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PRE 2010 DOCSCITY OF FRIDLEY Effective Date May 1. 1988 .APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE _ //�� ' Lii� �C RESIDE&TIAL RATE TOTAL Job Address -Q� Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 s-20,60 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tei. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (allsizes) $ 10.00 $ /l%- dC� Fridley, Minn. All Oter�paira"ncT tions �(� % ' o ' " �� 0� OWNER / � 1% of Value of Appliance or Work $ �1 6 P4 G KIND OF BUILDING (I/ cJ V IR r n Ebb COMMERCIAL/INDUSTRIAL USED AS 6J CA g 19 of Value of Appliance or Work S TO BE COMPLETED ABOUT TED COST State Surcharge $ .50 FEE 30.5' OLD -NEW BUILDING PERMIT N0. PERMIT NO. TOTAL $ Reinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough Insp. Date HEATING or POWER P , Steam, Hot Water, Warm Air- .c �- Z �v Trade Name -/`'y Size No. �7 Final Insp. Date Capacity Sq. Ft. EDR BTU HP Approval for Permit Total Connected Load Kindof Fuel BURNER - Trade Name 1" Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, Company PLUS $.50 STATE SURCHARGE 7y4/17 Signed By 1N1 Tel. No. *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Fill out back side for stack verification on replacement furnaces 1 CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (�) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Da to SUBJECT PERMI City ®f Fraley AT THE TOP OF THE TWINS BUILDING EMI (T6968 T RE 9! COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/3/98 JOB ADDRESS 6251 Rainbow Dr. I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John & Loi Jacob 574-0118 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Lennander Co 523 rpntral Amp 55369 425-0293 20039258 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION I$ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re lace windows; cover all doors windows soffitt & fascia in alum. 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of house. Call for builidng wrap inspection before covering. 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 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 7540 $3.77 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. $137.25 Fire SC $7.54 PLAN CHECK FEE TOT FEE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI S5 1 91-96 HEN PR P R VALIDAT HIS IS XQUR PERMIT / ,4 BLgg INSP -� MATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: Legal Description: Effective 1/1/97 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION An- , J � �' Own Contractor: Address: ��.� �..�cl-� 1 �e 0-5� X-4/1 5a Me Tel. # ' 2!T— 3 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 Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. onstructio pe: i Estimated Cost: $ (3er G�l� Lse��, t�;r�� 30'FF7�1- it�! q 1 n 'Q�� (Fee Schedule 0n Back) Driveway Curb Cut Width Ft. + 5 Ft = Ft x $ _ $ Permit Fee $ . �S Fire Surcharge $ 7.5L State Surcharge $ .77 SAC Charge $ License Surcharge $ 00 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ `N STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,00 Valuation da • &W J�✓i7� $950 per SAC Unit 'o�'` $5.00 (State Licensed Residential Contractors) f/A/ S in e Alt. "A" or Alt. "B" Above A� s • $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary tsuuuvcr t:t)!v"i'xACTOR'itJII.L�ITCr CtN ILL�#2aQ3S''LSS II�,#'..C�39zSfi IBUILDER B=M CORPORATION Expires: 03/31/1999 SCOTT ROGER LENNA DER 7 Hrs CE due by 3/31/99 DEAW.KMER COMPANM3 INC 523 CEtIi RAL AV'ENLTE NORTH OSSEO MN 55369-0000 �M-.00543 i COR1:10RATION . .. SUBJECT iApepmTrN City of Fridley 28973 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO.q411 � • _____ COMMUNITY DEVELOPMENT DIV. j PROTECTIVE INSPECTION SEC. 1 � NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 1•' 612-571-3450 910-F15 3/3/99 JOB ADDRESS 6251 Rainbow Drive NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Jacob 6251 Rainbow Drive NE 574-0118 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Builders & Remodelers 3517 Hennepin Ave, Mpls., MN 55418 827-5481 1100 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 0 ADDITION ❑ ALTERATION [ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) 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 CONSTRUCTIONc 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 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 714 $.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1, DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY ATE OR LOCAL LAW REGULATING CON - $56.75 Firo SC $1.71 CONSTRUCTION PLAN CHECK FEE TOT54YEE " Lic $5. 