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PRE 2010 DOCSApplication for Power Plants and Beating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices Partial Rate Schedule GRAVITY WARM AIR:l TOTAL Location ............................... ............................................... FurnaceShell & Duct Work .................. _.... .......... _......... ...__.$ ................................. Replacement of Furnace....._........_.................._............._.........._.._. $...... _..................... City of The undersigned hereby makes application for a permit for the work herein Repairs & Alterations—up to $500.00 ........... . ....................... $...... --------------------- ••• specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 ........... _.... _........... $..... _--- ...._...._--------- and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU .................. $---- _.---- ....--- ...------- ° Minn ................... _.............. _�r......�.,1�..., each add. 60,000 BTU .... ......................... ._................. $......_ �j2�'.' Owner .... �.v�%:Isvl�........../.............. ....._.._...................... _...... _.......................... _ ............................. .. Replacement, of Furnace ............... _.._.r... ................................. _.... �� $__................ Repairs& Alterations—up to $600.00 $. Kind of Building ....._....... F '.......... .................................... ........................................................ _......... Repairs & Alterations each add. $500.00 ............ ................. $....:....... ....... _.......... Used as ........ . STEAM or HOT WATER SYSTEM To be compeletd about _.............. _�.. `".......... ....Q...../.._..................._..............................._........ Furnace Shell & Lines --to 400 sq. ft. EDA Steam .. $._. _._.._........... �� Furnace Shell & Line—to 640 sq. ft. EDR Hot Water $..........._............... .... Estimated Cost, $ . ..........................................�'..�............................_......._.... . Each add. 200 sq. ft. EDR Steam _.__.___..._......._.. _..... _ $..... ._........ ............... Ol New. Building Permit No ......... .... .................... ...... Permit No....... .............. Each add. 320 sq. ft. EDR Hot Water ..... _.... _.......... _........... $--..- OIL BURNER—to 3 gal. per hour .......... _........ _..... ___ $... _......... ._.............. DESCRIPTION OF WORK over 3 gal. per hour—See Fee Schedule -••---•••••—•-- HEATING or POWER PLANTS—Steam, Hot Water Warm Air No ........... __.......... GAS BURNER (up to 400,000 BTU) .... _..... _.... _......... _�._. $..... 0,2?......_...... _ GAS FITTING FEES: NO TOTAL Trade Name.. ... r ................................................ Size N.o...7--z 1st 3 Fixtures _... �_. $... ......... Capacity!}.r,'.00...... Sq. Ft. E D R PeO, V 010 BTU .................................... H. P. Additional Fixtures _ _._.......... $_.._..... ...._........ ___; Total Connected Load. ........�........�-�_..'.�.... Kind of Fuel .... ... ......:. .. Gas Range to 200,000 BTU ...._..... —._.. $._......... __..._.......... VENTILATING SYSTEMS BURNER—Trade Name...... .......................................................... Size No ....... _ ... _....... _.,......_.......... Duet work etc. not to exceed 2,000 cfm ._..._... _......... _ $_.....------- ............._.... Capacity ................. ................... Sq. Ft. E D R ........... _....... _.......... —.BTU .............................. Each additional 1,000 cfm AIR CONDITIONING Signed...... .... `.c - ;-- ..d......... r :..... ..... FAN HEATING SYSTEM See Fee Schedule $........... _ _. _..... By .. _. _.......... ALTERATIONS & REPAIRS $-..__.__..._.. _ ...._ Business Phone No...... ..g/��........... TOTAL FEE (remarks—over) Business Address..... ... . CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures m $ io x $2.00 oWater New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 d +� x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 E Water Softener q A m $4 2 [*a x' $5.00 $ Heater H om ro x 43.00 $ m C J 30 x $10.00 a Gro o x ci M vii v 3 a w° W 4 u we 3 o as 3lec 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number 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: lst 3 fixtures x 43.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 each add. $100.00 or fraction $2.00 ii State Surcharge �XlSi4wC S�fYC Vb c, O F ) TOTAL FEE REINSPECTION FEE ($10.00) $ .50 . r -Job Address G- / �� �G�%z,�, cJ sl if' Department of Buildings 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, Mn. Gr h/z • 19 %i OWNER KIND OF BUILDINGS f, %if _6 USED AS X C `J TO BE COMPLETED ABOUT ESTIMATED COST OLD — NEW BUILDING PERMIT NO. PERMIT NO. 171,71 Company ra %�✓�E�� % �� �9 �I wE l ,�t�. Signed By� Tel. No. 4:� ROUGH INSP. Date FINAL INSP. L - - 7 Date APPROVAL FOR PERMIT W, MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 97-8h-879001 APPLICATION FOR ruimBING ANU UAa rl 11 INU , Crnii i Job Address 6119 .Riverview Terrace Department of Buildings City of Fridley I Tot, 0571-3450 The undersigned hereby makes application fora permit for the work specified agraeing•to do all work in strict accordance with the City and rulings of the Department of Buildings, and hereby declares that the facts and representations stated in this application are true And Fridley, )4,•�. 9-16-77 , 19, • PLUMBING FIXTURE RATES; N0. °j a. a rimer Fixtures '� 53.DO u Future ri-xture Opening X u $ water x $2.00 S Catch Basin • Ix $5.00 $ i Nater Heater - to 99,000 BTU, x $5.00 $ N x 510.00 $ Nater Softener i{eQter w .� u New Ground' Run Old Building � '�• K M h yNC $5,00 $ •GAS FITTING FEES; V 8 1st 3 fixtures x $3.00 $ XJditional Fixturaa o �o •?' .Can )singe to 199,000 BTU 'V $10.00 1A REPAIRS d ALTERATIONS b 8 14 0 $5.00 1 each add. $100.00 or fraction lac 0r= u' o p c� a $ , 9 On , a vas w K x o 3an -Is t 2nd 3rd ' S th �.. (R) - Future Connection Opening Connected with Sawer (�) - )low Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES; N0. RATE TOTAL rimer Fixtures x 53.DO S Future ri-xture Opening X $2.00 $ Nov Fixture, old Opening . x $2.00 S Catch Basin • Ix $5.00 $ i Nater Heater - to 99,000 BTU, x $5.00 $ 100;000 BTU to 199,000 BTU x 510.00 $ Nater Softener x $740 $ New Ground' Run Old Building � x $5.00 $ Electric Nater Heater x $5,00 $ •GAS FITTING FEES; 1st 3 fixtures x $3.00 $ XJditional Fixturaa x $1.00 9 .Can )singe to 199,000 BTU x $10.00 $ REPAIRS d ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ , 9 On , OWNER Jean uoehring ' KIND OF BUILDING _ _ flame USED AS res.. ft TO BE COMPLETED ABOUT 9`-22-77 ESTIMATED COST 3+0100 OLD - NEW BUILDING PERMIT NO, -PEP AIT N0. � n Company C;. mifwmsaasco Signed By Tel, No. ROUGH INSP. Date FINhL INSP. Data p APPROVAL FOR PERMIT! MXIIIMUM FEE FOR ANY PLUMBING PERMIT I9 $7.50 SUBJECT City of Fridley 6 8 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T E01iT6 • ___ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. -'1 CITY HALL FRIDLEY 55432 I.J NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/19/82 JOB ADDRESS 6419 Riverview Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 AUd. Sub. #23 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Scott Greewald 6419 Riverview Terrace N.E. 572-0988 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑_ ALTERATION ❑ REPAIR ❑ MOVE 11REMOVE X 8 DESCRIBE WORK Install soffit/facia and reside dwelling 9 CHANGE OF USE FROM 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 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 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 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $550 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. $15.00 PLAN CHECK FEE TOTAL FEE $15.50 SIGNATURE OF CONTRACTOR OR AUT RIZEDAGENT (DATE)WHEN 71/91 p / PROPERL VALIDATED THIS IS YOUR PERMIT BLDG INSP E SiG TORE OF OW NER IIF ONER DER) IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PER14ITS (New, Alterations, Additions, or Repairs) OVINER: ADDRESS:_ _ QI(',(. ADDRESS: TEL NO: ,� 7) - 09 Z TEL NO: Construction Location d c STMMT NO • In STREET: IAT: La. BLOCK: ADDITION: 5 u J Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Zrbntge " Depth: Height: Square. Feet: Cubic Poet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction:.. do., Estimated Cost: $ �� g� To Be Wnpleted: 06-;E.-- 31 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the �vrk'herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Depi-:rtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and porrect. DATE: 16- - S C? SIGNATURE: Stipulations: 5 c2 ���C/ m 01 SUBJECT 'E City of Fridley 21981 AT THE TOP OF THE TWINS BUILDING PERMIT i , E ► ►►' COMMUNITY DEVELOPMENT DIV. �' ------ ► PROTECTIVE INSPECTION SEC. r � ; a p� _ , CITY HALL FRIDLEV 55432 �"►'� ,'� NUMBER REV GATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/19/93 JOB ADDRESS 6419 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 16 Auditor's Sub. #23 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Judy Greenwald 6419 Riverview Terrace NE 572-0988 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 2114" x 106" and a 141" x 514" Addition to Dwelling; Construct a 201 x 20' Attached Garage; Cut down and move 18.2.5.' x 12.4' building to rear yard. 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WAIM" Before digging call for all utility locations 454.0002 REQUIRED BY LACl/ TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING S0. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 1 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 $50034.80 $25.02 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r 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- $41.9.00 Fire SC $50.03. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $494.05 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT gqIDATEI W OP ALIDATED THIS IS YOUR PERMIT S)tt4ATUQE OWNERUF OWNER BuTLDERJ IDATEI % BLDG NSP q4 TE m 01 .;: ..a ..QI :::.: i,Q:`a?<: a::?:f".:::::::..... r...a.................. . a . .. a .. ... .'2.. ..a a a...., . a.w..............a C)/'t`a a ...a. ....a.a..?Q•:a,a,Q it ..,v...... ?JP -W [ ] Effective 3/1/92 ADDN [ J CITY OF FRIDLEY I-7 ALTERLN SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �a Building Permit Application Construction Address: X419 g I VE - 91y un j T"e . Legal Description: 1 3 D 24 42. a 10 3 Owner Name & Address: -Tw>�I 4 K N 1J t✓Tel. # 7 Z -f aa8S Contractor:MN LICENSE # Address:�4t! �r�df kl i2 Tel. # Attach to this application, a Certificate of Survey of the K with the proposed construction drawn on it to scale. DESCRIP'T'ION OF IWROVEMEN' LIVING AREA: Length z .5' Width 29 Height moo`` Sq. Ft. fig, GARAGE AREA: Length Zo Width zo Height 5 Sq. Ft. 40b DECK AREA: Length Width Hgt/Ground Sq. Ft. 4o.6' OTHER: ®vL /� .�S /� U r� Comer Lot [ ] Inside Lot [ Ft. Yd .Setback 35'- d �' Side Yard Setbacks (), 63 Type of Construction:E� STRT K4 �D N Estimated Cost:. Approx. Completion Date: 6-54 Driveway Curb Cut Width Needed: Ft. + 6 Ft = ( Cost on zackj Ft x $ = $ DATE: 5-Z5-93--- APPLICANT: �'U�� (a� �lW -Lb Tel. Permit Fee 9191)0.$ Fire Surcharge Eo.. 03 $ State Surcharge $ SAC Charge $ License Surcharge Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $700 per SAC Unit $5.00. (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV, Effective On January 1;1993 •`6431 Unlversity'Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 512-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES MINIMUM FEE FOR ANY HEATING/COOL,INGNENTIL.ATION REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00 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 COMPANY Signed By Tel No. Approved By C—'?F Rough—in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS CP r1 �tu'e U I`ecJ RATE ,SCHEDULE The undersigned hereby mikes application for a permit for the work herein Residential }date TOTAL specified agreeing to do all work In strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ representations stated in this application are true and correc Nlb ,1993 Gas Piping (Needed with new furnace) $10.00 $ % (� OWNER Gas Range $ 10.00 $� n r f/ BUILDING USED AS Gas Dryer $10.00 $ v � ESTIMATED.COST PERMIT NO, l/� *Air Conditioning — Ali Sizes $10.00 ' $ All Others/Repalrs & Alterations (LIST ON BACK QESCRIPTION QF FIJ,j N60E 6NQ,08 BURNER 1% of Value of Appliance or Work $ o No, of Heating Units_,„ Circle One (Steam) (Hot Wate (Warm Ai Trade Name Size No. Commerclal/Industrlal BTU HP EDR 1% of Value of Appliance or Work $ Fuel p S Total Connected Load State Surcharge $ ,50 Burner Trade Name Size No. � � BTU HP EDR ' • TOTAL FEE $ MINIMUM FEE FOR ANY HEATING/COOL,INGNENTIL.ATION REFRIGERATION/AIR CONDITIONING PERMIT IS 115.00 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 COMPANY Signed By Tel No. Approved By C—'?F Rough—in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CHIMNEY AND STACK VERIFICATIoN The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or -deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes (-) No ( ) S. Meets all current Code requirements for size -and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR S, PLUMBING FIXTURE RATES: NO. PATE TOTAL JOB ADDRESS Ca �l New Fixtures $7.00 The undersigned hereby makes application fora permit for the work herein Old Opening, New Fixture Wash Floo r Auto. Gas er Water eat stories Urinal Sh ower e . Vay Drain and representations stated in this application are true and correct. Wash er Range . . . . . . . . . . . . . . . Gas_ Elec Basement Rain Water Leader $ 7.60 C111(a 91993 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $7.00 Water Heater — Gas $10.00 /a Building Used As A J1 Pas Range $10.00 to Cost PERMIT NO. 06 Gas Dryer Floor I 10 Estimated Back Flow Preventer Required )Yes O No Type $5.00 Floor 2 PLUMBING COMPANY ....... ..... SIGNED BY TEL No. ReInspection Fee $30.00 Floor 3 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Gv 1 % of Value of Fixture or Appliance /0? — Floor 4 Approved ByGV7 Rough—In Date Final Date State Surcharge $ .50 S, PLUMBING FIXTURE RATES: NO. PATE TOTAL JOB ADDRESS Ca �l New Fixtures $7.00 The undersigned hereby makes application fora permit for the work herein Old Opening, New Fixture $ C60 specified agreeing to do all work In strict accordance with the city codes Beer Dispenser t 5.00 and'fulings of the Building Division, and hereby declares that all the facts Blow Off Basin $7-.00 and representations stated in this application are true and correct. Catch Basin '$7.0 0 Rain Water Leader $ 7.60 C111(a 91993 Sump/Receiving Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $7.00 Water Heater — Gas $10.00 /a Building Used As A J1 Pas Range $10.00 to Cost PERMIT NO. 06 Gas Dryer $10.00 10 Estimated Back Flow Preventer Required )Yes O No Type $5.00 PLUMBING COMPANY SIGNED BY TEL No. ReInspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Gv 1 % of Value of Fixture or Appliance /0? Approved ByGV7 Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE PLUS THE $.SOSTATE SURCHARGE HOUSE HEATING TEST RECORD � °'� ✓��� (�� ` ��� 'SRAUR5 ADDRESS APT.—FLOOR CITY / OCCUPANT OWNER HEAT LOSS _--.—DATE HTG. INST. L/ ����� SOLD BY INSTALLED BY �'✓ Electrical Work By Gas Line By TYPE OF HEAT GA_ FA _HW STEAM SPACE HTR. UNIT HTR. ,,.OTHER GAS DEIGN CONVERSION MAKE MAKE OF BURNER Model i/®L ',o Model Serial 41 q-3 A9 d 51,6 1 a Max. BTU Rating INPUT <,;rdD © MAKE OF FURNACE Model CONTROLS ®r THERMOST T Heat Piuy Vent Size Vol— 14.1760 PLO 4P KIND OF LINER ® � SIZE d® NONE Limit Draft Hood Regulator Limit Setting ,.-7 42) Filters Size Ile- w, s Number—� Fan Setting F Chimney Location Insid®v Outsida Pilot Type jq Chimney Constructions -> Pilot Mak. - - -- Spillage Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tog L.W. Cut Off Door Pressure Lighting Inst. (3, Pressure 209 Percent CO2 ® Date Tested Input CFH Percent O2 7� Company Testing 0/✓S' .�� %�� Stock Temp. 17' !3.4 Percent CO. Name of Tester g®Certificate of Compentency_ # CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDEKTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer ' Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TOTAL $ 20.00 $ '16"00 $ 10.00 $—L4ft, ego $ 10.00 $ $ 10.00 $ $ 10.00 $ State Surcharge rZ*r�7 REINSPECTION FEE $30.00 Rough Insp. a ba ) De Final Insp. Date Approval for Permit ? F S MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE 'OAir Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address. (d/ /2 /ermc o— Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 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 ap2444"�� ion are trueand correct. a a '0- `d/ r 199 OWNER KIND O USED AS f� S %C%�,2 / / G?/ j� /� 6 /i e— TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, arm Air No. Trade Name y�� y�7� �G-�a� Size No. ,,�(4)0 l6 —T Capacity Sq. Ft. EDR BTU ZZd,00 HP Total Connected Load Kind of Fuel A,)gl- eliax BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Company Signed By `fid Tel. No. jr Ln Or Fill out back side for stack verification on replacement furnaces h e-)kne— CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,) No ( ) 2. Is free from rust or deterioration Yes ( } 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 ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Remarks Company _ Signed By Da to SUBJECT PERMIT NO. City of Fridley 26091 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. ~ i ! PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 1 612-571-3450 910-F15 5/26/98 JOB ADDRESS 6419 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 16 Auditor's Sub. #23 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Judy Greenwald 6419.Riverview Terrace NE 572-0988 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 B DESCRIBE WORK Construct a 188 sq ft deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. VAR111% Z 0001e digging tail for an Utility 10catrons 54.0002 RE UIR D 13Y LAW �� Pt;RAIMS WSE' RE tNG, HEATING, D .Mp PLUMS G 'gtyt} SIGIy�►b . 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 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 $.84 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $13,686 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- $54.00 Fire SC $1.69 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEEAL FEE -1-11 - / ;P$56.53 SIGNATUREOF ONTRACTORORAUTHORIZED AGENT IDATEI E PRO AB G IN., Y VALI A ED THIS IS_=R PERMIT ��•V// BATE SI NAT , OF OWNE IIF OWNER SUILDERI ID TE I NEW [ ] Effective 1 / 1 /98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (Ad Legal Description: Owner Name & Address: # 672 -6-3162, Contractor:�j��{-� MN LICENSE # Address: 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 /0 Width /® Hgt/Ground Sq. Ft. OTHER: `7Xl 4 uo q 9A- AX157T- AI& .6� 6.5 X � •C�" % j(9.7 Construction Type: W 00-h Estimated Cost: $ 164001-36 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ Wk - DATE: APPLICANT: a/ Tel. # (pm - CITY USE OIY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow R-rosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: $ " 5 -6- `3 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 9 Building $ C' S °A s BUILDING Permit No.: Inspections $ RESIDENTIAL APPLICATION Received By: 763- ,572-3604 $ CITY OF FRIDLEY Date Rec'd:' Curb Cut Escrow U �i d�I�ld`� rkx - DATE YOUR E-MAIL ADDRESSIJ . ���v P tc� "��`s; SITE ADDRESSrf1w b ('w K--1'— Total Due THISAPPLICANTIS: &QUNER ❑CONTRACTOR PROPERTY OWNER/ NAME:ti j �.�s� L� TENANT ADDRESS: 6 - t c(l 9165 C, Ft CITY F41bLE i STA _ZIP =�- PHONE: 2W 15 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE MINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH Z ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES iol ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2• 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. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE 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 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ( U OCCUPANCY TYPE Permit Fee $ C' S °A s Plan Review $ Fire Surcharge $ Surcharge $ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ 0 9 See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: City of Fridley Attach 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 whichggregr%s review and app oval of plans. aI SIGNATURE OF APPLIC l�° . PRINT NAME —50 T �f✓ �9 DATE � 1 �> L G1YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property atLq PV- 1911 2. , Fridley, I am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isi the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Nam Date (I e J 0�0 Building PLUMBING Permit No.: r �7 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CI'1,X ®E F12�DI,EY Da '& F C 2.9 200 DATE 0910YOUR E-MAIL ADDRESS SITE ADDRESS ` ✓ \1 Tu f C& THIS APPLICANT IS: Li OWNER °CONTRACTOR PROPERTY NAME: OWNER/ TENANT ADDRESS:--- PHONE: CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSEoimplon EXP DATE Q-- Q YOUR STATE ADDRESS: CrfY STATE ZIP LICENSE WITH PHONE_ FAX APPLICATION + PERAM TYPE SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV —FLOOR DRAINS SHOWER WATER PIPING _ BATHTUB _ GAS PIPING pzm cn7LjcemsL _ SWIMMING POOL SOFTNER ($35) —WATER _ CLOTHES WASHER KITCHEN SINKWATER CLOSET PREV. ($15) _WATER _BACKFLOW _ DISHWASHER LAUNDRY TRAY HEATER ($35) ' FOR IRRIGATION WATER METER,;s, OTHER MENKE Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ 5 . o State Surcharge = $ .50 Total = $ 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 PRINT NAME�C �T I�� DATE-1A 1 A -.,)0/�- lam' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604A JG% FAX: 763-502-4977 Building BUILDING PermitNo.: j L Inspections RESIDENTIAL APPLICATION. Received By: 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY D EFIMCTWE 1.1-08 DATE YOUR E-MATLADDRESS SITE ADDRESS THIS APPLICANT IS: Cl OWNER WONTRACTOR PROPERTY OWNER/ Nom, TENANT ADDRESS: 411 .[>� sTATETIMI ZIP S PHONE 7 5 2 — © JI. CONTRACTOR ADDRESS: CITY sTAT1177 ZIP D J SUBWT A COPY OF PHONE �) i — FAx YOUR STATE LICENSE �7 STATE LICENSE # EXP DATE PROPERTY TYPE SINGLE FAMILY SIZE D TWO FAMILY/NEW CONSTRUCTION STORIES PERNUT TYPE ❑ ADDITION ❑ GARAGEISHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑NEW HOME CONSTRUCTION ❑ ADDITION ,IS-MAIIVTII�TANCE�REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHTROOM S FT C3 HOUSE ONLY NUMBER OF SQUARES [3 HOUSE &GARAGE BASEMENT REMODELING ammo• GARAGES 13 ATTACHED GARAGE I. . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ vinyl pSofflt ADDITIONS & PORCHES SrrBMrr• ❑ Aluminum ❑ Trim 1. Site Phm/Sunw showing the existing structures ❑ Other p Fascia and proposed project. WINDOWS Z. Two sets of construction plans IN SIA ENDO Al� 3. Energy Calculations ORF FOR NEW OPENINGS -DESCRIBE SIZE OF L. , rn OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS A" rr r b AHL BAar y ON vALUA110N, INCLUDING THE COST OF LABOR AND MATERIALS; TOTAL JOB VALUATION $ //,, UW THE 1997 UBC FEE SCHEDULE) • ` OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dae $ '7"Y- 2P 5 See Back Page for Fee Schedule -- $ 65% of Building Permit Fee $ f . -L-6 .001 times the total job valuation $ , LQ D .0005 x Permit Valuation NImimum $.50 $ 5,06 -$5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks payable• to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT—NOT. VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information of the City of Fridleywith the to nshuction Codes; that I r permit on site; that the wo be ' ce the appro plan rpt SIGNATURE APPROVED BY is complete and accurate; that the work will be in conformance with the ordinances and codes ad this is not a permit but only an application for permit and work is not to start without a a of all work which requires man fp / ! :_.mmNAME wl DATLP'/;//0