Total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 g = Item I C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area GRAND TOTAL EXPOSED ROOF/CEILING AREA 2— D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II fir• d q0. y i E. Determine the "U" value of each segment (1-9) and multiply by the area as follows: 1. X fluff _ 2.r x fluff _ 3. x nU" _ 4. X fluff _ 5. X nu" - 7e X llull 8. X "U" 9. X "U1° - ADD 1-9 FOR TOTAL WALL. SEGMENTS - ITEM III r "` F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. X "U" - 11. X "U" _ 12. X "U" _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent . of State Builds nq Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I + Item II = J. Add Item III + Item IV = K. If the sum of items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, -as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: DATE: rAdEff GiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287 November 9, 1992 John and Joanne Holm 6220 Rainbow Drive N.E. Fridley, MN 55432 RE: Property at 6220 Rainbow Drive N.E. Dear Mr. and Mrs. Holm: This letter is to confirm the information which I provided to Mr. Holm in our telephone conversation on November 6, 1992. At that time, I granted an additional extension of time for you to complete the title transfer and obtain current Minnesota registration for the vehicle located along the west side of your driveway. It is my understanding that you will be paving a concrete slab during 1993, upon which the vehicle will be parked. I will be reinspecting this property on or shortly after November 30, 1992, at which time full compliance is expected. Should this deficiency still exist, legal action will be approved. Feel free to contact me at 572-3595 if you have questions or wish to discuss this further. Thanks for your cooperation. Sincerely, Steven Barg Code Enforcement Officer SB:ls CE -92-535 al SUBJECT PQ• ` City of Fridley'2273 273 AT THE TOP OF THE TWINS ?'4EGE-I-PT-W- BUILDING PERMIT COMMUNITYDEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ^ �� d , CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/20194 JOB ADDRESS 6220 Rainbow Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Holm 6220 Rainbow Dr NE 571-8584 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Lj ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 5' Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. 5/8" Type A sock O be provided on inside of garage to terminate at roof sheathing. Soldi closer to be provided between living area and garage. Before digging call for all utility locations 454-0002 REQUIRED 13Y 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 80 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 I 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 $.84 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,686 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- ' $39.00 Fire SC $1.69, STRUCTION R THE PERFORMA CE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $41.53 ��� ®® l�dv —�/-4y . SIG ATUREOF NTR R AUTHORIZED AGENT IDATEI EN RLYAIDATED THIS IS YOUR PERMIT E"W > BLDG IN f1A7E j6ANATO E OF O ER F I OWNER BUILDERI IDATEI al NEW. [ l ADDN [ 1 ALTER Construction Address: Legal Description: Owner Name & Address' Contractor: , Address: - 1..a -9- e LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 1/] /94 a 7 3 MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Length -2o Length Width Width g ` Width Height Height ;�5- Hgt/Ground Tel. # =-) W -'�-S—k7 Sq. Ft. Sq. Ft. �c Sq. Ft. Corner Lot [ ] Inside Lot Pq Ft. Yd Setbacks Side Yard Setbacks Type of Construction:.,�� Estimated Cost: $ Approx. Completion Date61 : ems/ (Cost on Back) Driveway Curb Cut Width Needed: F + 6 Ft = Ft x $ _ $ DATE: / �' �/ APPLICANT: Tel. # TOTAL $-/-//, 3 STIPULATIONS:'I- I C -'li 6 % - -e, �°l '/ y � CITY USE ONLY Permit Pee $ 39, ���' Fee Schedule on Reverse Side Fire Surcharge $ A �-q .001 of Permit Valuation (1/10th%) State Surcharge $ , z y $.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 Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary ( l TOTAL $-/-//, 3 STIPULATIONS:'I- I C -'li 6 % - -e, �°l '/ y � CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 FAX (763) 571-1287 RATE SCHEDULE DIViSION APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 e'Q t r: r�� *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 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. Effective January 1, 2003 JOB ADDRESS ® OWNER TOTAL BUILDING USED AS ESTIMATED COST PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name 1J�-4-^ &Jcr� Size No. BTU ��4-� HP EDR FuelTotal Connected Load Burner Trade Name Size No. $ BTU HP EDR $ 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. DATE HEATING CO t "Wa Signe a MN55rylaw is TEL # 65WS33-M FAX # Approved By 4Rough-In Date' Final Date /I Send 2 z,> c �7 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCA71ON WILL BE RETURNED When ra Ina _ing an eYi_e+inn Mranna, 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 (i 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 PyLaHnn cnmhtjstinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( No( ) When required to Install a new _nm6 ,conn ai .d will be sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When installing a new ventina SVSWm, 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 #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: Effective On January 1, 1997 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Bath Wash Drttlk Floor Oaxcta Auto tr3as Gas M[sG Water Heater Urinal Tiatz Shower Sank Tray Pliant Drain Baser Washer Appl Range Fixt...,., Gas Elec NO. RATE TOTAL JOB ADDRESS joA;z o New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank Water Treating Appliance $ 7.00 $10.00 Owner Water Heater —Electric $ 7.00 _ ` Water Heater — Gas** $10.00 At 00 _ Building Used As iz✓4--- Gas Range** Gas $10.00 Gas Dryer** $10.00 / Estimated Cost _� PERMIT NO. 331 Back Flow Preventer Required ( )Yes O No Type $15.00 PLUMBING COMPANY eC9�itOp�✓ m Reinspection Fee $42.00/Hr SIGNED BY STEL N0. ��� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance %0° V-0Approved By Rough—In Date State Surcharge $ 50 Final Date8 MINIMUM FEE F4 ANY PLUMBING GAS PERMIT IS $20.00 TOTAL FEE $+• PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. PURCHASE ORDER I DATE7pr) TMENT�-� T71 %�,'Al e-IrC n' -' )�F 39092 PURL SEDBY THIS NUMBER MUST APPEAR j / l ON ALL CORRESPONDENCE C SENT TO US THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY ® SUPPLIER %1 L_ r��{'�` ADDRESS CITY OF FRIDLEYPHONE NO. 6431 UNIV. AVE. N.E. FRIDLEY, MN 55432-4384 CONTACT 612-571-3450 PRINTED ON RECYCLED PAPER. PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN E P CUREMENT OF THE BELOW STATED ITEMS. ` AT R ED PAY NT THORIZED BY ACCOUNT QTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE LINT 1 �..