The URL can be used to link to this page

PRE 2010 DOCSCITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $ .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ $10.00 $ GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ S Replacement of Furnace Repairs & Alterations -up to $500.00 7.00 7.00 $ $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 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 & Lines 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)" ®� The undersigned hereby makes application for a permit for the•work herein $12.00 $ specified agreeing to do all work in strict accordance with the City Codes x- 4.00 $ and rulings of the Department of. Buildings, and hereby declares that all the 7.00 $ facts and representations stated in this application are true and correct. 7.00 $ 4.00 $ idley, Minn. $13.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ $10.00 $� S GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• $ AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS ALTERATIONS 4 REPAIRS $ State Surcharge $ .50 TOTAL FEE $ ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED C0SX OLD f NEW M PERMIT NO, t6 - i I DESCRIPTION OF FURNACE/BURNER BEATING or POWER PLANTS, Steam,_Bot Water, Warm Air- %No. ,r Trade Nam Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load. 6® Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR B �19 f"enter Drive Company 5543 Suburban Air Conditioning Co. 8419 "4rrier DriveSigned By t Zn__17 'L� 14ir-,neap n is, ft°ir:nesoa 553 Tel. No. - L,ltnrp MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE City of Fridley susJEcr JIAQ PER 1403 ® AT THE TOP OF THE TWINS P E R r S BUILDING RECEIPT NO. r 1 L'______, COMMUNITY DEVELOPMENT DIV. 17 dG°�saiO,IrO� PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-560-3450 910-F15 4/28/77 JOB ADDRESS 6221 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAILADDRESS 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 MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK I�L Ek NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Garage fir® NG Construct a 22' x 24' »Y,� and a 3219" x 42' Dwelling{��• �, Before diditg CO 10011 ECTRIC - 9 CHANGE OF USE FROM - TO HEATING, PLUMBING AND SIGNS, REOULRfO By STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. SEWER LOCATION: (Approx. 11' Deep in Street- Rice Creek Drive) 65' South of Manhole (Inv. 909.90) WYE ELEV: 909.64 TOP OF FOOTING: 912.64 Minimum WATER LOCATION: 10.5' North of Sewer Service, 60.5' S.E. of Manhole DRIVEWAY DEPRESSION: N/A (Fridley Surmountable Curbing) THE Cal OF FRIDLEY DOES NOT GUAMMM THE 'ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS 111IS DATA IS FOR INFORMAT'ON PURPOSES ONLY AND MOM USM IT SHOULD vimFlr Tma wDRmAioX ON TNI SITF. 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 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1212 + 528 28,872 Tota ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $18.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $36,390 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- $375.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $115.49 PLAN CHECK FEE TOTALFEE bt 28.87 $537.56 SSIIGGNNAlTURREEOF�C NTRACTORr�OR�A/U�THO�RIZEDAGENT (DATEI WHEN PROP RL/Y VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) �1 Cilitl@s G Etc. .AW P ! f >'. ',Wn� rtgr': e✓ i /%-" _ ' LICA"`ION FOk RESIDEN'11AL, AL.'1'1;RA'I'lON, OR ADDITION BUILDING 1'lila`II'1' CITY OF FRIDLMl'', MINNESOTA OWNER'S 6i9 �+R '�a c� tl3 BUI DER: d�weld IbLuuews ADDRESS:— awn: ADDRESS : s3s s; eVtz4(.. A A n -t 1 1 1784`- 602 NO:.. Z ( STREET: LOT: BLOCK: ADDITION: Cd r. V3f44aS � I CORNED. LOT: INSIDE LOT: SETBACK: S5 SID]?YA_M): Applicant