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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 365 6 Date: .... ....... k. .... ...... Owner ....................................... Builder .....•... ....... ....... Address...................................... Address .................... LOCATI OF BUILDING .. No. 6 % Street ........ !... � . l . ........... Part of Lot ....................... . . Lot .... ..... Block ...... I .......... Additior Sub -Division ....� .... . Corner Lot ........... Inside Lot ............ Setback ............ Side ................... .. • yard ...... DESCRIPTION OF BUILDING To be Used o =e .� .. Front Depths.. Height Sq. Ft. lQ Cu. Ft0.0. .. Front ........ Depth ........ Height .... Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... hist. Cost. F.? �.�. To be Completed .................... In consideration of the issuance to me of a permit to construct the building desribed 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �- �® .... Binding Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water.. Be sure to see the Building Inspector for separate permits for these Item& Application for Power Plants and cleating, Coaling.. Ventilation. Refrigeration and "7'd Air Conditioning Systents 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 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 $ � GAS PIPING (Up to 3 Fixtures) .......................... 1.50 $ (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARKS: See Fee Schedule TOTALFEE $ .A Dept. of Bldgs. Phone SII 4-7470 Location 16,5) ,5) €; r1 v e )a s E( g e 7� 2, 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, 1Nfin*+- January 29 � 195 Owner blS k Joneti' 195— Kind of Building P_ T11 195— Used as To be completed about P'i Q° i4 Estimated Cost, $ Old—&e4 Building Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No 00 Trade Name -n y '��� � Size No !+ 1QQ Capacity- ®` -+ Sq. Ft. E.D.R BTU H.P. Total Connected Load mss'59920 Kind of Fuel Gag S BURNER — Trade Name Size No Capacity Sq. FL E.D.R BTU H.P. Sign E �ECTf®i4 HEATING COMPANY, INC. By Ago o TA, 04?9?. 11 POST 1 M-8-58 BusineNI R MOMPMA City ®f Fridley, Minn. BUTT, ING PERMIT Date: 1wner. Builder Address Address LOCJMP OF U No. street I _A jo It .4 APJ-.d �ov u, ON Lot Block At tion or S. vision Comer Lot -- Inside Lot &ee Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING "Z. Front Depth Height Sq. Ft. Cul. Ft- Depthbt Sq. FL Cu. Ft. Type of ction Est.o TC be Completed Cjr-4� -J 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 a& Provisions Of ordinances of the city of Fridley. In consideration of the payment of a fee of permit Is hereby granted to th th to construct the building or addition as described above. This permit is granted upon the person to whom it is granted and his agents, employees and workmen, in all workdone 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 Building Inspector MCE.. permit don not eavu the censtmdlon, IndaRWan for wkhm phnubbigi on huting, 9nmr or water. Be un to me WIdIng hupwar for sopude pwmft for then ftenn6 APPLICATION FOR BUILDING.PERMIT CITY OF FRIDLEY, MINNESOTA Ower ° s Name—, Builder ` " (obi Address P� LOCATION OF BUILDING No. Street /� �9�`aoer� 'Ed�� Part of Lot ;�Cr' 44 Lot Block _Addition or Subdivision `_L) -t-s- � q Corner Lot Inside Lot--k—setback 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: 6a i-ck 9,5 Front Depth Height___?_ Sq. Ft.Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. �® � Type of Construction � � le, Estimated Cost .7, 000 To be Completed_ _ _ ���, A—z 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 thi application are true and correct. le) "', /i O„a W DATE 43-ZZ� Z SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). " . .. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. SUBJECT PE®1348 City of Fridley ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION AT THE TOP OF THE TWINS PERMIT NO. DWLG. UNITS r ` 1 BUILDING CEIPT N I 1 v ______ COMMUNITY DEVELOPMENT DIV. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $382.19 r I PROTECTIVE INSPECTION SEC. PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 1 � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 15/3/76 JOB ADDRESS 165 River Edge Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Rivers Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard L. Anderson 165 River Edge Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS TORE OF CONTFLA OR AUTHORIZED AGENT (DATE) ,,!=3 _7,a- UREOFO NERIIF OWNER BUILDERI (DATE) OCCUPANCYLOAD CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX .50 TOTALFEE $5.50 D THIS IS YOUR PERMIT TYPE OF CONST. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $382.19 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 95. 1:10 TORE OF CONTFLA OR AUTHORIZED AGENT (DATE) ,,!=3 _7,a- UREOFO NERIIF OWNER BUILDERI (DATE) OCCUPANCYLOAD CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX .50 TOTALFEE $5.50 D THIS IS YOUR PERMIT APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : �� �{ ,�. AP D 6rZSo A-3 BUILDER: 51? ADDRESS: /0"5' F Uttc D,di e G �� ADDRESS: NO: S LOT: STREET: KL u ir(Z t� BLOCK: / ADDITION: �11a�?ZS L rJ lZ, l-3 CORNER LOT: INSIDE'LOT: SETBACK: SIDEYARD: Applicant attadi to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As//: PC %�vU�— /dVfcYront: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Square Feet; Cubic Feet:_ Height: Type of Construction: Estimated Cost: $ -?5? • P To, Be Completed: _1),-74 L/ — 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:'" 3 SIGNATURE (See Reverse Side For Additiona.l.Information.) IU p; 97-Sh-416051 CITY OF FRIDLEY , • APPLICATION FOR PLUMBING AND GAS FITTING PEWIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. a TOTAL Ift=ber Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ ' water v +°� .-4 • � H a C:� •.4 'h q 8 y ro w p, w � 100,000 BTU to 199,000 BTU Heater ... u Q' c m ' water Softener x ," $ x u a $5.00 u .cc�a ..+ •c a u u d D yy O roN to V Oq .,3' GC. U Oq 4 $ l7 O a9 leC let range 2nd 3rd 4 tti 1 (R) - Future Connection Opening Connected with Sewer (•) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Ift=ber Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ ' New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ ' water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 •� $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ Additional Fixtures x $1.00 $ Gas Pange to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 • TOTAL FEE $ 10.50 REINSPECTION FEE � It1n nn. Job Address 165 '"iveredge Way Department of Buildings City of Fridley , Tel. 1)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, Mn. 10-31-78 , 19 OWNER ANDERSOk KIND OF BUILDING frame USED AS res TO BE COMPLETED ABOUT - 11-6-78 ESTIMATED COST 20.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. J i Company Signed By . Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT I3 $7.50 pLUS $.50 STATS SURCSA= City of Fridley SUBJECT AT THE TOP OF THE TWINS SEATER STOPPAGE -y-------, INTER-DEPARTMENT REQUEST 1 1 ; PUBLIC WORKS DIVISION 1 S CITY HALL FRIDLEY 55432 812'580'3430 NUMBER REV. DATE PAGE OF APPROVED BY J SEWER STOPPAGE ADDRESS 165 River Edge Way DATE 12-7-89 CALL RECEIVED BY Kory Jorgensen AT 12:45 am (AM)(PM) CREW LOCATION WHEN NOTIFIED Home EQUIPMENT TAKEN TO SITE Jetter CAUSE OF STOPPAGE Unknown TIME STOPPAGE RELIEVED 2:20 am DESCRIBE DAMAGE (IF ANY) _ 165 River Edge Way had very little damage. They had no carpet, and they had useda wet vac to clean up. NOTE ANY STATEMENTS MADE BY CREW OR HOMEOWNER REGARDING DAMAGE OR POSSIBLE CLAIM I checked 3 manhole§ on River Edge Way (north side) and they were all full of water. The manhole on easement between River Edge Way and 62nd lift station also t was full. 'W-e jetted between lift station and easement manhole. Owner had Root- master come out and clean their line, but Rootmaster told them it was in the City line. Homeowner said they called oo mas er a pm, oo mas er saidthey CREW AND HOURS were called at 11:00 pm. Kory Jorgensen - 3 hours - Greg Kottsick - 2 hours u SUBJECT O• City ®f Fridley * ( '� 216 4 0 AT THE TOP OF THE TWINS PERMIT BUILDING COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � � CITY HALL FRIDLEY 55432 IL NUMBER REV. DATE PAGE OF APPROVED BY ---- � e %.J 612-571-31450 910-F15 11/5/92 JOB ADDRESS 165 River Edge Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. $ 1 River Ede Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don Washington 165 River Edge Way NE 571-0597 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Panelcraft 3118 Snelling Ave S M ls. MN 721-6628 2179 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 B DESCRIBE WORK Reside 9 CHANGEOFUSEFROM TO STIPULATIONS 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 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 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 $6 X500 $3.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $90.00 Fire SC $6.50 STRUCTION OR THE PERFORMANCE OFCONSTRUCTION. PLAN CHECK FEE TOTAL FEE I� S �_ License SC $5.00 $104.75 SIGNA UR OF CONT RACTORORAUT IZEDAGENT I ATEI HEN PRO RL V LIDATED THIS IS YOUR PERMIT BLDG INSP MATE SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI u NEW [ ] Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: 1('J &T6 N Tel. # Contractor: ��iA I� �(�G l� ►Q MN LICENSE #d Z �� Address: t S N. eLk--� N C A ✓, S . M �%S 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:�� Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway ' Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $ 11 lz��71q l Z /- 6 v2 � DATE: APPLICANT: TeI. # CITY USE ONLY Permit Fee $ 90. 00 Fee Schedule on Reverse Side Fire Surcharge $ 6,-�D .001 of Permit Valuation (1/10th%) State Surcharge $ 3,,,2L7$.50/$l,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ) Not Necessary [ ) TOTAL STIPULATIONS:. .1% SUBJECT - PERMIT NO. City of Fridley 0050 AT THE TOP OF THE TWINS BUILDING PERMIT NO. `v _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � PROTECTIVE ��® 1 ; i CITY HALL FRIDLEY 55432 NUMBERpEv DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/12/99 10B ADDRESS 165 River Ede Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 River Ede Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald & Faye Washington 571-0597 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snellinjay Ave S Mpls 55406 721-6628 a 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 X® REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 22 S Tear -off; Fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. [Iraeimlt Inspection Cardo Will Be Mailed TQ Homeowner To Pose SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CON, T, 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4795 $2.40 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 $111.25 17 Fire SC $4.80 PLAN CHECK FEE TOTAL FEE Licens C/$50 123.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tDATE, HE Y VALI ED THIS ISYQ1R��T/� .®c d /�J��r// BLJIG -NSP DATE S-CNATUREOFOWNERa00WNER8URDER� r IDATE� NLtiY j � ADDN I I CITY OF FRIDLEY Aum'.iz SINGLE FAMILY ANI) DUPLEXES R-1 AND R-2 Building Permit Application instruction 1 !/ m/ LlICCLrVe 1/ r/94 off# 3L1(o� Legal Description:— Owner Naine & Address: D®rra, l4/6,;�,yVTel. 11_� ✓ _ �` Contractor: _� v q ��_ ���✓ _ MN LICENSE - Address: -54 l�h ��, �- ✓�%� A'� �s �d� TeI. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach t this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sy. Ft. Length Width Height Sq. Ft.- Length t.Length Width Hgt/Ground Sq. Ft. Corner Lot Inside Lot Ft. Yd Setback Side Yard Setbacks Tvpe of Construction: '_?-;Z0t' ��► �- �� Estimated Cost- $ V117-saia- .rox. Completion Date: _ (Cosi: on Back) I)rivcway Curb Cut Width Needed: Ft. + G Ft = 17. t x DATE: _/ ��a�' APPLICANT: _ a Tel. # 7 Pcrmil Fee Fire Surcharge SGrte Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charl;r TOTAL CITY USE ONL-Y $ 3 Fee Schedule on Reverse Side $ _ _ 8b .001 of Permit Valuation (1/10th%) $ o' r -*YO $.50/$1,000 Valuation $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $ $150.00 Conservation Plan Review Fee Determined by Engineering - - -----_ -- Agreement Necessary I I Not Necessary STIPULATIONS:e CITY &; FRIDLEY INSPECTION DIVISION Effective On January 1, 21102 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONI11 ONING SYSTEMS AND DEVICES JOB ADDRESS RAS HEDULK OWNS [?ON WASH ri6-To R"Ide tial Furnace Shelf and Duct Work, Burner Also Replacement Furnace (Side Vent • Fill Out Bade) Gas Piping (Needed with new furnace, but not replacement) Gas lunge Gas Dryer *Air Conditioning . All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work CommercialAndustrial 1.25', of Value of Appliance or Work Rate TOTAL BUILDING USED AS PSI W661J $ 30.00 $3-0-00 ESTIMATED {{:OST I WT -00 PERMIT Na. C� $ 10.00 $ PMRIP—TO—H OR FURNACE AND QRABU $ 10.00 $ No. of Heating Units ' Circle One (Steam) (Hot dater) 0%00500 $ 10.00 $ Trade Name CA Size No. BTU WS00 HP EDR $ 25.00 $ 25.00 Fuel Nin- C� _ Total Connected Load State Surcharge TOTAL FEE MININIVIA REE FOR Atil HEATI1-40-/ OOLIWt3-VENnLATION REFRIGERATIQWNR CONDl1iONING PERMIT IS S PLUS THE *30 STATE SURCHARt REINSPECTIOM FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. $ BTU HP S EDR a� 3 $ 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 El representations stated in this application are true and correct. DATE GI 03 0 HEATING C4 AX �G1r1 ni(C I� Signed TEL # (1-2 FAX # .a. Approved By%,J Rough -in Date Final Date -o FILL OUT RAM SIDE EOR SAM VERIFICATit3fY�EPLAGE�ENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL SURMNG APPLIANCES OR THE APPLICATION WILL, BE RETURNED COMMON V1714 UENT rnNN Tr%n ONh ~~ e�IR t1��rFlt'�aLTIDN When ®placing,anYES Ing flimme, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and Is seely supported and firestopped where required, Yes AA No( } The venting system is plestictPVC and meets all current codes and manufacturer specifications Including suing, 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 specific ons. This does Include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes � No ( } The muMna etam ,i lstfimLak is sted and Installed to meet the current codes and manufacturer's specifications. Yes j No( When required to Inatatl in now naMbi ofinn akjt VWH be isiaed and lWthud to meet the current codes and manufacturer's speclliications. Yes j No( When jnSMIIhg a naw uanf tW 9V , the undersigned hereby vies that K is a listed assembly and mee& the current codes and manufacturer's specifications. This does Include ACA QAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes )K} No { } Is the common vent and vent connectors sized and installed DorreCtly after an appliance has been removed from the common vent and vented separately as per current codes. Yes �Ko { } AaWlan= 3�ypm g td, Susi' mmaanent and Vent C=necfnr Information Appliance rpt Tape VA'�y- k STU Input _ Fan Assisted or Nat `t4. Appliance #2 Type BTU Input_ Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Not Total Appliances _ Total Stu Input oa Common Vent Type Vent Height Diameter_ Inches Appliance #9 Vent Connector Height _L. _ft LengM DIameter r' _In TYPe CLA- Appliance #2 Vent Connector Herght -ft Length ft Diameter' _ __ - n Type _ Appliance #3 Vent Connector Height ___ft Length ft ©iameter__--Jn Type, At 'TF_rze'1'M.A.,jr1nSGLjhQ �..�..� HEA'nNG CO., SIgrtect gy:`1-7 -- b®/zo ' d 01 d0 AJ. I0 wmd Sr:" zwz-'?T- M GNOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 22, 2004 Mr. Don Washington 165 River Edge Way NE Fridley, MN 55432 Re: Final Inspection at 165 River Edge Way NE Contractor: Max Mechanical Dear Mr. Washington: A mechanical permit was issued on September 17, 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. Sincerely, DJ/mh X10. 5ci3L4-051 re -e-- 's 116 .13 Building $ BUILDING Plan Review Permit No.: - % Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ ,aD iiRACT- 2007 DATE 91011101 YOUR E-MAIL ADDRESS 0-bV)Q0Y 1 tom •SIA �Jl fl'1� l$-. CS_Of1� SITEADDRESS -5 'K' kir ft + 6 ft = ft x $21= $ THIS APPLICANT IS: ❑ OWNER IONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME: 'TbnaA ck Q \40- y) i mbn Fee Determined by Engineering ADDRESS: )(06 /'),'J t)r �C�GIt \A Ow CrrYt' e &� EX4 STATE,Q MIP '� TENANT' Total Due - PHONE: -IU3— lb -1 I 911 Make checks Davable to: City of Fridlev Attach Stipulations CONTRACTOR NAME: 'FA4 X 1 U V S STATE LICENSE # i o -1,3L03 S5 EXP DATE [bS SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 135I Kir'Kuvmg Lant N x' 630 crrY ` W 6e (—'A—"TATE rn 53b5 WITH APPLICATION PHONE -1 . -1 0- FAX '7d#. `-1 0- a 00 PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED qVINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION INTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:! l 12 t 4 ��U.�_t )' " $r_ BlC ® r' d D43 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS Des ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS- SCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 19T7_U.f C_FEE SCHEDULE) AL JOB TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ ,aD $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / -)L) Make checks Davable to: City of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT CT0i /)�PRINT NAME AnQ it �)' n(s D M< DATE_�I� l I (7