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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT 4 s 1 Date: ....._.... _" .. _. • '. _ ._...... ._..__.._...._._...._ L .. Owner: ... Builder ... ..�..._ ..`�..�"` '� Address............... ........ ... _.__... ._..._ __.. _ _ _. ._ Address ........ _........ ..._............._............._.............................. .................................... .... L CTION No... 4 street -z ._ Part of Lqt .._... _ _.... _ Lot ...._'" ,, ....._....._. Block ...__ ...... .3 ........... _......_........ Addition or Sub -Division r`:'. ,ry •• Corner Lot .......................... _........ Inside Lot ....._................................ Setback ... ........................ Sideyard _ ..- •-- -- ------... -....... ........... Sewer Elevation . .... ............................. _.._.._....._......._...._...................................... Foundation Elevation ............................ DESCRIPTION OF BUILDING To be_Used as: , le Front .:..._.. Depth Height Sq. Ft. _ Cu. FtJ_ r ...... ....._.. ... :1 . .......: JDepth l H �ght �... Sq. Ft.� `Cu. Ft. Type Cx-........ Est o :..... To be Completed...._............._....................................................... 64 .e �� C E,SA� \Bv 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. In consideration of the payment of a fee of ......................... permit is hereby, granted to. ..... ............................. _.... :......:............... ..... _.... ______._.....__..................... ...... to construct the building or addition as described above. Thisg permit is granted upon the express condition that the person to whom itis granted and his agents, employee's 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 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 items. 4 ------------- APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Budder ' ice' ° (2:0 --- Address Address -- LOCATION OF BUILDING No. Street Part of Lot Lot 2,o Block_,_____Addition or Sub.Div„ Corner Lot____,,,Inside Lot__—,Set Back Side -Yard ~ SEWER ELEVATION FOUNDATION ELEVATION ~1"` Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: r ...........Front .......... Depth °Z. He3.ght Sq4 Fti Cu. rt. Front Depth Height Sq. Ft. Cus Fts Type of Construction � _ Tstitaated' Cost , 41-2= .. ....I �I��IIP ..,... �� A My The und4r0i9fied..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 Depar%nt of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE �- �% Ste_ -- SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side) City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK ` Location Number. Kind and Location of Fixtures" PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL F2 O Number Fixtures ...................... jgc <� S� �°' a �a F N WATER HTR. GAS ELEC. Catch Basin 3 x 3.25 ® ........................••.. a 3° oLL Water Heater (TTp to 200,000 BTU) ...... LLG V m <3 c�� c� too $ Base 1st 2nd _ 3rd — 4th Future Connection Openings Connected with Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL ® ®' d 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 (TTp to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ 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. 11 tFgr�i►dley, Minn, Owner Kind of Building P� Used as To be completed about'" Estimated Cost, $ Old6ev Building Permit No Permit No. '� Signed— By Business Phone No �f E" ROUGH (7 -7` & m 6 C FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... / x $1.50 $ s� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........... TOTAL FEE $ 42 2M r -sq Application for Power wants and Healing. Cooling. Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE 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 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ & a42 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM t5ee Fee Schedule Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ X. ® a GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ ® a% Additional Fixtures ............ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM t5ee Fee Schedule VENTILATING SYSTEM ) �� , /� ALTERATIONS & REPAIRS T FEE $� REMARKS: Dept. of Bldgs. Phone SII 4-7470 6A Location 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-0195— Owner "" F 195— Kind of Building 195— Used as To be completed about" Estimated Cost, $ e.0 Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, arm No Trade Name Size NoJi 2 i Capacity Sq. Ft. E.D.R.4o 4fro BTU H.P. Total Connected Load— s 3 Kind of Fuel— BURNER — Trade Name— m Size No Capacity. Sq. Ft. E D BTU H.P. Signe 11 POST IM -12-58 Business Phone 97-8b416051 f•F1'LIG..T10,1 FOR PWM11I14G A14 GAS FITTING P[.Ko, I r 1 - ac. 114 gut 0. Cld Ol•cr Sewer •r•] watar "';a 1 h 1 %: akL i.- TES t'r:.\tc t:.[..ct GLcr:GI �.tt.l, Yaalw Wats, 11eater - to S5,0uG b1T1 Iwv.JJta LIU W 1y G:.O 6T;. .aa®r a..faaner le.. Ct►.•Ind R.n Old b.61111r.1 Llectel.; Nater ilaatar I'll IING t I:ES; ',sa 1 tlaa\.caa +.Llttt..aal Yl.tucaa !•.yin*, g AI.TiKATtuN5 Y1.,t )I,)U.p, 94.1, 6.I1, 11.,...ro c.c 1ra:uJn tiu. RATE TOTAL. _---- x $3.00 $ . __. x $2.00 x .2. GO Tha undnrsrlgnc4 hsreCy r.akea arP11'"tiz- f.r a ;_rs:t t:.r apeelfled x • :� S 4 S� of 8_*1:3ir. 7�• 'e"t, .c�iaret WOO faCldr Mid C,;I�C.I;...1`C1L1Jtid 9[]10.1 $5.00 $ x $10.00 ryes° 17.00 g ^'- x ._ ; USCD AS res 55.00 g x , 1 x $1.00 x $10.00 s " CfiP'at,Elp,�Jr�O 55.00 • �-1` 1 � I,.tute :..rnccuar, Gl..:nlr J , �� .:.e.ted with 1 - ac. 114 gut 0. Cld Ol•cr Sewer •r•] watar "';a 1 h 1 %: akL i.- TES t'r:.\tc t:.[..ct GLcr:GI �.tt.l, Yaalw Wats, 11eater - to S5,0uG b1T1 Iwv.JJta LIU W 1y G:.O 6T;. .aa®r a..faaner le.. Ct►.•Ind R.n Old b.61111r.1 Llectel.; Nater ilaatar I'll IING t I:ES; ',sa 1 tlaa\.caa +.Llttt..aal Yl.tucaa !•.yin*, g AI.TiKATtuN5 Y1.,t )I,)U.p, 94.1, 6.I1, 11.,...ro c.c 1ra:uJn tiu. RATE TOTAL. _---- x $3.00 $ . __. x $2.00 x .2. GO Tha undnrsrlgnc4 hsreCy r.akea arP11'"tiz- f.r a ;_rs:t t:.r apeelfled x $5.00 5 of 8_*1:3ir. 7�• 'e"t, .c�iaret WOO faCldr Mid C,;I�C.I;...1`C1L1Jtid 9[]10.1 $5.00 $ x $10.00 4 . x 17.00 g ^'- x $5.00 ; USCD AS res 55.00 g x ;3.00 9 x $1.00 x $10.00 s " CfiP'at,Elp,�Jr�O 55.00 $ 52.G0 5 —' seta 5.r,r,ar7e 5 , 8.00 Job Adlress 285 Rice Creek Blvd. DtparLrar:rt ct b�L1 ,: . 1 City 6t Fridlay Tel. 1571-1450 Tha undnrsrlgnc4 hsreCy r.akea arP11'"tiz- f.r a ;_rs:t t:.r apeelfled Lh.5 wcjtk Lerclr, ag""119 L-1 d: a;! wcrk Se strIctt:3LrLar,za «ltL and rulings ct t►,c Sel-artment t1.I Ctty C.,�ca of 8_*1:3ir. 7�• 'e"t, .c�iaret WOO faCldr Mid C,;I�C.I;...1`C1L1Jtid 9[]10.1 LIAL all, t^. !tilt•.. .:eatie,. zea t\.,a and 5-1.9-80 OWNER Stoup KIt10 OF UUILG:;;.; USCD AS res TO BE CC 1HPUTLO rW,;;r 5-26-80 ESTIHhTLO COS•r 50.00 - OLD - OL1I UCILr1:1.7 PL►a•tl: CfiP'at,Elp,�Jr�O st;ilda By -:!t. 153. -- ROUGH I115P . Da Ld , FINhL I11SP,- Datu APPRWAL I i✓tt PLIwI r HIIIIHUil I'L'L t,.h L•1'i 1Lt::u:l;:, Pri,:.Ir IS i%.:J PLUS I,•p _;LTC 6vk0u.1tr,C City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT PER _ 18591 r � • __ COMMUNITY DEVELOPMENT DIV. w ---- r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 j, 612-571-3450 - TN f l NUMBER 910-F15 REV. DATE 8/12/86 PAGE OF APPROVED BY JOB ADDRESS 285 Rice Creek Blvd 1 LEGALLOT DESCR. NO, 20. BLOCK 3 TRACT OR ADDITION SEE ATTACHED Rice Creek. Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick Stoor 285 Rice Creek Blvd 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. North Central Builders 7401 - 42nd Avenue North, New Hope 55427 533-6168 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 1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House.' 9 CHANGE OF USE FROM TO STIPULATIONS 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 $rj 000 $2 50 DOESRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO SIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- RFORMANC OF CONSTRUCTION. $50.50 7��N PLAN CHECK FEE TOTAL FEE r _$53.00 S ATUREOFCONTRACTORORAUTHORIZEDAGENT (DATE) °" - WHEN PROPERLY LIDATED THIS IS YOUR PERMIT b ( /02 SIGNATURE OF OWNER IIF OWNER BUILDER) IDATE) BLDG INSP ATE NEW [ ] City of Fridley Effective 4/1/86 ADDN. I ] F R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: d g -C Tel6 C /ct:c1E Legal Description:— L67 d6 f3 /<3 Cr�� l� ��z�a Xo. 00jr16�' Owner Name &Address: Art p !c/l 's -T6, c d Tel. 4 57V-'_ ry t Z Contractor: 'V Z) C L `Li 'tk dim B L 4zS Tel. # Address: 7V6 L/-� AC)4)b, 9i1f o 1�6pc ml,, 5 S v 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: " S 1,oL STL'c z- Acr kt� Al 42, Corner Lot L ] Insi a Lot [ ] Ft. Yd. Setback Side Yard Setback __ 6-0 Type of Construction: Estimated Cost: $ t Approx. Completion Date: Alt. A Alt B Proposed Driveway Wid�h If New Opening Is Desired: $ $ See Back Page for Explanation Xo Ll Tel. �1� 3'/�� DATE: APPLICANT: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 4 • Fee Schedule on Reverse Side $ 25$ of Building Permit Fee $ < C� $.50/$1,000 Valuation $475 per SAC Unit $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] �S^ SUBJECT PER - --� City ®f Fridley 6681 AT THE TOP OF THE TWINS PERMIT BUILDING Ir EIPT NO. COMMUNITY DEVELOPMENT DIV. ______ ' ~ w r � � PROTECTIVE INSPECTION SEC. B e NUMBER REv DATE PAGE OF APPROVED BY "1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/17/98 JOB ADDRESS 285 Rice Creek Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 3 Rice Creek Plaza, North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE °Scott & Lynn Johnson 586-9779 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Grant Johnson 3844 France Ave So. St Louis P386-8399 20065242 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 ❑ ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof 23 SO Tear -off: re lace fascia W. end 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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. OWLG. UNITS OFFSTREET PARKING 1 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 ORDANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WH THER SPECIFIED kAREIN OR NOT. THE GRANTING OF A PERMIT $2,262.20 $1.13 DOES T PRESUME T G V AUTHORITY TO VIOLATE OR CANCEL THE G4 PERMIT FEE SAC CHARGE PROV NS OF A T R STATE OR LOCAL LAW R GUL TING CON- CONSTRUCTION ION O T E R7A�� 74.75 Fire SC $2.26 PLAN CHECK FEE TOTALFEE Licens $5.00 $83. SIbNATURECWC6NTRA bROR AUTHORIZED AGENT D TEI _ =;�KIDATED -10 BLD INSP THI IS YOUR PERMIT Zr/ 721 PATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 2-95 �Icrz- C�6-al' 6t'VQ Legal Description: Owner Name & Address: SC OT—T VdAl -J0 IW50d /X I3p✓re-- Tel. # Contractor: MN LICENSE # 6!r �- e Address: Tel. # Attach to this application, a Certificate of Survey of the6 lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE -AREA: Length DECK AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: Construction Type: +E�(-AC.(. A -SC U�Ver ` " Estimated Cost: $0 � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. , 6 Ft = Ft x $ _ $ DATE: 0 APPLICANT: Tel. #Tz'�- o Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge $ 600 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: r CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 DIViSION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ :30,00 (Side Vent — Fill Out Back) Gas Piping (Needed with new fumace) $10.00 $ Gas Range $10,00 $ Gas Dryer $10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (UST ON BACK) 1 % of Value of Appliance or Work $ Commercial/industrial 1.25% of Value of Appliance or Work $ State Surcharge $ .50 Effective On January 1 199 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. /a —Z& 11998 OWNER S_e&7% X - `O. ,,v ,- BUILDING USED AS c e ESTIMATED COST PERMIT DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_I Circle One (Sty Trade Name JA!vtZ(, BTU_ fsbL HP Fuel Total Connected Load am) (Hot Water (Warm Air) Size No. EDR Burner Trade Name BTU TOTAL FEE $ 30 ,5(D MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY_ b Size No. HP EDR Signed By Tel No. Approved By Rough—In Date Final Date FILL OUT BACK SIDE F STACK VERIFICATION ON REPLACEMENT FURNACE C AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes 7.1 ) No ( ) 2. 3. 4. 5. G� Is free from rust or deterioration Has no foreign objects lodged within Is securely supported . Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Beim Done: HEATING CO: Signed By: Date: Yes (} No ( ) Yes O No ( ) Yes ( No { ) Yes `:) No ( ) Yes No ( ) Yes () No CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 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 c -'a" *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/ Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. �Q C> Effective On January 1, 2002 JOB ADDRESS 06'6- Cres- 123&, OWNER -Sco-A TOTAL ,p BUILDING USED AS ✓��S•>`�( ESTIMATED COST PERMIT NO. a60 i DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. ,9-5_ C�o BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ The. undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE �'7 —��- HEATING CO Signed TEL #�� FAX # n Approved By Rough -In Date Final Date 0 `(8 -(a)- THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When reels at -Mg an taminti ng gran _p, 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 puyeting cnmb jetinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new _nmbuctien air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When jpgtaljna a new venting,iye�tem, 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 Tape and -q17e/Common Vent and Vent Cnnnortgr Infermatinn Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 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) 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% of Value of Appliance or Work ®o1�� Com/ e-1-1 1 ��✓� JOB ADDRESS The undersigned hereby makes application for a permit for the work herein Rate TOTAL 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 $ 30.00 $ representations stated in this application are true anc(correct $ 10.00 $ $ 10.00 $ $10.00 $ $ 25.00 $ State Surcharge 1114MA11 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr 50 BUILDING USED AS //�✓�iGl/ir✓y. ESTIMATED COST PERMIT NO. 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. BTU HP EDR Imam Approved ByA&. Rough—In Date Final Date s !v®, *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE F(�R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURN CE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rust or deterioration Yes O No ( ) 3. Has no foreign objects lodged within Yes O No (. ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for- size and total BTU's connected Yes ( ). No ( ) 6' Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes (} No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $ 10.00 Gas Range - If" #/"., ®UGC $ 10.00 Gas Dryer $ 10.00 *Air Conditioning — All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE Effective On August 1, 1995 JOB ADDRESS The undersigned hereby makes application for a permit for the work herein TOTAL 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.; co :: MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. 50 r BUILDING USED ASG%/�i�y ESTIMATED COST c PERMIT NO. SCRIPTION 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 BTU HEATING COMPAN Signed B Approved By FILL OUT BACK SIDE 0 REPLACEMENT FURN C Size No. HP EDR Tel No. Rough—In Date STACK VERIFICATION ON Final Date to - 9--0/ 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 O No (. ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for -size' and total BTU's connected Yes (} No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes (} No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 25, 2001 Mr. Scott Johnson 285 Rice Creek Blvd NE Fridley, MN 55432 Re: Final Inspection at 285 Rice Creek Blvd NE Contractor: Reliant Energy/Minnegasco/Blaine Heating Dear Mr. Johnson: Mechanical permits were issued on October 24, 2000 to install a built-in oven and cook top at your address. According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the mechanical work authorized by this permit. As of this date, no inspection has been called for. The permit fee that was paid covers the inspections to make sure the work was completed according to the Mechanical Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permit and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, vzov�a NSEN Build' g Inspector DJ/mh C110( OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 r �� JOB ADDRESS 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% of Value of Appliance or Work Effective January 1, 2003 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. $ 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 co rect DATE Earl 0 STANDARD HEATING & AIR CONDITIONING CO, 410 WEST LAKE STREET MINNEAPOU , X08-29SS 612-82 265E Approved B Rough -In Date Fina ate OWNER CI k5=- y -*)C-22I Rate TOTAL BUILDING USED AS 5 C $ 30.00 $ �o A 0 ESTIMATED COST l PERMIT NO. $ 10.00 $ DESCRIPTION � r°f �� OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ 25'0D Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR 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. $ 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 co rect DATE Earl 0 STANDARD HEATING & AIR CONDITIONING CO, 410 WEST LAKE STREET MINNEAPOU , X08-29SS 612-82 265E Approved B Rough -In Date Fina ate a THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When replacing an avis+ing furanna,. 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.( The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. ,, �, r Yes; ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan - assisted and natural draft appliances. Yes,o The avin inn rnmeiiatinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( o When required to install a new cnmbustinn ai ; it will be sized and installed to meet the current codes and manufacturer's specifications. Yes When iustafto a new venting svc pm, 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. Ye ( ) 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. Ye (�_o Appliance #1 Type Appliance #2 Type Appliance #3 Type Total Appliance Common Vent Typi Appliance #1 Vent Connector Height Appliance #2 Vent Connector Height Appliance #3 Vent)Co;Rector Height Signed By. BTU Input ®dary Fan Assisted or Nat f' BTU Input/96n Assisted or Na BTU Input Fan Assisted or Nat Btu Input, D ent Height Diameter inches ftngth Diameter in Type Length 'ameter Type T ft Le;5eL ngth ft Diamete in Type N CfiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 8, 2004 Mr. Scott Johnson 285 Rice Creek Blvd NE Fridley, MN 55432 Re: Final Inspection at 285 Rice Creek Blvd NE Contractor: Standard Heating & Air Conditioning Co. Dear Mr. Johnson: A mechanical permit was issued on July 17, 2003 to install a furnace at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, Wai W� i�i►_�. I, Epector INSEN DJ/mh Building Inspections 763-572-3604 763-502-4977 FAX PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 2-19-09 DATE IL1 4 1910`1 YOUR E-MAIL ADDRESS SITE ADDRESS 245- Kra GretK- Bid 146 THIS APPLICANT IS: ❑ OWNER )6ONTRACTOR PROPERTY NAME: G`✓ L - AW OWNER/ ADDRESS: 285 9 -at- C'.1W I� 131 TENANT -n' 4 -CA_ a mea Permit No.:AO, 0047 Received By: EQ 1 A' CONTRACTOR NAME: d-1 V STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS:g�aT/ I�ZIP��✓y ►r�W 4 a Ate *-CITYTA' 4 � SE� INSURANCE PHONE '10- f 1' ,?dq ( FAX 310 PERMIT TYPE *SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE —KITCHEN LAUNDRY TRAY O NEW L REPLACEMENT TYPE OF WORK: _ WATER METER W DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV DRAINS _ WATER PIPING _ _FLOOR GAS PIPING (NEED CITY LIC) —SHOWER SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER _ SINK _ _ WATER CLOSET _ BACKFLOW PREV. ($15) _ —KITCHEN LAUNDRY TRAY _�_($35) FORIRRIGATION —DISHWASHER _ WATER METER W —OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval �o'f/plans. SIGNATURE OF APPLICANT _ ! � PRINT NAME W0— C'J0 _DATE S �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977