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PRE 2010 DOCSilk it BUILDING PERMIT Village of Fridley, Minn. N° �2,t 77 Date �'` .". ... ............ . Ownerx� ,... Builder ....... ...... it AddressAddress .... ... .. ......... lip LOCATION OF BUILDING No. . /Z.2 ..... fi,... Street y ,: Part of Lot .... .......... Lot ... i . ... Block ............. Addition 7rsub-Division .. ..... Corner Lot .. ......... Inside Lot ......... Setback , Sideyard... .......... �I DESCRIPTION OF BUILDING To be Used as: II • �' * d .... Front .+4. Depth j,, ... height �'� .... Sq. Ft........ Cu. ........ . ............... Front ...... Depth ........ Height ..... Sq. Ft......... Cu. ......... Type of Constru pion,, Est. Cost . .o►.' .. To be Completed Ij II ij II lj Il II 11 �I In consider tion 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 rovisions of ordinances of tl a village of Fridley. II In done in, arou Fridley, Mini In the village ordinances. NOTICE: This sewer or, xr tion of the payment of a fee of $.. ,permit is hereby granted to .... . � .. .... .4........ to construct the buildintir�addition as `described above. This perrru 5 ted upon ndition that the person to whom it is granted and his agents, employees and workmein all work 4 and upon said building, or any part thereof, shall conform in all respects to the ¢rdinances of -ota regarding location, construction, alteration, maintenance, repair and moving of bi dings with - *its and this permit may be revoked at any time upon violation of any of the provisions of said does not cover the construction, installation or alteration for wiring, plumbing, Be sure to see the Building Inspector for separate permits for these items. Inspector heating, SUBJECT City ®f Fridley2 5 582' AT THE TOP OF THE TWINS BUILDING EMI T P NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 340 CITY HALL FRIDLEY 55432 NUMBER REV DATE 10/10/97 PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 132 River Edge Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2O 1 River Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ren Anderson 132 River Edge Way NE 571-4092 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Jansick Inc 6480 Squire Drive NE, Fridley, MN 55432 574-9679 8618 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 l)t ALTERATION ❑ REPAIR ❑ MOVE 0 REMOVE 8 DESCRIBE WORK Construct 6' x 11' Portico over front step 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 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 $3,400 $1.70 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- Fire SC $3.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $87.25 ° PLAN CHECK FEE TOTAL FEE �' License SC $5.00 $97.35 SIGNATURE OF NTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY �, ,DG NSP V IDAT D THIS IS YOUR PERMIT DATE SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI 00', ..a ?. NEW [ ) Effectiv ADDN [ ) CITY OF FRIDLEY .ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -Z l BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: _ Owner Name & Address: /%m 4,v,0 s„A, Tel. # 5 a / - 41d,? z Contractor: dnfjslec Inc. MN LICENSE # 8'61 sr Address: ® '50';DOe At Tel. # S'71/- 7077 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: Construction Type: —1110::910c,12 o vpK Fgovr 7-4-, Estimated Cost: $ (Ree Schedule on Back) Driveway Curb Cut. Width Needed Ft-- -61R DATE: 7 APPLICANT: Tel. # S Pd17 9 s"r1PULA"TIONS: e- . 0 CITY USE ONLY s Permit Fee $ , Z Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �7( $.50/$1,000 Valuation SAC Charge $ $950 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 $ s"r1PULA"TIONS: e- . 0 SUBJECT IT NO. City of Fridley roc 608 AT THE TOP OF THE TWINS BUILDING PERMIT r r. L- ----- _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � 1 . r NUMBER REV DATE PAGE OF APPROVED B {---1 CITY HALL FRIDLEY 55432 �---- �`' 612-571-3450 910-F15 10/17/97 JOB ADDRESS 132 River Edge Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 20 1 River Edge Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Ken Anderson 132 River Edge Way NE 571-4092 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Woods Construction Co 7728 Rnollwood Dr, Mounds View MN 55112 786-2321 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 8737 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 (18 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building 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 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 STALLS 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 $1,501 $.75 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 P RFORMANCE OF CO STRUCTION. PLAN CHECK F E 69&T Li e SC $5,,40 7TALFEE $58.50 SIGNATURE ONTRAC OR IDA EI H PR Y VALI ED THIS I YOUR PERMIT— . a INSP / , i /Q.,2.7 Y1AiE S,GNATURE OF OWNER. IF OWNER BUILDER, IDATEIDG NEW [ j Effective 1/1/97 AD'DN [ ) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION� ConstructionAddress: / 1 l Legal Description: Owner Name & Address: �U'p `y2ul %9�xl Lam' 1%/j,�✓, ,i` Tel. # !)� Contractor: % ; MN LICENSE # e -4? Address: `� 7 ,a CP J L��rll��IY�'l„��/i/` Tel. # �c� RU Z 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: Construction Type.: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. .�/O ,��1/i'.97e .✓ %�'v9w > ,^.�� �� %aen�at�.�/11 .��in��w✓J J��✓�oe la Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Estimated Cost: $ (Fee Schedule on Back) Ft x $ _ $ DATE: (� 7 APPLICANT: 2 ' 4 Tel. # I , STIPULATIONS: r CITY USE ONLY Permit Fee $ :S-/, -2S Fee Schedule on Reverse Side Fire Surcharge $�� S C� .001 of Permit Valuation (1/10th%) State Surcharge $ e %S� $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge, $ S-16.0- $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 $ ..S8 STIPULATIONS: r Io ­w m C17YoF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 May 6, 2002 Catherine Anderson 132 River Edge Way Fridley MN 55432 Re: Paved Driveways Dear Ms. Anderson: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a $700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, it" Stacy Stromberg Planner C-02-53 e AM CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 July 2, 2002 Catherine Anderson 132 River Edge Way Fridley MN 55432 Subject: Paved Driveway Reminder Dear Ms. Anderson: This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by December 31, 2002*. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, StacnSt mberg Planner *If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a $700 fine. C-02-83 Permit Number W eck Compliance Report checked By/Date 2000 Minnesota Energy Code MECcheck Software Version 3.3 Release Ib Data filename: C:\Documents and Settings\Denise My Documents\Mastercrafl\anderson.cck COUNTY: Hennepin STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 12/02/02 DATE OF PLANS: 12/2/2002 PROJECT INFORMATION: �,_ �ndgrson, Ken,-_. -x,132 River Edge_Wav Blaine, MN 55432 COMPANY INFORMATION: Mastercraft Exteriors, Inc NOTES: Upstairs only for addition. COMPLIANCE: Passes Maximum UA = 150 Your Home= 110 26.7% Better Than Code Ceiling 1: Raised or Energy Truss Wall 1: Wood, Frame, 16" o.c. Window 1: Above Grade, Vinyl Frame, Double Pane with Low -E Window 2: Above Grade, Vinyl Frame, Double Pane with Low -E Window 3: Above Grade, Vinyl Frame, Double Pane with Low -E Window 4: Above Grade, Vinyl Frame, Double Pane with Low -E Floor 1: All -Wood. Joist/ Truss, Over Unconditioned Space Proposed and Maximum U -Factor Averages Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA 884 38.0 0.0 22 884 19.0 0.0 49 20 0.280 6 20 0.280 6 6 0.280 2 6 0.280 2 884 38.0 0.0 23 Proposed Maximum Average U -Factor Allowed U Factor Above -Grade Windows and Glass Doors 0.280 0.370 Includes Foundation Windows > 5.6 ft2 Floors Over Unconditioned Space 0.026 0.033 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. Builder/Designer Date 3 SUBJECT City of Fridley 3 34 91 AT THE TOP OF THE TWINS BUILDING P E R M I T v -------COMMUNITY DEVELOPMENT DIV. 1 �1J`�•� r I PROTECTIVE INSPECTION SEC. �„ NUMBER REV DATE PAGE OF APPROVED BY i A '01...%� CITY HALL FRIDLEY 55432 -•_. L J \ 763-571-3450 910-F15 5/5/03 JOB ADDRESS 132 River Edge Way NE 1 LEGAL BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ILOTNO. 20 1 River Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Anderson 132 River Edge Way NE 763-571-4092 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Mastercraft Exteriors 5976 Hobe Lane, St Paul, MN 55110 651-481-8120 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20172626 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE] REMOVE 8 DESCRIBE WORK Remove existing garage; construct a 261 x 341 Garage (2 story) 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING SERERATE PERMITS Bef®r® digging SII f®Ir MIRED FOR: all Utility locations WIRING45"002 PIM�Id AN�S REWIRED I LAW 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 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 STALLS GARAGES AND KNOW TME SAME T BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINAN GOV FINING THIS TYPE OF WORK WILL BE COMPLIED @ $30 WITH WH HE PECIF ED HEREIN OR NOT. THE GRANTING OF A PERMIT $60,000 •00 DOES NO P UME GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO S F ANY THER STATE OR LOCAL LAW REGULATING CON- $713.75 Fire SC $60.00 T CTI THE P RFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Lice se SC $5.00 $808.75 SIG E O CON RACTOR OR AUTHORIZED AGENT iDATE, HEN PROPERLY VALIDATED THIS IS YOUR P RMIT CI j * b p iNSo )ATE S.GNATURE OF OWNER,iF OWNER BU4DER1 iDATE, C 3 FROM : MASTERCRAFT EXTERIOR FAX NO. : 6517629395 Dec. 05 2002 10:13AM P1 NEW (] J CITY OF FRIDLEY Effective 1/1/2002 ADON6431 University Ave NE, Fridley, MN 55432 (763) 572604 Bldg Insp ALTER (` SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 3a Jcar 4%Q WQ,aI Legal Description: _ Owner Name & Address: JkN fk Nfl-e.f %o �i Tel. `jDf Contractor. f�`'►►1'Q�_ 1�1!/"�L� MN LICENSE # �� 17 �� Address: S 9 % to 4j p' L,y✓ _ Tel. # (o',(`/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVINGAREA: Lei►gtt► width 3"1 Height 02 Sim" Sq. Ft, GARAGE AREA: Length Width '�—�— Height Sq. Ft. DECK AREA: Len Width HgVGrou Sq. Ft OTHER: =. 6 �.- � � CAt1'96(-!1 4 oto u ��� Construction Type: Wood Estimated Cost: $ &0, 0t� O Driveway Curb Cut Width Needed: Ft + 6 Ft = M. $ - f DATE: I % / b Y APPLICANT: Call (763) 572.3604 for Permit Fees if call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $--L-4 00 S S • 7S I"lp !on or Fax to 763.579-1287 if using credit card and we will ITY ONLY - Fee Schedule on Reverse Side 10 .001 of Permit Valuation (1/10th%) I� $.50/$1,000 Valuation $1200 per SAC Unit J $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. " S" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary[ J Not Necessary [ J STIPULATIONS: FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 APPEALS COMMISSION ACTION TAKEN NOTICE October 16, 2002 Ken and Catherine Anderson 132 River Edge Way NE Fridley, MN 55432 Dear Mr. & Mrs. Anderson: On October 9, 2002, the Fridley Appeals Commission officially approved a request for variance, VAR #02-18, to reduce the required rear yard setback from 25 feet to 23.5 feet to allow the construction of a garage and porch on Lot 20, Block 1, River Edge Addition, generally located at 132 River Edge Way, with the following stipulations: 1. The petitioner shall secure a building permit for the proposed structure by December 31, 2002, and install a hard -surface driveway within 12 months of issuance of that building permit. 2. The petitioner shall obtain all necessary building permits prior to construction. 3. The structure shall be architecturally compatible with the existing home and finished with complementary siding and color scheme. 4. All vehicles shall be stored on the hard surface driveway as approved by the City. 5. The garage shall not be used for a home occupation or living area. If you have any questions regarding the above action, please call me at 572-3595. Sincerely, tw' t �W"qnbll' Stacy St , jkberg Planner Please review the above action, sign below, and return the original to the City of Fridley Planning Department by October 30, 2002. SS:Is Concur with action taken 1 � • rn bF I 1 l 20 n 1 , Ito A 5 G G � _TJ J 7-0 �1\4 e o d� sZ W AUC W AY �•• SITE PLAN CITY OF FRIDLEY INSPECTION DIV. 6431 Urliversity Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2003 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range" NO. RATE TOTAL 0 Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 JOB ADDRESS 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 are true and correct. Owner Building Used As !7 0 Estimated Cost (3-6 PERMIT NO. 1 PLUMBING COMPANY `7��''�ie"��'`�'" Reinspection Fee $47.00/Hr SIGNED BV JiM-L TEL NO.6/1-?6 fa l ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 `� L MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ ';28-Sa PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When ranla _ina an -xicting fi Iran _ _, 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 8 ix.gyting r_nmhtistinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a naw cnmhustinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When 'inert—llinn a new vantingyystam_, 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 #1 Type Appliance #2 Type Appliance #3 Type Total Appliances — BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 HEATING CO: Signed By: Date : CITY Or 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 FAX (763) 571-1287 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 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. •: milks Effective January 1, 2003 TOTAL BUILDING USED AS ESTIMATED COST i�3D0��", PERMIT NO. $ iD �v DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units / Circle One (Steam) (Hot Water) arm Air $ Trade Name _L)62? -�)-5-041 Size No. �® BTU Ok HP EDR $ Fuel AlAr_ 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 $ .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 CO r7e- ,! r Cs¢Z Signed 4& TEL # 6S/ FAX # 6.5-/ - X2,C ` Approved By 1 ` Rough -In Date' Final Date 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 When :$ rn_aning an axk ing furan _e, 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 eY sting cnmh stinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a naw cnmhtjciien ai ;,it will be sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When jpgfulling a new venting syr, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAIIAA 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 #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 N HEATING CO: Signed By: Date: 08/11/2003 08:54 6127887860 ARCH MECH ,AUG-1� -2+ 03 09:07 FROM CITY OF FR I DL.EY TO 651636 7491 THE ezWW MUST ®E F'1L, AD IN WHEN REPLACING FUEL BURNING APPUANCES OR THE APP1,.IICA- ION WILL_ BE W URNED When , the undersigned herebY verifies that the vu nSV ho bei exertthtsd and is fm from deterioration, on, obstructions, Yes( 1 No ( ) and is sr®cu * supported and fires Peed whisk rete The venting syd on is pinW WC wd mss all currant codes and manufaduw Yes t No ( ) Mpdgmdons including ems. WO, number of elbows and tw*nadon. Tho undid aho veffes that the reptaoament unit is a aded assembly WW tt wts #w oxrwtt codes and manuMIC09V3 specifications. Phis does induct® AGA LAMA CateptY I Central Fumace Venting Tables for tan yes( No( ) awisted and natural draft appliances. theM&Agg eewnbmwrion,21cis steed and instated to meet the eaurtnt codas Yeas (} too ( ) and rnanufacturees spedficatlons. When required to it WN to cried od installed y"( No( ) to most to current cod®s nN manufacturer's sp®cifcatians. 4'd. W(�nyam= mnftm the undersigned hW§W vwifiss that h is a rusted assembly and meets ft to Twi codes and Ws specifbdoons. This does include AGA -G" Category I C I F m Yes' . No ( ? Venting Tables for fan assisted and natural draft pp me h removed ed ftm the COWSCUn siZOd oommon v st and venabd ted y after Yes ()No(:) suety as per current CDdW AI . ax1 Type BTU Input _ BTU Input.._,..._ Fan Assisted or Net _.- Fan AssisW or Nat A � Type P BTU Input Fan Assistod or Not___--, ApprtanN #3 Type Total Appliances Total 8br Input Common Vara Type Vent Hetght ��._,._. Diameter inches AAAanoe,#1 Veto Connector HeVt ft Ap WCS 12 Vent Con we W Height ft Appttarrce #3 Vent Gonne ow Height=ft ft Lengm�,1t Diameter _—i n Type . Length h Diameter in Type Length ft Uw1n Type__ HEATING CO: D3W;_/�L d3 PAGE 01 P.03/03 AJ 8 t 'fir® -n! Po E9FI0 fAh .fig I d+CM TOTAL. 2.03 Effective January 1, 2003 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 FAX (763) 571-1287 /� JOB ADDRESS 13.2 �+ Ver /�- a`© G s_' RATE SCHEDULE OWNER Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Pip' g (Needed with new furnace, ut not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alter-atic 1% of Value of Applaince or Commercial/Industrial 1.25% of Valueof Appliance ST ON BACK) Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 9 i f' 'k 0 Mate Surcharge TOTAL FEE 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. TOTAL BUILDING USED AS $ ESTIMATED COST PERMIT NO. Zy DESCRIPTION OF FURNACE AND OR BURNER No. of,Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. �I BTU HP EDR $ Fuel: - Total Connected Load �f�µfnGln y -Ar ­'7t l9cis _51-ove y Burner Trade Name Size No. $ `' BTU 3! VVV 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. l L,,�Lv 6_3 DATE ADW RGSW HEATING CO "8WMa+ Lioemoaacwl Signed e.muss+TEL # esv+ FAX # Approved By Rough -In Date Final Date 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 rnM MON VFNT- VFNT nQNNFr.TQR AND MMR1 IRTIM AIR VERIFIMTIM When rania _inn an eYictina Iran _ _, 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 plasticJPVC and meets all current codes and manufacturer BTU Input specifications including sizing, length, number of elbows and termination. Yes( No( ) The undersigned also verifies that the replacement unit is a listed assembly Fan Assisted or Nat and meets the current codes and manufacturer's specifications. This does BTU Input include AGA-GAMA Category I Central Furnace Venting Tables for fan Total Appliances Total Btu Input assisted and natural draft appliances. Yes( No ( ) The Winn rnmho ictinn air is sized and installed to meet the current codes _ Diameter inches and manufacturer's specifications. Yes( No ( ) When required to inciall a new cnmbuctinn ai_r_ it will be sized and installed Appliance #2 Vent Connector Height to meet the current codes and manufacturer's specifications. Yes( ) No( ) When inctallonn a new ventingsysLem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA 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 #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 AlTFRATIQN-q- ( ) 1 � S �� 1 gee- !!Ap eA; has S�� v � 6F, rePJG L e) C HEATING CO: AMORWM Signed By. "WM&rm Date: —LN3W&eWg" —M44 2=tLFaw wAve. Fosevft MN 85113 851m" +