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PRE 2010 DOCSSUBJECT E IT NO. City of Fridley v 14'705 AT THE TOP OF THE TWINS PERM1,0 r ` BUILDING R®EC IPT COMMUNITY DEVELOPMENT DIV. 7� r PROTECTIVE INSPECTION SEC. 1 � = �4 1 CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE - OF APPROVED BY j 612-560-3450 910-F15 5/17/78 JOB ADDRESS 1585 South Bavarian Pass N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Innsbruck North Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrel A. Farr Development 7286 - 72nd Lane No., Mpls. 560-2110 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 j1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 361 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1076+476 21,296 Total 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 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 OTHER STATE OR LOCAL LAW REGULATING CON- �p $400.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S=4X � $85.18 PLAN CHECK FEE TOTAL FEE $2 .30 $523.83 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) W N P PER Y A I AT D THIS IS YOUR ER%IT BLDG INSP ATE - SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) U11Y OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS Y (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS), , OWfJER: �cy-r�� Al y2�0- BUILDER:• Address : %� Address: Tel. No .: �7p O —a I 1 O No.: Street:�L��C��/Y LOT: g BLOCK: ADDITION: /j�Q) C,� lI�OQ i7-1 /U� cJtil�IC3z(S� S CORNER LOT: INSIDE LOT: ✓ SETBACK: SIDEYARDS: 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: T /v hnu3.s_. _ Front: +.3 Depth: Height: 75 P Square Feet: Cubic Feet: T rte: ze-,O u s Front: -1) 0 Depth: Height: < Square Feet: Cubic Feet:'. Type of Construction. 7„'7 Estimated Cost: $ 00 -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 De$artment 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. DATE: �`' �/ tl SIGNATURE: Stipulations: /., Fi2-- eoc-1� q LL r�m�, �k��A S 1Aj isAR«, Q�C 1 N V i N -I t L l LAS lC�ea 6� Fc)e /,s ° TC000- P/4 U 6 A L/QO. 0 0 Sp y. 31 i 773 J, Alg8 49''�� ol l ' Al 2.S moo? 3, 83 CITY OF FRIDLEY D $ 7.00 $ APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $ AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $ 7.00 $ GRAVITY IVARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley dle y Tel. #571-i450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 S1=4 OR HOT Y;ATER 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 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures A Additional Fixtures x Gas Range to 199,000 BTU x AIR CONDITIONING NMjon'q�•.�•/ FAN HEATING SYSTEMS See Fee Schedule VENTILATING SYSTEMS ALTERATIONS $ REPAIRS $12.00 $ /®?• ®® 4.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ $10.00 S $ $ 3.00 $ 1.00 $ $10.00 • $ State Surcharge TOTAL FEE BOUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP,� j 'X 6• - % Date APPROVAL FOR PERMIT $ $ $ .50 MINIMUM FEE FOR ANY BEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 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. KIND C Fridley, Minn. - , 19 USED AS TO BE COMPLETED ABOUT W - g u— ESTIMATED COST dZ9'& ®6 OLD - NEW BUILDING PERMIT NO. PERMIT NO. L DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name !jAylJ"!V- Size No. Capacity _ _ Sq. Ft. EDR _ BTU Md HP Total Connected Load �-r�-- Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EAR BTU HP Company � "DGWICK HTG. & AIR CONN, CO. Signed By Tel. No. _ 1001 i eFI 6-"' a r''.. _ r MINNEfrrOU5 I' CITY OF FRIDLEY APPLICATION FOR PUaMBING AND GAS FITTING PERMIT PARTIAL RATE4SCHEDULE PLUMBING FIXTURE RATES: NO. ?� TOTAL Rumber Fixtures /1 x $3.00 $ 33, OC) Future Fixture Opening x $2.00 $ New Fixture, Old Opening 03 $2.00 $ c x $5.00 $ Water Heater - to 99,000 BTU x o $ Water st x A A Water Softener w C »[+ a! Q New Ground Plan Old Building N a w Electric Water Heater Heater 4 a �CC GAS FITTING FEES: 3 $4 $3.00 s .3.O o Additional Fixtures x $1.00 $ 0 x $10.00 dql .fo�f C q .9 ci �q u $ awi each add. $100.00 or fraction $2.00 . N State Surcharge M H O .0 8 m H 41 c N ��Nyy V! U id1 fA uJ 3 Ct W Vi W U (A 3 t9 C7 o as lec l 1st 2nd 3 r,�. 