Loading...
PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 3706 Date: ... ®.. ..... ......... ..... ... ... Owner ....................................... Builder ...................... ..................... Address ...................................... Address .................... 6 ....................... LOCATION OF BUILDING No. �MP ... Street. . ......... of Lot ..,.-�..(( ....... . Lot .. ..... Block ... ............ Addition or Sub -Division .IstsP. ��'�•6 . . .......... Setback . �. � ®.. Sideyard .� � �. Corner Lot ............ Inside Lot � .................... DESCRIPTION OF BUILDING Z.A-��' ... Front .� r��Depth ®Height / �. Sq. Ft. .04-4 CU. Ft. PV/R'�,.� Front a g -P Depth .6�. Height ./C Q. Sq. Ft..,! i1 A Cu, Fk��Q.v Type of Construction ................... lilst. Cost. „[.1rX7tX...... To be Completed .................. . In consideration of the issuance to. me of a permit to construct the building desribe above, I agree to do the proposed work in accordance with the description above set fo d in compliance th all provisions of ordinances of the city of Fridley.I Al In consideration of the payment of a fee of $. i�� ..... permit is hereby ted 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 with- in the city limits and this permit may be revoked at any time upon violation of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wi sewer or water. Be sure to see the Building Inspector for separate permits for Items. gas heating, i �!M 0 0 City of Fridley Application for Fimbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures .10 ,�, < �� Z ,7� N Si pa� Z O� a Ci w N Z ,y * WATER HTR. 3 �g a 3f eu �' 0 N GAS ELEG Base 4 1st P 2nd 3rd 4th • Future Connection OpeningsI Connected with New Fixture, Old Openings Sewer Cesspool LJ PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $---A 60 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.5o $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........................................ $ TOTAL FEE $ / City of Fridley: 1 -1 " - Wr A 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. Owner Kind of Buildine To be completed about Estimated Cost, Oi—Ne Building Permit No Sign By Business Phone 11 POST 1M-12-58 193 Effective Aug'. 1, l7Rl CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE _ \ESIDEkiTL11L RATE TOTAL Job Address (, e��-Ci�a)�f�J Furnace Shell and Duct Work, Burnes (Also replacement furnace) $ 20.00 $ '2O,U� Department of Buildinqs, 6131 University Ave. N.E.. Fridley, MH SS472 City of Fridley Gas Piping G��`f'�Niv�eT �61� LY $ 10.00 $ Tel. 4571-3450 (piping needed with now furnace) Gas Range $ 10.00 $ The undersiqned hereby asked application for a permit for the work herein specified agreeinq to do all work in strict accordance with the City Codes Gas Dryer $ 10.00 $ and rulinqs of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct.' Air Conditioning (all sizes) $ 10.00 $ ®. G`L� rridley, Minn. 19 All Others/Repairs and Alterations OWNER 714-1- V-"/ It of Value of Appliance or Work $ F42/16 RIND OF BUILDING COIMIERCIIIL/INDUSTRIAL USED AS - d2E5,r Q F1" 0- f It of Value of Appliance or Work $ IV) BE COMPLETED ABOUT -'�2 %Ot ESTIMATED COST State Surcharge S .SO OLD -NEM BUILDING PERMIT 340. PERMIT NO. g TOM !EE $ 6 �� Reinspection Fee ($1S.00) $ DESCRIPTION OF FURHACZ/BURNER Rough Inep. HEATING or POWER PLANTS. Steam, Not Water, Nam Air- No. Date �� j!—�5 Trade Nage TA4A.)4 site No. '8L o6 Final Inep. Date J Capacity Sq. Ft. [DR BTU HP c/� Approval for Permit `� Total Connected Lead �U, ov-0 Kind of Fuel Nom? 1949 BURNER - Trade Name Tp�' AIF— Sime NO. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 Company PLUS $.50 STATE SURCHARGE Signed ey'�i��i����-- �- Attach stack verification tors with replacement furnace permits To-1. No. *Air Conditioners can tint la• placed in •ase• yard without written purtsis%ion frau adjoining witildior. CITY OF FRI fN_EY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND. STACK VERIFICATION THIS FOP14 MUST ACCON-PANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION DATE OWNER ADDRESS The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined ✓ 2. Is free from rust or deterioration 3. No foreign objects are lodoed within 4. Ttat it is securely supported 5. That it meets all current Code requirements for size and total BTU connected 6. Total Heating BTU LGA, D -0 All Other BTU 34, cq"-a TOTAL /1 REMARKS SIGNED 2 L/ r - Licensee by Address A -1t3 HEATING PERMIT # Telephone Fridley City License It FA SUBJECT P City of Fridley 31589 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. i tr V .......COMMUNITY DEVELOPMENT DIV. �4 f PROTECTIVE INSPECTION SEC. 1 � NUMBERREv DATE PAGE OF A0PROVEO BY = E "'1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 12/5/00 JOB ADDRESS 220 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. .3 3 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ethel Dzubay 220 Rice Creek Terrace NE 763-571-3268 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Windows 3938 Meadowbrook Rd, St Louis Park, MN 55426 933-6300 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 11 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 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 1997 Uniform Building Code. crit 103eflon Cards W10 Be Mailed To Homeowner 76 Poe SEPARATE PERMITS ARE REGUIREO 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 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 $3.68 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,364 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- $153.25 FirA SC $7.36 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE7164.29 FEE Cit cense SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT iDAtEi H N PRO % VALI AT D THIS IS Y_0 R PERMIT I ; OG 6 jrgAiE S-GNATURE OF OWNERni OWNER BU4DER1 FA NEW I j Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION�� Construction Address: l c e ae-lav- Legal Description: Owner Name & Address: Tel. # 63 3a j Contractor: PiV MN LICENSE # el'v/? Address: �� a?� , ��/" Tel. #�3&<5 Hp�/ 5s - 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: 6< Construction Type:yenk'temv�f � 0� k)11&6 Estimated Cost:ki $ � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee fR3 Fee Schedule on Reverse Side Fire Surcharge j. 3E .001 of Permit Valuation (1/10th%) State Surcharge $ a6� $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ �67' $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: � "'.r � �� ��' "b� .irk% oo� fir/ J-;'; li,97 e -el f. c% CITY OF FRIDLEY INSPEC•1 iON DIV. 5431 University Ave NE 'Fridley, MN 55432 I7a'A_r%79_AAn4 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2001 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" NO. RATE $ 7.00 $ 4.00 $ 5.00 Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () No TOTAL - JOB $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 d�© $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ 0 ,e&k —[_eX'rC,6 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. ,20d l Owner i Olt S U d Building Used As AD Estimated Cost 465 PERMIT NO. 3.21 PLUMBING COMPANY _5r -W 8 55W'JCJ - SIGNED BY TEt-wo. Approved By Rough -In Date Final Date n�" COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH F-LUUtt :$:.}•v: Wash ::>:: :$ Floor ' Auto. >>�'::.: : Gas 5 , Water Heater .}?•$::;r �: ry::: 5 f::?:< Traft:::<:: Drainiri ::: Washer >:.:?•;:?.::: Ran a I :> Gas Elec Stoneset..... }: Urinal `tt�-,$: Shower =it:4}::t::ii,v iY 3)�;:$F?:fi$:L•i,ti.:: ;:.. :n: ti•}}::?: }}Y::4:::.i :.:.:..:.:,>.:...:..,. :.::................. Base•�= •� Floor 1 .. i.. ipi$/••::.4. rr.;;: :>:<rr F 001 Floor 4 ..::.::: PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" NO. RATE $ 7.00 $ 4.00 $ 5.00 Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () No TOTAL - JOB $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 d�© $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $ 0 ,e&k —[_eX'rC,6 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. ,20d l Owner i Olt S U d Building Used As AD Estimated Cost 465 PERMIT NO. 3.21 PLUMBING COMPANY _5r -W 8 55W'JCJ - SIGNED BY TEt-wo. Approved By Rough -In Date Final Date n�" COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 ( ) 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 manufacturers 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. 