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PRE 2010 DOCSllLz'VIII F'. - VIN% SUBJECT PERMIT NO. City of Fridley 1303'7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. i VL ------� COMMUNITY DEVELOPMENT DIV. y) r i PROTECTIVE INSPECTION SEC. // �4 7 V 041 C� 1 ; � NUMBER REV. DATE PAGE OF APPROVED BY. CITY HALL FRIDLEY 55432 IL"" ,'J 612-560-3450 910-F15 6-23-75 JOB ADDRESS 160 SATELLITE LANE N.E. FRIDLEY MINNESOTA 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 1 1 SYLVAN HILLS, PLAT 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE VERN REYNOLDS, 3118 BOONE AVENUE NORTH, MINNEAPOLIS MINNESOTA 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 HOUSE & GARAGE 7 CLASS OF WORK XX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK CONSTRUCT HOUSE 28X36 x 18, GARAGE, 27141.x.26''x 12' 9 CHANGE OF USE FROM TO STIPULATIONS SOD FRONT & SIDE YARD AND PROVIDE HARD SURFACED DRIVEWAY �� PROVIDE TRUSS DESIGN 110031 Qt"o GET APPROVAL ON WALK OUT PRIOR TO CONSTRUCTION ELEpBetotNE - E EC , t��,�► �� jELEPI'i0N1 `ELECi�� SEWER: (APPROX. 8' DEEP)P. 145' of M.H. (Inv. 836.00) - "�uIRE�, ' '° '� REQUIRED FOR WYE ELEV. 835.57 SEPERAT� .PERMITS. TOP OF FOOTING: 838.57 (Min.) PLUMBING 00 SIG - }.;EATING, R: 12' East of Sewer Service TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. I RAW - THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED WITHIN ZONING SQ. FT. CU. FT. 18,144 IS NOT COMMENCED 60 DAYS, OR IF CONSTRUCTION 1, 052 & 710.58 OR WORK IS SUSPENDED, OR ABANDONED FOR A PERIOD OF 120 DAYS AT R--1 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 $33,000 $17.25 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR CTI N ORT FORMANCE OF CONSTRUCTION. $40.17 $325.00 PLAN CHECK FEE TOTAL FEE 7-4-- 382.42 SIGNATURE OFCON ACTOR OR AUTHORIZEDAGENT (DATE) HEN PROPERLY V LIDATED T IS IS YOUR PERMIT 9LOG. INSP JUNE 23, 1975 DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) F'. - VIN% P APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF'FRIDLEY, MINNESOTA C}WNER' S NAIiE : F.6t; eta BUILDER : Vekv Rr l ADDRESS: � dS ADDRESS �� e NO :. ® STREET: LOT: s� BLOCK: ADDITION: CORNER LOT: INSIDE LOT :0�SETBACK: �� I SIDEYARD : Applicant attach to this form Tcao Certificates of Survev.of Lot and.propose' building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front Depth • 7t Height Square Feet: &5- , Cubic.Feet: / d;f 3 cta Front: � ` y it Depth: —' Height: -.D � .7-1 Square Feet; Cubic Feet: C 0 Type of Construction: Estimated ost: $,3- ce 00 To Be Completed: 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 D&TE: Z SIGNATURE, (See Aeverse Side For Additional Infora (IN soo Fow"o-OT A. S1ic y14ov vt PO o u l;-Tt„ U -ba 00164J. R si9�+, ® C® 09PPRCP,11, L VAJ LJ#K� ®&P .q PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL. Furnace Sbell & Duct Work ... ... 410.00 Replacement of Furnace 6.00 it Repairs & Alterations—up to $500.00 6.00 fft Repairs & Alterations each add. 5500.00 300 CIL WARBI AM Furnace Shell & Duct Work to 130,000 RTU ench add. 60,000 BTU . .. ...... RepLwe meat of Furnace Repairs & Alterations—up is $500.00 Repairs & Alterations each add. 5500.00 STEAM or HOT WATER SYSTEM 3.uo S 6.00 S 6.00 $ 3.00 $ Furnace Shell & Lines—to 400 sq. ft. FZR Steam $10.00 $ Furnace Shell & Lines—to 640 sq. ft. EAR Piot Water 10.00 $,. Each add 200 sq. ft. EDR Steam 3.rA $ Each add. 320 sq. ft. EDR Hot Water 3.00 $_��_ OIL BURNER—to 3 gal, per hour 6.00 g over 3 gal. per hour—See Fee Schedule GAS BUR (up to M,000 BTU) 6m 5—�--- over 199,000 BTU So@ Fee Schedule GA$ FITTING ) 30 RA'Z'E TOTAL Ist 3 Fixtures 20 $ X Additional Fixtures A .75 g_— Gas Range to MGM 6.W $ State Surcharge .50 Fee sebsemb TMAL 73a t9ID • r� City of Fridley: The undersigned hereby makes application for a permit for the works Aero : specified, agreeing to do all work in strict accordance with the City Ordinancep and ruling of the Department of Buildings, and hereby declares that an the fad and representations stated in this application �are �true and correct. Fridley, iffinn (?urner Find of Building v - Used as To be completed about. Estimated Cost, S . j t Old --Nerd. Building Permit No. _—_ Ponnit No. C HEA77NG or POWER 1LAP tea % Not Water, Warm AlrNo Trade Name—Hca 7 Size No-WLC-s-D-0 Capacity—_-- — Sq. Est. F_D.R DT`U ► Total Connected L4nd Kind of t CkCa 3 BURNER —Trade Nam Skze NO Weatherstrips m.a.r2.V.L. Construction No. Guide Windows Doors Reference Out. Waq JInt.Wal1 Ceiling Roof Floor Kind Yes—No I Yes—No 19_ FlQRoom Length . Width , Height F1.1 Room 1 Windows and Doors—Crackage and Area Btu Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Q Mza -15 04 -2— 195-0 Ceiling ® 16 Coef.1 Btu Infiltration D Glass Exp. wall Z�S(® S las Net exp. wall Int. wall Ceiling Floor Cm -Z.0 1 40 1 '> -7 Cha 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length s Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack ea. ft. ULL Infiltration Btu Glass Exp. wau Net exp. wall 10 Int. wall -2— 195-0 Ceiling ® 16 Floor t�® Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Qj Room I Length � -,�S Width d Windows and Doors—Crackage and Area Wldth No. of Dans Helght No. of Lineal ft. Area of Dane Ilghte of crack ea. ft. Cm -Z.0 1 40 1 '> -7 Cha Btu Al Coef.1 Btu Infiltration '?, o 3-s ®7 GO Glass Z51 G-6 Exp. wall Net exp. wall ® Inc. wall -2— 195-0 Ceiling Floor v Tbtal Btu. (065-2— 65-2— Required Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Net exp. waA 23io / Windows and Doors --4 Width Height No. of Dane of Dans T11, -Z0 T Ik Insulation How Applied t I Width Height e and Area Lineal ft. I Area of crack W. ft. Windows and Doors--Crackage and Area Coef. Btu Infiltration Glass P T 1.-q9 Glass v Z-3 1 Z - Exp. wall Int. wall Net exp. waA 23io / Inc. wall Ceiling Int. wall Floor Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 6 6 A F1.1 V, a,, Rooter I Length It,, Width A f Height Windows and Doors--Crackage and Area Btu Width Height No. of No. of pane of pane lighta Lineal ft. Area of crack sq. ft. Glass P T 1.-q9 Exp. wall iq ?- Net exp. wall Int. wall Coef. Btu Infiltration Glass Exp. wall 10 1-1%� o Net exp. wall Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Int. wall Ceiling Floor Total Btu. I /I ``O Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.1 -x— Room I Length t a Width r Height Windows and Doors—Crackage and Area Width Height I No. of Lineal ft. Area No. of Dans of Dane ?IN to of crack aa. tt. Coef. Btu Infiltration Glass P T 1.-q9 Exp. wall iq ?- Net exp. wall Int. wall Ceiling Floor i .-o Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area BROOKLYN PRINTING 8 ADV, CO. _ R Weatherstrips S.H.V.E Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 19_ 1 1 1 _ I.I E,, Room I Length t G. Width - Heisht II Fl1 k Room' length t 3 Width 17 Height Windows and Doors—Crackage and Area GI& Width Height No. of Lineal ft. Area No. of pane of Dane ,lights of crack sq. ft. Glass wall Exp. wall Coef. Btu Coef. Btu Infiltration Glass Glass G yl Net exp. wall Exp. wall Int. wall Net exp. wall to 1 YE 40 Int. wall Inc. wall :2 i Ceiling FI.1 Room I Length Floor Heiaht Iota] tStu. 'I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1�, Room I Length I y Width Windows and Doors--Crackage and Area Width Helght No. of Lineal it. Area No. of pane of prns Ilghto of crack eq. ft. `d— 2e� ? IS.- 2,c--( Coef.l Btu Infiltration GI& Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sQ. ft. Glass wall Exp. wall Coef. Btu Infiltration Net exp, wall Glass Int. wall G yl Net exp. wall Ceiling Int. wall Floor Floor Total Btu. Inc. wall :2 i Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.1 Room I Length Width Heiaht Windows and Doors--Crackage and Area GI& Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sQ. ft. i ('0Exp. wall Net exp. wall /® Int. wall Coef. Btu Infiltration Glass Exp. wall G yl Net exp. wall Int. wall Ceiling i 0-0 Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors--Crackage and Area Wldth Height No. of Lineal et. Area No. of Dane of Dane lighto of crack oq. ft. 1� 2 I I I I I ICoef.1 Btu Infiltration t GI& Glass I_k (.� i ('0Exp. wall Net exp. wall /® Int. wall Coef. Btu Ceiling Floor - B S Total Btu. I G yl Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FU e9— ._.n t Room I Len:th G, Width 1 n Height Windows and Doors—Crackage and Area Width Height No. 08 Lineal ft. Area No. of pane of pane Ilghto of crack sq. ft. Lineal It. Area of crack ea. ft. Coef. Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Int. wall Ceiling Floor i 0-0 Total Btu. Required sq. ft. E.D.R. or sq. iris. W.A. Leader area Fl.I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of No. of pane of Dane lights. Lineal It. Area of crack ea. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Inc. wall Ceiling Floor Total Utu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area BROOKLYN PRINTING 8 ADV. CO. l9 :9,1 • WATEII MTII. lil3il 1 11;1 N CA 11 1.1 � i s � i P N GA4 [LEG Base 1st PLUMBING FIXTIME RATES- NO. RATE TOTAL Number Fixtures ...... • . • • • . • • • • 'SLOG $ Future fixture Opening .... o ...... x $1.50 $ New Fixture Olaf Opening .......... x $1.50 $ Catch Basin .............. ®®.... x $3.25 = Water Beater 'Up to 99,000 RTUI • • • . x $3.00 $ New Ground Run Old Bldg..... • . . • x $3.25 $ Elm Wates Heater .............. s $2.00 i GAS PITTING TEES. NO. RATE TOTAL lot 3 Fixtures • • ............. , • • �_ : $2.00 $ Additional .......... • ..... : $ .75 i Gas Rame to 199,000 BTU ....... a .... x $5.00 $ State Surcharge $ .50 Description..........oa so e.. aw...• e.p.... • •...s. s••* aa$ - TOTAL 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 ung of the Department of Buildings. and hereby declares that all the favi and Tepresentations stated in this application are true and correct eC 1 Kind of Building Used as —1—') Dpi To be completed about Estimated Cost. $ Old New Building Permit No. Permit No. Signed�� By Busin 1( E,( 7217 - 77th AVE. NO. MINNEAPOLIS, MINN. 55428 ROUGH 425-4183 a. - lcebm qW po a °gy m, Rove-.. a PARTIAL RATE SCHEDULE t. Of Bidsm now aw—um A WAS Ate: T 'TOTAL L Furnace Shell & T9uet Work ... ... .810.00 Replacement of Furnace 6.00 City of Fridley: Repairs do Alterations—up to $500.00 6.00 $ 'Phe undersigned hereby makes application for a permit for the ®Tori; hereW specified. agreeing to do all work in strict accordance with the City Ordinaneef Repairs & Alterations each add. $500.00 300 $ and ruling of the Department of Buildings, and hereby declares that all the fac and representations stated in this application re true and correct. NECIL WARW AM Frici e , Mnn Fara% Furnace Shell & Duct Work to 120,000 BTU ..$10.00 ¢ each add. 60.000 BTU . .. ...... 3.tlp $ Chvner Qgzt:a'� Replacement of Furnace 6.00 $ Kind Of Building A �® �►- Repairs & Alterations--up to $500.00 6.00 $ Repairs &Alterations each add. $300.00 Used as 3.00 $ To be completed about•_ STEAM or HOT WATER $'t7'ffii - Furnace Shell & Lines—to 400 sq. ft. FZR Sham $10.00 $ Estimated Cost, $ /' �! Furnace Shell & Line to 640 sq. ft. EDR Hot Water 10.0 0 $. bid—New. Building Permit No. _�_ p®zffiit Ai®. � Each add 200 sq. ft. EDR Steam 3.011 $. Each add. 320 sq. ft. EDR Hot Water 3.00 $__ DEECRUTMON OF WOF OIL BURNER—to 3 gal. per hour 6.00 $•________,� HEA77NG or POWER 1� --Stam, Not Water, Warm All lYo over 3 gal, per hour--See Fee Schedule GAZ BURNER (,up to 10,E BTU) &00 $ Trade Nameice*-- Sine 1�0- � {� � 3(D over 199,000 B'ZtTT See Foo Schedule Capacity—_— Sq. Fes. ED.R BTU Np-, GAS FMING FEES: NO RATE TOTAL Ist 3 Fixtures x$ 200 $ Total Connected Load mind of Fuel Additional Fixtures x .76 $-- _ BURNER — Tri Na size NO— State Gas Range to 10.0W $3 $,ft $ Surcharge .50 Camcity 9. 7L E,g8_ti3tc OOfiT8S1'IZF1Fd�� _ .. F SYYl3 sea F02 TMG GY2T X37—cfs9 >AL tA®maa9 560-3450 cif rrd1e ANOKA COUNTY 6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55432 August 29, 1975 Mr. Vern Reynolds 3118 Boone Avenue North Minneapolis, Minnesota Re: Final Inspection at 160 Satellite Lane Dear Mr. Reynolds: On August 29, 1975, a final inspection was made at 160 Satellite Lane N.E. There are three items that need to be taken care Qf: IF 1. Provide the City with a Verifying Survey 2. Provide an additional fire alarm for the downstairs bedroom. 3. Sod front and side yard. Items.l,.and 2 must be provided by October 1, 1975 and Item 3 must be completed by-aune 1, 1976, preferably yet this Fall. If you have any questions with reference to these matters, please call me at 5713450, Es. 41. Yours very truly, D CLARK Community Development Administrator DC/cs 01 SUBJECT PE City of Fridley ®, 18951 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIPT NO. 116 COMMUNITY - COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i /'--1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY •--.� `� L 612-571-3450 910_F15 5/14/87 JOB ADDRESS 160 Satellite Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Sylvan Hills Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph Grapevine 160 Satellite Lane N.E. 571-9129 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 fel ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remove existing deck.; Construct a 141 x 141 Screen Parch and an,V x 141 Deck 9 CHANGEOFUSEFROM TO S1°IPULATIONS See notations on plan VVARNMG SEPARATE PERMITS REQUIRED FOR Before digging call local utilities WIRING, HEATING, PLUMBING AND SIGNS. TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,700 $1, 85 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $44.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $11.13 &903� . SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) w' WHEN PROPERL DATED THIS IS YOUR PERMIT BLDG INSP BLDG fLI _ fjA tf -TUR F OWNER OF OWNER BUIL ERI t E) 01 NEM [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address:, 46 JffTE� L 17, /1/. C Legal Description: ZQ T ,� cO G , S �'� L/9nJ /bjj_ S 1e- /17- Owner 97Owner Name & Address: aS�H L7R�f`0�§!/i�/c` �/ O J�iPTE�UT� Tel. # 571-9122 Contractor: 61 A) ape— Tel. # Address: s r /I,-- Attach to this application, a Certificate of Survey of the CUtZ 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. EA: Length Width / 4)OI Hgt/Ground Sq. Ft. AREA: � �9 OTHER: ,�Pc�i7©vim �iC I J -��nrr DECIc �dLu Mft� Corner Lot ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback a Type of Construction: 1d.& D 52� ` Estimated Cost: $ � Approx. Completion Date: Z mOA/IW- Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: ` 13 -86 APPLICANT:^ ; Tel .10, CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ W 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ $ e c Agreement Necessary [ ] Not Necessary TOTAL [ ] STIPULATIONS: ;z,� ri WILLIAM A. CARLSON. PRES. 2324 WEST 110th STREET 888-2084 65431 4 CERTIFICATE OF SURVEY . SURVEY FOR: REYNOLDS CONSTRUCTION LAND SURVEYORS Licensed, Insured A Bonded /ie•S ire • SO7W,c1.1T.e _ . SMA A A 9,10/ 9 lv .W. A 0 1 � C, •'�a �rSnoN -� r9G•9 of h -ex /"�;rjL-)• 5pt-%-rt dttR!( w pEQUIREE-D BY La V• ' 4 I 96 L LEGAL DESCRIPTION: LOT St BLOCK 19 SYLVAN HILLS PLAT 3. VIE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGSt IF ANY9 THEREONi AND ALL VISIBLE ENCROACHMENTS' IF ANY FROM OR ON SAID LANDS AS SURVEYED BY US --.THIS 13TH DAY OF JUNE: 1975• NO. 56 /00•• M /"�;rjL-)• 5pt-%-rt dttR!( w pEQUIREE-D BY La V• ' 4 I 96 L LEGAL DESCRIPTION: LOT St BLOCK 19 SYLVAN HILLS PLAT 3. VIE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGSt IF ANY9 THEREONi AND ALL VISIBLE ENCROACHMENTS' IF ANY FROM OR ON SAID LANDS AS SURVEYED BY US --.THIS 13TH DAY OF JUNE: 1975• NO. 56 CITY OF FRIDLEY PERMIT O.: 2004-00073 6431 UNIVERSITY AVENUE NE --- FRIDLEY, MN 55432 DATE ISSUED: 01/21/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 160 SATELLITE IN NE PIN : 143024320003 LEGAL DESC : SYLVAN HILLS PLAT 3 : LOT 5 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A INSTALL AN ELECTRIC WATER HEATER # ELEC WATER HEATERS 1 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT NIINMUM FEE PLBG FIXTURES (NEW OPENINGS) 20.00 0.00 GAVIC & SONS PLUMBING 12725 NIGHTINGALE ST PLBG FIXTURES (EXIST OPENINGS) 0.00 COON RAPIDS, MN 55448- WATER TREATMENT APPLIANCE 0.00 (763) 755-6468 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS 0.00 0.00 0.00 OWNER VANGEY, DAVID 160 SATELLITE IN NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 20.50 PAID WITH CHECK # 10243 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 co vction or the performance of construction. A plican Date Bldg Insp Date 1 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �,-_ ; OF ,jN DIV. 6431 University Ave NE Fridley, MN :5432 (763)'572-3604. FAX (763) 571-1287 Urinal 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 Wash'ri i4 Floor+tct Auto. Q.:. Shower►1t.. Tray =Qunt< Drain Bain Washer NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric �— Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 JOB ADDRESS 1 ® S�� -�I t, Ltt=�Aivu UN .idfl 1, ')Uj1 i Water Heater Gas Elec The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Cryo 20 0q Owner Building Used As Estimated Cost Si)Q • DQ PERMIT NO. PLUMBING COMPANYUt G �' SLS1f1S�� l-�Wtb�l Y1L� SIGNED BY A ' `C, TEL NO.-7(P3'�%-(P q (A Approved By Rough -In Date Final Date TOTAL FEE $19•5a PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT- VENT CONNECTOR AND COMR1ISTION AIR VERIFICATION When replacing an Pxietinpff uranrP, 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The nxin ina combustion air is sized and installed to meet the current codes and manufacturer's specifications. ' , Yes () No ( ) When required to onstall a new _nmbuc_tinn air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When *nrdalling a np3u ventinagyc Pm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type 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 HEATING CO: Signed By: Date :