4 th (R) a Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water PARTIAL RATE4SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Rumber Fixtures /1 x $3.00 $ 33, OC) 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 $ 4�•C)0 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Plan Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 s .3.O o Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First 5100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REIIISPEGfijo!I FF.E • Job Address 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, -7 OWNER 'D 0-n I(IND OF BUILDING USED AS A / a. s ®PY stew TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. (°" �l - < t Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.40 pLUS $.50 STATE SUFE SUBJECT P T NO. City of Fridley 31 198 AT THE TOP OF THE TWINS BU I L D I N G PERMIT ` _. RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 44/33, � NUMBER REV DATE PAGE OF AVPROVED BY ,RIDLEY 532 '-' �CITY HALL F 31 0-'-'% ---.� L 612-571-3450 910 -FIS 7/14/00 JOB ADpRESS 1583 -. 85 S. Bavarian Pass I LEGAL LOT NO.9&10 BLOCK TRACT OR ADDITION SEE ATTACHED DESCR utx 1 Innsbruck North Townhouses _Plat 4 SHEET, 2 PROPERTY OWNER MAIL AODRES$ ZIP PHONE, Innsbruck Townhome Association 651-224-5482 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock -French Roofing Corp., 2301 E. 25th St,, Mpls,, PMT 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONELICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential T CLASS OF WORK O NEW O ADDITION O ALTERATION? REPAIR O MOVE O' REMOVE 8 DESCRIBE WORK Tear Off and Reroof Townhouse Building 9 CHANGE OF USE FROM TO STIPULATIONS r f. Underlayment must comply with the State Building Code. A Permit Wspecti®n arS , Will Be Mailed To Homeowner To Pbst.. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP' OCCUPANCY'LOitiD . VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL 'AND VOID IF, WORK OR CONSTRUCTION ZONING SO. FT 771. CU. FT ..`:_. AUTHORIZED IS NOT COMMENCED WITHIN 86 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 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 $8,528.42 $4026 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- $167.25 Fire SC $8.53 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT L FEE $180.04 SIGNATURE OF CONTRACTOR OR AurMORIZEO AGENT - IOATEI HE PROP VA UO T � THIS AU<IIPER� B INSP IF I. S'GNATURE Of OWNER,0 OWNERBUILOERI -- IDATEI =a s SUBJECT P City of Fridley 3 3 7 8 5\ AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. j 14-367 �6 r E I 1 NUMBER REV DATE PAGE Oi APPROVED B i CITY HALL FRIDLEY 55432 763-571-3450 910-F15 8/8/03 JOB ADDRESS 1585 South Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 innsbruck North Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rand; Waters 1585 South Bavarian Pass NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Straight Line Construction inc 13033 Rid edale Dr #152 Minnetonka MN 55305 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 612-423-2035 PENDING 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Ck ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 8' x 9' Deck and a 4' x 5' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan.. WARNINU Before digging call for all utility locations 45.0002 "O"'RF0 IRY 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 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 $1142 $.57 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- $44.85 Fire SC $1.14 UCTI OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE License SC $5.00 $51.56 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT liDATF,' THIS I Y UR PERMIT �PROPERLYDATED SIGNATURE OF OWNER.rt OWNER BUILDER. .DATE. =a s NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Q Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 571-1287 Fax Legal Description: Owner Name & Address: A o -e Tel. # Contractor. MN LICENSE# Address: Q033 c %Dgeo 1)9-v �I6z Mvova e-rm.jwA '0-1 .4 Gs3P5= Tel.