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PRE 2010 DOCSV SUBJECT PERMIT City ®f Fridley 1295'7 AT THE TOP OF THE TWINS BUILDING P E R I r � R TN RMT COMMUNITY DEVELOPMENT DIV. INSPECTION d � � PROTECTIVE SEC. 1 � NUMBER REV- DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-560-3450 910-F15 5/21/75 JOB ADDRESS 449 Rice Creek Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Holiday Hills nd Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Joseph J. Ulvin 417 Manor Drive N.E. 1 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. C & M Construction 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 R 8 DESCRIBE WORK Construct a 40' x 26' Dwellin and,a 20' x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a x1mid hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: (Approx. 9' Deep) WAR14ING 7' South of Manhole (Inv. 846.68) Wye Elev: 846.61 Before digging call local utilities Top of Footing: 849.61 Minimum TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW WATER LOCATION: 10' North of Sewer Service SEPERATE PERMITS REQUIRED FOR WIRING, HFATIr1G, PtUM81INIG AI' D SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING.I Wood Frame ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCEDWITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING '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 COM LIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $51,400 25.70 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. S57.98 325.00 PLAN CHECK FEE TOTALFEE SI NATURE OF - o AUTHORZEDAGENT (/DpAT ) PROPERLYVALIDATED THIS IS YOUR PERMIT .)WHEN �X I�Cs�i�d ! til S --' BLDG INSP 04TE 1 I N R16bF OWN IIF OWNER BUILDER) 1 ATE) V APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA n OWNER'S NAME: �' D,St��%� n l/� Lv1 � BUILDER: ADDRESS • -` 0 ADDRESS NO • . T r 1 STREET • LOT • BLOCK: I ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicarit attach to this form Two Certificate:..of Survey of .Lot and proposed building location drawn on these Certificates. To Be Used As: bw I tj (� DESCRIPTION OF BUILDING r 3 7_1� Front: 40 Depth: Height: Square Feet: Cubic Feet: AITI Gore— Front: x Depth: Height: I Square Feet; Cubic Feet: Type of Construction: 60/�nr Estimated Cost: $ 610 _.q4q,�d To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict 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 Informati'on.) Drn� irif , aqw,je ov//660 19 &g -j 90 yo r.e ,r C 4op, �� WIN S 40 u.3 1040 �' x S = � �,,., 11 w O It 01 rae x •L f9� C%.,..- c So 11.7 = q ' ' x 1 py91. o aeox so *1% _ 346 A� 12%1 V x �.�.. �.�. _ �- fs X 11 '` ► A k 1 O '� '�► �� 3g sc lu I, �yQe �rs$X ZZ.Go • aG, ��.�sa ' g 3 40 -780 �10 al,4,g 0 3K f . o yo S%*0 x SO Is.70 botmdor;ws 4f tan oro so-vefj. PM -1 n,9 As rne. A� fv d lcp ftni cr ea d. ed .5U5UPISM MWIVEf INC. frrCmfly-1 upri Application for P UMbInS and Gas Niffing Pe it Dept. of $1d ,z• 'a'ho �a � S53 'DI SCArPTION QVr WOE • • Lo L' oz� tttaJnU", Kind 8AA LINUMOsr ®F Figs : . City of Fridley: : The undersigned hereby makes application for a permit for t.`se, vo:Y herr specified. a„ree:ng :o do all work :a suet accc dance ulth the C t7 and ruling of the Department of iu• d+'ar•'s, and hereby declares that all L':e.fat • and representations st: —1 LnL".is aprl:ca'`ca :re :ran :.'� cored Fridley, In=..— Owner ann WAUR 647R. �•�: 'z,�. � r �a0<1e�� "� :i<17� 7z Z A N 6e+S Et�G )41 E3:! A 1 • 1.. xr }� . Kind of Building - Conn 4A wi$li O • ..:o Cc_.c:::�--.. ,c....:.;a iu. $eearg. 3rd 1 e ?tarn i iuzh:rv. Old O—;,oair-rs Ceasp" 7— To be completed about PAR71AL. SCHEDULE Estimated Cost. 1 Old—A'ew.-nuilding Permit er t No. N pj.VXijF-I%7 Ik& �►TRSi O. MQ RATE TOTAL ' � o� , 6 th 1 1171 1 . Norther Fix tures••••••••••••••• x9204 , 5 • ` _ B y x $1.53 S °.. ' tuce Fixture nperirg . • • • • • • • • •• F�.��_ City of Fridley: : The undersigned hereby makes application for a permit for t.`se, vo:Y herr specified. a„ree:ng :o do all work :a suet accc dance ulth the C t7 and ruling of the Department of iu• d+'ar•'s, and hereby declares that all L':e.fat • and representations st: —1 LnL".is aprl:ca'`ca :re :ran :.'� cored Fridley, In=..— Owner ann .50 State Surcharge lid � �L•TaA�':l��f a�.� tsd�.► , . ..........5 Ovmer ' Kind of Building - Conn 4A wi$li O • ..:o Cc_.c:::�--.. ,c....:.;a iu. $eearg. Used as e ?tarn i iuzh:rv. Old O—;,oair-rs Ceasp" ~ To be completed about PAR71AL. SCHEDULE Estimated Cost. Old—A'ew.-nuilding Permit er t No. N pj.VXijF-I%7 Ik& �►TRSi O. MQ RATE TOTAL ' � o� , 6 � Signed . Norther Fix tures••••••••••••••• x9204 , 5 • ` _ B y x $1.53 S °.. ' tuce Fixture nperirg . • • • • • • • • •• F�.��_ _ Businc= FrIvre !o New Fixture Old Opnring.. • • • •'• • • • -- — x $1.50 Catch Basin .................... — x $3.25 S -- 3-00 ' 'Up to Sri°000 - x o.G4 S K a.c: Heatcr ROUGH • aew Ground Run Old Bldg.. :..:. ^---- x $3.25 S £, •+ ..c :s'.,-. ►later F:ss tar.....:....... .�--•-- FI - • GAS IMTTZNC Fos: 210. RnTE TOT Ist 3 Fixtures • • • • • • ...... . X S2.00 $ • x $ ,7a $ Add:t:o=al Fixtures.....:......... . Gs F,,;, Ze to 19.9.030 BTU ............_-- x $5.04 'S a .50 State Surcharge lid � �L•TaA�':l��f a�.� tsd�.► , . ..........5 CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT O M e 8 1.50 8 a+ M e r. r- 4 8 e i u p $ e $ Hater 5.00 8 5.00 8 $ 5.00 8 q 7.00 8 $ w 5� Heater Iii 4 t Y~ ICF G M H gv C O i b OL M ;as ec a�m O� u d Y m oQ R a'ii a 3 •w� aw° $ aieaiw 99 e m sem. lot D 3rd Ith (R) Future Connection Opening Connected with Sewer (s) _ Now Future, Old Opening Hater , RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL now Fixtures i 5.00 $ Future Fixtures . Old Opening, us* Fixture beer Dispenser Blow Off Basin Catch Basin - Rain hater Leader Hydraulic Valve Sump or Receiving Tank Mater Treating Appliance Hot Water Seater Gas Range Can Dryer $ 3.50 8 8 1.50 8 $ 4.00 8 5.00 8 $ 5.00 $ 8 5.00 8 5.00 8 $ 5.00 8 $ 7.00 8 $ 5.00 $ g 10.00 $ 8 10.00 8 ALL OTHERS AVID/OR REPAIRS AND ALTERATIONS it of Value of Fixture or Appliance 80 r Reinspection Fee $ State Surcharge 8 50 /� (515.00) TOTAL FEE 8 I K t! Job Address --*q Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true .and 'oorrect Fridley. Mn. L.—. p`- ® , 19 OWNER Y !LINO OF surwiNG USED AS 90 819 COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PPAVM NO. PERMIT R0.- Company signed By Tel. No. -1 l ROUGH INSP. Date FINAL INSp. Date - APPROVAL FOR PERMIT r HINIHUM FEE FOR ANY PLUMBING PBRMIT IS 510.00 PLUS THE $.50 STATE SURCHARGE SUBJECT PERMIT NO. City of Fridley52 7 AT THE TOP OF THE TWINS BUILDING P E M I T r ` RECEIPT NO. { COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. s 1 r d1?6 iii 1 , NUMBER REV DATE PAGE OF APPROVED BY 1 CITY HALL FRIDLEY 55432 ''j 612-571-3450 910415 9/22/97 JOB ADDRESS 449 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Holiday Hills 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred Runze 449 Rice Creek Blvd NE 571-1307 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. DeMars Construction 8401 166 Cir NW, Ramsey, MN 55303 441-7084 6614 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 KI REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. SEPARATE ERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATIN OR AIR CONDITIONING. THIS PERM T BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZE IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK I SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT .ANY TIME FTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY ERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW HE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDIN NCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,378 $.69 WITH WHET ER SPE IFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESU T GIVE UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION OF Y THER ATE OR LOCAL LAW REGULATING CON- $45.75 Fire SC $1.38 STRUCTIO R E P FO CE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $52.82 S�GNA REO CONTRa TOR OR AUTHORIZED AGENT (DATED WHEN IPROPERLrYALIDATED THIS IS YOUR PERMIT B G INSP SGNA URE OF OWNERoF OWNER BURDERI iDATEi NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER y SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Constructio ddress: L� Legal Description: Owner Nam & Address: Contractor: Address: -41D f A (. G C�/C- g I W / /6 U n Z R.— q'( ° /, Effective 1 / 1 /97✓✓/4 �k Tel. # I W7 MN LICENSE Tel. # 761 , Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING ARA: Length Width Height Sq. Ft. GARAGE AOEA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 'ry ®, S z Construction hype: Estimated Cost: $ (Fee Schedule on Back) Driveway Cur Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: % APPLICANT: Tel. # ! �? 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%) $.501$1,000 Valuation $950 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 [ ] NJ RERMT NO. - City of Fridley 3 3 �88 AT THE TOP OF THE TWINS BUILDING PERMIT r ` IPT NO. COMMUNITY DEVELOPMENT DIV. _---- PROTECTIVE INSPECTION SEC. r � � � �� I 1 NUMBER REV DATE PAGE OF APPROVED By I { "" % CITY HALL FRIDLEY 55432 #I ".' j4," 763-571-3450 910-F15 12/6/02 JOB ADDRESS 449 Rice Creek Blvd NE T LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 1 Holiday Hills 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Waznik 449 Rice Creek Blvd NE 763-780-9321 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 ❑ ADDITION ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Finish basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE ITf UIE WIRINGRd IG 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 OWLG. 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 $2.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,000 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- $97.25 Fire SC $4.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE 103.25 SIGNAT a c CON ALTO R Ar THOR�ZEMO A NT i pTE�42P ENVIOY VALID AT THIS IS YOUR PERMIT ® i 7— B�0 NSP �AtE SGNATUAEO'OWNE wOWNERB i PER, tDA E� NJ NEW (J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J ' 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Tqq KjCe et p 1✓Ca ` Legal Description: Owner Name & Address: ek- l )h uk, 5,vue Tel. # -100 213 z) Contractor. LL- MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height -T f Sq. Ft Length Width Height Sq. Ft Len�-th Width Hgt/Ground Sq. Ft �`-iA®�� a9-S F/1✓1��1d�' Construction Tyr Driveway Curb Cut Width Needed: Ft + 6 Ft = Ftx $ —=$ DATE: 2-1f z /0 z APPLICANT: '?UAtk A4Tel. # - b 93Ll Call (763) 572-3604 for Permit Fees If mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ , , 7, Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $ d__ $.50/$1,000 Valuation $ $1200 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by'Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ _� STIPULATIONS: . il..: z J, . . 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Fift:C:iiV6 Vii .ldii i, PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 1 L%q New Fixtures $ 7.00l° The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 / Z 7 , 20 Sump/Receiving Tank $ 7.00 /J Water Treating Appliance $10.00 Owner � `' d 1c,7 [ A, Water Heater -Electric $ 7.00 / Water Heater - Gas** $10.00 Building Used As ��) (C`�� Gas Range" $10.00 Gas Dryer"` $10.00 Estimated Cost PERMIT NO. ®� Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr 4 SIGNED BY TEL NO.��U��—� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # A 1.5% of Value of Fixture or Appliance AV 3� Approved By. Rough -In Date Final Date 03 State Surcharge .50 MINIMUM FEE ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $_f� PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, IF TOR AND CC)Mat IRTION AIR VERIFICATION When ranlry acing an nwestang furantga, 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 (i 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 PY�g r--nmh ,Minn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When required to install a now _nmh uc+inn airs it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When inntallin:g a new venting nystem, 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 #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 N HEATING CO: Signed By: Date: <<. t%iLJLCY 11140er_k, I KJN UIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MOR1! M1 1:ARCD f1C CIVrl Ince -re-, rIr- ILI v . . Effective U1, .jarl 1.4uuz PLUMBING FIXTURE RATES: NO. RATE New Fixtures $ 700 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin -•-••<<'- :.:•.::.:?{•'::=:::<:}::: W ash Floor $ 7,00 Auto $10.00 HeaterSton•es $ 7,00 Unnal . ......... Shower Gas Range** Tra Drain $10.00 .:..,. Washe Rana .....Water :;.':>::>::::::::::}�::<:>::>: . .,.:.�:...Gas Gas Elec Basement me nt Floor 1 Floor 2 ..... x:::::.�:.... +•'}:: ..........n {::;:5:;,x.1,'•: ::: n•.•.•:: {ii:::i wn nn..:.: ivx, {: x:::....:.:::::: •}:::$ avi;i}:}'6'{v: k ;{:4 +`.•;?•.'{.:5:: {;:x:,x i0. _ 0.J:':•"• max•:»:•:s:,n{• Floor 3 Floor PLUMBING FIXTURE RATES: NO. RATE New Fixtures $ 700 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7,00 Rain Water Leader $ 7,00 Sump/Receiving Tank $ 7,00 Water Treating Appliance $10.00 Water Heater -Electric $ 7,00 Water Heater - Gas**_ $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes ( ) No Type Reinspection Fee $47.00/Hr $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB 10 50 $/. 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 and representations stated in this application are true and correct x2.20 Owner [' d 1 d Vii Ui a zn f K Building Used As Estimated Cost S� PERMIT NO. �� l PLUMBINGCOMPANY I i ��S�! e{�QPIM 1y7bIY�'. SIGNED BY -4 `~- / TEL N0. 7� 1 FAX # --7& 3— Approved Ba?�_ Rough4n Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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 *Air Conditioning - All Sizes Effective On January 1, 2002 JOB ADDRESS qq 7 && -— OWNER mmk_ &A VfA:k" Rate TOTAL BUILDING USED AS V -Cs ('d _eJA_C_t_, $ 30.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 4% of Value of Appl' ce or Work / Commercial/Industrial 1.25% of Value of Appliance or Work 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. ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) a Air $ Trade Name Size No. 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 HEATING CO Signed ` lit, & TEL # l 760 93 Z/ FAX # 1�s Approved By Rough -In Date Final Date jo THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT, VENT CnNNFCTnR AND .(WRI ISTION AIR VFRIFI ATInN When reIia ing an pxic inaf� ranntz, 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 plastictPVC 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 cnmh ,Mien air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No { ) When required to install a new r-nmhi ictien air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a naw v _n ing,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( ) APnliance Tune and Size/Commen Vant Vanand Vent nnn cter Infennatien 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 e.� HEATING CO: Signed By: Date: CITY OF FRIDLEY PERMIT •2004-01116 'J 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 07/14/2004 61"1111 E W.'KIM001 IN a earl ADDRESS : 449 RICE CREEK BLVD NE PIN : 143024210031 LEGAL DESC : HOLIDAY HILLS 2ND : LOT 5 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. REPLACE FURNACE (WARM AIR, CARRIER, 90,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES 1 VALUE (FOR MINIMUM CALC) 0 APPLICANT ACTION HEATING & AIR COND 8140 ARTHUR ST NE SPRING LAKE PARK, MN 55432 F AJU MARK WAZNIK 449 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of constructioi,. Bldg HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND. HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS NOD, Fee Total Owner 04 V11 C 4-"C, ?—,I 1 1 $35.00 $ 35-c)`> Building Used As 14"s�-- $10.00 $ ESTIMATED COST //-, /7S ` &--)PERMIT NO $10.00 $ Gas Dryer $10.00 $ *Air Conditioning -AII Sizes $25.00 $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is Treater on work less than $300.00 Commercia I/Ind ustria I/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/IndustriaVinstitutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR DESCRIPTION OF FURNACE AND BURNER # of Heating Units _/ Circle One (Steam) (Hot Water) 0arm Air Trade Name CA-,/// Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HEATING CO /41--PO-1 47-, 1--, f .4! Signed r Tel # FAX # Date 7/l Approved by Rough -in Date Final Date�' 't 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 (j 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 N" 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 a?— BTU Input 90,61.1 Fan Assisted or Nat 164-1 Appliance #2 Type z, 4,,— BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances -. Total Btu Input 130-c-- Common 30e-- Common Vent Type 6s`< ff Vent Height 1' Diameter -5— 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: AooL AL,, Jl= f A Date Signed By: CITY OF FRIDLEY PERMIT NO.: 2004-01483 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004 572-3604 t AX: (763) 571-1287 ADDRESS 449 RICE CREEK BLVD NE PIN 143024210031 LEGAL DESC HOLIDAY HILLS 2ND LOT 5 BLOCK 1 PERMIT TYPE ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER MARK WAZNIK 449 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 117431 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �iG- &�z �/ Building PLUMBING Permit N Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY bate Rec'd 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 9--7 - c l YOUR E-MAIL ADDRESS SITE ADDRESS 4!t 9 2t C1r C "_,F_►2 '6L.vD r n � THIS APPLICANT IS: ,_OWNER OCONTRACTOR PROPERTY NAME:_ M p, RIC, W IAZPJ1� K OWNER/ TENANT !� ' " ADDRESS: Q 4q te.e C�r.er B lv� CITY ig2-1P STATEWZIP 5!�_72/ PHONE: V3 7 �3 0— z 1 b -2-2-7-5-T16 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE O NEW V*ZPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK 5Y,t C( Le-ete--ba- L( 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 _FLOOR DRAINS SHOWER WATER PIPING _ _ BATHTUB —GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($3 _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. $1 _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER 61 S.' ''v-fi � � -. � K- � R � �d 1 i f � �i' ��i �, � 2 }i •i � �5 T �� -a. y y"V4a grc ..z � y � uu 3 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of allork which requires review and approval of plans. SIGNATURE OF APPLICANT L PRINT NAME f '`A)bC�— DATE RM MW avw$el low R 011 01 AMIM00 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977