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PRE 2010 DOCSCity Fr aney sue.IECT PERM ®12-6-3-9 OP AT THE TOP OF THE TWINS BUILDING PERMIT r R E C ENC�� COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. 72,33/ CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY s Jr 612-560-3450 910-F15 7/17/74 / JOB ADDRESS 6321 Riverview Terrace N.E. 1 LEGAL LOT NO. 1 BLOCK 2 TRACT OR ADDITION SEE ATTACHED Eva Erickson. River Manor DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Allan Mattson 6320 Riverview Terrace 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. DeGardner Construction Co. 10757 University Avenue N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING House and garage (residentialX 7 CLASS OF WORK Ejk NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 38 x 26 house 24 x 24 attached garage 9 CHANGE OF USE FROM TO STIPULATIONS 1. Provide a verification Survey 2. Provide a hard surface drive Variance approxed 7/9/7 SERVICES OFF 63rd Way . SEWIJR 59 feet East of M.H. (E. Inv, 826.32 Wye Elev. 826.54 TOP OF FOOTING 829.54 (Minimum) WATER 10 East of Sewer Service 73.4' from M.H. -SEPERATE PERMITS "REQWPED FOR WIRING, HEATING, PLUMBING AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO, FT�51 cHT.516 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1 L f OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 570 70 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 VAyJ/�f SURTAa(2.02 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. �?LL44 0 4 2 . 3 O 1 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- T y49. 00 $300. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE�C1Tt o 02 I URE OF CONTRACTOR & AUTHORIZED AGENT (DATE)EN PRO E -V DAT THIS IS YOUR PER -MST INSP ')ATE r iSIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) 01 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NANE: .. X - )I NO:. STREET: 41",4xj/L!-.f LOT: BLOCK: . ADDITION: 1L/ 1L� /I CORNER LOT: INSIDE LOT: SETBACK: �7 S I DEYARD : / 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: K Front: Depth: Height • - ,� s Square Feet: �f' Cubic Feet: a Front: f Depth: G�r Height: Square Feet;—(I Cubic Feet:_ Type of Construction: 257a42U1 Estimated Cost: To Be Completed =R4ZO The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kict 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: SIGNATURE: (See Reverse Side For Additional Information.) a4, � a City of Fridley Apploicalsitan fW Mmabbg toadcm ang Pwr& 4 Dept. of Bldgs. Phone 360-3480 DESCRIPTION OF WORE Number, Kind and Loca"on of Fixtures Location --Z/ ✓ -""" ' pp Oi 9 � � � �i F I Z s 2n N y p �t 'Z N Z • • WATER MR. i[ `+ qy v I N GAS ELM Base 1st p 2nd 3rd 4th -Futuro Connect" Openings Cc Sever * Now Fixture, Old Oponings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................. : _L� x$2.00 $ v b Future Fixture Opening ........... x $1.50$ �-f., 6'- New Fixture Old Opening .....:.... x $1.50 $ Catch Basin ...........:........ x $3.25 $ Water Heater ;Up to 99,000 BTU) x $3.00 $--31.0 s New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater........... a $2.00 $ SAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 �' d C) Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............. x $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 fact and representations stated in this application are true and correct Fridley, Minn / 7 19� Owner o-� C _v:5 C�L� Kind of Building 0" e Used as�- To be completed about Estimated Cost, $ Old—New. Building PermitNo. Permit No. Sig9 Business Phune No !;z ROUGH REPAIRS do ALTERATIONS--Refor to Code .50 State Surcharge Description ................. , ......'..............« ..... $ TOTAL FEE 4�01 71 7 "P -Y4 @MWM WARM Ants RATS TOTAL Faum SbeD & Duct Work ....... ..... .. WAD Replacenest of Famem .... . .... &00 Repairs & Alterstions -up to sM.00 &98 Repairs & Alterations ench add. MAD S,w WMAM at NOT VATICR STSTM Ptamace shell & rues—.to 4W sq. ft. EM Sbm $10-00 a. Furnme, SWI & Use—to 60 sq. ft. MR Hit Wow W" Each add. 200 sq. ft. ZDR Stearn &00 Each add. 330 sq. ft. MR Hot Water 300 OIL SURNIC11—to 3 gal, per hour over 3 gal. per bour—See Fee SdmduW GAS BURNER (up to 1 0 IrM Lao $ OVW 190,000 VM Sew Fee Sdmdub GAS Frff WC FICE& NO RATIC TOTAL 1st 3 Inxtures z$ 2011 Additional Fixtures z .76 $ Gas Range to 199,006 zs !Op $ iam Few EdwAde Wrim Fm 01 s - *.,., -;, i L- .51) DOPL Of DMIML Phone 8804M � 10 4 T-1 1-1 WKAM 6F7 F_71 .1m A Ilk; Ddb _7 '.,az Ci4i4_ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips Infiltration A.S.H.V.E. Guide Construction No. Insulation WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No Net exp. wall 19_ /.2 Int. wall ) FV Room I Length /, y WidthHeight II 1 FLI V _L_ Room I Lenath a Width / i IT Heistht Window and Doors—Crackage and Area Width Helght No. of Lineal t . Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef. Btu Infiltration Infiltration Glass ZA Exp. wall Net exp. wall Net exp. wall Int. wall Int. wall . Ceiling I Ceiling Floor Yd x 1 otal litu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room (Length JGi Width /q Heistht k' Windows an Doors—Crackage and Area Width Height I No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. lCoef.1 Btu Infiltration Btu Glass , Exp. wall Net exp. wall 20 Int. wall . / Ceiling Floor Net exp. wall 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef. Btu Coef. Btu Infiltration Exp. wall Glass IL / Exp. wall Ceiling X I Net exp. wall Floor /.2 Int. wall Ceiling el Floor 1 btal 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Q r Coef. Btu Infiltration .1"4 Glass Exp. wall Net exp. wall / Int. wall Ceiling X I / Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area I / F1.1 , J Room I Lenath /-1 ,- Width // 4, Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration I G Glass Exp. wall Net exp. wall Int. wall Ceiling / Floor 1 otal btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D•56 ,, `'< -42 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor !!::::1 Yes—No Yes—No 19— F1.1 Room I Length / Width /I Height FI.I Room Length Windows and Doors—Crackage and Area Width Helght No. oL Li neat ft. Area No. at pane of Dane lights of crack sq. ft. Btu Infiltration 3 Glass Exp. wall Net exp. wall Int. wall Ceiling f Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 P/� Room I Lenath /.L Width - 14o;oht ndows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. d o Coef. Btu Infiltration / Glass -- Exp. wall Net exp. wall / Int. wall Ceiling Floor / y 7 60 Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Kjej Room Length Width ndows and Doors—Crackage and Area Wldth Helght No. of Llaeal it. Ares No. of pane of pane lights of crack Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r FRIDLEY, MINN. Insulation How Width /1 Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. d o Coef. Btu Infiltration / Glass — Exp. wall Net exp. wall / Int. wall Ceiling Floor 1_61 7 60 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .o Fl.l /_,. Room I Length Widths V Height Bows a Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Zda , Coef. Btu Infiltration Lstl y& Glass — Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. leader area _AJ Room I Length eP Width /) Height Win ows an Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Zda , Coef. Btu Infiltration Lstl y& Glass — Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. - __7 Id I Required sq. ft. E.D.R. or sq. ins. WA. Leader area CITY Or FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY IVAP-M AIR: Furnace Shell & Duct Work * Replacement of Furnace Repairs & Alterations-gp to $5Q0.00 Repairs & Alterations each add. $500=00 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU *Replace=ent of Furnace Re?airs & Alterations -up to $500.00 Repairs & Alterations each add. $500,00 STEAM OR MT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each adds. 50,000 BTU RATE $12.00 7,00 7.00 4.00 $12.00 4.00 7.00 7,00 4,00 ;12. PQ 4.00 ?.PA P. - PA TOTAL 6 $ S OIL BURNER- to 3 gal. per hour s}g.qA each add. 3 gal. per hour GAS BURXER- from loO,000 BTU to 1�9,gl9 �� s}P.•AA . (over 199,999, BTU see Fee ule Sche . fit..... j - GAS FITTING FEES: 1st 3 Fixtures ?s S. 4 -AP $ P33itional Fixtures x $ ;;PA Gas Range to 199,QQQ BTU x�A;QA yS AIR CONDITIONING FAX HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTEPUTIONS 4 REPAIRS $ State Surcharge $ .50 TOTAL FEE $ FOUGH INSP. REINSPECTION FEE Date ($10.00) FI:iAL INSP. Date , APPROVAL FOR PERKIT MI:.'L":'ZM FEE FOR AIYY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE *Attac:ed stack verification fora aob Mdress �lG✓C� ��/ .� Department of B4I j9Ungg Ctty of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes - and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley; Minn. 6-- 2S , 19 '—f - OWNER PND PF BUILDING PPEP AS Fez ,,✓ TA FF P.WLETFP AFQki C — RT43 P.R CAST o' 4 AR ' nR PUTRTNG PFF-ITT N0,- PFR.°ITT N0. �')_Gl ,J gPsr_RTPTTRN PF FyR_NACE/$URNER BEP�INA Ap #?A{#( PFI+t St€4firRt Yj4xert Waw} A#- No. Trade Name � �/L�� � � � / � s4ze No. I�-33o Capacity Sq. Ft. EAR BTU 36",Q) HP Total Connected Load Kind of Fuel BU Trade Name Size No. Capacity Sq. Ft. EDR BTU HP `\ Company ZE �IL2 C 2� Signed By r% Tel. No. • SUBJECT PERMIQi-.., City of Fridley0 77 9 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 400 r ; CITY HALL FRIDLEY 55432 ,'j NUMBER REV. DAVE PAGE OF F/ APPROVED BY 612-571-3450 910-F15 5/1/91 / JOB ADDRESS 6321 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Knutson 6321 Riverview Terrace NE 571-2936 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW IR ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 16' x 12` Deck; Remove existing deck (.8r x 12') 9 CHANGE OF USE FROM TO STIPULATIONS See notations on Plan. Variance approved for rear yard setback on July 9, 1974 down to 18.51. Per Planning Dept, deck can extend 101 into this rear yard of 18.5'' NARNING SEPARATE PERMITS REO FIRE® FOR Before digging call for all utility locations WIRING, HEATING, PLI. NIBiNG Aft® SIGNS. 4540002 REQUIRED BY LAV TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $1,450 $.73 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- $35.00 Fire SC $1.45 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PL HECK FEE TOTALFEE q $37.18 SIG URE OF CO ' ACTO RA H R EDAGENT P OPE L TED THIYOUR PERMIT ®(DATE, S__P �� M BLDG WSP TE ' SiGNATURE F OWNER U OW R BUILDERI 10ATEI P [ ] Effective 1,/1/91 ADEN [ ] R-1 AND R-2 AMER [ ] Building Permit Application Construction Address: 6'3 2-1 -7L,�. �� 1z- - legal cription: /P.)Y- /,J — , 2- �e4 e 0-4',e0 oeA Owner Name & Address: r)eC�X Tel. L; 146LTel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D1prQtIPR'ION of II�IiOVH�TP LIVIIdG AREA: Length Width Height Sq. Ft. G RAM AREA: Length Width Height Sq. Ft. DDCR AREA: Length ' Width f ' Hgt/amu d .�� Sq. Ft. �-- 11tC' Lx 7. J 6 Z I qS1. 5--L-- Corner Lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 14WIA" 04;�ltDEstimated Cost: Approx. Coupletion Date: Proposed Driveway Width If New Is Ft. $ $ idth + 6' See Back Page APPLICAtU: Tel. # s-71- :" Permit Fee Fire Surcharge $ co $ �J State Surcharge $ �� SAC charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ �s 1 t. CITY DBS O1�Y Fee Schedule on Reverse Side .001 x Permit valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering raring Agreement Nary [ ] Not Necessary [ ] 1 q Iso ice, �;oc/ PERM:IT-tZ_ SUBJECT City of Fridley 22181 AT THE TOP OF THE TWINS BUILDING PERMIT i? RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ;��� r CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/14/93 JOB ADDRESS 6321 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Knutson 6321 Riverview Terrace NE 571-2936 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION jJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (:25 Squares) 2nd Layer 9 CHANGEOFUSEFROM TO STIPULATIONS Roo.�ng can be the 2nd layer but not the 3rd. Provide adequate attic ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in. basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $2,000 $1.00• 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- Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $45.0,0 PLAN CHECK FEE TOTAL FEE 48.00 SIGV�TURE OFC TWACTW105,41UTED AGENT MATEI WHEN RL LIDATED THIS IS PERMIT j JYOUR g I Da7E SiGNATUR F OWNER OF OWNER BUILDERI IDATEI NEW [ j Effective 5/26/93 ADDN [) CITY OF FRIDLEY ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2j�a� Building Permit Application Construction Address: t:� g`�/P�/ew Y�� Legal Description: �N� /e � %�� ��f � a4 Owner Name & Address: Tel. Contractor: Address: LIVING AREA: Length MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed constivction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. d OTHER: �1 P J,4J r✓2C�' cr�yd Corner Lot ; Inside Lot [ j Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: /d- / 7 %3 (Cost on Back) Driveway Curb Cut Width Needed: Ft, + 6 Ft = _ Ft x $ _ $ DATE :%— �� APPLICANT -- Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ - 0 C' .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 [ j Not Necessary [ j TOTAL $ ��� STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Residential Furnace Shell and Duct Work, Bumer — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commerclayindustrial 1% of Value of Appliance or Work Effective On January 1,19W/ State Surcharge $ _,,50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $1500 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING Signed By G Tel No. Approved By. Rough—in Date Final DateT7 !� FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE :. The undersigned hereby makes application for a permit for the work herein Rate TOTAL 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 $ 20.00 $ ' representations stated In this application a�� e an correct. I $10.00 $ OWNER $10.00 BUILDING USED AS $10.00 $do ESTIMATED COST PERMIT NO. r% $10.00 $ QgSCR IPTION OF FURNACE AND OR BURNER $ No. of HeatingUn C Is One (Steam) (Hot Water) arm Air) � Trade Name 1� e Size No. BTU D HP EDR $ Fuel „j Total Connected Load State Surcharge $ _,,50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $1500 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING Signed By G Tel No. Approved By. Rough—in Date Final DateT7 !� FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully exa Www Yes ) No ( ) 2. Is free from rust or deterioration Yes (v No ( ) 3. Has no foreign objects lodged within Yes (V jNo ( ) 4. Is securely supported Yes No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( No ( ) 6 Has total heating BTU's of /0 7 All other BTU's 3 TOTAL BTU's / X/ 7. Has a liner been provided for water heater Yes ( ) No 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: HEATING CO: Signed By: Date: