PRE 2010 DOCSCity of Fridley, YHnn.
BUILDING PERMIT N° C5 9 371,
.: .,.. ,
Date:
Ov►Yer, . Builder ..._...—--•�•••••-••---
Address Address
�OCATJON OF BUILDING
No. ' tt
Block ___ Addition or Sub -Division ,: - "
_ , 1�
Corner Lot Inside Lot __ ' Setback _ a _ _ Sideyard
Sewer Elevation ___ _ _ ____ Foundation Elevation
rA DESCRIPTION OF BUILDING
To be
Used rar
Front '� Depth Height. Sq. F t., :: N
cw. Ft
Depth Height Sq. Ft. �p Cu. Ft. ,..
Type of traction „: f;'� Est.To be Completed _ _ _ __
In consideration of the issuance to me of a permit 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.
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. A .'
& jBuilding Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumhlog, gas heating, sewer or water. go sura too we
the Building Inspector for separate permits for these items.
4
City of Fridley
Arpp ication for Plumbing and Pas Fitting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ....... .......—V--.50
$
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
Z�
1
Z
� �
Q
a
..i
dna
�
6
Z
!2
F
N
WATER HTR.
GAS
ELEC.
Base
NO. RATE TOTAL
1st 3 Fixtures ..........................��
x $1.50
Cl
$�/
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
1st
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer El
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ....... .......—V--.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 BTL)
...... x 2.00
$ n?
New Ground Run Old Bldg . ............
x 3.25
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................��
x $1.50
Cl
$�/
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE U
Dept. of Bldgs. Phone SU 4-7470 /- %�
Location -0; -5-1 % le., C C� %" U G � ri-"a C e
City of Fridley:
The undersigned hereby makes application for a permit for the work hereii
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 fact
and representations stated in this application are true and correct. _
Fridley, Minn
Owner 7�0
Kind of Building
Used as C
To be completed about
ty
19!z
Estimated Cost, $
Old—New. Building Permit No� Permit No.
Signe
By G�
Business Phone No. - -
ROUGH /6 ` 3 - G -z—
FINAL
Date:
Owner: Builder
Address ___ . M_ Address
C:9- ?e'16V��-
N® 6956
LOCATION OF BUILDING
No. r _ Street - v — Part of Lot
Lot --- _ Block Addition or Sub -Division
r
Corner Lot Inside Lot – Setback _ _ , __ _ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
as:l
TocFront Depth Height e) Sq. Ft. "—! Cu. Ft.1'/wee
Front DepthHeight Z"7- Sq. Ft. Cu. Ft.
Type of Constructio _ - _ _ Est..��To be Completed
In consideration of the issuance to me of a permit to construct a uild
the proposed work in accordance with the description above set fo in
ordinances of the city of Fridley.
In consideration of the payment of a fee of
permit is hereby granted to
to construct the building or addition as described above. This �rmit 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
ordinancea. - A —
NOTICE:
Thh peva t dou not cover the constwedon, hwmW@n for whing, plumbing, gn hearing, sower or water. Be ane to we
the Building Inspeeter for nparafe permhs for these Items.
.»
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER ° S BUILDER
ADDRESS ADDRESS
f► CATION OE $U]LDI1�
No. �-=�� reet Part of Lot
Lot
Block Addition or Subdivision
Cornier Lot Inside Lot Setback Side Yard.
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as: � `"
C ,
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
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 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 % SIGNATURE
(Sebedule of Fee Costs can be found on the Reverse Side),
4_J
PERM}7 .' .
City of Fridley
"r
AT THE TOP OF THE TWINS
BUILDING
PERMIT
_(7977s
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
I
1 i �
1 , 11-1 CITY HALL FRIDLEY 55432
j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/14/85
JOB ADDRESS 251 Rice Creek Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
1
Rice Creek Plaza South
SHEET
27 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Roy Hattitew 251 Rice Creek. Terrace N.E.
571-7825
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
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 221.x 11' Three Season Porch. Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Nil lok�xes SEPARATE PERMITS REQUIR"ED 'FOR
'00�
Ca`` 9RI,INGv PLUMBING
�E
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
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
$6,950
$3.48
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 OTHER STATE OR LOCAL LAW REGULATING CON-
$62,50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$15.63
$81.61
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT )DATE)
WHEN PROPERLY V )DATED THIS IS YOUR PERMIT
901p-S
S� NAT OF wNERUF OWNERBUILDER) (DATE)
BLDG iNSP
4_J
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address
21 ";1 t
Legal Description:
Owner Name & Address: � {
�` c'r c. 4/1 �. ,.. Tel. #
Tel. #
Contractor:
r �^ .a
, r
Address: �` s6�
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 IZ2
Width !1
Hgt/Ground
Sq. Ft.
OTHER: 5� 6 ► Q® �r
� 1C 1'L 2 2 �
>D 1�.� �— 2 ��
2 J.
P_,A L IC C ar) - 1 a n . 3 �
- 0 31).60
Corner Lot [ ]
Inside Lot [ ]
Ft. Yd..Setbaek
Side Yard Setback
Type of Construction:
Approx. Completion Date:
Estimated Cost: $
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $
See Back Page for Explanation
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ .,so Fee Schedule on Reverse Side
Plan Check $ 5.(.'3 254 of Building Permit Fee
State Surcharge $ Irq y $•50/$1,000 Valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sever Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ e� • C21
STIPULATIONS:
V
V
i
SUBJECT
PE
City of Fridley_
22 36
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
I � I
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEPAGE
OF
APPROVED BY
612-571-3450
910-F15
3/17/95
JOB ADDRESS 251 Rice Creek Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR,
5
1
Rice Creek Plaza South SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dorothy Linse 251 Rice Creek Ter NE, Fridley
571-4596
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
M A Peterson DesignBuild Inc 5100 Eden Ave #309, Edina MN 55436 925-9455 6704
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 El ADDITION ADDITION Ci ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house; Replace Windows; Interior alterations
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Any bedroom windows being replaced must meet the
State Egress Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$30,000
$15.00
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-
Fire SC $30.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$254.50
PLAN CHECK FEE
TOTALFEE
License SC $5.00
$334.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
)4LLUL Z,�C c s
HEN P
ERLY VALIDATED THIS IS YOUR PERMIT
3 `aT� �
11TURE OF OWNER IIF OWNER BUIL ERI IDATEI
BLDG P
DATE
V
i
- 1 1 VI 1 1\1LLL I
ICL• oiz ori izor inar `9,`9D y:Ly NO.uuz r.uL4
NNW (J Effective 1/1/95
ADDN 1 CrrY OF FRIDLEY
AUTIRR ( SiNGLF FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 251 Rice Creek Terrace
Legal Description:
Owner Name & Address: Dorothy Linse, 2,51 Rice_ Creek Terrace Tel. # 571-4596
ConVactor: M/A%Peterson DesignBuild, Inc. MN LICENSE # 6704
Address: 5100 Eden Ave. ,.. Suite 309 Edina, MN 55436. 'rel, # . 925-9455
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 Leight � . _ Sq. Ft.
DECK ARLA:
Length
_ Width Hgt/Ground _ _ Sq. Ft.
OTHER: °Pi 5' cQe C� al®�v s
Corner Lot Inside
Lot (j Ft. Yd Setback Side Yard Setback.~
Type OP Conso'uCtl()n_
Remodel existing Estimated, COSI: $ 30, 000.00 -
Approx. Completion Dale:
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. • + 6 Ft = rt x $_ _ $
DATE; iel�5
APPLICANT;
_
- �� ��... _ — .... _. Tel. #
CITY USE ONIA
Permit Fee
$�%
Fee Schedule on Reverse Side
Fire Sure, -tugger
S Y4. elo
Mi. of PCI -mit viduatiotY
State Surcharge
$ f b',
$.50/$1,000 Valuation
SAC Charge
$ _
5850 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 l ] Not Necessary ( ]
TOTAL
$ .3 Y a f6
STIPULATIONS;
01L LD 40
PAER�.'ON DESIGNBUILD TEL NO.6129259455
MAR 15 195 14116 HOME PLANNING BITER
E><MM i WBWPS AWMAG$ "ti" Ct1MP't>q'bOW
s
P7. I All
Mar 15 , 95 13:47 P . 02
Detomdae Working square footage of saoh
1. Total esposed Wall ansa...... '+���q.�'.• XL
20 •• �, • -. --
g. Total soot'/oeiiing arae. •......r„�W. aq.it.
d6
3 i Total llooar/canto urea...... i,�„ � . mq oft. x �
Total mWeed Wall area above floor •
go TOtal Kal,�, wl44► area.... •.......... •... •...
b. Total door a!'eQ.fi..f•.•o•i•.i..i.......•...• a
ai Total'aliding glass door area•..•..........•.
d. Total ftroplase Wall area0i6666...•6666..••..
s. Total wall flramiag area {average10�►) ........ L' •
f i Total
net wall
area above
Hoar i. i i 6 6 6 6 . • i • .. �
s. io� �� joi41� ar8a.•.i...if.•.....•.if.si•N
Toth rea
exposed fow4ation a«*r,-:r 1. •�
h. Total hien 1W aiaa...ii•fi.1.......f w �� M
is Total not fodation area above
YleURISIM or value of "Oh Wall Segment
Wavbs ;� 14ot w Low t.
As X "Q" ■
b x OV ■
Q x M
x ova
• 0 AfARIA19 x..,r.w, •, •
. a
g. x "U" .o
h x "go ■
ix NUN •� ...r..�r,�y.w�rpM.....
.rrr.w r'.rr.�ti�w■r+�
.www.
lbo 6000.06.6.0•.....*too ego" ......... Towo ZIP?<' 2.
tt haat #4 Is the salve as or leas than its% #i you have met
the Imem of SW 6006(-0)A.
P.1
PETERSON DESIGNPUILD TEL ND.6129259455 hear 15,95 13:49 P.03
FUM PUJJ"ING CENTER i P. 2
Total. oxpoeod soot/coiling area
j. Total alwlight arca...............••....................
k. Total root'/oslbmg framing area (aver. .10016"o/o), :„
1, Total not insulgted root/oeiliag
Dotes ino MD" value for oseh root/oohing oegwsnt
Xsun �
X gulf •
i. m WUP z'
S• ...:.......... .................................. Total
it total of is the rise aso or less then #zj you have not the
intent of Sao 6006 (o)''.
Total exposed !',Loonleant, area 41-g.,,
a.. Tota. !loco"/fent, lyras or" (average .1�6)........ ®• , &
Ike. Total,rAt flOer "Rt• area.!•®®!!!!!!pv®..mo®.
Vation dee "0" value for eaob flow/coats segssnt
a!x or
u. :
6L
. ...l.t..•..11...• ....1.....ii..f...ii.......•..! Teta! (•0
if total of f6 is the sane as, or lose than f3* you have slat th#
intent of 880 6086(()3.
ALTQWATf 9101IDL14% BWSLODPB USIGN
To utilise the total snvelape system method, the values established
by the suss of Itene #4, 03 and /6 shall ,d be greater than the sum
of items #19 #2 and #3.
y
r Prepared by
Dat(,
Nor: 19WCot
y
uvek.;.0%
0
CITY OF FRIDLEY INSPECTION DIV,
6431 University Ave NE
Fridley, MN 55432
572-3604
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
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
Gas Range
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
State Surcharge .50
TOTAL FEE $ 0-
`-c cUUv� r7kC II (j rel �► :i � r c� r -r �.�� .
JOB ADDRESS Z � Vy C-C� � �C .7 -E
The undersigned hereby makes application for a'permk.for the work herOln
specified agreeing to do all work in strict accordance with the Pity coded.'.'.
and rulings -of. the Building Division, and hereby declares that alLthe facts
and representations stated .in this application are true and correct.
j7/-1:::* ,1995
Owner
Building Used As ( P L�-
Estimated Cost PERMIT NO...
PLUMBINGCOMPANY��-�-•-
SIGNED 4BY (�'TELNL_j
ApproveRough-In Date final Date.a4r_`
MINIMUM FEE FO ANY PLUMBING/GAS PERMIT t$ $15 00
PLUS THE -$.50 STATE SURCHARGE
Effective On January
APPLICATION FOR PLUMBING ANIS-GAS FITTING
PERMIT..
MARK NUMBER OF FIXTURES TO BE INSTALLED.ON EACH FLOOR .
Bath
i ' " Wash
�� 11
D n' Fioor ;' is Auto.
U
as ' Gas
Miss ]Water
Heater.
Tub; ;Showerihk,
I I
Tray
I
Four.::+. ,:, Drain _.;._..._
tl
, , Washer
f h�
' �.,. _ ;; Ran
a
a Fiat;
Gas. Elea'
lit
NMINEt<
f
NIL Wi
..
NO. RATE TOTAL
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
Gas Range
Gas Dryer
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
State Surcharge .50
TOTAL FEE $ 0-
`-c cUUv� r7kC II (j rel �► :i � r c� r -r �.�� .
JOB ADDRESS Z � Vy C-C� � �C .7 -E
The undersigned hereby makes application for a'permk.for the work herOln
specified agreeing to do all work in strict accordance with the Pity coded.'.'.
and rulings -of. the Building Division, and hereby declares that alLthe facts
and representations stated .in this application are true and correct.
j7/-1:::* ,1995
Owner
Building Used As ( P L�-
Estimated Cost PERMIT NO...
PLUMBINGCOMPANY��-�-•-
SIGNED 4BY (�'TELNL_j
ApproveRough-In Date final Date.a4r_`
MINIMUM FEE FO ANY PLUMBING/GAS PERMIT t$ $15 00
PLUS THE -$.50 STATE SURCHARGE
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
MATE SCHEDULE
Effective On January 1, 1996
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
f �
JOB ADDRESS Ad��
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 20.00 $
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace) $10.00 $
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
$10.00 $
$10.00 $
$ 10.00 $
$
State Surcharge
TOTAL FEE
$50
'5 D
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
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.
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. ar
rulings of the Building Division, and hereby declares -that all the facts and
representations stated in this application are trueAnd come' .
OWNER
BUIL' DIIS
ESTIMATED.COST PERMIT NO. 7Y
DESCRIPTION 0 FURNACE AND OR BURNER
No, of Heating Units Circle One.. (Steam) '`(Hot Water) (Warm Air).
Trade Name . Size No.
BTU HP EDk3
Fuel Total Connected Load*
Burner Trade Name Size No:
BTU HP EDR
HEATING COMPANY �
Signed By i _ Tel No.,
Approved By Rough -In Date Final Date
FILL OUT BACKSIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
M1
The undersigned hereby verifies that the existing chimney or stack:
I
Has been carefully examined
Yes {)
No
..2...
Is free from rust or deterioration..
A.es {
} . NO
3.:
Has' no foreign -objects lodged: within
Yes (.:)
No'
(
}
4.-
Is securely'supported
ides..(
Nq
(
)
S.
Meets all current Code requirements for size
and total BTU's connected
Yes (
} -No
(
}
6
Has total heating BTU's of
Alf other BTU's
TOTAL BTU's
7.
Has a liner. been provided for water heater
Yes ()
No
(
)
8.
Has combustion air been provided for water heater
Yes ()
No
(
}
Remarks:
HEATING CO:
Signed By:
Date:
-
SUBJECT
r
City of Fridley
2 879; 6� 4
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RE
�v _ _ COMMUNITY DEVELOPMENT DIV.
�emv
INSPECTION SEC.
PROTECTIVE
9(vr
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIOLEY 55432
' 612-571-3450
910-F15
3/2/99
JOB ADDRESS 251 Rice Creek Terrace 'NE
1 LEGAL
LOT NO.
BLOCKTRACT
OR ADDITION
SEE ATTACHED
DES CR.
5
1
Rice Creek Plaza South
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dorothy Linse 251 Rice Creek Terrace NE
571-4596
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Walker Roofing 2701 36 Ave S, Mpls., MN 55406
729-2325 4229
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
0 NEW Q ADDITION O ALTERATION JJ REPAIR 0 MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (33 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,828
$1.41
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-
SC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$74.75
F e $2.83
PLAN CHECK FEETALFEE
T
Licen SC $
$83.99
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi
HE PRO
VALIPTI THIS IS YOUR PERIALT
G IN9'P '00,
L
OATE
_
S.GNATURE OF OWNEROF OWNER BUILDER, IDAT 1
l
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: —51 I *-R
Legal Description:
Owner Name & Address: 20 U \/ (_.I n 5 d Tel. # 5'7 1 - f5qja
Contractor: Il�� k�, � �� �� 27� � f ,� MN LICENSE # c9 -C]
Address: ry)D) ro [\/ 0(o Tel. # '19a
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length' Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: �€'_ ro(p °- rcOkGlele % f Estimated Cost: $ %917,9- ®®
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ . = $
DATE: 3p -1-q61 APPLICANT: Tel. # qohq9 c3a,5
STIPULATIONS:
K
CITY USE ONLY
Permit Fee
$ P%L ='`]-'5_
Fee Schedule on Reverse Side
Fire Surcharge
$ x-93
.041 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ S--
$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
$S3,,qq
STIPULATIONS:
K
CITY OF FRIDLEY INSPECTION DIVISION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
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
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $
$ 10.00 $
Effective On January 1, 2000
L L c_
JOB ADDRESS— --QS � � 0,
OWN
BUILT
ESTIMATED COST PERMIT N0. A119-)
$ 10.00
DESCRIPTION OF FURNACE AND OR BURNER
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00 $ Trade Name Size No.
BTUHP EDR
$ 25.00 $� Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
A �� � I U s ►4 c
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE -t.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE On
HEATING CO
B
Signed -LA ho "&T� TEL # (�^-
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 manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
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 G
�---
HEATING C
Signed By:
O:
Date