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PRE 2010 DOCSL� Village of Fridley, 31inn. BUHMING PERMIT 311 Office of MSPECTOR OF BUIbDINGS Owner Architect Frid!ey, Minn.,_ Builder, LOCATIC�,�,-,,O]T UIL,DING No street P Eo ad art of Lot, 4, Lot Block Addition Ap or Sub -Division 4 ov­ X '239,PUPTION OF BUILDING k Front Depth Height Stories Manner of Constr _ ction Z :!Cost 2 k fl To be used as, To be completedEstimated 0 Permit Is hereby granted to to 14rLJ the building. described in the above, tement. This. Oermit Is granted upon the express condition that tla'e person to whom it is granted, and his agents employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall co orm in all resects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, epair and moving of buildings within the city limits, and this permit may be revoked at any time upon violatio of any of the" provisions of said ordinances. J . . .... Tnspdctor of Buildings. --- AGREEMENT AND SWORN STATEMEe ] T -th Inc In consideration of the issue and delivery to me by t sq 'c the above permit, I hereby agree to do the proposed work in ace above set forth and according to the provisions of the ordinances of of Buildings of Fridley of rdance with the description Fridley, and,!being first duly sworn, I hereby state and say that the facts stated by me and cont - ined in the move permit are true as therein stated. A Subscribed and sworn to before me at Fridley, Minnesota, this day of A.D. 191- II �J 'j j Original PERMIT for Power Plants and Heating. Cool- ing, ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants to be installe here epaired Make Oil fired—,- Coal fired --L Gas fired ; Gas Authorization No. Remarks Approved Final Inspection 19— Inspector ,573 7 � Permit N° 4833 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., Cat. as , 19-9 Owner &1 �doh Location iV.26z r 1i€ i k Kind of Building,_ How Occupied-4JLAJ��.. Work to be Commenced—, n ^ , � 19_ f, To be Completed 0 ,19,2tl Estimated Cost, $ 0 Q (Fyew, Building Permit Permission is hereby granted to to install--erect—use the material and devices described in the above statement. This permit is granted upon tile express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications t f rth in the approved application for this permit on file in the office of the Inspector of Buildings. LJ -1 J– 711 Ab :iJ , Inspector of Buildings 42 2M 11-67 V a SUBJECT - E City of Fridley 19041 AT THE TOP OF THE TWINS BUILDING PERMIT r REC L'COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � i `•-_.� ��'-��CITY HALL FRIDLEY 55432 L ,•j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/29,/87 JOB ADDRESS ad 1420 Rice Creek °r&yg N. E. 1 LEGAL LOT NO. 30 BLOCK 2 TRACT OR ADDITION Irving ton Addition Candl SEEATTACHED DESCR. Pt. 14 Aud. Sub #22. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Yoava Klucsar 1337 Hillcrest Drive N.E. 574-9724 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 281* x 11' Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plans. Install products of combustion fire alarms in halls to bedrooms and basement,. No permit for garage until existing garage is removed. WARIT `� Bef"e digging Call Iutiliti es SEPARATE PERMITS REQUIRED FOR TELEPHONE .ELEC1Ric. GAS Etc. WIRING, HEATING, PLUMBING AND SIGNS. REQUIRED -1.4W BY 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 SQ. 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 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 $14 400 $7.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON- $110.50 STRUCTION R THE PERFORMANCE OF CONSTRUCTION. ON STF PLAN CHECK FEE TOTAL FEE `s $ 2 7.63 $145..33 SIG TUR F CONTRACTOR OR THORIZEDAGENT (DATE)WHEN PROPERLY VA TED THIS IS YOUR PERMIT s �P61,3971A /7 1 A RE OF OWNER tIF =R KILDERI tDATEt BLDG INSP ATE -71 a NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application I- Construction Address: Legal Description Owner Name & Address: _.1 Contractor: .� �� d � �� '� �P � � �.' `'�-° Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. # DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width ' v� HeightFt. 'Sq• vr eight �� Sq. Ft en - Widt -- DECK AREA: Length Width Hgt/Ground Sq. Ft. .OTHER: PCS O r) Corner Lot [ ] Inside Lot [d�] Ft. Yd. Setback/bo F' o Side Yard Setback' 3 Tb Type of Constructio.; "/ Estimated Cost: $ �' Approx. Completion Date: Alt. A Alt B i Proposed Driveway Width If New Opening Is Desired: _ 1—SeeBack Page for Explanation 21 pp � �- .f �.� �yb Y�. ` .t Tel . #�� / � DATE: � d- li! APPLICANT CITY 'USE ONLY Permit Fee $ w a - Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $A�.-_ $•50/$1,000 Valuation SAC Charge $ $ 525 per SAC Unit Park Fee $ __ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ 7 TOTAL $ ° STIPULATIONS: -A4Ad 9) -4 Z bay_ �a,,�► � @3 `�►'�L ■ . -fir'' ��,�"' .��,0�'t4_� , SUBJECT PERMIT City of Fridley A994 AT THE TOP OF THE TWINS D [ BUILDINGr Rv R CEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. 9 1 . � /---1 CITY HALL FRIDLEY 55432 1----A , ,-J NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 10/27/78 JOB ADDRESS 1420 Rice Creek Road N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 1 Auditor's Sub. #22 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Edward T. Bauler 1420 Rice Creek Road N.E. 571-8045 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 ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Install free standing fireplace 9 CHANGE OF USE FROM TO :STIPULATIONS SEFER,gTE PERMITS REQUIRED FOR HEATING, PLUMBING WIRdi�, AND SIGNS. 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 WITHIN60_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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000 $.50 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. $7- 50 PLAN CHECK FEE TOTALFEE $ 8.00 SIGN OEjC NTRACTOR OR AUTHORIZE GENT (DATE)' a WHEN PROPER_XTTALibATED THIS 1S YOUR PERMIT BLDG. INSP DAT SIGNATURE OF OWNER 0F OWNER BUILDER)ID TE) CITY OF FRIllLEY APPLICATION FOR RESIDENTIAL BUILDING PEII14ITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: A6 BUILDER: Address: tf Address: Tel. No. %/ �Q •L/ No.: Street: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: Applicant attachto this form T`vo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: FLfir. Front: Depth: Height: F( rLrz_ f) Square Feet: Cubic Feet: Front: Depth: Height:' Square Feet: Cubic Feet: Type of Construction: . Estimated Cost: $ :�•�� To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein' specified, agreeing to do all work, in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: SIGNATURE: Stipulations. SUBJECT PE �_. City of Fridley 20814 AT THE TOP OF THE TWINS BUILDING P IT i ? REI T NO. ___ _ COMMUNITY DEVELOPMENT DIV. Ue; PROTECTIVE INSPECTION SEC.ri/ / r 1 NUMBER 1 REV DATE PAGE OF APPROVED BY ` CITY HALL FRIDLEV 55432 612-571-3450 910-F15 5/9/91 JOB ADDRESS 1420 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30, Block 12, Irvingto Addn & Pt of Lot 14, Aud, Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Yoava Klucsar 1337 Hillcrest Drive NE, Fridley 574-9724 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 K3 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 241 x 20 2nd Accessory Building 9 CHANGEOFUSEFROM TO STIPULATIONS VAR #9.1-•07 approved 4/2/91 withthe following stipulations: One curb cut shall be maintained from Rice Creek.Aoad. The petitioner shall provide a hard surface driveway by.November 1, 1991, Special Use Permit #SP91-06 approved April,199 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $8,916 $4.46 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $108.00 Fire SC $8.92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $121.38 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PROP RL D D THIS IS YOUR PERMIT LDG INSP nATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI NEW [ ] Effective -l/. ADM [ ] R-1 AND R-2 J ti - MER [ ] Building Permit Application Oxwtn tical Address: �`� .