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 BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height _ 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) HEA71NG CO: Signed By: Date SUBJECT City of Fridley 33196 AT THE TOP OF THE TWINS BUILDING P E R M I T r ` RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; NUMBER REV DATE PAGE OF APPROVED 8V CITY HALL FRIDLEv 55132 763-571-3450 910-F15 10/22/02 JOB ADDRESS 220 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ethel Dzubay 1220 Rice Creek Terrace NE 763-571-3268 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Kirk Construction Co 423 E Wyoming St, St Paul, MN 55107 612-414-5864 5839 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 Cj ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 20' x 24' Addition with basement 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. y '3efole 1319 ging call for 'EPARATEP ITS 1116 Utility locations O02 REQUIREDED FOR:4 WIRi F 1 IF BY LAWG HUN0 G PLU RRANDSIG S 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 $ 44,332 $22.17 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 OF ANY PTHER STATE OR LOCAL LAW REGULATING CON- $593.25 Fire SC $44.33 STR CTION O TH P RfORMANCE OF CONSTRUCTI PLAN CHECK FEE TOTALFEE License $5.0 664.75 S�GNA E OF CONTRACTOR OR TNORi2E0 A ENT iDATE� _ EN ROP VALIDATE THIS IS YOUR PE MIT BLO NSP r�Ar SIGNATURE OF OWNEROF OWNER BUILDERi iDATEi NEW [) CITY OF FRIDLEY Effective 1/1/2002 ADDN () 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Ins ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 p5h BUILDING PERMIT APPLICATION Construction Address: �'��� G�r� �e�e ®� Legal Description: Owner Name & Address: Contractor./�f�-����'% �� . MN LICENSE # Address: V®-4w'�W� 5/1 i .1, 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 L/,go 7d`t6LI �r�,90 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft i / OTHER: -tas��w4 ® X Fd'� " 54&5- Aq,7� �I-q _6 ea Construction Type: �W &X XV R17749lfirB 10 /3 Estimated Cost: $ � 4 // 3 3 �8� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: I0 ® 62—APPLICANT: Tel. # 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 $ 693-0'0'-' Fee Schedule on Reverse Side Fire Surcharge $ , 93 .001 of Permit Valuation (1/10th%) State Surcharge $ 22 o / 7' $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ 00 $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 $ C04zy m' /..J STIPULATIONS: o,I . pppp jr f �,�a%' X107 ' 0 hax, of o ��✓ o U,o ani f a s/ 1'iC 71'0✓x a/a s oo ►!/r.'//fib 11+,r +,'� � �/`,rrr. jff / f, -,74e IdJJSSISSIW pj9 o�o2-71'2-8 -7 5-, TO CITY OF FRIDLEY INSPECTION DIViSION r 5431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE J Residential Furnace Shell and Duct Work, Burner . Also Replacement Furnace (Side Vent - Fill Out Back) _ Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer `-Air Conditioning - All Sizes Al I Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $_10.00 $ 25.00 U a .'ommercial/industrial r 1.2.5% of Value of Appliance or Work L L D State Surcharge TOTAL FEE 5 L MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATII 2EFRIGERATION/AIR CONDITIONING (PERMIT IS $25.00 ? 2LUS THE $.50 STATE SURCHARGE V ZEINSPECTION FEE $47.00/Hr 9 9 'Air Conditioners can not be placed in a side yard without NJ vritten permission from adjoining property owner. i r Effective On January 1, 2001 JOB ADDRESS 2C�I C 1 �c(e—, OWNER TOTAL BUILDING USED AS �` �� �� lS;� $ � ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND ORRBURNER �Q No. of Heating Units__ Circle One (Stearn) (Hot Water) �armAir $ a • Trade Name_� AeeiSize No. BTU Qc-- 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 specified agreeing to do all work in strict accordance with the City Codes an 50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ �� DATE � _ / 2-03 HEATING CO T_1a-re— 0 !i Approved By &,.) Rough -In Date SIDE MUSTN. FILLED IN ON V COMBUSTION AIR VERIFICATION TEL Final Date dT SIZE. VENT CONNECTORS I'Iti I—GJ—ceiY_11 LC - -4—) r RUl'1 1— 1 1 1 LJr r M i LLL l I W J1—V 1 1. V- ' vet COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When realacing an existing furans, 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 pl� No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes P< No ( ) The undersigned also verifies that the replacement unit is a listed assembly STU Input and meets the current codes and manufacturer's specifications. This does Appliance #2 Type include AGA-GAMA Category 1 Central Furnace Venting Tables for fan Fan Assisted or Nat assisted and natural draft appliances. Yes K No ( ) The existing combustion air is sized and installed to meet the current codes Yes O� No ( ) and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed Vent Height to meet the current codes and manufacturers specifications. Yes X No ( ) When installing a new venting system, the undersigned hereby.verifies that ft Diameter in Type it Is a listed assembly and meets the current codes and manufacturer's ft Length specifications. This does include AGA-GAMA Category I Central Furnace Yes K No ( ) Venting Tables for fan assisted and natural draft appliances. ft Diameter in Type 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. Yeso ( ) Awliance Type and Size/Common Vent and Vent Connector Information Appliance #9 Type STU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height 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) ` / 4 HEATING CO: Signed By: Date : f - I0 TOTAL P.04 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2003 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS ;� ® R, `c e Lye P %C T New Fixtures Jr $ 7.00 & 0 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 aZ , 200,E Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range** Gas Dryer** $10.00 $10.00 Estimated Cost g�e5_OC9- � PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 / PLUMBING OMPANY / C I Reinspection Fee $47.00/Hr SIGNED BY TEL N0.�— ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance „„ Approved By Rough -In Date Final Date �t c State Surcharge .50 s MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $—C PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, VFNT CONNECTOR AND COMl3l ISTION AIR VERIFICATION When replartang an _xis ing furance, 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 () No ( ) The venting system is plasticIPVC 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 cnmeustinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a now rnmhi ,c inn air, twill be sized and installed to meet the current codes and manufacturer's specifications. 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 #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height 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 HEATING CO: Signed By: Date City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit # Residential Application City of Fridley See Back Side For Reauired Information Date 3/ �?/o P Site Address: 2-21:> 4c- L rre/c / Cr"a L ' The applicant is: (cirlce one) Ownerontractor Property Owner. 45-t-ke1 A ,y Address: Z4-0 Cic.� Crccic 77-tr vec� City: F��a/c� State: �.N zip: IZ Phone: -7 6 3 - 5-71 -3 Z-(.- ? Cell: Fax: Contractor Information Company Name: Contact Person: TedpoWgift am � N G/L - 36 3 - Address: City:n a. zlp: Phone: Fax: Email: MN Bond# & Exp Date Type of Work (circle one): 6e=w Replacement Alteration/Remodel Detailed Description of work: 5a t 1 2-Iw licz-11%7 a' IG���ry d Equipment Installed: MFG: MFG: o Model: SIzeBTU: L7. ®®o Model: Size/BTU: MFG: Model: Size/BTU. Please check all that apply: ireplace (gas) $15.00 New Gas Grill $10.00 $25.00 (wood) $35.00 _Gas Unit HTR $10.00 _A/C _Air to Air exchanger $15.00 $35.00 _Fireplace Furnace $35.00 _Pool Heater $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Boiler _Chimney Liner $10.00eOGas Piping $10.00 00 Duct Work $10.00 as Range/Oven $10:00 Permit Fee $ (Total from above-Miniawr " Surcharge ,$ 0.50 0 -5 Total Due $ Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. Signature of Applicant: Date: 3 &'/d6 Approval Inspector Signature: Date: _ Please Note: Separate permits are required for Building, Plumbing, and Electrical work Building PLUMBING Permit No.: � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY / Date Recd: (� DATE J YOUR E-MAIL ADDRESS SITE ADDRESS % (, �` L' l-r�e V K Gt THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: ADDRESS: v CITY Fy"Yrev STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: Gt V' 11 Q '1A Ir STATE LICENSE #�k-(-,> (i EXP DATE D SUBMTT A COPY OF YOUR STATE ADDRESS: E '�.f% 6 y c -D In �D C� �` CTTY t.t- STATE ZIP LICENSE WITH PHONE l^ =f_CL �-2( FAX APPLICATION PERMIT TYPE XSINGLE FAMILY ❑ TWO FAMILY CI TOWNHOUSE TYPE OF WORK: N NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK 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) BATH SDM1,AV FLOOR DRAINS _ SHOWER _ WATER PIPING BATHTUB — GAS PIPING (Nm c77Ljc&ws4 _ SWIMMING POOL —WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK � WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER , LAUNDRY TRAY _WATER HE ($35) FOR IRRIGATION WATER METER —OTHER owl E' �: .. ` .