PRE 2010 DOCSCity of Fridley, Minn.1 105
�
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUMDING PERMT
Date: June 21, 1971
Owner: Robert . Deyries Builder ,,, rco- Incorporated
Address w w _ _ Address 3231 Central Ayanue
LOCATION OF BUILDING
No. 7158 _ Street Riverview Terrace , N.. E . Part of Lot
LotBlock 2� _ Addition or Sub -Division Riverwood Manor Addition
Corner Lot __T_ _ Inside Lot X Setback — Sideyard
Sewer Elevation ___ _' -..Foundation Elevation
To be Used as:
pme1.1ing s, Front 46'_ Depth 2 8 ' Height _20' Sq. Ft. ___1M Cu. Ft 2.5.7601
-Garage _ _ Front 24' Depth - 22' Height 10' Sq. Ft 5281 Cu. Ft. -, 28 1
Type of Construction __ _ V rye Est Cost 4,, 000 To be Completed IS a p t 15, 1971
Stiplations: Drainage to be directed away from adjoining properties. Provide a
hard surface drive. Provide a verification survey.
In consideration of the issuance to me of a permit to u building described above X agree to do
the proposed work in accordance with the description ae and in compliance with a'll pro ons of
Ordinances of the city of Fridley. _
In consideration of the payment of a fee of $ 58.00 , permit is hereby granted to Erco, Inc.
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 ordin4new Of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildino
Jivithin n� city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinBuilding Inspector
HANK MUHICH
NO9-rTICE:
•'This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be snore to m
„c the Building Inspector for separate permits for these items.
IN
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING.PERMIT
CITY OF FRIDLEY, MINNESOTA
/--2
OWNER'S NAME : ILDER :.,�}_'/'�J
ADDRESS: ADDRESS: J7i3 /
� F
NO.. . f �� STREET:
BLOCK: y ADDITION:- x // �� �� /P-.
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
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 C� ��u c'-----
�. Front: 41 i Depth: ,. Height:
Square Feet: ' N,
q ,�_ Cubic Feet:
Front: Depth: — = Height: a
e
Square Feet; 'J Cubic Feet: p
Type of Construction: Estimated Cost: $
To Be Completed: fs
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations ted in this application
are true and correct.
DATE : ' _ (r / / I I `% 1' S IGNA
(See Reverse Side For Additional Information -6
City of Fridley
Applicalfon for Phadgag and Gin Fktbg Penn*
Dept. of Bldg®. Phone W3
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
q
NO. RATE
TOTAL
Number Fixtures ................ .
x $2.00
e
e
WATER MTX.
$--
_New
New Fixture Old Opening ..........
x $1.50
$
Catch Basin .....................
x $3.25
$
Base
Water Heater (Up to 99,000 BTU) ....
r x $3.00
New Ground Run Old Bldg.........
x $3.25
$
1st
/
x $2.00
$
GAS FITTING FEES:
RATE
TOTAL
2nd
/NO.
x $2.00
$---A
- U6
Additional Fixtures ..................
x $ .75
$
3rd
x $5.00
$
4th
• Future Comeaion Openings
Com with
+ Nen® Fixture. Old O"niz ge
Ssawu ❑
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ................ .
x $2.00
$ 2 Q
Future Fixture Opening ............
x $1.50
$--
_New
New Fixture Old Opening ..........
x $1.50
$
Catch Basin .....................
x $3.25
$
Water Heater (Up to 99,000 BTU) ....
r x $3.00
New Ground Run Old Bldg.........
x $3.25
$
Electric Water Beater ..............
x $2.00
$
GAS FITTING FEES:
RATE
TOTAL
1st 3 Fixtures ............
/NO.
x $2.00
$---A
- U6
Additional Fixtures ..................
x $ .75
$
Gas Range to 199,000 BTU.. .
x $5.00
$
RLPAIRS 9: ALTERATIONS—Refer to Code
Description .............................................. $
TOTAL FM $
(SURCHARGE
CJi4- U
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 aR the fact
and representations stated to this application ire true and correct
Owner F
Kind of Building -�
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit No. A Permit No.�
Signed.
By
Business une No 7 e =2'
ROUGH
a
Application for Power Plants and Keating, Cooling, Ventilation, Refrigeration and
Air Conditioning Systems and Devices
Partial Rate Schedule
GRAVITY WARM AIR:
Furnace Shell & Duct Work ............ ...................... _----------__----._
Replacement of Furnace _ .................................. ..........._._............
Repairs & Alterations—up to $500.00 ........... . .......................
Repairs & Alterations each add. $500.00 ..............................
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ..................
each add. 60,000 BTU ................. ............ ._.................
Replacement , of Furnace ... .............. _... _............... _..........................
Repairs & Alterations—up to $500.00 ..............................
Repairs & Alterations each add. $500.00 ........... __...............
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...._
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
Each add. 200 sq. ft. EDR Steam _....... _..............
_.. _....._
Each add. 320 sq. ft. EDR Hot Water ...... ...........................
OIL BURNER—to 3 gal. per hour ................... ... ..... ............
__
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) ..........._ ..........
GAS FITTING FEES: NO
1st 3 Fixtures _...._. ...._
Additional Fixtures ....._.................
Gas Range to 200,000 BTU _........ ._._......
VENTILATING SYSTEMS
Duct work etc. not to exceed 2,000 cfm _....._._._.....
_._
Each additional 1,000 cfm...... .......... ......._.......... ....... ......
AIR CONDITIONING
FAN HEATING SYSTEM See Fee Schedule
ALTERATIONS & REPAIRS
TOTAL FEE
-172 7/
$.......... ....._ - ..........
Location.1...d............ .....e41
City of
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.
171
/D) Minn. ............ . ............... 19.4..
Owner
Kind of
Used as
Tobe compeletd about _ .............................................. ................... .............. _..... ............................... .........
EstimatedCost, ................................._............._..................._......._.........._......._.........._............
Old New Building Permit No.............._ .............._........... Permit No......__. f...{.-
DESCRIPTION OF WORK
"""........ .. '"'""'
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ........... __/.....
Trade Name..._...
TOTAL
..........................................Size No.�®........._..........
$.. _ ..__............
Capacity ....................................... Sq. Ft. E D R. ................ ................... BTU,/,..7H. P.
$ "------. '".""""""
Total Connected Load�.e .............. Kind of Fuel......... .....C......
BURNER—Trade Name ........... _.................................. _.._.__........... Size No ....... ......_........ _ __....._....
$--- _..----- _--- _.......... _..
Capacit�.......................... _.... _..... Sq. Ft. E D R. .......... _.... _.......... _.._..BTU.............................. H. P.
SUSURBA14 AIR. CONDITIONING GCS.
$---- .------ _..............
DRIVE
Signed .................... S4jjg...CEI�T.�R...... �,M
1VIll<LIVEAI�06I$-0 �1111NN'��...5b �;'.................
$............ _--- ..... ......
By_._. ............................................ .................................................. ....
$•••----------•---'--"
Business Phone No l.....(J.....��.Q.C)
....
$....�...J...e._........
Business Address ----- ----------- _...._-----------------------------------------
(remarks—over)
SUBJECT
City of Fridley
247 7 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
-RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
XI
r � �
1
NUMBER
REV
DATEPAGE
OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
11/13/96
JOB ADDRESS 7158 Riverview Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
. 1,2
2
1 Riverwood Manor Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Robert Devries 7158 Riverview Terrace NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Richard Hastings Co. 6331 Riverview Terrace NE, Fridley 55432 574-9966 4051
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 ❑
El NEW ❑ ADDITION C3 ALTERATION X REPAIR
X
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
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
$•80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,612
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
$1.61
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC MM
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$54.00
PLAN CHECK FEE
TOTALFEE
1110194
License SC $5,90
$61.41
SIGNATURE OF CONTRACTOR ORA THORIZED AGENT IDA E)
WHEN PROPS VALID
BL15G INSP
TED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application 4�t-:�Vy/
ConstructionAddress: 7/53 R E 01;712V 9, C w t E g.
Legal Description:
Owner Name & Address: !2o 6 c-iz l- D t U c e 5 Tel. #
Contractor: 'K Q c L S R Q A k Si t N6 S MN LICENSE s/
Address: G 33 J ; U E e o e,,) F-Fz z Tel. # 57
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF MIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Gro d Sq. Ft.
OTHER:
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: iF 7c v 1 a;✓� c2 . 'L,� y�� _Estimated Cost: $ /61o2 v
Approx. Completion Date: f z4l s l f 4
(Cost..on`Back)
Driveway Curb Cut Width Needed Ft. + 6 Ft = Ft x $
DATE: l r (3 V 6 APPLICANT:'_Tel. # 57 �( - r,C6
Permit Fee
$
"S .`
Fire Surcharge
$
-
State Surcharge
$
SAC Charge
$
License Surcharge
$
y
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL t
STIPULATIONS:
CITY USE ' ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 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 j ]
Arm
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
May 19, 1999
Janice Devries
7158 Riverview Terrace NE
Fridley, MN 55432
Re: Final plumbing inspection at 7158 Riverview Terrace NE
Contractor: Mr. ,Rooter of Anoka County
Dear Ms. Devries:
A plumbing permit was issued on April 7, 1998 for the property located at 7158
Riverview Terrace NE for a new water heater. According to Section 30.5(a) of the 1991
Uniform Plumbing Code a final inspection shall be performed on plumbing systems. As
of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, we will expire the permit and any inspections on this installation will
require a new permit.
Any questions can be addressed to myself at (612) 572-3603.
Sincerely,
&afw
Bary Riesch
Building Inspector
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
&
Was o0
th.... h # 'k>>< Floor Auto.
h }.:::.
Urinal
1. Tiu Shower
Sin
Urinal..........
Trav if,ioubtM Drain Msin-- .1 Washer
NO. RATE TOTAL
JOB ADDRESS ��� ���/��/�Glf %~�/YIF��C� A�_
New Fixtures
$ 7.00
The undersigned hereby makes application for a perm it for the work herein
Old Opening, New Fixture
$ 4.00
specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser
$ 5.00
and rulings of the Building Division, and hereby declares that all the fads
Blow Off Basin
$ 7.00
and representations stated in this application are true and correct.
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
_ % .1998
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Owner
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Building Used As
Gas Range**
$10.00
Gas Dryer**
$10.00
Estimated Cost_ PERMIT NO.
Back Flow Preventer Required ( )Yes () No
Type
$15.00
PLUMBING COMPANY %VA�o �--
Reinspection Fee $42.00/Hr
SIGNED BY TEL N0. 17W— 41,/ il®
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5'/0 of Value of Fixture or Appliance
'j'0"0.0 .0
Approved By Rough—In Date Final Date
State Surcharge
$ .50
MINIMUM FEE F R ANY PLUMBING GAS PERMIT IS $20.00 AW
TOTAL FEE
$42, 42:-P
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
CITY OF FRIDLEY INSPECTION DIViSION
5431 University Ave NE
t ('x'60
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25/0 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.
C,
Effective On January 1, 2000•
JOB ADDRESS 7158 RIVERVIEW TERRACE NE
OWNER ROBERT & JAN DEVRIES
TOTAL
$ BUILDING USED AS
CA
ESTIMATED COST PERMIT NO. l
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units t Circle One (Steam) (Hot Water) arm ir)
$ Trade Name Gi�VRA Size No. FMIUL,FVO
BTU SQ-- 0HP EDR
$ Fuel 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.
006D
DATE Ib 9'
`
®0
HEATING CO 1,�
Signed rtKCb TEL #
Approved By Rough -In Date Final Date
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
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 existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This 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 Type and Size/Common Vent and Vent Connector Information
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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
11/30/2000 10:47 6124455053 RONS MECHANICAL PAGE 02
COMMQN VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
YesX No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes () NK)
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 -LAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes ) No( )
�y ��--
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () No
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
YesNo ( )
When Installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances.
Yesx 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.
YesNo ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type ' BTU Input 96 Assistei-Fbj Nat
Appliance #2 TypeH BTU Input
Appliance #3 Type _ BTU Input aFan Assisted or Nat
Total Appliances Total Btu Input /
Common Vent Type j� Vent Height 2�,r r Diameter inches
Appliance #1 Vent Connector Height `2 ft Length ft Diameter in Type CUSS
Appliance #2 Vent Connector Height 2 ft Length ft Diameter `' in Type C-CA55'G
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO: 0 5 I C - /
Signed By: Date: ilia 9)4)
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
May 25, 2001
Mr. Robert DeVries.
7158 Riverview Terrace NE
Fridley, MN 55432
Re: Final Inspection at 7158 Riverview Terrace NE
Contractor: Ron's Mechanical
Dear Mr. DeVries:
A mechanical permit was issued on November 6, 2000 to install a furnace at your address.
According to section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be
conducted on the mechanical work authorized by this permit. We were called out on December
14, 2000 for the final and corrections were noted that had to be completed before we could final
the installation. As of this date, no reinspection has been called for.
The permit fee that was paid covers the inspections to make sure the work was completed
according to the Mechanical Code. 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 expire the permit and no
further action will be taken.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
:ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
431 Urkersity Ave NE
'ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
763) 572-3604, FAX (763) 571-1287
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
stories
..
Urinal
Shower
...:.::
.......
Wash
Tray
" ..:......Floor
Drain
Auto.
.
.�
Washer
Gas ��••
Range
Water Heater#
Gas Elec
Basement.
><<=>
I
Floor 1
Floor 2
Floor 3
0
Flo r 4
ILUMBING FIXTURE RATES:
Jew Fixtures
)Id Opening, New Fixture
leer Dispenser
llow Off Basin
'atch Basin
lain Water Leader
iump/Receiving Tank
Nater Treating Appliance
Nater Heater -Electric
Nater Heater - Gas**
NO. RATE TOTAL JOB ADDRESS O -W KLW
Sas Range**
Sas Dryer**
3ack Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
kLL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
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 Buildinq Division. and herebv declares that all the facts
and repres DEVRIES, JANICE and correct.
7158 RIVERVIEW TERRACE N.E.
FRIDLEY, MN 55432
(763)571-4211
/ 20 01
OWNER
BUILDING USED AS
ESTIMATED COST q6
o 0 PERMIT NO. r/ ` 00 78 c,-',)
PLUMBING COMPANY D f \0` aVA UAAk QV
SIGNED BY� TEL Na���� /��r`4 ®3�
Approved By
Rough -In Date
Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF CO:
$ 35-. S OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, 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 O No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( )
No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes ( )
No( )
When Installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This 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 Type and Size/Common Vent and Vent Connector Information
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 _ Taal 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
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date
CITY OF FRIDLEY PERMIT N4: 2004-00788
6431 UNIVERSITY AVENUE NE
�••
FRIDLEY, MN 55432 DATE ISSUED:
05/27/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 7158 RIVERVIEW TERRACE NE
PIN : 103024420049
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 400.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL GAS WATER
HEATER.
# ELEC WATER HEATERS 0
VALUE OF FIXTURE/APPLIANCE
0
# NEW FIXTURES (EXIST OPENINGS) 0
# GAS WATER HEATERS
1
# GAS DRYERS 0
# GAS RANGES
0
# OF NEW FIXTURES 0
# WATER TRMT APPLIANCES
0
APPLICANT
PLBG PERMIT MR41MUM FEE
PLBG FIXTURES (NEW OPENINGS)
0.00
0.00
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
PLBG FIXTURES (EXIST OPENINGS)
0.00
MINNEAPOLIS, MN 55408-2173
WATER TREATMENT APPLIANCE
0.00
(612) 8274033
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
35.00
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
0.00
0.00
0.00
OWNER
DEVRIES ROBERT & JAN
7158 RIVERVIEW TER NE
STATE SURCHARGE, PLBG FLAT
0.50
FRIDLEY, MN 55432
TOTAL
35.50
PAID WITH CHECK # 28318
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Appli�t . Date
Bldg Insp Dat PR6�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Building
PLUMBING
Permit No.: G
InspectionsRESIDENTIAL
APPLICATION
Received By:
763-572-3604
763-502-4977 FAX
CITY OF FRIDLEY
nate R
EFFECTIVE 2-19-04
DATE 3 YOUR E-MAIL ADDRESS
p
SITE ADDRESS % K c( "e/- V r t W Te-r-ra
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME:OWNEc.e/, e s a
TENANT
�,r'� \e
` pc -t1
ADDRESS:-? 19) 0r ttf�j' V �e� tfr CITYF�, A, 1"CCl STATE /�►�"LIP" J t
PHONE: -% (o
CONTRACTOR
NAME: I e- r,4- o yw, V,L ,M1
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE, BOND AND
STATE BOND # EXP DATE
CERTIFICATE OF
_
ADDRESS: S VS <; CITY � ; STATE ZIP S� ?D
INSURANCE
�
PHONE L6 3 ` 7 �L ;qs�-R'O FAX
PERMIT TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT
DETAILED DESCRIPTION OF WORK P, ,eZ=�_<'f
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
_ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
_ _
BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($
CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. $1
_ DISHWASHER —LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
�
OR
Ogg
�� *a'a: 3M � �,:_ v., .p ?i �''�v���Tiy�' rr ii y �: aaz v 3 a 2 -- Y �,.,�, , ✓
d !'4 � '� xt - a � _ +ik 'xz,.av^ �•�' i2 'a. � N
ay
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I here a plumbing 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 on site; that the work will be in accordance
with the approved plan in the case o all w rk wv h requires review and approval of plans.
JJ q
SIGNATURE OF APPLICANT PRINT NAME /�) er Q , f i IC DATE 1
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
im
Department of Administradon
February 6, 2003
Shirley Severson
6490 Riverview'Terrace
Fridley MN 55432
RE: Chair Lift - Elevator ID#-08992PT02-28R
Residence: Severson, Shirley Residence
6490 Riverview Terrace
Fridley 55432
Dear Sir/Madam:
Minnesota Statutes Chapter 16B provides that the Department of Administration, Building
Codes and Standards Division, Elevator Safety Section, inspect and approve elevators and
manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the
Elevator Safety Section recently inspected your residence and determined it meets
requirements of the Minnesota Elevator Safety Code.
NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for
Elevators and Escalators does not necessarily assure compliance with the
Americans With Disabilities Act of 1990.
Sincerely,
BUILDING CODES AND STANDARDS
Mark A. Jo son
State Elevator Inspector
maj/rkr (CE -2)
c: Julkowski, Ronald, BO, City of Fridley
Arrow Lift Accessibility
ElFormMR
Building Codes and Standards Division, 408 Metro Square Building, 121 7th Place East, St. Paul, MN 55101-2181
Voice: 651.296.4639, Fax: 651.297.1973; TTY: 1.800.627.3529 and ask for 296.9929