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PRE 2010 DOCSCity ®f Fridley, .Minn. N° 8630 BUILDING PERMIT Date: DECEMBER 14, 1965 Owner: Builder CHARLES JOHANSON Address - Address 160 Hartman Circle N. E. Fridley, Minnesota.55432 LOCATION OF BUILDING No. 425 Street RICE CREEK BOULEVARD Part of Lot 3 1 HOLIDAY HILLS, 2ND ADDITION Lot Block Addition or Sub -Division ._.u. Corner Lot de Lot X Setback 35' __._ Sideyarrd, 15'611 Sewer Elevation mon Elevation C2 DESCRIPTION OF BUILDING To be Used as: DWELLING Front 58! 8"8" Depth 26 ,eight 24 Sq. Ft. 1, 006 Cu. Ft 24,144 ATT. GARAGE Front 20'4" Depth 22 Height 10 Sq. Ft. __4L8 Cu. 4,480 Type of Construction Frame Est. Cost ,_ X20 000, 00 To be Completed In consideration of the issuance to me of a permit to const the proposed work in accordance with the description above set ordinances of the city of Fridley. s T / '�� 0✓h°/� o above,I agree to do rljh a'll provisions of In consideration of the payment of a fee of $-19 --00 , permit is herebjgranted to CHARLES JOHANSON to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Mirmeaota location, construction, alteration, maintenance, repair and moving of buildings ordinances. within the city limits permit may be revoked at any time upon violation of any of the Provisions of said ALLEN G. JENSEN guilding motor NOTICES Ub pom* does not sorer the eonetwedon, hutallatt o for whine, phnn+ine► en hentine, ower or water. Be am to as the Building Ineped r for aperote pennih Por thea Noma OWNER'S ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING r street � � Z Vo Part of Lot LOT IC� ADDITION OR SUBDIVISION .o Corner LotInside LOT Setback Side -yard_ ...SEWER ELEVATION FOUNDATION ELEVOk ... .. Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be -fused as, Front Depths Height'` Sq. Ft. ,®� Cu. Ft.y— Fron pth � .�=- Height Jt Sq. Ft._ Cu. Ft. Type of Construction Estimated Cct ee i e 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 of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicati5op are true and/correct. DATE SIGNATURE. (Schedule of Fee Costs can be found on the Reverse Side) Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR '00 Furnace Shell & Duct Work to 170,000 BTU ............ $10.00 $1 o' each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule o® GAS BURNER (up to 199,000 BTU) ....................... 5.00 $i over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE T OT,iL U� U 1st 3 Fixtures ..... ................ x$ 2.00 $� Additional Fixtures ................. x .75 $ Gas Range to 199,000 1 .......... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE iZ 0 Dept. of Bldgs. Phone 560-3450 Location `/ - LC (� 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. J n Fridley, Minn 3 - 2 6 , 19 Owner ( 'AA -42,e A Kind of Building Used as To be completed about I Estimated Cost, $ ' ? 0-5— ` Old New uilding Permit No. ff6 34) Permit No._41a 71a DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water,'Warm Air—No Trade Nam Size No 7®� Capacity a 3 ® Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel XV BURNER — Trade Nam Size No- Capacity o Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signed � ��- By az Business Phone No- O>ighw 0 PERMIT for Power Plants and Heating. Cool= ing, ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. o. ! Heating Plants d—z'u to be Ens' --altered—repaired Make , Size �> X 19 f3 L9., Oil fired ; Coal fired—, Gas fired—L; Gas Authorization No. /?r . /} A< A . r7 . a d/ Remarks Approved Final Inspection 19_ Inspector Permit N® 4679 Fee $ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn.; 177wifew ,19z- OwneriAc� Location 3c2 Rr' ,E. CG 46ElC' RL�� Kind of Building �4P19/y How Occupied i iC11°.L, j t) Work to be Commenced—, 19— To be Completed _:&'qfE / ,19z�)- Estimated Cost, $ Z-kQ Old -New, Building Permit No. Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon thtf express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications t fo h in the approved application for this permit on file in the office of the Inspector of Buildings. ,Inspector of Buildings 42 2M 11-67 V SUBJECT - . City of Fridley rE3 302 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. L-------- COMMUNITY DEVELOPMENT DIV. 1 PROTECTIVE INSPECTION SEC. 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 11/5/75 JOB ADDRESS 425 Rice Creek Boulevard 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Holiday Hills 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald R. Maeckelbergh 425 Rice Creek Boulevard 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Chas. Johanson 424 Rice Creek Boulevard 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 EX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a fireplace 9 CHANGE OF USE FROM TO STIPULATIONS Per specifications attached. �'R`�G, PERMITS gJIRED SEP ERATE AND SONS' HEATMIG, PLUMBING TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Concrete 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 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 $1,500 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .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- $9.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $9.75 tfEIGN"A'TUREOFCR RACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 91� BLDG. )NSP DATE SIGNATURE OF OWNER OF OWNERBUILDER)(DATE) yrs �'' des AIE. Minrkafvl's3z. ENGINEERING' Sods Trshi� ' !NC Si4jgf 4.066 inn! b Ademx: al E irc�er ' EC] in E' e d".5 i U�� VE'�Ul "-S )o" V -1s F cap`,► -gyp, S r - d c x r 3' �' 4 t• � ► �" � :"� 1..1 � �•'� S a °..- � L tel Caf2l�SPF��+� a � ' s �''tlrc �o� akscr►bai'd t�r4, �� 1 tF0vby WN< the tills is ® h -W cars/ er�rtcf pre ,faon d - . d lard As .st r w ycd by trh 1"Otmin Ord# E►ua Ui t r� r , / sire ed cr5arie�►fs . rs A.0 SW UIWAN ENONH- ING , IVC. c.Y _lit~• At1' ' Cy L-!- cy I. r 3' �' 4 t• � ► �" � :"� 1..1 � �•'� S a °..- � L tel Caf2l�SPF��+� a � ' s �''tlrc �o� akscr►bai'd t�r4, �� 1 tF0vby WN< the tills is ® h -W cars/ er�rtcf pre ,faon d - . d lard As .st r w ycd by trh 1"Otmin Ord# E►ua Ui t r� r , / sire ed cr5arie�►fs . rs A.0 SW UIWAN ENONH- ING , IVC. c.Y _lit~• At1' •' -APPLICATION FOR RESI'DE'NTIAL., ALTLRATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �.�UI OWNER'S �N�AME: LDER: ADDRESS q7,6- •7G2 i� �C,ffrJ� ADDRESS : e NO:. STREET • �' �2 tC ►�✓ L �� c ODD LOT: BLOCK: I ADDITION : �L l D 4 y l C 4,11 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: . i Applicant attach this fors. Two Certificates...)f Survey of Lot and.propos•ed • ' building location drawn on these Certificates. r r DESCRIPTION OF BUILDING • i To Be Used As: ' ?L v_t Front: Depth: • Height Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: 60/ye.26Estimated Cost: $ 1500 To Be completed: The undersigned hereby makes application for permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fiidley 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. • DATE: SIGNATURE: _ (See Reverse Side For Additional Information.)' SUBJECT PER O. City ®f Fridley 2076 AT THE TOP OF THE TWINS BUILDING PERMIT CEIPT i tr: -------COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. pp / r I NUMBER REV.L4/16/91 ATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 425 Rice Creek Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Holiday Hills 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald Maeckelbergh 425 Rice Creek Blvd NE 574^9580 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW IR ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 81 x 51 Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $500 $.50 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- $155o oo Fixe SC $.50 STR CTION OR THE PERFORMANCE OF CONSTRUCTION, P CK FEE TOTAL FEE $16.00 SI NATURE OF CO�/T�'(�4CTOR RA UTH RIZED AGENT IDA Ip/f{E IS Y UR PERMIT C,.J/� J �EjI �ROPELHIS iGNa7URE OF OWN R iiF OWNER BULLDERi ID TEI BLDG iNSP r)aTE NEW [ ] Effective 1/1/91 ADIN R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: q7-5- t& " x%13 Legal Descripticn: 3 9bo 'e, ) l bLt DA X 141U., -5j Owner Name & Address: 6&)ZA'L %/'r �� C � � � C� Tel.. # 5'7 V f SS Q Contractor: t LV AAG/1 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIMICK CF MEMM UMM AREA: Ler:gth Width Height Sq. Ft. G RAM AREA: length Width Height Sq. Ft. MOM AREA: Length Width 5- Hgt/M=zn l Lz . Sq. Ft. �y 1::�7- Corner lot [ ] Inside Iot [ ] Ft. Yd Setback Side Yard Se lacks Type of Construction: C DA fz, Estimated Cost: $ Approx. Ccerpletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DAZE:f� I(� t APPLICARr 'Pel. # S% Ii 9 c) Permit Fee IOU Fire Surge $ O State Surcharge $ SAC amrge $ Driveway Escrow $ Park Fee $ Sewer MainCharge 70ML $J—(2 10� SzzPUTATICNS: 00 CITY USE C�II,Y Fee Schedule cn Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 0 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 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 Gas Piping (Needed with new furnace) Rate TOTAL $ 20.00 $ $ 10.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning - All Sizes $ 10.00 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1 % of Value of Appliance or Work $ State Surcharge $ .50_ TOTAL FEE - �® MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB yzS- !� �Cr free k i U� 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. -F/ ,1991 LID. -Che I BUILDING USED ASDwe_ Y/ N g ESTIMATED COST �YO U PERMIT NO.�C 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 6Y��: iC1N HEA7I�JG � ���'l1PaG-''+ HEATING COMP Y 120.85th AvrrUt1 moux, Fa 9v 424-8333 Signed By Tel No. Approved By Rough -In Date Final Date - 2 _ Y< FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND BTACR VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date n SUBJECT PERMIT NO. City of Fridley 23728 AT THE TOP OF THE TWINS BUILDING PERMIT f RECjEI O. COMMUNITY DEVELOPMENT DIV. _ >. ______ PROTECTIVE INSPECTION SEC. 3 7; NUMBER REVDATE PAGE OF APP B CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 425 RICE CREEK BLVD 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 HOLIDAY HILLS 2nd ADDITION SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE GERALS MAECKELBERGH 425 RICE CREEK BLVD FRIDLEY MN 55432 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. RICHARD HASTINGS 6331 RIVERVIEW TERRACE NE FRIDLEY MN 55432 574-9966 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 REROOF TEAR -OFF (23Sq) 9 CHANGE OF USE FROM TO STIPULATIONS UNDERLAYMENT MUST MEET STATE BUILDING CODE. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS I 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 1840.00 92 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- 59.50 FIRE SC 1.84 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION, ® �y �y d �l C is PLAN CHECK FEE TOTAL FEE 67.26 SIGNATURE OF CONTRACTOR O UTHORIZED AGENT (DATE) WHEN PROPERLY LIDA ED THIS IS YOUR PERMIT d BLDGFINSP ` DATE _ SIGNATURE OF OWNERUF OWNER BUILDER) IDATEI NEW [ AD15 [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 8/1/95 3s 77 Construction Address: ` Z 5 � , c E c � P E Legal Description: Owner Name & Address: 6,E,?A tel AA A EG k,9 L- 13F2!5 1, Tel. # Contractor: ? , C-4 a F - dust; n(6 S _ MN LICENSE # y® S/ Address: Tel. # S �(— 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 [ ] Ft. Yd Setback. Side Yard Setbacks Type of Construction: °-E A R o Ft= 4- K E R O c, F Estimated Cost: $ _® Approx. ComDate: ® X �V!�T , (Cost on Back) Driveway ' th Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: zL-? S APPLICANT: Tel. # S ? c/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: _ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,00 Valuation $850 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 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION.AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS o� ' Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with nowfurpace) G�e �� Gas Dryer *Air Conditioning - All Sizes Rate TOTAL $ 30.00.• $ $10.00 $ $10.00 $ $ 25.00 : $ All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $� Commercial/Industrial 1.25% of Value of Appliance or Work $!_, State Surcharge TOTAL FEE $ MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION 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. Effective On August 1, 1995 , 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. /c'Z / 00--' ,1995 BUILDING USED AS ESTIMATED COST 9-6*7,'�? e) � PERMIT NO. wagelp-agN OF FURN E AND OR BURNER • No. of satin nits _ Cirole One (St m) (Hot Water) (Warm A1r) _Trad6.Name Size No. BTU • _P HP EDR Fuel . Total Connected Load Burner Trade Name Size No. B.M. ` ' HP EDR a HEATING COMPANY Signed By �et_e_" Tel No. �� % -FV .9 j Approved By Rough -In Date '9� Final Date '3 FILL OUT BACK SID FOR STACK VERIFICATI00 ON REPLACEMENT FURNACE f6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a Inver 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: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) Z. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. U securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes {) No ( ) f6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a Inver 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 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Effective On January 1, 1997 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Beth WashFloorgt>::< Auto Gay Gas EyliC Water Heater Urinal :TU Shower Sink Tray Fount Drain gmstrf Washer A: 0 Range z� > < Gas Elec NO.RATE TOTAL JOB ADDRESS7� J �J 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 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE The undersigned hereby makes application fora 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. Owner t✓ 19 Building Used As Sliv Estimated Cost PERMIT NO. PLUMBING COMPANY SIGNED BY "`""'d TEL N0. Approved By Rough—In Date Final Date (, $ .50 MINIMUM FEE F R ANY PLUMBING/GAS PERMIT IS $20.00 $ PLUS THE $.So STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.