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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: .� ...... __ _.._. _...... Owner: .�� _ .. ?�" Builder Address ;.. :..: ._ ......rlA4- .. .. a...._.fe Address NO 4778 LOTTO V BUILDING . .------ street ___<.�' r�....,..__.._.... __._ Part- of Lot _. ............ _....... _---_...._.... LotNo...... ......................:.: Addition or Sub -Di r.... _.._.. ..........:..: Block ....... ... r vion,.. Corner Lot .........................:---...... Inside Lot ........... Setback ....._......::.. ................. Sideyard e.- ......: ............... .--- _....... Sewer Elevation ------------- •.................... .............. _...... -.:............ _.... _.................... ... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: - _ : FrontY!..Ox! Depth Height .... ... Sq. Ft._.. Cu.Ft� -- Front ..n�:_, Depth .w�+�-rtz� Height..... Sq. Ft..: Cu. Ft... f onstru....... Est. Co�....X.: ; ......... To be Completed ..... . ............. _................................ Type � etion CAUT THIS PERMIT DOES p}0:f AUTrl0 IZE VBOLAT ION OF ANY PRIVATE LAND D COVENANTS AND BUILDING RESTRICTIONS. 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, shallconform in all respects to the ordinances of Fridley, MlnnesoiW 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. °7 - '"r__." .244. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 per, - � -. - •:, b APPLICATION FOR BUILDING PERMIT CITY OF .FRIDLEY MINNEGOTA'• _... ....._. Owners. Name �% Ad Builder Address l l .� �� DA-- Address' . •71 1 �, No. Lot Corner of Lot Block Addition or Sub.Div. Lot�Inside Lot Set Back � Side -Yard SEWERELEVA T, ION FOUNDATION ELEVATION , Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: S e - Front Depth Height �� SM. Ft. Cu. Ft. __.... �.`.. �. Front. �- Depth-' Height..*.' Sq. Ft. -Ci:. Ft. Type of Construction ` • Estimated Cost!vV A To be completed C -f , The undersigned hereby makes application fora permit for the work herein specified, agreeing to do all work in strict accordance with the City'Oidinances and ruling of the Department of Buildings, and hereby declares that all the"facts and repr®senta- tions stated in this.applica.tion are -true and ct. DATE SIGNATURE (A Schedule of Fee costs can be found on the verse Side.) Application for Power Plants and. Heating, Cooling, Ventilation, .Refrigeration 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 $ MEC& WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $_ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace...........................:..P.00 $ Repairs & Alterations—up to $500.00 ............... j'. 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. EDR 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 $ 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 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FF,E $) e ROUGH Dept. of B l dgs. Phorra]]e Std 4 ''1v` 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. Owner 1 ' Kind o uilding A Used as - To be completed about Estimated Cost, $ ,r - Old—New. Building Permit No. 4 Permit No. DESCRIPTION OF WORK HEATING or 110WER PLANTS --Steam, H t Wa —No Trade Nam Size No Capacity : Sq. Ft. E.D.R 3� BTU f H.P. Total Connected Load q/ ®(6 Kind of Fue] BURNER — Trade Name –9 Size No. Capacity .£ras ?. RV r L T C® 4637 CH1CAR0 AVE. M INZAPOLW 7" , INWHESST-A, 4 2 2A FINAL (REMARKS -OVER) City of Fridley Application for Plumbing and teras Fitting Permit Dept. of Bldgs. Phone 0 4-7470 DESCRIPTION OF WORK®, Number, Kind and Location of Fixtures Location.- ffi I� yy a Z�c °ppCz 6z 0=1� UN z WATER HTR. s'j' ���a t�m(70 �a R N GAS ELEC. Base 1St 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $1.50 $16 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 $ `® New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ r !� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE d 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. 1 .I' - rridla;r%Minn. 4 - '- 'P 3 1 46 Owner Kind of Building Used as , To be completed about Estimated Cost, Old—New. Build ROUGH FINAL da 2M 7-39 City ®f Fridley, N° 7505 BURDING PERMIT Date: Nay ?4t 1965 Owner: Chester Yee Builder Mork %ilders Address --!740 Rice Creek Terrace Address 2621 Kyle Ave. No. LOCATION F BUILDING lvo. 740 street -ce Creek Terrace Part of Lot Lot - 11 - - _ Block 4 Addition or Sub -Division Brookwiew Terrace 3rd' Add. Corner Lot Inside Lot Setback _ Sideyard Sewer Elevation _ _ _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft Type of Construction Fast. Cost 66-,400*0() To be Completed Repair storm Dmmge 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 ce with ail provisions of vrdinanoes of the city of Fridley. ''' l 5,r PA In consideration of the payment of a fee of $ 10°02 , permit is hereby granted to Mork Builders the to construct the building or addition as described above. This permit is granted upon express condition that the person to whom it fs granted and his agents, employees and workmen, fn all work done in, around and upon said huilding, or any pari thereof, shall conform in all respects to the ordinances of F hin the city limits and th�,s permit may be revoked at any time upon violation of any of the provisions of said inances. Building Inspector NOTICE: Ub pemdt doss not corer the coeutmetloe, hnmWen for wiring, phm bing, ens hed ing, sewer or wafer. Be ours to sae the Building Inspector for separate pwm6s for theta h ms. LOCATION` bF BUILDIEG No. 7110 -4-Ce- L � - ' eet Part of tot ' LOT,__ t $LOCK ADDITION OR SUBDIVISION Ay ?,R. mw). Corner Lot Inside"LOT Setback Side -Yard SEWER ELEV'ATTON IN ELEVATION App`liddht •attsi to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. ` DESCRIptt6 T 'OF BttliDtm Front Depth Height Sq. Ft.. Cu. Ft. Front Depth Height %� 3q. Ft. Cu. Ft. _ Type of Construction. Estimated Cost L� Co .,. , To be 'completed , The undersigned` hereby makes application:='for`& permit for the work herein specified, agreeing to do'.all work in strict accordance with the City of.Fridley Ordinances and rulings '6f' -the Department 'of Buildings, and' hereby declares Chat_ all the .facts and represeutations'stated in thii-application'are true and correct. DATE'/� li SIGNATURE a1-� (Schedule of Fee Costs can be found on the Reverse Side). Z�88'th. Minneapolis. Minnesota SS422 a o Telephone S88-3858 262. Kyle Ave. No. Key Igo 1965 Chaster Yes 740 Rice Creek Terrace Repair of storm damage at above address to consist of the following: Remove oak floorn dining (wdth glitter) living room and dining room eel -ling and re- paint walls, New sheetrook on west wall of dining room, Re—hang zy dre.-fit two @'. ? tl. x doorso '# :: -: <;, me { doorand .b -alp #hooI from house to garage. New screen combination door. Check y.electric. New pull-down fixture in kitchen$ dining room. Garage fix., tore, front and rear. New sheetrook on galling and walls In eating area of kitchen. Redecorate same. New Armstrong linoleum (std..gauge) Floor in kitchen. Gutters and downspouts on rear and garage. Replace stone .. front planter. Rebuild double garage$ plus new joists and rafters on 12 fe of house. RG -paint trimn rear and east side of house. New ».`n entire house. All debris 4 4removed from premises 1,11` '•'W Is oompletel SUBJECT P City of Fridley 24003 AT THE TOP OF THE TWINS P, BUILDING PERMIT IPT NO. Ir • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY �""" ,•� 612-571-3450 910•F15 3/13/96 JOB ADDRESS 740 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 4 I Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Theresa Yee 740 Rice Creek Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dave Wi er Const 901 Rice Creek Ter NF, Fridley, MN S5432 572-8403 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE A 8 DESCRIBE WORK Reroof House & Garage 28 S 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 1STALLS 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 $1,680 @ $ 84 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT • DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $1.68 UCTWYN OR THE P FORMANCE OF CONSTRUCTION C PLAN CHECK FEE TOTAL FEE License SC $,5.00 $61.52 S NATURE OFCON'RACTORORRORI2EDAGENT IDATEI WHEN PROPE VALIDATED THIS IS YOUR PERMIT ` �� L INSP / OAT _ SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 / D Z Building Permit Application ConstructionAddress: V' /e fCc (f1?et� 7`�r��� c� Legal Description: Owner Name & Address:/t��r�'S�' ,��� Tel. # Contractor: L?Aly fit) 16 MN LICENSE Address: /?/ � CAW- Tel # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 1% ?-go %®�'i L 11G4,P6�F 4 9L? 15-q s, 'recav® d 101eR Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ �r Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: F + 6 F = Ft x $ _ $ DATE: AAA? 1..3 23c APPLICANT: Tel. # CITY USE ONLY Permit Fee $ / � Fee Schedule on Reverse Side Fire Surcharge $ /, ���, .001 of Permit Valuation (1/10th%) State Surcharge $ ly $.50/$1,00 Valuation SAC Charge $ $900 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 [ ] l g d, TOTAL $ < STIPULATIONS: SUBJECT City of Fridley 26467 AT THE TOP OF THE TWINS BUILDING PERMIT r R T NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 30 1 NUMBER REV DATEPAGE OF APPROVED BY � 1 CITY HALL FRIDLEY 55432 j 612-571-3450 910415 7/6/98 JOB ADDRESS 740 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. j j 4 1 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Karl Schmid 740 Rice Creek Terrace NE 586-9870 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 ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install basement egress window 9 CHANGE OF USE FROM TO STIPULATIONS Window must comply with the State Egress Code. 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 SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 1STALLS 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 $300 $.50 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- $21.00 Fire SC $.30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $21.80 OF CO R oR AU ORI AGENT (DAT I ;S111.TUUR WHEN PROPERLY SLIOG gP s DA TED THIS IS YOUR PERMIT OAT 1�:_ F WNER OF WNER BU I L1ERI (DAT I NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 7 lo 12 Cte eua Legal Description: Owner Name & Address: S ,� A o e- Tel. # Contractor: MN LICENSE # Address:. Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA:' Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length- Width Hgt/ round Sq. Ft. OTHER: �.SC G P®L o� Construction Type: Estimated Cost: $ C'C� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = t x $ _ $ DATE: %16 APPLICANT: a ITY USE ONLY Permit Fee $ 00 Fee Schedule on Reverse Side Fire Surcharge $ • 36 .001 of Permit Valuation (1/10th%) State Surcharge $ SO $.50/$1,000 Valuation SAC Charge $ $1000 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 [ ] TOTAL $ STIPULATIONS: 0 SUBJECT P IT NO. City ®f Fridley 6 9 4 9 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. I ; fr e-s-e-� �� pl r PROTECTIVE INSPECTION SEC. P1J° I NUMBER REV DATE PAGE OF APPROVED BY "'1 CITY HALL FRIDLEY 55432 A, �j 612-571-3450 910-F15 7/31/98 JOB ADDRESS 740 Rice Creek Terr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 4 1 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Karl Schmid 740 Rice Creek Ter 586-9870 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 Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 26 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 STALLS I 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 2168 $1.08 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 CON TRUCTI $74.Z5 Fire SC $2.16 PLAN CHECK FEE TOTAL EE AT OF CO CDRO AUTHO ED AGENT C ID EI 77.99 N POP ALIDAT IS IS Y R P MIT ell NATURED OWNERoFOWNER BUILDER) 1 TEI BLO INSP BATE 0 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Q n ConstructionAddress: � () jekc,�e Legal Description: Owner Name & Address: Tel. # —70 Contractor: - MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: _pock " cn A -r � r -e Construction Type: Driveway Curb Cut Width Needed: DATE: 9 APPLICANT: Ft. + 6 Ft Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ -(Fee Schedule on Back) Ft x n = $ STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, C) $.50/$1,000 Valuation SAC Charge $ $1000 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 [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (76-) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS �® 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 41 Y e_ Commercial/ Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.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. Effective On January 1, 2002 Signed L - 4&A_&LZ,� TEL # Idl— FAX #?— " Approved By Rough -In Date Final Daj� FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE OWNER TOTAL BUILDING USED ASJTY/�� ESTIMATED COST�� PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER $ f No. of Heating Units . / Circle One (Steam) (Hot Wate (Warm Air $ Trade ame Size No. Q BTU HP EDR Fuel Total Connected Load �® Burner Trade Name Size No. $ BTU HP EDR $ The undersigned hereby makes application for a for the herein permit work 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 HEATING _C0 If Signed L - 4&A_&LZ,� TEL # Idl— FAX #?— " Approved By Rough -In Date Final Daj� FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When rl:El..ni�� nn an existino f prance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes No( ) and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer Yes) 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 manufacturers specifications. This. does include AGA-GAMA Category I Central Furnace Venting Tables for fan Yes )Y No( ) assisted and natural draft appliances. . The Pais ina rnmbus ion air is sized and installed to meet the current codes Yes No( ) and manufacturer's specifications. When required to install a new comb ust� ion air, it will be sized and installed Yes K No ( ) to meet the current codes and manufacturer's specifications. When in ^Ili a new yen ing cya Pm, 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 �%�1 No( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes No( ) separately as per current codes. A121214mcp Zype and Cite/Common Vent and Vpnt Connector Infonna ion Appliance #1 Type BTU Input Fan Assisted or Nat BTU Input v0 Fan Assisted or Nat . Appliance #2 Type�g Fan Assisted or Nat _ Appliance #3 Type BTU Input Total Appliances Total Btu Input Common Vent TypeVent Height I S464�r Diameter I inches �1A ft Length ft Diameter in Type Appliance #1 Vent Connector Height 9--q—,, Appliance #2 Vent Connector Height ft Length �ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: I� G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 15, 2004 Mr. Steve Monday 740 Rice Creek Terrace NE Fridley, MN 55432 Re: Final Inspection at 740 Rice Creek Terrace NE Contractor: Anderson Heating & Air Cond. Dear Mr. Monday: A mechanical permit was issued on October 10, 2003 to install a furnace and an air conditioner at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh