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