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PRE 2010 DOCS011 SUBJECT MIT NO. City of Fridley ® AT THE TOP OF THE TWINS .14'703 PERMS BUILDING Ir � ECEIPTNO L ______ COMMUNITY DEVELOPMENT DIV. II; PROTECTIVE INSPECTION SEC. 1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 5/17/78 JOB ADDRESS 1567 South. Bavarian Pass N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITIO G/ SEE ATTACHED DESCR. 11 1 Innsbruck Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Darrel A. Farr Development 7286 - 72nd Lane No., Mpls. 560-2110 3 CONTRACTOR MAILADDRESS 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 ❑ REMOVE x 8 DESCRIBE WORK Construct a 36' x 32' Townhouse and a 20' x 28' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Fire rock all frame areas in garage. Provide combustion air to furnace. Mail copy of :truss design to City. Douglas Fir #2 or better suggested for 18 foot floor span area. Provide energy calculations. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood .Frame 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 1S SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 1.076+476 21,296 Total 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $34,700 $17.35 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHERSTATE OR LOCAL LAW REGULATING CON- $400.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $85.18 PLAN CHECK FEE TOTAL FEE 21 30 $523.83 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) W N PR PERL,X VA ATE THIS IS YOUR �Mt l /19 SIGNATURE OF OWNER (IF OWNER BUILDER) (DAT*- BLDG INSP 011 L11Y OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)_ . owr y, �, �jL �p h12 V2�0+o BUILDER: _ gyti Address : %a S(o 1..Address: Tel. No.: ,O-�I10 No.: / street Street: LOT: l l-�i�b LOT: -- � ! BLOCK: ADDITION: /AZJ 1 ' ClC kjc) ._ CORNER LOT: INSIDE IAT: ✓ SETBACK: / SIRDS: f `/ Applicant attach to this form Two Certificates of Survey of Lot and proposed Building location drawn on these Certificates. DES2,RI PTION OF BUILDING To Be Used As: %ted %nu�ahuuse. Front: 3 Depth: Height: Square Feet: Cubic Feet: f �, L��� Front: Q Depth: Height: Square Feet- Cubic Feet: Type of Construction:_U)aZ'A .mac Estimated Costs $ -Tb Be Completed: _.!' /Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. s DATE: Stipulations: F-)/26 ae0 fl �-l>. A><1 QgeAG(-'- o �-- %ovi o�' (5JUL)eGV. U -/9 I e 7-0. Fc,j-,oe i1;gCL 70 Ci.T 43,�� r rE op- GG.Es i - E 40 4IA) 0E1 4/0 7.r C 9 1�,�4 x 7-21/ 4tj,./off Sc? 3, 8_3 w -- C 07 5d 7S' CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, 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 MECHANICAL WARM AIR: Furnace Shell & Duct -Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Altezations-up to $500.00 Repairs & Alterations each add. $500.00 STEAM OR I-.K)T WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3.ga1. per hour each add. 3 gal. per hour RATE $12.00 7.00 7.00 4.00 $12.00 4.00 7.00 7.00 4.00 $12.00 4.00 7.00 6.00 $10:00 10.00 GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x $10.00 AIR CONDITIONING ��f��.'� �•� e FAN HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS ALTERATIONS $ REPAIRS State.Surcharge TOTAL FEE ROUGH INSP. Date FINAL INSP.3_ Date APPROVAL. FOR PERMIT REINSPECTION FEE 010.00) TOTAL S $ ®0 MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE CO, ®® Job Address /576,� 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, Minn. gig 19 OWNER KIND OF BUILDING A le USED AS���� ESTIMATED COST C:�C?2 9A OLD.- NEW BUILDING PERMIT NO. PERMIT NO.�� DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. ��,�® _ - _ Capacity Sq Ft. EDP. BTU&0 tHP Total Connected Wad ®� Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP company Signed By �® ,f Tel.., No., 7 . - ����/.• 7,, 'j T H 7,LyT_ �id`�.i 5jS410 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE '$3.00 $ 3 6 PLUIM ING FIXTURE RATES: NO. $ a [ TOTAL 4tamber Fixtures $ x $3.00 $ -33 W Future Fixture Opening Water $2.00 $ m each add. $100.00 or fraction x $2.00 $ Catch Basin x $5.00 $ water Beater - to 99,000 BTU / x $5.00 Heaterv 100,000 BTU to 199,000 BTU ); $10.00 $ Water Softener x $7.00 $ New Ground Pan Old Building x $5.00 $ Electric Water Heater x $5.00 $ 0 +G 2 m� y ' V 0 m ai (4 3 oro,. vii w U w a 3 c�7 t o as lec Ra I J 1st 2nd 3rd 4 th (R) a Future Connection Opening Connected with Sewer (') s New Fixture, Old Opening Water PARTIAL RATE SCHEDULE '$3.00 $ 3 6 PLUIM ING FIXTURE RATES: NO. $ RATE TOTAL 4tamber Fixtures $ x $3.00 $ -33 W Future Fixture Opening x $2.00 $ New Fixture, Old Opening each add. $100.00 or fraction x $2.00 $ Catch Basin x $5.00 $ water Beater - to 99,000 BTU / x $5.00 $ 00 100,000 BTU to 199,000 BTU ); $10.00 $ Water Softener x $7.00 $ New Ground Pan Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ 3 6 Additional Fixtures x $1.00 $ Can Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ ,o TOTAL FEE $ ,//, �b Job Address _ /� �, 7� - �p 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. , 19 OWNER i) e4 n n j? n n a KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. �pl� Company _ ut,sl -- � Signed. By , Tel. No. — ROUGH INISP. Date FINAL INSP. 3 - ;� L ` ? Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE gVVM A = z SUBJECT City of Fridley�� 6 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i i NUMBER REV DATE P PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/27/9 JOB ADDRESS 1567 South Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 1 Innsbruck North Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE RNM Vivian Hoese 1567 South Bavarian Pass NE 571-4639 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Steven Lee Co 9465 Irving Ave, Brooklyn Park MN 55444 424-1198 5758 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 Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (33 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code.. 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 $2,722 1.36 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION —e_ PLAN CHECK F AL FEE Y183.83 Lice se S 5.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N PR LY VAD/,D THIS PPP 'M • LDG INSPI` ?OUR /n DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) z NEW j ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstmetionAddress: / S- (z, 7 Xa,. v V c- t-- >° o--j� Legal Description: Owner Name & Address: 1 /110Tel. # Contractor: ILI, Ile- L MN LICENSE # Jr- 7 Address: % / S - _-)- I., Tel. # 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/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback 7 -J- i � Side Yard Setbacks Estimated Cost: $ -? - 2 7-2,2- STD (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 7 APPLICANT: _� Z-1— Tel. # f J FdO" CITY USE ONLY Permit Fee $ IA/ 9y- Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ 4-34 $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $. '93 STIPULATIONS: SUBJECT ' City of Fraley 3119 7 AT THE TOP OF THE TWINS BUILDING PERMIT �, RECEIPT NO,.,.. COMMUNITYDEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 414133 1 NUMBER REV OATE AGE OF F/p APPROVED BY i �� ���'� CITY HALL FRIDLEY . 55432 ---• L 612-571-3450 910-F15 7/14/00 /0B ADDRESS 1565 - 67 S. Bavarian Pass '1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11&12 1 I Innsbruck North. Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAIL AODFIES$ ` ' ZIP PHONE Innsbruck Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock-French Roofing Corp., 2301 E. 25th St., Mpls,, MN 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Tear Off and Reroof Townhouse Building 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. Peri Inspection Cat— Will Be Mailed To liome®wnerT s� SEPARATE PERMITS ARE REOUIRED 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 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 ,7,686.00 $3a 84 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• $1530257069 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE' TOT FEE 164.78 SIGNATURE OFCON 'RACTORORAUTMORIZEOAGENT IDATE, VALIDATEpr THIS IS Y R PERMIT jI.FIeE/NROPE I S,GNATURE OF OWNER,IF OWNER BUILDER, IDATEI r N CITY OF FRIDLEY INSPECTION DIV 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Closet::>:1 Urinal C �r1 Iv APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash Drink Floor Catch . Auto. >' Shower <Sink ;; Tray Fount Drain gasiri Washer pbce- w PLUMBING FIXTURE RATES: 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 $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE -A-e,r , JOB ADDRESS � � 50-1 t('k' a�r� 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. C 2 ✓ X999-' Owner Building Used As b k)ALL, jics- �s Estimated Cost PERMIT NO. PLUMBING COMPANY y�e� SIGNED B TEL N '.-9 �7 Approved By Rough—In Date Final Date Xn( $ .50 S-0 MINIMUM FEE F R ANY PLUMBING/ $o20— PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. mlwilm rJAW CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 February 28, 2003 Mr. Richard Ripken 1567 South Bavarian Pass NE Fridley, MN 55432 Re: Final Inspection at 1567 South Bavarian Pass NE Contractor: McGuire & Sons Dear Mr. Ripken: A plumbing permit was issued on October 19, 2001 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY PERM O. 2004-01276 6431 UNIVERSITY AVENUE NE FRIDLEY, NIN 55432 DATE I /2004 F63) 572-3604 FAX: (763) 571-1287 ADDRESS : 1567 S BAVARIAN PASS NE PIN : 243024440081 LEGAL DESC : INNSBRUCK NO T H PLAT 4 : LOT 11 BLOCK I PERMIT TYPE : BUILDING PROPERTY TYPE : TOWNHOUSES CONSTRUCTION TYPE : RESIDING VALUATION : $ 6,700.00 NOTE: PER R703,2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN APPROVED WEATHER BARRIER VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. INSTALL VINYL SIDING, SOFFIT & FASCIA, WINDOW AND DOOR TRIM. STATE LICENSED CONTRACTOR 0 APPLICANT HEDTKE TODD SIDING SPEC LP 20335959 1208 TRAPPERS PATH BUFFALO, MN 55313 OWNER RIPKEN RICHARD R 1567 S BAVARIAN PASS NE FRIDLEY, MN 55432 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 worl 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 reaulatine construction or -the Derformance of construction. Bldg BUILDING PERMIT FEE 139.25 FIRE SURCHARGE 6.70 STATE SURCHARGE, VALUE 3.35 LICENSE SURCHARGE 5.00 TOTAL 154.30 PAID WITH CHECK # 3595 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEYQ4;" < Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: f 5 ��A-- Tel. # _ Contractor. . MN LICENSE # Address ®�%r-!c-7:213I. # 6/Z a-��/� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length _ Width Height Sq. Ft. GARAGE AREA: Length _ Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft �y Type:Construction -• • ii Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ -=$ DATE:- 0 _APPLICANT: ��� Tel. Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 3 ® STIPULATIONS: Fee Schedule on Reverse Side $ = 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $1350 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 [ ] $ 3 ® STIPULATIONS: CITY OF FRIDLEY BUILDING INSPECTION 6431 Unlversity Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Bumer & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5961 of cost of Improvement whichever is greater �Oc> a; A C) too )— Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Fee Total o i' Owner. �/ % 7, $35.00 $ Building Used As $10.00 $ ESTIMATED COST PERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) ®� Trade Name Size No. $25.00 $ BTU HP EDR Fuel Total Connected Load $ Burner Trade Name Size No. BTU HP EDR Commercial/industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/industrial/institutionai State Surcharge TOTAL FEE $ �� REINSPECTION FEE $50.00/HOUR *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE 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. �--, _ , � it ► I � _L._`, _ r t� Approved by Rough -in Date Final Date 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, Yes () No ( ) and is securely supported and flrestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer Yes ( ) No ( ) specifications including sizing, length, number of elbows and termination. 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 Yes () No( ) assisted and natural draft appliances. The existing combustion al r is sized and installed to meet the current codes Yes (} No( ) and manufacturer's specifications. When required to Install a new combustion air, it will be sized and installed Yes () No( ) to meet the current codes and manufacturer's specifications. When Installing a new venting system, the undersigned hereby verifies that the current codes and manufacturer's it is a listed assembly and meets specifications. This does include AGA GAMA Category I Central Furnace Yes () No( } Venting Tables for fan assisted and natural draft appliances. is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented Yes { } No { ) separately as per current codes. Appliance Type and Size/Common Vent and Vent Connector Inform tion Appliance #1 Type BTU Input Fan Assisteistd or Nat Na BTU Input _________ Fan Ass Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type 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 ____ �t Length It Diameter in Type ALTERATIONS: Describe HEATING CO: Signed By: Building MECHANICAL Peff nit Na.: b®7 -O UY 3 Inspections RESIDENTIAL APPLICATION R= ved By: 763-572-3604 CITY OF FRIODLEY �• DATE L� YOUR &MAAIL ADDRESS i THIS APPLICANT IS: D OWNER WONTRACTOR PROPERTY NAME: kolyee N ADDRESSf i STA NT TEN'Al�t'!' TE CONTRACTOR COMPANY NA SUBMIT A COPY OF CONTACT PERSON: YOUR STATE LICENSEWITii STATE LICENSER EXP DATE _ ' ADDRESS: 3�t1- ftuc— APPLICATI©N _ PHONE_Ak� 1,� FAX PERMIT TYPE T+LE FAMILY ® TWO FAMILY 13 TOWNHOUSE TYPE OF WORK: ONE W V+' g_ CEMF'.NT 0 ALTERATIONJREMODEL RETAILED DESCRIPTION OF W R .PER MS 1613.665 the permit See is a minimum of $15.00 or 5% of the total cog up to $50.00, whichever is greater, for dw improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Lahr cost under $300 = $15.00. Labor cost between $300 to $500 = cast of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $SOD, FEES ARE BASED ON $1D.00 PER FDaimg, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) 3344me a Irratalled MFG MODEL: SIZWBTU MFG: MODEL. SIZFJBTU MFG: MODEL: SIZWBTU AIC $25.00 FIREPLACE (GAS) 513.00 GAS RANGFJOVEN $10.00 AIR TO AIR EXCHANGEER S I S 27 LACE (WOOD) $35.00 _NEW (IAS GRILL $1000 —BOILER $35.00 ACE S3S.00 GAS UNIT HTR S 10,00 CHIMNEY LINER $10,0D CTAS DRYER $10.00 FOOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.0D VENTILATOR $15.00 F'E13MIT EE PRO�Ci'S FOR LiDER $500 i;RM11` Fly WED 2VEII $500 Permit Fee $ -- 'L-j!!�j Number of fmtWM ® $10.00 x $10.00 — $ Surcharges .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $� Number of fixtures Q $25.00 x $25.00 = $ Number of fixtures Q $35.00 x $35.00 = $ State Surcharge = S .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 80pNeation for a permit work is not to start without a permit; that the work will be in accordance with the approved plan in thecase f a I w r which r a al of p f SIGNATURE OF APPU NAME ATE PLEASE NO`FE: SEPARATE PERMM AUMUMM FOR B=IN 13CTRI ANL?.�E�IdAb1iCA>. Rid City of+Mdley Building Inspections Departme®t 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FARC: 763-5024977 ctm,