4.32 SIGNATURE 61: CONT OR AUTHORIZED AGENT IDATEI WHE PR P VALIOA THIS IS YOUR PE IT SIGNATURE Of OWNERof OWNER BUILDER, IDATEI VIDG INSP QATE NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: Legal Description: _ Owner Name & Address: "7 � . Contractor: n, -x "7 Effective 1/1/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION q41 -Ybin C0.6 Arco Tel. # J%!Y— O I I E MN LICENSE # //00 I /X Tel. # 92-'7-!5;-Y8 I 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: Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ Q Tel. # DATE: /M APPLICANT: CITY USE ONLY Permit Fee $ . Fee Schedule on Reverse Side Fire Surcharge $ /,2/ .001 of Permit Valuation (1/10th%) State Surcharge $ 0$.50/$1,000 Valuation .SAC Clge 1 oLicense $ $1050 per SAC Unit 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 MainCharge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: SUBjEGT City of Fridley 29446 AT THE TOP OF THE TWINS BUILDING PERMIT Ir I RECEIPT NO. R�EO. COMMUNITY DEVELOPMENT DIV. � SEC. vvIP r � PROTECTIVE INSPECTION 1 � = I CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 5/11/99 10B ADDRESS 6251 Rainbow Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Jacob 6251 Rainbow Drive NE 3- CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Improvements 523 Central Ave, Osseo, MN 55369 425-0293 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION G REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 WITH WHETH SPECIFIED HEREIN NOT. THE GRANTING OF A PERMIT $59000 $2.50 DOES NOT SLIME TO GIVE A HORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO ANY OTHER TE OR LOCAL LAW REGULATING CON. STRUC THE PERFOR $111.25 Fir SC $5.00 NCE OF CONSTRUCTION PLAN CHECK FE TOTA EE L✓v / Li e S $5 X123.75 URE OF C WRA OA OR AUTHORIZED AGENT IDATEI EN RO ��9LINSP ALIDAT IS IS YQLLA PER60iT patE S�GN4 TUAE OF OWNERJF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: nok 1 Owner Name & Address: Kn Tel. # Contractor: - MN LICENSE #�l Address: 4r' LJ 0 Tel. # Attach to this application, a Certificate of Survey of9e 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: Construction Type: / i �a Estimated Cost: $ 115600 ` (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: fI APPLICANT Tel. #_ CITY USE ONLY Permit Fee $ ll ys� Fee Schedule on Reverse Side Fire Surcharge $ 7, 6b .001 of Permit Valuation (1/10th%) State Surcharge $ .,s� $.50/$1,000 Valuation SAC Charge $ $1050 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 $Q.S STIP TIONS: CITY OF FRIDLEY PERMIT NO.: 2004-00759 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 05/21/2004 572-36U4 YAX: (763) 571-1287 ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS : LOT 2 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL 200 AMP UNDERGROUND SERVICE AND GROUND TO CODE. APPLICANT SOUTH SIDE ELECTRIC INC 9201 E BLOOMINGTON FRWY STE H BLOOMINGTON, MN 55420-3494 OWNER JACOB JOHN 6251 RAINBOW DR 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 regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MAX (RESI) 85.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 85.50 PAID WITH CHECK # 202876 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 f'AIX: (763) ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS : LOT 2 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N 2004-00798 DATE ISSUED: 06/08/2004 VALUATION : $ 39,836.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 24'X 19' ADDITION TO LIVING AREA. APPLICANT JACOB JOHN 6251 RAINBOW DR NE FRIDLEY, MN 55432 OWNER JACOB JOHN 6251 RAINBOW DR 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 viol r cancel the provisions of any other state or local law re atin onstyyction or the performance of constrMction. BUILDING PERMIT FEE 542.75 PLAN CHECK FEE 352.79 FIRE SURCHARGE 39.84 STATE SURCHARGE, VALUE 19.92 TOTAL 955.30 PAID WITH CHECK # 8245 Bldg Ins �u D SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. _,NEW [ ] CITY OF FRIDLEY R-3 f4(a Effective4/1/2o04 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICAT ON a C� Construction Address: y, b6 W ' Legal Description: L v Z ldc /L Z 1 6,-Z s/ ,vl� J Owner Name & Address: Lar and ahn �f fkOo f -it /-et, My ss�� Contractor. FIM ills T/el..3# -76 3 - :NSE #3�- 6 YO 7 Tel. # 76 574 a%l si Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. �D DESCRIPTION OF IMPROVEMENT LIVINGAREA: Length �( Width Height (6 Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Ir. 7OX Construction Type: wood -Ya_ YM" Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft DATE: S _6 / APPLICANT: Call (763) 572-3604 for Permit Fees if mailing in you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Tel. # 76 3- 5 Fax to 763-571-1287 if using credit card and we will call CITY USE ONLY - S� Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 kAX: (763) 571-1287 ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS : LOT 2 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01001 �3S DATE ISSUED: 06/25/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 1 APPLICANT DEPENDABLE ELECTRIC INC 2619 COON RAPIDS BLVD NW COON RAPIDS, MN 55433 OWNER JACOB JOHN 6251 RAINBOW DR 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 regulating construction or the performance of construction. Applicant Date Bldg Ins p Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 28557 SEPARATE PERMITS REQUIRED FOR WORK 0-fHER 1'HAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT NO.: 2004-01361 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 08/18/2004 5 72-36U4 YAX: ( 763) 571-1257 ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS : LOT 2 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITIONALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL 8 CIRCUITS IN ADDITION. # 0-100 AMP CIRCUITS 8 APPLICANT JACOB JOHN 6251 RAINBOW DR NE FRIDLEY, MN 55432 JACOB JOHN 6251 RAINBOW DR 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 work 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 ELEC CIRCUIT FEE (0-100 AMPS) ELECTRIC FORM FEE STATE SURCHARGE, ELEC FLAT TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 48.00 1.00 0.50 49.50 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 k'AX: (763) 571-Il87 ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS WATER TREATMENT APPLIANCE : LOT 2 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMI NO.: 2004-01362 DATE ISSUED: 08/18/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. MOVE KITCHEN SINK VENT. INSTALL OUTSIDE SPIGOT. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT JACOB JOHN 6251 RAINBOW DR NE FRIDLEY, MN 55432 OWNER JACOB JOHN 6251 RAINBOW DR NE FRIDLEY, MN 55432 0 # GAS WATER HEATERS 0 0 # GAS RANGES 0 0 VALUE (FOR MINIMUM CALL) 100 0 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 work 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 regulatipg,qpnstrWtion or the performance of construction. PLBG PERMIT MINIMUM FEE 15.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 15.50 Bldg Insp Da t T['Y!'IT TTTT ♦Tl1t 7T Ulil Al\A 1 Li 1 lil\l�'l11 U 1\lil,e V 11\LiL L. Vl\ VV %jx ll V 111111\ 111A1\ Lli llvl\I — — — CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 0� APPLICATION FOR PLUMBING AND GAS FITTING PERMIT p,,4 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas** $35.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type _ $15.00 61101 � ��7Y+1 I *V Reinspection Fee $50.00/Hr ®` l rn,:�y6r� NQ s� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE Y JOB ADDRESS `=2 4/ !�;_ ( 12`%�'r"/6® tA'/ 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. DATE: '? I ? , 20 OWNER BUILDING USED AS 0 ESTIMATED COST /00-0Z) PERMIT NO. I) ` rJI PLUMBING COMPANY SIGNED BY TEL NO,�b) ^J 7Y� yr 1F Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 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 ( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When 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 CITY OF FRIDLEY PERMIT NO.: 2004-01524 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6251 RAINBOW DR NE PIN : 143024330017 LEGAL DESC : SYLVAN HILLS : LOT 2 BLOCK 2 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. REPLACE FURNACE (WARM AIR, CARRIER, 80,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 7140 APPLICANT HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK 0.00 35.00 ACTION HEATING & AIR COND 8140 ARTHUR ST NE GAS RANGE FEE 0.00 SPRING LAKE PARK, MN 55432 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 GAS PIPING FEE 10.00 STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 8222 0.50 70.50 OWNER JACOB JOHN 6251 RAINBOW DR 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 work 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 afiv other state or local law regulating constructigi or the pe ormance f construction. Applicant Date Bldg Ins D SEPARATE PERMITS QUIRED 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 Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All Other 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 a4�io Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 625 N R� 40 L 40 Fee Total Owner�nNN A!icnis, $35.00 Building Used As $10.00 1/29, &b ESTIMATED COS �� PERMIT NO L $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units —I Circle One (Steam) (Hot Water) Warm Air Trade Name CArv; eV Size No. $25.00 tL4� BTU HP EDR 5161 Fuel _N mS Total Connected Load Commercial/industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR $ Burner Trade Name BTU HP Size No. 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. *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 Rough -in Date Final Date 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 No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacture's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No ( ) When 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 Tctal 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) CO:HEATING ,.<� )moi Signed By: Date Building BUILDING Permit No.:,9 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY fQ 10M.13 2b07 - DATE / ' YOUR E-MAIL ADDRESS SITE ADDRESS _ Dr t u e�, A)G THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT / �– ADDRESS: 4—')SI ?O i nlb'i �. A / CITY {_ t�� I ' STAT IP J 5 �' PHONE: d -.5-7 V– ® 1) 2 / CONTRACTOR NAME: de"c., tp e� STATE LICENSE # PC- JJ D 0 EXP DATE ,fit ADDRESS3.5, h eelri CITYA • P `S STATf+)ZIP S1!J 0 ` SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHONE / °� �1 FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH grZOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: -e 30 -P4 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 'HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS []Yes []No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: -2 /ft5i S (USING THE 1997 U.B.0 FEE SCHEDULE) fl— TOTAL JOB VALUATION Permit Fee $ i Plan Review $ Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due OCCUPANCY TYPE See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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.41 �yy SIGNATURE OF APPLICANT , ' PRINT NAME 9i f p '� CA Jew v+ DATE ��' 0 '