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PRE 2010 DOCS- s City of Fridloy Application for PlurAlns end G= Filling POit Dept. of Bldv. Phon• 500.34,50 DESCRIPTION OF WOnI► t1' ; � � 0 - / C- on. HumSar, Kind tad Lacr!Lo�cati !ea o! Fixtures t C = r Z $ JA1011' 5 7 u 7< z 7 W r N WATE4 MTIL GAS ncc Bast I st 2nd 3rd 4th - _ Futuro Conaoclien OponiNS Coazattad vita $etw+dr e How Fixture. Old Opsnings Cta:.pool C 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 Dere,-•hent o1 Buildings, and hereby declares that all the fad and representations stated in this application are true and correct' Fridley, titian l 19! Owner � Kind of Building Used as To be completed about - PARTIAL RATE SCHEDULE Estimates cyst, $� Old --New. Building permit No. P.rmtt //__ PLUMBING FIXTURE RATES: NO. RATE TOTAL • �D x 82.00 $ Sid Number Fixtures ............... . Future Fixture Opening .......... x $1.50 $ _. New Fixture Old Opening ........ • . x$81.50 $ C.)!. h Basin ............... e e ... x 83.25 $ !uai:r .Tzater 'L'p to 99.000 BMe . e e ` x $3.G0 $ �. C) C) , • Fiouvx 1',•., Ground Fun 714 Pleg........ e x 8a.25 3 Elvc!rk Wnlar Fs3' ar. . . . ........... s $2.G0 $ FINAL :T TING FF.£8: No. RATE TOTAL Ist 3 Fixtures • • . • • / x $2.00 $ y Additicnal Fixtures ........ ► x $ .75 3 Gas Range to 199.040 BTU ........... x $5.00 L REPAIRS is ALTERATIONS—Refer to Cods .50 State Surcharge Description ... . ................................... TOTAL FEE $ `2 5 • �� Business Phone --s C— --- City of Fridley SUBJECT ®13'7'72 AT THE TOP OF THE TWINS BUILDING PERM r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-660-3450 910-F15 I I 9/22/76 JOB ADDRESS 6220 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 Rice Creek Iii Estates 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pine Tree Builders, Inc. 8535 Central Avenue N.E., Mpls 784-6013 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ClX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 14 IN Construct a 26' x 40' Dwelling and a 26' x 24' Garage r SEPERATE PERMITS REQUIRED FOltA" Before ' TELEPHONE- ELECTRIC -US Eta 9 CHANGEOFNEFAMNM PLUMBINGAND SIGNS. TO REWRED BV L� G H STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Set house back 36 feet to allow for cantilever on front. Brace rafters with 2" x 4" 32 inches on center from purlin to bearing wall. SBWER LOCATION:(Approx. 11' Deep) 157' North of Sanitary manhole North Inv. 908.76 WYE ELEV: 909.39 TOP OF FOOTING: 912.89 Minimum �bpI1{�T�0 WATER LOCATION: 10' north of sewer service LMPVVR�11 NOTIFY THE FRIDLEY ENGR. THE CITY OF FMDLEY DOES NOT GUARAN'I'£E ., qHE ACCURACY OF UTILITY LOCATIONS AND ELEVATIGi ". DIVISION REGARDING CURD LZ DATA IS FOR INFORMAWN FUI:PCSt:S ONLY AN., REMOVAL AND REPLACEMENT FQWNS USM R SHOUW VERO THE AT DRIVEWAY OPENINGS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 1100 + 564 27,160 Total 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 1 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. $35,065 SU $17.53 WITH WHETHER SPECIFIED HEREIN OR NOT.ITHE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. - STR C_ ON OR THE PERFORMANCE OF CONSTRUCTION. $108.64 G /�:,® $350.00 y PLAN CHECK FEE TOTAL FEE $503.33 ,SIGNA RE OF CONTRACTOR OR AUTHORIZED 'AGE NT (DATE) WHEN PROPERLA VALIDATED THIS IS YOUR PERMIT n SIGNATUREOFOWN IIFOWNER BUILD ERI j (DATE) BLDG INSP DATE 46 o70;-4 !let ---------- R -i-} I " � y I oot LI I�I II I iiij � y , i , 3i3 e i 1 i ' I. 1-- I + APPLICATION I OR R TL1LN]'IAL` ALTERATION, OR ADDITION aliU;ILDING PIiRhII']' CITY OF FRIDLEY, MINNESOTA X t r, OWNER'S NAME:_ � Vem V0'WU�s �pL BUILDER: C � ADDRESS : %-% IV eek-rP_A . AV* Nom. ADDRESS: 1P �I it SS_4_31 NO:. b ZZ. 0 STREET : toe CVUWIC Q CLi plc& LOT: CG BLOCK : ADDITION: Q exo ¢- CORNER LOT: INSIDE LOT: SETBACK: a S;� SIDL`YARD: IQ YKLW Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As UtgL_Sa. Front: �_61 Depth: kLo! Height: Square Feet: 109 lm Cubic Feet: t b' (I A'OL ima Front: _Jto t Depth: 9,-q- '—Height: 17—( Square Feet; ^611 Cubic. Feet: Type of Construction: VP 4 �-'4Wltg Estimated Cost:i .4S, 000, To Be Completed: A �,► 44 16,65c61e The undersigned hereby makes application for a permit for the work Herein specified, agre.cing to do all work in st:r-ict accordajjcj� J'1Ith tlic Ci.Ly of Fridley Ordinances and rulings of the Department of Btiildiogs, and Itcroby declares that all the facts and representations stated in this application are true and correct. /1-1\ �7 a DATE: (� SIGNATURE: (See Reverse Side For Additional Information.)�Fi� j a 15 Z44 -4e_ CERTIFICATE OF SURVEY FOR: Pine Tree Buiiders, Inc. N Denotes iron monument #-1MpOR_ RT W-" CA low .Q*m r�uu EQUO ° Cift ED LAW AT D�VEN►w t , 191F1TI Description: Lot 6, Block 1, RICE CREEK ESTATES 2ND ADDITION, Anoka County, Minn. INCRYr r 1r oohs M GUAR T TIS DATA is wommi ! n CMY MW 61)4�. t7 �u Room44 we � Q sNoue ver In y � ,� z°�®LLi1i/Z eT®Ld®Zt®' I hereby certify that this is a true and correct representation of a survey of ��Jci; Na Y the boundaries of the above described land and of the location of all buildings, Z-54 sLZO°Veyor.4 if any, thereon, and all visible encroachments, f any, from or on said land. Book Page Land Rurveying ® Site Planning As surveyed by me this ��1—_ day of ��. , 19 -75. Civil Engineering 8116 70th Av. N. (1 94 at Boone Av. N.)JScale Brooklyn Park, MN 55428 Phone: 533-7340 Minn. Reg. No. 10wA _ _ `�0 /5,7,/ 0,0E �4:F- i..", - 9� 9 ,meq T � D F 9-1 6 - %X02 - 76) e - A/) 'Alaen, 42-r J�ajve lirexIcs, 41 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Job Addresses s(reS l4�C_Q. Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 3 /4 OWNER KIND OF BUILDING�-�� USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST Z'2 m m PLUMBING FIXTURE RATES: NO. o RATE x o Number Fixtures 9 Water UJ N N AJ x $2.00 N.0 14 N 0 $2.00 4J S4 Cl rs4 � $5.00 Heater a� i aJ Sd N r rdf. H N Tel. No. E 11 rt N 1 k N P m 4# rd 0 N CL a $7.00 $ N New Ground Run Old Building x $5.00 p 0 0 . •m xm Q N •�r4 :3 O O B M P �m m m m O o C M a`i in 3 A w W w U M 3 0 c`� as lec rn r -2 1st / 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water Job Addresses s(reS l4�C_Q. Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 3 /4 OWNER KIND OF BUILDING�-�� USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTIMATED COST Z'2 PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO. Number Fixtures 9 x $3.00 $J.(�o 1 / Future Fixture Opening x $2.00 $ Company�'"� New Fixture, Old Opening x $2.00 $ Signed By Catch Basin x $5.00 $ z f7 d Water Heater - to 99,000 BTU x $5.00 $ QU Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ ROUGH INSP. Date Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures 1 x $3,00 $ 3.00 Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ r.50r� TOTAL FEE $ �1 .0 REINSPECTION FEE ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT / MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STEAM OR HOT WATER SYSTEM: Boiler & Lames up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING FAN HEATING SYSTEMS _ See Fee Schedule VENTILA'rING SYSTEMS t� ALTERATIONS $ REPAIRS l ROUGH INSP Date FINAL INSP. --f--.Z 7 - Date Date APPROVAL FOR PERMIT 0, $12.00 $�� ' 4.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ $10.00 $�� S x $ 3.00 $ x $ 1.00 $ x $10.00 $ State Surcharge TOTAL FEE Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER KIND OF USED AS TO BE COMPLETED ABOUT ESTIMATED C OLD - EW BUILDING IT NO. PERMIT NO.. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No.O�- Capacity /rSq. Ft. EDR BTU HP Total Connected Load �,> Kind of Fuel BUTtNER - Trade Name Size No. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP ($10.00) Company Signed By Suburban Air Condi'tianinS 8419 rMinnesota Drive Tel. No. _ o a MinneaP°iis, 55432 7 MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 V CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE �• GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: lst 3 Fixtures x $'3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ AIR CONDITIONING $ D FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS & REPAIRS $ State Surcharge $ .50 TOTAL FEE $ ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT ° MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE Job Address Department of Buildings City of Fridley Tel. #571-3450 .The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes '. and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 1017 _ _,'Fridley, Minn , 1910L�r OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT N0. -, DESCRIPTION OF FURNACE/BURNER BEATING or POWER PLANTS, Steam,.Hot Water, Warm Aii- No. Trade Name Capacity Total Connected Load BURNER - Trade Namef Capacity Size No. Sq. Ft. EDR BTU _HP Kind of Fuel Size Iu urban Air -Conditioning Co. Sq. Ft. EDR BTU S41q ran$eTv® Minnevo , innesota 55432 Company % Signed By Tel. No. March 14, 1977 CITY OF FRIDLEY 6431 UNIVERSITY. AVENUE ' N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 Pine Tree Builders, Inc. 8535 Central Avenue N.E. Minneapolis, Mn. 55434 Re: Final Inspection at 6220 Rice Creek Drive N.E. Dear Sirs: A final inspection was made on March 11, 1977 of 6220 Rice Creek Drive N.E. and.the following items were noted which must be completed before the structure can be finaled out; 1. Provide sod in the front and side yards by June 7, 1977. 2. Provide retaining walls in rear yard by June 7, 1977. We will expect the above items to be,completed by June 7, 1977 when a reinspection will be made to determine compliance. If you have any questions on the items, please feel free to contact me at -571-3450. Since y RON HOLDEN Building Inspector RE/mh ,0%-UTlph e�C, C1 m 4y8.�g16 SUBJECT E R M I T NO. City of Fridley _ 25038 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir • COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC. �Gi NUMBER REV GATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910-F15 5/7/97 JOB ADDRESS 6220 Rice CReek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 Rice Creek Estates 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis Christensen 6220 Rice Creek Dr NE 574-1534 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Western Remodelers 2520 W Larpenteur, St Paul, MN 55113 645-1411 CITY 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 JJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install vinyl siding and trim 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer's specifications state it is not required. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 $8,000 $4.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE LIME T GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION O ANY HER STAT"R LOCAL LAW REGULATING CON- $137.25 Fire SC $8.00 S RUCTION THE P FOR N F CONSTRUCTION PLAN CHECK FEE T AL FEE 149.25 SIGNATUREO ONTRACTORORAU ORIZEDAGENT (DATE) N Q% Y VALI AT THIS IS YOUR PERMIT J BLC.'!+tlSP CCC DATE _ SiGNATUREOF OWNER)IF OWNERBUILDER) (DATE) NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER DI SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� BUILDING PERMIT APPLICATION ConstructionAddress: 2 Z D R 1 C C' UK 0 P Legal Description: Owner Name & Address: D E-vNi S C /) �, I r.- S F.v Tel. # Contractor: '✓& s -74'y Rc"O e/r /c9s MN LICENSE # Address: 25-20 U,/, L P P -f 67,E E7L"p- S�- PPuL ems-- -/) �S Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: 'V 1N y si o iron° i Ab -ma TR, M Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 t = Ft x $ _ $ DATE: 7 '7 APPLICANT: Tel. #� CITY USE ONLY Permit Fee $1, j Fee Schedule on Reverse Side Fire Surcharge $ 8-00 .001 of Permit Valuation (1/10th%) State Surcharge $___5, 6 $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Pian Review Park Fee $ Fee Determined by Engineering Sewer. Main Charge $ Agreement Necessary [ j Not Necessary [ j TOTAL STIPULATIONS: CITY OF FRIDLEY PERMIT NO.: 2004-02282 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/14/2004 572-36U4 VAX: (763) 571-1"Ltf"l ADDRESS : 6220 RICE CREEK DR NE PIN : 133024440091 LEGAL DESC : RICE CREEK ESTATES 2ND : LOT 6 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 1 APPLICANT KOVAR ELECTRIC LLC 23049 ARROWHEAD ST NW ST FRANCIS, MN 55070 (763) 753-5731 OWNER CHRISTENSEN DENNIS L & S R 6220 RICE CREEK DR NE FRIDLEY, MN 55432 STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (RESI) 20.00 TOTAL 20.50 PAID WITH CHECK # 7112 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 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6220 RICE CREEK DR NE PIN : 133024440091 LEGAL DESC : RICE CREEK ESTATES 2ND GAS DRYER FEE : LOT 6 BLOCK I PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION 60.50 NOTE: PH:763-754-4000 CONTACT PERSON KRISTA # A/C UNITS 1 # FURNACES I # GAS RANGES 0 APPLICANT RICCAR CORP 2387 STATION PARKWAY ANDOVER, MN 55304 OWNER CHRISTENSEN DENNIS L & S R 6220 RICE CREEK DR 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 const�ction or the performance of consjction. . _ � Date J - AN /T1sm PERMIT NO.: 2004-02292 DATE ISSUED: 12/17/2004 IR(;*5 VALUE OF APPL OR WORK 0 # GAS DRYERS 0 VALUE (FOR MINIMUM CALC) 4000 HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 PAID WITH CHECK # 49923 FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 Un ivers ity Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE #residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION m n REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES m N J013 ADDRESS Fee Total Owne'�\ `�. �w ®6 ago $35.00 $ Building Used As $10.00 $ ESTi MATED COST�� 00 PERMIT NO $10.00 $ $10.00 $ ®® $ 25.00 $ O_ All Other Repairs or Alterations (List on Back) i% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater on work less than $500.00 Go mrnercial/I n d ystria I/I n stitutiona 1.25% of -Value of Appliance or Work (Liston Back) Minimum -.Fee $35.00 for ComrnerelaVindustriaVInstitutiona! State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR DESCRIPTION OF FURNACE AND BURNER # of Heating Units Circle fine (Steam) {Hot Water) (Warm Air) mn Trade Name Size No, BTU HP EDR Fuel Total Connected Load m -< 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 $ and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct, $ •SO HEATING _ Sig C9`. Tel FAX �- (�� -c�- Bate_.®c �\®\� *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 -o m Approved by Rough -in Date Final Date ti m FiLL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUS'nON AIR VERIFICATION When mp_lacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, is and securely supported and firestopped where required. Ye No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Y No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA -LAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances, Y No( ) The existina. combustion air is sized and installed to meet the current codes and manufacturer's specifications, Y ( No( ) When required to install a new combustion air, it will be sized and installed to meet the current odes and manufacturer's specifications, Ye ( No( ) When install! a new ventinq system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Y s 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. Ye No( ) 6epilance T e and Size/Common Vent and Vent Connector Information Appliance #1 Type h )lr re BTU input � an Assisted or Nat Appliance #2 Tyles BTU Input __ Fan ss ed or Appliance #3 Type Nat BTU Input Fan Assisted or Total Appliances _ Total Btu Input Nat _ Common Vent Type Vent Height -:2 — Diameter inches Appliance #1 Vent Connector Height ft Length if Diameter in Type Appliance #2 Vent Connector Height ft Length Diameter in Type _ft _i Appliance #3 Vent Connector Height �ft Length ft Diameter �in Type ALTERATIONS: Describe HEATING CO: Signed By: Date : la/o 90/£0'd A37M=l d0 AM BS:CT ti00z-0Z-03a