PRE 2010 DOCSCity of Fridley, 1Vlirm..
BUILDING PERMIT N? 5 I.0 3
Date:
Owner:''` Builder_ ,"". _._.....
Address Address - --- —• --
• LTIONI ® ILDING
No. _ _ Street;0 A l! _Part of t _.
Lot Block _ _ _ ._._.— Addition or Su ion
Corner Lot --•— Inside Lot Setback ..,a _ _ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
T Used as: +�
Front Depth Height Sq. Ft. Al Cu. Ft.
Fr , t Depth a +""Leight Sq. Ft. _ Cu. Ft.4
Typeo tnstruction Est, Cost a - No 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. .01A A
�dY._.... _.:. :+i/h��.�_.u1e1111�sd�JA :1 1 • • i y�:=iNio
NOTICE:
This permit does not cover the construction, installation for wiringr: plumbing, gasheating, sower or water. Be sure to see
the Buiiding Inspector for separate permits for these Items.
s- - 4, 1 4 7 _ "
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name Builder
Address2J?zz:::�z Address
®�
LOCATIONOF BUILDING
No. 72 Street Part of Lot a-'&
LotBlack Addition or Subdivisio r
Corner Lott Inside Lot )C Setback ,,303 Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
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 _� 7 - — ,�.� SIGNATURE
. of.,
(Sche`dule' of Fee Costs can be found on the Reverse. Side) .
Y e .n w . A
I
AppOcation for Power Punts end Heating. Cooling, Ventilafion, .Itefri and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
t' Furnace Shell & Duct Work to 120,000 BTU ............
i; each add. 60,000 BTU ........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ................. .
Repairs & Alterations each add. $500.00 ....... :......
STEAM or HOT WATER SYSTEM
RATE
TOTAL.
8.00
$
5.00
$
5.00
$
2.50
$
8.00
$
2.00
$
5.00
$
5.00
$
2.50
$
Furnace Shell & Lanes—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
$
k'_
GAS FITTING FEES:
NO RATE
TOTAL
1st 3 Fixtures ......................
x $1.50
$
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 FEE
ROUGH
FINAL
City of Fridley: V
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.
Fridley, 11 in ® –' 19 —
Owner a
Kind of Building
Used as
To be completed about®�
Estimated Cost, $
Old New Building Permit No. permit No. Z
DESCRIPTION OF WORK
BEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No
Trade Name z��t°���"`` _ Size No,26/` ® '
Capacity Sq. Ft. E.D.R H 9- M RTU H.P.
i;
Total Connected Load Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Signeri
191
By A. , _1362�-
427M 7-59 Business Phone No-
Compliments of North Central Public Service Co.,
TW- 2HEAT LOSS CALCULATIONS ®' TOW N
DEPARTMENT OF BUILDINGS VILLA
Weatherstrips A.SJLVX Construction No,
Guide
WidowDoors Reference Out. Wall Int. Wall Ceiling I Roof I Floor I Kind
Ye
sI Yes—No 19........ I
®Room I Length Width / Height P0
Windows and
Doors—Crackage and Area
_
No.
No.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
9
L,
r
Coef.
Btu
113
L/
IRtu
Infiltration
'
Glace
Coef.
Coef.1
Btu
Infiltration
Exp. wail
-1,3
'y o
0
Glace
Net exp. wall
/6z
.-a
Exp. wall
Exp. wall
273 -
3 ,
Net exp. wall
Ceiling
o
/0'
0? 0
Int. Wall
Iv /
Floor
57%
Ceiling
a
Floor
°�
o
Floor
Total Btu»
moor
e�
Total Btu.
�
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I Fl _ Room I Length -1 Width k Height ,X �
Windows and Doors—Crackage and Area
Doors- Crackage and Area
_
No.
Width Height No. of
of pane of pane lights
Lineal ft.
of crack
Area
sq. ft.
No. of
lights
Lineal ft.
of creek
Area
sq. ft.
Coef.
Btu
Infiltration
L/
IRtu
Infiltration
'
Glace
Coef.
Y -)--
-)Glass
a
53
Exp. wail
-1,3
fir' 1.)
La
Exp. wall
Net exp. wall
'3 V
/-)
Exp. wall
Int. wall
3 ,
Int. wall
Ceiling
�!5�
Ceiling
Iv /
Floor
57%
Floor
a
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
8 FL I _ '7 Room I Length I -D Width / -Y Height
Windows and
Doors- Crackage and Area
_
No.
No.
Width
of pane
oP Height
I ane
No. of
lights
Lineal ft.
of creek
Area
sq. ft.
Coef.
IRtu
Infiltration
Infiltration
'Y/
Coef.
Y -)--
-)Glass
Infiltration.
Glass
Glass
-1,3
fir' 1.)
La
Exp. wall
Exp. Wall
'
Net exp. wall
Exp. wall
Net exp. wall
3 ,
Int. wall
Int. wall
�1
Ceiling
Int. wall
Ceiling
1, '' ,
Floor
Floor
°�
o
Total Btu.
