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PRE 2010 DOCS
NOTICI:: 'Chis permit -does not cover the construction,' Installation or alteration for �!lrI plumbingo, gas heating, sewer or water. Be sure to see th tding Inspector for separate permits for!:tU items. 1 sueJEcr PE City of Fridley 20500 AT THE TOP OF THE TWINS BUILDING PERMIT r RE T N0. L __--_ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. (� r 1 NUMBER REV. DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 19/1/90 JOB ADDRESS 414 Rice Creek Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10 3 Rice Creek Terrace Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clayton Storley 414 Rice Creek Terrace N.E. 571-5429 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Energy Expert Construction Co., Inc. 5736 Nicollet Avenue South., 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 866-8934 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 261811 x 8' Addition to Duelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Ixista,ll smoke detectors on both levels of existing house. Provide new frost footings- with. 18"' crawl space; ARH G On all new., roofs or tear-offs an-4 reptacment roofs, �i State Code requires that 2 "vers tit 15 I;)- felt, Before digging call for mopped together, be installed to a point 24 inches all utility locations up from exterior wall line, or the use of other 454.0002 approved underlayment membran& REQUIRED BY W TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $10 800 $5.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE NY OTHER STATE OR LOCAL LAW REGULATING CON- PROVISI!:;2H $126.00 STRU E PERFORMA OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE q $131.40 SIGNATURE OF CO ,RACTOR MR-AUTHORIZED T 1DATEI HEN PROPERLY VALID TED THIS IS YOUR PERMIT BLDG INSP TE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI 1 NE [ ] ADON [ ] ALTER [ ] Construction Address: � ,/ Y Legal Description: L l r,!i Owner Name & Address: Contractor: R-1 AND R-2 Building Permit Application 6 Effective 1/1/90 7�3 Tel.. # i5:VI Tel. #�—d�'� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP cK OF LivnJG AREA: length Width _ r Height Sq. Ft. a,'3 GARAGE AREA: length Width Height Sq. Ft. DECK AREA: length Width Hgt/Ground Sq. Ft. OTHER: Pt3,� ld,�f�� % Corner Lot '' [ ] Inside Ft. Yd Setback Side Yard SetbaGks�.-, Type of Construction: 9, 6vvo aCli 9" oaf inated Cost: $ e� .0 Od Approx. Completion Date: Proposed Driveway Width If New Opening Is .D�ir"ecl�..:�' , Ft. ` Width6' a $acjc page DATE: (I`/// APPLICANTS gd '` lAt_F� Tel # 'lSL nYK ti °S, 1j ' GZTy, t" USE ONLY t ' , Permit Fee $ ra�.� Fee Schedule on Reverse Side State Surcharge $.50/$1,000 Valuation SAC Charge $ $600 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] Tam s. STIPULATIONS: C `0 eA_zo T-AJs%JtA— SOK&C &C-41TCON4 ?�df7r Acca ars,.1s7N` r � P� v ✓x /jk &1 Frwuf 0 667NGs Uj nig- Op., CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 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 Not Water Heater Gas Range Gas Dryer Back Flow Preventer Required. Type NO. RATE S 5.00 $ 3.50 S H $ 4.00 $ in $ q $ UX $ 5.00 w 5.00 Water 7.00 $ 5.00 $ 10.00 $ 10.00. Heater U u4 r UI g~ W r. u a vq O wr q 3 i aU ioto lec w R1 W 1 i as ter /3 �r 2nd 3rd 4th .L (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening 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 Not Water Heater Gas Range Gas Dryer Back Flow Preventer Required. Type NO. RATE S 5.00 $ 3.50 S 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00. . Yes ( ) No ( ) $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Is of Value of Fixture or Appliance Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE Effective May 1, 1990. Job Address Department of Buildings City of Fridley Tel. 1571-3450 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 A( Fridley, Mn. d . Q , 19 ( O OWNER S 7©/C Z,14 KIND OF BUILDING Woo 6 FR ,4-,-4 ,�N USED AS //0 JAlr z' �j TO BE COMPLETED ABOUT _/_9 .J 7 1 / Q ESTIMATED COST /,� '3' o' 0, -Cc- OLD - NEW BUILDING PERMIT NO. PERMIT NO.®� 7��j t Company J� 6 /✓ y�^G-1J C ' Signed By Tel. No. S-/ �ry� ✓� ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT !1ININUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE ✓ '56)fo CITY OF FRIDLEY INSPECTION DIViSION Effective January 1, 2003 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763).572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 JOB ADDRESS CM/ Wi cO Cg -eel< Tears D RATE SCHEDULE �/ OWNER C_ rVhy-i '540KIeZ Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS KeS�rP �cC Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) $ ESTIMATED COST 3.3 cy- cO PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACEAND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) ( arm Air) Gas Dryer $ 10.00 $ Trade Name p2&jeS4-i Size No. £G�✓�OIZ�-'' BTU_ 3cJ, QD0 HP EDR *Air Conditioning . All Sizes $ 25.00 $ Fuel- A41h, rm Ctrs Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) 1/0 of Value Appliance Work Burner Trade Name Size No. of or $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $ representations stated in this application are true and correct. S. DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION CenterPoint Energy Minnegasco HEATING C013562 Central Ave NE, Anoka, MN 55304 REFRIGERATION/AIR CONDITIONING PERMIT IS $25.60 PLUS THE $.50 STATE SURCHARGE Signed 763--757=6202 REINSPECTION FEE $47.00/Hr FAX # 763-757-6701 �D�. *Air Conditioners can not be placed in a side yard without Approved By _ Rough -In Date Final Date 11q k A written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED r.nMMQN VENT %IENT ry)NNC^T()R ANn r.QMR1 IRTIQN AIR M REICLUM Whenthe undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes (X) No ( ) and is securely supported and firestopped where required. The venting system is plastictPVC and meets all current codes and manufacturer Yes X) No ( ) specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and l Central fFumurees ace VentingcTabn s fors. fan oes include AGA-GAMA CategoryYes (X) No ( ) assisted and natural draft appliances. The raxietine rn btietinn sir is sized and installed to meet the current codes Yes No ( ) and manufacturer's specifications. When required to jpetall a new cnmeustinn air_ it will be sized and installed Yes �) No( ) to meet the current codes and manufacturers specifications. When iG4aw11n a nsus' 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 Yes f) No( ) Venting Tables for fan assisted and natural draft appliances. insta led Is the common vent and vent connectors sized as been removed from the commonvent alnd vented tly after an appliance h Yes (X) No ( ) separately as per current codes. Appbn T� ee and o;i7Pi^nmmnn Ven and Vent Cnn►+p�+er 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 Diameter in Type in Type Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height _ft ft Length _ft Length ft Diameter in Type Al TERA33ONS' HEATING CO:CenterPoint Energy Mi-nn13562 Central Ave NE, Anoka, MN 55304 e�asEe B Date �U _.- --)3 Signed y: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 k'AX: (763) 571-1287 ADDRESS : 414 RICE CREEK TER NE PIN : 143024240065 LEGAL DESC : RICE CREEK TERRACE PLAT 3 : LOT 10 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N .(I:. 2004-00942 DATE ISSUED: 06/21/2004 " VALUATION : $ 6,800.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, RUUD, 75,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 APPLICANT CENTERPOINT ENERGYMIlNNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 - OWNER STORLEY CLAYTON L & MARY E 414 RICE CREEK TER NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construc ' or the p ormance of construction. Applicant Date Bldg Insp A-L •�<'Z'/-� HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 PAID WITH CHECK # 5726 V.,F.PAR ATF. PF.RMTTC RF.(ITTTRRTI FOR WORK (ITTTRR THAN T1RCC'RT1RF.T) ARnVF v Ciel( Of FRIDLEY BUILDING INSPECTION 9 5431 University Ave NE 9 =ridley, MN 55432 L 763-5723604 FAX 763-5714287 9 D RATE SCHEDULE Residential Furnace Shell and Duct Work, Surner & also Replacement Furnace Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Tota $35.00 $ '35 .p6 Gas Piping (Neiv Furnace, Fireplace, Insert) $10.00 $ Gag Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning -All Sizes $25.00 $ �2_vu'� \'3�\M(N-1.-03C) All Other Repairs or Alterations (List on Back) >- 1% of Value of Appliafioe or Work $ aMinimum Fee $15.0p,; for Residential or 5% of cost of Y Improvement w ick i*er is greater on workless than $300.00 Commercis-h/Inc s riat/Institutional 1.25% of Value of -Appliance or Work (List on Back) $ _ Minimum Fee $36.Ob for CommerciaijindustriaVirfsiituiional YState Surcharge $ TOTAL FEE $ v v REINSPECTION FEE $50.00/HOUR m*Air Conditioners can not be placed in side yard without written approval R+ from adjoining property owner - copy to City i CL N FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE cc 10B ADDRESS L4 t y \ k i o - e Cre -e- �-- T -e-- r r e-<:� -,-- A Building Used As �� S e ►'� c '2 0 ESTIMATED COST U �C )J , Q C) PERMIT NO Ll � `� DESCRIPTION OF FURNACE AND BURNER # of Heating tints 1 Circle One (Steam) (Hot Water) (Warm Air) Trade Name l7 - U-1 `c MCC!" Size No. BTU ®o HP EDR Fuel Nca I 0001-S - _ Total Connected Load Burner Trade Name BTU HP Size No. EOR 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 ara In iA -1 correct. '( ( HEATING CO Le- Y,Le:__ _ cy C_ -4 L — ��304 Signed FAX #'-1 �3 - I S `I - (L) rJ 1 Date - /& Approved by Rough -in Date Final Date !�� C__T�/ z© ' d 1d101 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Ye� No( ) The venting system is plastic/PVII and meets all current codes and manufacturer ft specifications including sizing, le th, number of elbows and termination. Ye No( ) The undersigned also ver�ies-jhm the replacement unit is a listed assembly and meets the current codes - manufacturer's specifications. This does include AGA-GAMA Categoy:l Central Furnace Venting Tables for fan assisted and natural draft appliT. ces. Yes No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications, Ye� No ( ) When required to install a new combustion air, t will be sized and installed to meet the current codes and•rnanufacturees specifications. Yeslk<C 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. YesNo ( ) 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 q41°�{, JL' Appliance #1 Type CU-- \n ©-0 �- BTU Inpuf�5_,60C, an Assisted r N Appliance #2 Type ►.! 4; ., - I`,�.O± tet. BTU Input 3y� Fan Assi ed o at Appliance #3 Type BTU Input Fan Assisted or at Total Appliances Total Btu Input 34 ago Common Vent Type t - Vent Height �_ Diameter Lf 4 inches Appliance #1 Vent Connector Height S L ft Length ,2 'Lft Diameter, ~ in Type ��- Appliance #2 Vent Connector Height „eft Length __y ' ,ft Diameter min Type cl C-. Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) 4, -• -1 n p.- . Ah f X .Z4,4 4Z.1 Czo� e6 414rAy0--- CenterPoint HEATING CO: Ham Signed By: Date - / -n`( FRIFn ' A LO11.91.SL Ol J,31Q 1 NA AO Alin WON -4 q?: T T VOOF—LZ-Ndd kc CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: ( 763) 5 71-1"Lii 7 ADDRESS 414 RICE CREEK TER NE PIN 143024240065 LEGAL DESC RICE CREEK TERRACE PLAT 3 LOT 10 BLOCK 3 PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION �i PERMIT NO.: 2004-00943 DATE ISSUED: 06/21/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPLACE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- F 5011 STORLEY CLAYTON L & MARY E 414 RICE CREEK TER NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 5726 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. `11 "'f Building BUILDING PennitNo.• s �' Inspections RESIDENTIAL APPLICATION Received By: 763-57 -3604 CITY OF FRIDLEY Date Recd: DATE < - 90 – C116 YOUR E-MAIL ADDRESS �– 1� 9Zy� i� 1►12 ( ��'�A�� t C.'� SITE ADDRESS )-114 klcti' CTi'* THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: CL ft y®uzLuh TENANT ADDRESS: CITY —STATE—ZIP– TATEZIPPHONE: PHONE: CONTRACTOR NAME: 0SI'Jc(:5 CCIA P99'65 a �- STATE LICENSE # �) �J EXP DATE ® ]I@ 7 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 6 9co ca�r CITY FL o 0 Lt�STATENAfLIP SSV 3 4 WITH APPLICATION PHONE 763-j71-- Zeop FAX -763-:57i7---91731 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE JWADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING POTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: J0 X LLL AQP P %I to f:7i�'T C X®6508 6-'411-1 SIZE OF IMPROVEMENT ® LENGTH WIDTH HEIGHT 2,1If> Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 3 ❑ 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 13Trim I. Site Plan/Survey showing the existing structures 13Other TuOe © ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS K'es ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & 3 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.V FEE SCHEDULE) � � : k ��o Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due VALUATION $��a $ $ 31S -tom d $ $ $ :5 - Co ANCY See )Pack Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: Citv of Fridlev Attach 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 Wan in the case of all work whi h requires review -9 d approval of plans. a SIGNATURE OF APPLICANT Z �– ,k -'IA,nt4 PRINT NAME lam/ �IWJ DATE_ Building MECHANICAL Permit NO.: Inspections RESIDENTIAL APPLICATION Received By: 7.63-572-3604 CITY OF FRIDLEY Date Recd: DATE ®- 9 - ®(® YOUR E-MAIL ADDRESS NEW GAS GRILL $10.00 SITEADDRESS % , GQ, �ea,k -%�cCA- _GAS UNIT HTR $10.00 THIS APPLICANT IS: O OWNER De6NTRACTOR POOL HEATER $35.00 —VENTILATOR PROPERTY OWNER/ NAME' CITY STATE ZIP TENANT ADDRESS: PHONE: CONTRACTOR COMPANY NAME: M f D SUBMIT A COPY OF CONTACT PERSON: M Lo- ZR' IeG YOUR STATE STATE LICENSE # IF EXP DATE Z " 1."e CITY �� / tCN � STATE!!!NZIpAS 37� LICENSE WITH ADDRESS: 1105'0 (o`er APPLICATION PHONE -7(a 3 - 5(17. 2®:y d FAX !'SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE PERMff TYPE &15 I, TYPE OF WORK: p NEW ❑ REPLACEMENT PER MS 16B.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) MODEL: SIZEBTU Equipment Installed MFG: MODEL: SIZEIBTU MFG: MFG: MODEL: SIZE/BTU GAS RANGEIOVEN $10.00 &A/C $25.00 —FIREPLACE (GAS) $15-00 $35 D) $35.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 SPACE $3� _GAS UNIT HTR $10.00 BOILER $35.00 DRYER $10.00 POOL HEATER $35.00 —VENTILATOR CHIMNEY LINER $10.00 DUCT WORK $10.00 _GAS ,GAS PIPING $1000 $15 04 tea. ��. �.a .��v r�i+r �iWNFE kh y:✓arii'giyVir.�nu{3's 7;r;.g;avc - ,^r. xar-..--, _,. •,.,.,.-. ..,.—r..,„...... _ __. _.... _. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 �x $25.00 = $ �S TOTAL DUE $ C� Number of fixtures @ $35.00 i x $35.00 = $� 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 work which requires review and approval of �plans. ; SIGNATURE OF APPLICANT Q a, PRINT NAME - /'^� 'DATE City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel TMC Chapter 7 with MN Amendments b. Natural Gas or Propane/TGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. TMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Chapter 5 with MN Amendments b. Fuel other than gas IANC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a Required on new construction TMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. RCCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building PLUMBING Permit No. • - InspectionsRESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE yhl Z02. YOUR E-MAIL ADDRESS SITE ADDRESS oLs �ivaG✓ THIS APPLICANT IS: 0 OWNER XCONTRACTOR Clayton Storley Rice Creek Terrace PROPERTY414 NAiviE: Fridley, MN 55432 OWNER/ TENANT ADDRESS: 7635715429 "TE ZIP PHONE: CONTRACTOR NAME: NORBLOM PLUMBING CO- STATE LICENSE # X0617 tF:'1'71 fl'2'2 SUBMIT A COPY OF - W w YOUR STATE ADDRESS: ZIP ELD AVE——STATE LICENSE WITH PHONE APPLICATION PERMIT TYPE )(SINGLE FAMILY ❑ TWO FAMILY Q TOWNHOUSE NEW KREPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK kt1D & 4(,)6hLe_ Ile, aiG✓ 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 pr replacement of a residential fixture, excluding the fixtures. (This.should_reflect only.the cost of labor ) Labor cost under $300 = $115.00. Labor cost between $300 tq. $500 =cost of labor X.05 = -•F0"ROMCTS WHERE LABOR EXCEEDS$500;TEES ARE BASED ON $10.00 PER FIRTURE, EXCEPT:V4IEREPO:TE.:FI�e.,(INDICATE TOTAL NLWIBER OF EACH BELOW) BATH SINK/LAV _ FLOOR DRAINS _ SHOWER _ WATER PIPING _ BATHTUB _ GAS PIPING wm cmtums-r) SWIMMING POOL _ WATER SOFTNER ($35) _ _ i CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) _ _LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _ WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00" x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15,00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = S 50 Total = $ 3 . SO THIS IS AN APPLICATION FOR A PERMIT RIOT 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 a 1 tion fora ermit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case al wont w ' requires review and approval of plans.r SIGNATURE OF APPLIC PRINT NAME j; 7/t/ OM I40% DATE Z City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977