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PRE 2010 DOCSCity of Fridley, .Minn. BU11DING PERMIT No 12 Date: Owner: Builder Address _ _ __ Address��_ - ..—._----.---.- - � . LOTION OF BUILDING No. +_ Street.," _ _ P Lot Lot _ __ Block Addition or Sub -Division Corner Lot — Inside Lot __ _ Setback ,T Sideyard Sewer Elevation _ __ _ _ _ Foundation Elevation DESCRIPTION OF BUILDING To Used I Al,% Front Depth _ ' ' Height Sq. Ftia�`-� Cu' F .a Front Deptheight Sq. Ft. Cu. Ft. Type of Construction Est. t be Completed In consideration of the issuance to me of a permit to construct the building described aboveI agree to do propose the d work in accordance with the description above set forth and in compliance with a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of —.., 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 Pe iA 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, cepa and moving of buildings within the city limits and this permit may be revoked at any timlation of4lhny of the provisions of said Ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plunihing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these Items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name, /r® A;' os� fir/ �iiie Builder Address C�rzo�9 Address �- LOCATION OF BUILDING No. Street & 11 / Part of Lot Lot Block L3 Addition or Subdivision Corner Lot _Inside Lot Setback `3 �� Side -Yard 2 ref SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used.as: DESCRIPTION OF BUILDING ar r Sq. Ft. 12-32 Cu. Ft. -za 226-1- Front 26 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Xw Estimated Cost '� . Q -o z) To be Completed MMOM 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. F1 i I DATE 1�20 7�zek- (°/ SIGNATURE vt (A Schedule of Fee Costs can be found on the Rev a Side.) V - City of Fridley Application for Plembing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .............. ....... x $1.50 Z , x WATER HTR. $ ELEG x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ O R N GAS $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ j� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base ! 1st 2nd _ 3rd 4th • Future Connection Openings Connected with I Sewer New .Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .............. ....... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ j� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ....................... ..... ...........$ TOTAL FEE $ / J ( ev Dept. of Bldgs. Phone SII 4-7470 . f 12 e 4 1 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. Fridley, Minn�� - 19A c Owner Kind of Building t Used as f To be completed about Estimated Cost, $ Old-& Building Permit No Permit No. 6 d-/ Signed By�!��l ROUGH q- 20- to t FINAL .QjW42 2M 7-59 Business Phone • J Application for Power Monts and.Heaffng. Cooling, Ventilation. .ReFrigoaa! and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 1073" 4-74! GRAVITY WARM AIR: MATE TOTAL, 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 $ ,r each add. 80,000 BTU 2.00 $ Replacement of Furnace .0.00 $ 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. IDR 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 TO AL 1st 3 Fixtures x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS r ROUGH FINAL See Fee Schedule $ TOTAL FEE $ ' �® 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. ,�Pll? A— `�l ,r 1l Owner Kind of Building Used as 19 — To be completed about Estimated Cost, $ ding Permit No. �1�! ®1 Permit No. DESCRIPTION OF'WORX HEATING o _�, W Air—NO.- L 7� Trade Nam Size No�� Capacity Sq. Ft. E.D.R v' BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Names Size M,4;; Capacity Sq. Ft. E.D19, 014 J& p) 1001 Xenia Ass. S. d" Minneap olis 16, Kim Sign U. 1611 542 1M 7-59 Business Phone I (REMARKS -OVER) �qJ 9 C`/✓l�%�'�-r y` I Width Height T No. of Lineal ft. Area No. of paneof pane lights of crack sq. ft. r D56 79�p if /m HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Coef. Construction No. Infiltration Int. wall Insulation Glass Ceiling ' GuideHow. Reference Out. Wall Int. Wall Ceiling Roof Floor Kind Applied Windows Doors Required sq. ft. E.D.R. or sq. ins. W.A. Leader area e 19- 9.— Width s 5, 2-,� ev � -; Width Height 1,/ I/ R.,,,.., I T math Width /4' Height II Fl �` Room Length Windows and Doors—Crackage and Area y` I Width Height T No. of Lineal ft. Area No. of paneof pane lights of crack sq. ft. Glass `- t Exp. wall r1' Coef. Coef. Btu Infiltration Int. wall Glass Ceiling ' Glass's Floor 1L. ", C Exp. wall' Int. wall Int. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Net exp. wall Width s 5, 2-,� ev � Int. wall Floor Ceiling R� ,I Floor _ / -( x Total Btu. ° Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. , ;i ; Room (Length Width Windows and Doors—Crackage and Area Width Height No. oY Lineal ft. Area No. of pane of pane lights oP crack e4. ft. Coef.I Btu Infiltration y` I AAJ Glass `- t Exp. wall r1' Coef. Net exp. wall "4a Infiltration Int. wall Glass Ceiling ' r Floor 1L. Total Btu. Int. wall Int. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Jam, - ✓ = %Room I Length � Width s Height Windows and Doors—Crackage and Area Floor'~ X / Are Width Height No. oY Lineal ft. a No. of pane of pane lights of crack% eq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall sa Int. wall Ceiling ='/ Floor —. -�� ;i:��?a ` Total Btu. rt� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area y` I Width Height No. of Lineal ft. Area No. of pane of pane lights of crack, sq. ft.✓ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration Infiltration Glass Glass r Exp. wall Net exp. wall 1L. r' Int. wall Int. wall Ceiling Ceiling Floor'~ X / Floor /' h` A-21 tcoom, Lengtt> , 5 Windows and Doors—Crackage and Area _ ��'F Lr Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration %/6 ) Glass Exp. wall Net exp. wall�f/ r' rill' Int. wall Ceiling Floor /' h` A-21 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .a — 1 r 1 i _ _.L 4 W.All ( I 14.;aht Windows and Doors—Crackage and Area / Width Height No. of Lineal ft. Area�r-y No. of pane of pane lights oY crack s4. ft. Coef Btu Infiltration %/6 ) Glass Exp. wall Net exp. wall Int. wall Ceiling Floor R� ,I II Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ° i D•S6 -79 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling I Roof Floor Kind How Applied s e 19— dr Fl. Roam I Length =y Width Heisht II FI.I Room I Length Width Height Windows and Doors—Crackage 2d Area C', Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. /13 Coef.1 Btu Infiltration Coef. Btu Infiltration Exp, wall Net exp. wall 4 Glassy Ceiling Floor 1f id. ``. Exp. wall Net exp. wairea m Int. wall Ceiling Floor Total Btu. " I®r a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area % FLXA i Room I Lensrth V Width a Heistht Windows and Doors—Crackage and Area ' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp, wall Net exp. wall Int. wall Ceiling Floor 1f id. ``. Total Btu. aha j Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIA Rnam I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. , Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft.. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane I lights of crack I sq. ft. Infiltration Glass Exp. wall Net exp. wall Int, wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Height Btu City of Fridley W- DEBCMPTION WORK Num1mr, Kind and Location PARTIAL RATE SCHEDULE PLUMBING FIBT1tiRE 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 $3.35 $ Water Heater (Up to 99,000 BTU) x $3.00 $ New Ground Run Old Bldg. x $3,26 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .. ...... . .... ......... x $2.00 $ Additional Fixtures ..... —x$.76 $ Gas Range to 199,000 BTU ............... x $5.00 $. REPAIRS & ALTERATIONS—Refer to Code Description ............................. ...........$ TOTAL FEE $ 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. OFA Pidley, Mini 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. _ _Permit No. e Signed. . By-- Business Phone < _. ROUGH FINAL ��" N W WATER NTR. c�0 N GAS ELEC. Base A– — — Ist � — 2nd 3rd — – 4th _ ° Futnre COM*C fou Opeaiags Connected with * New Fixture, Old OpenhW sewer ❑ cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIBT1tiRE 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 $3.35 $ Water Heater (Up to 99,000 BTU) x $3.00 $ New Ground Run Old Bldg. x $3,26 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .. ...... . .... ......... x $2.00 $ Additional Fixtures ..... —x$.76 $ Gas Range to 199,000 BTU ............... x $5.00 $. REPAIRS & ALTERATIONS—Refer to Code Description ............................. ...........$ TOTAL FEE $ 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. OFA Pidley, Mini 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. _ _Permit No. e Signed. . By-- Business Phone < _. ROUGH FINAL ��" N? 5075 Original Permit for rLl! RING AND GAS FITTING 15--6 � y N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee $ 0 O DFSCREMON OF WORK II Number. Kind and Location of Fixtures Stories W4 F 2 m Z m ® Y W m r t Z w m O x F z¢ m y W WATER HTR. 6A8 ELEC. O 3 U 7 M F m z U d 7 M 0 O 0. O Y J LL O Gl a Q Q O U m J X £ I% M< dd `U d 0 x Q Q e W Basement lot 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings Permission is hereby granted to do the plumbing and gas fitting in the building described in the sta t hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. <z see–"9-v City of Fridley / % ,19_q_0 Owner � Location - Q�� /–�-+lob-� � ,Q . Kind of Building_/�� Used as To be Completed , 19— Estimated Cost $ ew. Building Permit No. Date Inspector of Buildings. SUBJECT 1 4 9 6 City of Fridley - - AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC.5-5 r PROTECTIVE "1,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 3/11/82 JOB ADDRESS 1204 Regis Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Parkview Oaks 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Patnode 1204 Regis Terrace.N.E. 571-1108 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. B & K Builders 1500 - 14th Avenue N.W., New Brighton, MN 636-0674 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW X ADDITION ❑ ALTERATION 11REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct an 18' x 15' Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke alamn in existing house. WARNE Before digging call loral ut Ift.1 TELEPHONE - ELFCMIC .r GAS Efasz SEPERATE PERMITS REQUIRED FOR WIRING, REQUIRED BY LAS; HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 270 2630 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 $10,600 $ 5.30 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- $86.50 NONE STRUCTIO OR THE PERFOR ANCE OF 20NSTRUCTION. PLAN CHECK FEE TOTAL FEE 3O'/L��`!� J $21.63 $113.43 SIGNATURE OF CONTRA O oR UTHORIZED AGENT (DATE) V7EN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG WSP DAIE SIGNATURE OF OWNER OF OWNER SUILDERI IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIGN FOR RESIDENTIAL BUILDI11G PER4ITS (New. Alterations, Additions, or Repairs) OWNER: ' 4 BUI LDER : c� �° _ � � �� _14 14 ADDRESS: _ ADDRESS: : 4y6` TEL N0: _ � �r TEL NO: e-,- �I Construction Location 9 - STREET NO: STREET: LOT: 3 BLOCK: 13 ADDI ION:J`Sr` 14Qd/ R 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 ALSO 4b p dJ Front: / ` Depth: S� ® Height: c�20 Square. Feet_:_ Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: Estimated Cost: 4b Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the tvrk*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 in this application_e true and c,rrect: z, DATE: SIGNATURE: Stipulations: ��• 1� G , 6'L /c c) p 8(0• mac! P.Q ai•cas :�'' 3o To: John Flora. Fram: Pam and Mark Patnode Subi: Illegal sump pump drainage 1. In regard to our telephone conversation Wednesday, I wish to ask for an extension to the July 1 date for repair of our system. Olson plumbing has given us an estimate June 29, and will be able to complete the work the week of July 10, 1995. (See attached estimate) 2. Please do not assess the $300 fee. I am asking for a waiver until the work is complete. Our home will be ready for inspection after July 15 and I will notify your office ASAP. Sincerely, 10 10 615451 Pam Patnode 1204 Regis Terrace 71619' Evil sit- 1 kM t 931 - 44th Avenue N.E. • Mpls., MN 55421 "Olsons Plumbing(612) 788-5635 (612) 788-4570 Proposalc "Your FULL SERVICE Plumber" Date ! Proposal No. Name Streel City State Phone Number / I- U.) Wor To Be Performed At Street City State Date of Plans Architect We hereby propose to furnish all the materials and perform all the labor necessary for the completion of All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specificaq'onnss submit r abov�f w k and com led a substantial workmanlike manner for the sum of pc - T =,-- �(/ �<r� Dollars ($ '215° ) with payments to An alteration otkeviation from above specifications involving extra c become an extra charge over and above the estimate. All agreements control. Owner to carry fire, tornado and other necessary insurance u Respectfully submitted will be executed only upon written orders, and will gent upon strikes, a�efglents or delays beyond our Note -This proposal may be withdrawn by us if not accepted within 4days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date Signature SEF -05-1996 14.31 CITY OF FRIDLEY � r c Q m oil LP a W c n2 ?X m z = m o m a to S� a w CL m —� U - ,5 VA Q o m l' C EL m =r• 10a maw mm CDCD 03/12/15 04:34 m u, 1� 612 571 1287 P.01.,101 TX/RX N0.1217 M, rt TOTAL P.01 P.001 D G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 October 2, 2000 Mark Patnode 1204 Regis Terrace NE Fridley, MN 55432 Re: Final Inspection at 1204 Regis Terrace NE Contractor: Gavic and Sons Plumbing and Water Specialties Dear Mr. Patnode: A plumbing permit was issued on June 3, 1999, for the above noted address, to install an electric water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. rely, DAVE �NSEN Build' Inspector ' Sum& -.. City of Fridley 30421 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. ` `COMMUNITY DEVELOPMENT O v ------ INSPECTION SEC.. &..�/,Jt?3 f � � PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L J` 612-571-3450 910-F15 10/19/99 108 ADDRESS 1204 Re is Terrace NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DEscR. 3 3 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pam Patnode 571-1108 3 CONTRACTOR MAIL ADDRESS 571-1108 ZIP PHONE LICENSE NO Midwest Roofing &_Siding 18979 Gladstone 1 -MUle Grove 55311 - 20010277 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 Q ADDITION O ALTERATION M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (29 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit inspection Cards Will Be Mailed To Homeowner To.Dost 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 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 $2535 $1.27 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 $83,25 Fire SC $2.54 PLAN CHECK FEE TOTAL FEE Lice a 5.00 92 6 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATti HEN ROPE IDATED IS v®PERMS BL -NSP gAiE SIGNATURE OF OWNER IIF OWNER BUILOERI IOATEI W NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMULY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor: _ ► CA , Address: l 1R_?C1 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # 571®1 LDeZ MN LICENSE # `LA Tel. # 571— )ADS Attach to this application, -a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IIN1PROVEMENT Width Width Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Cost: $ "Z'� > Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: I D/I APPLICANT: t Tel. # CITY USE ONLY Permit Fee $ S Fee Schedule on Reverse Side Fire Surcharge $ aLl .001 of Permit Valuation (1/10th%) State Surcharge $ , ;1.7 $.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 $ Z STIPULATIONS: �� / AP' 47-- 47'7 CITY OF FRMLEY PERMIT N.: 2004-00940 � 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/21/2004 572-3604 VAX: (763) 571-12K7 ADDRESS : 1204 REGIS TER NE PIN : 243024310082 LEGAL DESC : PARKVIEW OAKS 1ST ADD : LOT 3 BLOCK 3 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 500.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. REPLACE TWO FIXTURES. # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES APPLICANT JEFFREY GUNDERSON 1204 REGIS TER NE FRIDLEY, MN 55432 OWNER JEFFREY GUNDERSON 1204 REGIS TER NE FRIDLEY, MN 55432 0 # GAS DRYERS 0 0 # OF NEW FIXTURES 2 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 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 construcgon. PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 20.00 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 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 1667 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures NO. RATE TOTAL JOB ADDRESS % Z �� KP S S d) � 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 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: 4161� -/P _ , 20 OWNER BUILDING USED AS 0 `-'-- ESTIMATED COST fJ� 00 PERMIT NO. 6 660 4 ` CJ l $15.00 PLUMBING COMPANY Z—/ - Reinspection —/- Reinspection Fee $50.00/Hr SIGNED BY ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ Approved % TELNO.-7( Final Date Ci 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 installina 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: