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PRE 2010 DOCSCity of Fridley, . Mmo UILDING PERMIT N95013 �� Date: Owne += " '" Builder Address Address oe••-••--- --- LOC ION ® Btu � NG No. Street �,_.. .� ,� Partof'Lot— Lot Block Addition or Sub -Division . _ ._ _..-- -? ----•— _ — Corner Lot _ Inside Lot _ _ . ! !r""_�__ Setback ____...__E Sideyard Sewer Elevation Foundation Elevation DIESCRIPTION OF BUILDING To Used Front .%.a -.L...__ Depth Height Sq. Ft. Cu. Ft. ;;�' "�'' �� p Front Depth eight M Sq. Ft. Cu. Ft. 4 ro �� !Yon struction _ W Est. Cot'__ To be Completed In consideration of the issuance to me of a per to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. A In consideration of the payment of a fee of $" , permit is hereby granted to _ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. •, - ,rpt Building Inspector NOTICE: This permit does not cover the construction, installation for whiner"plumbing, 'Bas heating, sewer or water. Be sure to see the Building Inspector for sspar@te permits for these Hems. a' 4 APPLICATION FOR BUILDING PST CITY OF FRIDLEY, KWMTA: Owners Name �? z;4 -'Builder r' Address ,0 � �'- - . 3`' `._._.Address .J--2 .�®: T.�.._.._._..� ._..,.n.r LOCA!fION OF BUILDING/�%C�j No. A 1 Street ' 11 '4L" Part of Lot h 00 Lot Block. Addition or Sub.Div. Corner Lot side Lot_ Set Back 3,5' Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To usedLa, Depth--- Sq. epth-Sq. Ft. Cu. Ft. Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all, work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. SIGNATURE, (A Schedule of Fee costs can be found on the Reverse Side.) 9 O� �( Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Aar Conditioning SystenEs and Devices PARTIAL RATE SCHEDULE Dept. of Bld Phone SII 4-7470 /�oi GRAVITY WARM AIRS RATE TOTAL Location 14A ® oci Crete oc��9 s a.�� trS- i9 U, il" Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace .......... 5.00 $ City of Fridley: Repairs & Alterations—up to $500.00 • • • • • • • • • • • • • • • . • specified, . 5.00 $ s eco a undersigned hereby makes application for a permit for the work herein d, agreeing to do all work in .strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each. add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. IDR Hot Water .................. 2.50 $ OIL BURNER to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 �l GAS PIPING (Up to 3 Fixtures) .......................... 1.50 (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS $ See Fee Schedule TOTAL FEE $ !� Fridley, . inn. '195— Owner 0 011--e 195— Kind of Building -5�71 c2 195— Used as To be completed about �� /* � C) Estimated Cost, $� Building Permit No. DESCRIPTION OF WORK C ATING r POWER. PLANTS—Steam, Hot Water, Warm. Air—No SC07 � Garr �� P� de Name 0-ZA10A-1,4- ® � �'``��� Size No ` 0 Capacity Sq. Ft. E.D.R BTU H.P. __ ® R -Total Co ected Load - Kind of Fue]_ :S�j� URNE Trade Name 0 11 if /�� /14 �' � s Size No (J�6'�`� Capacity Sq. Ft. E.D.R. BTU H.P. Signed By 11 POST IM -8-58 Busin ' Phone No City of Fridley Application for Plumbing and Gas Fitting Permit De 3 of Bld Pho SII 4 7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures rn ce gz UN' �p F N WATER HTR. GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings I .Fixture, Old Openings Connected with Sewer ElNew Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: -M0—.-RATE- TOTAL - Number Fixtures ......................�— x $1.50 $ /35 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ..... ...................... x 3.25 $ Water Heater (Up to 200,000 BTL) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Of Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 .$ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE $ -5 p. V— Location Location 14 ® / - oe' C atE C° oe0 � City of Fridley: The undersigned hereby makes application for a permit for the work here! specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the faci and representations stated in this application are true and correct. Fridley, Minn i - , 19 e Owner S -;-4- '/1- i_. / T - /�V Kind of Building�����' Used as &f./ - To be completed about Estimated Cost, $ Oldew Building Permit No ��,� Permit No. Signed ROUGH / /0 " (/ / FINAL dz 2M. By - Business Phone No IDEAL PLU11V]'SI G C"; CO. 807 - 4n ST. S. E. FE 8-3930 FE 8 3749 MINNEAPOLIS 14, MINN. Application for Rawer Plants and. Pleating. Cooling. Ventilation, AeMgelration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ...... .................. Replacement of Furnace .............................. Repairs & Alterations—up to $500.00 ................. . "RepairsLL& Alterations each add. $500.00 .............. . SH STEAM or OT WATER SYSTE 6'4 Fly rJ Furnace Shell & Lines—to 400 sq. ft. EDR Steam- ...... Furnace Shell & Line—to 84 _� ft. EDR Hot Water ... Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. EDR Hot Water .................. 8.00 $ 2.00 $ _ §.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 $ 2.50 $ 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTI) ....................... 5.00 $ a GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FF E $ f ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn / ® 19 Owner J mak//-C �/ a% _ Kind of Building � �s Used as To be completed about 6 Estimated Cost, $ Old—'e . Building Permit No.-���tM / 3 Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, kof Wa , Warm Air—No- Trade Name l --T"/ � A!' 6Qi 1 Size No Capacity Sq. Ft. E.D.R. (RTU � /" �_0 H.P. Total Connected goad 5(Li Kind of Fuel' BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe IDEAL PLU�,"ONG & FlE 6INC CO. 807 - 4th ST. S. E. By F€ 2-2920 FE 8- 78CJ MINNEAPOLIS 14, MINN., a'y 4 2 2M 7-59 Business Phone No ��.-�-moi •.-��°o..-���_ (REMARKS—OVER) HEFT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips /,P' /6 A.S.H.V.E, Guide Reference 19_ Construction No. Coef. Insulation Windows ( Doors Out. Wall Int. Wall Ceiling I Roof Floor Kind How Applied jYes—No Yes—No Glass 1 77 /0 "lo i F1.1 / /i w G Room I Length Width Heiaht II ! FLI .?9 J Room I Length Width Height Windows and Doors—Crackage and Area .y3 's' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. / 3 G a Z-- /,P' /6 Coef. ICoef.1 Btu Infiltration (r j, f I fe' 3 yo Glass Glass 1 77 /0 "lo Glass Exp. wall Net exp. wall Exp. wall Exp. wall f 3 z Net exp. wall 1 ,O X// Net exp. wall Net exp. wall Int. wall S' a 2, -Jam" d Int. wall Ceiling C (o C v Floor Ceiling /G / Total Btu. V27--"/ m Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ( F1.1 k ('t Room I Length Width Height Windows and Doors--Crackage and Area . Id �6 '- 01f /_/O.) N Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2 C !J- / � r 4(df /,P' /6 Coef. Coef.1 Coef. Btu Infiltration (r Infiltration W. I s/ P - Glass Glass f d) /0 "lo Glass Exp. wall Net exp. wall Exp. wall Exp. wall f 3 z Net exp. wall 1 ,O Net exp. wall Net exp. wall Int. wall S' a 2, -Jam" d Int. wall Ceiling C (o C v Ceiling Ceiling /G / to Floor Floor /CV Total Btu. v Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.1 ,W a-rAW Room I Length Width Height Windows and Doors—Crackage and Area 1(.0 looms u y Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3a 3 � / ►y !o Coef. Coef.1 Btu . Infiltration (r Infiltration W. I s/ P - Glass f d) /0 "lo Glass Exp. wall Net exp. wall 1-51/ Exp. wall f 3 z Net exp. wall / Net exp. wall Int. wall a Net exp. wall Ceiling C (o C v Floor Ceiling /G / Tbtal Btu. '2 - Required Required sq. ft. E.D.R. or sq. ins. W.A. Leader area C ( % 43, -/P-t 30, Windows and Doors—Crackage and Area I a -v r! Width Height No. of Lineal it. Area No. of pane of pane lights of crack sq. ft. or - Coef. Btu Coef. Btu Infiltration Infiltration Ze //o Glass /0 "lo Glass Net exp. wall f 3 Exp. wall f 3 z Int. wall / Net exp. wall a Net exp. wall Int. wall /V 6 1 /6 bv G O Int. wall Ceiling /G / to /6 /0 Floor /CV ® Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / FI.I Room I Length Width Height Windows and Doors—Crackage and Area I a -v r! Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. or - Coef. Btu Infiltration Coef. Btu Infiltration Glass Exp. wall /0 "lo Glass Net exp. wall f 3 le f 3 z Int. wall Exp. wall Ceiling a Net exp. wall /V 6 1 /6 bv G O Int. wall Ceiling /CV ® 6 7�-o Floor Total Btu. S' Required sq. ft. E.D.R. or sq. iris. WA. Leader area / F11e. -/_ 3 Room I Lenath Width Heitrht Windows and Doors—Crackage and Area �r y y-` Width Height No. of Lineal ft. Area No. of pane of pane lights of crack aq. ft. Coef. Btu Infiltration a .do Glass Exp. wall Net exp. wall f 3 le f 3 z Int. wall Ceiling a Floor Total Btu. 41/0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 74, 3 C 6 --- Windows and Doors—Crackage and Area / G � Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. Lt. HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips 3 ASHV.E• Coef. Construction No. Infiltration Insulation v Int. wall 0/e e( 3 e Glass Floor Windows I Doors Reference Out. Wall Int. Wall Ceiling RoofTE Kind How Applied Yes—No Yes—No Net exp. wall 19_ 3 ,, / . G F1.1 Room I Lenath Width Height II FI_I Rnnm I Lenath Width Heisrht Windows and Doors—Crackage and Area / G � Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. Lt. _a i s ✓ a__0 Coef. Btu Infiltration 3 30 Coef. Btu Infiltration Net exp. wall v Int. wall 0/e e( 3 e Glass Floor Exp. wall y i Net exp. wall 3 ,, / . G Int. wall 6 / y Ceiling Floor �-o S 37 '37-4 Total Btu. ioo Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room ( Length Width Height Windows and Doors—Crackage and Area Width Height I No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lenath Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack Area ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor I btal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Inc. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lenath Width Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor "1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECTPE NO. City of Fridley ® 130'70 AT THE TOP OF THE TWINS PERMIT • Ir � BUILDING REC L'-_____ - COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i 1 . � NUMBER REV. DATE PAGE OF APPROVED BY i 1 CITY HALL FRIDLEY 55432 '.J 612-560-3450 910-F15 JOB ADDRESS 1613 RICE CREEK ROAD 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. PT. OF tj ARCEL 780 AUD. SUB. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE TED GONSIOR, 1613 RICE CREEK ROAD, FRIDLEY, MINNESOTA 3, CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. OWNER 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENCE 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION NX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK REPAIRS DUE TO STORM = RE -ROD IN 9 CHANGE OF USE FROM TO STIPULATIONS WARNINGs�titiy�i i'S RtgUIRED FOR w1fi G, Before digging calf focal utilities SEP ERA i PLUMBING AND SIGNS. TELEPHONE - ELECT 1C - GAS Etc. ..mAT1NG, REQUIRED Y LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION [VALUATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5, 000 $2.50 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. 930.00 PLAN CHECK FEE TOTAL FEE 32.50 SIGNATURE OF CONTRACO OR AUTHPRIZED AGENT (DATE) WHEN PROP VA THIS IS YOUR PERMIT r s JULY 1...197 a . BLDG. )NSP DATE SIGNATURE OF OWNE F OWNER BUILDER) DATEI •APPLICATION FOR RL•SI•DENTIAL., ALTERATION, OR ADDITION -BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAXE- : BUILDER: ADDRESS:-�- ADDRESS: CORNER LOT: INSIDE LOT: SETBACK: SIDE -YARD: Applicant attach to this form n%7o Certificates.. -if Survey.of Lot and.proposed building location drawn on these Certificates. • DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic.Feet: Front Depth: Height: Square Feet; Cubic Feet: Type of Construction—,, �/Estimated Cost: To -Be Completed: CP The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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. DATE: 7 /- zly SIGNATURE: (See erse Side For Additional Informs n:� CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT -79 Z",/ RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE TOTAL 7 Effective Aug. 1, 1981 Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct OWNER Q USED A Fridley. Mn. "-e -OsL . 19 X-5 TO BE COMPLETED ABOUT fD -/�-z O ESTIMATED COST J�'�a��• 4-z�' OLD ANEW BUILDING PERMIT NO. PERMIT NO. Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. b J( w Date APPROVAL FOR PERMIT/' MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE dq W mro e >. N E+ 3 e r. "i .au 4w { N .808 ro N x `A 11 e11ao3 o. � m m W k w m g� w s+ o Water Heater lec 1st 2nd 3rd 4th (R) = Future Connection Opening (*) = New Fixture, Old Opening Connected with Sewer Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE TOTAL 7 Effective Aug. 1, 1981 Job Address Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct OWNER Q USED A Fridley. Mn. "-e -OsL . 19 X-5 TO BE COMPLETED ABOUT fD -/�-z O ESTIMATED COST J�'�a��• 4-z�' OLD ANEW BUILDING PERMIT NO. PERMIT NO. Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. b J( w Date APPROVAL FOR PERMIT/' MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE suB�Ecr PE w Fridley City of F 4-817 AT THE TOP OF THE TWINS BUILDING PERMIT i , RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r e PROTECTIVE INSPECTION SEC. /r7 0 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPROVED BY 612-571-3450 910415 5/26/93 7 JOB ADDRESS 1613 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Parcel 78 5 dud. Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gonsior 6425 Able Street NE 571-2727 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Herbst & Sons Const. Co. 2.299 Co Rd H, New -Brighton, MN 55112 784-8510 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 O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE Xf7 REMOVE 8 DESCRIBE WORK Wreck House, Garage & Shed 9 CHANGE OF USE FROM TO STIPULATIONS Clean site of all construction debris. Cap sewer & water lines at property line and call for inspections on same, SAC credit to be used with.building permit for new house on lot. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 N/A WITH WHET ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES N RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE NF PROVIS OF ANY OTHER TATE OR LOCAL LAW REGULATING CON- $23.75 STRU I N OR THE PERF M NCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $23,75 II SI T R OFCONr A O 'OR ITHORIZEDAGENT IDATEI WHEN PROP LY VA DA D THIS IS YOUR PERMIT �V�L"-iNS DATE SiGNATUREOF OWNERiiF OWNERBUILDERI (DATE) [ ] Moving [ ] Wrecking vih�Ah� Legal Description: ' Owner &, W490)40448 11, Tel. Tel. 'Living Area: Lengthy widthHeightSq. Ft. � o2 Cu. Ft. ` Garage Area: Length Width , - Height /E) Sq. Ft. Cu. Ft. 07L4117 5Kt Q Other: Length %- L Width / 0 Height Sq. Ft. ✓00 Cu. Ft. / Estimated Cost of Wrecking/Moving Approx. CMP1etion Date V!'ILITIFS TO BE Norjr= City Water/Sewer Mpls. Gas Cmpany Northern States Power Northwestern Bell Tel Co. 571-3450 [� 372-4720[ ]� 566-9120 293-0665/293-1319 [ Water Bill Paid: Yes Amount To Be Collected [$ n s ] Initials Moving Route: FEE'S Moving: Principle Building into Fridley . . . . $ 80.00 Accessory Building into Fridley . . . . $ 20.00 i ni'mu Tree: $15.00 4hrnugh, within or out of City . . . . $ 15.00 Wrecking: For each 1,000 cubic feet or fraction .