# r6I �j q2 -3--'z- -36 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Length e 0Tr9b2 0-cck y Width Width p4 Height Sq. Ft. Hgt/Ground Sq. Ft. %2- 5' 0 Construction Type; �Q�"Wb0 Estimated Cost: $ %f � ® ` `�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: 4 �� APPLICANT: �� Tel. # i2 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) 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 $ a5co STIPULATIONS- SUBJECT PER City of Fridley 33959 AT THE TOP OF THE TWINS BUILDING PERMIT r `y ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC �y� I n r 1 . � CITY HALL FRIDLEY 55432 NUMBERDATE PAGE OF APPROVED BY 763-571-3450 910-F15 J71_1 10/9/03 JOB ADDRESS 1585 South Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 Innsbruck North Townhouses Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Randy Waters 1585 South Bavarian Pass NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Builders & Remodelers Inc 3517 Hennepin Ave S, Mpls., MN 55408 612-827-5481 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 8 DESCRIBE WORK Reside Townhouse; Soffit/Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building 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. Caulk and flash all exterior openings. Install soffit ventilation to meet the state code. 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 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 $12,000 $6.00 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_QF ANY OTH R SR LOCAL LAW REGULATING CON- $209.25 Fire SC $12.00 STRUCTIO O' THE PERF ATCEOF CONSTRUCTION PLAN CHECK FEE TOTAL FEE /® h ( icen e SC $5.00 1 $232.25 GNATURE OF CONTRACTORNOR14EO AGENT ATE EN PROPERLY VALIDATED THIS ISyg YOPR JERMIT JkLOG -NSP GATE S-GNATURE OF OWNER,.F OWNER BUILDER, iDATEi OCT. 9.2003 8:30AM BUILDERS/REMODELERS NEW (( CITY OF FRIDI.EY ADDN (] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING, PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor: NO. 630 P.4/4 Effective 1/1/2002 (763) 572-3604 Bldg Insp Tel.* Aa 4Z�Qtb MN LICENSE # Address: 3517 HENNEPIN AVL. SO .,gip ; Tel. # M. M146 5540a w -w t NSE #0001100 Attach��6 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 I Height -.Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft, DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: -At - Estimated Cost: s Driveway Curb Cut Width Needed: Ft. + 6 Ft = F $ = DATE: l0 � �APPLICANT: Tel, # (a�� •�� Call (763) 572-3604 for Permit Fees if mailing In appli ation or Fax to 763-571-1287 if usirlg credit card and we will call you for card number, Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ C)()9.& AWS Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50!$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Aft, "13" AboVe $450,00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ j STIPULATIONS; V Building MECHANICAL Permit No.: Inspections'�+ SIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: 763-502-4977 FAX I t 0'6 2011 EFFECTIVE 1-1-2010 ^� DATE 10 `2.� —1 YOUR E-MAIL ADDRESS i Yl�0Q CL6Jz 6dee.1,-t1 &b% Loam SITE ADDRESS I rj�j �� A2.1 d� leD ( Ae S THIS APPLICANT IS: ❑ OWNER XCONTRACTOR PROPERTY NAME: Kty'qL ZAiJ t ,b` ADDRESS: VumbS Ro CITY 8➢. 0M1A ' I3I4 STATE00 ZIP5643% TENANT -197-01 • PHONE: q5 -L— CILN -"L= 0jp CONTRACTOR COMPANYNAME: Fi_IxRft_ 1 `%N-TiYt31.9 -' AI- —Xjl2f, . CONTACT PERSON: b2tk1('CL YoaX5 SUBMIT A COPY OF STATE LICENSE # EXPDATE YOUR STATE LICENSE WITH 11 ADDRESS: 'q305 p1.1�mwlti �� CITY C�pC� il U^UgSTATE�ZIP �iZ7/ APPLICATION PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/R�j!1'ODEL Jir� m DETAILED DESCRIPTION OF WORK Rct_PLAC_t_Mcr_Q-T OV 9_ri15Ti Alb NIP, UUP 710&Y&_ FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: C,A Z I-ja _. MODEL: 24Ajjb324 SIZE/BTU -7-7 0j�i MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS _DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 0 x $25.00 = $ ?. •®� Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 5:C►C� °S0 - (MINIMUM FEE $35.50 Total = $ L o . cl0 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 ch wires review and approval of plans. PRINT NAME I.i'LN N i� c� It'1 DATE 6__L9—�� SIGNATURE OF APPLICANT APPROVAL INSPECTORS SIGNATURE DATE PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977