� Legal Description: f_. d r -O. 61, --' �>I Owner Name & Address:� Oontractor• �G� �' Z+e1. # Address: Attach to this application, a Oertificate of Survey of the lot, with the proposed omwtruction drawn on it to scale. DEF1(3LUVIM OF IIoi1II0RTr L1VIM AREA: Ier th Width Height Sq. Ft. GRPJM AREA: Ieng 'h Width Height Sq. Ft. DECK AREA• ierx th Width Hgt/Grm d Sq. Ft. OTMM- Corner Lot [ ] Inside Lopt [' ] Ft. Yd Setback Side Yard Setbacks Type of Const xticn: CIU D D rk A -p7? �_, Estimated Cost: Approx. Om pletion Date: Prapoeed Driveway Width If New Opening Is Desired: Ft. S $ Width + 6' See Back Page DATE: �� � APPI+ICANr: � ©� v' ,� � SCS � � Tel. # Permit Fee $ /09-00 Fire Surcharge $ 9.9 g - State Surcharge SAC Qzarge $ Driveway Escrow $ Park Fee $ Sewer Main Qkarge $ CITY DBE CHLY Fee S&Aedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering reeri rig Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 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 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner �L� /1 _ e-1c�� Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 Building Used As Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes O No Type $5.00 PLUMBING COMPANY. Reinspection Fee $30.00 SIGNED BY TEL N0-' ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved By C, Y F Rough -In Date Final Date p State Surcharge .50 _ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ �� �� PLUS THE $.50 STATE SURCHARGE Y atryr:• > :Bfr: Shower >11. Wash Tra Drrrtit:::::: Floor ildh:::: Auto. t0::::<::::> Drain `5' Washer r 'R Gas Water Heater . n e` Gas E lecSories K. `Urinal amen Basemen Floor 1 Floor 2 Floor loo 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 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 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner �L� /1 _ e-1c�� Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 Building Used As Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes O No Type $5.00 PLUMBING COMPANY. Reinspection Fee $30.00 SIGNED BY TEL N0-' ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved By C, Y F Rough -In Date Final Date p State Surcharge .50 _ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ �� �� PLUS THE $.50 STATE SURCHARGE SUBJECT PERMIT NO. City of Fridley 142 18666 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � i I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �•j 612-571-3450 910415 9/26/86 JOB ADDRESS 1420 Rice Creek Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 Aud. Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Yoava Klucsar 1420 Rice Creek Road N.E. 574-9724 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 1337 Hillcrest Drive N.E. 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 Cj ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel back porch to be insulated 9 CHANGE OF USE FROM TO STIPULATIONS • SEPARATE p r7's WIRING, HEAT GREQUIRED F OR PLUIW81NG AND SIGNS.' 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 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 ISTALLS 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 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $17.50 PLAN CHECK FEE TOTAL FEE $18.00 tOFCONTRACTOR ORAUTHORIZED AGENT IDATEI/ WHEN PROPERLY LIDATED THIS IS YOUR PERMIT Mv, BLDG INSP DAT Si URE OF OWNER IIF N BUILDERI (DATE) NE's [ ] City of Fridley Effective 4/1/8c ADDN. [ ] R-1 AND R-2 ALTER. I ] Building Permit Application Construction Address: Legal Description: Owner Name i Address: �� v� ���'St�i`z `�� c`���2' `• Tel. f Tel. i Contractor: Address: Attach to this application, a Certificate of Survey of the lot, With the proposed construction drawn on it to scale. DESCRIPTION OF IHPROVEHENT LIVING AREA: Length Width _ Height ____._ Sq. Ft. GARAGE AREA: Length ______ Width — Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHER: 7165,MoDe-Z. LSI'r.0 lTec 1 z -a ( ✓p,!j G ��� Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd. Setback Side Yard Setback Estimated Cost: $ �Io6v -fib ~ Alt. A Alt P Proposed Driveway Width If New Opening Is Desired: $ See Back Page for Explanation ' Tel DATE: APPLICANT:, r - CITY USE ONLY J Permit Fee $ 1 /• U Fee Schedule on Reverse Side Plan Check f 25% of Building Permit Fee State Surcharge $ c'�iC)— $.50/$1,000 Valuation SAC Charge t__ $475 per SAC Unit Park Fee $ Fee Determined by Engineering, Sewer Hain Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL C ' U STIPULATIONS: �pv�,Uv - SUBJECT PE 31077 City of Fridley C_ AT THE TOP OF THE TWINS BUILDING PERMIT r RE IPT NO 0, COMMUNITY DEVELOPMENT DIV. y ------ r PROTECTIVE INSPECTION SEC. � 1 CITY HALL FRIDLEY 55432 NUMBER REVGATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/21/00 JOB ADDRESS 1420 Rice Creek Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 14 2 Ivington Addition Auditor's Subdivision22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Yoava Klucsar 1420 Rice Creek Road 574-9924 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO B&B Remodeling 6760 Madison St. NE Fridley, MN 55432 571-0248 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 O ALTERATION XJ REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Reroof - Tear Off 3 sq. 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $262.00 $.50 D NO PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE V'5'0 OVISIO S OF ANY OTHER STATE OR OCAL LAW REGULATING CON - OR THE PERF MANC O ON UCTION $23.50 Fre SC $.43 PLAN CHECK FEE TOT FEE Lice 5. 9.43 SIG NATUR FCONTRACTORORAUTHORIZEDAGENT IDATEI N P OPE ALIDA B�0 INS EO HIS IS Y P IT 5� nArE SIGNATURE OF OWNER.IF OWNER BUILDER, IDATEI NEW [l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description:i�- Effective 1/1/2000 (763) 572-3604 Bldg Insp t'� rr��4 I> V A( Owner Name & Address:/�� ��� �L C� 5��2 Tel. # Contractor: A ,;/ Z MN LICENSE # Address: 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:-5�/� �S di== /��7�G/`re Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ DATE: L1411ne APPLICANT: Tel. # .57/eaVY-- CITY USE ONLY - Call (763) 572-3604 for Permit Fees If mailing in application Permit Fee $ c'), 3 .5' 6 Fee Schedule on Reverse Side Fire Surcharge $ -43 .001 of Permit Valuation (1/10th%) State Surcharge $ '�Yl $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ i!!�'. $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: El 7 j ^d SOBEO2622B C3 4 R 4. A ir ' r `a 21 � 6e +z` o. c •'gym . Ln CL 2040 `cl 9@8£0z6ZS6 j ^d SOBEO2622B C3 4 R 4. A3'ia i uzi dQ .0 ► 0 wow=, T a : ST claza-6e-m1 SW0NI SW0N3 WUBS:G e002 OE Tne A ' r m r a 10 +z` o. c •'gym . A3'ia i uzi dQ .0 ► 0 wow=, T a : ST claza-6e-m1 SW0NI SW0N3 WUBS:G e002 OE Tne Jul 302003 7:58AM CRONSTROMS 8528203806 ail "d rrmlMOWtAU3*rAEF;LMINVMNAEPLACMFtJELlitMi1 GAMLM AWL�CAT11;11Y WW -13i FMMM CE 8 OR rM Cnedunpi UMMEAin f I Coin 3M O Whstt lhia0001qned h4rebpvom" awt the and W."1Y SUPPOned and Ore*' daterforaffan,ic bq�wteii rcqu*d. pp"Yes The vanong SyMGM.js.Vjg"cjpVC and" 8# cuffent cl� ad$$ a-himril SPOdftfths