$ 1.25 For strictures which would be impractical to cube, the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. Zhe undersigned hereby makes application for a permit to wre ,,,e the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Department, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and declares that all facts and representations stated in this application are true ando0 PEBMIT FEE.: r � 3.96 SignaturSTI MAnCINS:e W SUBJECT PERMIT NO. City of Fridley 2211 3% AT THE TOP OF THE TWINS BUILDING P E IVB I T i NO. � L _ COMMUNITY DEVELOPMENT DIV. I PROTECTIVE INSPECTION SEC. 3c� 77 CITY HALL FRIDLEY 55432 "`j NUMBER REVGATE PAGE Of APPROVED BY 612-571-3450 910415 9/17/93 JOB ADDRESS 1613 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. E 91' of W12361 of S 230' of Lot 5, NX Auditor's Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tollefson Homes Inc. 311 Sunrise Lane, Champlin, MN 55316 867-4141 1365 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK [I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 50.' x 38' Dwelling and a 30' x 20' Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with verifying survey before capping. See notation on lot survey. SEWER LOCA91DN: 200' E' of Manhole (E. Inv. 903.66) WYE ELEV: 906.52 + 6' Riser --912.52. WATER LOCATION: 14' E of Sewer Service. TOP OF FOOTING: Expose service prior to establishing top of footing. DRIVEWAY DEPRESSION COST: If applicable - #13.50 per Lin. Foot. WARNING SAC Credit from razed, house. $750.00 Park Fee Paid 9/8/93. Before digging call for THE CITY OF FRIDLEY DOES NOT GUARANTEE THE all utility locations ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. 454.0002 THIS DATA IS FOR 'INFORMATION PURPOSES ONLY, REQUIRED BY L AND PERSQNS USING THIS INFORMATION SHOULD VERIFY IT OW THE SITS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 COMME14CED 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 VALUATION SURTAX Fire SC AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $113, 833 $56.92 $113.83 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- $688.50 SAC CREDIT STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE License. SC $5,eO0 TOTAL FEE $864.25 7 7 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE)HE ERL V DATED THIS IS YOUR PERMIT BLDG )NSP QA'TE SIGNATURE OF OWNER) IF OWNER BUILDER) (DATE) W 81.1 TX'1 ':J01t 1?11Vl'TOPP. A.VF;(:ACl: +'Ll" (`QAPUT 11`101•f Coz,%1,.,1CIML, /P F�,.a �,, DA'1'1 FIT01f1r Dwwr,liiio v;0rl:lnv equ"I'a footago 01' ouoh. 1. ......1`i 71,'sS sqt 1't. x�•„„�, - 2 6.95 2. `lbtal r+,of%collir,g nxorl...•.._ /nen aq4 fto x .076u w . �$� � y'� �,%'q �M fiIG''�+��7a`"9i1dS�d�F4��'17(t11'dl�.t."VA��IY`,1���y�q �.ie':!t?1�1 e��n af,e; o�.� as rte's ma�s!�t �r�t ,ass t F a•..� .., .,. . , r -•..__ ... .. tk.!1{�.� E'`'l'Nf1'i6�`'iS�.U�.A,'4X�a�tt�`a5+'�'i'^.t�lf'tr'e�.7�'�r�!�a�',�.'&�i':�ti�'��'�.�4.i'W.;fb�i',t• !;'�'._�?at 'it) eal uxporsod wrl•ll rr..,u ltbava ;'loor -4444..-.....�..,....,.�..... a• lbtal 1Vt111 wi11dUU";Veao.•.ss•s••••.••••►••..•••.••..e.••...q.� Y•< i U. V 11btal ,lryb, '1'44'11 doom arrlit........•..t4.......444.•...................... filia1116 door �. . '+. T O dal gx'l '7:i.. 0 0 4 .. • .. • .. 4 0 6 0 . • • . 0 0 0 4 • . • ... .. 6 .. • . X► Z-411 lac 'j LVal1 arl',il... • • . • ° .. • 6 • 6 • . 0 • • • • 0 • �j l - :. ^`��. a. ). TAI . • • • .. 6 6 . + t' • r • V"11 rtiuti rt;; &Xua (uv►'1 aj,u ) • ...... 4 4 4 4 .. • ........... ' /on . C, , i. ► 'lq nav Wall urea abovo floor..............6...too te4444.e����.�, b%•�� (j4 {1.AI 111 Y(.. 1 rills .101 Q t QX L -a' 4 .. • .. 4 6 6 6 .. • I. • , t . 6 • • .. 6 .. 4 . . • .. .... d 4 4 4 4 77 a 'Total oxl►oo:;a foalul,al.lorl a r•oa 1,. i. Titin TO U4 f0undal.lun Boor Mroat.... ..... to* ..... off . of -of ,o•p°,pot.. Aundation window urua (iiicludea sliding aooivo)......t..`"' ----- j• YQt4l rlot founaution u4!oa auovrj grLtd3e..te...e........4444•tt• � <.Y It. TO tul Viall rl�auiil ; aroa (uverl:ige JUA) .................. • • 6 6.6 • 5,2 2 ? 1. `lb 144 dot wall SwW1111I1; arca..... , .. • .......................... n, n �. ))u1A:+.rulir4c W u vulue oi' Ua4h wall &IctpQ, It h4 C''I•'�),.y4�- IOU il -+.ori- .i.Z•+.......,.« 0 . 1y 10 xlllj 11^• x4fu II 2 x IOU of 1•...._.;a:2.i;.(.! If }�GI31 � ;•P t w m unu alts or laws Uiurl j,1" #11 you have mcn late trltGnt 0i, SW 6006 (C)'?, �$� � y'� �,%'q �M fiIG''�+��7a`"9i1dS�d�F4��'17(t11'dl�.t."VA��IY`,1���y�q �.ie':!t?1�1 e��n af,e; o�.� as rte's ma�s!�t �r�t ,ass t F a•..� .., .,. . , r -•..__ ... .. tk.!1{�.� E'`'l'Nf1'i6�`'iS�.U�.A,'4X�a�tt�`a5+'�'i'^.t�lf'tr'e�.7�'�r�!�a�',�.'&�i':�ti�'��'�.�4.i'W.;fb�i',t• !;'�'._�?at NEW Effective 5/26/93 ADDN (] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 *--2"79 Building Permit Application Construction Address: 1&1---5 7�-i e t EWW�' -K6 �J SOA -f ce 4 ®d Fee- ®f `f -kc- 0,5. t- z-3�,,ao u F Legal Description: tot AI, oL ' s s c-3 �T),e.r` �� s E � cam-, G ! oG� PEtTel o s. Owner Name & Address: Contractor: _� 0 11 fa EVA i�-' S1 n� MN LICENSE # Address: [ 1 Su, c; s (�,) Tel. # �� 7 U�) Attach to this application, a Certificate of Survey of the / lot, with the proposed construction drawn on it to scale. DESCRIPTION OF B"ROVEh"INT LIVING AREA: Length . r Width Height d Height Sq. Ft. S U GARAGE AREA: Length 30'x'0 Width 0 ,� " Height Sq. Ft. 6 �® DECD AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot (] inside Lot [) Ft. Yd Setback. Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: j DATE: APPLICANT: Y I It Permit Fee $ �ogg Fire Surcharge $ 1/3.8.3 State Surcharge $ '56, q2' SAC Charge 7'u,&T $ 25-0,00 License Surchge 70 $ 5,06 Driveway Escrow $ Erosion Control $ Park Fee $ 7,6• ©c) Sewer Main Charge $ Side Yard Setbacks Estimated Cost: $ (Cost on Back) Ft. + 6 Ft = Ft x $ _ $�/3�3�� Tel. # CITY USE ONLY ;-, 4e CA /-70 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $750 per SAC Unit rt' 07) 5 $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] TOTAL $ �� STIPULATIONS: 4 4 . % SUBJECT P -_ City ®f Fridley�122 2 4 2 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. 3� r NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/22/93 10B ADDRESS 1613 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 5 Auditor's Sub. #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tollefson Homes Inc 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Fireplace Co 1525 West River Rd N, Mpls., MN 55411 588-0791 8055 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 J] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install gas direct vent fireplace (Heat N Glo 6000 GDV) 9 CHANGE OF USE FROM TO STIPULATIONS stall per manufacturer's specifications. Framing/chimney vent and gas pipe inspection needed before enclosing. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 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 $2,000 $1.00 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- $45.00 Fire SC $2.00 STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE Z2 -A3 License SC $5. 0 $53.00 SIG ATUREOFCONTRACTOROR OUTHORIZEDAGENT I IDA EIW O VALIDATED THIS IS YOUR PERMIT /( —�f— BcD INSP GATE SiGNATUREOFOWNER iIFOWNER BUILDER) IDATEI NEW K ADDN { ] . CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: s Coctor: i /,4 � c -,X Address: I,v ; Effective 5126/93 *q/ 3s - Tel. # MN LICENSE # Tel_ # - 0-7 / Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMPu" LIVING AREA: Length Width Hei, GARAGE AREA: Length Width Heig n DECK AREA: Length Width Hgo OTHER•77 Corner Lot [ j Inside Lot [ ] Ft. Yd Setback Side Yazd Setbacks �— Type of Construction: Estimated