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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT No C487 Date: Owner:.�... +��� `� .._... BuilderAddress Address __ _ _ _ .._ Address._..___ _... _ ..._ . LOCATI Of BUILDING r� W No� Street ...__... P Lot -•-. Lot _ Block S_ _Addition or Sub -Division -•�= Corner Lot --- Inside Lot_ _ . + "" "" Setback _ _ Sideyard---- Sewer Elevation _ _ __ __ _ Foundation Elevation DESCRIPTION OF BUILDING 71 n Front _ Depth Heigh Sq. Ft. Cu. Ft.` '.r Front Depth Hei Sq. Ft. Cu. Ft." jo i s Type Constructicm" ",` Est. Cost „ 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. 77,11 Allee In consideration of the, payment of a fee of $ permit is hereby granted to to constructthe 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. Building Inspector m?1 NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building, Inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA q Owner Is Name, Builder Address ,LOCATION OF BUILDING No. f ` �`. Street d v= '" Part of Lot . tot 7 Block � Addition or Subdivision F Corner Lot _Inside Lot Setback / Side -Yard SEWER ELEVATION I FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To bused as: Sq. Ft.�� „�- Cu. Ft. &--JQ 7 ° Front44a Depth ,,, Height Sq. Ft. Cu. Ft.� f � s 00 Type of Construction _=��=�P Estimated Cost�5—e--l� To be Completed 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. DATE ��%�� SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) f �dmi L Uq i d ,3 � - ( iTl - ^v ora �I �dmi L Uq i 55- r 1E ~Y�ff ? qjf ,3 . Mrs iTl - ^v (Tl �I 4 U t o x t� r s t d o :� �dmi L Uq i 55- r 1E ~Y�ff ? qjf M . Mrs �dmi L Uq i 55- r 1E ~Y�ff ? qjf t Yfi Pin t o r o :� FOOTINGS sem'-• ONt`Y; st 15, f fl .�.� 1 s is t _ 9 �dmi L 55- r 1E ~Y�ff ? qjf t Yfi City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7 c DESCRIPTION OF WORK .J Number. Kind and Location of Fixtures Location y i C Y oe N u°f w 0 Z Z O • F b N WATER HTR. GAS ELEC. 07 F Base jo 1st 2nd 3rd 4th • Future Connection Openings Connected with I Sewer � New Fixture. Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .............. x $1.50 $ Future Fixture Opening .............. I. -Z x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ......--Z x 2.00 $ New Ground Run Old Bldg. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ........................... x $1.50 $ �� d Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $� City of Fridley: I Ci The undersigned hereby makes application for a permit for the work herein 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. Owner Kind of Used as To be completed about — Estimated Cost, $ Old ew uilding Permit ROUGH 7 — / FINAL .4630a42 2M, D-56 42 NEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall I Ceiling Roof Floor Kind How Applied —No I s—No 19.-->� F1.1 Room I Length,?-// Width /,3 / Height �' Fl.� Room Length �� idth / Height / Windows aM Doors-Crackage and Area Windows and Doors--Crackage and Area idth Height No. of Lineal L . Area No. ofWpane of pane lights of crack /10N Fl.�!4/,A,®%-.Room I Length –2 P Width /1, Height sP / Windows and Doors—Crackage and Area Coef. Btu Infiltration 9�,,� Glass /d s Infiltration .rte i Exp. wall , Coef. Net exp. wall ,fig Pe� Int. wall -7, .0 Glass Ceiling �,� /v Floor Floor Exp. wall Total Btu. Exp. wall ® �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.�!4/,A,®%-.Room I Length –2 P Width /1, Height sP / Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane IlBhte of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. ft. Coef. Btu Infiltration .rte i y8 r Coef. Coef. Btu Infiltration Net exp. wall / y ,�,p -7, .0 Glass 4� Glass Floor !® --- Exp. wall ,p y Exp. wall Net exp, wall ,3j /0 Net exp. wall Int. wall 22=/— Int. wall Floor Ceiling 2J( Floor 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ..Zo / m 1�z.,�D � R,..,... I t .....►t. /-5, W.1L a r ra_:_L. im., Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane IlBhte of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane llghte of crack sq. Lt. Coef. Btu Infiltration .rte i y8 r Coef. Btu Infiltration /®, L Net exp. wall / y ,�,p -7, .0 Glass Ceiling le �. Floor !® --- Exp. wall Net exp, wall ,3j /0 3� ,2 Int. wall Ceiling Floor Tbtal Btu. Required sq. ft, E.D.R. or sq. ins. W.A. Leader area /Z ' Width Height No. of Lineal ft. Area No. of pane of pane IlBhte of crack eq. ft. Coef. Btu Infiltration .rte i y8 r Glass Exp. wall Net exp. wall / y `�✓ Int. wall Ceiling le �. Floor Total Btu. 7%1/ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.I Room I Length 3 ' Width /d Height 00V Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of Wane ltehte of crack eq. ft. Infiltration Glass golld, Exp. wall Net exp. wall L /0 ?�- Int. wall Ceiling Floor Total Btu. 1i Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 19.1 Room (Le16kngth.,� / Width / Height J' Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pane tights of crack Coef. Btu Infiltration 3 Glassy y Exp. wall y Net exp. wall Int. wall Ceiling ® 0 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area OVA sueJEcr PERMIT NO. City of Fridley AT THE TOP OF THE TWINS PERMIT r BUILDING RECEIPT N0. S COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 7/18/78 JOB ADDRESS 5546 Regis Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 4 Parkview Oaks lst Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane M. Jahn 5546 Regis Drive N.E. 571-6019 3 CONTRACTOR MAILADDRESS 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 El11NEW ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE a 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third roof. Install ridged galvanized valleys. TYPE OF'CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt 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 I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000 $.50 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- $ 7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SIGNATUREOVONT�CTOROAUTHORIZEDA NT ( ZTE) WHEN PR PERLY VALI TED THIS IS YOUR PERMIT J - BLDG. INSP DATE SPNATURE OF OWNER IIF OWNER BUILD (PATE) OVA • CITY OF FRIDLEY OWNER: Address APPLICATION FOR RESIDENTIAL BUILDING PERMITS NEP, ALTERATIONS, ADDITIONS, OR REPAIRS) No.: Street: BUILDER: Address: Tel. No. � � ` � C) LOT: 14 BLOCK.: ADDITION: CORNER LOT: INSIDE LOT: P"'� SETBACK.: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING Be Used As: 7:" Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Fe- Cubic Feet: d -B Type of Construction: �— ®- Estimated Cost: $ /W0. To Be Completed: ';�2 =/ 44� Alt. A Alt. B Prciposed Driveway Widd If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The 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 and representations stated in this application are true and correct. See reverse side for additional information. DATE: /X % SIGNATURE: � Stipulations: CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE VWQTnVx.TTTT Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE TOTAL $ 20.00 $ 20.00 $ '10.00 $ $ 10.00 $ $ 10.00 $ * Air Conditioning Call sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) $___1_0.0 $ .50 $ 30.50 Job Address 5546 Regis-, Drive Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. September 12, 1988 OWNER Ed Callier KIND OF BUILDING Frame USED AS RPGirlt�ntial TO BE COMPLETED ABOUT ESTIMATED COST $2800.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. 9994 MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 company Dependable Heating and A/C PLUS $.50 STATE SURCHARGE (� Signed ByC�Y Attach stack verification form with. replacement furnace permits Tel. No. 7575040 *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. DESCRIPTION OF FURNACE/BURNER Rough Insp. Date **Alro installing one HEATING or POWER PLANTS, Steam, Hot Water, Worm, Air- No. one Carrier 38EN024/24 2 ton _ , Final Insp, air conditioner Trade Name Carrier N size No. S8SS060R('. Date Capacity Sq. Ft. EDR BTU 60.000 HP Approval for Permit Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 company Dependable Heating and A/C PLUS $.50 STATE SURCHARGE (� Signed ByC�Y Attach stack verification form with. replacement furnace permits Tel. No. 7575040 *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. SUBJECT P City of Fri ley +t 2 AT THE TOP OF THE )WINS BUILDING PERMIT NO. r i _ COMMUNITY EVELOPMENT DIV. PROTECTIVE I SPECTION SEC. r e � 1 CITY HALL RIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-5171-3450 910-F15 9/10/92 JOB ADDRESS 5546 Regis rive NE 1 LEGAL LOT NO. BLOC TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 Parkview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda/Ed Collier 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D. M. Sather Cc 7 20 Rowell Rd Hopkins MN 55343 938-7989 3778 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 q� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE I 6 DESCRIBE WORK Construct a 191 x 1411Addition, an 181 x 14t Deck; add window j 9 CHANGE OF USE FROM TO STIPULATIONS See notat�ons on plan, Smoke detectors must be added if not already installed. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $27 000 $13, 5O WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $265.00 Fire SC $27.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE p - ? License SC $5.00 $310.50 HE P R Y A®D TED THIS IS YOUR PERMIT SIGNATURE ONTRACTOR RAUT O IZED AGENT IDATEI - 2-Z BLDG 'NSP nATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 3/1/92 ADDN (] CITY OF FRIDLEY ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address Legal Description: Owner Name & Address: A `,A -,g - P—J CoA A d ,ts- r— Tel. # S� 1- 3 S-6 � Contractor: Co.MN LICENSE # Address: Eove,1 1 Tel. # !r3 — i'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 lWidth Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground -3S"Sq. Ft. OTHER:. Comer Lot ( ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Ad A a' -i `o v-- Estimated Cost: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = (Cost on Back) Ft x $ _ $. DATE: ��APPLICANT: , �L� �. „� !� e� ,*-d-�, Tel. # `P� $a� 2Q�✓ Permit Fee $ 26S.'00 Fee Schedule on Reverse Side Fire Surcharge $ 2'71 .001 of Permit Valuation (1/10th%) State Surcharge $ /3,5-0 $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ — Alt. "A" or Alt. "B" Above Park Fee $ " " Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary TOTAL CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE New Fixtures _�3__ Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 TOTAL JOB ADDRESS ✓-S_74( (-/ 5 T� /. 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. Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge TOTAL FEE .50 199f- OwnerAw Building Used As Estimated Cost` -PERMIT NO.— $7.00 O. PLUMBING COMPANY /#/.AEA7%S oAZ �c� �/�///✓�- r oe SIGNED B TEL N0. ��7� C0 '-0-:3 �z Approved By & V' Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE ::::. Unn ow r .. Wash Tray Floor ..... Drain uto as Water Heater Washer r Range Gas EI e ecStories ":.:::...:....... ' Base e m n Floor 1 Floor 2 Floor 3 Floor PLUMBING FIXTURE RATES: NO. RATE New Fixtures _�3__ Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 TOTAL JOB ADDRESS ✓-S_74( (-/ 5 T� /. 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. Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge TOTAL FEE .50 199f- OwnerAw Building Used As Estimated Cost` -PERMIT NO.— $7.00 O. PLUMBING COMPANY /#/.AEA7%S oAZ �c� �/�///✓�- r oe SIGNED B TEL N0. ��7� C0 '-0-:3 �z Approved By & V' Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE SUBJECT PERMIT NO. City of Fridley 2 2 6 2 AT THE TOP OF THE TWINS BUILDING P E R M I T r COMMUNITY DEVELOPMENT DIV. _ PROTECTIVE INSPECTION SEC. ✓a� I_ � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 12/8/93 JOB ADDRESS 5546 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 Parkview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Callier 5546 Regis Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Fireside Corner 2700 Fairview Ave, Roseville MDT 55113 633-2561 1068 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 gas fireplace 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,000 $1.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $45..00 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $53.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROP RLY V ATED THIS IS YOUR PERMIT BLDPrI 'P DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ Effective 5/26/93 ADDN j ] CITY OF FRIDLEY ALTER j ] SINGLE FAMILY AND'DUPLEXES R-1 AND R-2 4 'g31s5 Building Permit Application Construction Address: Legal Description: Owner Name & Address: VYLA Tel. # .571- A9049 A Contractor: MN LICENSE Address: 770o Tel. # LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: Id - Attach to this application, a Certificate of Survey of the lot, with the proposed cow drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Corner Lot [ j Inside Lot �,], Ft. Yd Setback Type of Construction: -,�e2 - &--�W-YDi P Approx. Completion Date: Side Yard Setbacks. Estimated Cost: $61?(�ro (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: g,2 -,?' jl'3 APPLICANT: JTel. # 63 2-25e5'/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ -O 0 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary j ] TOTAL $ J3° 06 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV, Effective On January 1;1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 5� RATE SCHEDWLE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated In this application are true and correct, ,1993 Gas Piping (Needed with new furnace) $10,00 $ ' �. C� D • OWNER Gas Range $10,00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED.COST > oda ®. PERMIT NO. *Air Conditioning — AD Sizes $10,00 $ • DESCRIPTION OF FURNACE &N12 08 BURNER All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrlal BTU HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge X50 Burner Trade Name Size No. TOTAL FEE, BTU HP EDR HEATING COMPANY�„���� MINlIMUM FEE FOR ANY HEATING/COOLINGNENTIL.ATION �s6� REFRIGERATION/AIR CONDITIONING PERMIT IS X15.00 Signed By� TelNo. PLUS HE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By Rough—In Date Final Date°/ *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION`:,._ The undersigned hereby verifies that the existing chimney or stack: .1. Has been carefully examined Yes (j No 2. Is free from rust or deterioration Yes ( ) No ( j 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes (-) No ( j S. Meets all current Code requirements for size -and total BTU's connected Yes ( ) No ( j 6. Has total heating BTU's of All other BTU's , TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY ZIA- Signed By Date 12 g SUBJECT City of Fridley 5 4 4' AT THE TOP OF THE TWINS BUILDING P E R M I T r RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910-F15 6/5/95 JOB ADDRESS 5546 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 1 Parkview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Callier 5546 Regis Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Greg Wills Exteriors 4246 Royce St NE, Columbia Heights MN 55421 788-0529 EXW 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 O NEW 0 ADDITION ❑ ALTERATION REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Soffit/Fasic & gutters 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,755 $.88 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 WERFOAMANCE OF CONSTRUCTION. $41.00 Fire SC $1.76 e PLAN CHECK FEE TOTAL FEE License SC "City" $43.64 ate' SIGN RE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT BL INSP L. �yj/ L TE SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R=I .AND R-2:. Building Permit Application :. Constructioi A4dress. Legal Description:. ::Owner Name &: Address"'oe del. #. . . .. Contractor: ( �� A/c `� (' �!'©C . MN LICENSE #S�c.�ifi�cr'v c��rT . / --r---- Address: %-�_ �= ' �. ,—�C�� Tel. # 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: Comer Lot [ ] Inside Lot f ] Ft. Yd Setback Side Yard Setbacks Type of Construction: :;�rAV 121;ocjl Js 1 � /.. mated Cost: $ T Approx. Completion Date: - Driveway Curb Cut Width Needed: DATE: APPLICA (Cost on Back) Ft. +_ 6 Ft = ]Vt x $ =$ Tel. # ' ! CITY USE ONLY Permit Fee $ `1 1 - Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 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 $ ` 0 STIPULATIONS: r� SUBJECTP..-E:aw- of Fridley " 24787 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir?City I ' ______ COMMUNITY DEVELOPMENT DIV. ~ r 1 i PROTECTIVE INSPECTION SEC � I "1 CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910-F15 12/3/96 JOB ADDRESS 5546 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 1 Parkview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda/Ed Callier 5546 Regis Drive NE 571-3506 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Cascade Builders Inc 8024 Aldrich Ave N Brooklyn Park MN 55444 561-9507 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20003261 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 Basement bath remodel 9 CHANGE OF USE FROM TO STIPULATIONS see notations on plan. WIRING, HEATING, PLUMBING SAND SIGM 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 WITH WHETHER SPECIFIO HEREIN OR NOT. THE GRANTING OF A PERMIT $3,500 $1.75 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. $87.25 Fire SC $3.50 PLAN CHECK FEETOTAL FEE o�®�®gj Li -c -end SC 5.00 $97.50 i SIG TUBE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI RLY VA(DATED THIS ISYOUR PERM17 1'ZIN;Pg JSIGNATURE IN P GATE OF OWNER I IF OWNER BUILDERI IDATEI r� NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: -754,6 -W�61:5 -Da-- Fg4 oL-moi mtjv -5432. Legal Description: Owner Name & Address:�Q4b CQ,, �,�,, Tel. # Contractor: ��5 �"� —,3. b . ' N < , MN LICENSE # ?zi i Address:�� Tel. # SE `ri-7 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: 134srwo V1^ OLL Apffi'x 5X3 Comer Lot [ ]` Inside Lot Ft . -',Yd Yd Setback Side Yard Setbacks _ Type of Construction: Estimated Cost: $ - Approx. Completion Date: ` (Cost on" Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 119 46 APPLICANT: ,_� Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ g,00 $ 97,Sv Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, t993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT UAAW N1 JU RPR (19 FIXTURES TO RE I NSTALLE13 ON EACH FLOOR PLUMBING FIXTURE RATES.' NO. RATE TOTAL New Fixtures $ 7.00 Wash Floor R -0 1 Auto. ater Heater Gas ;Water Blow Off Basin S7.00 Catch Basin $7.00 Rain Water Leader $7.00 _}`ii: -Gas Elece Stories Urine, Shower $7.00 Tray U" Drain NO Wa Sher Ran ge Gas Dryer $10.00 Back Flow Preventer Required )Yes No Type -$5.00 WO M-, p; Floor 1 mMvn­l . . .... .... .. Floor 2 ma Floor 3 IMMMM-' W, Floor 4 PLUMBING FIXTURE RATES.' NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $4.00 Beer D!spenser $5.00 Blow Off Basin S7.00 Catch Basin $7.00 Rain Water Leader $7.00 Sump/Receiving Tank $7.00 water Treating Appliance $10.00 Watter Heater -Electric $7.00 Water Heater - Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required )Yes No Type -$5.00 Reinspection Fee $30-00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 196 of Value of Fixture or Appliance State Surcharge $ .5 TOTAL FEE JOB ADDRESS q515A110 R%"—% b-AMO—E The undersigned hereby makes application for a permit for the work herein specified agreeing to do afl work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and represerW%ions stated in this application are true and correct. Building Used As Estimated Cost PERMIT NO. G' r) — PLUMBING COMPANY _'OVA ' L M%Itt� mv m -P SIGNED BY '.4 20 TEL No. I M n-1 Approved By Rough -in Date j2d4—Final Date PLUS THE $.50 STATE SURCHARGE 1 SUBJECT I IT NO. City of Fridley (� 25 941 AT THE TOP OF THE TWINS BUILDING P RMIT P • RECEIPT NO. COMMUNITY DEVELOPMENT DIV. -------- PROTECTIVE INSPECTION SEC. 0f 5-3 r o 1 . , NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 4/17/98 JOB ADDRESS 5546 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 4 Parkview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Cailler 5546 Regis Drive NE 3 CONTRACTOR - MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contr 6331 Riverview Ter NE, Fridley MN 55432 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 4051 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION IR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Partial Reroof (19 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 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 $1,190 $.60 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- $40.25 Fire SC $1.19 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE _ f7 672� License SC $5.00 $47.04 SIGNATURE OF CONT RACTORO AUTHORIZEDAGENT (DATEIWHEN PAR/O/PERE ALIDATED THIS IS YOUR P�EEJ////RJMIITTT Z�'V < BLOA INSP fJ�•�L GATE _ SIGNATURE OF OWNER OF OWNER BUILDER( (DATE, 1 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� ConstructionAddress: Legal Description: Owner Name & Address: C A I Tel. # Contractor: OAC r G +� %�,� 57Li �� s MN LICENSE Address: Tel. # 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: /�j,',d L aZ�� Estimated Cost: $ (Fee Schedule on Back) 3riveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:l7 y APPLICANT: _ / Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ 1, /9 .001 of Permit Valuation (1/10th%) State Surcharge $ 6 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �. STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25/0 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 On January 1, 2000 JOB ADDRESS OWNER TOTAL BUILDING USED AS $ j ESTIMATED COST PERMIT NO. s DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ aS -IOD 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. VLAINIE HTG. A/C ,. DATE 7 " ��— M62 CENTRAL HEATING CO I h v7 Signed #1��� �� Approved By Rough -In Date Final Date –1 "00 COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing 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 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 - - 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: i 135' CENTRAL f KEE HEATING CO: r1k, MNOKA, MN }5304 Signed By: Date : `7'� Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-360-4 CITY OF FRIDLEY Date Rec'd: �T!-- DATE S—j 5 YOUR E-MAIL ADDRESS SITEADD SS J!55glr Q%C(S THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: DCk/S c l&/S ii Al2` — ADDRESS:.SS49c, /S 13le• Iii E - TENANT PHONE: 'q6' CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHO FAX PROPERTY TYPE NISINCTLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED 0 ❑ BASEMENT FINISH ❑ ROOF ❑ DRAINTILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ oN ❑ MAINTENANCE/REPAIR VTEMODELJNG DESCRIBE WORK BEING DONE: F-- � CNVoo pus 0 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING 0 HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soft 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $Agreement necessary ( ) Non Necessary ( ) Total Due $ _ (rC Make checks payable to: City of Fridley Attach Stipulations 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 applica ' r 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 h equires review and. approval of plans.�A SIGNATURE OF APPLIC 6`'✓�fO� PRINT NAME DATE