attach to this form Two Certificates of Survn of Lot and proposed building location drawn on these Certificates. ___ DESCRIPTION OF BUILDING To Be Used As: GA -n- Front. `�� Depth.l Height i Square Feet SZb Cubic reet �S280 - - c 0 Front:— _ Depth • k4�- Height • aQ ._ Square Feet;_ Cubic Feet: aJ, 6-ga Type of Construction: WWm F-Mwvg- Estimated Cost:___ To Be Completed: A SAP AJ# The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the CiLy of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts ant ] represcntritions stated in tliis appl tcatioxi are true and correct. SIGNATURE: C�- i (See Reverse Side For Additional Information.) r 41Al / 0 r CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT 9 o L In +� ro v e .-i H O p, 9 0 w OJ c w >, y� H 3 N qI +xi �., ,q O caw • ro b rn ro W 8 w A� m v ani o 14 1jg�y7 d 'J ro 3 p, ip c0 c� SC w 0 W I 1 N .$4 4 +� O Water Heater as lec $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU �_ x $5.00 $ .S•�G 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 \} New Ground Run Old Building lst $5.00 $ Electric Water Heater x' $5.00 $ GAS FITTING FEES: 1st 3 fixtures _L x '$3.00 $ _®® Additional Fixtures x $1.00 2nd Gas Range to 199,000 BTU x $10.00 $ 3rd 4th (R) = Future Connection Opening (*) = New Fixture, Old Opening Connected with�Sewe a" terr PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures 9 x $3.00 $ %o Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 a $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU �_ x $5.00 $ .S•�G 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x' $5.00 $ GAS FITTING FEES: 1st 3 fixtures _L x '$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 $ .50 TOTAL FEE $ S V REINSPECTION FEE ($10.00) 01 Job Address �z I 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 Fr ey, Mn. 2—P , 19 7 OWNER KIND OF BUILDING USED AS e TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company eXSC, Signed B -� *� Tel. No. L ROUGH INSP. Date i FINAL INSP. 6 - 24 - #2 7 Date APPROVAL FOR PERMIT J MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE k� Vim?'.^4t9 Ci17f t 4 iE,'SYRS 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 June 20, 1977 Pine Tree Builders, Inc. 2001 - 105th Avenue N.E. Blaine, Mn. 55434 Re: Final Inspection on 6221 Rice Creek Drive N.E. Dear Sirs: A final inspection was made on June 16, 1977 of 6221 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 September 18, 1977. 2. Block sliding glass doors or render them inoperable by June 22, 1977. 3. Install ball check in floor drains by June 22, 1977. 4. Repair leaking water meter by June 22, 1977 5. Patch gas meter hole in wall by June 22, 1977. We will expect the above items to be completed by the scheduled dates when reinspections will be conducted to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Si ncly, RON HOLDEN Building Inspector RH/mh CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE 0 A Jq l 0 Effective On August 1, 1995 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,. REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 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 Conditio'rring — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value f Appliance or Work Rate $ 30.00 $10.00 $10.00 $10.00 $ 25.00 Commerciik-ijlndustrial 1.25% of<l%e of Appliance or Work i gS f V State Surcharge TOTAL FEE 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. 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. BUILDING USED AS ESTIMATED COST ls�s( 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 HEATING COMPANY Aft aft IIN Signed By ,, TeI9 J LAVq mu�No. s a 4L . Approved By FILL OUT BACK SI REPLACEMENT Fl_ Rough—In Date RCK VERIFICATION OK CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) n {' 2. Is free i1im t or deterioration Yes ( ) No ( ) 3. Harm , ects lodged within Yes O No .