•`e, �.. M: f` Y' ,_... F .. J:'.-,'+... ns.M �. �a .. '.,6 ,�. �5., J. .._ „ =? it Permit Fee. $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .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 of all o which r�reviiew d approval of plans. PRINT NAME tJ °� 'LLL �� DATE �® SIGNATURE OF APPLICANT City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 G9 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No.: Received By: , l Date Rec' d: ' r '7 - a4 DATE YOUR E-MAIL ADDRESS G,4 P rA SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME:_ '45 n-1 4 I , (' ADDRESS: SI-/" E CITY TATE ZIP TENANT d01;/ PHONE: '74.5 5�7/ Fire Surcharge CONTRACTOR NAME: LI -1 hur/rs ,,-� .001 times the total job valuation Surcharge STATE LICENSE # 5.' 3 1 EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: LtZ 3 -- ty V e", CITY • U mss / STATErn'UZIP 5-5-11V WITH APPLICATION PHONE & 2:1 *— 59 & 5E� FAX $5.00 (State Licensed Residential Contractors) PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE $1550 per SAC Unit (Plans to MWCC for determination) ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS $ `6(13ASEMENT FINISH Sfon-ac- ❑ ROOF ❑ DRAIN TILE Park Fee ❑ DECK 4-&qTf-1 ❑ SIDING ❑ OTHER Fee Determined by Engineering ❑ SWIMMING POOL $ TYPE OF WORK: ❑ NEW ❑ ADDITION Total Due $ ❑ MAINTENANCE/REPAM VREMODELING Make checks payable to: City of Fridley Attach Stipulations DESCRIBE WORK BEING DONE: fl"A istj 85rnT 14 D DiTImA-) (moo z- oD lHee P_acr- 't ADO SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 3. 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. ESA y�E55 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 ze9 0 OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS AT T 'GVFc ART RscF.n nN VeT.TTeTTnN_ TNCT.TmTNG THF. COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Sc9-o OCCUPANCY M W5 Permit Fee $ 4 I , (' See Back Page for Fee Schedule Plan Review $ d01;/ 65% of Building Permit Fee Fire Surcharge $ Z& 6 6T, .001 times the total job valuation Surcharge $ 6, P .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ R + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ • Make checks payable to: City of Fridley Attach 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 whi r uirrees review and approval of plans. SIGNATURE OF APPLICANTA.,✓��-i /C PRINT NAME �/� A" /t 5 5 /' DATE 3— FROM :City of FridleyFAX F# Mar. 24 2006 09:28AM P4 0603 %/O� 0 Builiz dinPermit No.: &ZW MECHANICAL hispections RESIDENTIAL APPLICATION Received By: 763-5723604 CITY OF FRIDLEY Date Recd: '2' DATE 0-1, YO AILADDRESS P- r:). SITE �'I)T)RFSS )DRESS L A THIS APPLICANT IS: El OWNI?R W.ONTRACTOR PROPERTY NAMP; I - OWNER/ ADDRr4..g LV TATZJ66P TENANT PHONE: _� CONTRACTOR COMPANY NAME: zlve-- ST-IBWTA COPY OF CONTACT PERSON; YOJ . JRSTATE STATIi LICENSE #_.. EXI) DATE LICENSE, WITH A D D R E SS: crpy 0 STAW?/1/Zrr' APPLICATION FAX - PERMIT TYPE P(.StNGLr, FAMILY 0 TWO FAMILY Cl TOWN140t.1$F TYPE OF WORK: 0 NPIW 0 REPLACEMENT )rALTERATIONIRFMOI)FI, — -------------- DUAILED DESCRIPTION OF WORK PFR MS 1613.665 the permit lbe is MiRiMUT111 of $1.5.00 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, (Ibis should reflect only the cost of labor Labor cost under $300 = $15.00, Labor cost between $300 to $500 =,cost of labor r -"05 FOR PROmcTS WI-JERE. L.ABc)R p.XC.EE'DS $500, FEES ARE BASED ON $ 10.00 PER PIKI'LIRE, EXCEPT WHERE NOTED, FIXTURES- (INDICATE TOTAL NUM8HR OF EACH HFI,()W) Equipment Installed MFC: MODEL: STZEffiTU MFO: MODEL: SIZ MITIJ—" MFG! MOTIRL; SIV1VJBTU * _FIREPLACE (OAS) $15.00 GAS RANCR/()VEN'�l A/C $25.00 0.ffj — MR 1-0 AIR EXCIIANGFFR $15 —FIREPLA(7, (WOOD) $3.5,00 —NEW (j,AS GRILL $10.00 —BOII,F,R $.31.00 —FURNACE $35.00 —GAS UNIT HTR $10.00 — 9INVEYLINER. $10,00 G16.9 DRYER $10,(x1 POOL ITEATkli $35.00 --f)LTCT WORK $10.01) --GAS Pill] NU $10.00 _POOL $15.00 = U-171i i � I — iml�- � Perm it Fee $ Number of fixtures @ $ 10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE Number of fixtures @ $25.00 x $25.00 = $ Nwn&,r of fixtures @ $35.00 x $35,00 = $ State Surcharge = $ 50 Total 71-JIS IS AN APPLICATION FOR A PFRMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City ol'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 intl)e cage 0 al work which roq ' review and approval of plans. �� �-�DATE SIGNATURF OF APPLICANT NAMEA� 0 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977