Induft3tzk1g,- jang1h, number of elbows and kmonutacturerinag'k No'( Yes 7he WWGW' ned�WsO "066.1hilt 1119 rGPWcwwt unit is a astild assembly fact and Rwbihe cuftnt codes VW Mnuuives Specff "Vc)ns. This does 4WW*-AG"Af*:C*"" I Central Fumace Venting Tables for fen Yes (�No etasMUPAW a&&.15 fted .and installed to inset the =ant cadpedlfcatsorta.ej- soon Yes KNc VW= TwOmd to will be ailed a>rtd irtatallscl to WOW the Qvr*A Mcles and manuftftnen, —Sped-rwaftft. Y*5 �tNo Bing* k 1904M35seft4yand Meft- th �Mnrftadas and marwracklmes ape d, Thls,doea 1ndWa AGk42AW Cg"Gry I Centrs, Furnace Tab)" fcrfgn assisted *W ngkialdrafl applin; 'Yes No( Is the. On vent and vent ccm*cj=.*ed and IneW led cofmcgy after an appliancehas been mmoved from 04aammon vent and vented SSPWWAty As Per Wfreni Codes. YOGVNo Apftwe 01 Too .BTU input . I I Ap#bnm 02 Iryp&... anAsslE � hlatwwmmww� OW input F Nat AppRarm #3 7�" . STU I I Input pan AsftadorNat ipjin!!�S .7041BIumptit Commonvent TV, a*,. Vent "eight 01Am6(Or--- inchev Appftrm #I Vat 06nned . 4r m4ht Appknce #2 Vent ALength_& Diameter 01"" n Type / -L c Length Diamew APPQMICe 43 Vent CoMector mdght 'A Length �Jh TYFPG---- ,ft Diameter.— 111 1 �ln Type___ P.2 AO 14A v T, Date: O, i.� . ..I� cu ABIC I Z� 4 Al 10 woau Etp.,Cr I CITY OF FRIDLEY 6431 University Ave NE Fridley MN 55432 Dos ` 0 Effective 1/1/04 MOVING [ ] WRECKING [ ] PERMIT APPLICATION (763)572-3604 FAX (763)571-1287 Job Address: Legal Description: Owner & Address: Contractor: Address: Tel. # Tel. # State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Cu. GARAGE:Length Width Height Ir Sq. Ft. Cu. OTHER: Length Width Height Sq. Ft. Cu. Estimated Cost $ Approx. Completion Date _ CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL UTILITIES FOR DISCONNECTS BEFORE WRECKING MOVING STRUCTURE. Water Bill Paid: Yes [ ] or Collect [$ ] Signature Moving Route: The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property,o be seale State licensed water well driller, and hereby declares that all facts and re resentaf tated in is 6plication are true and correct. ALL MOVIM Wreckinn Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City....... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. Uv PERMIT FEE: A®_ MINIMUM $20.00 STIPULATIONS: 3uilding $ \`1 S-9 195 BUILDING Permit No.: nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY Date Rec'd: 0005 x Permit Valuation Minimum $.50 License Surcharge $ SATE — Ay' OA& YOUR L ADDRESS $ JEsktj $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ITE ADDRESS Erosion Control $ $450 Conservation Plan Review Park Fee $ `JBL a 00 HIS APPLICANT IS: OWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: $ 44 f� 03. Ll 3 Make checks payable to: City of Fridley Attach Sti ulations TENANT ADDRESS: 00 CITY - Al2— PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION VQNE FAX PROPERTY TYPES INGLE FAMILY/INEW CONSTRUCTION SIZE ' ❑TWO FAMILY/ANEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW ❑ ADDITION ❑ MAINTENANC PAIR ORWODELING DESCRIBE WORK BEING DONE: -'� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES❑ ATTACHED GARAGE I. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE:�� ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans VANDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA•f11X1AJ_z: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ oi°O' W4. ,8D OCCUPANCY TYPE Permit Fee $ \`1 S-9 195 See Back Page for Fee Schedule Plan Review $ 11 5q . t9 65% of Building Permit Fee Fire Surcharge $ Q-.`((„) . (0_0 .001 times the total job valuation Surcharge $ O'AO . 