� ) 4. Is s&,curry Yes O No ( ) ro 5. Mee" Code requirements for -size and , } ATL connected Yes ( ) No ( ) 6 Hai. total heating BTU's of A>f 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: HEATING CO: Signed By: Date: NO. 656 SUBJECT - IT City of Fridley 2 9 AT THE TOP OF THE TWINS U I L D I N G P E R M I T r � R O. `v --_--- COMMUNITY DEVELOPMENT DIV. SEC. r � � PROTECTIVE INSPECTION i1 i � L f,'� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 6/10/99 JOB ADDRESS 6221 Rice Creek Drive NE T LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ] 2 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHO Ron & Lynn Larson 586-0840 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO The Builders 486 Old Farm Rd Shoreview- 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 O NEW SDC ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 18' x 17' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan. AWING Before digging call for all utility locations 454.OW2 � tE rrS REQUIRED FOR REQUIRED BY LAW LING, HEATING, PLUMBING AND VMS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2876.40 $1.43 DOES NOT ESUME TO GIV UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI S F ANY OT R ST TE OR LOCAL LAW REGULATING CON- STRUCTI R THE PER ORM CE OF CONSTRUCTION 83.25 8 PLAN CHECK FEE TOTAL FEE SIGNATURE .RACTOR RAUT ORI2EDAGENi IDATEI License SC t5-004 I S92,55 WHEN PROPER ALIDATED THIS IS Y UR PERMIT BL -NSP riAtE SIGNATURE OF OWNER, IF OWNER BUILDERI (DATE- NO. 656 NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 lr p BUILDING PERMIT APPLICATION Co �2 i Construction Address: � 1 G � G t�� (�, 7 Legal Description: CCS N F -O R wn i"® 5-r R6 ierr- �o 04C 65 Owner Name & Address: JZON 'w 1..Y^/" z-ArAs ®N Tel. # '5 -VG —0'990 C'Co tractor: T'k"6-sy i i,06A S MN LICENSE # it 5 O Address: O L 0 FSP A 0 5 k45PZ J Ew m N 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 0 Width l ° Hgt/Ground (4 Sq. Ft. OTHER: �r��Cp V% Construction Type: Estimated Cost: $ J O® O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 60 /3 /—Z APPLICANT: Tel. # w� CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: STIPULATIONS: (e5 /—'Y 8) -®9G 2-- !T4 •r ,�� ; sgti � � ,.r.•t+.a \�•r¢f'j�+a+1'r. , _ .f ,y� ' a' : *ir 'w , � r• . . '. +'!e. `.L ,}•`• ..ir±•a �r;';�� M'•7 ''•' ,^t 1r .i.._ '•r (rtt^'.I.:� ,,:' ..•.,(��44�,lAl (t, ix^•as. •A 4tlr yJ �CERTIFICATIE�^OP-SUR VEY , '' ` !•'!' 4lip ti J` ' •F f71i' 1.'[F� ': �`!; t� J?�:1 1'�r2:4 1 Tnc .:, ir`;� r+ ., ,�d r '•; a •,A •' ••t. .. r.. •":`�'.i'*=• 4t• .may r ",a, y+ � l'b. 1 %,4` i 1 .: t � IJ 1 r .\ ' ,• . ,t�•1 • �'. /••xywrtt'S'f•' .. , + Ka•' = i + ` . , J ', .�' '} J�r.• e- e'y,•� r• 't •r rJ r{ ,,, .y. ,�, t'F fit,•/,ts 4 rT•' s.r, ri �. '1', ',,. ,+. •i ..�•• .. r' ':�:• � '.'. Nom: 4•' ! - t .11 - r .. t f .. ' .:. b ... .� : j.,l,/ 'tr4iq�H'6,i�'��?•,.r'r.•x.ti }^ + t .! ° ♦ISION'SAFET:Y'CQNTRQ.L:ONE"t " -4,-�.J f�' '• ,�i '.NOI''PLti°►NlJ OR .P1:AGE: ANY "h ,:. �:• , `,;:•.:gt..l."�.'f , t r ~� +7 ,;;.. -'THING IN THIS'XkeA•WITNOUT'AP� F-7777--. • , 1 n_ ., PRQV'/(I.`b' -4HE(�'CiTV. OFT FR-MLEj'� `A' . • r `�, riit 4 t r b rKlr •rr' t' f w' .* 9 r .�•YYOygoD 1 m '/i} COUP t r t r1 t.1 3 .r1% 4,4 rig irr '`; t 7 •t . a,a" '� •••,�.i/'"'i .�,:� .•�/, ., J r i t: w`t t'w •41t �; -t J:� ` _ , bt Rpi ,rl •w• ij. s ,' r 1 'tr'a•', tG tt-- ! J +.. ,• 'r�•, .!• y t'Na• t+r . ; . ' 111 ri ..OfQftTQ C t ttt;�S,lrw,r�„ d�:Igt'+ tr 1 ,l,r •/!'� , Q: y age '".4an�'S_'_-�! } fif}�•a7}h ;�yft�+ r�,"r V�t.l.- ; •. j //��'��',// .i '� r. �T•5'r •�+, �'t' •'i 1 t•?l j ytt,�S ; It �i i•.rJ1 �I t t rn ,4c } • q � ' ♦ .. � ; i.!• l� s "� . f. •. �L urj i« t ; t • •r t 4..1- i f '. 7 ,'., s Ir. ,, t+ •• j•M4ffi .M7 '(r q tl 7f ;b y , s Rd . ;1: :. f es, ! lily .. (j Q ir�.l ' ' (�ia1 ;�+ i• ; ?`" ji t a. �s r�- 7 `a+j;,t �tr,a�� ;(� a . •4~! r ' '. yt•~t .. � r . � 4' f' a •� � �J r • .� f r f ♦ fK,`' �.9 'k 4 �,R �r , ,�.' V•,w1 � ' �' •.'� �' M1. P•x � ,a :1y�•.,tJ,: ••1- qT{�•5ffon y'r r�,�rRrr .f .i ,q +.W t: ) ; '''p r ' .r ''•'fit•: r,• t H rR'Q'o�.i• t ' i,; + •jl ; •aw •9 Ilri ~' , •'4 ��5 � r :x Kt • �t r ,. Yr,V .tg,J,�+�t }.'t'' IP. , i{i �. � ,' ,t, �' • r t 'rr � !,� » : � `' fM .++:•5(f�'+L i+1/'1 h � � -rt •. t ..y. r.s^e, ' � .i r � . „- � �. �t • r S�� *� ..�` •� ; � rP w1 1'*i- .f ,4• t t r,ef`• ,:d"'err,' ' 1• .� r ,) , +: r4 1 ., •r- a •yr'r 1- s'. S v Q, i • t t ' "{,�'' y _ ,, t rf i r ... •�, t }• r .. 1 " �'• • • � y e d •41 'I, I Y,(d. : h •til.,• h � ,;•:r�: ��' �'� I :syr � 1 �. { p.:t rl; q t,j t r ;r �: 1 }' '' ..�'• . a•,r r' 1 f j�r ,, y F , q . ' a* t ` !i c Q j �t'. , t r !b. '•'tile' 1 j' J y ♦+\ f l 'r t , � J rl % i'a!rrt'lCv:,a 1•' ",r` ♦ 1 uj. t eft "�. r !r. t.. J i r .� r •� tom• ` :. e j�''HMV' +,.4 ` t •• •r ltt rM1 .tt6 t't� rt,t ,✓L q'I ,,, t` t _,r .'1' �.,;7 ,' IJ 1 .J"f 6 11; . �, 4'�•`a >:...tryG idtt t I a.LEPHONtrEfC�'RIC ;.. L t•q•�y+rt �t `tt13;1,r.t i,.r,.,. MI;•.4f�:•. t''7txJ.• .� r ,� Q�C_1lJ.e.�e-r'•.'`:r.�••..+?'syYW?`-�, . ,�T [PJl ' �` 4tta_ r y,l' •1 i. r � , . •' Y •' r Q • �eT10-�'e r i °tK'dt '�0,�°'�4:t.pOE$'.,NOT• -GUARANTEE'' THE ' • �y.l .�y+! 7 '�;,. IODATIONS • IWb :ELEVAiidk Trh:t yl�ORjWIi4ItON'�.:p1�IRPOS�S `ONL1'�AND ;SFlblfLb ; 1%ERiPY TME . INFOR1r1 l". s r s Daft N� l rtt y ♦ � pp s. / � 11. •t sig r r t t ;�.i,,�'b�Yjf;'� �;,•p,aa,J �'�* , , :,' •''1n�r':: �x t f�'t •• rt }:' � J r�•� t''r'?''••.:;,i+ l c' 1: 1t : ¢�. kty�t+xar, ��...+ "yam ly "y,'r •,r./.'S4a.�%ifA!}•.•~,t �t'1 jJ, tt t, l:%'l!i .Ll+l'� r. tll. ri lt� t -!! ,� , +t +fir ' t� t,`. t.' 1 .y :t;• 1 f . w!• Y.i� . .. .• a i esrt r tC��; . C3.!•,l`J � bw•: ?1 1 �N t1•'T rr ,tt•,- •. rta t ,,.t rub, t•A. [!t . a.,•t• •'�' *,fin '.s rlj b' fA i t l'r: Jt' J � t•r_ f•yr •::. "'' !.,.: �••r: •... y'• rl a , d t d:t `.•{ey:tAt.•. ;s_.J: ,i,i r.t._i, .'{ .t .. ' 1.��l�itt�l�`' �� Qiif�• f•rl D I':h„I:'li� r'C' ;•)!I 1. •It tt tlit;l• '' a itl'�:..}t1i1 ..•:rr [ : •: � ih• }it::l:ttl::. ,.r l4} tl'••FPllr...r tk.•r''•h• f. r.t:•:) rNi a �}M+pI.1��'�'/ �Iq,�.�NN a. i' '�• •I�A••�t�,_ ,fit: j... ,`I� ,t7'•� 1l1 r : liai (:1t iii.. .}p';'t,• ?!+Y4{Nj tt► t�'�T�P attrrlt 11„ ! �.'::rr;, 'r• �1 Wit tt.f•'•} ,ArcJwi 're cnwo'it.11:11�,, { t -�� '� ttf 4•�rT 15 ty"� V-1 Y i " 6y't"i! t •� r v, ''' `r •t` r��,�t•' 'T1 ••�it�•:21;~,�.e• ;•! .i :•ICY nT i 4 • .. ori.: r ° ;7' �:':.:,1 : r lw,S t•''••{e: J:.b '�'6r1 •� 7p,, hldttl .'7. tett II !t, tit t al. 11 4 • qfy�. •7♦C pi . .•Se'p'ia, , 1�1 i•i,.- ,. tc CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6221 RICE CREEK DR NE PIN : 133024440098 LEGAL DESC : RICE CREEK ESTATES 2ND : LOT 1 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERM 0.:2004-01075 DATE ISSUED: 07/12/2004 VALUATION : $ 200.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES # WATER TRMT APPLIANCES 0 APPLICANT H P PIPEWORKS 3670 DODD RD STE 100 EAGAN, MN 55123- (651) 365-1340 191"AW 104 q, LARSON RONALD W & LYNN M 6221 RICE CREEK DR NE FRIDLEY, MN 55432 PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENINGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 9176 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 re constru tion or the performance of construction. ADDlicant' Date r)�6�'flfs4 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.50 35.50 CITY Off` FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Stories 'Floor 1 Floor 2 Floor 3 Floor 4 Urinal -77 "1 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR �f Wash ?_ Floor : Shower �I: . Tray �'> Drain TS r Gk PLUMBING FIXTURE RATES: NO. 1i JOB ADDRESS 4 a ,�, I New Fixtures Old Opening, New Fixture $10.00 $10.00 The undersigned hereby makes application for a permit for the work herein Beer Dispenser $10.00 specified agreeing to do all work in strict accordance with the city codes Blow Off Basin $10.00 and rulings of the Building Division, and hereby declares that al the facts l :.atch Basin $�0 00 and representations stated in this application are true and correct. Rain Water Leader Sump/Receiving $10.00 DATE: �''� / TS r Gk PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 4 a ,�, I New Fixtures Old Opening, New Fixture $10.00 $10.00 The undersigned hereby makes application for a permit for the work herein Beer Dispenser $10.00 specified agreeing to do all work in strict accordance with the city codes Blow Off Basin $10.00 and rulings of the Building Division, and hereby declares that al the facts l :.atch Basin $�0 00 and representations stated in this application are true and correct. Rain Water Leader Sump/Receiving $10.00 DATE: �''� / Tank $10.00$35.00( , 20 ci Nater Treating Appliance , 'Dater Heater -Electric $35.00 OWNER ry Vater Heater - Gas.*�[_ las Range' $35 00 � BUILDING USED AStsa_ 'as Dryer** $10.00 $10.00ESTIM ATED ;ack Flow Preventer Required ( )Yes ( No t� COSTrc PERMIT NO:�� Type $15.00 PLUMBING COMPANY einspection Fee $50.00/Hr LL OTHERS AND/OR REPAIRS AND ALTERATIONS SIGNED BY TEL NOe11 b / 46 —1 5 1.25% of Value of Fixture or Appliance State Surcharge $ Approved By Rough -In Date Final Date TOTAL FEE $�5,5b MINIMUM FE FO ANY PLUMBINGIGAS PERMIT IS 15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE OMBUSTION AIR SHALL BE PROVIDED PER UMC SURCHARGE. SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VFNT win nti 0Ar•u oinr Building BUILDING Permit No.: � " -065cP Inspections RESIDENTIAL APPLICATION 763-572-3604 gpveAph:7M Nut Rec d: CITY OF FRIDLEY DATE_ ®� �� W5A lel YOUR E-MAIL ADDRESS .a SITE ADDRESS \ THIS APPLICANT IS: ❑ OWNER NTRACTOR PROPERTY OWNER/ NAME: �Y1 TENANT ADDRESS: CITY STATE_ZIP 11 PHONE: NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE 4 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t STATE ZIP WITH APPLICATION PHONE ❑ SINGLE FAMILY/NEI License #20130983 PROPERTY TYPE ❑ TWO FAMILY/NEW G 651-264-4777 ❑ ADDITION ❑ GARAGE/SHED INDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION NANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE. `0101 ® t SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structure ❑ Other ❑ Fascia and proposed project WINDOWS IN EXISTING OPENINGS es ❑No LOCATION OF WINDOW� 2. 3. Two sets of construction plans Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF Ameac y '_ OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S 7 999 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 6,19 .001 times the total job valuation Surcharge $ 1.59 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5, Ob $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( } Total Due $ Make checks payable to: City of Fridley Attach Stinulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will ben conformance with the ordinances d codes of ity of Fridley and with the Minnesota Construction Codes; that I understand this is not o permit but only an application fohpermit and o is not to start without a permit; that the work will be in accordance with the approve( plan in the case of all work whic ufes rev' d aDDroval of Dtanw—, SIGNATURE OF APPLICANT