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PRE 2010 DOCS
City of Fridley, Minn.. BUILDING PERMIT N° C5! 2 0 Date:' Owner:e` `'` _ Builder —... Address --.—.--- --..-- L i :ATI ILDING NO. street .. r« � e �../_ `° �� � _ Part of Lot Lot " __ Block ___ Addition or Sub -Divi�si . ."= Corner Lot_ ' Inside Lot __.__14-e - _ Setback Sideyard Sewer Elevation ____ _ _ _ _ _ Foundation Elevation DESCRIPTION OF BUILDING T04. Used Front Depth - _� Height Sq. Ft. Ft.df '`' t� o Depth t Sq. Ft. Cu. F't.+ d� r dA a �.r P t u '�,. Type Construction -K-f;, y Est. Cost..., — To be Completed . In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of prdinances of the city of Fridley. In consideration of the payment of a fee of $ .,�,....�..._._......._.., permit is hereby granted t0._.._. 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 � f any of the provisions of said ordinances. ,.+a �. uilding Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see tho -Building Inspector for separate permits for these Uems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, M DMSOTA o c u o 2 [..W1, '� . • - / - - aha e.^TATA -- LOCATION OF BUILDING No. /:2:1 , Street _e- Aje &D 12m A Part of Lot Lot„ Block Addition or Subdivision T &_ Corner Lot r side Lot Setback ati Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front Depths Height 0 Sq. Ft. M-46 Cu. Ft. SP1 Or Sq. Ft. ,-,-> e -f- Cu. Ft. 2,3"76, Type of Construction — -y" Estimated Cost QyzZl 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 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. (A Schedule of Fee Costs can be found on the Reverse Side.) 1111111111111op'" n City of Fridley Application for P'lueebing and Gas Fitting Femdt Dept. of Bldgs. Phone SU 4-747 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Locaifon PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL y 12x)- Number Fixtures ...................... zz $1.50 Oz taT3z x , WU' 00 Z x • N WATER HTR. GAS ELEG 3.25 $ Water Heater (Up to 200,000 BTU) F - 2.00 $ 3�(�90 x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ �— Additional Fixtures .................... � .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd _ 3rd 4th Future Connection Openings Connected with Sewer * New Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL �© Number Fixtures ...................... — x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $� 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 Kind of Building/1.4- – Used as To be completed about Estimated Cost, $ Old—New. Building Permit Permit No. ®� Signe By Business Ph e No Z ROUGH r 1 FINAL -490-42 2M 7-59 Application for Power Plants and Heating, Coating, 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 2i each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 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 $ J GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $� Additional Fixtures ................. x .5o $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ - REMARKS: Dept. of Bldgs. Phone a 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. / Fridley, Owner 195— Kind of Buildin Used as To be completed abo Estimated Cost, $_ Old—ew Building Permit No. 195— DESCRIPTION OF WORK HEATING or PO team, Hot Water, arm No Trade NamM-d4z�Size No 'V 6 Capacity /Sq. . .D.R / BTU H.P. Total Connected Load—°°/ QS , Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H P. 11 POST IM -12-58 No- &✓%f% % i 01 sueIEcr PER City of Fridley 19903 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. 2 r PROTECTIVE INSPECTION SEC. 1 , i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APP90VED BY j 612-571-3450 910-F15 5/19/89 JOB ADDRESS 124 Rickard Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 2 Garten`s Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeffrey Bolz 124 Rickard Road N.E. 571-0869. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (19 Squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.. On all new rods"or tear=offs., and replacement roofs, State Code requires that 2 layers ` of 15 Ib. felt, mopped.together, be installed to a point 24 inches UP from exterior wall tine, or the use of other approved underlayment membrane. 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 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 $950.00 $.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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $25.00 PLAN CHECK FEE TOTAL FEE $25.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) W EN PR AT THIS IS YOUR PERMIT G )NSP OA SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 01 NEW [ J ADEN [ l AL'T'ER [ J Construction Address Legal Description: R--1 AND R-2 Building Permit Application Effective 5/1/88 l� vim' � Owner Name &. Address: Jeffms =rel Z - - Tel. # s?/� Contractor: Lw=( Tel. # S<~ Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: length Width Height Sq. Ft. GARAGE AREA: .length Width Height Sq. Ft. DECK AREA:. Lehi Width Hgt/Ground Sq. Ft. OTHER: 'h2,c �J Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: FA6zer,,14ss s4,Lw512g Estimated Cost: $ 1.l ' D Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLICANT: Tel. # Permit Fee $ State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Change $ $ '2�•gZ� STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] On all new roofs or tear -offs and replacement roofs, State Code requires that'2 layers of 15 lb. felt, mopped together, be installed to a point 24 inches up from exterior wall line, or the use of eft approved underlaymont membrane. CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer t Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work RATE TOTAL $ 20.00 $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ State Surcharge TOTAL PEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not he placed in side yard without written permission from adjoining neighbor. $ .50 Job Address / -,P f7 /ri%J�rG X') ' Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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. /Fridley, Minn. C3 '1996 , 196 OWNER�✓(/�� KIND OF BUILDING %y (?,I icl e & C e - USED AS Ta BE COMPLETED ABOUT ZZ ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. / e& DESCRIPTION OF FURNACE/BURNER HEATING or POWER LANTS, Steam, Hot Water, Warm Air- No. Trade Name Le Lc Q Size No. Capacity Total Connected Load BURNER - Trade Name Sq. Ft. EDR BTU/�C HP Kind of Fuel . 'zy"'l C✓�' /� Size No. Capacity Sq. Ft. EDR BTU HP Company f a e g a/ e Signed By.% Tel. No. Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,r. -----No ( ) 2. Is free from rust or deterioration Yes i1i)i No ( ) 3. Has no foreign objects lodged within Yes (-) No 4. Is securely supported Yes ( No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes (J�-' No ( ) 6. Has Total heating BTU's of /ter✓, Gr�� All other BTU's TOTAL Rema rk s Company Signed By Date 9 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 *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB ADDRESS-Aa4 r re'y' ►PD,��t'�1r:��L��L� Effective On January 1, 2001 Rate TOTAL BUILDING USED AS $ 30.00 UD 33 ESTIMATED COST PERMIT.NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units_ Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. BTU HP EDR $ 25.00 $ Fuel Total Connected Load 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. $ .50 $ SO.50 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 ru!ings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. HEATING CO Signed DATE 10 • KO -0a TEL # '7(03—LW� .t-1 �--1 Approved By Rough -In Date Final Da BACK SIDE MUSVBE FILLED IN ON VENT SIZE, VENT CONNECTORS 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 /yLc9 specifications including sizing, length, number of elbows and termination. Yes( ) No M 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 Yes No( ) and manufacturer's specifications. When. required to install a new combustion air, it will be sized and installed No to meet the current codes and manufacturer's specifications. Yes (,� ( ) 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 doses include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes Q0) 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 0) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type 1U/^m &-ee- BTU Input b Oft an Assjsis:te or Nat Appliance #2 Type &U, H 17a, BTU Input �o Fan Assisted o Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input ilaoc- Common Vent Type /k Vent Height 40✓ Diameter inches Appliance #1 Vent Connector Height L ft Length ft Diameter in Type Appliance #2 Vent Connector Height L ' ft Length __J_ft Diameter min Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) - HEATING CO: Signed By: 1 _ -