0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ JEsktj $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 $ `JBL a 00 Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 44 f� 03. Ll 3 Make checks payable to: City of Fridley Attach Sti ulations 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 be in conformance with thejordinanpe,anJe the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an apr a worksnot to start without a permit; that the work will be in accordance with the approved plan in the case of all rew and approval of plans.iA F� ®� SIGNATURE OF APPLIC PRINT NAME / City of Fridley 6431 UniversityAve NE f Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 /U -__ - Water and- Sewer Permit Application New Connection Utility Line Repair/Relocation ❑ Existing OWater and Sewer Connection Date: It'; —(?6- <c)0 Job Address: Name of Applicant (Plumber): f/4,,,& l/r Name of Property Owner: -h er"tv^� Existing Structure Permit # Permit Type: ew�30.00Wat Meter Fee: Repair Fee: Relocation: State Surcharge: I SAC Charge: Special Assessment Fee: Applicant Signatw Inspector approva Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineering Cost of Water Meter See Utility Billing SAC Charge $1550 State Surcharge $ .50 Water Ta See Engineering 04/04/05 Effective 1/1/04 CITY OF FRIDLEY MOVING [ ] WRECKING PERMIT APPLICATION 6431 University Ave NE kf Fridley MN 55432 (763)572-3604 FAX (763)571-1287 Job Address: I q )--0 )CA7 j 0 1 Q p k 4?PL Legal Description: Owner & Address: Contractor:_ Address: State License # Tel. # Tel. DESCRIPTION OF BUILDING HOUSE: Length 0110 Width Height Sq. Ft. 9/ � 4ed/�' Cu. Ft. GARAGE: Length 2.1— Width Height Sq. Ft. Cu. Ft. OTHER: Length Width Height Sq. Ft. Cu. Ft. Estimated Cost r Approx . Completion Date ; U CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL UTILITIES FOR DISCONNECTS BEFORE WRECKING MOVING STRUCTURE. Water Bill Paid: Yes [V/'or Collect [$ ] Signature Moving Route: The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated this application are true and correct. ALL DEMOLITON DEBRIS, INCLUDING FOUNDAT LAB, SHALL BE REMOVED FROM SITE. Date Signature M� Wrec ' Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. � C� PERMIT FEE: � S. STIPULATIONS: MINIMUM $20.00 Office Use Only: c-,**' SAC -D form completed 3674 o- 0 Effective 1/1/04 CITE OF FRIDLEY MOVING [ ] WRECKING ] PERMIT APPLICATION 6431 University Ave NE Fridley MN 55432 (763) 572-3604 FAX (763) 571-1287 Job Address: C& Legal Description: Owner & Address: �61125- Contractor:- N, I Tel( Tel09-- Address: Address :,�rP7� �,�a State License # 4 DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Ft. GARAGE: LengthA�Wwidth Height _!WCu. le., �Sq. Ft. Cu. Ft. OTHER: Length Width Height Sq. Ft. Cu. Ft. Estimated Cost $ ®49e Approx. Completion Date CALL GOPHER STATE ONE AT 651-454-0002 FORS UTILITY LOCATIONS. CALL ALL UTILITIES FOR DISCONNECTS BEFORE Water Bill Paid: Yes e-'_ or Coll ct [ a N Moving Route: TURE. Signatur The undersi hereby es app icati n 'rapt frapt to eck/ 10v& building described above, agreeing to do all work ' s 'ct Accor ce ith e C Or ' lings of the Building Division, and the State Code which equ' es y wa w 11 o th prope to be sealed by a State licensed water well driller, and hereby decl es that cts r entations stated in this application are true and correct. ALL DEMOLITO RI INCL ING FOUNDATION & SLAB, SHALL BE REMOVED FROM SITE: x Signature \ Mo ink Wrec Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total goat Move a building out of City ...... $ 20.00 of gat a rate of $6.00 for each $500.00 or fraction. PERMIT FEE: MINIMUM $20.00 STIPULATIONS: Office Use Only: SAC -D form completed L�-, CITY OF FRIDLEY PERMIT NO.: 2006-02364 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 11/20/2006 572-3604 YAX: (763) 571-1287 ADDRESS 1420 RICE CREEK RD NE PIN 133024430001 LEGAL DESC UNAVAILABLE LOT 1 BLOCK 2 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DEMOLITION NOTE: CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED. DEMO HOUSE. 4000 APPLICANT JANKOWSKI, EUGENE 1420 RICE CREEK RD NE FRIDLEY, MN 55432 LIMA10 Do JANKOWSKI, EUGENE 1420 RICE CREEK RD 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 construction. Applicant Date Bldg Insp Date DEMOLITION FEE (PROJ COST) 48.00 TOTAL 48.00 PAID WITH CHECK # CC SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRiDLEY BUILDING INSPECTION 5431 University Ave NE O Effective 4/V201 =ridley, MN 55482s APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 7e3-572-3604 FAX 763-571-1287 REFRIGERATION AND AiR CONDITIONING SYSTEMS AND DEVICES RATE SCW D 31.iQ#�� EN =umace Shell and Duct Work, Burner & also Replacement Furnace $35.00 Sas Piping I ew Fuma , Fireplace, Insert) $10.00 Sas Range $10.00 Sas Dryer $10.00 0Alr Conditioning - All Sizes $25.Q0 k1l Other Repairs or Alterations (List on Back) LSO of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of mprovement whichever is greater 20m111erei®111ndustrIayr Wit" tlonn L.25% of Value of Appliance or Work (List on Back) Minimum Fee $35,00 for CommerciaVindustrial/institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR low JOB ADDRESS Owner, is $ :0-0 $ "'Air Conditioners can not be placed In side yard without written approval 'rom adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Building Used As ` ESTIMATED COST PERMIT NO # of Heating Units,__„L_,,,_- Circle One (Steam) (Hot Water) arm Alr) Trade Name___Z7fgAA, 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 8POOhled agreeing to do all work in striot 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. HEATING CO 'f�- �7 �-- Signs d `J5 C - Tela -3.P7V FAX## j4S- Date_ �-' 0- 7 Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL- BURNING APPLIANCE PERMITS COMtI►ION VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When mplaaina an wdsOnufurrtacs. the undersigned hereby verifies Vig the venting has been ownined and is two from ns, ddaiioration, obstructions. Yes( No ( ) and is securely supported and wham The venting system is plastic/PVC and meets all c unw t codes and manufac ti m s�cifications including sizing, length, number of elbows and termination. Yes( ) No() The undersigned also verifies that the replacement ural is a listed assembly and meets the c unent codes and manufacturer's spedfications. This does Include AGA-G� Category I Camel Furnace VOOV Tables for fan assisted and natural draft appliances. Yes( ) No( ) The existltta cornb_uegon air is sized and installed to meet the cunw t comes and manufacturer's speclficons. Yes( No( ) When required to install a now combustion air, it will be sized and 'installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When Instafta a new ventim the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufadxmWe specifications. This does include AGA -C~ Category I Central Furnace Venting Tables for fan assisted and natural drat 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 skdCommon Vent and dent Connector information Appliance #9 Types BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assam or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances � Total Btu Input -- -- _ Common Vent Type Vent Height Diameter inches Appliance #9 Vent Connector Hit ____ ft Length ft D1ameter in Type Appliance #2 Vent Connecter Height ft Length ft Diameter in Tyle Appliance #3 Vent Connector Height ft Lerma ft Diameter in Type ALTERATIONS: (Descrft - i- EM ING CO: Signed By: Date Knight Heating and Air Conditioning 13535 89th st. NE - Otsego, MN 55330 763-274-9945 - Whole blouse Meat Loss/Gain System 6 mike Sherman Sales Consultant: Ken Lien Proposal#: Fridley, MN