Total Btu»
moor
e�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I �%
ti
Insulation
How Amlied
F`L I /� Room I Length 7 Width Height
Windows and Doors—Crackage and Area
G 113&1
I I I I Coef. Btu
Infiltration 0 0
Glassy
Exp. wall Id 3 X /'P
Net exp. wall - ' / i) / b
Int. wall
Ceiling �` U
Floor so
Total Btu,"s
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
,/ FL I %?® ® Room I Length 47 Width j Height A "
Windows and Doors—Crackage and Area
Doors—Crackage and Area
/J
No.
Width a ght
Of pane of pane
No. of
lights
Lineal ft.
of crack
Area
sq. ft.
Area
sq. ft.
t5
Coef.
Btu
Infiltration
Coef.
Btu
Infiltration.
Glass
fir' 1.)
La
�
Exp. Wall
'
Exp. wall
Net exp. wall
3 ,
/ 4)
Int. wall
Int. wall
Ceiling
1, '' ,
Floor
Total Btu»
moor
�
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area.
i FL I /1_ A Room I Length /-7 Width I �L- Height A
Windows and
Doors—Crackage and Area
/J
Na.
Width
of pane
Height
of pane
No. of
lights
Lineal ft.
ofq crack
Area
sq. ft.
Coef.
Btu
Infiltration.
4g,
fir' 1.)
Glass'
'
Exp. wall
Net exp. wall
Int. wall
Ceiling'
/ L, 3 --
moor
Total Btu.
-> L
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area. I
52-84-5915.51
City of Fridley
Application for Plumbing and G= Ming Pwndt
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK 72 IticeCreek Way
Number, Kind and Location of Fixtures Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
x $2.00
�
Future Fixture Opening ................
�
ii
�^ ZF�ji a?8C
Z
laTj Z O 6
-jO
U�' °d
Ute'
z
(�90
•
R
•
N
WATER HTR.
GAS
ELEG
Base
Electric Water Beater
a $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
I t
as
er
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
Gas Dryer
Ist
5-00
REPAIRS & ALTERATIONS—Refer to Code
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ......................
x $2.00
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg . ........:...
x $3.25
$
Electric Water Beater
a $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ..........................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
Gas Dryer
5-00
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FSE $ 5.00
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
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 facl
and representations stated in this application are true and correct.
Fridley, AUnn 10-13-6° 19_
Owner Ue0 Reilly
Kind of Building frame
Used as 72 as
To be completed about 10-18-67
Estimated Cost, $ 10_00
Old—New. Building Permit No ermit No.
gIIe
By
Business Phone No
ROUGH
FINAL
SUBJECT
PERMIT NO.
City of Fridley
m -1.71.8 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
t �
= CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/6/83
10B ADDRESS 72 Rice Creek Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
9A,9
4
Edgewater -Gardens SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Bruce Bishop 72 Rice Creek Way N.E. 574-7414
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
L.R. Tabor & Sons 1800 Central Avenue N.E. 788-6665
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
X
8 DESCRIBE WORK
Remodel three season porch (add insulation)
9 CHANGE OF USE FROM TO
STIPULATIONS
Porch can not be heated.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULLAND 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
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
$4,200
$2.10
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
P OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RUCTION OR CE OF CONSTRUCTION.
$50.50
OFRFORMA
LAN.CHECKFEE
TOTALFEE
`
$52.6.0
NATURE OF CONTRACTOR QRA ORI2ED AGENT IDATEI
WHEN PROPERLY V D ED TH IS YOUR PE
/Mj'IT
6, f
BLDG INSP DAT
SIGNATURE OF OWNER t IF OWNER BUILDERI IDATEI
CITY OF FRIDLEY
APPLICIITIO:1 FOR RESIDb4TIA1L BUMMING PEW -HITS
(14w. Alterations, Additions, or Repairs)
OWNER: '6z u cI~- Je1 'sw a
ADDRESS: % 2- �' CE: C--
TEL NO: 5 Y_-.'7 V1 V
Effective Aug. 1, 1981
BUILDER: Z-- R- 7;9-ed5 y- c,d.,4j
ADDRESS: / F6,:f3
TEL 140: % s k — 16/49
Construction Location
STRMT NO: -)2- STREET: i-- t C' '2f—i'/
LOT:
BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Typeo ®� L & �'�-�dPU Estimated Cost: $ � >,
of Construction: �
7b Be Cbrnpleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE FZVF:RGE SIDE OF SHEET .
9.9ie 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 Build' g and hereby declares that all the facts and
representations stated in this applicati are trug Md correct.
DATE: � r 3-00 SIGNATUIE:��'�--��
Stipulations:
�.
SUBJECT
PERO.(2
City of Fridley
2 0 8 1
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
RECEIPT NO.
__ __ COMMUNITY DEVELOPMENT DIV. s
------
r PROTECTIVE INSPECTION SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
I', 612-571-3450
910-F15
8/26/93
e e
JOB ADDRESS 72 Rice Creek Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9A&9B:
4
Edgewater Gardens. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Gary Ludwig 72 Rice Creek Way NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Gates Roofing 4640 X' es Plymouth, 55442 5500043 6793
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 E� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage 23
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with. the State Building Code. Provide adequate
attic ventilation, Provide smoke detectors as per UBC 1210 adjacent to all sleeping
areas and in basement,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. 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
$1 300
$,65
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AU HORITY TO VIOLATE OR CANCEL THE
PROVISIONS F ANY OTHER ST E OR LOCAL LAW REGULATING CON-
$ 31,00
Fire SC 1,30
STRUCTI R THE PERFOR CE OF CON ON.
PLAN CHECK FEE
TOTAL FEE
' --Ic7 5
License. SC $5, 00
$37,95
ATURE OFCONTRACTOR OR AUTHORIZED AGENT IDATEI
WHE PERLYMIRLIOATED THIS IS YOUR PE,MIT
•
I
G IN" OAfE
SIGNATURE OF OWNER I IF OWNER BUILDER) IDATEIBL
NEW [ ]
ADDN [ ] CITY OF FRIDLEY .
ALT [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Owner Name & Address:
Contractor:
Effective 5/26/93
Tel. # 5-7
MN LICENSE # 7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER: L
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date:
DESCRIPTION OF IMPROVEMENT
Width
Width
Ft. Yd Setback
Height
Height
Hgt/Ground
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Side Yard Setbacks
Estimated Cost: $ Z-3 on
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + Ft = Ft x $ _ $
DATE: r�APPLICANT:
Tel. #
Permit Fee
$ —3 • G'
QTY USE ONLY
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ;
$.50/$1,000 Valuation
SAC Charge
$
$750 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
Conservation Plan Review $450.00
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,
763.572-3604 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
*Ai,, Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1%v of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 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
$ .50
JOB ADDRESSe-
����
OWNE
Effective On January 1, 2001
BUILDING USED AS Res, .;
ESTIMATED COST PERMIT NO. Y/x
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units c-9- Circle One (Ste ) (Hot Water) (Warm Air)
Trade Name —amu- " L- o.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE r 52 %
HEATING CO
Signed TEL #62.x/) 63-3 -0LS6 /
*Air Conditioners can not be placed in a side yard without Approved By Rough -in Date Final Date
written permission from adjoining property owner.
�^ j1
l416 �e,6 -J,-e_e ,,, c,"" BACK SIDE MUST E FILLED IN ON VENT SIZE, VENT CONNECTORS
� Zoo r� ��� AND COMBUSTION AIR VERIFICATION
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)
HEATING CO:
Signed By: Date:
0
SUBJECT
0.
City of Fridley
3372 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEI T NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
(�
I
NUMBER
REV
DATE
PAGE OF
APPROVED By
; CITY HALL FRIDLEY 55432
L f ` 763-571-3450
910415
12/6/02
JOB ADDRESS 72 Rice Creek Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
I 9A & 9B
4
Edgewater Gardens
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Paul Laughlin 72 Rice Creek Way NE
763-586-0194
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Window Lite Home Imp. 8400 89 Ave N STE 460 'Brooklyn
Park MN 55445
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
763-391-8313 20039258
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
Replace 6 windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all
exterior openings.
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 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 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
@
$6,500
$3.25
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 COW
$139.25
Fire SC $6.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTALFEE
_/yliyt�
License AC
$5.00
54.00
Tv�_._WE OF CON 7RAC TOR OR AUTHORIZE AGENT IOATE,
EN ROP
Y ALIDATE THIS IS YOUR PER IT
SIGNATURE OF OWNER0; OWNER BU4DERi
B G INSP
pA
0
NEW (J FILED
®YY OF
CITFR DLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
rA
Effective 1/1/2002
(763) 572-3604 Bldg Insp
Owner Name & Address: Piju J cr-eL Tel. i ��
Contractor. lea "a3 UR OAmp `rte a . MN LICENSE #
Address: $?V 66 - gk*1- awe • Al 64_ ; q& 0 (a,r&oAQ �d rt ra,r- L Tel. # 7/0.3- 39� 1.3/ �
763' V-2 - o?�6t7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
ov
Construction Type: 6 ' w ry4ni a )I Estimated Cost: $ tg�Q0
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ = $.
DATE:, a -d APPLICANT: Tel. # 763 - 30 13
m'd P -
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ 25
$ po 56
$ -- 3_a5
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 1 Sy ® STIPULATIONS:
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 1 Sy ® STIPULATIONS:
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 7-Z '0" `e eelf A)°�Z
Legal Description: /��
Owner Name & Addrress: Aa -Z L";'644"1 Tel. # 7�3-�
Contractor: y fi a.�ZT—e MN LICENSE #
Address: c -P ('fee k A-),=' Tel. # J'Aih1 tc'
Attach to this application, a Certfcate 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:
d
Construction Type: _ e-- t 25�-3 Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: 6"/?
APPLICANT:
%Z-7 Z-- Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1450 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ !? � �� STIPULATIONS: