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PRE 2010 DOCSCity of Fridley SUBJECT P O. ® 13231 AT THE TOP OF THE TWINS PERMIT r BUILDING CEIPT N0. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . � NUMBER REV. DATE PAGE OF APP O D BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 9/29/75 JOB ADDRESS 6240 Rice Creek Drive NE. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pine Tree Builders 8535 Central Avenue, Blaine 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 ❑ X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 . DESCRIBE WORK Construct a 32'6" x 3916" Dwelling and a 20' x.24' Garage 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a.verifying survey before capping. Provide sod in the front and side yards. See agreement on rear lot grading. Utility As-Builts are not availabel at this time. For specific locations contact Comstock & Davis, Inc. at 784-9346 SEPERATE PERMITS REQUIRED FOR WIRING,, ®�`�\gxzs'o HEATING, PLUMBING AND SIGNS Q► VP-' ���\o�a SPS ge��QNp�� 'V SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST., OCCUPANCY 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 22,356 +4860 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 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. $35, O5O 17.53 WI HETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT D ES OT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR VISI NS OF ANY OT ST E OR LOCAL LAW REGULATING CON- $50.35 $325.00 STRO R THE P FOR A C OF CONSTRU c' PLAN CHECK FEE TOTALFEE $392.88 SIGNATURE OF CONTRACTOR OR AUTHOR) A ENT (DATEI EN PROPERLYV ID ED THIS IS YOU;P MIT J �J �_j BLDG INSP a DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) r APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER:' MNV– TRa a- �3UL 14 NO:. 1400ST?ZEET:Cox d / DR, uv%¢ CORNER LOT: INSIDE LOT: SETBACK:- SIDEYARD: Applicant attach to this form Two Certificates ofSurvey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: V Front: -'i Depth: j' Height: Square Feet: —Cubic Cubic Feet: 74 & - -1 r Front: Depth: -2— V Height: r� Square Feet;Cubic Feet: Type of Gonstruction: +jtx"L_Estimated Cost: $ r To Be Completed: x –Z� U'00��� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kict 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 aZe true and correct. DATE • �' / SIGNATURE: (See Reverse Side For Additional Information.) See" Awits-r Uca'r° 6w Q`c Luv- do- La W •-roc • , Pi ®S3 " w P� ,,,-.�.^?� m.t.'�.•w,� `e•' ey ie?''.,,e � 1. t m ; �,. .:� �;1?..-. �"' .,c� �n,-.?° .may a,`. ..rU'�.. «� �'-E°-�....-....«-��.�,,.� y� r+�..a_ L+_•.. L-.� K `t..�. ...-9 L i..++1..1 4:...w mLw�..:a ..w•y.i '.i"Oiv:.� �a ci wi._. ��.w.e�w'1� ,b.i:.-�.... 6y _.i v.:�ua"�� C�.v...� '4m,., _. -�; �,rM�.s�:•r.o fry r mrvo �,ti� .6 i� t� aY° u 3tS L c d+ til 6u?sd to s vE.Z FAs�.� AL RATE SCH IMEDULE lit. a B'uv. na'vzo ---1 01"VITY WAte$ Ara: :�:''?2 T0 rurnrce Shell ac Duct Work ... ..... .. Replacement cf F1:rnace 6.00 Repairs & Alterations -up to W0.00 6.00 Repairs & Alterations each add. 5500.00 3 ou $ 1=cm V'&` M AM Purnace Shell & Duct Work to 120,000 BTU ea -r -'i add. 60,0GO BTU . ......... r rp!acennent of F urn: ce Sr Altersaons--up to $S00.00 z1_;:zi7s & Altera ior_,s each add. $500.0 6.00 _ 6.00 $ 3.00 $ STEAM or HOT VIA-IM11 C=T 11 Furnace Shell & Lines --to 400 sq. ft. F.DR Steam $10.00 $ Furnace Shell tin Line --to 640 sq. ft. EBR Not Water 10.00 $, Each add 200 sq. ft. EPR Steam 3.&1 $ Each add. 320 sq. ft. EDR Hot Water 3.00 OIL 8U1114= -to 3 gal. per hcur 6.00 over 3 gal. per hour -See Free Schedule GAS ]girl= (up to MS.= BTU) 6.03 $ mover ?`'x.000 BIM See rera t,'ch�dula GAS FITTING :.:Z: 1'.O RATE TOTAL Is% 3 F%xtsres xa 200 $-a ---- Additional FI:tures x --- Gas Range to 10.= x3 &GO, $ _ AIR co�M;17190==G State Surcharge .50 S �f SIM Foo zCt ToTAL 111419-1 err �PERM City o? Mddlcyy: The undersigned hereby makes application !ora permit for the work hereii. specified. agreeing to do all work in strict accordance with the City Oz.dLua=. of and ruling of the Department of Buildit:ys, and hereby declares that an the fuU and representatiuns stated in this application are true and correct. /� F1 id1yP-As an / (/,) �F a :7 Owner Kind of Building Used as To be completed about Estitnated Cast, $ Old N�wuilding Permit No: _ r_ Pa mit No. D :41.U-1'=11:1 or X O RMUING or PODVR PLANT.3-.Stern, Hot Water, Warm Air -No Trade Name Sizx idol✓� Capacity-.-,._._._ .— Sq. n E.D.R Total Connected Lo*A2 117 6 Wnd of rutt. TBURI3M - Trude Name Sires Pdo Capacity SO, YL EJ3 R T3'i'1 T 1 SUBURBAN AIR COd9DIT1Q�{ Sig�r� 8419 rr"n ARi1JNEAFDy OLIS M 32 `�„ MA 01 SUBJECT so City of Fridley ? 4 2 5 6 AT THE TOP OF THE TWINS BUILDING PERMIT( NO. 'r ` ' • L _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC 9_ 9 toot NUMBER REV DATE PAGE OF APPROVED BY ' �'--': CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/10/96 JOB ADDRESS 6240 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. /{ 1 Rice Creek Estates 2nd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paula Baron 6240 Rice Creek Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Right Way Roofing Inc 16475 45 Ave N, Plymouth MN 55446 557-8678 3999 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 X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 $1 650 $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $1.65 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEETAL FEE Licens C A00 /7'$61.48 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PR 1 GIN LY VALI jell ED THIS IS Y UR PERM '9� 7 qAT _ SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI- MA 01 NEW [ ] ADDN I l CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �r'c1 ro' -'P® Building Permit Application ConstructionAddress: (OD 9 (� (?-�M c w'�- � r' Legal Description: Owner Name Contractor: Address: MN LICENSE # ! in Attach to this application, a Certificaafe of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Effective 3/1/96 N 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: Cr"Caf Estimated Cost: $� Approx. Completion Date: �Si (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: (0—[G— APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Tel. # $ Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $900 per SAC Unit $ 00 $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 Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Rate $ 30.00 $ 10.00 Gas Range $10.00 $ Gas Dryer $ 10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK I% of Value of Appliance or Work $ Commercial/Industrial Effective On January 1, 1997 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. C � � •. ,1997 1.25% of Value of Appliance or Work $ State Surcharge .50 TOTAL FEE $ MINIMUM FEE FOR ANY HEATING/COOLING/NENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr OWNER BUILDING USED AS ESTIMATED COST r� PERMIT N0. 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 Signed By Approved By Tel No. `3®5t> Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FQq STACK VERIFICATION ON written permission from adjoining, property owner. REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the -existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes {) No { ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SuB.iEtT PERMIT NO. City of Fridley 29119 A7 THE TOP OF THE TWINS I I D I N %�` BUILDING P E p A A I T r � v L �,J 1" r 1 RECEIPT NO. `v ------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. C//I 1 � NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 ' L 612-571-3450 910415 3/31/99 JOB ADDRESS ' 6240 Rice Creek Drive NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 1 Rice Creek Estates 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paula Baron 6240 Rice Creek Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Rusco Inc 9935-9669 2173 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 4 ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE O 8 DESCRIBE WORK Replace bay windows 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1994 Uniform Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. hrmit Inspection Card- NIIII Be Mailed Ou ((�� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIR L AL 9[ HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. 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 $3.49 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,997 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHA PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. ire01 ;V$7. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $124.75 PLAN CHECK FEE TOTAL E License C5.00 0.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE. yy pq BLOG. S ERL�QTS IS RPZRM HATE S-GNATURE OF OWNER,,F OWNER BUILDER, iDATE, - SEP -19-1996 11:2.3 CITY OF FRIDLEY lvtw 612 571 1257 P.01/02 i ! ADDN [ J CITY OF FRI.DLEY Effective 3/1/96 ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Z ConstructionAddress: �7_® Legal Description: Owner Name & Address: ,%CLI,//Ct .6Qno- s �; s Tel. # 71- rd 32 Contractor: e div / MN LICENSE # , Address: �'9©/ d5h-i e �a�,a tiD/ i �� � o �, ln0 �� �/3 Tel. # �!� 9 - 9�� 0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP' ON OF IlVIPROVEMENT LIVING AREA: Length Width � Height _ Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Conner Lot [ ] Inside Lot [ ] Ft. Xd. Setback , Side Yard Setbacks Type of Construction: /geeme t lt�f'�a�Oecl� Estimated Cost: $ 179 7 Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tei. #�( ?ermit Fee ?ire Surcharge State Surcharge ;AC Charge .icense Surcharge )riveway Escrow zosion Control CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit 'Valuation (1/10th%) $.50/$19000 Valuation $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Ah. "B" Above $450.00 Conservation Plan Review 'ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement Necessary [ J Not Necessary [ ) TOTAL TEAT ONS:` � 01 SUBJECT P City of Fridley 3079 AT THE TOP OF THE TWINS BUILDING �A I PER I � 1 ! 1 RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 �1- fl Ilum NUMBER REV •DATE PAGE OF APPR VED BY J CITY HALL FRIDLEY 55432 L j\ 763-571-3450 910415 9 / 12 / 02 / / JOB ADDRESS 6240 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ] 1 Rice Creek Estates 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paula Baron 6240 Rice Creek Drive NE 763-571-8632 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO American Eagle Exteriors 19512 Country Cir E, Rogers, MN 55374 763-420-3107 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20159912 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK a ❑ NEW X ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 20' x 12' Deck; Reside & soffit & fascia; an 8' x 11' storage addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARN100' 42 SEPARATE PERMITS efore digging call for REQUIRED FOR:' all utility locations WIRINGHEATING 454.0002 PLUMBING" AND slGs El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ire SC $24.90 U TION 0 H RMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Licens C $50/$ .60 SIGNATURE OF CON• RAUT AGENT IDA, HEN PROP ALIDATE.DFHIS IS YOUR PERMIT S-GNATURE OF OWNER,IF OWNER BUILDER, IDATEI BLUt INSP rIA�E 01 NEW [) CITY OF FRIDLEY Effective 1/1/2002 ADDN (J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 612g6 Los eZ�-k dig - Legal Description: Owner Name & Address: Contractor. Tel. # 5-71 —R(-3 Z MN LICENSE # /b/ X99 / 2 Address: /c'i,,3-/,2 4' Rog6e '; Tel. # A, 3 ` O 310 7 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 1 Hgt/Ground 1 Sq. Ft OTHER: 51 � o NJIL S e� �4-. 1,4 J 5 7-e I Awl - 10 Aj DM k &I COZ4 '?qo- Construction Type: Estimated Cost: $ 3 Driveway Curb Cut Width Needed: t = Ft x $ _ $ DATE: 9 `9 C4 Z APPLICANT. Tel. # %b 3 Ll 2-6 "Id Q7 - Call ' -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 $ 39/, a 5- s, $ • `i® $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.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 [ ] TOTAL $ 33E too STIPULATIONS: 431 University Ave NE .ridley, MN 55432 763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO RF INSTAI I Fn nm FAr-N 1=1 nnR v Unnal Shower .... = Tray Drain. ---- ----- .: -- --- .Washd Auto WasherRan Gas water Heater a Gas EIec 9 ire"��., Stories Basement ' <. r Flo4 1 Floor 2 >'> Floor 3 Floor 4 :- :<:::: 'LUMBING FIXTURE RATES: NO. RATE TOTAL dew Fixtures )Id Opening, New Fixture leer Dispenser Now Off Basin match Basin lain Water Leader lump/Receiving Tank Nater Treating Appliance Nater Heater -Electric Nater Heater - Gas** 3,as Range** Sas Dryer** 3ack Flow Preventer Required ( )Yes () No $10.04 $10.00 $10.00 $10.00 $10.00. $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 Type $15.00 reinspection Fee $50.00/Hr 4LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE $ JOB ADDRESS 52AW 1131e7 ©&VIAW 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. DATF* 2§ OWNER BUILDING USED AS_ BARON,PAULA 6240 RICE CREEK DRIVE NE FRIDLEY, MN 55432 (763)571-8632 -!4-2'tC66e, — GV ESTIMATED COST L4 N PERMIT NO. NORBLOM PLUMBING CO. PLUMBING COMPANY_ 19) B27AO33 2905 GARFIELD AVE. SO. SIGNED BY -TPt_ Na Approved By _ Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 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 O 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 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. k; 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 Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input _ BTU Input Taal Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 ALTERATIONS: (Describe) HEATING CO: A� Signed By: Date Froin: City of Fridley To: 6546467388 Pace: 215 Date: 3126/MD9 10.,43:19 AM Building MECHANICAL Permit 1,46.l� Inspections RESIDENTIAL APPLICATIONuK 763-572-3604 ' CITY OF I+RI�I.,tEY Daze �� 763-502-4977 FAX EFF'ECTIVI 2-]99 -0 ,,nn DATE V YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: 13OWNER CONTRACTOR PROPERTY NAME ADDRESS-,!9CITY STATE ZIP TENANT TENANT��Z�_ PHONE:�Q a..� CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON' YOUR STATE STATE LICENSES EX? DATE LICENSE WITH ✓t C, ADDRESS: (9no (rI' 0 bQ �I A Ale—— APPLICATION PHONE FAX PERMIT TYPE1NCYLE FAMILY C] TWO FAMILY 0 TOWNHOUSE TYPE OR WORK. 11 NEW eXREPLAL AIENT Q ALThRATIONIXEMODEL DETrAILED DESCRIPTION OF WORK E FM ARE BASED ON 31OM PER FIXTURE EXCEPT WH)&RE -NOTED. FIXTURES_ l�F01CAT1' TOT A �1BEK OF EAdlt BE �Y Equipment Imblied MFG: Qi�� MODEL: SILE(STU ,�/� MFG: MODEL smL %Tu (�/V MIYy: MODEL: SIZEMTU A/C $25.00 _FIREPLACE (GAS}$15.00 _GAS RANGEOVL74 $10A0 AIR TO AIR EXCHANGEER $ r5 FIREPLACE (W00'IDI$35.00 Ni~W GAS GRILL $ I0.G0 -GAS HOILER $35.00 j[ I<'URNACE $35.00 UNIT HTR$I0A0 CHIMNEY LINER $10.00 _GAS DRYF']t $10.00 HEATER $35.00 _POOL _DUCT WORK $10.00 GAS PIPING $10.00 vENTiLATOR $IS o0 :.r;S:::?�:•-i%;ff:-�`ri.ci?;Lim,;`;: ii33:::�=:-`i a�2:`•_};::'r+.xi;'-}::_>:_?F:z:};:;_}z•}�? - _ - - }==�;=:'T::zas;::i:: ::::{;;}_::s:;:a;::?2 . ............},.......,..?x _.......... ... i. .. .. ,.......... _............. _..-.._.. •<•:r: r.-?;...... _.._ ,._.:_ :rfrt,._.:;:c :.:✓.::r._>•ux:.-?«:;: �rz :i'F{:.:£<r:;:;r{.:;..f .:{:_ •_-.. r.«. r.. r...:... ..A.. - ,. _. - ✓ -✓r �' ..:::::-:vii:.. :...:.. _.. t_.. _.::v:v_s:::s..f..svvrasu. 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THIS 1S AN APPLICATION FOR A PERMIT -NOT V'ALI'D UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes ofthe City of Fridley and with the Minnesota Construction Cocks; that I understand this is not a permit but only an app tion or cxmit and work. is not to start without a permit; that the work will be in accordance with tho 'alt approved plan in the casco workWA wulicsplYroval of '�0 „ - e SIGNATURE OF APPLICANT t2° NT I DATE �� =3i�is$-. _ -- ..` .:=p'.F o- : s.=s: -#.�• :. c -•:�y ? � }: •- '- -r - .' ... .. ..:•�. .:may. .. ......✓: ; ._ .. _ : :?]�...y�.i ....... .. ..:.y�.•{l.,p���;#+�...,:. �p:.g���e: :J?>:;•s�.''.�:•is�,.:�xf£i-'.�'.'.':1`�X3F�:=iF'' .'_ }: .�' '...�'.'�_:: '� .c=Ott'”'iC'G?�.:.'�=t««''-`':�.�x�-.-:•'itit'FtiFre�i`:�!�����Y'�:�.•k.?.'L_'R;:Sl�TKi:?�litil is 's:':�:: Cit► of Fridley Building Inspections Department 6431 University Avenue NF, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977