Date: 12/19/2006 763-571-8181 Design Conditions: Winter Outdoor Temp. -20 Summer Outdoor Temp. 95 Winter Indoor Design Temp: Summer Indoor Design Temp: Loss/Gain Summary: Loss Walls 15512 Gain 2673 Windows 20023 14464 Doors 734 197 Ceilings 4769 2299 Skylights 0 0 Floors 4977 0 People/Kitchen 0 2400 Infiltration 47901 4860 Duct Loss/Gain Total Sensible 93916 26893 Total Latent 0 8068 Total 93916 34961 72 74 Total BTUH Gain 34961 Capacity Multiplier 1.00 A/C Unit BTUH Rating 34961 Nominal A/C Unit Size* 3.0 Gas Furnace Output BTUH 93916 Electric Furnace KW 27.5 Calculations are Estimated values based on a Whole House Heat Loss/Gain analysis for a typical application. Please refer to our Room by Room program for atypical applications. *Equipment Selection should match Manufacturers Performance Data. (Latent and Sensible) Date: 12/19/2006 Revision Date: 12/19/2006 Site Information Address 1: Address 2: City: Fridley County: Application Information Business Name: knight heating and air conditioning Contact Person: ken New Construction Project* Mike Sherman Lot: Block: Subdivision: MN Contractor License #: Office Ph: 763274-9945 Fax: 763274-9946 Cell Ph: 612221-0395 Address 1: 13535 89th st ne City: otsego State: mn Zip Code: 55330 House Details Square Feet: 4500 sq. ft. Avg. Ceiling Ht: 10 ft. Number of Bedrooms: 3 Ventilation : Balanced Total Ventilation Capacity: 197 cfm. Minimum Continuous Ventilation :60cfm. Intermittent Ventilation: 137 cfm. Combustion Appliance Water Heater: Power Vent Input BTUs: 50,000 Independently Vented Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 100,000 Independently Vented Other Combustion Appliances Gas Fired Direct Vent Fireplace(s): Yes Gas Fired Power Vent Fireplace(s): No Gas Fired Natural Draft Fireplace(s): No Solid Fuel Appliance(s): No Exhaust Equipment Continuous Exhaust Ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135 Exhaust Fan Rating (cfm): 180 Make -Up Air No Make -Up Air Required by Code Combustion Air Minimum Combustion Air Requirements Met. Applicant Name (print): �'� "� Signature/Dat Code Official (print): Signature/Date: 0 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page I City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PLUMBING Permit No.6-7 Building Inspections RESIDENTIAL APPLICATION Received By: l (0 7 763-572-3604 CITY OF FRIDLEY Date Recd: DATE � 0 7 YOUR E-MAIL ADDRESS SITE ADDRESS W10 THIS APPLICANT IS: ❑ OWNER OCONTRACTOR PROPERTY Nom: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: S *k 6'0"evf- 4 r e y' V L"X pi "S STATE LICENSE # 3 "S t N/"- EXP D ";'21?S Ivey LA 971 -\CITY Nv "IF Y A2 STATL�� ZIPSsI!Z SUBMIT A COPY OF YOUR STATE ADDRESS: LICENSE WITH PHONE t5S j 63696r5'L( FAX APPLICATION r `� S GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE TYPE OF WORK: AE'W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK F)u. Wl5" w_ Q W PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) l SHOWER WATER PIPING 3 BATH SINK/LAV C FLOOR DRAINS BATHTUB _ GAS PIPING (A� cnTLlm m) SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER 1 KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER I LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION OTHER WATER METER _ ft Permit Fee $ Number of fixtures @ $10.00 PY x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 _/x$35.00=$ TOTAL DUE $ 1 50 State Surcharge = $ M .50 Total = $ 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 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; that the work will be in accordance with the approved plan in the case work which requires review and approval of plans. /o�f/1all SIGNATURE OF APPLICANT vT VPRINT NAME OA-' S &'y DATE f �� 2 Q City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977