Cast: $ 2-eo o Gil Approx. Completion Date: Driveway Curb Cut Width Needed: (Cost on Back) Ft. + 6 Ft = Ft x $ _ $ DATE: t Z z APPLICANT: Tel. # S -El' -7 % / CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ O © .001 of Permit Valuation (1/10th%) State Surcharge $ / U 0 $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ UC) $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ Conservation Plan Review $450.00 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary { ] Not Necessary { ] TOTAL $ �' STIPULATIONS: NEW [ J Effective 1/ 1/94 ADDN [ CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R -i AND R-2� Building Permit Application 0 Construction Address: /(g)3 42,ic�t Ci-ea`7, -kp. _ Legal Description: Owner Name & Address: OftLz� Tel. # Contractor: �i�-0:-11t1j w, e> MN LICENSE # Address: 3m CI�p ntau-IJ I hJ4 553i ce, Tel. # '6(g'7- +141 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: Corner Lot [ J Inside Lot [) Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: bt (C St on Back) Driveway Curb Cut Width Needed: 4- 'Ft. + iFt = Ft x $ �� _ $ NPATE: 4- 1 eb 4 4- APPLICANT: oTel. # `0o "l— 4A 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 $ $800 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 [ ] fEel r1l-4 STIPULATIONS: FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287 February 10, 1994 Mr. Jerry Tollefson Tollefson Homes Inc 311 Sunrise Lane Champlin, MN 55316 Re: Final Inspection at 1613 Rice Creek Rd NE, Fridley Dear Mr. Tollefson: A final inspection was conducted on February 10, 1994 of the above address and the following items were noted which must be completed before the structure can be finaled: 1. Provide sod in the front and side yards by June 15 1994. 2. Provide a handrail return on basement stair by February 21, 1994. 3. Render sliding door inoperable until deck is constructed and approved. 4. Install window well for basement egress window before occupancy. 5. Provide a hard surface driveway by June 15, 1994. 6. Provide City with copy of verifying survey by February 21, 1994. We will expect these items to be completed by the scheduled dates and reinspections called for. If you have any questions on this matter, please feel free to contact me at 572-3602. sincerely, C, �c? GARY �R . FORD Acting Building Official GRF/mh CITY OF FRIDLEY INSPECTION DN. 6431 University Ave NE Fridley, MN 55432 572-3604 VA i4U--iqL;;0111 Residential Effective On January 1, 1993 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner — Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/industrial 1% of Value of Appliance or Work Rate TOTAL $ 20.00 $ 1.01 ®� $10.00 $ /�®08 $ 10.00 $ /0.00 $ 10.00 $ $10.00 $ -/0-00 M State Surcharge TOTAL FEE WMERN MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONIMR CONDITIONING PERMIT IS X15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS Z 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 c rrect. 0 `25 11993 OWNERlAl�-�Pi, ( LAI 0 1-7 BUILDING USED AS �eS ESTIMATED COSTa ®® PERMIT NO. % /L No. of Heating Units / Circle One (Steam) (Hot Water) arm Air) Trade Name Size No. BTU /0, HP EDR Fuel &-)6— Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY 441'K,PZ�4 1 Signed By6j, _ mei No. Lt, s Lt -411-17 5�7 Approved By I' Rough—In Date 10 -,?5 Final Date 2 - IV _94' FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE r 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 ( j 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) S. 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 Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS W3 ICCGL New Fixtures )_3 $ 7.00 Old Opening, New Fixture .. Urinal $ 5.00 Wash Tray i<i#If7ky .. Floor Drain f#11 ; Auto. Gas ((o. .Water Ran e asher Heater Stories Gas ElecShower Basement $10.00 Water Heater —Electric $.7.00 1 $10.00 D.00 Gas Range $10.00 Gas Dryer $10.00 Floor r 1 Type -$5.00 FI oor 2 l• Floor0 Fio 3 Floor FI 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS W3 ICCGL New Fixtures )_3 $ 7.00 Old Opening, New Fixture $ 4:.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $.7.00 Water Heater — Gas �_ $10.00 D.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type -$5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge TOTAL FEE The undersigned hereby makes application fora permit forthe 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. •` , 1993 Owner Building Used As� Estimated Cost PERMIT NO. PLUMBING COMPANY 1 h� rUl'c SIGNED BY TEL N0. Approved By Rough—In Date Final Date _9 $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE x.50 STATE SURCHARGE Building $ BUILDING Permit No.:LXV Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY Date Rec'd: /?- to DATE YOU1;,E-MAIL ADDRESS / / 6��sp z ( tel. S I� • �� e �/ SITE ADDRESS SAC Charge THIS APPLICANT IS: ❑ OWNER rNTRACTOR PROPERTY OWNER/ NANM: j , 11 -(e - ADDRESS: / a e�.Pc�` C°,�q r"Y CITY ErSTATF.�ZIP TENANT $ PHONE: CONTRACTOR $ STATE LICENSE # a `Z EXP DATE ✓ O' _ � Lri, SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: / c CITY t� l� STATEIP S S ?Z. WITH APPLICATION PHO ✓ - FAX Gs' PROPERTY TYPE INGLE FAMILY/ MW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REP ODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT c°JLENGTH WIDTH HEIGHT Sq. Ft ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 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 WINDOWS 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 MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ BOO. (X-7) OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ (0.00 .001 times the total job valuation Surcharge $ '3.0® .0005 x Permit Valuation Minimum $.50 License Surcharge $ ,ter, oo $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 $ 1 .;q 0 C Make checks payable to: City of Fridley Attach Stipulations 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 applicatio for a rmit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all warp ich quires review and approval of plans. OF APPLIC W PRINT NAMEI,)- SIGNATURE \ Gre < <�^ DATE O CI� 3uilding BUILDING Permit No.: (USING THE JX & P- inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY Date Recd: %' )ATE —Z� , ro,pp YOUR,E-MAIL ADDRESS $ ;ITE ADDRESS int �.� ���� dC 65% of Building Permit Fee Fire Surcharge $ PHIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR .001 times the total job valuation PROPERTY OWNER/ NAME: ADDRESS: CITY STATE ZIP TENANT `-. oQ PHONE: SAC Charge CONTRACTOR NAME: $1550 per SAC Unit (Plans to MWCC for determination) STATE LICENSE # 1 -71) 4 ( 1 EXP DATE f $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: -ftC. CITY c�.t' ATE ZIP ,=4 , WITH APPLICATION PHONE 6 1 Z—Z -r— (MQ () AX Park Fee PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Fee Determined by Engineering Sewer Main Charge ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS $ 1 a`1 5?_ -3's ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ® -,I-- 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 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROSED 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 WINDOWS 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 MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $j t , e'z �� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ (4,0S .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ `-. oQ $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 $ 1 a`1 5?_ -3's Make checks payable to: City of Fridley Attach Stipulations 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 of all work which requir review and approval of plans. // / SIGNATURE OF APPLICANT PRINT NAME i/ /& !i f DATE �� 6