�(rj 7- 100 • ' �V' ( V _ n TOTAL THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR — YELLOW, PURCHASING — PINK, ACCOUNTING — GOLDEN ROD, DEPT. HD. CITY OF FRIDLEY p 6431 UNIVERSITY AVENUE N.E. FRIDLEY, MN 55432 (612) 571-3450 COMMUNITY DEVELOPMENT DEPARTMENT VARIANCE APPLICATION FORM PROPERTY INFORMATION - site plan required for submittal; see attached Address: Property Identification Number (PIN) ®®S364 y`,� Legal description: P l a_+ 5 -9 68 / / J°C) Lot Block Tract/Addition- Current zoning: Square footage/acreage Reason for variance and hardship: A,.-- ` Section of City Code: Have you operated a business in a city which required a business license? Yes No X If yes, which city? If yes, what type of business? Was that license ever denied or revoked? Yes No FEE OWNER INFORMATION, (as it appears on the property title) (Contract Purchasers: Fee Owners must sign this form prior to processing) NAME ADDRESS DAYTIME PHONE SIGNATURE DATE PETITIONER INFORMATION NAME ADDRESS DAYTIME PHONE SIGNATUR — DATE Fee: $100.00 $ 60.00 X for residential properties Pei mit VAR #� ceipt # (03a Application received by: Scheduled Appeals Commissi da e: Scheduled City Council date: CITY OF FRIDLEY PLAN REVIEW CHECKLIST Applicants for vacations must submit the legal description of the parcel (easement, street, etc.) to be vacated. Complete site plans, signed by a registered architect, civil engineer, landscape architect, or other design professional, to include the following: A. Generali 1. Name and address of project 2. Legal description (certificate of survey may be required) 3. Name, address, and telephone number of applicant, engineer, and owner of record 4. Date proposed, north arrow, scale, number of sheets, name of drawer 5. Description of intended use of site, buildings, and structures including. type of occupancy and estimated occupancy load 6. Existing zoning and land use 7. Tabulation box indicating: (i) size of parcel in sq. ft. (ii) Gross floor area of buildings (iii).Percent of site covered by building (iv) Percent of site covered by impervious surface (v) Percent of site covered by green area (vi) Projected number of employees (vii) Number of seats if intended use is a restaurant or place of assembly (viii) Number of parking spaces required. (ix) Number of parking spaces -provided including handicapped (x) Height of all buildings and structures and number of stories B. ' site Plan:'- l.. lan:' 1•. Property line dimensions, location of all existing and proposed structures with distance from boundaries, di3tonce between structures, building dimensions and floor elevations 2. Grading and drainage plan showing existing natural features (topography, wetlands, vegetation, etc.) as well as proposed grade elevations and sedimentation and storm water retention ponds. Calculations for storm water detention/retention areas. 3: All existing and proposed points of egress/ingress showing widths of property lines, turning radii abutting rights-of-way with indicated center line, paving width, existing and proposed median cuts, and intersections of streets and driveways 4. Vehicular circulation system shoving location and dimensions for all driveways, parking spaces, parking lot aisles, service roads, loading' areas, fire lanes, emergency. access (if necessary), public and private streets,. alleys, sidewalks, bike paths, direction of traffic flow, and traffic -control devices 5. Landscaping Plan 6. Location, access, and screening detail of trash enclosures 7. Location and screening detail of rooftop equipment S. Building elevations from all directions 9. Utility plan identifying size and direction of existing water-hfid sewer lines, fire hydrants, distance of hydrant to proposed building 0 Proposal for variance 1. General 1. Name and address of project. John L. and Joanne Holm 6220 Rainbow Drive N.E. Fridley, MN. 55432 2. Lot 5, block 4 of sylvan Hills (a survey will be made to comply with the variance if granted). I have located the metal survey stakes that mark the lot lines and roughed out the proposed area to be used in the addition to the garage. See attached drawing 3. John L. Holm, 6220 Rainbow Drive N.E., Fridley, MN. 55432 4. July 8th, 1994, see attached drawing 5. The use of the garage will be to store our vehicles inside. On several occasions we have had car windows broken and items stolen from our vehicles while they are parked outside. 6. Zoning is now residential 7. See drawing B. Site plan 1. See drawing 2. See drawing 3. See drawing 4. See drawing 5. See drawing 6. The enlargement of the garage will allow for the storage of garbage cans in the garage. 7. None 8. See drawing 9. Fire hydrant is located to the West about 200 feet • Reasons for requesting the variance 1. We would like to have a two stall garage for our vehicles. 2. Several acts of vandalism have occurred to our vehicles while they were parked outside over the years we have lived in Fridley. This includes two broken windows and a stolen battery. 3. We can not extend the garage to the rear because of the family room behind the garage. 4. The variance would be for a limited area due to the pie shape of the lot (please see drawing). 5. The variance would not interfere with the sight lines of neighbors 6. A two car garage would enhance the value of the property. 7. The variance would not adversely effect any one in the neighborhood.